09.25.14 Young school children, more smiles and some tears!

More meetings today. One case of dengue is now an outbreak, so the island is in high gear to destroy mosquito habitat, isolate the sick, and a campaign to avoid the daytime mosquito bites. From a rationale point of view, to avoid mosquito bites one must wear long pants, long sleeve shirts/blouse, and socks and shoes to  minimize exposure during the daytime. (Bednets are used to semiquarantine the afflicted to keep mosquitoes from biting carriers of the disease.) That is so far from the cultural norm here as women wear skirts or pants that go just below the knee, no one wears long sleeves and very few wear shoes and socks. (Yes I am an oddity here for many reasons.) A lot won't wear repellant either. Stay tuned. The Center for Disease Control (CDC) is an integral component of outbreaks here.

Back to school. My last day doing the early school children. It really is good to have the parents there as I can examine the child and ask about soft drinks and snacks. Too many decays.

Here are a couple of pictures from today:

Talk about a small world. This child was watching a movie on a computer while his Mother was in the dentist's office! Sounds like home, except the child and computer were alone on the bench  with no concern for safety or theft. I sat with him for a while because I wasn't that comfortable leaving him by himself. Most likely a grandparent or auntie was around the corner, but I  wasn't that sure.

I turned around and here was a visitor on her computer. We are all linked.

School exams:
Cute little girl. She was four.

OK, here it is. Over 80 degrees and 100 percent humidity. Pouring down rain. And he is wearing a hoodie! I was "glowing" perfusely and he is having fun with the hood.
Hot. Hot, Hot. But reduced risk of mosquito bites!

 

Another set of twins. This is the fourth set in four days.

Bigger student showing the little one how blood your finger is picked for blood drawing. You guessed it, the bigger one cried, the little one didn't!

The staff are so good with the kids. They are  kind and gentle and effective. I like watching them in the schools and public health office. The lady and man are wearing a mask because each has a cold. They all do that when they are sick with colds. No one comes in to work with the flu. More people at home should do that.

After lunch, all of the children brush their teeth. The teacher has a tube of toothpaste and she applies it to the brush for them. They use the sink - not that red bucket in the picture! He was just keeping an eye on us. No shoes inside for anyone.

Waving good bye after singing a song. Kafel!

Met with the Yap Comprehensive Cancer Control Program director and staff and we are moving forward on a breast health awareness program. Now I have to get back to completing the culturally specific brochure (I really like making them) and then begin the Knowledge, Attitude,and Practice assessment of the doctors, nurses, community health workers who will be involved in breast cancer screening. There is no mammography here - yet. But we are at the point of where awareness, clinical examination, ultrasound and a biopsy are the primary components of an assessment. Time, it takes time. The interest is there, the dollars are in short supply. We will do as much as we can for a sustainable program. Martina leads the CCCP, no doubt she will work to continue it after I am gone. She is married to Dr. James, Ob/Gyne and informed me that she will inform him that I will teach him how to perform breast cancer surgery. So I will!

On a really fun community note, I now see some of the kids in town that were sailing or paddling a canoe on Saturday. It always surprises me to here Hi Dr Rosemary as I walk down the street. Hoping for a nice day Saturday to help with the practices for the canoe festival. I did volunteer to help with the door to door campaign for TB with the PH office, but alas they need someone who speaks Yapese. So Saturday for helping the kids with racing it is YES!!!!!!!!!!!!!!!