IPSL Service: Day 1

Yesterday was my first day at my IPSL placement. I was a little nervous because of the language barrier, but today was a great day and I learned a lot. I started by going over to the hospital after class. Every Thursday, they have a meeting and they decide who is going on rounds where. The same doctor does not go on house rounds each day, they all take turns going to the different barrios. After the meeting, I had the option to come back at 2:45 for this special program that they run for the elderly, or to come back at 4 when we started our rounds. I decided to come back for the “programa del buen vivre del adulto mayor”, and I am so glad I did! It is a program that two of the doctors run each Thursday. It is a community program that encourages the elderly to keep informed about their health, to exercise, and to keep them engaged in the community. First, one of the doctors, Victoria talked for about a half hour. I didn’t really understand what exactly what was she was saying, but the people in the program had the chance to ask questions and actively participate. After that, we all got up and they put some music on so we could all dance. It was very reminiscent of the time I went to the Parkinson’s Disease Community Group with my Freshman Seminar class.

Then, at 4 pm, I went next door to the hospital so I could start my rounds. I was with a doctor and a nurse, Catalina and Jenny. We went to the barrio Manzanillo, which is one of the poorest neighborhoods in the Galápagos. We had the sheets that I had learned how to fill out yesterday. We went to all of the “at risk” and new houses that had been marked down before we left. We went from house to house (which was not easy because there was no real road) knocking on doors and checking on people. Many of the people were not there, so we need to go back today. I met several people who did not want to come to the hospital, for some reason, so we took their blood pressure there, and tried to make a compelling argument to convince them to come. It was a little difficult for me to understand what was going on, but I started to get more and more of the new Spanish vocabulary after a few hours. Some people clearly did not want to talk to us. Some people were more than happy to answer our questions. The doctor I was with was on her family medicine rotation. It was interesting to me to see what Family Medicine is like here, because back in January, I was talking to my cousin who practices Family Medicine. She was saying how sometimes she feels like her profession is turning into a glorified social work position. I definitely could see that after today. I felt like what we were doing was more of a social work type thing, but I still enjoyed it a lot!

We were finally done at 7 pm, and it was about a half hour walk back to the hospital. On our way back, I was telling Jenny (in broken Spanish) that I would like to learn some medical skills. When we got back, she said she was going to teach me how to take someone’s blood pressure! She explained it in Spanish, which was pretty confusing, but I think I understood the basics. I am also learning a lot of medical Spanish terms, which I think will be really useful in the future. When I get back, I can teach my Dad them because he always says he wishes he spoke Spanish because there is such a high Hispanic population in the Brooklyn/Queens area.

It was also really interesting to see the differences between a developing and a developed world from a health-based perspective. I have taken Dr. Matcha’s “Health Care in a Developed World” class, which is basically a public health class from a sociology-based perspective. I really enjoyed it (barring the 18 page paper), and I learned a lot about different health care systems. It is fascinating to see the contrast in health care here, because the Galápagos are still developing. However, it is still interesting to see how surgeries and hospital visits are free. I am not sure yet how they are subsidized because I cannot find anything online about public health in the Galápagos. After I finish my research paper, I am going to look into Ecuador and see how they lump the Galápagos into there.

 I am excited to go back to my placement today!

Language barriers

I knew that when I was abroad I would experience both triumphs and trials. Today was the first day that I felt really overwhelmed here. Today was the day that I started my IPSL service. I went over to the hospital to meet the doctor that I was going to be interning with. I met a bunch of people and they explained how home visits were set up. It was actually quite fascinating to see how they organized everything and how they knew everyone because the island is so small. They also tried to teach me how the house identification sheet worked. It is this giant sheet that has all these little boxes where I am supposed to record things, such as the living conditions, number of people in the house, etc. I think I got most of it, but it was really hard to understand because I am not that great at Spanish yet. It also didn’t help that there were a bunch of people all talking at once over each other. Sometimes I feel like if I don’t understand something, people will just repeat it louder. I really wish I had taken Spanish in high school now. The language barrier was pretty frustrating, but I am excited to start my rounds with the doctor and I know that the only place I can go from here is up. My Spanish class starts on March 3^rd and I have never been so excited in my life for a class.

They say a picture is worth 1000 words, so how about a video?

I think I'm hysterical

Super duper glad I'm not in Albany

Pictures from Miss Internationale Carnaval

An excerpt from Paul Farmer's structural violence reading

The idea of "race," which most anthropologists and demographers consider to be a biologically insignificant term, has enormous social currency. Racial classifications have been used to deprive many groups of basic rights and therefore have an important place in considerations of human inequality and suffering. The history of Rwanda and Burundi shows that once-minor ethnic categories—Hutu and Tutsi share language and culture and kinship systems—were lent weight and social meaning by colonial administrators who divided and conquered, deepening social inequalities and then fueling nascent ethnic rivalry.  

I have never thought about the concepts of race and ethnicity like I have here. 

island temptations & structural violence

$1 giant fresh empanadas that they constantly make across the street from my school are my downfall. Choosing between a somewhat flat stomach or a handful of dough, cheese, and chicken is my day to day dilemma.


Then, I read articles such Paul Farmer's Structural Violence, and feel guilty. It's really sad that things such as a "human suffering index" exist.


(although I think choosing not to eat a freshly made empanada would rank pretty high on the index)

On a more serious note, suffering, poverty, and violence exist. However, I never looked at these things as being able to be ranked. Who am I to determine who’s suffering is worse than another person’s suffering? How can we discern the nature of structural violence and explore its contribution to society is what Paul Farmer aimed to answer in his writing, and if we would be able to devise an analytic model, one with explanatory and predictive power for understanding suffering in a global context. It is a very daunting task. Although I may be naïve, I think it is feasible and something that we as a society must work together to do if we want to protect human rights.

marine life and more

The past few days have been very busy. I took my midterm, which was pretty difficult for me because I have never taken a marine biology class before, gave a research presentation on Marine Iguanas (so cool!), and I am currently in the middle of a group research project which involved looking at species diversity in fish with respect to how populated by humans different beaches are. It was pretty interesting, but I am kind of sick of snorkeling. I also might be able to pass myself off as an Ecuadorian in a few weeks. I am so tan! I also have officially gotten my service placement with IPSL, and I will be going around on home visits to patients who cannot make it to the hospital with a doctor! I am really excited about it, and I hope I get a lot of hands on experience!

The festivities of Carnaval have finally ended, and I am glad. I have definitely become more conservation-aware since being here, and drunk people and sea lions do not mix. I become so angry when I watch intoxicated people throw rocks at sea lions. One person even rode by one that was sleeping on a bench and sprayed shaving cream in it's face. The festivities are fun, but I am glad that the animals will be able to go back to their natural state without having to deal with DJs and loud music on the beach until 6 am. They have become really agitated with humans lately. One of the other research groups in my class is actually doing a census on how many sea lions were present before and after Carnaval, and how they change their interactions socially with humans. I definitely see a change. Before Carnaval, the sea lions were pretty friendly. Some like to play with you in the water, but most just keep their distance if you keep yours. Now, it's totally different. When I walked out of the water today on the the beach that most people go to, I was chased down by a mama sea lion. The water is really rocky, and since it was low tide, you had to climb over all of these super slippery rocks in about 6 inches of water. It wasn't easy because it was so slippery. I was a solid 10 to 15 feet away from the sea lion, minding my own business, and all of the sudden she came charging at me! When I was in a safer area, I looked back and saw that she had 5 little cubs that were feeding by the shore. Mom's gotta do what mom's gotta do, right? Anyway, on a sillier note, my host dad took this picture of me after the pageant and put it on Facebook, so I thought I'd share it with everyone. Everyone wanted to smear the runner up with paint! (Miss. San Cristobal was too good to be touched). That night, I also held my own in an Ecuadorian card game called Quarenta. It's really fun because it involves a lot of strategy. My host uncle asked me if I was a card shark back home! I just like games that involve strategy.

Hot mess express

More Scuba Pics!

Some Galapagos Pics!

Post scuba diving at Kicker Rock! 

Always repping!

I am going to have quite the collection of flag pictures when I come home

Me and my friend, Torrie!

The giant school of fish is behind me

Our favorite ice cream on the island is from the scuba shop. It's only 60 cents and homemade!

My friend Sam got an awful sunburn. 

Gopro selfies from my Marine Life class

Life's hard on an island in the sun.

IPSL Reflection #1

Kate Ackert

Reflection Journal

February 16^th, 2015

                  To hell with good intentions, right? I absolutely loved this reading. As we discussed Hitler, Mussolini, and more, my 10^th grade European History teacher always said, “the road to hell is paved with good intentions”. My 16-year-old brain didn’t quite comprehend this as well as I can now. In terms of service for me, good intentions are defined as wanting to help others altruistically. I don’t believe this is always the case.

                  In the reading, Illich says, “all you will do in a Mexican village is create disorder. At best, you can try to convince Mexican girls that they should marry a young man who is self-made, rich, a consumer, and as disrespectful of tradition as one of you. At worst, in your "community development" spirit you might create just enough problems to get someone shot after your vacation ends and you rush back to your middleclass neighborhoods where your friends make jokes about "spits" and "wetbacks." You start on your task without any training. Even the Peace Corps spends around $10,000 on each corps member to help him adapt to his new environment and to guard him against culture shock. How odd that nobody ever thought about spending money to educate poor Mexicans in order to prevent them from the culture shock of meeting you?” This is one thing that I really want to focus on. I want to be here and learn how to serve while respecting the culture of the Galapagos, without making this out to be a “voluntourism” trip. You know, one where you come home with a sunburn, lots of pictures for facebook, and another item to add to your resume. This leads me back to my constant internal conflict about service. Is service done for the wrong reasons still worth it? To the students, to the community, to the 'common good'? We are humans and have expectations for our service experience, we want to use our talents and skills, but the community may be expecting to complete a different but necessary task they have prioritized with no regard for your resumes achievements or personal/professional goals for the semester. This is something that is very close to me right now as I am now starting the application process for medical school. When I first spoke with Amy, the IPSL coordinator, she mentioned that she was looking into me working at Casa de Cultura, which would be a summer camp (summer here is now) that focused on the arts, photography, etc. This would have been a lot of fun, and I think I would have been very useful because I am good with children, but I had this internal conflict that made me talk to Amy about seeing if I could work in the hospital or with a doctor. I didn’t know exactly how I should feel about doing that. On one hand, I have all of this science knowledge that I have been cultivating and a need gain health professions experience. On the other hand, I want to do what they need me to do here. By asking if I can work in the hospital, am I pretentiously imposing myself on these people? As Illich said, I am here to recognize my inability, my powerlessness and my incapacity to do the "good" which I intend to do here. I have only been on the Galápagos Islands for one week, but I have already recognized how tiny my place in the world is. However, I think this is a good starting point for me.

                  My expectations almost always are proven wrong, but I’ll say what I am expecting anyway. I think (hope) that I will be interning with the doctor as he or she visits patients in their houses that are too sick to go to the hospital. I am not completely sure what my role in this will be. Hopefully, it will be as hands-on as possible. In the United States, when I have shadowed physicians, it usually entails me standing in a corner observing silently. It has been really interesting to watch and definitely a learning experience, but I think I am ready for some more hands-on experience. Of course I would do whatever the doctor needs me to do, such as helping move patients, writing down vitals/statistics, but I hope I also get to practice things such as taking pulses, blood pressure, etc.

                  Many people try to leave something permanent on the Galapagos. Some try to do this by leaving things here, such as graffiti. This is neither permanent nor something that is helpful to the community here. I want to leave my permanent mark by making an impact on the lives of people and patients that I have helped. Even if they don’t remember my name or face, the fact that I helped someone feel more comfortable is the impact that I would like to leave here. That is the legacy I would like to leave on the island.