THE LAND OF BAD SKIN

The retirement websites tell you that medical care in Panama is as good as you can get in the United States at a much cheaper price.  It is cheaper, but good is a question mark.  Two hospitals in Panama are supposedly linked with US research hospitals like Johns Hopkins.  That means some of the doctors may be bilingual and US trained, but not necessarily the one you get in ER. 

In the US I worked as a quality control nurse.  Doctors got dinged if they didn't see the patients within 20 minutes of their appointment times.  In Panama, appointments are given as a range of time, like 2p.m to 6 p.m.  While I was in Panama I had three appointments with two different doctors.  The first one, a dermatologist, never had me waiting less than three hours.  The second one was not even available for the appointment, but had taken the week off.  I was rescheduled for the next Monday, and ended up waiting another three hours.  Lesson learned: take a good book and some water with you.

The doctors I saw spoke fair, not good, English, but we were able to make ourselves understood.   I can see this as an issue if there is something out of the ordinary going on that is hard to explain.

My skin developed a nasty rash on the left side of my face almost as soon as I got to Panama.  The dermatologist diagnosed it as allergic dermatitis and gave me steroid shots locally, antihistamine pills and two different creams ($75 senior price plus $35 for the appointment).  After a month and not much improvement in the rash, I saw him again.  He said to keep taking one of the creams till the tube was gone.  I questioned him about the insert that said (in Spanish) not to use the cream for more than ten days.  He said he had used it on a baby's bottom for six months with no problem.  With no alternative, I continued using the cream for the next two months.  The red rings went away, but the bumps continued.  The rash never really cleared up till I saw a dermatologist in Santa Monica the day after I flew in from the US.  One week on her creams (free samples, even) and my skin was fine.

I saw an internal medicine doctor at Chiriqui Hospital for a physical exam prior to taking a ship around the world (semesteratsea.org).  I had him fill out the examination form required by the University ("what do you want me to write?") and asked for routine meds for malaria, a typhoid booster shot, and medication for seasickness. 

He said they only prescribed doxycycline for malaria, which is what made me sick when I took it in Africa last year.  He called the infectious disease doctor at the county hospital and said he could give me daraprim if I went there the next day.  I remember taking daraprim when I went to Africa in the mid 1970's, but it is not even recommended by the CDC anymore due to widespread resistance to the drug.  In other words, it doesn't work. 

Typhoid shot?  No, they apparently don't give them in Panama.  They use doxycycline.  I repeat, this made me sick in Africa.

For seasickness he prescribed Vontrol.  I had never heard of this, so I looked it up on the internet.  It is for nausea and vertigo, but should only be used in a hospital situation under close supervision because it can cause hallucinations.  I can see myself acting crazy on the ship and nobody would have the slightest idea if something was wrong or that was my normal behavior.

In summary, three requests and the doctor struck out on all of them.  I did get my physical form signed, but ended up filling out most of it myself.  The only clinical thing he did was take my blood pressure.

I was able to send the form in by the deadline, but will have to see a travel doctor in the US.  Of course, this is not covered by my $636 a month insurance policy.

GRADUATION

On Saturday all the the high school students taking classes at the University went to an end of term party at the Adventist compound near Volcan.  It is a huge place with many buildings and sports fields which is a private school during the week.  We took over the huge covered patio that had bleachers on one side and had many activities and games for the kids, which they seemed to enjoy.  All the classes  had different colored T shirts and gave their groups names so they could compete against each other.  We had a parade with all the different groups and the banners they had made.  Many of the groups were my former students since I assisted with two groups each term over two terms.

The entrance to the Adventist school

Some of my fabulous students

...and more

...and more

...and more

...and more

The parade goes on for a quarter mile

My advanced students

Student groups had to make a flag out of newspaper and twigs (Survivor style) and fly it

Ball relay the hard way

Bees loved the cake so much we didn't get to eat it

Some volunteers served a nice lunch one of the families provided which included the usual rice, beans, and potato salad.  There was a gorgeous store bought cake with the Survivor logo on it.  More than half of the students who started the program in January had dropped out for various reasons, so "Survivor" was the theme of the day.  The brother of one of the teachers works on the TV program and she was able to get the logo, some T shirts and bandannas.  Unfortunately, the bees just loved the beautiful cake, and they ended up giving it to the people that worked there so the students didn't get bee stung.  One of the teachers did get a nasty bite and her whole hand swelled up.

So it is goodbye to my high school students, but now I can spend more time on my adult classes.

SANTA FE

Entrance to Hostal La Quia

This weekend almost all of the WorldTeach volunteers met in Santa Fe to meet the new cpuntry director, Amanda Colon, and to celebrate Anna Reusink's birthday.

Santa Fe is a small town up in the mountains between Santiago and Bocas del Toro.  It is an up and coming retirement haven and the land is much cheaper than in well established Boquete.  You can get a few acres with waterfalls and a tropical feel for little money (although prices are going up fast), but there is not much else there.  A curvy two lane road leads there, whereas in Boquete they are completing a four lane highway from David.  I had to take a bus three hours from David to Santiago, then transfer to another bus for 1 1/2 hours to get to Santa Fe.

We stayed at the Hotel La Quia.  It has one main building and several outbuildings with dormitory and private cottages.  I stayed in a room upstairs in the main building.  It did have a mosquito net, which seems rare here.  Malaria was conquered early in the 1900's so they could complete the Panama Canal.  There are still bugs though, because the walls are unchinked wood boards.  That serves as air conditioning.  I came a day before most of the group, and they took over the whole dormitory of eight beds.  The facility has been sold to an American University, who is turning it into a research center.  I am not sure what they will be researching, but it is a beautiful location.

 

 

My room.  You have to stand on the bed to attach the mosquito net to the ceiling

View from upstairs balcony

Santa Fe cemetery

The two Michaela's in front of the dormitory

For dinner we walked to the Blue Iguana to celebrate Anna's birthday.  It is run by an American couple from Texas and has decent American food.  We sat outside and were soon attacked by chitras (like sand flies).  Veraguas province is apparently noted for them.   You can't see them, but you certainly feel them biting.  I rarely use insect repellent because they aren't a problem in David or Boquete, but I could have used some here.  On Monday I went to an already scheduled doctor's  appointment to get something for the itching.  He had taken a week off, so I went to the pharmacy and got an anti itch pill and some Caladryl lotion.  I still ended up scratching in my sleep and by the time I saw the doctor the next Monday, my legs were full or sores.  I blame him for taking an unscheduled week off.

We met for dinner at the Blue Iguana.  We certainly look a lot scruffier than when we left Panama City

Happy Birthday to Anna!

MERY'S BIRTHDAY

Today we celebrated my host mom, Mery's, 64th birthday.  The two sons and their families came, as well as Juan's sister and her granddaughter and daughter.  I skipped the dinner but had a little cake and ice cream.

Mery and Juan Lara

Marisol is expecting in December

Juan's sister

Juan Alberto and family

Mery never lets me help clean up

VALLE ESCONDIDO

Church at Valle Escondido

On my trip to Boquete this weekend I visited Valle Escondido (hidden valley), which was established as a kind of survivalist stronghold.  It was founded in 1991 by an American nicknamed "John Galt," who was one of the main characters in Ayn Rand's book, Atlas Shrugged.  They have a river running through the valley but also springs for water and a hydroelectric plant to supply their own electricity.  People from many countries have bought homes or condos here for a safe haven in case the world falls apart.  The guards all speak English and carry guns.  I looked at homes and condos here with a realtor, who doubles as a pilot for a private air company and has pictures of famous people he has flown all over the world.  Some of the homes are mansions, and the condos range from small to huge.

They have a cute church, a hotel, golf course, tennis courts, a fitness center with a knockout pool, and trails.  The prices are similar to what I paid for a condo in the upscale area of Asheville, but the monthly fees are a less, even including electricity , cable, and water.  Asheville has more to do.  All in all, it didn't make me want to move there.

Hostal Refugio del Rio is just down the road.  Former vacation home of Noriega's secretary

Downtown Boquete

If the world truly starts to fall apart, I may change my mind.

BOCAS DEL TORO

Finally I have four days off in a row and can go somewhere!  I decided to go to Bocas del Toro, a resort area on the Caribbean side of Panama.  It was formerly the headquarters of Chiquita Banana Company.  The region has many tropical islands and hosted the Survivor show at least once.  The WorldTeach volunteers in Santiago are going there the next week, but they have one or two weeks off since they teach in elementary schools, which have a regular spring vacation.  I will have to go alone (which seems to shock my host family) since this is my only longish stretch of time off.

I took the bus to the other side of Panama, which took about five hours and cost $8.50.  Then I took a 40 minute water taxi to Bocas Town, which cost $2 (senior rate).

My hotel is the rear building

I stayed in the Hotel Palma Royale, which was a splurge at $80 for a room with air conditioning, a small patio, and breakfast.  I later looked at some of the hostels in town.  They cost $10-20 but some look pretty noisy and potentially unsafe.  I booked a boat tour to a nearby island which had snorkeling and lunch for the next day but it ended up raining.  I skipped the boat tour and took a bus to Drago Bay on the other side of the island.  We went through a lot of jungly areas for about an hour and ended up at a kind of low rise hotel complex with an outdoor restaurant, a small beach, and an ecology institute.  I had red snapper for lunch and browsed through the souveneir stands before taking the bus back to Bocas.

Taken from the water taxi

Across from my hotel

Restaurant in Bocas del Drago

I cancelled my boat tour because the sky looked like this

Small boats to get to other islands

It rained pretty much the rest of my time there,which is typical for Bocas.  At least I felt like I had a little vacation.

BOQUETE

The mountain town of Boquete is where I go on some weekends to get out of the heat.  It is an less than an hour and only $1.75 to take the bus up there but seems a world away.  It is famous for coffee and flowers.  It is always high on the list of places to retire.  One reason I like to come is to get a hot shower, since most of the houses in David seem to only have cold running water. 

My room at Hostal Boquete

View from my room at Hostal Boquete

My first time I stayed at the Hostal Boquete and had a room overlooking the river.  I walked all over the town, something it is harder to do in David due to the heat.  I took a tour of the Sarracin coffee plantation for $25.  It is family owned and the first male descendant is always named Francisco.  The original Francisco came from Italy in the 1800's and married an Indian woman who knew how to grow coffee beans.




I also went to the Boquete Community theater to see a comedy revue.  The participants and attendees are mostly Americans.  I met and talked with many of them.  Many live her only part of the year, but most are full time residents and seem happy with their choice to move to Panama.  They get discounts on almost everything, from food to medical care to transportation, hotels, movies, etc.

The latest Francisco Sarracin at the coffee plantation

Peanut butter glazed salmon over a corn fritter

On other weekends I stayed at Hostal Gaia, which is $8 for four bed dormitory, Refugio del Rio, a nice house turned hostel on the river and formerly owned by Noriega's secretary, and Hostal Doraz, which is more on the main drag but has private rooms  with shared balcony for $20.

My host mom, Mery, is a great cook but it is nice to have a change from the typical Panamian diet of rice, beans, and chicken.  Memorable meals included peanut butter salmon ($15 at El Oasis), coffee rubbed filet mignon with chipotle sauce and yucca fries ($14 at The Fish House), and Peruvian corvina fish and langostino shrimp ($17 at Macchu Picchu).  I also enjoy breakfasts at Punto de Encontrado, where they give you a cheese, bacon, and tomato omelet with orchid garnish for $7 or Central Cafe downtown overlooking the central plaza where you can get scrambled eggs, fruit bowl and local coffee for $6.