The Bread is Fresh...

So we're at the endish of our first week. It has been extremely challenging on many fronts.

First the good:
It has been awesome to be here with Swell. We don't see a tonne of each other during work but its nice to get home at a decent time 5:30-6:00 and sit and watch TV or DVDs together.

On Wednesday we were invited to go to the local Catholic Church where some Eskimo folks were "practicing their dancing". We weren't entirely sure what that meant but after arrving realized that we were experiencing one of the coolest things I've experienced in my life. It ranks up their with sitting on a roof top in Palestine listening to some locals play music (in '99). It also ranks with when I was sitting in the back of a truck in rural Honduras zipping along listening to the frogs croaking. On Wednesday we sat in this Catholic church and listened to three men play traditonal drums and sing. Whenever anyone felt like it they would jump up and do a dance associated with the song being played. What I found most interesting is that there were many young people there (12-14 years old) and would at times be the only person dancing. It was actually (for this bleeding heart) a very moving experience and one that I won't soon forget. I'll try to put some pictures up but that will require going to the pizza place and spending a bunch of money on lunch or dinner (this Sunday or tomorrow for dinner).

The patients here are very challenging. They people are beyond nice but they are a sick/old population (the ones we're seeing this week any way - remember that they are all diabetics this week). The previous optometrist was meticulous in her note taking and I would argue extremely conservative in her treatment plans. Swell and I, having worked in the worst of all situations, are far less likely to call something a problem. It makes it difficult to reconcile our findings with the previous optometrists. We were astounded by how much the previous optometrist did but have come to find out she was really only doing one exam an hour. We will be doing at least 2 an hour each.

The negatives are just things we have to learn to live with.

A lack of communication is a big one. There is no one "in charge" of optometry here. No one really seems to know how things work. There is no policy and procedures manual. We are going out to villages all next week and were told to make sure we had all the necessary equipment ready. Most of it was already packed away but we really don't know what we need as we've never done this before. If I were ruler of the world I would make a manual that states bring this and that for every village trip. No such manual exists. This wouldn't normally be a problem because there were two optometrists here but because both quit there is no senior OD here to guide the Jr. ODs (us).

In the villages we really only have enough equipment to be doing one exam at a time. We'll have to figure out a way around this.

We have to bring our own food and water to the villages. We only have one duffel bag and then a tourist style suitcase. We can bring as much luggage as we want but I don't think a four wheeled suitcase is going to work well in a small rural village.

Because they are without an optometrist we are pushing a lot of "special testing" off. Many of the charts have the notation to do a visual fields in a year, or photos, or someother non-regular testing. Well, a year is up but we can't really do this extra testing as we don't have the time. We tell them to come back in a couple of months and hopefully we will be here and able to do it or they will have hired someone.

A yet to graduate optometrist is coming by sometime this week or next to tour the facilities. They hope to hire this new grad. I couldn't have done this work right out of school but I hope that this new grad is willing because they really need someone.

Well thats that. We haven't been overwhelmingly busy because a couple of villages were snowed in and the folks couldn't make it into Nome.

I should explain that there are medics in many of the villages (these are well trained lay people who are able to prescribe some medications and take care of minor issues). They can also communicate with providers in the hospital and send pictures and questions for guidance. (Telemedicine at its finest).

Once in a while a specialist comes to Nome and all those requiring help from said specialist come into town to be seen. Physicians also travel to the villages on some set schedule.

It is a very public healthy set up and seems - albeit from the outside looking in - to be an efficient method of providing care to the local people.

We were in Safeway yesterday as a man took bread of the shelf he exclaimed: "The bread is fresh today!" He proceeded to thump it and explain how he knew it was fresh "Its still frozen!"

Thats Nome in a nutshell. Fresh bread is still frozen bread put out on the shelves.

Its been fun.