Thursday, 19 December 2013

Jatuita kanoi! ..

...Ngobere for 'see you again soon!' were the final words I called out to my smiling friends as I raised my hand, waved and ducked into a local minibus to start my long journey back to the UK from the jungles of northern Panama.  
It's been a long journey home; Miami airport is not a kind place, and my body threw me a hefty dose of tonsillitis just to make the travelling that much more pleasant. But I made it in one piece and into the giggling, smiling arms of my 2 year old niece at London's Heathrow.  After a warm reception and the usual faff of car park tickets, figuring out where to deposit your now-empty luggage trolley and navigating the airport exit signs, we made it back to the tranquil countryside village of my family home. Only then did it began to sink in that I really had left Panama.  Well, it's now fully sunk in and It's blowing a hoolie outside my Oxfordshire window (and for those of you with no Scottish blood that means there's a huge great gale trying to force it's way into the house); so as I pull on my thermals, wiggle into my fleecy slippers and cup my hands around a warm hot chocolate it is time to look back, reflect upon the last twelve weeks and share with you some of the finer details that have escaped me whilst writing excitedly from my Panamanian jungle hideaways. 
The first thing that is dying to spring from my fingertips is a description of our most recent multi-day clinic to La Sabana, but that deserves a whole blog to itself, so I shall refrain and instead embark upon a virtual 'day in the life of a Floating Doctor volunteer' (not least because I have been gently nudged into doing so by a very wise lady who brought to my attention that she really had absolutely no idea of how life unfolded when we were not out on multi-day clinics!).  So this one is for you Chris.
Well, Xylophone girl really deserves a mention here. She is the first thing any of us hear in the morning time and has become somewhat of a legend/mascot for us long-termers. Xylophone girl is thus named because none of us have ever seen her (I must point out here we do, admittedly, assume that the player is a girl for no particular reason other than the phrase 'xylophone girl' stuck..) and she crashes around on a very durable xylophone for, mas o menos, three to four hours a day. To her credit she has improved dramatically in three months; every so often someone will shout out a song name that seems to roughly fit the spluttering of notes wafting in through our windows and everyone else cries out in celebration that she has finally learnt a new tune.  Good on her.  If only she wouldn't start at six thirty in the morning.  
But to rewind for just a moment, I need to explain our set-up entirely. We live in the upper floor of what is charmingly nicknamed the Warehouse.  Not an imaginative nickname; the lower part of the building houses a series of cavernous storage facilities, one of which is our much loved local Veterinarian Dr Dan and the other is the quad bike garage for a local company. The upper floor where we live though is well appointed and on first inspection surprisingly upmarket for a charity.  It is only when you realise that there are three other people sharing your open plan studio room that expectations return to those befitting a money-conscious organisation. Entering the room is pleasant enough, with large built in wardrobes designed to absorb the majority of our kit and clothing, the fridge-freezer hums quietly - not a patch on the squeaky drone of the four large standing fans whirring on full speed as they attempt to circulate the damp, hot air around the room.  Somehow, despite having glassless windows along one side of the building, there is an extraordinary ability for the rooms to heat up to oven-like temperatures.  The resulting (and quite amusing) effect is that most volunteers spend their first week acclimatising by lying/standing in-front of the fans in disbelief at the amount of sweat their bodies can produce. Resignation is the name of the game. 
So you have arrived, safely and triumphantly, deposited your belongings at your bedside and met your new roomies. It's now time to gather essentials and get a feel for the town.  Bocas is a very small, almost entirely friendly island town that is used to having many 'gringos' pass through on the hedonistic backpacker tourist route as they drop in from Costa Rica on their way to Columbia.  It can be frustrating to be lumped in with this stereotype but the longer you stay the more faces recognise you and slowly the vibe changes and genuine calls of 'Que sopa Tia!' (What's up my friend!) follow you down the street.  
This island has grown up fast; ten years ago there were virtually no tourists and the rapid growth has been fantastic for tourism but sadly is not without its deleterious environmental and social effects. Rubbish disposal is a major issue on a small island and, although there is an organised system, there are times when it is desperately depressing to walk around town.  Water is another huge issue - tap water here is unsafe to drink and as a consequence the hundreds of tourists that pass through buy small, medium, large water bottles and discard the empty vessels in the bins in favour of refilling. There are water purification and refill stations that we all use as much as possible but I am as guilty as the rest when I forget my five litre jerry can.   I could go on; an oil generator is responsible for supplying the islands electricity; I spoke with an American couple who own a large solar energy company who had submitted plans for installation and maintenance of solar grids for the whole island but had been turned down in favour of a (much more expensive) new oil generator.  Clearly politics and power are no different here than anywhere else.  
Apologies for straying into dangerous territory, may I bring our attention back to the Floating Doctors.  It is now six thirty am and as promised Xylophone girl is practising furiously.  I am awake and am slowly waking my body up with some yoga as the coffee drip drips through into the bowl, spreading it's heavenly aroma out of our room and down the corridor to the other five Floating Doctors rooms.  The sun is rising in the East, showering golden rays through the windows and signalling a brand new day to the birds whose songs warble alongside the metallic twanging from next door.  Slowly but surely over the next hour and a half sleepy people wander up to our room, mug in hand, to pour a cuppa and come for a morning chat. Where are we off to today? Do we have a day clinic or are we heading to the residential home (Asilo)? Um, it's so hard to keep track of actual days, let me see, it's Tuesday. We're off to the Asilo. Oh gawd, better get a second cup of coffee..
Enough for now I think or you will be reading all morning long! I promise to continue the virtual tour very soon. To placate you, please find a few more gorgeous pics, taken by several of our crew over their stays:

A baby boy born the day before we arrived for a follow up clinic; I had ultrasounded the pregnancy the day before his birth to make sure he was in a good position and low and behold, here he was upon our return! 

Simply stunning views. Not a bad commute to work.

Some of the residents of the Asilo, the residental home we look after in Bocas. We take them for a walk to the park, a banana and a soda twice a week. It's simple but actually wonderful to do; these lovely folk have no-one and without our input would stay in the same compound 24/7.


There is no doubt that there is huge need for the medical work we do, and the room to grow, the capacity to expand, integrate and work towards a sustainable locally driven healthcare system is enormous. I have never felt more alive.

Friday, 1 November 2013

Playa Verde

Lining up to be weighed and measured:

The crowds of interested onlookers everywhere you go: 

A patient patient:

You wouldn't believe how good a warm coke tastes when you're almost in the floor with fatigue...

More patients arriving:

Our fantastic team:


End of the day! Time to..play Jumping Frogs:

..go for an explore:

..watch supper being made:

..take in the sunset:

..and fall asleep under the stars:


Wednesday, 30 October 2013

Chino Rojo and making chocolate

Throughout the world in the minds of young children lay visions of sea monsters covered in barnacles emerging from rolling, frothing surf ready to gobble them up and toss their dainty bones aside to be used as toothpicks.  And it's heartening to know that Playa Verde (our latest mulit-day clinic) is no exception! The village is possibly the most beautiful I have visited yet; sculpted sandstone cliffs sagging and crumbling under their densely vegetated tops, home to toucans, sloths and a myriad of other tropical creatures.  The quiet coves below are used to shelter the cayucos whilst the fishermen come home to rest and are the scene of these fantastical childhood nightmares.  The Chino Rojo are a mythical group of underwater pirates that live in submarines and come ashore at night to steal the children, but unlike myths of the west where it is usually the naughty children that get spirited away, here it can be anyone at anytime.  And God forbid that you swim at night, that's a sure fire one-way ticket to the dark seaweedy underworld.  Sadly though, my jaded grown-up mind wonders whether this myth is just an easy way of keeping the harsh reality of childhood mortality away from young eyes; after all, here, pneumonia and diarrhoea are still the biggest killers of the under 5's and the infant mortality rate has a long way to go.

That doesn't stop the kids from whooping and laughing or running off wide-eyed with terror as we finish clinic at sundown and head for a refreshing dip as the sky lights up pink and orange.  In fact, this is without a doubt my favourite part of the day; that first dive into the water after a hot, sweaty, tiring, long day somehow cleanses not only my skin but also my spirit and helps me release the confusions and irritations that inevitably arise in an environment like this.   Washing, however, is something of an art form.  The communities here are very conservative so we swim and therefore wash in scrubs.  I'm not sure if you've even been thrown into a swimming pool in your pyjamas but it's a very similar experience! If you will, imagine distracting the tightly sticking cotton from your skin enough to sneak a bar of soap around your body at the same time as trying to make it froth in sea water, and you will have conjured up the entertaining evening ritual that we perform every night. Despite still feeling sticky from the salt, this is immeasurably better than the slightly sour odour that accompanies everyone at the close of day. 

This multi-day saw a similar spread of illness and public health issues as we usually see, with more scabies, tooth decay and pregnancies than you can shake a stick at. One gentleman in particular touched our hearts; he had some kind of developmental delay and did not speak - he could hear perfectly well, and understand basic conversation but at aged 40 was a comparably 'unaccomplished' man with no wife or family (presumably due to his disability as he seemed like an affable chap).  On attending my consultation, aside from being charmed by his enthusiasm to communicate, I had absolutely no idea what was actually the purpose of his visit.  Was he here with a medical complaint? Did he just want a check up or to say hello and be sociable? Did he want a toothbrush and soap and be on his way? After a good twenty minutes I enlisted the help of the local men in the community who were looking on in kind amusement.  They began talking to him with a combination of sounds and hand gestures: Panamanian sign language!! In fact I think it may have even been Ngobe sign language, even more special.  So with several local men as my translators we managed to deduce that he did indeed have a medical reason for attendance and we were not only able to assess and treat him, but also confidently explain the medications and plan.  Something that I would have been at a complete loss as how to do had I not been so fortunate to have had these friends of his nearby.  It was a wonderful demonstration of the real meaning of community, and one that will stay with me for a long time.

In my writing I do seem to find myself veering away from the medical side of these trips and describing the 'out of work' pieces much more, and I suppose that's a reflection of how many extraordinary experiences it is possible to have (and I am aware that nobody reads this blog to get a discourse on the life cycle of a mosquito).  So humour me as I take us off into the world of chocolate making and bouncing around like a frog with a dozen school children..

The cacao tree, if you have never seen one, is a bit of a bizarre looking beast.  Huge pods sprout off the trunks at random intervals and the process of harvesting, sorting, fermenting, drying and roasting the seeds is complex and intriguing.  Not having anything beyond a rudimentary understanding I will not bore you with my fumbling descriptions but will cut to the kitchen, to the roasting, and to Anna (a fellow volunteer) who is in the middle of grinding roasted seeds.  She stands beside one of the most important women in the village, the Curandero, or botanical medicine woman, who is stooped over an open fire stirring seeds as they roast.  After grinding, the cacao is mixed with milk and a little sugar and patted down into a shallow container.  In a cooler climate I suspect it might set, but here, it is comfortable staying a bit floppy as it rests in thirty degrees heat.  It was an amazing process for Anna to experience and for us to view; we were watching first-hand the traditional method of chocolate making directly from the indigenous healer in the village.  The taste was more earthen than Green & Blacks but all the more extraordinary. 

And what about these frogs? Well one story tells the enormous racket that the real frogs make come sunset.. you would not believe the decibels these guys can achieve. But the other story follows half a dozen local children who took myself and another couple of volunteers on a little explore around the village.  We ended up on the top of a cliff overlooking the bay and after having had our hair plaited by the girls (they go mad for blonde hair) we had a crazy half hour scampering around in the dirt bouncing around like frogs playing 'tag'.  By the time the sun touched the sea a few other children had come down from their homes and had joined in, and the air was filled with the gorgeous sound of innocent, ecstatic giggling as these barefooted potbellied beautiful children roared around like mad.

So with glad hearts we leave Playa Verde behind and look ahead to a busy couple of weeks of day clinics and working in the Asilo.  Time to settle back into Bocas for a while, re-calibrate to 'town' life and re-feed our bodies with leafy vegetables and maybe a beer or two..



Saturday, 19 October 2013

A few more pics..

Packing for a multi-day:

Setting off on our trusty boat:

A new village, a new ranchero to set up home in:

With kids always ready to play in our hammocks as soon as we disappear:

Beautiful little washing creeks:

And laundry drying on trees:

Plenty of patients:

With wierd and wonderful problems:


And the most amazing fresh agua de pipa (coconut water) in the world!!

And a guaranteed swim at the end of each day!








Thursday, 10 October 2013

Multi-day clinic in Norteño, with an unexpected patient

I'm living a very satisfying moment right now. Sitting in my hammock, which is one of eleven spread out in a star shape connected to a central pole underneath the Peace Core workers house, I'm listening to music and relaxing with my FD friends having just bathed in a crisp, fresh, crystal clear river in Norteño, the jungle village we are staying in for three days to deliver a multi-day clinic. 

Today produced some unexpected events, although it started normally enough; cockerels crowing at dawn, dogs causing merry hell and fighting underneath our hammocks; school aged children being bundled out of their houses, hair scraped back in perfect plats and bodies neatly covered in pristine white shirts and blue skirts; bleary eyed volunteers hopping out of hammocks and contemplating the day ahead over a cup of coffee and some fried bread. And the day continued as usual with bundles of children and clusters of teenage sisters presenting themselves and their various relatives for assessment. After what we thought was a very successful first day we were all relaxing in the clinic as the night set in when a commotion outside caught our attention. A woman was being rushed in towards us on a stretcher with blood all around. She had fallen whilst exiting her house (which is about 1.5m up from the ground) and landed on rocks on her head, knocking herself unconscious.  Time for some gloves, a trauma assessment and some problem solving. Fortunately for her there didn't seem to be any immediate life threatening danger but her injuries were such that we had to immobilise her spine and get her to hospital to have X-rays to look for neck fractures. 

Oh but hang on a minute, we're in the middle of the jungle in the dark and there's a river to cross to get to the road. Now you know why I mentioned problem solving..

Fortunately for us, we are a resourceful bunch with a broad set of skills. Our firefighter (a female, just in case you had pictured a man!) proved to be invaluable as did our four ambulance technicians. They co-ordinate the foot transport and worked together with great teamwork to deliver the patient to the waiting ambulance that we had ordered. Except that "ambulance" was pushing the definition just a little.. It did have impressive flashing blue lights which gave us all great feelings of reassurance as it arrived, but after a cursory inspection there was no escaping the fact that it was just an old flat bed pick up truck. No paramedic, no drugs, no nothing really. But it was wheels and it was the only option that could get our lady where she needed to go. So we strapped her on (if you can imagine this she is lying on a makeshift stretcher which has just been tied down to the truck, the end of the truck is open so her feet are poking out into nothing and at this point she's not actually secured to the stretcher by anything except for her head tape..). The ambulance driver seemed quite happy to head off like this but with scenes from a horror movie unfolding on our minds we persuaded him to wait whilst we secured the patient on to the stretcher so she wouldn't slide off the end of the truck as they started the bumpy ascent up the track to the road.  It certainly gave me a new gratitude for our poor battered old NHS. 

I am actually writing this end bit in retrospect two days later and we are still waiting for news of her condition. In all likelihood she will fine but she's not returned home yet so there's no way to know. We have only the pay phone in the village and it hasn't yet rung.


Monday, 7 October 2013

A few Baya Azul multi-day pics


Early morning coffee with a Cayuco silently being paddled in the background:

The organised chaos of clinic:

Everyone is really keen to have their pictures taken! Especially as they can see the results:

Explaining treatment of a sick child to his sixteen year old mother. In Spanish. In fourty degree heat. I would be sitting down but we don't have enough chairs:

The result of us having previously visited this community? Being able to review X-rays that we had previously organised to look for TB when they have chronic lung complaints. It's a four hour round trip in a motorboat to get to the hospital, and costs far too much for these people to imagine paying for themselves. Fortunately for this guy his xray looks pretty good:


We are our own pharmacists, creating robust treatment regimens from what we have in the bags. We often run short of drugs and have to be creative (yet safe and effective) to be able to adequately treat te diseases we find:

Lunchtime! (note the rice and beans.. I wasn't kidding about the sweetcorn being my saviour)

Diedre having a well deserved shower at the end of a hard day:

The sight of our hammocks looking more and more inviting as the sun goes down:

The view from sitting in my hammock:

And the reward for hiking at dawn to watch the sunrise over the village:




Thursday, 3 October 2013

Bocas and beyond

First of all, apologies for having not posted for a while; since joining Floating Doctors I feel like I have been swept up into a whirlwind of adventure and am in a permanent state of ecstatic exhaustion.  It's currently six thirty am and the coffee is hubble-bubbling away in the background, filling the room with that familiar aroma of morning as the world awakens around me.  Every day is different here and today we are up early to pack for a multi-day clinic at Norteño, a large village on the mainland (one of the few non-island communities we serve). Having been on a multi-day clinic in my first week I have a few extra experience-based additions to my rucsac, loo paper being the most valuable! It is amazing what people (and in this context I mean volunteers) will trade for a few sheets of cotton soft luxury upon the realisation that the community has no plan to provide for our creature comforts.  Tinned sweetcorn comes a close second and is an immense morale booster when, tired and powerless over the food being served, we are faced with the third bowl of rice and beans for the day. But do not mistake my list for complaints.. far from it.  It is actually a complete joy to derive such immense pleasure from these simple things. It brings life into sharper focus, highlighting the immense privilege we experience day to day without even giving it a second thought.

Another treat on multi-day trips is that of living in a Ngobe village for four days. We arrive, set up our clinic in some form of structure: a school house, an open sided barn or a library, and set about making our homes. This, for the uninitiated, is quite an entertaining spectator sport for hammocks and mosquito nets are not the easiest in the world to set up and invariably at least one or two people end up on the floor part way through night one. Fortunately I lived in the Belize rainforest in a hammock for six months as a teenager so, after hearing the familiar squak and thud of a midnight hammock catastrophe, can pretty quickly and easily sort it out even blindfolded by the rainforest's velvety darkness. 

Following a restful, rocking sleep we rise early and are in full swing seeing patients by eight thirty and do not stop until nightfall save for a quick bite here and there to keep energy levels up. The Ngobe people are absolutely wonderful; open hearted, playful, inquisitive, earnest and exceptionally hard working. There is very little alcohol or drugs in the culture and even smoking is a rarity. 

 Baya Azul was the village we visited for one such multi-day a couple of weeks ago and, it being my first week with FD, was a baptism by fire into the whole process and I am still grinning like a goofy school child at the memories. Packing gargantuan amounts of medical supplies, food and coffee into Elvis' boat (yup, that really is his name!!) a group of twenty of us - some medical and some with absolutely no medical experience at all - climbed aboard and out across the archipelago of mangove Islands to receive patients from across the region. It would take a very long blog to detail the experience so I will tell it through photos in my next entry. (To follow imminently!) 

As for this last week, we have been living and working from 'home' in Bocas, going out on day clinics and doing ward rounds at the local old peoples home. This elderly care facility by all accounts was a pretty dismal place to be up until FD partnered up with the locals.  It still has a long way to go but the residents now at least are clean, fed, have regular medical attention and probably most importantly they have people that come over and spend time with them, shower them with affection and take them on outings.  After all everybody needs love.

So here I stand, on the brink of another multi-day adventure, my complete heart and soul open and engaged. But let's not romanticise here, I'm absolutely pouring sweat as I sit here in the early morning sun, my balcony overlooking a grim shanty town that was created when the govennment displaced an entire village to make way for a runway. It is a relentless, tough environment here with challenges coming no only from disease but from the diseases of power, greed and neglect. We are making a hugely important difference but it is a grain of sand in a desert of need.


Sunday, 22 September 2013

A few great picture moments over the last 10 days

I had to start with the most famous..

A great installation that showed a video from inside a ships cab..

One of the monsters passing through with only 24 inches breathing space either side..

The little stream outside my house in Boquete before the rain..

And the same 'stream' six hours later..

My favourite local honey!

And not just any espresso: this is Gesha coffee from The Ruiz coffee growers in Boquete, in 2012 this particular coffee broke world records as the most expensive coffee in the world. Even at source today it is $160/kg.. 

and it tastes amazing! 

Atop Volcán Baru

Dawn..

and sunrise..

from the summit..

having wiggled a lot to get there!..

and walked up some pretty hefty hills..

Was it worth it? 

Every step!

Night-time jungle exploring



Waking up this morning there is very little to bely the heroic efforts of yesterday's climb up Volcán Baru. I feel surprisingly normal which in some ways makes me feel great for having a body that can tough it out, and also slightly un-nerved that perhaps it was actually all a dream. Fortunately for me I have two groaning companions who fared slightly less well and can testify to my presence. 

As Panamá's highest point the dormant volcano, often shrouded in cloud, is an obvious "must do" for anyone stepping off the bus in the Chiquiri province. Most people however do it in a 4x4 rather than wrestle with the challenge of a 14km,1700 vertical metre hike starting at midnight. With a gradient worth respecting, a track swimming in mud and boulders and no sleep I feel quite proud of myself for maintaining a measly 2.5km/hr on the ascent. And even more proud that I was whooping and smiling as dawn came and the sky exploded into colour. 

As you well know by now it absolutely pours with rain in the afternoon but the beneficial result of this is clear skies from around eleven pm until around nine am the next day. This makes a midnight hike not only an adventure (this is tropical rainforest not the South Downs Way, with it's resident jaguars, snakes and other various hungry carnivores on the hunt) but also almost guarantees clear skies for the duration of the climb and most importantly for the summit.  The moon, full and shining brightly, casts silvery light down through the canopy catching tree bark and lichens and outlining the forest to contrast against the inky blue sky. Quite extraordinarily and something that filled me with wonder was that throughout the night at some place in the sky (never directly overhead) there was lightening striking and thunder letting out it's ominous growl. As we climbed we gained an elevation advantage over the clouds and began to see the lightening from above, something I have only previously witnessed from an aeroplane. 

Throughout the night we were accompanied by the various cries and calls of the jungle night. At one point my hyperactive imagination (or maybe not..) thought that we were being stalked but it was just wishful thinking that the monotonous grunt of slipping over greasy boulders might soon come to an end with a spectacular wrestle with the illusive jaguar. 

Suffice to say we made it to the top. Chasing time as we so often seem to do in life I sped up for the last two km to ensure that I didn't miss the sunrise I so desperately wished to see.  And sure enough, as the dawn light began to glow we rounded the final corners, rested weary legs and sat on the rocks to watch a glimmering orange sun rise and fill the skies with pinks and yellows.  Elated and having unceremoniously plonked ourselves on the ground we dug around our bags for the assortment of squashed sandwiches and crumbled biscuits we had brought for a picnic and, hiding from the cold wind at the summit, ate them with smug satisfaction. A satisfaction, however, that was not to last too long: as those of you who walk in the hills will know the descent is more often than not the devil of the hike, especially for the knees. 

Lying here in my hammock the morning after however, the fiery heat in my knees is only a memory and I am left only with fabulous memories and photos to match.  This mini adventure marks the end of my time in Boquete, it's time to pack up my spanish dictionary and head across to my new home for the next few months: Bocas del Toro and the crew of Floating Doctors. 

So my next entry will be from a whole new world. Stethoscope and hammock in hand, the fun is well and truly about to begin.

Friday, 20 September 2013

Kicking back in Boquete

There is a bird in my bedroom. Probably something most men would be elated to discover, but for me it comes as a slightly puzzling surprise. Sneaky little critter, I only noticed him/her when (lets call it a she) she let out a chattering squak from under my bed. I was half expecting to find one of the local kids down there playing a practical joke but no, there stood a little red headed, black and white speckled little bird. I'm guessing she doesn't think much of the weather either and has come in for a bit of R&R. There's probably a feast of foodcrumbs under my bed as the little two year old of the house, Hosue, has been galavanting around my room, cookies in hand.

It'll be no surprise to those of you following my travels that it is raining once more. I've decided though that this must not dampen my efforts to explore .. as the spanish say (at least according to Luis) "no está hechas de azucár" which literally translated means something along the lines of "you are not made of sugar" but I'm assuming it relates to me not dissolving in the rain.. 

So I've left the little bird to fatten itself upon my cookie crumbs and have ventured out to Bamboo Spa for an hours massage. Not exactly mega exploring I hear you cry, but I like to think of it as exploring the holistic and soothing side of the valley. After all I will be hiking up Volcán Baru a 3500m volcano tomorrow starting at midnight.. 

Thunder and blackouts


Sat here in a little local cafe, lights blinking as the electricity struggles through ancient bare wires, I'm wondering just how wet is it possible to get just by crossing the road? Given that at this present moment I can't even see the other side, I'm guessing pretty damned wet. I pose this question not through wont of another thought, but as I have been sat in this seat for two hours now hoping that the rain might ease up enough to cross to the taxi stand. It turns out that the rainforest is well and truly living up to it's name.

Rain and bone-shaking thunder included (of which there is a spectacular show every afternoon), I am very much enjoying this little town of Boquete. It is nestled in an impressive, fertile valley which is reflected everywhere you go. El quetzal, a favourite and endangered brightly coloured bird, is painted everywhere! Hand-painted panoramic forest-scapes cover the interior of cafes and shops lending a friendly, almost childlike quality to the atmospheres.

Spanish classes began on Monday and are both hard work and exceptionally rewarding. It's just Luis, my teacher, and me. I'm benefiting so much so that I have arranged with the sister school in Bocas to continue classes twice a week for the entirety of my stay in Panama. What sense does it make to half learn the language when I have the opportunity to continue studying? And anyhow it'll come as a welcome break from pulling worms out of people's feet...

Panama City and beyond


Well i'm very much alive and kicking! It's been a fantastic first few days of exploring.  Stepping out alone as a young, white, blonde female is always a challenge to local men and the familiar cry 'que guapa' (something akin to what builders say in the UK) rings out from street corners, balconies and cars. It is not threatening or aggressive in any way and after getting used to it, it's absence can sometimes feel insulting, does my bum not look good in these jeans?!

Casco Viejo is the old fortified part if town that I have been staying in. Left to ruin by the city folk decades ago as the main city moved east to accommodate it's rapid growth, this old area has recently benefited from investment by boutique hoteliers, restaurants and bars, turning it into a new 'must visit' area of the city. It reminds me very much of Havana - seriously crumbling, derelict houses (still with inhabitants) rubbing shoulders with sparkling air conditioned marble floored coffee shops. It's an odd mix but strangely seems to work, contrasting to Havana (where locals are never seen in expensive places) a lot of Panamanians come here to relax and party. There is still of course a major divide between rich and poor, but it is a domestic divide as much as a tourist one so somehow it doesn't feel so bad.

I visited the 8th wonder of the world yesterday as National Geographic call it.. The Panama Canal. And what a sight it is! Huge, and I mean huge, ships navigate the same style of locks that you see on the Thames (slightly larger and more controlled I must admit). 10years, 250,000 workmen (many dying of malaria and yellow fever), millions of dollars and an engineering feat of it's generation likened to landing on the moon. Quite something to behold.

Today I flew to David to catch a bus up to Boquete -  a small rainforest village renowned for it's coffee (known as Geisha it broke records in 2012 for being the most expensive coffee in the world), hiking, white water rafting and importantly for me, it's Spanish school. I will be living with a local lady Miriam for the week and having 6hrs a day of classes in an attempt to jump start my learning and give me a better chance at communicating well with my future patients. I have plenty of reading to do - my Spanish GCSE revision book, phrase book, medical essential phrases etc.

Miriam, a widow, used to be a salsa teacher and apparently loves nothing more than to teach her lodgers to dance.. So here goes! My last salsa experience was in Santiago de Cuba where three girlfriends and I were adopted by this wonderful ancient couple (easily 85!) and taught to Salsa whilst their daughter kept an eye on the local boys and swatted away their advances! Just brilliant.

I arrived at her house today to find it full of life: a niece with husband and two small children, two dogs, a cat and a parrot (how the two coexist seems a mystery at present but I'm guessing the cat is well fed or the parrot's talons are sharpened).  It promises to be a busy household and I am looking forward to getting to know the family.  The only unwelcome inhabitants I have come across so far are the sandflies, they seem to be in their bazillions, which doesn't bode well for my avoiding leishmaniasis. Slightly over enthusiastic spraying of deet has commenced: I aim for complete eradication by the time night falls.

By nightfall also I will have sat my Spanish test (amusing for an onlooker I am sure, for the testee I feel it will be a sweatbox of confusion). The aim of which of course is to place me in the correct class... which is without doubt 'beginner' plus or minus a few points for wild gesticulation, giggling, excellent mastery of a phrasebook and international sign language. All of which will keep me in good stead over the coming weeks I am sure.

As for now I am going to wander into town and find an Internet cafe to ping this off to you all

With a stethoscope in one hand and a rucsac in the other


Hello all! And welcome to my blog. Take a seat, get comfortable and come exploring.. 
As most of you know, and as an introduction to those who don't, I'm heading off to work as a volunteer doctor for a fantastic charity called 'Floating Doctors' in the depths of rural Panama. They have an information packed website under the same name if you fancy taking a closer look. The basic idea is provision of joined up sustainable health care and education to the rural, mostly tribal, people of the Bocas del Toro region. This, in reality, involves a lot of time and effort working with the local Elders, shouldering backpacks, filling up boats with kit and heading out to extremely rural hilly coastal rainforest to provide outreach clinics for those who can't get to the static ones. I imagine there will be many muddy boots, river crossings, moments of improvisation, moments of desperation, tears of frustration and tears of joy.  But most importantly there will people. People who don't even have the very rudimentary basics of modern western healthcare. (At this point I think it's important to point out that I'm under no illusion that dragging these people into a Western environment or life is in any way better than their own, but dying from simple treatable diseases in this day and age just because your country hasn't developed an accessible enough health system seems tragic and unnecessary). 
As I head off into the unknown I hope to take you with me and offer you a glimpse of the world through my eyes: stethoscope in one hand, rucsac in the other.