Jail Time

August 18, 2011

It was time to face the facts. We were going to the slammer. There was no getting around it. We had been caught. Perhaps learning Spanish in high school instead of French would have been a better idea... =( Our hands were tied and there was no escape from the inevitable.

Alright, alright. I'll stop with the melodrama. But the slew of status updates on facebook were great fun without added explanations. =)

Alive, well and going to jail tomorrow! XD
We're going to JAIL!!! YAY!!!!!!!

So perhaps we were also a bit too excited for the update to be believable, but it was definitely a memorable experience.

A bit of background:
The previous night, we counted heads and broke into 4 groups. To be more precise, 3 pairs and one group of 3.

Group 1 - Naddi and Mike
Group 2 - Steve, Tram and Dr. Shupe
Group 3 - Daniela and Andrea
Group 4 - Jen and Dimitry

Groups 1/2 were to go to the mobile clinic in the morning while Groups 3/4 went to jail. In the afternoon, after lunch, the groups would switch.

After breakfast, we all split up and headed out in our respective taxis. Daniela, Andrea, Dimitry and I met up with Armando, our translator for the day, and went to the jail.

Jail (looks innocuous, doesn't it?)

Steve, Tram, Naddi, Mike and Dr. Shupe went to the mobile clinic.

When we arrived in front of the jail, it didn't seem like we were anywhere near a prison. In fact, it was merely a few blocks away from Pinocho. As it was our first day, we were unsure what was required of us. Standing in the street, we waited for the nurses to motion us into the building. The officers just changed shifts and things were a little chaotic as we waited to get permission to enter.

Once we got the ok, we walked to the wrought iron gate. We were also patted down before we were allowed to continue further into the courtyard. Armando had to relinquish his cell phone into the possession of the guard on duty.

A few tables had been set up with benches along the wall to receive the inmates. After delegating tasks, we took our spots and waited for the inmates to be let out of the cells.

Daniela, as our resident Spanish speaker, took charge of filling out the medical forms with the vital signs Andrea, Dimitry and I took. Name and weight was recorded for each individual while blood pressure was only measured if they had a history of high/low BP or were new inmates. The same principle applied to taking temperatures. Unless they reported feeling feverish or were new, temperatures were assumed to be normal. A fever was considered to be an increase from normal temperature of about 37 degrees Celsius to 38 degrees or higher.

Temperatures were taken using mercury thermometers which had to be shaken down after each reading. We used the axillary route as opposed to oral and used alcohol wipes to wipe down the thermometer in between each patient.

The basic procedure
- the patients signed in on a sheet and told their names to the nurses who found their medical record in a large binder
- Daniela received the records and asked if they felt feverish
- Andrea and I took turns practicing our numbers in Spanish and weighing the patients
* basic vocab to follow this post
- Dimitry, Andrea, and I took turns taking blood pressures and temperatures

Dimitry taking BP

- All the numbers for temperature, BP, weight were reported to Daniela who returned the completed form to the nurse- patients continued on to speak with the doctors at another table
It was in this way that we passed our entire morning. We got to see a lot of interesting things and apply the knowledge we've learned so far in basic sciences.

A little later in the morning when there was a slight lull, another individual was brought into one of the cells. While we only caught a brief glance, Andrea and I instantly began thinking of questions for Armando when we saw the enlarged mass in the man's left cheek. We wondered if it was hard or soft, and the possible causes. Turning to Armando as a pair, we asked what the warden had said about the man when he was brought in. Apparently, he had to see the dentist because his tooth was hurting. Instantly, our mind turned to Actinomyces israelli. However, we were unable to get a closer look since he was in a cell that we were not taking vital signs for that morning.

Another one of our patients had a chalazion that was pretty large. While it was hard not to stare, the second half of block 1 of med micro was a little difficult to ignore. It was most likely another bacterial infection like the inmate with A. israelli. Given the lack of sanitary conditions in the jail, it could be either P. acnes or S. aureus with equal possibility.

In the meantime...

At the mobile clinic, Groups 1/2 were being worked equally hard.

When we think of a mobile clinic in the US, most individuals probably think of the giant vans which the blood banks use when drawing blood for donations. However, the mobile clinic we worked at that day was nothing like the white vans filled with equipment so commonly found during deficits of blood and during large emergencies.

It was truly mobile.

Putting white sheets over open window frames for more privacy

An abandoned building which the nurses and doctors took possession of for a day to provide health care to those who lived too far to make it to the clinics on a regular basis. The windows were devoid of glass, merely the wooden frame where windows would have sat. The doors... yet again, only the door frame.

A screen set up in the smallest room for more privacy during exams

At the mobile clinic, we serviced mostly the elderly and young children. As with the jail, we took vitals and filled out forms consisting of: neighborhood, name, age, birth date, blood pressure, temperate and weight. The forms were then passed to a nurse who placed them in order of their arrival. After vitals were taken, the patients waited to see the doctor who was set up in the smallest room with sheets and a screen to provide more privacy especially during physical exams.

Tram taking the blood pressure of a patient

Steve and Naddi working together with a patient

Dr. Shupe holding a young patient

Both groups spent approximately 4 hours each at the mobile clinic and in jail. After a full day of seeing patients, interacting with another culture and learning numbers and simple medical questions in a foreign language, we were exhausted. In some ways, it was harder than studying and in others, it was easier. But despite still recovering from finals and the plane, we were oddly energized. Our first day opened our eyes, made us laugh and showed us the reason why we had decided to go on a medical mission.