Friday, August 8, 2014

Corvina


By Lauren Mills


As I reflect on my time in Panama, the first thing that comes to mind is?corvina!!  Corvina, or sea bass as we call it in English, seems to be linked to all of my favorite moments that I had outside of the medical center.  At our official welcome lunch at the causeway I enjoyed corvina in a creole sauce with rice. It was a beautiful day and we were right across from the water at arestaurant called Pencas.  Not only was this my first time eating corvina, it was my first time at the causeway where people can enjoy bike riding, restaurants and shopping. 

My next corvina encounter occurred the next night when three of us decided to try a Peruvian restaurant near the hotel called Machu Picchu.  There were many delicious looking items on the menu but I quickly became attracted to a dish that consisted of corvina in a Peruvian sauce that was topped with shrimp and came with a side of rice.  This was my first exposure to Peruvian food and it was a good one.  In addition to the food being really good, our waiter was really great and was very entertained by the fact that were from Los Angeles.

After dinner at the Peruvian restaurant, it only took a few days for my third meeting with corvina to take place.  This time it happened at the very popular and very busy fish market in Panama City.  A group of us had been waiting all week to have the chance to go to the fish market and eat some ceviche and freshly caught fish for lunch and today was the day. We enjoyed two types of ceviche; shrimp and a combination type that included octopus, squid and shrimp as well. To follow up the ceviche we had—that's right you guessed it—corvina!  We all dug in on fried filets of freshly caught corvina with a side of plantains. Our group then decided to walk back to the hotel where we got to seedifferent parts of the city on our way back.

Three days after my afternoon at the fish market, I enjoyed a fried filet of corvina at arestaurant within walking distance of hotel. Three of us ventured out that evening and decided to try a new restaurant called Costa Azul.  Costa Azulhad your typical Panamanian foods, which of course included fried corvina.  It had been several days since I had lastenjoyed corvina, and I couldn't resist the chance to try another restaurant's version of my new favorite fish.


My last encounter with corvina was also my favorite; we were at the fish market once again but this time it was forone of our last meals in Panama.  We tried a new spot and everything seemed to be even better than the last time we were at the fish market. This was also the time where I decided to live dangerously and order the whole fish. Ok, well what really happened was I wanted to try a different fish and when I ordered the waitress told me no, and then told me what my order was going to be and that was that.  My order turned out to be a whole fried corvina with plantains (I got to choose the plantains).  The entire meal was delicious and set the tone for a great day to follow.  We left the fish market and Jaido, our driver, took us to a place where local crafts are sold so we could buy gifts for our families and friends.  After that we went to ride bikes along the causeway.  The bikes were four person bikes and we rode them to an area where we stopped for froyo and smoothies before riding back.  After the bikes, we went back to the hotel and got ready for our goodbye dinner where we enjoyed traditional Panamanian food and folk dancing. Like I said it was a great day, and of course it would not have been complete if it did not involve a meal of my beloved corvina.



About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »

Tuesday, August 5, 2014

Chagres River & The Embera Community

Aiman Tohid


On Saturday, the 26th, we left early at 7:30 am to the Chagres River National Park and to meet the Embera Community. Manuel, the tour guide was with us today. He is the most well read and well-informed tour guide, I have ever met in my life. We stopped over at El-Rey market to buy school stuff including notebooks, pens and colors for theEmbera community children along with rice and oil, as a gift. It was a long 1hour and 30 minutes long ride to the National Forest. During the long drive, Manuel kept giving us information about the City and the Embera Community aswell. Along our way Manuel showed us the bridge of the Americas known asCentennial or Cantilever bridge, which connects the North and South Americas.We arrived at the River Chagres around 9:30 am. I was amazed to see thebeautiful view of the river and the greenery, when we arrived there. We took a Canoe ride (Cayuka) through the river we go see a Beautiful waterfalls with theForest. The ride was once in a life time experience with that beautiful view. It was a 20 minutes long ride.

Later, we went to meet the Embera Community. We again took the canoe to reach there. The community played welcome music for us.They were all wearing their traditional outfits which is a small cloth covering, with jewelries and stuff. We went to the house of the community leader, whichwas a palm tree hut (Rancho). We helped the local ladies prepare meal for us. They cooked fish with plantains and served them with many fruits. I loved the fish, it was fresh fish that they caught the same day.


Later, the leader of the community spoke to us and gave us information about his community. He told ushow they moved from the Darien forest and now living in the National Park. Hegave us a lot of insights related to Public Health as well. It was interesting to know that as by Panamanian law, all kids have to have education till 9th grade and now Emberra Community is concerned about preserving their culture. There is no school where they live but they send their kids to anothercommunity close by to study. The Community uses traditional medicine for diseases but they also have a biologist who helps with modern medicine. He also told us that Embera women have their own natural methods of contraception. Whenwe were leaving the Forest, it was raining really hard. Our canoes got filled with water and we had to use buckets to empty them. It was the most exciting and different experience I have ever had.

FIELD EXPERIENCE: Vector Control


Aiman Tohid

On Thursday, the 24th, we went to the Pacora community with the vector control team of the health center including Franco, Pacheco, Jelissa and 3 more promotoras. We divided into three different groups to do our surveys. Few houses which were on the main street were very well built like the city houses. They had TV, cars and other stuff like city houses. But few of the houses which were deeper behind those big houses, were in pretty bad condition. Those houses did not even look like houses. The residents looked poor and had no proper water supply or even clean containers to store water. During our surveys, we found out that the biggest problems for the community were water and transportation. They had no access to portable water. The portable water was supplied to them at 3 am mostly and the supply was not even regular. They received water twice or thrice a week. The community was very friendly and they knew each other as they were mostly all related to each other. It was a very exciting yet depressing experience to meet and talk to this community. Later after doing our surveys, the vector control team took us to Cerro Azul, which is a dog training facility. We saw a trained dogs show there on different tricks they had taught them like detecting bombs, drugs etc. It was another exciting experience for me as I have never seen a dog training facility before.

On Monday, the 28th, we went out in the field again. We conducted few surveys with in the clinic first. Later, we went out to the 24 de Dieciembre community with Dr. Calvo. She helped us with the translation and surveys. It was a good experience to meet this community. They had good water supply as compare to the Pacora community, we visited on Thursday. Few houses in this community were very well built and few were small and not properly constructed. In the afternoon, we worked on our presentations and projects.

On Tuesday, the 29th, we again went out in the field. It was an exciting experience, as we saw the water filtration/sanitation plants for both the rural and urban areas. First we went to the community of Pacora. The roads were broken and not developed. They had broken pathways with pebbles on them. It was hard to drive through those ways. We first saw the river which the community use for their drinking and washing purposes. They had built a wood bridge over it which was very dangerous. We walked over it and took pictures. Now the Ministry of Health and the Community is constructing a new bridge with cement. Later we went to the school and houses. The community has 48 houses and 182 residents. The vector control team took water samples from the school and put a chlorine detecting solution it. It turned red and hence there was no chlorine in it. They showed us the water well and the water tanks for the community as well. They keep it filtrated and clean through chlorine. They also collected samples from a house and it had no chlorine in itas well. They sent the other car to take samples to the Gorgas Memorial Institute Laboratory for inspection. Later they took us to the area of CerroAzul, where they have the urban water sanitation plant. It was a huge plant with different processes of filtration, sedimentation and processing. They also showed us all the chemicals they use for water purification. This is the water for human consumption. It was a great experience to see all this purification plants and water wells.





About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »

Monday, August 4, 2014

The Embara

Lauren Mills

Panama is home to the Embara, Guna Yala, Ng?be-Bugl?, Kuna de Madugand? and the Kuna de Wargand? communities. These five groups represent the five different indigenous groups that still remain inPanama today. Each group is organized intocomarcas ind?genas, orindigenous territories that are spread across the entire country. On July 26, we had the privilege of traveling to the Chagres National Park, also known as the home of the Embara. The journey began with a long bus ride from our hotel through the city and community of Chilibre to the entrance of the Chagres national park. Once we entered into the park, we quicklyarrived at the location of the canoes and indigenous guides waiting to take us into the park where the Embara live.

We got into the canoes and travelled up the river for a while to the location of a waterfall tucked away in the jungle. It was only a short hike to the waterfall where we were able to get into the water and cool off from the hike. After the waterfall, we hiked back, got into the canoes once again and journeyed to the homes of the Emabara community that would be hosting us for the afternoon. We received a welcome reception and were soon in the meeting room of one of the groups of families. The community is organized by groups of families that each shares a kitchen and sitting area.

Once in the kitchen several of us were recruited to perform different tasks to help the women prepare a meal for us, I was recruited to cut the melon and pineapple. We enjoyed a meal of fried fish, plantains and fresh fruit; this was oneof the best meals that I had while in Panama. During the meal we also had the opportunity to speak the leader of one of the families and ask him questions about his lifestyle and health beliefs and practices. To end our visit, we journeyed to a main area that housed all of the crafts made by the various families. In addition to the display of crafts, we enjoyed traditional music and dances of the Embara.

Visiting the Embara and being welcomed into their community was an incredible experience. It is amazing to see how well they have beenable to preserve their culture, beliefs and practices for such a long time. Their spirit, pride and strength of family are the things I will remember most and hope to remember in the future. Learning a little about their health beliefs and practices were very interesting as well. While they do prefer traditional medicine, they recognize and understand that they can access modern medicine in serious cases of illness or disease, and they do. This was verified on our tour of the children's hospital where we saw families from several of the different indigenous communities receiving medical care. Our trip deep into the Chagres National Park to the home of the Embara was one of my most memorable experiences of my time in Panama and I hope to remember that journey always.



About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »

Health Information Delivery Gap


Lauren Mills


On July 25 we attended a meeting for the maternal health group at the 24 de Diciembre medical center. The maternal health group is a result of the clinic's recent efforts to increase the amount of health education andpromotion in the community. The meeting focused on topics that stressed the importance of proper prenatal care, dental health and mental health for pregnant women. There were three main speakers that presented on one of the topics listed above. All the women in attendance were Panamanian and so too were the nurses, physicians and staff that spoke, yet I couldn't help but notice a bit of a disconnect between thegroup delivering the information and the group receiving the information. It was very apparent that the women in attendance did not understand all of the information being presented, as it incorporated a lot of technical, medical language.

The health information delivery gap that I observed in the maternal health group meeting lead me to a question from PM 508 the night before where we were asked, "Is increasing the (racial) diversity of the health care workforce a necessary strategy for reducing disparities inpopulation health?" In other words, will patients having physicians of their same race, culture and ethnicity have an impact on reducing health care disparities within that community. I sat there thinking about this question we had debated the night before and the types of presentations that I was observing in the maternal health group meeting the next day. This experience showed me that it is not enough to just have physicians of the same race and culture as their patients to make a difference in reducing health care disparities. Physicians also need to pay attention to their audience and make adjustments for reading level, avoid using technical language and constantly double check to ensure that patients are understanding the information being delivered about their health. Here I am sitting in this meeting where I do not share the race, culture or ethnicity of the patients or physicians but Iwas able to follow along with the physicians better than their target audience solely due to the fact that I was able to understand their medical jargon.

Attending this meeting showed me first hand that while a physician sharing the same race, culture and ethnicity as their patient may improve patient-physician communication; they still must do the little things correctly so their patients can leave with a clear understanding of their health needs. If your audience cannot follow along and comprehend the message being delivered, a shared racial, cultural and ethnic background will not be enough on its own to improve comprehension of health information.



About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »

Friday, August 1, 2014

Denouement

Jeanie Park


It is finally the end, and I cannot believe the past two weeks went by so quickly. The two weeks seemed daunting when I first arrived in Panama, but I can now say it was a great learning experience, one that ended too quickly.

My group was caught off guard from the first day of being in the clinic. I would not say we expected something more, we just expected something different. But I guess that's the first lesson of being on the field—expect the unexpected. This trip was a much-needed dose of reality, as I truly got to experience what it is like to work "on the field." Professors used to say time and time again that we should enjoy making these hypothetical projects because in the class, we were free to do whatever and were not limited by funding. I understand now what they meant because we were very limited by time, resources, and ideas.

I wish we had more time to work with the community and come up with a better deliverable, but I feel that we at least got to understand the community better, and have made an effort the help bridge the gap between the health center and the people.



About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »

First home visitations!

Jeanie Park


We got a chance to shadow Inspector Franco and his team as they made rounds in a community inPacora. It was a humbling and sobering experience as I got to see inside the homes of some really impoverishedfamilies.

As I walked through the neighborhood, I was surprised once again by the vast difference in wealth, even within a street. The first home I visited had uneven concrete flooring, bare concrete walls, nodoors, and no real furnishings. One of the rooms had a bare mattress with adirty yet loved stuffed animal. The other room had blankets on the concretefloor for a bed. Hanging on a rope that was secured against the wall were the children's clothes and uniforms. The next two homes we visited were complete opposites of the first home. Not only were their walls painted and homes secured by gates and walls, they had ornaments decorating their walls and the furnishing of their home was incredible—LCD flat-screen TVs, ceiling fans, decorative bowl of fruit, mini statues, and the list goes on. It was interesting though not surprising that their answers regarding how they felt about thecommunity and its needs were drastically different from the first home.

Being "in the field," I'm beginning to find out more about the kind of work I want to do in the future. The more time I spend talking with the people of Panama, the more I realize the type of impact I want to leave as a public health professional. I hate to saythat I gained something by witnessing the woes of others, but perhaps this is the kind of cross-cultural experience we all need to get us all moving.



About the MPH Panama Practicum

A group of University of Southern California graduate students are researching public health in Panama City, Panama, for a two-week international practicum, organized by the USC Master of Public Health (MPH) program. This post was excerpted from panama.usc.eduView all posts in this series »