Elective to Panama
Univ Old Members’ Trust Graduate Travel Report – Hannah Farley (2012, DPhil Medicine)
On 24 February I flew to Panama City for my medical elective, ten weeks of placements that takes place after finals where I could choose exactly what to do. I was undertaking a two week volunteer placement with Floating Doctors, a charity that provides medical care for rural indigenous communities that live in the archipelago along the Caribbean coastline of Panama. There is very limited access to healthcare in these communities, and the best way I can describe it is that Floating Doctors is their GP service by boat, visiting communities regularly every 4 months and seeing patients both for reviews of chronic diseases like hypertension or diabetes, and for acute issues (which could be anything).
The charity visits some locations for a single day, with transport there and back by boat on that day, and some locations for multiple days in a row. The clinic locations that ran for multiple days typically take several hours to get to – staff spend the night in hammocks and are cooked for by local families. The first week that I was there, we ran three separate one-day clinics. I spent my time running consults as a medical provider with a translator and clerking in patients, taking vital signs and a brief history in Spanish. My Spanish improved dramatically although is very medically focused!
We saw a variety of complaints, including typical management of conditions common in the UK too, such as high blood pressure, but also conditions like scabies, worms and malnutrition that are less common here. Some of the presentations were much more advanced than I had seen at home due to poor access to medical care, with scabies in particular unrecognisable compared to the characteristic rash we had been taught to look for in dermatology. We also provided the “depo” contraceptive injection. As the average family size in the communities we visited was 8-10 children, this was an intervention with dramatic potential and was popular among the women we worked with.
The second week of my placement, we visited one community for four days and ran a multi-day clinic. It was a six hour boat ride away across the bay and upriver, with low water levels in the river nearly stopping us before we had begun. After some boat rocking we made it through the shallows and were well on our way. We set up clinic and prepared medication refills for regular patients – it is fair to say that all of the medics developed a newfound respect for pharmacists after counting out 180 tablets of metformin all afternoon.
The next day, we woke up early in hammocks strung up in the clinic location to see that queues had already formed, with some patients walking for several hours to visit. Working alongside translators and other medical providers from different backgrounds and nationalities was an interesting challenge, as was planning treatment strategies from limited resources (for example, making a spacer for an inhaler out of plastic cups). The longer clinic length added some new experiences, including volleyball matches and bathing in the river, as well as lots of visits to the local tienda (store) for ice cold drinks after sweltering days. Overall, this was an incredible start to my elective period. I learnt so much about being an independent medical practitioner, as well as gaining insight into how lucky we are in the UK to have a universal health service. I am very grateful to Univ for supporting me in this opportunity and cannot wait to go back to Panama to volunteer again!
Published: 4 May 2022