Wednesday In San Carlos City

This is the entire Bridge of Life group that's here right now plus Raffy (the gentleman to my right) We have three more clinicians arriving tomorrow and that will be it for team one. This morning we were asked to stop by the Capital on our way to the center. Raffy is the Governors top assistant and has been our primary contact since this project began over a year ago. I met with him twice in August of 2007 when he was visiting family in the Bay area. He is so committed to this project and a pleasure to work with. This morning he gave us the VIP tour of the Capital including the Governors office ( who was out today) He insisted I try out the Governors desk for size. It was cool but the best part was standing on the roof. I'm not sure if the pictures do it justice but the view of the Province was just breathtaking. You may notice my hair is clipped up in these pictures- I thought I cut it short enough before I left to just let it hang but the heat here is just sweltering - so very humid doing anything with hair is pretty much a waste of time and any hair hanging on your neck is soaked with sweat by 9 am. The hotel and clinic have air conditioning (sort of) I have a wall unit in my room that works hard all night long to keep things cool. Not quite the central air we are used to.

48 hours into it I have become very accustomed to having a "Driver" at my disposal. I was uncomfortable with it at first but found I quickly came to appreciate the Governors (and Raffys) generosity. There are actually 2 drivers assigned to our group and they stay with us wherever we go. (and carry everything in and out) Today we needed a few items for the center and the driver took Neill, Peter and I to a mall (not like ours). The big store is CSI which I would liken to a Smart and Final though for some reason trash can liners could not be found. The big search was on for paper towels. Not the ones on a roll like Bounty- though we couldn't find them either but the basic paper towels we use in clinics in a dispenser. Apparently the hospital requires the nurses to dry their hands on toilet paper as a cost saving measure. After searching we found some and bought out their entire supply for a little over 2,000 pesos. I'm still working out the math ands should know for sure since I'm the one who paid but I think that's about $50. We have a huge opportunity here to improve the infection control practices of the nurses we are training . I just want to be sure we come across as helpful and not judgemental. They are all RNs but the basic hand washing technique they were taught in school pretty much went out the window when they got to the hospital and found the limited supplies. I find it ironic that the nurses in the hospital here are required to wear white crisp uniforms with the standard white hat (I am not kidding) but they don't even have anything to dry their hands on. It's all a matter of priorities I suppose. If the patients here expect to see a nurse in a white hat I guess that's' what they get. That will not be the case with the young crop of nurses we are training. They are excited to be able to wear colorful, functional scrubs in the dialysis units. I was so surprised that they are such a YOUNG group. The average age is 22 and the oldest is 28. They seem more like high school kids- lots of giggling as they practice priming machines and sticking needles in the fake arm. I suspect things will sober up a bit tomorrow when we dialyze our first 2 patients. Up to now it's all been play acting but tomorrow at 1 pm the blood will hit the first dialyzer .

One final comment about the photos of the view...that's what its like in the government compound here in the Capital city of Lingayen where we are staying. As we we exit and drive through the Town Proper (their term for downtown) and through a couple more cities to the clinic in San Carlos City- it is a very different situation. On the weekend I will get a few pictures to try to capture the reality- but though the roads are paved it is very primitive especially in the various modes of transportation...more on that later....

oh my gosh the Governor just stopped in to say hello to me...no kidding gotta go!