Sooo maybe some of you, like my mother, are wondering what I'm actually doing all day at this mysterious internship of mine. So in order to show you, and to not have to complete a different field journal tonight, I am going to take you through today (not a typical day, just today) living in Otavalo and working in San Pablo.
6:00am- Some mysterious neighbor's roosters start crowing. I haven't enough sleep, or maybe I'm used to them, so I don't hear them.
6:15am- My alarm goes off-I hit snooze, giving myself a lecture on how I actually have to shower this morning.
6:30am- I actually wake up, take a shower and head down to breakfast.
7:10am- Breakfast is on the table, like it always is. It is a cup of hot water with a plate over it so it stays hot, a glass of juice of a mystery fruit- it is always the same fruit, but I still don't know what it is, kiwi (so much better than the usual papaya), and bread. I always hope it will be eggs. It is almost never eggs.
7:25am- I leave the house to go to the bus stop. It is a short walk, but to get there I have to cross two busy roads. Since crosswalks mean nothing in this country and pedestrians do not have the right of way, I'm getting pretty darn good at judging when is an appropriate time to enter traffic, and when is definitely not.
7:30-something am- I hop on the "buseta" which is a little bus that says "escolar" on the side of it- it takes a group of people to San Pablo every day for the same price as the regular bus with fewer stops.
8am- I arrive at SCS San Pablo and greet the street dogs that have made this place their home. I put my stuff down and wait around for people who are late to get here.
8:15am- I watch Dr. Chavez, the person in charge of the subcentro, give a talk to all the patients lined up outside about how they should call ahead to get an appointment. This doesn't usually happen, so I wonder why he is just telling this group. I think, good luck with that one. He also reminds everyone of the large campaign going on this Saturday where the provincial government is giving an educative talk about uterine cancer and those women who attend will be eligible for free PAP smears, free treatment if needed, and lab results much faster than usual.
8:30am- I help out in giving the people who called ahead "turnos," which is the closest it gets to an appointment here.
9:15am- One of the doctors, Dr. Gloria, is asked to make a house call. While we usually go to the community every morning to do school screenings or check on the elderly, pregnant women who didn't come to their checkups, or those with disabilities, a house call is unusual. We visit a woman who has some form of bone cancer who has gotten sick on top of this. She lives in an elaborate, brightly-painted house with her extended family not too far from the subcentro. Her son-in-law brings us to her in their car, and I watch the doctor give her a checkup. She seems to just have something viral, but she is prescribed pain medicine and nebulizers. The family brings us juice and bread as we visit. I can't help but compare this visit to the visits we pay to the elderly in Topo, a rural and mostly indigenous community. There, many elderly are abandoned and receive no family care at all- some cannot hear or speak or can barely walk. Not twenty minutes away lives a woman who could be just like them- socioeconomic status is the only thing that separates them, and I don't have to look back to my experiences in the US to find disparity.
10:20am- We arrive back to the subcentro. The doctors are already in their appointments and I do not want to interrupt. I have observed enough pre and post consult for my entire life, so I sit down at a little desk and do some planning of my final term paper on my experiences here.
11:40am- When I get sick of that/ observing in the post-consult a bit, I go to see if Adrianna needs help- she's the auxiliary who runs the front desk- she doesn't, but she shows me the room that is supposed to be for the nutritionist, which the subcentro doesn't have right now. Instead, this is where they do TB control. I look through a book on sputum tests that they have done on suspected cases and read a flipbook on drug-resistant TB.
12:15am- Dr. Lorena, the other doctor completing her one obligatory year of rural rotation, has been asked to do a presentation about drugs at the police academy down the street. I go with her to observe yet another facet of community health promotion the subcentro does. The visit is interesting because I get to re-experience 10th grade health class in Spanish but also because I do not think I have ever been in a room with that many men my age before. I know that women can be police officers, but do they have to go to a different school or something? We are invited to eat with the instructors, so we have a great meal, and then head back to the subcentro.
2pm- I catch Dr. Arotingo (He introduced himself to me as Jose, but everyone always calls him Dr. Arotingo.) on the way into an appointment and ask him if I can observe. Dr. Arotingo is probably my favorite doctor at the subcentro. He is also a student, already a general practitioner, but doing his specialization in family medicine. He specifically invited me to observe his appointments, and he is very good with his patients. Plus, his family medicine specialty calls for looking at the whole patient- including their family structure and household relations, which is basically social work and a bit of mental health work. He also always tries to speak English with me, and even though his accent is hilarious, he knows a lot. Today, one of his patients is more comfortable speaking in Kichwa than Spanish, so they do the appointment in Kichwa. Dr. Arotingo is indigenous and the only doctor at the subcentro that speaks Kichwa. I think understanding and being understood is SO important to the medical encounter, and I am happy we have at least one Kichwa-speaking doctor for our significant indigenous population
3:40pm- I leave the consultorio to try to find the club de adultos mayores (Senior club), but I learn that all of them decided not to have club today because we had a surprise activity yesterday. Since I have worked way over my hours this week, I decide to leave a little early and go walking to find some food to feed the "new dog of the subcentro." She is the sweetest thing I've ever seen and she is afraid of everything. She is also very obedient, which makes me think she maybe had owners. The subcentro already has two dogs, and we feed them and they come with us on our journeys. This dog has recently, very tentatively, joined them, so when they got fed today, she got nothing. Logically, I know that it is futile and counterproductive to feed the street dogs, but I decided I'd rather be the kind of person that feeds the street dogs than that doesn't, so I buy my new friend two rolls (couldn't find meat), and head for the bus.
4:45pm- The 4:30 bus never comes, so I spend 25 minutes at the bus stop. Luckily it is beautiful and the most important item on my agenda for tonight is going to get (yet another) $3 manicure with my host sister. Oh yeah, and just a bit of work finding a faculty mentor for my summer research program, deciding how I'm going to write my term paper, and planning the trips I'll be taking for the just a little bit over a month I have left here.
My head always hits the pillow hard when I finally get back in my bed in Otavalo, but I'm pretty happy about that.