Saturday, April 6, 2013

Pupusas and Harry Potter in Cuba

The river valley of La Estancia
After the marathon of clinical rotations of third year and the endless lineup of tests, applications, and interviews that dominated the first half of fourth year, the freedom of these last few months has been incredible. No tests, no grades, no pressure, just time to do anything we can convince the school to give us elective credit for. For me, this was my chance to go back to Latin America and recharge the other half of my soul. I spent the month of February in El Salvador, living and working in a rural community called Estancia in Morazán province (in the Eastern half of El Salvador, near the border with Honduras). I went through an organization called Doctors for Global Health, who partners with a local community organization called Campesinos para el Desarollo Humano (Farmers for Human Development).

Dr. Juan Carlos Martinez and I
The doctor I was working with in the clinic is named Juan Carlos. He grew up in Estancia, and as he tells the story, one of his high school teachers said to him "you are smart, you should apply to this scholarship to study medicine in Cuba." He applied, got the scholarship, and went off to Cuba at 17 to the same school where I studied, the Latin American School of Medicine (ELAM). He graduated three years ago and has been working as the doctor in his community ever since. It is such an amazing, classic story of ELAM, and after spending so much time with students just like Juan Carlos from communities across Latin America, it was incredibly moving to work alongside him and imagine the future that my friends will have and what amazing work they will be doing for their home countries and communities.

Meggie with our drawings of vaginal infections
During my month in Estancia, I worked in the clinic with Juan Carlos and a couple other medical students, taking care of anyone who came in the door for any reason - parents worried about a one month old baby with diarrhea, children with cuts and scrapes and rashes, adults with joint pains, asthma, or high blood pressure, and eighty year old great grandmas who had walked two hours in 100 degree heat to get some Tylenol for their back pain. The clinic is well stocked with the most common medications, so we could give most patients everything they needed right on the spot. If not, we wrote them prescriptions to an outside pharmacy and if needed, filled the prescription for them and had them come back to pick it up. We also did a lot of house visits, when someone had fallen or was too sick to navigate the mountainous terrain in the hot sun, we would pack a little bag and hike off to their house and do a clinic visit right there. And finally, I also did quite a bit of health promotions, working with another medical student and the local health promoters to give outreach sessions about women's health and cervical cancer. 

As you can imagine, I absolutely loved the work, and really got a sense of what it would be like to be a rural community doctor. You can bet I'll be coming back!  

Sunrise from the top of Pelon, a mountain near la Estancia

On the top of Pelon

After my too short month in Estancia, I bused back to San Salvador and flew to Havana. I hadn't been back to Cuba since 2nd year of med school, and now all my friends were 4th years and in their clinical years at hospitals across the country. I hung out for a week with the US folks that I started the program with four years ago, and had such an amazing time. I cannot even express how warm a welcome I receive each time I go, how we fall back into such comfortable friendships it is like I never left. We did a lot of cooking -- homemade pizzas, hummus made by smashing garbanzo beans by hand with a cup, curries and Iranian stew. Each day was a glorious combination of familiar and new experiences. Some things never change, like when I went to buy vegetables at cuatro caminos and one of the vendors, a friend from four years, recognized me and walked across the market to give me a hug and some ginger tea. Other things were new - more formal signs and official food vendors, novel fashion (the union jack is the latest fashion and is blazened across shoes, pants, t-shirts man-purses, any clothing surface you could imagine) and new musical hits.
My amazing ELAM friends!

Sunrise over Cayo Coco
I also got to travel more in Cuba than I ever had before. I took a 7 hour bus ride from Havana to Ciego de Avila, which is around the middle of the island and spent a couple of nights with my friends from Mexico who are studying there. Ciego is a great little town with very few cars, almost everyone has a bicycle and uses it as exclusive transportation, although there are some horse drawn carriages around for hire when you find yourself without a bike. Especially at night, the bicycles totally rule the road and riding and it was so idyllic to ride around the town plaza, park, and pond, right in the middle of the road with only other bicycles to avoid! The next morning after I got there, we got up at 3:30 in the morning to catch a ride out to Cayo Coco, a couple hours away, and got there just as the sun was rising over the ocean! There were some significant mosquitos so we submerged ourselves in the still-cool water, but gradual the sun came out and began to warm the fine white sand and light up the crystal clear aquamarine water. It was heavenly! These are the sorts of places that tourists come to Cuba for, although they probably don't pack spaghetti and mayonnaise for lunch like we did to avoid buying expensive food in the restaurants and hotels along the beach.
With my friends Maritza and Rocio on Cayo Coco

A pupusa topped with curtido and salsa
After Ciego, I went back to the other side of the country: Pinar del Rio, where two of my best friends from El Salvador are now in their 4th year. I had actually been able to visit each of their families for a night while I was in El Salvador, taking tons of pictures and collecting letters and gifts from their family members. It was a real treat to be able to bring these treasures to my friends, as well as spend a wonderful weekend in Pinar. The highlight was definitely making Pupusas -- a typical Salvadoran food that is essentially a stuffed corn tortilla. I brought Maseca (dried corn flour) from El Salvador, since it is impossible to find in Cuba, and we had a blast making bean and cheese pupusas along with the smooth tomato salsa, and 'curtido' (shredded cabbage and carrot with vinegar and oregano) to top them. They came out incredibly well, just like in El Salvador.

While we were cooking, in one of those moments of global interconnectedness, the Harry Potter and the Prisoner of Azkaban came on Cuban TV, shown like all the Sunday movies in Cuba straight through with no commercials. We half watched it as we cooked, everyone intrigued by the British English and whether I could actually understand it. I was left marveling at how different a place and time and moment I was in compared to the first time I saw that movie at home in Wisconsin during high school. And yet it is all part of the same world, and the worlds within it are connected in the most mundane and profound ways. 

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