Friday, August 12, 2011

Ensenada 2011

This last June, I spent two weeks in Mexico as part of a service oriented nursing/medical education course as a SRJC student. We took a flight down to San Diego and then loaded all our gear into a 12 passenger van and a suburban and hauled a trailer across the boarder into Ensenada. Professor Ezbon Jen, the Dean of the Health Care Department at the JC, has been making this trip along with Dr Jan Sampson for 15 years. Aside from bringing all the medical supplies we needed, we also brought clothing to donate.


Most of our medical rotations were done at the "Hospital General". Folks get help on a first-come-first-serve basis. This is one of a number of facilities but the only one that takes the uninsured. We wore our white nursing uniforms the same ones I am obligated to ware during my clinical rotations in the US. The difference is that all nurses in Mexico wear white. The color is a symbol of respect and easily identifies you as a medical worker. Soon after taking this picture we walked across the street to our van and traffic stopped to yield our way. We had people shake our hand, offer us coffee and food, the attention was cool. Part of the reason why medical workers are treated this way is because all Dr, RN, etc have to do a year of service after they graduate.

A typical exam room. I immediately felt at home--sort of.

Yes, we watched a number of surgeries. Some were very interesting. I did learn that the OR is not the place for me. I would rather be at the bedside taking care of a patient that is somewhat awake.

I got to help out with some easy procedures. This lady was getting an IUD. Every woman that visits gets family planning education. If they choose a birth control method it is free of charge to them. Keep in mind abortion is illegal and if suspected the woman will go to jail.

We got to see several births. This is a C-section being performed on a 17 year-old who was having her third baby. Yep, I am not lying. The patient admitted just after this surgery was 15. It is not uncommon to see many young girls in the labor and delivery department. I am telling you a little education goes a long way.

Happily she gave birth to very healthy baby boy! Oh, for those out there curious to know, no circumcision was performed. Circumcision was more common in the private hospitals.

It was fun to see a nursing diagnosis book in one of the nurses stations. It is exactly like the one I use day-to-day with my patients, but in Spanish. Even though we perform similar duties, I did notice a few differences. We get to do a head to toe assessment and implement several nursing interventions as we see fit. Historically, a nurse in MX will do some vital signs and wait for the doctor. With the recent implementation of the Nursing Diagnosis framework (it has been in use for the last 3 years) the responsibility of a nurse is changing and she is able to "specialize" and do a focused assessment, do the needed interventions and chart accordingly. It isn't about bed pans and feedings anymore, they are truly becoming the eyes and ears of the doctors. Nurses can travel anywhere to do their jobs.

I got to meet a 104-year-old "Abuelita" at a home for the elderly. This particular home was managed by a group of Catholic nuns and they make it all work on 100% donations. She was so happy we came for a visit she sang us two of her favorite songs. Most of the resident's at this home were men. Some of which had spent their working years in the US. The staff explained that since they had lived all those years away from home, their families didn't feel a close enough connection to take them in as their health care needs increased.

Karem and I became friends. She lives in an orphanage with 150 other kids. This 3-year-old was all smiles and she wouldn't let go of me. I didn't want to let go either. Karem most likely will live her entire life in the orphanage as adoption of Mexican children is not easy for foreigners and adoption among Mexicans is not customary. There are government supported and private orphanages. We visited both and happily Karem lives in a wonderful place called Door of Faith

When I wasn't at the hospital I was paying attention to all the wild life and natural beauty.


We fed lots of dogs.

If I had a bee box I would have.... what can I say, I am a dedicated beekeeper.




We were in some of the poorest areas. This is an outdoor kitchen, 1/2 bath and laundry room.

Most of the families we helped lived in a one room stall. This kind lady has 8 kids to take care of while her husband and two oldest work in the fields. They are growing chard, corn, broccoli and cabbage for our consumption. During my visit I spent a bit of time with her and asked her about the aloe plant she had. She uses it for cuts and burns. She also chews on it to help her control her diabetes. She washes the kids hair with it when they have lice and she even drinks it to calm her heartburn.

This little one kept following us while we toured the migrant camp. He wouldn't say a word, he just watched.

When we weren't in the hospital we were doing well-checks for both kids and adults. Migrant camps exist everywhere. Farm workers leave their mountain homes and come down near the city to find work. They often don't have running water, money, or medical attention. Diabetes is a problem among this population so we did several glucose and BP screenings, did nutrition education and made referrals when needed.

When we weren't doing our nursing thing we were playing with the kids.

We purchased lots of beans and rice to donate. It is a tradition that we happily followed. Next year I will be doing some fundraising in order to send both money and clothes to donate.

There were both nursing students and dental hygiene students present. We helped clean teeth and teach dental hygiene. It is a great service since most of the folks I met over the age of 40 had missing teeth. Unless you have money when you get a cavity you get your teeth pulled instead of filled.

We followed all US protocols for standard precautions and for patient safety that is why this patient is wearing sun glasses while her teeth were being cleaned. Note there is no HIPAA, so I could take picture of patients with their permission and post them on the internet and talk a little about them.

We hope we made many people smile.

We did make a few trips to the ocean.

We rode horses on the beach. I got my feet full of sand but sadly I didn't get in the water. I wanted to but I didn't have a swimming suit. :(

Everything seamed so colorful in Mexico. Even this snack cart was amazingly vibrant.

Just in case you were wondering, of course I got some knitting time. With a group of 17, there was a fair share of waiting.

Most of us were from the JC but we had 4 students from the Sacramento area and one pre-med student with us. We made new friends and had a great deal of fun.

Cristine, Jennifer, Amy and I will be all graduating this December. We were all so pleased to have had the chance to work with and learn from all the amazing people we met in Ensenada. Our sincere appreciation to all!

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