Finally out on the farms-- 7/26/09 entry

The Canoy family and their farmworkers (who are like family!)

Some of the items that are given to each farmworker: First Aid kit, Books and cassettes to learn english, resource directory, information about local clinics and the Latino Coalition, also a hygiene kit. (All items donated by local organizations and businesses)

A beautiful tobacco field on the Saunders' farm in Coleridge, NC

My first day on the farms was today! I started out at 3pm and finished up around 10:30pm. I went to 5 different farms in the Coleridge/Ramseur area. I did a Blood pressure and/or a Blood glucose test on 22 workers and 6 farm owners. At each farm I did a quick talk on heat stroke and also handed out the supplies that are pictured above. I also gave 2-3 first aid kits to the farm owners to place on their trucks and tractors so that they can have some first aid kits handy on the field. Today was fun because of the 5 farms that I went to. Two of the farms are owned by my relatives. And the other 3 farmowners are family friends! It was nice to be out and visit with each of them.

During the day, I found 3 workers with diabetes. One of the workers that I tested already knew that he had diabetes. His Blood glucose was controlled but he did not have supplies in order to test his sugar at home. The 2nd diabetic that I found had a Blood glucose of almost 400! He knew he had diabetes but had not been checking his blood glucose. He was only taking a low dose medication that he was given back in mexico and had not seen a doctor to follow up on his diabetes. He had been feeling very poorly and told me that he could barely keep up with the other workers. Now he knew one reason why! The 3rd worker that I found had a Blood glucose level of 300. I told him that I would return and do a fasting Blood glucose level later in the week. I was able to help get an appointment at Siler City Community Heath Center for the two patients with elevated blood glucose levels.

Total number served today:

Farmworkers-22

Farmowners/Family-7
# of farms visited-5

7/24/09 Blog Post

NC East District Wesleyan Women's Conference

Cathy and Me at our meeting place-- "The coffee Break"

Still in the planning phase of my farmworkers outreach project. Monday was my last day in the Hispanic clinic at Moses Cone. The rest of my time was spent calling farms and telling them about the project. I spent a lot of time preparing the talk on Heat stroke. Cathy, my Spanish tutor, helped me make corrections to my handout for the farmworkers. Also this week I worked at gathering all the supplies I will need for my first farm visits that are scheduled for Sunday July 26th.

Last Saturday morning was spent at the NC East District Wesleyan Women's Conference. One of the Wesleyan Women's leaders had asked me if I would come do a workshop on missions as one of the breakout sessions. There was a good turnout to the missions workshop...approx 30 women. I shared with them about the missions trips that I have gone on since 1999. I shared in particular about my recent trip to the Dominican Republic. I challenged the ladies to simply consider going on a missions trip in the future. Why? 1) Because it is fun 2) The best way to travel and see the world 3) Helps you become a more "flexible" person in general 4) It can help you become a better missionary here at home. 5) The people you go to serve will end up giving you more than you could ever give to them.

Still planning....

Randolph Co: The most beautiful county in North Carolina

I have to admit throughout my entire medical school experience my southern accent has been a curse! Lets be honest, there is nothing about a southern accent makes you sound smart in morning rounds. Finally, having a southern accent and being from a small town pays off! (The may be the only course in all of medical school that this is the case) I have truly enjoyed talking with the farmers on the phone. There is something nice about telling someone your hometown and then figuring out that we know some of the same people or that they know some of my kin. I have been pleased with their willingness to have me come out to the farms and do some medical outreach for their workers. Seriously though, you have to admit, if you were a farmer and someone from Chapel Hill with a Northern accent called you and asked you if they could visit your farm and talk with your workers, you would say "yeah right!" If you don't believe me just get on the internet and do some research, like I have done in the past week, and you will find what the farmer owners are up against!

Well this has been a busy week of planning for the farm visits. I researched and found almost 40 different farms in Randolph County. There are a variety of farms here in Randolph County: curb side vegtable stands, large produce production farms, Tobacco, Soy, corn, and dairy farms. And I called them all! The rest of my time was spent preparing my talk on heat strokes. I have reviewed some of the case reports of NC farmworker deaths from heat stroke. I may use some of these case reports, if the opportunity presents, with the farm owners. We can discuss in each case what the farm owner or farmworker themself could have done differently to prevent the heat stroke and death. Monday was spent again in the Hispanic Clinic at Moses Cone Family Practice. This has turned out to be a valuable learning experience and a great way to practice my medical spanish. Just curious....do you know how hard it is to do a Nuero exam in Spanish? Well...I do! ha ha Like I said, great practice! Dr. Hale and Dr. Breen are great teachers and very patient with me. Also, I spent 3 hours with my tutor, Cathy, this week. We meet at a local coffee shop and work intensely on my Spanish. (today was the subjunctive tense, yuck!) She actually makes it a lot of fun. She is getting her masters right now in Spanish education at UNCG. She is a great teacher. I am glad I found her. OK that is it for now. I will post more next week!

Also a BIG THANK YOU to Chatham Cares Pharmacy, Chatham Hospital Diabetes Education Program, and True Track Monitors who have donated Blood glucose monitors, strips and other testing supplies so that I can do the medical outreach on the farms!

Getting started...

(Above Picture is of the Latino Coalition in Asheboro, NC- I really like the sign that they have on the door- "Together, we are more")

This week has been very busy. We got back into town around 2:30 in the morning on Monday. I was scheduled to be in the Hispanic Clinic at Moses Cone Family Practice at 8:30 Monday morning. So, after getting a few hours a sleep I headed over to clinic. I met Dr. Hale who will be my preceptor each Monday at the clinic. We saw patients all morning. All of the patients were Spanish speaking. I also presented each patient to Dr. Hale in Spanish. That was a new challenge for me. I loved the mix of patients that I saw: men, women, and children. The more I am exposed to Family Medicine, the more I love it!

I began working on my outreach project that I will be doing in the upcoming 3 weeks. I met with the Latino Coalition in Asheboro and learned more about the services that they offer there. We are going to partner together on this outreach project. They wrote a grant from Rite-Aid pharmacy headquarters. Rite-aid has agreed to supply first-aid kits that we can give to each of the migrant farm workers and also give to the farm owners to have in the field. They are also going to provide book bags and school supplies for 50-75 kindergartners who are part of migrant farm worker families. The Health Department has agreed to help us distribute these as they do the kindergarten physicals this summer. I am busy working on putting together information for the farm owners on heat stroke and exhaustion. I hope to do a quick review of first-aid that they can do in the field if they suspect heat exhaustion or stroke. I also hope to do some education with the farm workers themselves. I am also in the process of checking with different pharmacies and glucometer companies to see if anyone will donate blood glucose testing supplies for me to use for screenings at the farms. I am going to start trying to call the different farms next week to see if anyone will allow me to come out. I am curious to see the response I get from the farm owners.

Catalina Island

Today was spent relaxing on Catalina Island, a beautiful island off of the coast of La Romana. My favorite part of today was teaching Mary and Kendra how to snorkel. Mary got her mask on, began to get the hang of breathing through the tube, when she finally put her head under the water she began shrieking because a big school of blue tropical fish were right beneath us. It was so neat to see different ones on the team experience this for the first time. God’s creation is so beautiful and amazing!

Thursday July 2nd--It was the best of times...it was the worst of times...

It was the best of times it was the worst of times…..Today started off a little rocky. First I woke up at 2:00am with body aches, fever, and nausea. After a couple of doses of pepto-bismol, tylenol, and motrin I felt a little better by the time the sun rose. I decided that I was going to go out to help out in clinic anyway. After all it was our last day of clinic and I didn’t want to miss anything. We got there and because of some miscommunication they did not know that we were coming. Therefore they had not advertised the free clinic in the community. We decided to set up clinic anyway. I spent most of the day with my eyes closed, resting, trying to control the dizziness and nausea on a portable cot that many sick Dominicans had laid on before me. Oh and by the way, there was not bathroom at this location. The neighbors kindly offered up their restroom for the team to use if need be. Michael went over to check it out and decided against the offer…you had to wade through a few inches of excrement to get to the “toilet.” But even though it was the “worst of times” the day turned out to be “the best of times.” Our van turned and began to creep down a long dirt road with deep potholes that very few American have ever been down. Little children began to run out of their homes waving to us. They jumped up and down, screaming “yay”! I asked the Dominican interpreters what they were so excited about. They said “You!!! The only time that these kids see Americans is when someone is coming to help them or to play with them.” They all came around and watched us set up for clinic. Even though no one knew ahead of time that we were coming, the word traveled fast and we saw almost as many patients with less people! Four of us were sick that day. I saw just a few patients in the morning. One of my patients was a lady that I diagnosed with Type 2 diabetes. I was able to do some diabetes education with her. (Are you proud Doris?) Then, we had 2 children from 2 separate families come into the clinic within 10 min of each other. Both of them unresponsive except to painful stimuli. David quickly assessed both of them and had me to give rocephin and start an IV in both of them to bolus them with fluid. They began to perk up some after this and we had their parents take them directly to the hospital. The amazing thing is I felt terrible the entire day except for when I was taking care of these children. Some say it was adrenalin, Michael’s mom said I was just faking all day, but I know it was God that placed me, an X-ER nurse, there in that village today. I know it was His divine providence that we were scheduled to have clinic there, even though the town had no idea that we were coming. Oh, on another positive note…Michelle and Jeff designed a toilet for us to use. (See picture). And the day ended perfectly with Dr. Yelverton (also an artist) drawing faces on blown up gloves and giving them to the children. Also, Shadrach, our interpreter, gave out all the extra food that we had left over from lunch to the children, who were so appreciative. Some may say that it was truly the worst of times….but to the team it was the best of times…the best day of the entire trip.

Being ministered to....

Today's clinic ran smoother than ever. We have learned over the past few days how to work well together as a team. One patient that stood out for me today was a lady that has had chronic osteomyelitis for approx 25 years. When she was 20 years old the doctors said that she would die from this bone infection. She said that she has had multiple surgeries and has been on antibiotics for many years. She said that she gives all the credit to God because according to her doctors she should be dead. This same lady had a daughter that was deaf. She had never had the opportunity to go to school because she had this special need. There are no resources for a child like this. So, she and her mom communicate via a sign language that they have created as she has grown up. She was so grateful and did not complain about her life situation. I had come to minister to her but instead she ministered to my heart. What a good example she is for me.

Above are pictures from clinic today. One thing I learned today...It is very hard to teach a kid how to use a albuterol inhaler IN SPANISH!!!!! Oh well we got the job done. See the picture above.