I hope I have time to walk around with a camera because it’s so frustrating to write this all down but not really having the words to capture what I’m seeing. But that seems to be the resonating theme for me here: It is something that you can learn SO much about a place before arriving and that knowledge has nothing on the actual experience of it. No matter how prepared I was, no matter how much research I did, no matter how good of a traveler I might be, nothing could accurately describe the experience here, and I’m assuming that tomorrow’s day at work will be no different.

As for tomorrow, I’ll be on the labor and delivery floor unless things change (which is also common here…you have to go with the flow or you’re bound to be frustrated). I naively thought it was an error in my information packet that 27,000 babies are born here each year. It was not a typo: I’m told 80-100 deliveries per day.

Click here if you’d like to read more about the hospital.

My plane landed in Entebbe and I can’t think of any airport arrival more breathtaking. We walked down the stairs onto the tarmac in the middle of the green hills dotted with terra cotta roofs. After immigrations and customs, I found James, the driver sent to pick up students, and we headed to Kampala. On a two lane road, you have three or four modes of transportation in one lane each way and congestion is an understatement – cars and trucks, bota botas (motorcycle drivers that rent the extra one or two seats), bicyclists and pedestrians all in one lane and the shoulder. The colors and smells overwhelmed me. Tiny eight-foot by eight-foot rooms with a roof line both sides of the road and house the businesses of tailors, sandals being fashioned from old tires, airtime card sales, chipati bread  (tasty local take-away sandwich), Rolexes, auto oil sales – you name it. If you can sell it, there is a small building for it. There are also lots of brick buildings being built that are two or three stories and, if you look into the city centers, taller 20-30 story shiny buildings live among the banks and ground level vendors.

The road from Entebbe blends into the road to Kampala – it was hard to tell where Entebbe ended and Kampala began. After dropping off my suitcase at NUFU House on Makerere’s campus, James took me to the medical school offices on Mulago Hospital grounds. NUFU is a five-bedroom house on university grounds. We each have a room with a desk and bed with mosquito net. We share three bathrooms, and the NUFU caretaker/office manager Margaret serves toast, coffee and fresh mango or watermelon juice every morning for breakfast. Depending on the day, samosas, banana bread or boiled eggs are also served. It’s a nice way to get to know my house mates.

I was able to take in a little bit of Kampala on Saturday and tagged along with a housemate to a coffee shop that ended up not having wifi but did have the most wonderful coffees and smoothies. We had lunch out and it was the most amazing Indian food I’ve ever had. After that we trekked to the Baha’i Temple and I learned a lot about their faith It’s a very beautiful and peaceful belief system. There is one temple on each continent and the African Temple is here. On the walk home, we stocked up on water and some fruits and veggies – jack fruit is the strangest fruit I’ve come across and it’s a delicious flavor blend of slight banana and mango. Saturday was certainly a day of acclimation and soaking in the city.

A line of patients waiting to be taken into triage.

Heading home is going to be very bittersweet. I am sure everyone is excited to see friends and family but the experiences and memories we have made here have been unforgettable. The one thing we will never forget is the gratitude on people’s faces when they got to see us. These have been some of the greatest experiences of most of our lives. Tomorrow we are going to do a little touring before heading to the airport. Talk to you soon!

Morning sunrise at the compound

Today we moved to the next community of Naranjal. The bus ride in the morning was a little bit shorter and we arrived at the new community bright and early to get started. The set up worked the same way as the first community with a triage station, consultation, pharmacology, Charla and cytology. Similar to the first community we were located in a school with classrooms and a soccer field. Lucky for the students they get a couple days off when we are using the site.

At the children’s Charla the kids learn to brush their teeth properly and receive a fluoride treatment.

It is interesting how each community is different and we tended to see a lot more and larger families at this site. A lot of children came in to receive anti-parasitic treatments which can be a huge problem in this country. Thankfully due to Global Brigades, and many other organizations, the water sanitation and public health projects are reducing these problems by up to 90%.

Our group also got to experience a dental station with the Honduran dentists. This was such a cool opportunity because it is something that we may never experience in practice. They really took the time to explain what they were doing, what tools they used and how they did their procedures. The amazing thing is most of the fillings and extractions are done without any anesthesia!

Breanna cleaning the dentistry tools.

Tomorrow is our final day of Medical Brigading and we will return to Naranjal once more. After that we will head back to Des Moines with memories to last a life time.

When I asked some of the students about their favorite part of the day this is what they said:

• Opportunity to learn extensively from the doctors traveling with us
• Children’s “Charla” (educational talk) and teaching the kids proper hygiene while connecting with them!
• Having the ability to practice “real medicine” vs. “class medicine”
• Practicing Interprofessional education
• The bus ride home
• Opportunity to develop your Spanish, no matter what level you are at

The amazing community volunteers who helped us the past two days.

One of the other great things we have been doing on the trip is being put on by the Dean of the COM College, Dr. Reed, as well as Dr. Mortensen, a professor in the physiology/pharmacology department. We have been participating in interprofessional education experiences at night where we reflect on our day and discuss interesting things that were seen in clinic. Today we discussed a foot abnormality and a cyst case as well as the pharmacology involved.

Kelsey Randel explaining her master’s program at our IPE session.

Tomorrow we will be in a whole new community and serve a whole different group of patients! Talk to you soon!

Pharmacy set up at the first day of the brigade.

View from inside the clinic. In the middle is where soccer was played.

Arriving at the first day of the brigade.

Tomorrow we will return to the same community to set up Brigade day #2. Students will rotate through each station at least once to get an opportunity to experience as much of the health care process as they can. Stay tuned for more details on tomorrow’s brigade and starting Thursday we move to a brand new community! Thanks for checking in.

After lunch we had an amazing opportunity to visit a local Honduran orphanage called Sociedad Amigos des las Niños. This was started by Sister Maria and she has created the single largest orphanage system in Central America. Not only did we get a chance to interact with some of the children, we got an amazing tour by our Brigade leader Moises and second year D.O. student Hiral Patel. For those of you who aren’t aware, Hiral is closely tied to Global Brigades and her knowledge and work here in Honduras is amazing. We got to see the school systems, plantain factory and a beautiful clinic that unfortunately has been unable to be occupied for several years. After a quick game of pick up soccer and a few bags of plantain chips we headed back to the compound for dinner.

Once we arrived in the country we were greeted by a group of Global Brigade staff and hopped on another bus to head to our compound in El Paraiso. The second bus introduced us to an important cultural aspect…the music. Being entertained by music videos for an hour and a half gave us a chance to pick up some possible Honduran dance moves.

After 20 hours of travel we arrived at the compound, had a fantastic lunch and explored the surrounding area. Tomorrow brings a full day of packing medications as well as visiting the local orphanage. Thanks for checking in on us! Talk to you soon!

So what am I getting at? We tell ourselves that this level of stress is “normal.” We signed up for this long trek of academic punishment, so we just have to deal with the associated stress. True, elevated stress is to be expected while earning any terminal degree, but does it have to be as high as we think? Honestly, for the majority of students here, it doesn’t.

When I interviewed at DMU’s College of Podiatric Medicine and Surgery (CPMS), two of the questions the interviewers asked me were what I do for fun and how do I handle stress. In retrospect, I now see how these were not two separate questions, but two parts of a single question. The faculty on the other side of the interview table know exactly what you are getting into. You, on the other hand, have no idea. They know you need an outlet and a healthy way to handle the stress.

One of the things we can do soften the blow of this torrential onslaught is to take a look at your study style. If there is one thing I could go back and change about my experience so far, it would be to come to DMU with an open mind about how I study. Your study strategy worked great in undergrad; it still works per se at DMU, but is it the most efficient and effective way to study? Be aware of how you learn. Are you an auditory, visual or kinesthetic learner? I was surprised at how much my style changed from kinesthetic in undergrad to visual now. Use this re-evaluation to strategically schedule your study time, and you have just increased your study efficiency exponentially.

But how do you schedule study time strategically? Isn’t setting aside a large chunk of your day for studying enough? I would beg to differ. Take your six-hour study block and turn it into several small blocks with a break in between each block as a reward. Setting out a stretch of time to study “subject A” creates short-term goals and (at least for me) creates a rewarding feeling of accomplishment throughout the day. When the day is over, you’ve actually had a lot more focused study time than before, because you spent less of the “study block” goofing off.

Now, what to do with those breaks and other time off? Aside from sleep, may I humbly suggest reading a book? Yes, a book and not the electronic kind. A physical, in-your-hand, made-of-paper book. You have just spent the last block of time staring at the Krebs Cycle on your computer screen; it is time for you and your computer to have a break. It can be amazing how spending some time reading can relax your mind and charge you up for another go-around. I challenge you to pick up a book this week and give it a shot. Even though these seem commonsense, try and give these simple ideas a go and see what happens to your stress level over time.