Saturday March 30th: We boarded the bus to Chilibre to go to Chagres National Park and Alajuela Lake to visit the indigenous people of the area, the Embera tribe. The Embera people are indigenous people of Panama and Colombia who are originally from the remote Darien Province in the rainforest. They currently reside in Chagres, and many have mixed lives that include retaining their culture through dress, dance, weaving, fishing and living off the land, as well as taking buses into the city for work to provide for their families. Although the Embera have adapted their lives into current society, many still live in the way that their ancestors lived and provided views into their culture and way of life to tourists from around the world.

Claudio, our tour guide, informed us of the various entities developing the different areas of Panama as we drove to our destination. After an hour-long bus ride, we arrived at the river. People from the Embera tribe greeted our group and had dugout canoes ready for us to start our adventure for the day. Although the trip wasn’t always smooth sailing, the journey down the river was beautiful, and no complaints could be made, even with having to push the canoes occasionally.  

After the canoe ride, we were lead through the wilderness by an Embera guide. We walked along a shallow rocky river, wading through the water when we needed to, and climbed over boulders that were in our way. At the end of the path, there was a beautiful waterfall with a cool water pond. Many of us enjoyed taking in the beauty and relaxing in the cool water.

After our waterfall adventure, the Embera guides took us back to their village. The Embera people and their Chief welcomed us and directed us into a small hut structure. The Chief gave us a brief history of who the Embera were and the current health and economic problems the village was facing. We were served a beautiful lunch of freshly caught tilapia, plantains, pineapple, and melon.

Following the presentation and lunch, we were able to visit tables that various family members had set up to sell the items they had crafted (earrings, baskets, woodworking items). Some of us received traditional style tattoos, using a dye made from berries of the genip tree. The end of our trip was when Embera gifted us with the Dance of Macaws.

We were all very thankful for the experience that the Embera people gave us. It was an unforgettable experience that none of us will forget. We were all sad to leave such a beautiful national treasure.

Authors Kacey Luensman and Amanda Lum

Friday March 29th: Sadly, today we had to leave Chitre. We were packed up and on the bus by 9:00. Our stay at the Gran Hotel Azuero was absolutely amazing!! Today we are headed back to Panama City, marking the conclusion of our global trip. On our 3-hour trip back to Panama City, we were able to admire the beautiful scenery of Panama once again. We said goodbye to our incredible driver, Francisco, who has gone out of his way to accommodate our travel needs throughout our stay. We will miss you, Francisco!

We arrived at the Holiday Inn in the city of knowledge, where the staff was once again was happy to greet us. After getting settled into our temporary accommodations, some of us napped while others went out to the plaza for some last-minute shopping and a coffee fix. We stumbled upon a Panamanian gem, the Duran Coffee Store (AKA the Starbucks of Panama).

We concluded the evening with a farewell dinner at La Taberna with the entire gang. The dinner gave us the opportunity to reflect on our experiences and prepare for the last day ahead of us. We all have been looking forward to our excursion to the indigenous village of the Embera.

Leslie Moore and Farah Alibrahim

Wednesday March 27th: We visited a rural, multi-grade school with about 10-15 students, some with special needs. We were invited to provide health education to the students and parents and discussed the importance of washing hands, nutrition, and portioning meals throughout the day. We also taught the students a handwashing song and sang together in Spanish!

As an interactive session, the students completed a small arts and crafts activity where they grouped foods in their appropriate categories on a ‘nutritional food plate’.

The children really enjoyed picking and choosing their favorite foods and placing them on their plates. They learned which category their foods belonged to and got to take their plates home with them to show their families. 

Dr. Hernandez spoke to the families about avoiding sugary juices in favor of water. The students listened to their corazón (heart) with our stethoscopes and we taught them how to count their pulse! 

Then, we all played soccer! The school mothers made fresh tortillas for use and brought us fresca! It was a great experience and such a pleasure to interact with these students.

We ended this experience with beautiful music, dancing and hugs! 

Nia Joseph and Noorine Plumber

Tuesday March 26th: Hola from Panama! Today we had the exciting opportunity to go to the El Montoso, a forest reserve in the Herrera providence about 90 minutes from Chitré. El Montoso reserve is protected under government law, and supplies fresh water to local communities within the area, through a river that splits into smaller streams.

Upon arriving in El Montoso, we were greeted by the director of the reserve, where he explained the importance of the reserve to the surrounding communities. He highlighted community concerns such as access to clean water, the loss of habitat and the forest fires that can occur. These fires devastate the communities, causing respiratory issues such as asthma from breathing in the smoke, alongside serious burns people might attain trying to fight these fires.

While El Montoso is a forest reserve, the director stressed the importance of the river within the reserve. Having access to clean water in the community helps to reduce instances of water-borne diseases such as typhoid and cholera. Our guide, Luis, was able to take us through El Montoso reserve so we could witness the river for ourselves. Climbing across bridges and hiking up the steep mountainous terrain was not easy, but everyone thoroughly enjoyed themselves.

Luis guided us to a beautiful waterfall, an integral part of the river that flows through the reserve. We were able to venture further then, hiking the reserve’s most difficult trail to the observation deck, where we were able to identify the origin of the river through the mountains surrounding the park.

Being able to go to El Montoso reserve and seeing how nature can impact the community is something we as a group will remember for years to come!

¡Hasta la proxima vez! 

Sydney Wren

Saturday and Sunday, March 23rd – 24th: Our busy week of clinical and exploring called for a relaxing weekend. Saturday included a trip to our friend and nurse educator Celibeth’s house. We were amazed at the process of making sugarcane honey, and we were even able to help. We put the sugar cane through a homemade cane mill that squeezed the juice out. Then watched as they cooked it down to make honey called Miel de caña. The whole process takes about 6 hours. It’s a lot harder than it looks but after trying it we had to get some for the road! Not only did Celibeth have a sugar cane mill, but her family also owns horses. We all took turns trying out our horse-riding skills while her sons and neighbors cheered us on! The heat wore everyone out so before leaving we gathered on the porch and ate watermelon taking in the beautiful view.

(pictures coming soon!)

Sunday was another day full of fun and nature. We went to an organic farm located in Herrera. Our first stop with our tour guide Margarita was learning how to milk a cow and how they nurture baby cows. Next, we fed calves their daily formula. It was hard to say goodbye to those cuties. We got our second opportunity to be cowboys by riding a couple of the farm’s horses. Next, Margarita took us on a walk around the farm, showing us all the wildlife. We tasted some exotic fruits right from the tree and even picked up some coconuts for lunch. Lunch was a group effort. Some of us made homemade tortillas and cheese, while others shredded coconut for dessert. Each dish was organically and traditionally prepared. We gathered around tables and ate the delicious meal with our tour guides and cooks. Bellies full and with happy hearts, we had to say goodbye to our new friends and head home to start the new week.

Monday March 25th: The start of a great day begins with a hearty breakfast and the chef loves to make us a wide spread of delicious food. Once we were all satisfied we loaded up onto the bus to go to the public hospital in Chitré. Being able to go into the hospital was a very unique experience. Unfortunately we were unable to take photographs inside the hospital so bear with us and use your imagination as we describe our journey through the hospital.

To begin we met with the head of Nurse Education who gave us a tour and a brief history lesson about the hospital. She informed us that this hospital is a 136 bed hospital with 103 employees. Nurses work 8 hour shifts, there are 8 units, and typically only 3 nurses working in one unit per shift.  This hospital was built in the 1950’s and was used as a labor and delivery, OB-GYN hospital until 2000, when they added 7 more specialties. Currently this is the busiest hospital for deliveries in this region of Panama.

We were fortunate enough to be able to tour their OB unit which included mothers who were high risk pregnancies, those who were post-partum, and those hospitalized due to gynecological reasons.  In a separate are of the hospital we got to see the two delivery rooms that they had, the room where the keep laboring mothers until they are ready to deliver, and where they bring the mothers to recover for a couple hours after delivery. As soon as we walked into the labor and delivery unit our ears were filled with the sounds of strong fetal heart tones… music to a nurses ear. Following that, the nurse took us to the neonatal room where it was divided into multiple sections: one where the pre-mature babies were in their incubators, another section for babies who were more stable, and then a room where mothers could pump milk. The other two units of the hospital that we got to tour were the emergency room and the general adult medical section.

After the visit at the hospital we went and visited one of the campuses for the University of Panama.

We got a tour from the director of the campus, and we will be going back there on Thursday to help put on a health fair.

To end this wonderful day we had the unique opportunity to go and watch two local baseball teams play. We loaded ourselves up into the hotel minivan and Luis drove us about a half hour away to the stadium. Admission to the game was only 4 dollars!

The best part was… our town won! It was the perfect way to end an amazing day.

Chao,

Courtney Whyte

Friday March 22nd: We started the day earlier than usual to travel to Ocúr to help with a preventive health census. When we got there, it wasn’t what we expected. There were hundreds of locals getting health checkups and waiting to see the doctor. We were able to check blood pressures, height, and weights, and educate patients. The nurses kept the locals engaged while educating them on some important health issues in Panama. Our students, with the help of Dr. Hernandez, were able to present our Service Learning Projects about nutrition and diabetic foot ulcers. The locals loved it!

After a long drive home, and getting energized by lunch, some of us decided to go exploring. Our first stop was Museo de Herrera where we learned about the rich history and culture of Chitré. We saw the tibia of a giant sloth and outfits of the indigenous people.

After learning about the San Juan Bautista Cathedral, we decided to try and find it ourselves. The Cathedral was beautiful, and after seeing a couple of neighborhood parks, we then stopped for 1$ ice creams.

While some of us were exploring others stayed back to set up for Noorine’s surprise birthday. Our stalling worked, and as Nia distracted her, we crowded in the room with Tres Leches and balloons to celebrate a beautiful birthday in Panama.

Jessica Brandt and Rachel Jaison

Wednesday March 20th: We had the privilege to accompany community outreach nurses in Chitré, Panama going “Casa a Casa” (house to house). The goal was to reach out to the indigenous population, who come to Chitré for work, in need of vaccinations.

The indigenous people invited us into their homes. We met two adorable little girls dressed in traditional Panamanian dresses. In Panama, vaccination is mandated for all residents by law; the family of eight was able to provide documentation of their vaccines. During that time, the children’s grandfather was visiting from their village, and we had the opportunity to provide him with the Tdap vaccination.

(All clinic pictures were taken with permission.)

To provide vaccinations to the community, we had a backpack with supplies including syringes, needles, band-aids, and hand sanitizers. Alongside the backpack, we had a cooler packed with a variety of vaccines. We were drawing up vaccinations and giving them right on the front porches of these family’s homes. It was an amazing opportunity for all the students to experience the level of community outreach these nurses provide on a weekly basis.

After completing Casa a Casa, we explored the Panamanian culture and visited the Artisans in Chitré. It is common for these artists to create and sell unique pottery or handmade hammocks from their homes. Many of us were so blown away by the creations by each artist that we ended up purchasing souvenirs to take home for memories.

Today was a community health experience that we will cherish for a lifetime!

Pattiya Laorngsudhi and Lori Alvarado

Tuesday March 19th: Hola from Chitré, Panama! Today was our first official day of clinicals in Panama. We met the president of the Chitré Campus of the University of Panama. He educated us on the healthcare system in Panama and told us all about the programs offered through the University. We then traveled to the Chitré Clinic and toured the facility.

(All clinic pictures were taken with permission.)

We met the nurses and local nursing students that would be helping us treat patients. The clinic provides care for all ages in the community including annual women exams, pediatric care, vaccinations and wound care.

On our voyage back to the hotel, we stopped for some delicious pipas (or as we call them in the States coconuts). A great treat on a hot Panama day!

Our next adventure included Exeter students from the UK. We completed a windshield survey based on the condition of the city. Through this survey, we were able to observe life in the city and evaluate the physical environment, economy, business status, threats to health, transportation and safety.

To finish off the evening, we went to try Tres Leches. It was an amazing day!

Until next time…

Nia Joseph and Noorine Plumber

Monday March 18th: This morning we boarded our bus to take the 3.5-hour journey from Panama City to Chitré, our home for the next ten or so days!  With a small bus being used for transport, we had to put some of our luggage on the roof to save space. 

The ride from the capital of Panama to the more rural city of Chitré had amazing views, allowing us to see a boat pass through the Panama Canal, where we toured yesterday!

At the halfway point of our trip, we made a stop at “Va & Ven” (translated to “Go & Come”) which is almost like the Panama version of Wawa!  After a bathroom break and some quick snacks, we were back on the road for the second half of the trip to Chitré.

When we arrived at our hotel, the “Gran Hotel Azuero,” we were surprised to see how unique and nice our hotel was.  There are no front doors of the hotel, making the lobby open-air which is something that many of us have never seen before!  The hotel has a beautiful pool, restaurant, and courtyard that had a Spanish/European feel. 

We all settled into our rooms, and later met as a group to discuss the details of the next two weeks.  Our night ended with meeting the medical students of the University of Exeter, our partners in learning until this Friday!  We then had a karaoke social and are all going to bed early in preparation for clinic trips tomorrow.

Roberto Velasco and Brendan Maye