By Nandini Puranprashad, Pharm D. Candidate c/o 2013
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Felipe Camacho is a 6th year student at the University of Florida College of Pharmacy. He received his Bachelors of Arts in Music Composition from Rollins College, Winter Park, FL. After graduation, Mr. Camacho plans to pursue a residency at the Veterans Affairs (V.A.), Lee Memorial Health system, or the Indian Health services. As part of his 2-month ambulatory care rotation, Mr. Camacho participated in a health outreach trip to clinics in Nicaragua where he was directly involved in patient care.
Q: What are some of the best moments from your trip?
The trip was an amazing experience. I enjoyed all of the doctors and students that came along on the trip. The doctors and pharmacists were very informative and taught without being condescending in any way; it was very stress free and I learned so much. I thoroughly enjoyed going into town and actually seeing how the more modern people of Nicaragua interacted. I loved our hotel and all of the food that was prepared for us. The fresh juice for dinner that was like a little “leit motif” to the morning’s breakfast fruit was also a wonderful surprise and very thoughtful of the hotel hosts.
Q: Tell me about one person you met.
I remember seeing this pretty little girl, “JB,” at the triage station, when we were in Los Mangos. She was about six years old and had a bright pink sundress on with black shoes. She looked like she had just walked 5 miles with her mother and seven siblings. I remember telling her how pretty she was and seeing her face light up as she smiled. Her eyes had pierced my soul. Her cheeks had risen and her lips parted. My heart sank into my chest when I had noticed that all of her teeth had rotted down to brown-black stumps. The translator helped me write down JB’s chief complaints: upset tummy after meals, can’t sleep, and generalized pain which triggered the question, “How many cups of coffee does she drink in a day?” I remember my jaw had dropped when the mother confessed to giving JB 9 cups of coffee per day.
My first shift had ended when I finished with the triage of JB and her family. I was able to walk them over to the next station to see the physicians. I wasn’t able to listen in on their diagnosis, but I was able to see it at my next station at the central pharmacy. JB’s mother was told to significantly limit the amount of coffee that JB could have and well as given 10 mg of famotidine, twice daily for GERD. JB was also given children’s vitamins and was counseled on taking the famotidine 30 minutes before meals that makes her symptoms worse and to take the children vitamins once per day to make her strong and healthy. I got to watch her smile one last time as she and her family walked away into the tall banana plant forest. She stole and broke my heart…
Q: What was the hardest or most frustrating part of the trip?
Not a big fan of the toileting practices here: we can’t, under any circumstances, flush the used toilet paper. We have to place them in plastic bags to be picked up the next day because they will clog up their delicate drainage system… I am so going to be constipated.
Q: What are some interesting things about Nicaragua that the average person may not know?
– The minimum wage salary here, if the even choose to enforce it, is $112.00 US dollars per month, that is $28.00 per week, $4.00 per day, $0.50 cents per hour and that is not really accounting for their week hours being way more than 40hours/week.
– The gas here cost roughly 33 cordobas per liter, which is about $5.50 per gallon! It cost us over $100.00 to fill up Brenda’s Jeep…a whole months salary! You would think that stuff would be super cheep here. It’s not!
– I get sad thinking about it; seeing mothers walk, carrying their children miles and miles on ankle-twisting, rocky roads, seeing a family of four creatively riding a tiny motor bike, one-hundred people squeeze in and burst out of a yellow school bus, and finally, how my annual salary as a pharmacist would mean I’d make $2,530,000 per year here…literally a millionaire!
Q: Describe a day at the clinic.
My first clinic day was in El Chile. As we set up our makeshift pharmacy, triage, and operating room, more people started to show up at the clinic and the line grew exponentially. They were happy to see us, they never complained about waiting, and even after miles of walking and hours of waiting, they always came in and left with a smile and with not one complaint. My first shift was in the OR with our makeshift operating table. Our first and only operation was on a man that could not stand the sight of the lipoma on his forehead. After I watched and helped with the bloody excision of the lipoma, I took on patients to diagnose and treat. Triage seemed scary at first but once I got the hang of it, it was pretty awesome! Brenda, our trip hostess, took in the chief complaints and age, and we took vital signs and weight. After 8 hours of treating ~218 patients, I still had the energy to play soccer (with a beach ball) with the kids. They are cute kids. It was hard to leave them and it sucked seeing their faces as we left on the bus…no more smiles.
Q: What did you learn about yourself on this trip?
I learned a lot about myself here. I am perceived to be a millionaire to these people. I thought we (insert minority race here) were born to fail in the US—the people here really have no choice but to fail it seems. I often think now how I used to stare a rich people in the states and wonder what it would be like if we swapped. It is also weird to see all of this poverty and then drive a few minutes and then see majestic mountains and you can’t help but wonder: how did things get to be this way? Maybe I am over-thinking it. Maybe they are fine the way things are and I shouldn’t compare the US to Nicaragua. I love this country now and am going to miss the people and my new friends who translated for us. I do hope to go back and visit someday.
