Contributed by Janice Wong
After two hours of turbulent travel on small motorboats called pongas, the Global Medicine team and I, soaked from the waves, arrived on an island off the coast of Panama called Ensenada. For our one-week immersive experience, we slept side by side in mosquito-net hammocks, bathed in the ocean, and ate traditional meals of beans and rice each day.
Students at work and play in Bocas del Toro, Panama
Not only were our living conditions unlike what we were used to, but clinic days also provided the opportunity to learn from cases different from those in the United States. These differences stemmed from a lack of resources and access to quality, affordable health services. We learned that community members had to travel for hours to get to the nearest health clinic, which was often understocked and understaffed. Moreover, for cases that required surgeries or consultations from specialists, members of this remote community needed to cross to the other side of Panama; the travel costs alone would exceed $150 for families who lived on less than $120 per month. In this context, it was easy to see how community members were susceptible to many illnesses that were otherwise completely preventable.
For example, one of my colleagues and I had the opportunity to accompany Dr. Ben LaBrot on a house visit to a teenage girl who had an infected wound on the bottom of her foot. The infection had spread such that she was unable to walk, and she was running a high fever. She was undergoing the first stages of sepsis, a systemic infection that can result in death. In other settings, this girl could easily have bandaged her foot to keep it clean. Yet, without Band-Aids or shoes, the wound was left open to the mud and the elements. Using antibiotic cream, gauze, and bandages from our supplies, my colleague and I were able to sanitize and bandage the wound and educate the patient on proper wound care. From this experience, I observed firsthand that deadly cases of infection can be treated because Floating Doctors visits remote communities like Ensenada and provides medical services, house visits, and follow-ups.
An auspicious sign for GM’s trip to Panama
Beyond this problem of basic access, women’s health issues stood out the most. Many women relied on Floating Doctors clinics to provide contraceptive Depo-Provera shots every three months, and this served an important role in empowering women. According to USAID, increased access to reproductive health services is connected to reductions in poverty and maternal and child deaths, as well as improvements to women’s opportunities for education, employment, and full participation in society. Floating Doctors provides safe and effective women’s health services and family planning, which can ultimately save lives and contribute to improved economic futures.
One fellow student, Samantha Garcia, recalls her interaction with a cook who had a history of dangerous pregnancies and who was worried she might be pregnant again. Samantha remembers, “I knew she was very anxious — she couldn’t concentrate on what the doctor was saying and instead kept looking at her pregnancy test. We paused her consult, and I spoke with her and rubbed her shoulder to calm her nerves. When her test was negative, she repeatedly thanked me for waiting with her. At every meal after that interaction, she always said hello with a huge smile.” Reflecting upon her experience, Samantha says this trip made her realize that, even in a foreign community, “Human beings have an incredible gift to impact each others’ lives with the universal languages of kindness and compassion.” Interactions of this nature were common with Floating Doctors, where meeting each patient’s long-term health needs was always the priority.
For anyone who aspires to work in the global health arena, understanding this community-based and sustainable healthcare delivery model in the context of under-resourced or undeserved areas is critical. For aspiring healthcare providers like myself, these observations provide valuable insight into the practice of compassionate medicine. I cannot think of a better or more rewarding way to understand global healthcare challenges and interventions than experiencing them firsthand with Floating Doctors in Ensenada, Panama.