On our way home!

David Drozek, D.O.

Friday, August 19

I awoke at 3:30 this morning, my mind whirling with the things needing to be done to finish off the trip.

We had a lighter than anticipated brigade today, about 120 patients for clinic and 55 for glasses, and were done by mid afternoon, which gave us plenty of time to inventory and pack things away for next year.

The village was in a hilly rural agriculture area. We set up in their local school, which gave us lots of space and a more relaxed atmosphere without people crowding. The patient flow was very good, contributing to the more organized feel. Of course, this was also our tenth brigade, and the team functioned as a well oiled machine! I had little to do but walk around and take pictures, the residents supervising the students.

I was concerned about the flies, evoking memories of our illness of past weekend, which I am confident was tied to the flies attacking our food after sitting in the cow manure. There were no animals around, other than a few dogs. No cowpies were visible in the school yard.

Before lunch I walked around offering pepto bismol to the team. Most were happy to partake, also remembering the weekend. Lunch was wonderful; rice, vegetables and tortillas, tightly wrapped in cellophane. We all cautiously ate quick bites scooping food out from under the plastic wrap, recovering it as quickly as possible.

This evening we had a wonderful final meal with our Salvadoran hosts; more of their traditional pupusas. Daniel, the CEDEINFA director then showed a power point with music background of selected pictures from our cameras giving a great summary of our trip. We each were then presented with a copy of the DVD, and look forward to sharing it with our loved ones back home.

Even though I am beat, the young people, full of energy, are enjoying their last evening together in great spirits, celebrating all that we have shared together, the good, and the not so good, but a wonderful time that has changed us all!

Thank you for sharing them with us!

We will see many of you tomorrow.

David Drozek, D.O.

Thursday, August 18

Today we had a small brigade in a very poor community. Lunch was a wonderful peruvian rice and vegetables.

We then sorted medical supplies and had some free time.

Tonight was our celebration dinner with the CEDEINFA staff where we heard the history of the organization and viewed several power point presentations. Speeches of appreciation were given by many and we were presented with certificates.

Tomorrow is an all day brigade; our last and maybe largest!

Time for bed.

David Drozek, D.O.

Wednesday, August 17

As a workaholic and introvert, a day at the beach with a group of people is not something that usually appeals to me. Having lived on the Caribbean coast of Honduras for 7 years, I much prefer the cool dry mountain air to the hot humid salt breeze of the coast. But today was an exception. I am grateful to have shared this day with some wonderful young people who give me great hope for the future. (I did however find an hour or two to do some work on the computer!)

It was my daughter’s 21st birthday, which added to the specialness of the day, as she and my oldest son are part of our team as translators. The day started with my daughter finding the door of her room and a special chair decorated with balloons in her honor. The party continued all day!

We arrived on the beach at about 10:30, quickly dispersing, some to the hammock, others to the beach, a few reading or contemplating. The beach house on loan to us for the day was a perfect spot to relax and enjoy a much deserved day off.

Early afternoon we were served a lunch of rice with a tomato sauce of diced vegetables, grilled steak and sausage, followed by birthday cake and the traditional birthday song. Then back to swimming in the surf, volleyball in the pool, reading, napping, sunbathing or strolling.

At 4:00 we gathered for a traditional Salvadoran birthday party! Many had the opportunity to slowly dismember a piñata, followed by games that are common for Salvadoran school children. It was great fun!

Back to the beach for some sunset photos, change clothes, and mount the bus. Currently we are stopped in a traffic jam. There is quiet talking and laughter, as many look ready to fall asleep, others reviewing pictures on their cameras or phones.

During the two weeks we have been asking questions at our debriefing time in the evening, such as : “What surprised you? What frustrated or challenged you? What are you grateful or thankful for?” We will be closing by asking “How have you been changed?” Today, as the sunset and the tide came in, one team member wrote “El Salvador” in the sand. Within two waves, it was gone. I was impressed with the idea that by next week, El Salvador will be gone from our present reality, but it will continue to exist in our memories, and the effects of our experience will persist, changing each of us forever in some way or other.

The students have been asked to journal their experiences, and to write six word memoirs to share with the group at the end of the trip. An appropriate one for today would be: “Sunscreen: I forgot to reapply! Ouch!” I look forward to hearing from each team member. As they discussed what they would write, many said Pepto Bismol and Cipro (an antibiotic for traveler’s diarrhea) would be prominent.

The bus is moving again, so I need to stop. More to come!

David Drozek, D.O.

Tuesday, August 16, 2011

This morning we slept in a bit. At 9:00 about half the team went souvenir shopping. The rest lounged about reading or doing things on their electronic devices.

Daniel, the director of CEDEINFA came by at 11:00 to get our orders. I missed the first part of the conversation, but heard him describe the menu choices: lasagna combinations with meat, chicken, spinach and mushroom choices, as well as pasta with various combinations and choice of marinara or alfredo sauce. We placed our orders. The bus came at 11:30 and drove us around the corner to the mall where some CEDEINFA folks met us and led us to Pizza Hut, the Italian restaurant! With the AC, American pop music and the sports channel on the big screen, it was easy to imagine being back in the states.

The afternoon brigade got going a bit late due to being delayed in Pizza Hut with a mix up in orders and slow service despite placing our orders in advance. We set up in a little suburban church nestled between middle class homes of concrete behind walls or fences covered with barbed or razor wire. The church was small and the sanctuary packed with people. The church members had set up dividers by hanging sheets from clothesline strung around the periphery of the sanctuary. They meant well, but the dividers really hindered our visibility and patient flow. Because all the pews were full in the church we had nowhere to set patients after processing for vital signs. As soon as I cleared a bench for people to wait who had already been checked in more people rushed in to sit down. There wasn’t even standing room!

We finally were able to back some people out of the door, who were very worried they were going to miss their place in line, and establish some flow. It was a chaotic crisscross through the sanctuary; from the middle of the church to the front entrance to have vital signs; back to the middle to see the doctor; to the rear for lab, to the front for the pharmacy, again to the back for counseling, upstairs for the glasses. After getting through the first 25-30 patients we had room to breathe and the waiting people seeing how the flow was going settled down and followed instructions.

We saw about 100 patients for clinic. I don’t have the glasses numbers.

As our second year medical students have now all seen many patients in the clinic when working with one of the fourth year students or doctors, we have begun pairing them together to work as a team, two students and a translator, seeing patients more independently. They then present the patients to one of the three team physicians for approval of their diagnosis and plan. For me, it is extremely gratifying to watch these students mature at lightning speed due to the volume and repetition. I have see them progress from wide eyed bewilderment to confident patient care over the last several days.

We rode home in a very welcome gentle rain bringing relief and freshness after a hot day, to enjoy a wonderful Mexican meal of tortilla soup and tacos. Laughter and singing fills the house tonight as friendships have been forged through uncomfortable climate, illness, close quarters, some uncomfortable situations, and a common purpose. It almost sounds like karaoke as someone begins a song to be joined by many others in a poorly harmonized chorus that ends in laughs and shouts, to be restarted by another singer.

Today I have been reminded why this is the fifth year I have done this, and look forward to many more.

Tomorrow we head to the Pacific coast for a day of relaxation. One of the team members, (who happens to be my daughter) has her 21st birthday tomorrow, which gives us a great excuse for cake and a piñata at the beach!

That’s it for today.

David Drozek, D.O.

Monday, August 15, 2011

Sunday, August 14, 2011

The last 24 hours have been interesting! Several of our team members have experienced "Montezuma's Revenge". Eight of our team of 23 stayed home today to recuperate, but by this evening, everyone was feeling much better and looking forward to tomorrow.

This morning was scheduled as free time. Many slept in. Several went to church. This afternoon was a brigade for Soyapango, a portion of San Salvador that contains a million people. An urban church near the center of town hosted the brigade which was a great cooperative effort. Four Salvadoran physicians and a host of volunteers participated. Today the big interest was eyeglasses.

This evening several are heading to the mall to get gelato. Some are playing soccer in the street with the neighborhood kids. And a few are sitting, drinking Gatorade.

Tomorrow brings another morning brigade and afternoon sightseeing to "Puerto del Diablo", "Devil's Door" which is an interesting mountain peak. It looks like something from Lord of the Rings, and has a spectacular view over the city.

Sorry I don't have any pictures for today. I stayed back with the ill folks, which turned out to be a relaxing day of reading and catching up on emails.

More to come!

David Drozek, D.O.

Saturday, August 13, 2011

On the way to the village today for the brigade road construction prevented the bus from progressing so we were shuttled up the mountain in a cattle truck.

David Drozek, D.O.

Saturday, August 13, 2011

The Thursday and Friday brigades went very well. We provided care in the clinic to more than 300 people and more than 100 received glasses.

The first clinic was in a private home and was very cramped. We did vital signs in the road in front of the house which was blocked and had a series of canopies set up. Glasses were on the back porch. The OMM table was in the backyard.

Thursday night we stayed in a country club resort hotel. We arrived in a thunder storm which knocked out the power. "How ironic!" stated one of the students as we sat in the dark in a covered area in the dark, listening to the rain poor onto the roof. We had rooms with air conditioning, television, and refrigerators, and were surrounded by 7 swimming pools that were equipped with lighting for after dark use, and we could enjoy none of it. Our evening meal started out in candle light, but the power did come on before we finished. Some were able to swim. It took a couple of hours for the AC to cool the rooms down into a comfortable sleeping temperature. We did enjoy the good food and had a short time in the morning to walk around the grounds before we left.

Friday we went up, up, up the mountains on a very windy road, into the clouds above to have a brigade in a nice, neat little town near the Honduran border. In contrast to the day before, we set up in a large church building with more than enough space.

Other than some motion sickness from the ride, we are all well!

Today we set up in a school, which usually affords a nice setting for brigades with a line of rooms, usually some shade trees, and reasonable facilities.

More later! It's about time to go.

David Drozek, D.O.

Wednesday, August 10, 2011

It is a beautiful morning in Salvador: low 70’s, a shower cooled things off last night. We get to sleep in a bit this morning. A few folks went running, but most are still in bed.

Today we leave at 9:00 to visit some archeological ruins, have lunch at a restaurant, and then go to a lake for swimming and site seeing.

Yesterday, our first all day clinic went very well. We were set up in a poor little village church building that was in much needed repair. The clinic stations were in the sanctuary where sun light peaked through the multiple holes in the roof. Even so it was pretty dark inside. The wiring in the church was in disrepair, so extension cords were run from neighboring homes and light bulbs hung from the rafters. The lab and eyeglass clinic was set up on the covered back porch providing some shade, but to get the needed 20 feet for the eye chart, patients were able to sit or stand in the shade, but needed to look across a frequently traveled road to see the eye chart on the wall of a neighboring building. The pharmacy was set up in the church’s kitchen, which was crudely built adjacent to the church with a very low ceiling and lots of insect inhabitants.

On arrival we were greeted with the bellowing of cattle heading to pasture and had to dodge the cow pies as we walked up the road to the church. Flies were everywhere! Some ladies set up a concession stand to sell food to the patients that were waiting under a temporary canopy set up to keep the patients out of the sun. One gave out the food while the other kept shooing flies.

I was concerned about what lunch would be, since often times the villages provide the food, prepared under CEDEINFA’s supervision to ensure it is safe. This village evidently didn’t pass muster, as CEDEINFA brought in pizza from Pizza Hut and hamburgers from a fat food chain restaurant for our lunch, and carefully kept everything covered until we were ready to eat. They also passed out granola bars mid morning and mid afternoon for snacks along with safe drinking water and other beverages.

After lunch, the pastor, who had earlier dressed up in a clown suit and had been entertaining the kids who waiting at the clinic, was back in his black shirt and tie, and proudly led us up the cow path to their villages pride and joy, a sugar cane candy shed! They claim to be the top producer of the best sugar cane candy in El Salvador. They walked us through the process of crushing the cane and collecting the juice, showing us their stoves, huge boiling pots and molds. The pastor told us some stories that left us wondering, such as about one guy who was drunk and fell into a boiling pot. All they could recover was his bones. We wondered what happened to that batch of candy? The other story is that the guys who tend the fire don’t shower for the 8 days they are working, since they think a cold shower would be unhealthy while doing such hot work. Maybe it wasn’t just the cow manure we were smelling!

During part of the tour, several of us were rudely disturbed by a swarm of fire ants that were occupying the ground on which we stood. They made their presence known by encouraging us to dance around swatting our legs and brushing of the little insects with a potent sting.

At the end of the tour, a block of candy was unwrapped from its corn husk container and offered to us to enjoy! I saw the team’s reluctance, so I reminded them that nothing infectious can survive to harm them in sugar, and took a piece to try myself. It tasted like maple sugar candy with a slight smoky flavor.

Thursday we begin the most grueling part of our time here, three all day clinics back to back. Yesterday we packed clinic supplies for the first two days.

Planning on about 400-500 patients for medical care and about 200 for glasses. We will spend Thursday night in a hotel, returning San Salvador Friday evening, replenish supplies, and head out again Saturday morning for another long day. After that we have several half day brigades and a day at the beach on the Pacific coast, finishing with one more all day brigade the day before we leave.

So that’s the news from El Salvador!

David Drozek, D.O.

Tuesday, August 9, 2011

Just finished a long day; 182 clinic patients and 76 for glasses.  It was a very humble community with very rustic conditions, unlike yesterday.

Davis Drozek, D.O.

Monday, August 8, 2011

It is hot and humid. It took awhile t get through customs, but we have everything medical. One bag of school supplies was lost, but should arrive tomorrow.

Everyone is in high spirits! I thought they were tired, but as the sun sets they look energized. We are sorting supplies and medicine for our first clinic tomorrow morning. It will be a smaller one to help us get our feet wet.

In the afternoon we will visit the center of town to see some historical sites and the market.

I think we will all sleep well! There is a two hour difference in time, see even when it is 9:00, our bodies will still say 11:00, at least for a day or so!

More tomorrow, and hopefully some pictures!

David Drozek, D.O.

Monday, August 8, 2011

Sunday, August 7, 2011

We have safely arrived in El Salvador! More details to come.

David Drozek, D.O.