Public Health Research in Panama: Foundational Site Visits in the Community

On my flight from Houston to Panama City is when it really kicked in that I was headed into an experience that would not compare to anything I had done up to that point in my life.  I reflected upon the meetings, the readings, my own preparatory research, and realized that what I would remember the most – the people, the sights, their community, health conditions, and their resources – were something that I could not truly understand until the trip was actually happening and I was a part of it. I suddenly felt nervous, despite feeling excited, and I knew that in two weeks my life would be completely changed.  Flash forward to two weeks later, as I am getting out of the van at the Panama City airport to head back to California, and I pause to realize how unique my experiences there were.  I was returning to my community with a much deeper understanding of multidimensional health disparities, the ups and downs of community-based participatory research, of being a visitor in a community so different from my comfortable life in Orange County, and of myself and my education at USC.

I knew I did not want to graduate without participating in such a course as PM 599: Public Health Research and Practice in Panama, one that would involve immersion in the culture of a different country and within communities facing different economic realities from the ones I knew.   However, the class in Panama sounded like even more than what I had hoped I could experience – I could not wait to try designing, conducting, and analyzing research, and I was excited to know that there was a proponent of giving something back to the community upon the class completion.  I had worked in communities with health disparities and poverty before, both in Los Angeles, New York, and Mexico, but I knew that each community had its similarities and differences, and I was eager to get to Panama to participate in research in the community of 24 de Diciembre.  I had been selected to research nutrition in the community, particularly amongst children, and was anticipating what was to come.

After arriving in Panama and meeting the 7 other MPH students who were also participating in PM 599, we spent our second day there visiting the Embera community.  The only way to access this community was by taking canoes with motors attached down a river.   Once our canoes docked at the embankment of the river, we were welcomed by community members with music, song, and dance.

Once we had observed traditional jewelry and artisanal crafts, we were given a presentation by community members about the history of the Embera community, their access to medical care, education, technology, and then provided a traditional meal of the most delicious fresh pineapple, watermelon, tilapia, and plantains, served in a palm leaf.

After, we cleansed our hands in a bowl of water that also contained lemons and leaves. The community members were also proud to give us a tour of their newly-created butterfly house, designed for conservation of local butterflies.

We were treated to traditional dances by the youth of the community, and invited to dance along.  Our student group danced, holding hands, with the members of the community while music was played on drums.  Our visit to the Embera community was eye-opening, as we were still not too far from Panama City and yet their rural community remained committed to a traditional way to life.  Despite this, influences from technology were noted.  They did mention that their butterfly conservation center now had a Facebook page!

Our group also visited Panama’s immunization headquarters at the Ministerio de Salud in Panama City.  All of the country’s vaccines pass through this clinic before they are distributed to other regions of the country.  Staff spoke with us regarding their cold chain process.  A vaccine cold chain is the unique system of storing vaccines while waiting for distribution.  The vaccines are stored in locked coolers whose temperatures are strictly regulated for compliance.  All vaccines are provided at no cost to all Panama residents.  Once vaccines are requested from certain areas of the country, staff members transport vaccines stored in coolers that may only be opened twice per day.  Their coolers are designed to limit the amount of cold air that is emitted each time they are opened.  Panama is proud of its vaccine program, its rapid response to providing vaccines, and of its cold chain process.  While we were at the Ministerio de Salud, we were asked if we would like to receive flu shots that are distributed in South America, if we had not already.  It was hard to imagine the same scenario occurring in the States, with flu shots being dispersed to foreigners at a health clinic.  The importance of being vaccinated in the Panamanian culture would soon be that much more real to us as we began to immerse ourselves at the clinic in 24 de Diciembre.

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