Tuesday, August 17, 2010

Mexico

Somehow traveling by plane has a way of making things seem surreal upon arrival. It's just too fast I guess. One moment I was hanging out with my family on Bainbridge Island and the next I was stepping out of an airport into a muggy afternoon in Guadalajara with people speaking Spanish all around me.

First, the who, what, when, where, and why.

Who: (see pic below)
What: A service learning project through the University of Wisconsin medical school in partnership with the University of Guadalajara in which we carried out community health and wellness projects with local partners.
When: June 20-July 25
Where: Mexico, state of Jalisco in several small rural communities
Why: Our mission in two words was “aprender serviendo” or service learning. In greater detail, we had traveled to this part of Mexico to learn how to find out what matters to a community and how to assist in achieving said goals regarding health and wellness.




(Our team. L-R Me, Dora a nursing student who worked with us, Maria - our team leader and long time nurse/university professor, Joel a fellow medical student, Melissa a fellow med student, and Alyson a Spanish and Library sciences grad student who was with us for the first week and gave several talks on accessing free online medical literature.)

My plan here is to share a bit of what happened in each community and then tell a few choice stories.




(The church in Tepatitlan, a medium sized city we stayed in for several days before starting our project. It is also the location of the University we partnered with and where Maria lives.)




(A pastoral view of Tequililla.)


Tequililla:

This was the first community we traveled to and the one we stayed the longest at. During our two weeks in Tequililla we were housed with the local health promoter, Berta, and her family, which turned out to be a definite highlight.




(Berta and 2/4 of her children with our team. L-R Me, Berta, Melissa, Joel, Jorge, and Kary)


Upon arriving in Tequililla we held a town meeting of sorts where we outlined what areas we (three medical students) had experience in, asked what projects the town was interested in, and came up with an itinerary together. Before going to Mexico we had talked with Maria and she related several ideas the community had passed on to her (as she had been working with them for over a year) but at the meeting the community seemed more interested in a different set of ideas. For example, I had put some time preparing to run a healthy cooking/nutrition series of classes but most of the people were more interested in a workshop on how to make soap. I guess I should have known that things always have a way of changing:)

So, what did we end up doing? A whole hodge-podge of things but in the end they all linked back to health and wellness somehow. One of those projects was renovating a dilapidated volleyball field and getting games going almost every evening. This single act ended up being one of the best things we participated in as the daily volleyball became a main avenue through which we came to know a great many people in the community, built trust, and ultimately increased interest and participation in the other projects. Volleyball is great because really anyone can play (you don’t have to be in the best shape) and we always had mixed teams of all ages and both sexes.




(Volleyball!)


As this was a farming community in planting season people would work all day. This meant we had to do our programming later in the evening. For example, we would show up at the volleyball field around 6:30pm and start playing. People would gather over the next hours and we would play until dark (around 8pm) at which point we would transfer to our evening event from 8pm-9/10pm.

These other events were variable and consisted of:

- Salsa dance classes (Joel and Melissa are great dancers and no one knew how to dance salsa there – they all dance Banda instead and later taught us a bit of it!)
- Yoga classes (Melissa and I had experience in this)
- A basic bike maintenance class (I had worked in a shop for 6 years and Joel knew some as well)
- A more traditional health talk (which then prompted several personal visits as family members of individuals too sick to attend wanted us to visit their loved ones at home)
- An artisan soap-making workshop combined with a game to teach how infections spread and a demonstration of the most missed spots during hand washing
- Star gazing via telescopes we had brought
- Volleyball and soccer tournaments




(Preparing for the telescope workshop that night by spying on people working and cows. The telescopes invert the image and the kids got a huge kick out of seeing all the cows "upside down":)


The soccer tournament was particularly exciting. The day it was planned for dawned gray and it soon began to rain. We arrived at the field at the appointed hour and found a few kids already gathered. When we inquired if they still wanted to play the answer was a resounding, “Si como no, no somos de azucar!” or, “Yes, of course, we’re not made of sugar!” And so it was on. The rain continued and by the final match the dirt field had become a mud pit. Joel and I felt like ungainly giants almost unable to change direction on the slick surface. Much of the community came out to watch from a covered area and after the game Joel had the idea, after everyone else had cleared off the field, to run and slide on his stomach. We did it at the same time and right after all the other kids ran back on to the field and started sliding as well. We did a mass group slide for the cameras and came off the field laughing and smiling. It was a special moment; you could almost feel the excitement and happiness emanating from those involved.

(Post trip note: Alejandro, one of Berta’s sons who helped us on many projects and refereed the soccer tournament, informed us over facebook that the community has continued to hold soccer and volleyball tournaments after we left – awesome!)




(After the soccer tournement:)


While walking around the community during the day we noticed that there seemed to be a lot of people smoking. Could we do anything in this regard? I thought back to training I had received during my Americorps year on how to develop a smoking cessation plan and based on that I worked with Berta to develop a “Quit Plan” that she could use help her fellow community members who wanted to stop smoking. The plan attacks smoking as both a chemical addiction and a social addiction. For the chemical part we discussed the proper use of nicotine patches and I researched where to get them and the price. But even without the patches having a plan can help and thus we spent most of our time on the social addiction.

One starts by designating a quit date several weeks in the future and making sure everyone knows about it. Then, it is important to break the link between smoking and daily events. For example, if you smoke a cigarette with coffee every morning, for the next 3-4 weeks before your quit date you will have to drink your coffee and then wait for 15-20 minutes before smoking your cigarette (outside). Doing this with the other “linked smoking events” in your day will make quitting easier as you won’t be constantly thinking about cigarettes as you go through your daily activities. However, assuming you won’t have any desire to smoke is not reasonable and thus one also must prepare several emergency strategies such as taking 5 deep breaths, chewing on gum, etc. to deal with strong cravings.

Before leaving Tequililla I pretended I was a patient to help familiarize Berta with the material and also ran one cessation session for two co-workers who wanted to quit smoking. Their quit date was August 8th and I hope they had success. This was a project that had potential to be of real use long after we are gone and I am hopeful it will be so.

Switching topics, a few pics of one of my favorite things – food:)




(The kitchen with us at breakfast, my favorite room in the house:) There was always much laughter, great food and good conversation when we gathered there.)




(Joel grinding up corn kernels for later use in making handmade tortillas. The food overall was spectacular. I like Mexican food in the states but down there is the real deal! Nothing like a taco with handmade tortilla, special local sausage, avacado and freshly prepared salsa - yum!)




(A typical, yet amazing, breakfast. This was one was made on a wood-burning stove. Sweet-potato, gorditas (a thick patty of tortilla dough with beans or cheese inside, avacado, and cheese. We finished things off with mangos (not pictured))

As we spent the most time in Tequililla it proved the most rewarding for me as we really got to know people in the community. Our second week there we had lunch invitations at a different house every day!




Presa de Barajas

This was our second stop and we only stayed in Presa for about 4 days (Presa means “reservoir” in English). Our first night there we were invited to the QuinceƱera of a relative of the people we stayed with (a “QuinceƱera” is the huge 15-year-old birthday bash that marks when a girl transfers to being a young woman) . They were frying a great number of items in hot oil (tortillas, chicken, nopales (cactus)) and more) and even though it was 11pm and we were pretty full we had to eat so as not to insult. From there we were asked to participate in karaoke and we all three gave our best shot at a Linkin Park song which must have sounded pretty bad but was, I think, a goodwill gesture that earned us some community points:)

That night we were shown to our lodging, a formerly nice house that had not been lived in for the past 10 years. Our first evening the power shorted out (and while trying to fix it the family who owned it almost caught the box on fire before giving up!), then the water stopped flowing to everywhere except the shower head, and during the night I heard scratching in a cupboard and opened it to find three mice staring at me with a look of, “what are you doing here, this is our house now.” All that being said it provided a roof over our heads (albeit leaky) and we made due without too many problems; we just had to get creative, use our headlamps, and take freezing showers:)

So what did we work on in Presa? Four days wasn’t much time, but like Tequililla we held a meeting, came up with a plan, and by running around 3 activities per day we were able to fit in quite a bit! The citizens of Presa were very eager to participate as much as possible. Many of the activities were the same (salsa, health talk, yoga, volleyball, soap making) but there were a few differences.

One of these was turning the peanut chicken cooking idea into a community event. We did this and incorporated local vegetables such as keleite (a local green-leafed vegetable much like spinach). The reception here was mixed, some liked it a lot, others (including many kids) not so much. Compared to the food that is typically eaten our meal had way more vegetables, way less salt, and a completely new flavor so I couldn’t have expected it to be a taste-bud success:) Many of the adults though were interested by the fact that it would be a good meal for those with diabetes or those looking to prevent it.




(Part of our cook-off team for making peanut chicken.)



Las Jicamas


This was our final community and we only spent 3 days here (and no nights as it was so rural and remote that Maria was of the opinion we would be bitten by snakes or scorpions and die and therefore wouldn’t let us stay).

Our main project was to turn a messy storeroom into a library. This had been identified as a project the community was interested in by a UW group that had traveled to the site the previous January. The room designated for the library already had a great number of books but no one had been able to get shelves, organize, paint the room etc. We enlisted the help of numerous local kids and over the course of several days we, well, you’ll just have to see what happened below!




(The building on the left was a former school storeroom (inside view below) that was designated for remaking as a library.)




(Inside the room.)




(After!)




(Melissa had the great of idea of doing a tree mural where the leaves were handprints from kids from the community!)


The area around Las Jicamas has many nopales (a special kind of cactus that provides both a vegetable and a fruit). One can eat the new paddles (boiled and cut up in a salad with tomato, cilantro and onion, or grilled whole) or the fruit that gives rise to the flower. The fruit itself is quite juicy (almost watermelon texture) but with a unique (and delicious!) flavor all it’s own. There are quite a few seeds but they are easy to eat and swallow. Extracting the fruit can be tricky though as it is encased in a thick outer covering full of small spines that are almost impossible to remove from ones skin.




(A nopale or cactus. This plant provides a great deal of food. The new pads are cleaned of spines cooked and eaten and the little ovals you see are the fruit which are called "tunas".)




(Preparing the tuna. First you have to rub it in the grass to remove the many hair-like spines, next cut off the ends and then slice it vertically to remove the fruit.) Then enjoy!




And now some adventures/stories:

1. Under the Rock

On one of the open days we had in Tequililla I decided I was going to hike to the farthest off huge hill/small mountain I could see from the farm and climb it. I reckoned it would take about an hour to an hour and a half to make it up and the same back. No one wanted to go with me so I set off by myself with a nalgene of water, my camera and two bananas. For some reason the hill didn’t seem to be getting any closer for the longest time but after 2.5 hours I finally made it to the top. There were probably going to think I had been killed by narco-traffikers as my faulty time/distance estimate meant I would be getting back about 2 hours after I had told them (and they did end up thinking I had gotten lost/abducted or been killed even though we were in a safe area of the country. But, that isn’t the point of this story.) Once on top I had a strong urge to defacate and figured I would just pry up a rock, go under that, and no one would ever know. I found a suitable candidate and after lifting it up I was about sink down into battle position when I spotted some movement. Looking closer I saw it was a scorpion! It was small, about an inch long, but I had heard the smallest ones are the most poisoness – yikes! I got a stick and played with him some; his sting reaction was super fast! I threw a grub in at him and bam! A quick sting and the grub thrashed around for 15 seconds or so before remaining still. Eventually I reckoned I should leave the poor guy alone but it was my first scorpion and I was just so excited!


(My scorpion friend!)


2. Mad Cows


On the way back from playing with the scorpion I had to pass through a field of cows that had given me some dirty looks on the way out. This time they were on the other side of a fence but the fence was open at one spot a ways ahead of me so they could cross back over if they wanted. As I started to pass the herd several large ones took notice and began to moo vigorously. Soon the other 30 or so cows took note and began to moo and follow me. Now, they were still on the other side of the fence at this point but they would be able to cross over in about 100 feet when we reached the opening and this was not something I wanted to be around for. I picked up the pace and started fast walking. The cows increased their pace and matched me, coming closer to the fence and bellowing. Now I was getting worried, what was going on with these cows? There was no one else in sight. I stopped to see what they would do and they stopped too (where I took the pic you can see below). We were still a bit off from the opening and my plan was to sprint past and if they spilled onto my side and chased me I would try and hop the 4 foot barbwire fence and land on their original side. With this in mind I took off – and so did the cows! They were running right behind me on the other side of the fence and bellowing! For whatever reason they did not cross at the opening and we ran another quarter mile or so this way before their pasture ended and I escaped. Whew!




(The herd right after their initial bluff charge staring at me after I had stopped.



3. The Beach


I have already introduced you to Joel who is a fellow second year medical student (one of three of us on the trip). It turned out that one of Joel's uncles had moved to Mexico permanently 12 years ago. Joel had not seen him since he left Wisconsin but we were only a 5 hour bus ride from his house on the coast and he informed us he would be happy to have us come visit!




(Inside his canal-side house.)


Besides free lodging Joel's uncle graciously provided us with all the food we could eat. As his uncle happened to be a chef back in Wisconsin this turned out to be a mouth-watering experience twice per day.




(A seafood paella he prepared for us our first afternoon there!)




(One of the beaches we visited. This one had great waves for boogie boarding, which we did for hours on end.)




(Sunset at the beach. For the last rays we swam 100 feet offshore and bobbed up and down as the sun sank. The ocean seemed to be on fire.)




(Another shot)



4. The Burn


This story reaches back to the time we spent with Berta and her family. After trying so much good food they had prepared for us we decided to share something we know of. I used the same peanut-chicken recipe I cooked for my Ecuadorian host family and once again had to prepare the peanut sauce from scratch (peanut butter, milk, oil and chiles) as one cannot buy pre-made peanut sauce in Mexico.

Everything was going to plan and I decided to go to the bathroom quick before we served the meal. About two minutes after getting out of the bathroom I started to feel a burn that spread up inside my urethra (where the pee comes out in guys) that intensified quickly. What was going on? Did I have a rapid onset STI? I couldn’t think of anything that would have put me at risk… but the burning, it kept getting worse and worse. I tried to go to the bathroom again to see if I could “pee out” the problem but it only increased the pain. What was going on?! Then it hit me. The chiles! I had not washed my hands after splitting the chiles open (by hand in fact as I was in a hurry); I somehow must have self-contaminated myself and it had traveled up my urethra!

The meal turned out to be a hit but needless to say my enjoyment of it was tempered by the penile burning I was experiencing and that lasted a good 30-40 minutes.

Lesson. Be careful when mixing chiles and the use of bathrooms.

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So that’s all for now. I hope to have to my Guatemala experience out soon but in the meantime I’d love to hear from all of you!

1 comment:

  1. You know I was wondering if there were any uncomfortable parts of this trip in the digestive sense (that always seems to be my biggest problem when adjusting to new foods/time zones), and then you shared those two lovely stories.

    Good luck this year!

    ReplyDelete