Mini-travels keep the feet from itching

Mexico ended, Chapel Hill nourished my craving taste buds, and Clemson put my brain back to work all within a month. Though getting back into the academic groove is proving difficult when I know it will all be over in December, a brief weekend trip up to Maine to meet my brand new, first, best, and cutest niece was a fantastic break. Just a few pictures to illustrate!

Meeting dearest miss Ada Ruth

Granhappy having an atypical baby-holding session with his great-granddaughter

hanging out with Ada

4-generations of women

Granhappy and Dad - cutting lumber for the floor of the second level of the Yentes-Quinn house-to-be

Mom & dad on the partially finished floor

Pretending like I know how to help put down a floor...

The New Family on the New Floor! Success!

Collage day

Well - I leave for NC in 3 days, and this Mexican adventure is rapidly drawing to a close. With this crazy business about having real classes with real assignments, that means tomorrow is finals day and I must write an essay and read, read, read. So, no long thoughts today, just pictures with captions, enjoy!

Our second brigada in Preciosita - check-ups for the whole family!

I had the privilege of being the check-in/vital signs lady.

The eye doctor

The fanciest darned clinic you've ever seen.

Field trip to Taxco, "Silver City"

Another critter who tried to take up residence in the dorms

Outside of the Diego Rivera Anahuacalli museum (One he made... not of his stuff)

Leaving Frida Kahlo's house

LUCHAS LIBRES

Tiffany where the bus dropped us off to go to the Italian town of Chipilo.... it was just the side of the highway. We had some direction-asking and a lot of walking to do.

Pyramid-hopping

I'm solidly past the halfway mark on this Poblano adventure of mine, and with the completion of my required internship hours, I have been afforded the luxury of much more free time, and therefore adventure time. Life has changed quite a bit since my last post, I've only been going to my internship about 2 hours a day, just to keep working on some projects and finish up some older ones. The rest of my day has been left open for exploring Puebla, taking naps if I so please, and a minimal amount of class-time and homework time, when necessary.

A week and a half ago the hospital had its second overall brigada (medical service trip), and the first one that I went on. For some reason that I cannot quite understand, the marketing department is the one in charge of organizing the brigadas to under-served communities anywhere in the state of Puebla, but I'm not complaining at all, because that means more things for me to work on that are not marketing related. However, the department is a little bit at a loss for how to identify and connect with the communities that may be the most in need, and is mostly just using word of mouth to set up trips to other communities. The first brigada that was carried out was in a community that was already connected to the same university that the hospital is affiliated with, so it was fairly straightforward to organize a trip there between the resources of the hospital, the university, and the women in the community that were already familiar with the university's work in their town. The one we did most recently, however, was a community that was recommended to us by the manager of the HR department. It turns out she knows the community because her church group goes there regularly essentially as evangelists, as far as I can tell. Therefore it was also her church group that informed people that we would be coming to their town that weekend, and she was even involved in checking patients in. Although I was curious, it was hard to tell what portion of the patients came because of the link with this church group, how many of them came despite it, and how many came completely independent of it (it was also getting announced over the town's loudspeaker when we got there.) Elections for state and municipal officials are coming up early next month, so we were also mistakenly getting announced amongst political campaigning on the loudspeaker, so who knows how much that ended up affecting us too.

The brigada was organized a bit hastily and not completely by our department, so there was some confusion, resulting in that the only doctor that came with us was an ear/nose/throat specialist, and then 3 interns came as well. Despite any of this, the patient turnout was very satisfactory; we had a lot patients who came by just for check-ups or vaccines (tetanus and flu), and a few who came by because of specific problems. We saw 85 patients in the space of about 5 hours, but there was only one that we had come to the hospital the next day to see our pulmonologist because of some funky asthma.

During the week, a few other exchange students and I explored around town, including the restaurant where mole poblano originated, according to one legend, we visited the cathedral at night because it gets lit up and looks all pretty-like, Los Sapos which is just a few blocks away from the main square but has a lot of arts and crafts, "rustic" furniture stores (which smell deliciously like freshly carpentered wood), some neat little bars and cafes, and finally Cholula, the neighboring municipality which harbors, supposedly by area, the largest pyramid in the world. The Cholula pyramid is fascinating because when the Spaniards arrived, in order to prove their all-powerful superiority (and that of catholicism as well, I guess) they not only built a very ornate church smack dab on top of this pyramid, but then proceeded to cover the entire pyramid with dirt, effectively turning it into a large hill. we got to walk around the comparitively small portion of the pyramid that has been excavated, but there are tunnels that under the pyramid that we were told were "Indiana Jones-like," which were tragically closed for renovation.

Not to go without mention is the start of the world cup, where Mexico and South Africa had the inaugural game on Friday morning. I went to work that day at 8:30ish, and was able to witness the lack of traffic on roads and sidewalks, which became clear when I got to the hospital, was ordered to the auditorium, and there found almost all the hospital's staff packed in to the room in order to watch the game which was being projected on the wall. Despite the marketing department's internal promotion, which enters any surgeon who does more than 12 surgeries this month at our hospital (most doctors have offices in at least 3 different hospitals) in a raffle for a flat screen TV, I found out that Friday morning not a single surgery had been scheduled, and the only one was that took place was on a patient that came into the ER.

This past weekend, I went to the neighboring state of Morelos with Roberto and Maru. Saturday we went to an archeological site, Xochicalco, which is most famous because one of the pyramids has an "observatory" and sports a snazzy hole in the tip of it that funneled a huge beam of light into the pyramid during the right time of year and day. This, regrettably, was also closed because of flooding/crumbling but still got to explore the rest of the very expansive site which had several pyramids and structures. The next day we went to Tepoztlan, a very old town under a mountain with another pyramid atop it called Tepozteco. The climb up to the pyramid was just about an hour of strictly upwards hiking and steps, which makes for very uncomfortable thighs. The pyramid itself was nice, although by this point I think I am nearing pyramid-capacity.

Overnight we stayed with Maru's family in their town of Tepalcingo, where her dad is the Municipal President, so it was interesting to walk around with them. I think I may have gained about 10 pounds over the weekend, but the food was so darn delicious there that I ate as much of it as I could. I discovered by new favorite food, the gordita, which is a fat tortilla made with only minimally processed corn filled with cheese, sour cream, salsa, and other delicious options. Also, an aunt apparently runs a pozole stand, so that was a delicious snack as well.

getting lost on the way to the brigada

our ENT

checking patients in

Cholula

Xochicalco

top of the Tepozteco pyramid

side view of Tepozteco

I got included in the Mexican census too! (B106 is my dorm room number)

Settling in

The last couple weeks have marked the absolute onset of a full-fledged rainy season, the arrival of my two fellow exchange students, and very gentle beginning to session I of summer classes.

Until Friday night, the rains had been coming conveniently after I already got home for the night, and I could comfortably listen to those beautiful summery thunderstorms and downpours from inside the comfort of my room. I finally gave up on figuring out the dorm's laundry system and brought my laundry to a nearby laundromat last week, and when I went to go pick it up on Friday I got caught in a massive rainstorm that required I take an otherwise unneeded taxi home to avoid soaking all my fresh clean, very wrinkly clothes. I have been told that the start of the rainy season is usually accompanied by a bunch of little critters showing up. I'm assuming that because of this, I was visited by a little froggy who somehow showed up in my room one night, and who was having a very endearing battle with my walls, which are plastic and he

couldn't get his little sticky feet to stick to. I spent about 10 minutes ushering him out the front door of the dorms, which I afterwards realized probably looked very, very curious on the security cameras. Oh well.

My internship has been chugging along pretty much as it should, as of Friday I have completed 109 hours, so I am getting towards the required minimum of 135. I started working with the another one of the women in the department, Fernanda, to do surveys with hospitalized patients about the factors that they take into account when they decided which hospital to go to (i.e. if their insurance provider decided, if it was their doctor, if they had known other people who had been to our hospital, etc.) I had to get a rapid intro course on how insurance works here in terms of social security, copays, deductibles and discounts - it still isn't all that clear to me. At any rate, we are supposed to have 100 of these surveys completed by Thursday of this coming week, and in the past 2 weeks we have only done a grand total of about 40 so we aren't doing to0 hot. I did my first solo surveys on Thursday and got about 8 done, so hopefully in the coming week we can get a lot more done, even if it isn't quite 100. The other main thing I've been working on is creating flow charts for some of the packets we have that are a little bit more complicated so that everyone involved in the process, from checking the patient in until they leave, knows what is supposed to happen when.

The highlight of this past week was definitely the field trip we took to Mexico City and Teotihuacan yesterday. It was really nice to get out of Puebla, have some time to get to know my new fellow exchangies, and chat with Ignacio and his assistant, Karla.

They started us off with a guided tour of the Diego Rivera murals in the Palacio Nacional, which is right on the central square in Mexico City. However, in light of the upcoming bicentennial(of independence)/centennial(of revolution) celebration, everything seems to be under construction and getting renovated, so their was a ton of construction going on. Our guide was only partially understandable, but he clearly had a sense of humor and got pretty excited about some Diego murals.

The Anthropology museum was lovely, I think there were some international anthro exhibits, but we just perused the prehispanic civilizations ones. There were lots of interesting stone sculptures and artifacts from the mayans, aztecs, olmecs, and some more minor civilizations, but the biggie was definitely the misnomered Aztec "Calendar."

We made it to the Teotihuacan pyramids around 3ish, and after all three of us white girls were appropriately spf50ed up, we took off to explore the site. We were definitely not alone, there were tons of other people there, both Mexican and other. We learned that with our university IDs from the Iberoamericana we can get into a lot of these sites for free. Exciting!

The Piramide del Sol is the larger pyramid, we counted somewhere between 246-250 steps to get to the top. It was definitely some good exercise, and my thighs certainly are feeling the burn today. Here Selina, Tiffany, and I are at the top of the big pyramid, the one in the background is the Piramide de la Luna.

Here Tiffany and I are, after climbing the much more modest steps of the smaller pyramid (that is the big Piramide del Sol in the background). They also don't let you go up to the top like on the big pyramid. I wish we had a guide to take us through the whole site, because I felt like there was a lot to know about what all when on in all the mini-pyramids that we walked past, and there were a ton of other smaller stone structures scattered around. It was still a beautiful day with some decent exercise and a lot of history.

I started my Latin America and its Cultures class last week, but Monday will be my first Spanish for Health Care Professionals class, and next weekend we will be doing a mini medical service trip to a town outside of Puebla, so more news later!

La Cotidiana

It's 11:30 at night, and I just caught my first whiff of rain in Puebla and in 6 hours I must wake up so that I can get to my internship in time to be able to sit/stand-in on a hysterectomy. This is exciting.

Puebla is at around 6,000 or 7,000 ft. elevation, and I have largely avoided any adverse altitude effects, aside from slightly swollen feet and a decreased appetite. Both of these are subsiding notably. In the mornings when the sky is clearer (like in the bus on the way to the internship) I can clearly see the volcanoes surrounding Puebla, but i have found that trying to take pictures over chaotic traffic and city buildings is not only often unsuccessful, but makes me look very much like a touristy white girl in a not very tourist-friendly bus. Days are hot, dry, and brutally sunny, hence the welcome scent of rain.

This is the dormitory for the university, only a very small percentage of students seem to live here. Boys are in the closer half, girls in the farther one. Over the weekend I moved down to the first floor so that I could have a roommate (usually the opposite of what I would hope for), but I figured that as an exchange student I am obligated to be considerably more social than I usually am. For better or worse, I recently learned that the girl I moved in with is going home after the semester is over in 1 week anyways.

I have to leave the dorms around 8am to get to work by 9ish, although as I found out this morning, the buses can sometimes just decide not to come for a while which is very prohibitive to getting to the hospital on time. The bus comes right by the dorm, but then once I get to the downtown area I have about 6 more blocks to walk.

This is one of the blocks I sometimes walk down to get to work; it is also one of the nicer ones. There is a great mix of official buildings, hotels, nice restaurants, hole in the wall lunch spots, carpentry shops, old-school printing shops, cobblers, little parks, and convents, to name some of the things I see depending on which streets I take.

This is one of the convent/churches that I believe is also open to the public. I really enjoy how cheery it lucks, except for that menacing gray front door.

The cathedral that is smack dab in the middle of the historic downtown area. The two tall towers in front are visible from most of the area, which is really handy if you happen to get lost. It is also topped by a really pretty dome that is hidden behind one of the towers in this picture.

The hospital was originally founded (125 years ago, as many employees are anxious to remind me) as a maternity hospital. I took this picture because I thought you would be able to see the "Case de Maternidad" above the door and below that big red cross window, but it doesn't actually look that clear. At any rate, this is the main entrance to the hospital and most of the building has remained relatively unchanged exteriorly due to historical protection, although at the east end they have added on a wing that is mostly the ER. I also learned today that where they keep old patient files is in this awesome little side building that is very Rapunzel-reminiscent. Its a little tower with a spiral staircase up through the middle with a pointy top. I was also informed that it used to be the crematory. Interesting conversion.

The hospital is basically designed as a square with the middle being an open-air garden area. This is looking down one of the hallways on the second floor.

The cashiers' domain.

The "minareta" that Roberto took me up in on my first day. There is a spectacular view of the whole city from there, but I had forgotten to put the memory card back in my camera so I will have to go up again sometime before I leave.

This is the best picture I could get of the inside part of the hospital, I think it is absolutely amazing and gorgeous. Roberto and Maru (the rocks of the "mercadotecnia" department where I have been placed) were explaining that one of the biggest obstacles to attracting patients is that patients who are able to pay to go to a private hospital would rather go to one that is considered more modern and advanced, and that the appearance of this hospital tends to deter some patients because it isn't shiny and new. I tend to think that if I had the option of looking out my window and seeing this, I would far prefer it to most of the hospitals I have been in before.

In general, my days have felt very full, between working 7-8 hours, 1.5-2 hrs worth of commuting time, and coming home in the evenings, and having to read and do the homework for my Comparative Politics class that I'm taking online. I'm hoping that as I get more into the groove of things I will have more time to explore and wander aimlessly, but I am not quite there yet. However, I have definitely been realizing that I am pretty fortunate to have been placed is such a beautiful and central location for an internship, and to be working with really fun, young people who go out of their way daily to help me better understand different aspects of the Mexican health care system.

Ambling on Cinco de Mayo

The majority of my Monday was spent lounging in various uncomfortable positions in the Houston airport, waiting out my 10 hour layover. The kind family friend who gave me the third book in the Stieg Larsson series was a true hero, as I passed many of those hours getting over halfway through the 600pg book, alternating only with breaks for the requisite layover naps. I finally got to the dorms of the Universidad Iberoamericana Puebla at 9 or 10 that evening, and promptly discovered that dorm noise-levels are a little bit louder than I am used to, and I think quiet hours are nonexistent.

The coordinator of my exchange program, Igancio Diez Elortegui, or "The Big Ig" as my friend Liz refers to him as, had asked me to meet him the following morning and he conducted a pseudo-orientation, and we started working out some of the details of my internship. He then drove me to the hospital where I'll be working, formerly known as the Hospital UPAEP, though recently bought by a Texan corporation, and therefore renamed as Hospital Christus Muguerza - UPAEP. I didn't bring my camera with me, but a good picture of the hospital is here: http://www.upaep.mx/hospital/index.htm.

We met with the man who will be my supervisor (Roberto, no good nicknames yet,) shown at the right, who I was surprised to learn was actually the head of their marketing department. I told Ignacio that marketing was neither a strength nor an interest of mine, but he assured me that was not an issue. I felt even more confident when we actually met with Roberto, and he outlined some of the projects he had in mind for me, like thinking about how to make admission forms for indigenous non-Spanish speakers and the illiterate population, working on a new breast cancer prevention campaign, helping out on weekend trips out to el campo for medicine/care distribution, and maybe one day per week spent with the General Director of the hospital (one very friendly Lebanese anesthesiologist.)

We decided in our meeting that I would start my internship tomorrow, Thursday, due to the fact that today is Cinco de Mayo, commemorating a battle that took place in Puebla - so this is the place to be today. However, I was informed by my taxi driver from the airport that the celebrations have been halted for the past couple years and this year due to construction projects and H1N1, so everyone in Puebla still has off school and work today, but the celebration itself was mostly just a parade. I couldn't figure out what time the parade was supposed to be at, but someone mentioned that noon might be about right. I think it actually was much more towards 9 or 10 in the morning so I missed the parade, but i did get to wander around city for a while with all the other Cinco de Mayo tourists.

These two pictures are of the zocalo, which is the central square area.

a really cool mural above some department store

a lot of the buildings had some variation on this brick/tile facade, i thought it was very beautiful, though a little busy.

Some street performers - I missed most of their show I believe, but did catch the end of it.