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an exciting week in the clinic

June 25, 2010

Of course, just as things start to get interesting and I’m getting comfortable in a new place it’s time to leave. I have one more week left here in the clinic and then it’s tourist time!

On Wednesday one of the nurses asked me if I wanted to do something new and I said sure! Turns out we had two women in labor. One had ruptured her membranes and the doctor had ordered Pitocin, ayuno (fasting), and had her lay in bed on her left side and told her only to get up to go to the bathroom. Sound familiar to anyone? I never thought that laying in bed on your left side was the best way to get a labor moving and neither did any of the other nurses in the clinic. We were all talking about how she needed to be moving and walking around because she was not dilating flat on her back in bed. Finally this doctor that ordered the bedrest left and a new doctor came on in the afternoon and said she could walk around if she wanted. She was then worried that walking around was going to hurt the baby because the other doctor had said to stay in bed. We reassured her that it wouldn’t and she paced back in forth in the room. After that she quickly progressed from 5 to 7 to 8 to time to move to the Sala de Expulsion. Yeah, pretty much translates to Expulsion Room. I need to get a picture of it, because it’s pretty interesting. There were the knee stirrups for her legs and a very small bed for her to lay on and push. The pushing phase was the most different for me because at UNC I’ve pretty much seen women be able to push how they wanted and while many ended up in a semi reclined position no one was every put in stirrups.

I honestly don’t have the time or mentally energy to totally process the birth right now. It always takes some time for me, especially the more medicalized births.  It was the first episiotomy I’ve ever seen and therefore the first repair I’ve ever participated in. I’m pretty sure epiosiotomies are routine here. I had to hold the woman’s labia open while the doctor sewed up her perineum and the nurse explained why it’s so much better to cut than to tear. That was hard. I know that 45 minutes away from me they routinely cut episiotomies and it was routine in many hospitals not so long ago. To me that is the most insanely frustrating thing ever. There is absolutely no medical reason for routine episiotomies, they do not heal better than natural tears, and, with an episiotomy you’re always guaranteed a 2nd degree tear. Whereas if you tear naturally you only tear as much as you need, if you even tear at all. There is no reason to do that to a woman’s perineum, to her vagina, none at all. It would be one thing if the baby is in distress, but routine episiotomy is not about fetal distress, it’s about medical convenience. It’s about shaving 5-10 minutes off of a birth and speeding up your stitching. It makes me angry and this isn’t about Mexico or the U.S., it’s worldwide and it needs to stop. The thing I hate about obstetrics is they start doing things without much evidence (episiotomy, electronic fetal monitoring) but then you need to build up a mountain of evidence to make them stop doing things that harm people.

Oh look, I got all worked up. Back to the great week at the clinic after a few nursing notes.

So, the things that were different about this were the fact that I had to manually adjust the drip rate of the IV. That was hard. Does anyone from N360 remember our TA saying that we would only have to do this manually if we happened to be working in some developing country? Yeah, thanks for that lesson! Ugh, it took forever to get the drip rate adjusted. One time I was counting with the MD and she was like “eh, that’s 16, close enough (to 15)”. Then every hour you have to go back and check it again. One of the doctors had a doppler otherwise I would have had to use the Pinnard Horn, which I tried once, but it was hard to hear. I had to manually feel and count the contractions for 10 minutes every hour and that’s how we measured frequency. Then we did maternal vitals every hour. Also, after I upped the Pitocin I didn’t have to go in and check the fetal hearttones after 15 minutes like was protocol at UNC. They were like “just check it in an hour.” That made me a little nervous because I have had babies respond poorly in just the few minutes after upping Pitocin.

The other thing that was weird for me was that we got into full sterile surgical gear for the birth, but the dad and mom weren’t. It didn’t quite make sense why we needed full body coverage. Also, after the baby was out they just kind of put her on the table with the warming lamp and looked over at her every once in a while. They focused most of the time on trying to get the placenta out. The intial assessment didn’t happen until 40 minutes after the birth! I did wrap her up and show her to mom and have dad hold her, but mom couldn’t hold her until, well I couldn’t quite figure that out. Mom, dad and baby stayed the night. When I came in in the morning the baby was in bed with the mom nursing. There’s no separate bassinet for the baby, babies just stay in bed with mom. They left a little later in the morning and then came in today for the vaccines (BCG and Hep B) and the neonatal bloodwork.

I’m not sure what happened to the other laboring woman. She walked for a long time and then the medical team tried to convince her to go to Oaxaca for an induction, but apparently she said no and went home. She was a first time mom and at 39 or so weeks, there really wasn’t a reason for the induction.

Okay, so then Thursday was lots of fun too. Basically, I walked around the entire town with two other nurses vaccinating children under 5 against polio (Sabin vaccine-oral). First we stopped off at the town market in hopes of getting some kids there. We would see a young child, ask them how old they were and what section of town they lived in. Then we would check our list of those who needed the vaccine and have them go find a responsible adult so we could vaccinate them. Right there in the middle of the market. It was awesome.

After we had vaccinated all the children in the market we sat down and had breakfast. Every morning we have a breakfast break and this coincided with that break. Then we walked and walked and walked. I got sunburned. We had to haul around this heavy cooler with two tiny vials of vaccine that could have fit in my pocket. We all took turns with the cooler and our bread that we had bought at the market. I’m glad I decided against buying fruit! We had our list of houses and families that needed vaccines and basically just circled the town hunting people down. Sometimes it they would be home or other times we would ask a neighbor where they were or tell their sister to tell them that they needed to come to the clinic. We also knocked on some doors to remind people to bring their children in for height and weight checks. I think we did this for about 5 hours stopping a couple times for water or to look at the stuff in the shop of one of the families.

It was really great because I got to see the different types of houses in the community and how people lived. There’s really a huge difference, some people are relatively well off artisans or merchants and other people are very very poor. The nurses really play a role in educating the population on everything. They don’t do as much in the clinic, but you could really see their role when we went from house to house. If the house/yard/kitchen was in disarray and unsanitary the nurse would talk to them about how they need to keep the food separate from the animals (until they became food), food off the floor, separate the trash into one area of the yard, wash the dishes after every meal, etc. They also do family planning. Birth control is free at the clinic, anyone can just walk in and get an IUD, Implanon, or depo shot for free. I have not seen them dispensing the pill or other types of contraceptives At one house the nurse looked at the family with 4 children under the age of four and asked them point blank if they were using any form of birth control and they laughed said “more or less” then something to each other in Zapoteco and the nurse gave them a lecture, but then everyone was laughing and I think it was because they said they weren’t having sex, but I’m not sure. She would also tell the men that they had to help around the house. She was really awesome. We walked by one house and she peered over the fence and remarked at how clean the yard was. Then she said that she had talked to them before and they had worked hard on it. She would talk a lot to the families about how they needed to do things for their health and for their children as well.

Then today I thought we were going to be really busy because several families said they were going to bring their children in for vaccine updates or peso y tailla,  but only a few showed up.

For the weekend I plan to watch the World Cup games and gear up for my final week!

Hierve del Agua aka my biggest travel adventure yet

June 22, 2010

This weekend I took a little side excursion to a place called Hierve del Agua, literally, Boiling Water. But the water’s not really boiling, it’s very cold, but it bubbles out of the ground like it is boiling and these amazing limestone cascades formed because of the high mineral content in the water. It was beautiful and I took a million pictures, but unfortunately this computer doesn’t have a slot for my camera card, so the photos will have to wait. For now you’ll have to be satisfied with the story.

I left Saturday around noon and couldn’t believe my luck with transportion. I was able to catch the Teotitlan/Oaxaca City bus to the crucero (intersection) for 5 pesos right at the corner of my street with practically no waiting. Then I stood at the crucero hoping that a bus or collectivo to Mitla would drive by and I could flag it down. I also thought about the possibility of hitching a ride with one of the tour vans that stop at the Mezcal stand on the side of the road. I didn’t have much time to think about it because a collectivo to Mitla pulled up and let out two passengers and I jumped in. It was another short ride to Mitla and on the way in I saw collectivos to Hierve del Agua. This was exciting because I was concerned that I would have to hire a car for a significant fare at the Mitla ruins. After walking back from the center of town (the collectivo dropped off there and I wanted to see it) I learned that the collectivo was 25 pesos a person and that he wanted to wait for at least 5 more people before we left. This ended up being the longest wait of this leg of the trip. A pair of French girls got off the Oaxaca bus and he asked them if they wanted to go too. The French girls and I ended up having a French-English-Spanish conversation and somehow ended up deciding that we would go to the ruins to find more people and then go to Hierve del Agua.

The ride is up a very steep winding dirt road with amazing views. It was not too insanely scary since the collectivo driver was a relatively calm driver. The whole ride took about an hour. We got to Hierve del Agua and I inquired about the cabañas that they rent. It was $100 pesos for one night and we’ll just say that I got what I paid for. I requested a cabaña that had a view of the other mountains. I think this request came back to bite me later. When I got to the cabaña there were no sheets on the bed and a weird dust on it. The kid went back to get some sheets while I cleaned off and flipped the mattress. Surprisingly this has been the best bed I’ve slept on the whole trip. There was a bathroom with a shower I did not plan on using and a little desk.

After I put my stuff in the cabaña I went for a little walk down to the lagoons where the cascades were as well. There were lots of people there, mostly families. Some were swimming, others taking photos, and some were having a cookout. I thought about swimming and went into my knees, but it was just too cold. Then I took a long hike around the side of the cascades to see them from the bottom. Words cannot do it justice, I hope my forthcoming pictures can. This took almost two hours round trip so I was very tired at the end!

In addition to the cabañas there is an old swimming pool that was not in use. There is also a brand new bright white building with non-functioning bathrooms, food stands, and a gorgeous pool with a view. It looks like it could be operational in the near future. Since that wasn’t open I ate a couple of quesadillas at the food stalls that were operational. They were nothing special and I suspect that they or the lukewarm coffee I had the following morning may be to blame for my not so happy tummy right now.

There really wasn’t much more to do so I took a few more photos and headed back to my cabin a little before sunset. This is when things started to get interesting scary. I enjoy traveling alone quite a bit, it’s flexible, there’s no one to argue with and it’s easier to transport one person rather than two. It does get a little lonely sometimes and this is one of those times where a travel companion would have made things a lot better. I am also traveling in the low season right now, which has many advantages, including decreased crowds, prices, and not having to worry about getting in or getting a place to stay. The problem with traveling alone, in the low season is well, that sometimes you just end up alone and lonely.

I was literally the only person in the entire area that night. Clearly there were people in the town, but it was just me at the site. As I tried to fall asleep I tried to convince myself that I was just as safe as I would be if there were other people there, if not safer. Unfortunately all the horror movies I watched as a teenager made the little voice in my head say “yes, but there will be no one to hear you scream!” I got up and put my stainless steel water bottle next to the bed as a weapon, just in case. I also tried to convince myself that I had been in scarier situations, that this wasn’t scary, but I couldn’t think of a time I had been more scared than this.

Why was I so scared? Besides the fact that I was sleeping, alone, in a strange place with no one else around, literally in the middle of nowhere, there was the wind. The wind was so loud and scary I thought that it was going to blow my concrete cabin off the mountain (turns out it wasn’t concrete, but that comes later). I also discovered where that weird dust came from as little bits of it kept blowing on my face. Oh, and there were no pillowcases and a t-shirt makes a great makeshift pillowcase should you ever need one. At least I knew that the sheets were clean thanks to the heavily perfumed detergent that Mexicans love to use. So, I pulled the sheet up over my head to keep the dust off. Then I had to go to the bathroom. Well, when I turned on the light I saw a huge cockroach, which I decided to kill, and did, but then when I woke up the next morning he was gone. Shudder.

At one point I thought about taking the Benadryl I had brought to help me sleep, but somehow talked myself out of it. I think I wanted to be alert in case of attack. How did I get so paranoid??? Anyhow, I slept on and off for most of the night and actually woke up a bit when the wind died down and thought “now I can sleep better,” and tried to doze back to sleep. That’s when I heard the buzzing. “Ugh, flies,” I thought to myself, until I realized they weren’t flies, they were bees. Lots and lots of bees. They were in the windows trying to get out. Turns out that the cabañas are made of straw bale mud bricks and bees just love to hang out in them when it gets wet. Yay. This is when I decided to get up and pack my things. It was barely 8 am.

I was able to get the bees out of the room and carefully packed my bag checking my clothes for bees, cockroaches and spiders. Did I mention the huge spiders I saw? I sound like such a wimp. You would never guess that this was the woman who lived in a tent in Colorado for three months. Of course, I slept with a crowbar next to my sleeping bag back then.

Anyhow, I decided to make the best of the beautiful morning and ate a breakfast of mangos and pears while enjoying my gorgeous view. The bees were otherwise occupied with the blooming flowers at the edge of my cement deck. I went for a walk back down to the lagoons and decided it was the perfect time for a swim. I was all alone, the water was beautiful and calm, and I had actually gotten a little warm on the walk down. I enjoyed that moment of solitude immensely. It almost made the night worth it.

The swim was lovely and refreshing. When I ducked my head under I felt all the stress from the night before melt away. I even did a few laps and felt like I got a little exercise. I dried out looking out at the mountains and the mezcal farms and thought about my plan to get home.

Initially the plan had been to get a collectivo back to Mitla and then see the ruins at Mitla and then head home. I guess it was 10:00 at this point and there was no one else there. One woman was opening her stall up and she made me some coffee while I sat and read, for two hours, waiting for someone to come. She said they would come, because it’s the weekend. A car full of early 20-somethings and two kids showed up a little while later. After they walked down the trail I checked to see if they had come by collectivo or car. Car. It was maybe big enough to fit them and maybe me, if we squished.

Bit by bit more cars showed up, but no collectivos. I started rehearsing my Spanish in my head thinking about how I would ask if I could ride down the mountain with them. The group of 20-somethings I had seen earlier sat down across the stall from me and during a lull in their conversation I asked where they were headed. One of them replied “¿De donde eras?¨And when I replied Estados Unidos she started talking to me in English. Turns out she was from California visiting Oaxacan relatives that she hadn’t seen since she was five.

After some talking between them they agreed that we could all fit if we squished. So we squished, three of us in the back, plus my backpack and two adults two kids in the front. They didn’t have the keys to the trunk so my backpack sat in my lap. It was a relatively calm drive down. The most interesting part was listening to this young woman  processing her culture-shock of being in Oaxaca. She was born in the U.S. and lives in California and she just couldn’t believe how poor everyone was here. She went on about how here you have to wait and take the bus instead of just getting in your car and driving, the lack of water, and so on. She also really wanted to talk in English so her cousins couldn’t understand what she was saying. It was a very eye-opening experience for her to be here, she talked a lot about how she wasn’t going to take her life in the U.S. for granted anymore.

I got dropped off at the Mitla ruins and had texted a friend and turns out that she was at the ruins so we met up and talked for a while. I was extremely tired and decided not to go into the ruins and just save the experience for when my mom is here. It’s also such a short trip from Teotitlan that I could do it in one evening after clinic. We walked to the fork in the road to catch the bus back to Oaxaca for her and I would get off at the crucero in Teotitlan and hope for a ride into the center of town.

This turned out to be the best luck I’ve had transportation wise so far. I really hope I didn’t use it all up! The bus showed up shortly after we got there, stopped in Tlacolula and then let me off at the crucero. As I was putting together my things to get off the bus the woman in the seat next to me stopped me and told me that this was Teotitlan. I told her that I knew and that I was getting off here. She just looked at me like she didn’t understand why. It was funny. A few minutes after I got off the bus a collectivo got off the highway and I took it the rest of the way into town and they left me off at the corner.

So, that ends my story about Hierve del Agua. Definitely worth the visit. Only stay the night with friends or if you never watched horror movies as a teenager.

super extra

June 17, 2010

I appreciate that I can buy lots of super extra things in Mexico. For example Arroz (rice) Super Extra and Azucar (sugar) Super Extra. Now, with the order of adjectives it could translate to Extra Super Rice or Super Extra Sugar, it’s hard to say, but it sure is super and extra at that! I also appreciate that on my way to the internet cafe I saw a man herding his cattle into a door off of the street. I will also never complain again about dog poop on the street after having to dodge piles of cow and burro poop. I am also appreciative of the rain that has cooled things off quite a bit and makes things much more tolerable. I appreciate that things are cheap for me in Mexico, like the 10 peso ride in a Mototaxi or a bag of pears for the same price. I also appreciate that things are not necessarily so cheap for Mexicans. It makes me happy when someone I met once at the clinic waves and shouts ¡Buenos tardes! across the street to me. And, I thought Carrboro was small.

Today I am trying very hard to be appreciative of everything that I have, both here in Teotitlan and at home. While today was not a bad day, I am feeling a little frustrated. I had plans, lots of plans for this experience, but am feeling like maybe none of that is going to happen. I spoke with the OB/clinic director and he seemed to think that 4 weeks wasn’t long enough for me to do anything useful for him and was more interested in help researching a newer fancier ultrasound machine, which I did. Instead I am going to try to make friends with some midwives in Oaxaca and find out about the work their doing. I have been making an effort to get involved with things at the clinic. I was excited to find that one of the nurses was going on home visits to update vaccinations in her section and she agreed to let me come with her. Then yesterday the head nurse asked me to stay at the clinic because they were short staffed nurses. So, I was at the clinic today checking in patients, which was still good, enjoyable and educational.  Tomorrow I had planned to go to the meeting of the diabetes group in the community, unfortunately, there is not enough transportation for all of the people in the group and the nurses, so again I was asked to stay behind. So, today I feel a little frustrated. Yes, pretty much every moment of every day is a learning experience, so I know I will learn something tomorrow at the clinic.

Today I learned that my Spanish is good enough to answer people’s questions in the clinic, but not necessarily good enough to tell them what they want to hear or explain to them why I can’t tell them what they want to hear. There is a dentist in the clinic, unfortunately the dental cleaning machine “no servi”, which means no dental cleanings. For the last few days I have been explaining to people why they can’t have a dental appointment and to call on Monday to check to see if it was working and did they have the number of the clinic? Well, today I explained that to a woman and she said that the was a dentist here and he said she could have her teeth cleaned, I explained that the machine wasn’t working and to please call. She said that she had spoke to the doctor and he said to come in. There was no way I could accomplish what I needed to in my Spanish, so I pointed to the group of nurses and said to ask them. Then one of the nurses explained for the third time why she couldn’t have a dental appointment. While the woman didn’t seem happy, she accepted that explanation.

The clinic kind of reminds me of SHAC, but, well I was going to say but in Spanish, except that the majority of SHAC is in Spanish. So I’ll just say it’s like SHAC with real doctors and faster. I still spend a significant portion of my time looking for lost charts and pieces of paper. I’m not sure how you describe that skill on a resume, but it sure does come in handy. There’s also time spent negotiating with patients and colleagues on how to get everyone seen. Is someone sick enough to warrant a consult with the doctor? which doctor? how long will they wait? Today the doctor for my section was giving a patient education talk, but there were still appointments. I ended up working with the nurses and doctors from the other section to get them seen. Again, describe that skill on a resume.

Basically my day consists of checking patients in. I call their names, find their charts, taking their temperature (with a mercury thermometer that I am so scared I’m going to break) and other vital signs. Then I give the chart to the doctor and they see the patient. I do it in Spanish though. People will occasionally ask me where I’m from. Some have heard of North Carolina, but if they’ve been to the U.S. it’s been California. One of the nurses worked in a CD/DVD factory somewhere in North Carolina for a short period of time and someone else said they had a cousin there.

Has it been a week already!?

June 15, 2010

I can´t believe that I´ve been in Teotitlan for over a week! It´s very different here than in the city. First of all, the weather completely changed in both places at the same time, so it just feels different. It´s cool and rainy right now, it´s delightfully refreshing. Teotitlan is also a small village, whereas Oaxaca is a very modern city. I mean, we have running water, light, electricity, 400 plus cable channels and all other modern conveniences in the house. Burros also roam the streets, the neighbors have pigs, roosters wake me up at 3 am and little sheep bah at me on my walk to work. I have yet to take my camera out, although I can´t imagine I would draw any more attention to myself by doing so. I am probably a full head taller than everyone here and people already recognize me as the foreigner that volunteers in the clinic. One woman saw me and invited me to her home to see her weavings and drink juice. I have given anti-parasite medications to all of the school-age children and they wave at me in the street. I am fascinating to small children and have never had so much attention focused on me, probably ever. I was walking home in the rain today and two people stopped to offer me a ride and I knew them both.

I arrived on Sunday and already posted that story, so I guess I´ll start with last Monday.

Monday June 7th

Today I had to go to Tlacolula to get permission from the central health office to volunteer at the clinic. It´s a slightly larger town about 15 minutes away and apparently I should not miss their market on Sunday. The process was relatively easy, just go up and down a few (or 6) flights of stairs and get the appropriate people to sign, date and stamp forms. After I get my letter we go to the Centro de Salud and I´m introduced to the clinic director and the director of nursing. The letter basically says that I´m going to be volunteering in the clinic for a month. It feels a little weird, because I´m not really sure that they even knew I was coming, although the central office knew I was coming earlier in the Spring.

Tuesday June 8th

My first real clinic day. I don my bright blue scrubs and walk the 25 minutes to the clinic. It´s really nice here in the mornings and I enjoy the fresh air. When I get to the clinic I´m told I´ll be working with Blanca, the nurse who also speaks English. I hang out for a while and wait for her. She orients me a bit to the clinic and shows me how to check people in. Every clinic has its own unique process and this one is relatively straightforward except there are certain programs where you have to fill out certain lines in certain books, which it turns out poses a problem for me sometimes. I also spend some time doing clinic busy work, which involved individually wrapping tongue depressors. I tried to ask in a way that didn´t sound like I was complaining why they sterilized tongue depressors and from what I understood of the answer, it has something to do with the union? It was then that I started to feel less confident about my Spanish language skills.

I felt pretty good about my Spanish after my two intensive weeks in Oaxaca City. However, talking with one or two people who are used to speaking to foreigners is different than trying to figure out what five different nurses are saying while they talk all at the same time. That´s something that´s challenging to me even in English! At one point I asked a nurse to speak a little bit slower and she was like ¨Sorry, I can´t!¨So, someone else repeated it in Spanish. It´s a little better now after a week. I also think that people have realized that they need to get my attention before they start speaking to me otherwise I need it repeated. I can communicate relatively effectively with the patients though, except, well, this leads me to my next story on Wednesday.

Wednesday June 9th

One of the things that many people here have found intriguing is the fact that I (and most Americans) only have one last name. Everyone here has two, their paternal last name and their maternal last  name. So on Wednesday I am checking in an older woman and ask her her name she tells me her two first names and then the last name Martinez. I ask for her other last name and she says Martinez. This is weird to me because I interpret it as her only having one last name, so I go through the card file looking for the one last name Martinez. Of course there´s nothing there. So I ask again, and she says Martinez, I must have looked very confused at this point and I said ¨only one?¨and her husband is like ¨NO! Martinez doble!¨Meaning her last name is Martinez Martinez. I felt really dumb. People also look at me funny when I ask them how to spell last names like Jiminez or Alavez. I just want to make sure I get it right.

Yeah, so, the other nurses in the clinic are fascinated by this whole one last name business. Juanita was asking me a bunch of questions trying to understand the other day. She started with ¨So whose last name is D—? Your father´s? But what about your mother’s?¨I replied that I just only had one last name. ¨Why?¨I was like ¨I don´t know, it´s a patriarchal society?¨ Then she wanted to know what would happen when I got married. I explained that I could take my husband´s last name or keep mine, or hyphenate, but that a majority of people in the U.S. take their husband´s (or so it seems). She was absolutely fascinated by this and my only explanation again was the patriarchy. Her next question was about the children, whose name do they have!?! I have had some form of this conversation at least 3 times in the last week. Also, everyone seems really interested in when I am going to marry my boyfriend and have children. I get asked this question daily and have now changed my response from ¨I don´t know,¨to responding that they can ask him when he gets here. Just a warning in case someone is reading this.

Wednesday was also the day I got to sit in on some prenatal visits with the OB-Gyn. Essentially the visits here seem to consist of asking if the mother is feeling okay and a very detailed ultrasound of the baby. It´s very medically oriented. I was also told that they consider 36 weeks full term, 38 weeks post-term. Today when I asked the doctor what they did at 40 weeks he said they sent women to Oaxaca for a c-section. He got pulled away before I could ask him if they tried induction, but I am very curious. For those not familiar with the U.S. standard it´s typically 37-40 weeks (or 38 depending on who you talk to) is considered term 40-42 is considered post-dates and then most places induce at 42, some at 41, it depends. Automatic c-sections are reserved for breech or malpresentations, placental problems like previa, or severe pre-eclampsia.

Thursday June 10th

I spent most of Thursday in the secondary school handing out anti-parasitics to teenagers. We were also there to catch them up on their Hepatitis B vaccines. Let me tell you, teenagers are the same here as they seem to be in the U.S. You can feel the angst and see people in their separate groups, the cool kids, the nerds, the mean ones, the smart ones, the rebels. Oh, and all women of fertile age get free folic acid and there´s a census of the distribution as well.

Friday June 11th

Friday we did the same thing at the primary school. The kids were so funny. Some of them love the anti-parasite drug and some were practically in tears because they didn´t want to take it.

That´s all the blogging I have in me for now. I have more stories for another day!

the exciting travel story that wasn’t

June 10, 2010

I’m here in Teotitlan and I’m pretty tired. I arrived on Sunday via collectivo. There were many points during the trip where I thought it was going to turn into a crazy adventure, but it was relatively tame. The first point was when my host mother Helvia stopped on the side of a 6 lane road and pointed to the opposite corner and said that was where the collectivos left from. Well, she must have seen the look on my face when I thought about crossing that highway with my insanely heaving mochila and she offered to drive around. The next point was well I was standing at the corner waiting for the collectivo. The collectivo drivers were all very nice and told me the collectivo I had to wait for. I told the driver for the Tlacolula collectivo that I was going to Teotitlan and he said that he only went to the crucero, turns out that means intersection. I knew from another travel to Teotitlan story that meant a 4 km walk into town. Several images went through my head, one was of me walking 4 km with that heavy backpack, the other was of me hitchhiking and wondering if I could talk about hitchhiking on my blog, the other was of finding a random taxi at the intersection and the last one was of me hailing down a tour bus on the way to Teotitlan (that was my favorite image). Then he offered a private trip to Teotitlan for $110 pesos, I thought I accepted that but while we were putting my backpack in the trunk 4 other people got in the car and turns out we were headed to Tlacolula. We went 100 km down the 40 km highway and got to the crucero relatively quickly. As I was paying him I asked if I could just flag a taxi and he paused and was like “Do you want me to just take you there on the way back?” I said sure, got back in the car, this time in the front seat sitting on the emergency brake (cleverly padded, who needs and emergency brake when that means you can squeeze 3 people into the front seat of your 80s model Toyota) so I had a clear view of the windshield I might fly through.

On our way back through Tlalocula I got a nice tour of the town and we had a nice chat about the market that happens every Sunday. We got into Teotitlan and he asked around for the place where I am staying…another point where I was worried that things could go awry-the first two people we asked didn’t know, but it turned out they weren’t from around here (now I get in a mototaxi and tell the driver where I’m going and they ask if I’m staying with this family). We asked some police officers and he drove me right to the door. There was some guy leaving the alleyway and I said that I was looking for Janet and he looked at me blankly. I barely had time to worry because at the same time Janet came running out of the house shouting my name.

So, that’s my arrival story. More to come.


June 2, 2010
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There have been a lot of bloqueos lately, in the street, in my brain, in the zocalo, in my stomach, and so on. The first bloqueo I got to experience completely blocked off access to the center of down, traffic was backed up pretty much all the way to my house. Imagine some place it takes you 10-15 minutes to drive to, now imagine traffice from there all the way to your house. That was fun. It turned out to be the day I had to go into the center of town to meet someone and had no way to contact him (no cell phone yet). We ended up meeting just fine and hanging out for a few hours, the biggest problem was getting home. No taxis or buses could leave the immediate area surrounding the zocalo, they were just driving around in circles. We ended up walking clear out passed the blockade and I caught a taxi there back home. There was another one a few days later. I was glad that my house is across the street from the language school so I just avoided downtown.

On Monday there was word that there was supposed to be a teacher protest, but the vendadores blocked access to the zocalo with their carts so the teachers couldn’t get in. Apparently now there are teachers camped out in the zocalo and they may be there for several days. I’ve been advised to head down there to do my touristy things and shopping before it starts to smell (from the lack of sanitation services). Everyone here seems to be taking it all in stride and I’m doing fine too. I hesitated to post about it before because I was afraid it would worry people, but things are under control and non-violent. I head up to the mountains in a few days and will be there for a month. My only concern will be if the bus station is blockaded the day I have to leave.

The protests are about everything, voting, teacher salary and vacation, the upcoming election, etc. There are two major candidates for governor right now and their signs are everywhere–it’s kind of crazy. My flickr account is uploading as I type this so I will try to add some photos to illustrate.

The bloqueo in my brain has to do with switching back and forth between English and Spanish. My brain is having a harder and harder time. My Spanish is getting better, I can tell because my English is getting worse. Sometimes I forget words or I am talking to my intercambio partner and I reply in Spanish when we’re talking in English.

Then the other day I had a bloqueo in my stomach. I went to eat breakfast…it was a fried tortilla with Oaxacan cheese smothered in salsa verde. Oh it was good. Yeah, well I took one bite, then another and my stomach was like, um no, no more. I didn’t get sick, feel sick or anything. It was like my brain told my stomach that it would not allow any more rich food in my stomach. The food has been great, but I am not used to eating cheese, cream and eggs for breakfast and lunch (I don’t eat dinner because I’m still fool from lunch)!

Tomorrow is Wednesday and I’m going to try to go into the zocalo after class to buy some shoes and check out the food in one of the markets that’s supposed to be amazing. I can’t believe I only have 4 days left in the city!

no hay agua en Oaxaca

May 31, 2010

There are two things that are hard to come by in Oaxaca: change and water. I’m not sure why, but it is impossible to make change here. I tried to buy an ice cream the other day, but the only thing I had was a $200 peso note and the woman looked at me like I was crazy. No ice cream for me. The other day I needed the internet, but had just gone to the ATM, which usually gives you $200s, so I walked around for a while trying to find a place to buy my cell phone so I could get change to pay for the internet. I swear when I had priced them out before everywhere I turned had cell phones. I zigged-zagged up and down the streets for an hour and could not find a place to buy an economico (pay as you go cell phones). I finally found one and it was a crazy process to actually get it. First I had to pick it out, then the woman behind the counter took me to her boss, where I had to type in my nombre, appelido paternal, appelido maternal (first name, first last name, second last name). They looked at me a little funny when I said that I didn’t have a second last name, so my official name according to the Mexican cell phone authorities is now Amy D… P… Then, you take a little sheet of paper to the bank (luckily there was one in the back of this store) and wait in line to pay. There were a couple people in line in front of me and I noticed a woman arguing with the bank teller. Apparently he had given her a 1000 peso note and she wanted smaller bills. He refused to give it too her, she walked away annoyed and then showed it to her husband and they both had this look on their faces like “What the — are we supposed to do with this?” I rarely see people brandishing money in Mexico, but they didn’t seem to care that anyone knew they were walking around with 1000 peso note. Maybe because you can’t actually use it anywhere? So my digression comes full circle, no hay cambio en Oaxaca. The rest of the cell phone saga is a story for another day!

Y agua, water is the topic of many conversations in Oaxaca these days. Oaxaca has a fairly dry climate, and right now is the end of the dry season, which has been particularly dry and hot. There is very little water and no place to store it. I think I understood that there is not a reservoir or a dam for the water to collect. In addition, the tubos or pipes are very old and don’t work well. So, not only is there little water, but there is little water pressure. Those of you who watched Seinfeld may recall the episode where they all switched to low flow showerheads and the entire episode they walked around with flat greasy hair (Then Kramer and Nelson went on a hunt for illegal showerheads and bought one designed for elephants out of the back of a van). Remember? Yeah, that’s kind of how I feel about washing my hair here. I’m getting used to it those and am starting to understand why a lot of women around here wear their hair in slicked back ponytails.

Vanity aside, water is a serious problem. The current governor promised to fix the pipes and water problem, but nothing happened. Now there is an upcomng gubanatorial election and water promises are everywhere. Vote for Eviel, he’ll bring you water, the sign says. There are certain days where you pump water into your tank and then if you run out before the next pumping day, you have to order a tanker full of water to come to your house. That can cost you 600-700 pesos! That means you do the kind of water conserving showers where you get wet, turn off the water, soap up, rinse off and then you’re done. There’s not much time for the water to heat up. So it’s mostly cold showers for me.

Additionally, the water that comes out of the tap is not potable. What a privilege to be able to turn on your faucet and drink the water pouring out of it. Instead everyone gets 5 gallon jugs of water delivered to their house or buys them off of one of the vendadores on the street. Although my friend from school got sick this weekend buying it from a street vendor–so then you have to pay more from a reliable company. Then, if you want water when you’re out you can’t just fill up your water bottle at a fountain, you have to buy a bottle. No tap water at restaurants either, it will set you back 20 pesos for a small bottle of agua puro.  I have been meaning to take pictures of both the tanker and the cases of water that are unloaded in front of the stores, will post those to flickr shortly.

I wish I knew more about the politics of water in the world. I know there are huge issues with the privatization of water. Can someone recommend a documentary or maybe a book about the issue?


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