Clinical Observations AKA Time reserved for Athena to almost faint (and other thoughts)

          The main reason why I came to Santiago was because my study abroad organization has a program called the Clinical Observation Seminar. Since I'm one of those "maybe-I'll-just-go-pre-med-because-I-have-no-idea-what-else-I'd-do-with-my-life" students, I decided it'd probably be a good idea to observe some doctors and interact with patients before I do a full-blown commitment to med school (aka... a commitment to taking biochem and physics at Grinnell). Although I haven't yet made a definitive decision one way or the other, I've learned a lot about Chile's healthcare system and my own limits when it comes to doctor-y things. Like needles. Apparently they're not my best friend.
          We started out the class with theory lectures about how private insurance and public healthcare works in Chile. There are basically two options: FONASA, the public insurance that is funded by taxes which 75% of the population is signed up for, and the ISAPRES, the private insurance an individual can buy based on their own health needs. Because of this system, and this is a huge generalization, the insured population is divided between the young, healthy, and rich that can afford Isapres and the old, sick, and poor that sign up for Fonasa. If you have Fonasa, you can only go to public hospitals and clinics unless you can pay for private centers, which boast low wait times for surgeries and better quality healthcare overall. Public hospitals suffer from a lack of resources and are often understaffed, sometimes leaving people waiting days in the emergency room and months for surgeries.
          For the practical part of the seminar, we go in pairs to spend Thursdays with different medical centers. First, my partner and I went to a dialysis center where we learned about how the blood is filtered when the kidneys no longer function.We talked to many patients about their experiences with the clinic and about life in general. The day was going splendidly until the time came for one of the nurses to stop the dialysis for one of the patients. Standing by the machine and realizing that soon the nurse would be pulling out the needles from the mass of scarred veins and arteries made me... just a tad dizzy and nauseous. I thought I was just suffering from lack of sleep and dehydration (excuses?).
          The next week, we visited the maternity ward. We changed out of street clothes and into scrubs (they are SO comfy!) so that we could observe some live births, an emergency surgery, and a C-section. We observed an anesthesiologist perform an epidural. Almost fainted. Then we observed some nurses working with a woman who was about to give birth. Almost fainted. At the end of the day, we observed a C-section. What happened? You guessed it. Almost fainted at the end of the surgery. I'm glad I know my body well enough so I can sit down as soon as I know it's getting bad... otherwise I would have become a patient instead of an observer! If this trend keeps up for my observations for a family clinic, emergency room, and a cardiac surgery, I think it'd be safe to say that I should pursue a career in medicine that doesn't involve being a doctor.
         Apart from learning my physical inabilities when it comes to clinical work, I've learned a surprising amount about the Mapuche culture from the seminar. The Mapuche are the largest remaining indigenous population in Chile; 85% of the indigenous people are Mapuche. I've been learning a lot about them in many of my classes; their religion in theology, their basic anthropological information in Native Cultures, and how intercultural exchange occurs with medicine in the seminar. We had the opportunity to visit a Mapuche "ruca", which is a hut in an area about the size of half a block in Santiago where the Mapuche can practice their culture, festivals, and traditional medicine. Anyone can consult a machi, the Mapuche healer, as an alternative to western medicine.
          Learning from a professor and a machi (the mapuche healer) about the benefits of intercultural dialogue and practices has made me realize how valuable this experience has been for me as an individual potentially entering the medical field. A lot of people study medicine because they love science. You study ochem, physics, biochem, and learn about all the metabolic pathways and which drugs are used to treat which illnesses and how analgesics work in the brain to stop pain. What about sociology, psychology, and anthropology? What about understanding the various social, economic, and religious reasons for why people will seek healthcare for certain occasions? Often times these are added on as an afterthought and differing perspectives aren't fully understood and therefore are less respected. But the necessity of recognizing that not every individual operates under the western, scientific medical paradigm that dominates society and suffocates the system is SO important. Reading The Spirit Catches You and You Fall Down in high school introduced this topic to me, and now I actually can apply it and see it in action. Study abroad kind of rocks.

Kind of rotating to a different topic/afterthought that's still a little relevant...

          The discussion about the importance of intercultural dialogue and listening to other perspectives made me realize how much my internship this summer has prepared me for this trip. I spent the summer interning at the Christian Conference Center in Newton, IA, the place where I attended church camp for 10 summers. Being able to step back and grow in my faith and listen to other people's journeys was such a valuable experience looking back now.
          I got much more involved in and passionate for my denomination, the Christian Church (Disciples of Christ). Being a disciple, to me, means being open-minded and recognizing the importance of listening to other perspectives on God and religion. Only through listening will you be able to expand your own knowledge about God and your role in the world. Reaffirming that my own point of view is one tiny sliver of the truth about God has been an important lesson I've learned and developed through this summer and this study abroad experience. I've learned more about how other people contribute to my life and how they add to my rich experience with God and the world around me. It's refreshing to understand that there is not one truth; rather, a messy but beautiful web of experiences and beliefs between people that form my faith in God.

Thanks for reading my hodge-podge thought pensieve. :)
Til later,
Chao!

13 down, 7 to go (Wait... What??)

           In the post where I did a mini-overview about the first third of my stay in Chile, I thought I still had all the time in the world to explore Chile and get to know its people better. Now that I'm down to my last third, I feel a little bit crunched for time. This "third" of my stay, mid-September to mid-October, was characteristic of a few things: traveling, homesickness, and developing a new feeling of home.
          I spent of lot of weekends away from Santiago, traveling to Bolivia/Chirimoyas, La Serena with Coquimbo and Valle del Elqui, and most recently the classic venture to the Atacama desert in northern Chile. I've only seen a little bit of the top half of this country, but Chile has the coolest and most gorgeous sights I've ever seen. Even though I've seen so many different things on my road trips around the states (only have Hawaii and Alaska left to see!) the different hemisphere provides radically different climates and really interesting geography.
          A six hour drive north of Santiago brought me and my two friends Hudson and Nick to La Serena and Coquimbo, coastal cities that are a springboard for experiencing the more central Valle del Elqui (Elqui Valley). La Serena offered a wonderful view of the Pacific with dolphins swimming in the surf and an interesting archeological museum with a mummy and a moai statue from Easter Island.

In Coquimbo, we went to the top of the Cruz del III milenio (The Third Millenium Cross) that was built to commemorate 2000 years of Jesus' birth. It was really neat, with panoramic views of the city, ocean, and cordillera from the top of the cross and a mini-museum of catholic artifacts. It also had a series of life-size statues depicting the "final journey" of Jesus' crucifiction and resurrection.

Next, we traveled to the central part of the country to see Valle del Elqui. This region is famous for its grape crops that are used in the production of pisco, the very Chilean hard liquor which is pretty much a less processed version of white wine. Usually they mix it with cola to make "piscola" or add some other things to it to make "pisco sour", which basically tastes like margarita mix. A bit south of Santiago is where you'll find all the vineyards, where the Mediterranean climate predominates.

          In mid-October, I traveled alone for 5 days in San Pedro de Atacama, a base for exploring the vast and arid Atacama desert. I met people from all over the world at my hostel, and the main streets of the town are always crowded with tourists. I went on four tours where I saw awesome rock formations in Valle de la Luna (Valley of the Moon) and climbed through a cave/tunnel, floated in Laguna Cejar (higher concentration of salt/lithium than the Dead Sea) and saw a gorgeous sunset at Laguna Tebinquiche, saw the Tatio Geysers and swam in a hot spring, saw gorgeous reflections of the snowcapped mountains in the altpilanic lagoons and felt like I was in Middle Earth. There are SO many beautiful views I tried to capture with my camera, and my album on facebook has some comments about the pictures. It's very clear why this town is so touristy with all the views it has to offer, and people tend to come here to see some of the sights and then hop over to Bolivia. The completely superficial swing-through of the areas made me abhor tourism. I would much rather stay in one place for a longer period of time and actually form a connection to the land and the people than just check off some views from a list. In the end, traveling alone boosted my confidence in my ability to trust myself, provided more opportunities to meet new people, and made me appreciate the beauty of not really having a plan.
          During the traveling and the routine of school in the second third of my stay, I became painfully aware of how much I miss my original home in SLP. During almost the entirety of September, I had Christmas carols stuck in my head and couldn't wait to get home for the holidays. I browsed through all the Halloween decorations on target.com when the Halloween displays in local stores left much to be desired. I had extreme cravings for pineapple Domino's pizza at Grandma's house and a cinnamon-sugar bagel with strawberry cream cheese at Bruegger's Bagels.
         But even with all this lame homesickness, the traveling away from Santiago made me miss the city and my host family. When I stepped off the plan from Bolivia, a friend picked me and my host mother up from the airport and said "Welcome home!" to me in English. Hearing those words spoken to me in my native language made a strong connection in my brain. Even though I've only been here for 3 months, I'm starting to call this place home. I walk down familiar streets, see the same people in my classes, eat Chilean comfort foods like manjar, and feel some Chilean pride when I think about how they're going to the world cup in Brazil in 2014.
          The stability of familiarity and routine can never be underrated for me now, as I realize that in the midst of new experiences that shake my world (even though I still haven't felt seismic activity here because I've slept through them all) there is always comfort in knowing I have foundations and the ability to return home. This is a luxury I appreciate more and more, especially as I learn more in-depth about the ways the dictatorship shook this country and displaced so many people and ended so many lives. I wish I could stay in Santiago longer, I feel like I'm just starting to scratch the surface that is Chile.
          So, with 7 weeks to go, I'm motivated to see how much more I can discover about Chile.
See you all in December,
Athena

MOSAIC article

My good friend from Grinnell invited me to write an article for a magazine on campus about my experience in Chile, and I decided I could use it as a blog post! Here it is:

After the whirlwind of grabbing luggage, going through customs and immigration, and finding my group of fellow abroad students at the airport in Santiago, Chile, my study abroad experience began. Since this was my first experience outside the US, even my first airplane ride, I knew the next several months would involve new experiences, foods, education systems, family structures, and cultural practices. I had the expectation that Santiago would immediately feel different from the US, but on the surface, it looks and operates just like any other big city in the US: tall buildings, traffic, and typical US fast-food chains popping up around every block. The first few weeks felt like I was just speaking Spanish all day in the US.

I think a lot of this has to do with the way the country has progressed since the 20-year dictatorship that started on September 11^th, 1973. Augusto Pinochet, with help from the US government, organized a coup against Salvador Allende’s left-wing administration to prevent the county from “falling into communism.” Aftershocks of the dictatorship are still felt today: the government has not offered apologies to families of the more than 3,000 “desaparecidos” (the disappeared) or to the 30,000 victims of torture, leaving a large chunk of society without closure. Most government officials who instigated the human rights violations have not been brought to justice and some still work in their departments. The rapid economic growth that accompanied the adoption of westernized economic policies caused huge divisions between socioeconomic classes. While Chile is often referred to as “Latin America’s success story”, the “success” is really only felt by the upper classes. I live in the wealthier part of Santiago and when I travel around and see different parts of the city, it is very clear to me that not all of Chile benefits from what Pinochet began.

So with a little more time and some knowledge about the country’s history and current issues, I started recognizing some differences between Chile and the US. While the divisions between social classes also exist in the US, in Chile the different classes barely interact with each other. I had the opportunity to attend a diverse high school and a college with a strong dedication to ensuring that those with limited resources can still receive a quality education. Coming to Chile, and seeing how the education system perpetuates the socioeconomic divisions, I realize even more how unique of an experience I have. Another difference appears in family structures. I would not necessarily say that family is more important here than in the US; Chileans express their love for each other in actions and words more so than back home. Interestingly, this cultural difference becomes apparent in healthcare. In my seminar about Chile’s healthcare system, we visited the Clínica Familia, a type of hospice care that attends to the spiritual and physical well being of terminally ill patients. It is the only clinic of its kind in the Santiago area and not very well known. A Chilean family will usually take care of its terminally ill members at home, but sometimes the family does not have the resources so the clinic will step in. In the US, hospice care is fairly well known and is used a lot more often than in Chile. It’s fascinating seeing how different cultural norms create unique systems.

In the middle of September, I had the opportunity to travel to Bolivia and volunteer with a small community called Chirimoyas. Established around 3 years ago from a chunk of land previously owned by one landowner, the community is working on making the land viable for crop production and developing the community into a safe, healthy, and prosperous town for its members. In the middle of the jungle close to the Brazilian border, I could slow down completely and really look at myself from an outside perspective. These people had no running water during our stay (the motor in the well was broken), the children ran around barefoot playing soccer on hard, rocky ground, a little girl told me she wanted my skin color because she thought hers was ugly, and some the houses didn’t have walls to block the winds. This made me feel guilty knowing that these people will work so hard to receive one small percentage of the opportunities I have received through my sheer luck of being born in the US.

Yes, this experience made me grateful for the basic material goods I have in Santiago and Grinnell, but it also helped me prioritize my life differently. Coming from Grinnell, with the atmosphere entirely driven by how much you need to read and how high you can get your grades before finals, study abroad has provided a fresh start and a new perspective. There is no better way to develop awareness about other ways of life than to actually live them, something no amount of studying or reading can substitute.