Playing catch up!

I AM SO SORRY! To all my loyal fans ( that's you, Mom!) who have been dying of anticipation for my next post, your wait is over. Teeheehee, just kidding, I have been really busy these past 2 weeks. Seeing as how so much as happened in the last 2 weeks; Mexico City Trip, Hospital Civil, Dia de los Muertos, Caves and Zip Lining. So I will be posting more than one blog- one for each subject. It will be a lot of blogging, lemme tell you.


It has been an emotionally stormy these past two weeks. I am just over half way done with my trip and I am realizing some peoples true colors. While I am having fun, making new friends and such, I need to know that "my persons" (to quote Greys Anatomy) are thinking about me . The distance of both time and place has really shown me who cares about me, and who doesnt care as much as I thought they did. It is painful to make certain realizations about those whom I love and trust, but it is better that it happens now and not years later, when I am bittered and hurt beyond repair. There are some friends I didn't even realize cared about me so much- I get emails and messages (and blog comments, hint hint) from people who really care about me and I know I need to cherish them more.

So how does Samantha get out of an emotional funk? PARTY!!! I have gone drinking and dancing 5 nights in the past week! Uh, maybe a little too much drinking one of those nights, but hey, I am studying abroad with an awesome bunch of people and how many times in my life will I be able to say that I partyed in Mexico for Los Muertos?

So today, I am feeling better, but I am not going to let anyone or anything bring me down anymore. This trip is about me, and I am going to enjoy it. No one or nothing will bog me down ever again!

On being Mexican

*** This was actually posted on November 4th but written on Oct 22*****

So, this past week was busy because I had a midterm due on Saturday. I did not procrastinate (yeay!) but I did want to get an A really bad so I stressed out a little. But it got done, I felt good, and Saturday night I drank and danced the night away! I love the nightlife in Oaxaca, its so diverse. We went to a super packed bar, our group's preferred location, FreeBar. Then we crossed the street to La Tentacion, a cumbia/merengue/salsa club where people were so chill and dancing their hearts out! I taught Max how to cumbia! Then we went to Sabina, which is my new favorite spot, because there was enough room to dance comfortably and the music was fun! I went to the bathroom, and the Shakira song "La intuicion" was playing, and all the ladies were a little buzzed, waiting in a long line (typical of bars and clubs) and we just started singing and dancing while we waited our turn. By the way...I like that Coronas are only $1.50 or 20 pesos and I especially like it when I dont get hangovers from cheap, delicious beer :) I thought I would be sad to go out without my boyfriend, and I was thinking about him a lot that night. But we have had a lot of fun together in the past, and we will have many more opportunities in the future to drink cheap Coronas and dance together.


Our new professor, Dr. Melnikow, started her term with us on Monday. She is here for two weeks, so it feels like we dont have very much time, but we actually have learned a lot in lecture. It has been a very relaxed few days of classes, mainly because most of us didnt do our assigned readings because of the midterm. Guilty as charged! Well, I can't be perfect, plus, it has been a lot of hard work in the past 4 weeks!

So something that keeps coming up is this whole "being Mexican" idea. In the US, if someone asks me that dreaded "what are you?" question, I feels like Mexican is not accurate, but no one wants to hear that I am American, because after all, I am brown. So then I start rambling about how I am American of Mexican decent, and people look at me with blank, confused stares, as though the idea of me being American still doesnt penetrate through their skulls. So why am I not Mexican-because I was not born in Mexico and while my parents were, they are now American citizens. My dad served in the US Marine Corps and works in law enforcement for crying out loud! Why am I not American? Because I am not white, which by the way is not an accurate description of American, neither.

Oh, my country tis of thee, why must your people fail to recognize me as a product of your beauty? Why I am looked at differently than children of Irish or Polish immigrants who came through Ellis Island? Why I am discriminated against in the the country I pray for, the country I vote in, and the country I want to die in? Why must I feel foreign in the only place I know as my home? Being in Mexico has given me a sort of confidence I have never before felt in my life- I walk the streets and see brown people in all walks of life- from doctors to street vendors, and not only as bus boys and janitors. My self esteem is boosted by seeing so many beautiful, curvy, Latina women and hearing my American friends talking about how beautiful Latina women are. I dont look different, and this sense of belonging is unknown to me. Whereas in the US, especially in Davis, I feel like people look at me like this exotic, cheap Mexican import, no different that that 6 pack of Corona beer that was purchased at the Nugget. Lets face it- Americans discriminate against my type-Latin American immigrant children. My Oaxacan host mom showed me a local paper which had as its top story, front page, a headline that says "Increase in discrimination against Mexicans in the US." Much has changed in America, but we have a long way to before I can say I am American without judgement.

Crashes, floods and infections; the honeymoon is over

It was the dawn, 5 am, when I woke up to the sound of two cars screech and crash into each other. I jumped out of bed, a little frightened but aware of what happened, stepped outside and looked down from my second story patio to see shaken people walk out of their crumple metal cans and motocycle and foot patrol cops came flooding from all areas. People in the hotel across the street from me were taking pictures from their windows. This is an all too common sight; last weekend an accident on the same intersection during the night claimed 2 lives.

In the centro historico, where I live, all the streets are one way only and the street light flash red during the night and wee hours of the morning. According to a taxi driver, the law states motorists do not need to stop at red lights if there are no cars around. Driving in Oaxaca is dangerous- streets are poorly paved and narrow, no respect for other cars or pedestrians, and speeding is common. Dr. Tenorio, our medical director in Oaxaca, says his main concern for student safety isn't kidnappings or assault: its the fact that every day, there is at least one pedestrian fatality due to automobile accidents. Most people don't think of car accidents as a public health concern, even though they are the leading cause of death for Americans between the age 15 and 25. Think about this next time your buddy decides to drive home buzzed.
------- Post Script 11:30pm- Another car accident just happened, this time, involving alcohol. What are the odd of two crashes within 24 hours of each other?-----



On a lighter note, OMG, freakin' Noahs ark almost landed in Oaxaca today. I had been locked in my room all morning and afternoon, reading and writing my midterm paper ,when around 4:30 pm, big fat raindrops started to fall, and then it came down hard for 40 mins. Flash flood alert! I stepped outside me room to take these photos,







Centro de Salud Santa Cruz Xoxocotlan - October 1-10, 2008

This week had been work, work, work! This was the last week at our first clinical rotation site. Alexa and I really enjoyed our time at Centro de Salud Xoxo (ho-ho) and we are bummed to leave. We became good friends with the nurses, the physicians, the nutritionist and the other workers. Dr. Raymundo Murguia was our preceptor for the majority of our time there. He is a really great person; as a physician, he is thoughtful and thorough, and as a person, he is really caring and energetic. The first day of clinic, we drank a shot of mezcal together! But sometimes we felt a little uncomfortable with certain behaviors. For example, he has a prosthetic leg and in order to not have him stand up from his chair when I have a question, I will kneel beside him at his desk. While I ask the question, he would caress my cheek or brush my hair, which would be major sexual harrassment back in the States. It is not meant as being sexually forward- at no point did Alexa and I think he was doing so- but is part of the machisto culture. We are young women, lower ranking in the health care strata, and he feels a sort of tenderness or affection towards us. We are nice looking, we are excited about medicine, and he finds it endearing. But if you know me, you know I have a hard time with male dominance bullshit- it took a lot for me to not be offended.

When we weren't in consultation with Dr. Ray, we went on vaccination campaigns! AWWW YEAH, PUBLIC HEALTH ROCKS MY SOCKS! This is the motor of public health-going out into the community to educate about health and prevent illness on a mass scale. Every couple of months, a team from the clinic goes out into the public schools to give vaccinations and other preventative measures. A group of clinic workers hopped on the back of a truck, drove to the rural colonias (or regions) of Xoxo, and did a thorough job of reaching all target children. Alexa went on a tetanus vaccination campaign in Colonia Los Angeles (which BTW is at the foot of the mountain where Monte Alban is!) and I went on a anti-parasitic and vitamins campaign in Colonia Rufino Tamayo. Kids were given a small bottle of albendazol, an antiparastic treatment, and federally sponsored vitamins and minerals to supplement their nutrition. We had to make sure all the children drank the bottle of albendazol in front of us- some kids loved the taste of it, claiming it tasted like coconut, banana, strawberry, while a few kids were gagging and needed to chase it with fruit juice in order to keep it down. Oh, one kids spit on me on accident- he was gagging and ran out of the room to throw it up and started spewing near me!

So here were the highlights of my time at Xoxo- Reader Discretion Advised!

- Learning procedures. I learned how to: administer intermuscular and subcutaneous injections; perform and teach patients to perform a breast exam; perform a thorough general exam of the eyes, nose, ears, mouth, teeth, throat, neck, abdomen, feets and legs; determine the developmental stage of a fetus, find its heart beat and determine what position its in; and finally, how to interpret laboratory results for infection, anemia, diabetes and renal failure.

-Observing procedures- Pap smear (papanicolao in Spanish) and pelvic exam on a woman with a pelvic inflammatory infection (aka: white liquid spewing from what may be her uterus, since we were at her cervix and it was still coming out); suturing of a stabbing wound in the rib cage of a arma blanca (domestic violence)

- I was impressed with the high rates of diabetes. I knew it was a problem, but geez, its monumental! Feet exams are important to see if diabetes is affecting circulation. Diabetic feet are characterized by edema (swelling), uneven or discolored skin on the calves and feet, bed sore type wound that health slowly, little or no pulse in feet, and in the late stages, tough and hard black or purple skin on the feet. Also, diabetes is the leading cause of blindess in the world- Oaxaca is no exception. Retinopathy occurs when excess amounts of glucose (aka uncontrolled diabetes) cause the tiny veins in your eye to burst , causing blurring vision, and later, causing your retina to seperate from the macula causing permanent blindness. Crazy.

- There is little education on hygiene. This gets is where it gets a little gross. Cleaniness is important to be healthy, such as in this case. We had a 17 year old pregnant woman come in who had a UTI and vaginal infection for what appeared to be months according to her lab results. UTI was caused by a long term vaginal infection that wasn't treated. The vagina is a great place for bacteria to grow- its warm, moist, and dark. When bacteria begin to grow on the surface, it can enter the urethra by wiping forward after going to the bathroom or by sexual intercourse, causing urinary tract infections or worse. A lot of things cause vaginal infections and UTI, but sexual activity is a main contributor, and we talked to her about hygeine practices to prevent more UTIs. She brushed her teeth once a day (which was a lie), bathed every other day (I doubt it) and changed her clothes every other day. While there may be a socioeconomic factor playing into certain hygiene rituals, but poorer people than her are cleaner than this. After talking to Dr. Ray about hygiene education, and after a few more clinic visits, it became clear that genital hygiene is not addressed as part of general hygiene.

- Echoing on this past case, education about hygiene comes from the parents, and there is a lot of shame in talking about sex between parents and children. Dra. Gloria, another physician at Xoxo, said she will get young girls come in for a visit, worried because they think they injured themselves "there" because they are bleeding. Seriously, that still exists. Another case of this was when a mother brought in her 8, almost 9, year old daughter who was complaining about pain in her left chest. After talking to the young girl and examining her chest, we noticed her left nipple was sprouting. Her mother began menarc (her first menstruation) at age 12, so this little girl was beginning puberty, since the first menstruation is towards the end of puberty for girls. I understand the mothers concern, but couldn't the mother have looked at her own childs breast?

- Another woman, in her 40's with 3 children, did not know how to do a self breast exam (SBE's). No problem, a lot of women dont know, but she was embarassed to touch her own breasts and refused the exam. Alexa and I were going to show her how to do it, the male physician wasnt not going to adminsiter it, but regardless, she refused. Okay, you breast fed 3 kids, and you are ashamed to touch your breasts? I guess this shouldnt really surprise me, since people are shameful of their bodies in the USA too, but when breast cancer is the most prevalent and deadly cancer for this population, it is very frustrating that these cultural nuances get in the way of effective preventative measures.

So far, I have really enjoyed the primary clinic setting. As of yet, I still want to be in primary care and this experience got me more excited about prevention and treatment of illness. But next week I begin at Hospital Civil, a large general hospital with many specialties. I am most excited about oncology, general surgery, OB/GYN, and internal medicine.

Ugh, back to work on my midterm. We have entirely too much work this week. I cannot wait till weekend...again...5 days away.

Para todo mal, mezcal. Para todo bien, tambien.

" For all the bad, mezcal. For all the good, also." -Traditional Oaxacan saying

Besides having killer bloating and painful GI movement, it was a good week. Last week was the first week of clinical rotations and classes. It is a pretty packed schedule.

Mondays and Tuesdays we have UCD courses from 10 to 3 pm, Tuesdays and Thursdays we have Spanish classes at Becari Language school from 5 to 7pm, and clincal rotations are Wednesdays, Thursdays and Fridays for 4 hours each day. We also have to accomodate to family meals, which consists of breakfast and la comida, which is the biggest meal of the day, usually between 2 and 3pm. It is kinda hard to get used to eating meals at 8 am and eating again at 3pm, but I usually get a snack around noon. The host family took me and Alexa (my housemate who is from UCSB) to a mayordomia, which is a celebration each parish has for their church. It is on the saints day on which the church is named after, and one family from the community is given the honor of preparing the food for the entire community. It is a very traditional celebration, where a mass is celebrated in honor of the saint, and food and dancing follow. Madrinas (or sponsers/godmothers) are also a part of the celebration. They help prepare for the celebration by decorating the church, providing desserts, and more. The little girl in the photo is a madrina infantil (child sponsor) and she was so proud to carry around that basket of goodies, to be handed out to the community after the meal. They prepared mole negro, a Oaxacan icon, and drank a shot of mezcal! Okay, since I had been ill, the nun sitting across the table from me highly encouraged me to drink it, because it helps digest the highly greasy mole. It is INTENSE! Mezcal is made from the maguey plant, which is the same succulent that is used to make tequila, but processed differently. Tequila comes from Jalisco, while mezcal comes from Oaxaca. So mezcal prevents indigestion and helps break down fats and other lovely stomach problems from occurring due to the Oaxacan party foods. I also drank a Corona and some tepache, or pinepple beer. It is homemade fermented pineapple rinds and sugar, and it is pretty good. Hey, if a little alcohol helps with indegestion, more alcohol helps more, right? Then on the drive home, my host sisters wanted some cotton candy, and made our toungues insanely colorful. Car ride+ sugar+pre-school children= awesome!

But the highlight of the week (the cherry on top of a sundae I was too sick to eat) was clinical rotations. Alexa and I were assigned to Centro de Salud Santa Cruz Xoxoctlan, which is in Xoxocotlan (ho-ho-koh-tlahn) a suburb of Oaxaca, a 20-40 min bus ride south of the centro historico. Centros de Salud are government run primary care clinics and are open access- that is, anyone (insured or not) can receive care. In Mexico, 54% of spending in health care is private and the shotty condition of the public system is a big reason for it. Xoxo has a fairly basic centro de salud, with a handful of primary care physicians, slightly more nurses, a dentist, a psychologist, a nutritionist, a pharmacist, and a community health representative. The only x-ray machine is for dental; no ultrasound, and hells no on an MRI or CAT, and all paperwork is completed by typrwriter-yes-typewriter. All instruments are heat sterilized on site-no sterile and disposable instruments like plastic caps on the otoscopes (the instrument used to view in the ear and nose), no one time use thermometers: seriously, they have the basic stuff.

So what is the common Oaxaquenos ailment? Well, DIABETES, DIABETES, DIABETES. 7 out of 10 patients we see in consultation, and nearly all patients over 40, are diabetic. More to come on clinic in next weeks post!

Sunday was eventful! Our new exchange student sister from Holland came on Saturday, and we invited her to our outing today. Alexa, Kirsten (my Dutch Oaxacan sister), Prof. de la Torre and I went to Mitla, a village about 1 hour outside of Oaxaca that is home to small, but interesting mixtec ruins.

It was small, not nearly as impressive at Monte Alban, but the detail of the buildings were really neat. They did not use any adhesive or clay to make their designs- everything is carved and places in a position and weight is applied to keep it in place. It is 95% original, with restoration only for preservation or safety of visitors.

After we returned from Mitla, the family took us to have la comida at Santa Maria del Tule, a small suburb outside of Oaxaca to get some empanadas, tlayudas and quesadillas. This town is famous for the worlds biggest tree- biggest girth, not heigth, since Sequioas are the champs- but this tree is 14 meters (approx 43 ft) in diameter. Its volume is 816,829 cubic meters and weighs 636,107 tons!

It's the kind of tree I dream of living in, like the ultimate treehouse. You get that feeling of inferiority; as though the human species isn't as bad ass as we would like to think. Sure, we have cognitive processes and opposing thumbs- but can we live 2000+ years? No, this tree has more power, more experience, more fitness than we (humans) could ever imagine to achieve.

Moctezuma hit hard

Sorry I have been lagging on my blog! Its been over a week since I gave any juicy deets, but I have been majorly sick! I dont know what got me sick, but I had major stomach bloating and cramps, fever, nausea and diarrea. I have been sleeping a lot this past week and was prescribed some anti-parastic meds, which helped a lot. After 7 days of being sick, I am so glad to feel healthy! I guess I take being healthy for granted! I was also feeling a little homesick, mostly because I am a big baby when I am sick and need my family, friends and Cole around to kiss my booboos. I have so much to share, but I will catch up on my blog tomorrow.

Alright, a quick little teaser of last weeks events!

Pic 1-On Sunday, my host family took the students out to eat at Santa Maria del Tule, a quaint village/suburb of Oaxaca that has the world biggest tree. You may be thinking "but Sam, sequioas are the worlds biggest trees." Well, yes, but they are tall, and this tree is MASSIVE.

Pic 2-Also, drink to your health has a new meaning for me, since mezcal (which is super strong liquor made from the same plant as tequila) is a preventative treatment for...read tomorrow for the answer!

Pic 3-And finally, no, that last pic is not a glamour shot, it was taken in an ancient Zapotect ruin in Mitla.

Alright I got to catch up on reading, there will be more to see tomorrow!

Tired, wet and happy

It has been raining a lot this week and we have been running all around Oaxaca! We had a whole week of activities planned with our program, including cultural excursions, getting our syllabi and assignments for the quarter (ugh), taking Spanish classes at Becari Language school, visiting the locations of the clinics we will rotating through and getting to know this kooky bunch of UCD (and one UCSB) kids!

Monday 9/22

We met with our tour guide for the week, Esther, who is highly knowledgable about Oaxaca, both the the city and the state. She is so energetic and lively at 60 something years olg, I really hope to have her spirit when I am her age. We met at Santo Domingo, a beautiful cathedral with green bricks (a result of oxidized copper in the bricks) and the interior is covered in gold, reminding me a lot a Greek Orthodox church. We had a presentation on the native fruits and vegetables of the area and tasted some interesting fruit. We walked around the city and ate some pumpkin flower quesadillas by some women street vendors. Again, Oaxaca cheese is amazing, the pumpkin flower has a subtle taste, and the corn tortilla is smokey. We walked around a lot! In the evening we went to Guelageutza show, which is a presnetation of the folkloric dances of the 7 regions of Oaxaca. A Guelaguetza is an annual event in Oaxaca City that brings people from all the 7 distinct regions of Oaxaca State to a week long cultural event. It includes the regional dances, but also regional foods and traditions are shared through events and activities. The Guelagetza is held in July, so I will not get to see the real one.

Tuesday 9/23

Orientation stuff, ice breakers, university regulations about behavior (aka- learn to hold your liquor) and syllabi. Yuck, a long, but necessary, day. We are swamped with reading, especially since 2 weeks out of the quarter are in Puerto Escondido, a beach resort where very little homework gets done. So technically, we only have 8 weeks to do 10 weeks worth of work. I also started Spanish classed today at Becari Language School, a local language school that we must receive 40 hours of Spanish and Medical Spanish coursework. I was a little dissapointed, frankly, that I got into the intermediate Spanish course, but the placement was based off of a Spanish grammar exam and I have not taken formal Spanish courses since senior year of high school (4 years ago.) But it is quite easy, I am not complaining, I want to spend less time doing homework and more time hanging out in this lively city.

Wednesday 9/24

Cinic time! We took a tour of all the clinic sites for our our clinical rotations. I will be attending UCD classes on Monday and Tuesdays, attending language classes on Tuesdays and Thursdays, and clinical rotations for 4 hours each day on Wednesday, Thursday and Friday. We are busy little pre-meds! My first assignment is in Xochimilco, or Xoxo ("ho-ho") which is a suburb of Oaxaca that is 40 minutes away from el centro (downtown.) It is far and I have to be there by 8 am, so lots of coffee for me! We will all get a chance to work at Hospital Civil, or general hospital, where a lot goes on! We will also get to observe surgeries here and get access to various specialties, like oncology and general surgery. In the evening we went to a really lame presentation about cultural events in Oaxaca. It would have been cool, but the presenter spoke really slow and loud, so that the low level Spanish speakers would understand. But if people dont know what a word means, slowing your speech and increasing volume is not going to help; it actually irritates. But after that, PARRRRRTTYYY TIMEE! Geez, it was Wednesday night but we went clubbin! Oaxaca has an active nightlife and cheap drinks. We didnt stay out too too late, though, cause we had to go hiking in ruins the next day!

Thursday 9/25

Monte Alban is the site of ancient Mesoamerican ruins, where Aztec, Zapotec, Olmec and Toltecs lived and later abandoned around 500 BC. I had visited Chichen Itza before, but Monte Alban was smaller. More is being discovered every year, since it is an active archaeological site, but the charm of overlooking a fertile valley and the weather made the experience almost magical. It was raining the entire time we were there, but it was okay, since there were no mosquitos out. But the clouds were low, and the mist was grazing the hills and flowing through the valleys, as though a spirit was hovering the ruins.

Friday 9/26

The longest, most expensive and exciting day EVER! We starting our tour of several pueblos outside of Oaxaca City to explore different artesian crafts. First we went to San Bartolo, a town known for its black ceramic. The style of ceramics was created in this village, where a special kind of soil found in the hills of Oaxaca, can be treated at different lengths of time and at varying temperatures to give a black color, there is no paint or dyes. We saw a presentation of how the ceramic cantaros (jars) are made and it was so cool to see Valentin, an experience and aged craftsman, share his love and knowledge to us.

Next we went to Ocotlan, known for their huge market and native painter, Rodolfo Morales. We went to the food court and ate at Cocina Frida Kahlo, whose chef was dressed as Frida! We had some awesome mole colorado and then walked around the market.

We went to the church, where just to the side is a musuem of original artwork of Rodolfo Morales. I am very drawn to the bright and contrasting colors, the sharp images and the abstract shapes. I guess I have the art taste of a kindergardener! Sorry about the poor picture quality, but I was not allowed to use flash to preserve the paintings!

Next we went to San Martin, a village that makes its living off of textiles. We went to a womens artesan cooperative where a group of women make handicrafts and sell them at a fixed priced. They have beautifully woven cotton rugs, handbags, dresses, it was a feast for the eyes! I went a little scarf crazy and got 6 different colored scarves, but I loved just loved the bright colors!

Just outside of San Martin was a a woodworker that specializes in painted wood sculptures. They are made of the copal wood, a tree indigenous to the area, and are a worldwide folk art craze. They prices show it too, they are really expensive! I couldnt afford anything, what with spending 100 pesos on scarves and all! :)

After a long day of shopping till were dropping, Alexa and I came home and watched the brand new episode of Grey Anatomy. We are super lucky, our host family has wireless internet, a luxury for Oaxacan families. We went to get some amazing street burgers, which have 2 slices of ham, beef patty, pineapple and grilled onions for 20 pesos or $2, and then sat down to watch some trashy TV. It was the perfect end to an awesome week.