Formas, Flexibility and Fun:

Carlos, Mary, Gladys, Drs Bob and Walter.

Day 1: Today started with a demonstration (manifestacion en Espanol)   While the Providence St Joseph's MTI Service Team road off to a small village to begin constructing a water storage and filtration system an hour away from Chicamam, Mar, Dr Walter Lopez, Gladys Ramirez and I walked just a few blocks to the MTI office for our planned day of orienting the nurses, staff and physicians of the planned health facilities assessments this week. Earlier that morning the main roads into Chicaman form the south were blocked by a series of demonstrations protesting unsafe road conditions. Needless to say, Walter and Gladys quickly and calmly delayed the start and reorganized the training by instituting a Plan B, C and even D (as they say is always necessary in this beautiful country)

Dr Walter Lopez explaining the "PDSA" vision

So after a brief morning diversion hike, we re-started and met nurses Fausto, Andres, Rebecca, Clarita, Irma, and Lubien and dug right into the presentations by Walter and Gladys explaining the rational for the assessment, the results of the survey 3 years ago and the importance of continual process improvement. Mary and I did are best to enliven the process with our role playing, dinamicas and my mispronunciation of many Spanish palabras. Can you tell which one of us is role playing a pregnant lady in labor and another with an 8 month infant with a cough needing an examination.

The attention span of our colleagues was impressive as we reviewed in depth these 8 instruments that have been developed by US AID and the WHO. Tomorrow Mary will serve as an advisor of the assessment of the Health Care facility (known as the "CAP") in Chicaman, while Gladys and I meet with some of our old friends from last year at the hospital in Uspantan and repeat the training with them.

The service team also had an amazing day, but worked a heck of a lot harder than us, well at least physically, mixing cement, connected gutters and pipes and forming molds for the cistern and water system they are building at a village nearby known as San Antonio. This evening we were privileged to hear their stories of their work and the amazing community they visited.

Hasta Manana! Dr. Roberto