A Chilean Thanksgiving

I have way more reasons to be thankful than I can even begin to comprehend.

          Today in clinical observation we went a rather different route and went to Hogar de Santa Clara (Home of Santa Clara). This place houses up to 17 children living with HIV/AIDS who have been neglected the proper care from their parents. They live here for typically 6 months to a year, with ages ranging from 2 months to 15 years, while they work with the family to teach them proper care or to find a new family for the child. We played with 2-month-old babies, helped organize and clean the building, and ate lunch with some of the children. I'm so thankful for my family and their ability and willingness to take care of me when I was sick or injured. I'm so thankful that the worst health problems I've had to deal with are minor broken bones and asthma. I'm so thankful I could witness the children's instincts to show sheer joy with the simplest things in their lives.

          The day after, I celebrated thanksgiving with my host family and some friends. My host family had no idea what Thanksgiving meant and how it originated, so it was finally my turn to share a concrete piece of my home culture. We had a huge dinner, with food cooked from scratch from each person who came. So many salads (Chilean definition of salad: one or two vegetables mixed together with a mixture of oil, lemon juice, and salt as dressing), the cranberries I'm always able to successfully make (in whatever country now), coleslaw (the Chileans thought it was SO weird to put mayo, sugar, and apple cider vinegar on cabbage, but they still thought it was good) and my grandma's stuffing recipe, with rosemary instead of sage. Sage just didn't appear in any of the stores I ran to.
          I said goodbye to my host sister's boyfriend, David, who served as a wonderful guide to Chile's sights and offered so many unique perspectives on current events and Chilean youth culture. I didn't know that would be the start of a long string of many goodbyes I would go through in the last few weeks of my stay here. I'm so thankful for all the time I got to spend with the people I met here. I'm so thankful for the conversations we had around the Thanksgiving table. I'm so thankful that I could feel so much happiness and love from people who were complete strangers 4 months ago.

Prepping the final 3 weeks

          I never thought I'd get to this point. I only have 3 weeks left in Chile! I have no homework and no plans, I feel so free! I'm planning on going to yoga and running everyday (I have less than 2 months until the track season starts... SO out of shape), going to concerts, taking some day trips to areas a little outside Santiago, hopefully going to a soccer game, riding the metro and getting off at random stops to wander the city, hanging out with my Chilean friends, and doing as much as I can in the few weeks I have left. Granted, I'm getting off to a GREAT start today... I slept in until 6 pm because of a late-night salsa, merengue, and cumbia dance party. But Monday is a whole new day!

As far as current things that have happened...
          I ran a 5k with the Color Run, visited a rural healthcare post outside Santiago and realized how important health is to a community as a whole, finished up all my classes, gone to a few farewell parties, and had some great conversations with my host family (like always) and with Maya and Natalie from my abroad program while we were trying to finish up a final project. I also learned how to dance cumbia! That's one thing I'm really going to miss about Chile: how people actually know how to dance socially instead of just twerking.
          In my clinical observation this week, I observed a cardiac bypass surgery. I felt dizzy for the first 3 hours; so I definitely know that it's a trend associated with needles and doctory-things. It was SO intense and SO cool. I saw the actual heart beat, the lungs inflate and deflate with each breath, and the importance of working as a team. Every person in that surgery room had an equally important role; they all moved and conversed like it was a perfectly choreographed dance. My favorite person to watch was the woman in charge of laying out all the instruments and handing them to the surgeons. She knew the surgery so well she could hand them whatever tool they needed before they asked. Every observation I go to I think that it's my favorite. This experience has been incredible.
          We had our last meeting with our program on Thursday, November 21st for a Thanksgiving dinner and farewell/cultural re-entry session. We received a pin from the program with the US and Chilean flags crossed, and I hate to admit it, but I almost started bawling right then and there. I realized how not ready I am to go back to the US. I've established a whole new way of life here, lived in a different reality, learned so much, formed a new family, new relationships, and a deep connection with this place. Chile holds many of my "firsts": first airplane ride, first catholic mass, first solo travel adventure and hopefully the first of many more times I learn about a new culture and deepen my understanding of Spanish. How do I just leave all those new experiences behind and go back to the routine of home? It will be an infuriating comfort, I'm sure. People have changed back home, life went on, and it'll be a process to adjust again. I'll have to keep the same open mind I came here with when I go back.
           I'm sure the next 20 days will fly by; no matter how hard I try to control the passage of time it will always slip through my fingers like grains of sand. So much to see, feel, touch, taste, hear, remember, and understand. Live it up. :D

See you all in a few weeks,
Athena

PS: Now on to organizing a shopping list for the Thanksgiving dinner I'm going to try to cook. Hopefully I don't set any towels on fire like last week when I tried to help my host mother cook... :)

A new reality: the public healthcare system in Chile

For those of you unfamiliar with the healthcare system in Chile, here's a brief overview:
          There are basically two options for insurance: 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.

          Today in my clinical observation, I had the opportunity to observe the emergency room at Hospital Sótero del Río. It's a public hospital in an area of Santiago with fewer resources than wealthy Providencia, where I live. It was an exhausting day, but I learned a lot about the realities of the public healthcare system in Chile.
          I arrived at 9:30 am in the waiting room, which was already packed with people, and got shown back to the actual room where patients are treated and met the doctor I was going to follow for the day. He was very friendly, outgoing, and upbeat. As the day went on, my respect for this man increased exponentially as I saw how he maintained his positive attitude in light of the circumstances he works in. The emergency room's main room has 15 beds, separated by curtains, with just a computer and an IV stand next to each. There are three rooms that open into the main room, each with different roles: the first is the waiting room where people wait hours to be treated, the second is for people waiting to take blood tests, x-rays, or other exams. The third one is reserved for people who were hospitalized. There aren't enough beds, so four to five different IV's hung in front of a row of patients sitting in waiting room chairs.
          To start the day, the doctor talked with a man who's liver was failing due to alcoholism. I could see the yellow eyes from jaundice; he was only 49. After that, the doctor spent a while filling out the patient's "ficha", the physical document that stays with the patient during their hospital stay that has all the medications, tests, medical history, and other relevant information, and organizing the ficha's of other patients. Although they have a computer system which logs the medical history, it's not available to every patient. The electronic system also serves as a mode of communication between different parts of the hospital, so the doctors can request different tests and send patients on their way. The system broke down twice, so the patients were stuck in limbo and the doctor's were unable to move on to other patients while the system got fixed.
         After that, I moved on to the "sala de reanimación", basically the room where the most vital attention is given. Although the room was technically outfitted for 3 beds, there were 5 in the room. The most attention was being given to an 83-year-old woman who was moaning in pain and not breathing well. The doctors were discussing what to do, and they came to the conclusion that they should perform an intubation on her. They explained to her what was going to happen, said "Usted va a dormir ahora" (you are going to sleep now), and she nodded her head. I didn't realize that that would be her last communication with the world; she passed away after more than an hour of chest compressions. I was surprised at how much it didn't affect me; I guess surviving my mother's passing really did make me stronger. While they put her under, it was fascinating seeing all the doctors and nurses working as a team. They communicated and trusted each other during the entire process.
          After those pleasant experiences, we went to lunch. It was really weird, transitioning from the enclosed emergency room with all the noise and movement, to going outside where a strange calm envelopes the rest of the hospital. While I was eating lunch with the doctor and the supervisor of the emergency room, it was hard for me to separate the ER environment from two normal people having a conversation about what they were going to do for the weekend. I guess that's something you learn on the job, separating your work from the rest of your life.
          After lunch, the activity in the ER picked up noticeably. Stretchers from ambulances were used as beds because of the shortage. People were standing in the hallways because their weren't enough chairs. Because of my white lab coat I need to wear for the observations, people came up to me thinking I was a doctor and telling me their symptoms and asking when they were going to be seen. I constantly repeated myself saying "no soy doctora; no trabajo aquí" (I'm not a doctor; I don't work here). I heard the phrase "hay que esperar" (you'll have to wait) more times than I could count.
          The second half of the day was WAY more exhausting than the first. I think it was because I started to feel trapped: I was in this place where clearly so many people needed help, but I couldn't do anything. I just sat and watched. I couldn't help the doctors organize the fichas, send requests for exams, listen to patients, I felt helpless because I didn't know anything. The doctor I was shadowing kept the same understanding and level of patience throughout the whole day, and didn't show any signs of exhaustion. I guess that's something else you get from the job, endurance.
           This observation was the most challenging (even though I didn't come close to fainting once!!) but by far the most valuable. I saw a new reality and learned some truths about the quality of public healthcare in Chile. Most of all though, it reinforced in my brain that some of the most important and valued work someone can do often goes unrecognized. The doctors who work in the public system don't get paid as much as in the private sector. But they stick with their jobs because they know these people need help and they know they're needed, even though they know they can get more of a monetary reward working in the private system.
          Now that I've seen Chile's public ER, I need to see one in the US to compare how bad the discrepancy is. The US has SO much and people never realize it and appreciate it enough. I wish there was a way we could balance out the quality of healthcare for everyone in the world. Such a Miss-Congeniality-world-peace-style desire, but one can dream, right?

It's a right, not a privilege, to have a functioning body that allows you to pursue happiness. And nothing should stand in your way of achieving that.

One day in Santiago

So I've been posting realllllllllllly long winded posts about what I've been thinking, but I haven't posted anything about what I do on a day-to-day basis. So, without further ado...

Monday 4/11/2013:
7:30: ALARM!!! snooze...snooze...snooze...
7:55: a car alarm goes off with its typical pattern of sirens, honks, and beeps. It's not just a simple "beep beep beep". Well, if the city's waking up, I guess I should too.
8:00: Breakfast! Usually oatmeal, but sometimes the Chilean tecito (tea) and hallulla or marrequeta (bread) with butter and jam hits the spot.
8:30: Do homework I haven't done yet or work out or write in my journal or blog.
10:30: Walk out my door!!
10:31: Walk back in the door. Forgot my keys. Forgetting your keys in your room here is definitely worse than on campus... I can't just call up my host mom and be like "hey... leave work and let me in".
I walk outside down Pedro de Valdivia, the street that runs through the municipalities of Providencia and Ñuñoa. It looks just like any street in the US, except there's probably some stray dogs laying in a sunbeam and TONS of posters of politicians' faces running for office (presidential elections are in mid-november).
10:35: Walk by the park maintenance workers who are... surprise surprise... literally flooding the grass with water. Everywhere in Santiago where there's grass, I always see people with a hose watering it or sprinklers on for hours drowning the blades until lakes of mud and dead grass form.
10:35: Arrive at the bus stop. I look around and see faces of typical Santiaguinos: women with gorgeous long brown hair and brown eyes, professionals with dark colored clothing on their smartphones, college-age guys with long hair/dreadlocks with sunglasses and their headphones in. But I definitely stick out as a gringa with my lighter eyes and general "aura". I miss the diversity of my college and the US.
10:45: The micro finally arrives!! I get on and pay with my blue bip! card that everyone needs to ride public transport. Sometimes a musician gets on and plays his guitar and sings classic Beatle's tunes with improvised English lyrics or classic Chilean songs. Towards the stop where everyone gets off for the metro, they go along the micro asking for tips and then leave to catch the next.
11:00: Get onto the metro. SO HOT. It's now summer here and there's no air conditioning in the subway system, so it gets pretty stuffy. I usually pull out my cell phone and play solitaire or sudoku (...look casual). About halfway through the metro ride the train goes above ground and I can see other parts of Santiago; the mountains always remain in view.
11:20: "Estación San Joaquin" buzzes over the loudspeaker and I get off with dozens of other students at the Pontificia Universidad Católica. I never see anyone wearing PUC sweatshirts or tshirts because college is a time where students can really express their personal style after years and years of school-logo emblazoned uniforms.
11:30: Religiones y Cristianismo (Religions and Christianity)! Today we started our final unit about Christianity. It's been a really interesting course about all the different kinds of religious beliefs around the world, and the professor often makes really interesting comments about Chilean and US culture. It's pretty clear to me that a Christian bias comes through his teachings, though, as he often makes some off-color comments that make me realize this is a VERY catholic university.
1:05: Once again, the professor lets us out late since he got carried away reading from a book.
1:10: Back on the metro! Ugh. There's a couple eating each other's faces right next to me. PDA is everywhere in Chile. I don't really understand what's so romantic about a metro-make-out-session, but to each their own I guess?
1:30: Back to the IES center where I'll heat up my lunch and eat frantically before class.
2:00: Español para Gringas! (haha, that's not the title of the course, just one my Chilean friend suggested. But that's pretty much what it is, a Spanish class to help us poor lost gring@s understand Chileans) Today we had a man called Eledin Parraguez come in and talk to us about his experience in the integration programs from the 1970's. The "integración" was an effort of the Allende presidency to have poor students study at the rich private schools, to prove that those with less resources could be just as successful as wealthy people if given the opportunity. He was the inspiration for the Chilean film "Machuca", which is about a poor boy who is integrated into a rich private school and makes friends with a wealthy peer just before the Pinochet dictatorship started. It shows the "golpe militar" (military coup) of September 11th through the children's perspective. I highly recommend watching it, it highlights many of the divisions within Chile that still are prevalent today.
4:00: Medical Spanish! Typical day; we talked about healthcare for the elderly and discussed how it differs in the US vs Chile. Chile's population is growing older, but there are only 30 geriatric doctors in the entirety of Chile for their aging population. Then we had our vocab test. The last one, YAY!!
5:30: I walk home from the IES center, down Manuel Montt, Francisco Bilbao, then Pedro de Valdivia again. This is my FAVORITE part of the day, just walking around the city and taking it all in. Hearing people talk on the phone in Spanish, reading Spanish street signs, the constant impatient honking, the occasional car blaring reggaetón or "Black and Yellow" (**see below), and the general sounds of the city make me SO happy (except when boys honk, whistle, make kissing noises, or yell things at you. The "piropos" are DEFINITELY things I could do without in Chile).
6:00: Arrive home!! Do some homework and chill before my host sister comes home. Then we'll have "once" (elevensies!! hee hee, more bread but with palta (avocado) or scrambled eggs with a tecito) and chat about the day or religion or education or some other interesting topic.
And then... write in my journal about the day and go to Sleeeeeeeeeeep.















**this one just happened once and it was an older guy listening to it in the car. I remember cruising through St. Louis Park with Ellyn and Jackie eating Arby's and trying to rap. We were SO COOL. So the combination made me lawl. :) Miss you guys!