by Jill Patel

Jill Patel joined us as initially as a global health student in the summer of 2018, and has been working on a research project focused on mental health within the Ngäbe-Buglé population. She will continue to work on Phase I of the project both in Panama and in the US through the Fall. Keep reading to know more about her initial time spent in Bocas, and be sure to check back in a few months with an update on her research!

Note: Written in summer 2018- future dates noted reference 2019

Words cannot begin to justify my experience in Bocas del Toro this summer with Floating Doctors. What I thought would be a simple medical mission trip turned into a life changing opportunity that has inspired my new path to global medicine. From the outside, I saw a beautiful landscape filled with lush green trees, tall mountains, and colorful houses. However, hidden behind this was a community that has daily contact with the jungle, high worm loads, untreated water, latrine sanitation, and wooden huts. Despite this, the Ngäbe-Buglé people welcomed me with open arms—they laughed, cried, and went on an emotional journey with me, never making me feel more or less than they were. I thought I would be helping them improve their health, but they gave me a whole new perspective on life that enriched my physical, mental, and emotional well-being. All of this may seem so abstract and good-to-be-true, and I would have agreed before coming here.

My most memorable and favorite moment was doing a community health project on mental health with children in Cayo de Agua. Nicole and I had brought coloring books and crayons, as well as prepared activities, from breathing exercise to hand-shakes, to teach children how to relieve stress We also created a simple questionnaire to better understand their emotions. Our activity started with five students. I used my broken Spanish, which was surprisingly better than I expected, to introduce myself. As more children joined our activity, our coloring circle grew from 5 to 30 students scattered, around us. Here I quizzed students on what they were coloring to practice my Spanish. The funny part was that I did not know if they were right—I was just asking to expand my Spanish vocabulary. However, I think they soon realized that and possibly taught me some inappropriate words because they kept laughing every time I repeated it—I wish I remembered the word so I could look it up.

This fun quickly turned upside down when I interviewed a five-year old boy. I still quiver every time I think about him. He was very reserved and would not look up at us when we spoke to him. At first, I thought his actions may be driven by socio-cultural factors and thus was common in this community. However, I soon realized that this was not the case. When we asked him what makes him happy, he said nothing, and he does not do anything to make himself feel better. He also told us that “ellos”—everyone—scares him; instinctively, I leaned in to give him a hug. He disclosed that a girl, who was present in the circle, was bullying him at school. My eyes watered up because I was no stranger to bullying myself. I was bullied up until high school for having thick facial hair, not shaving my legs often, and wearing long, oily braids- I know what it feels like to be different and to want to be a normal teenager. Before he left, I told him, “Tú eres muy fuerte y yo soy tu amiga.”

Mental health remains unknown and under-served in the Ngäbe-Buglé community, but the need is very large. From bullying at school to young mothers, children and teenagers are vulnerable to various mental health conditions as they are pushed into adult roles from a very young age. We all have been fearful, anxious, nervous, scared, and traumatized. Unfortunately, these communities lack the resources and support we receive here, and Floating Doctors has taken the initiative to address this issue. In January, a Family Therapist and a PhD candidate will come for a year to examine the mental health statues and needs of the community. I will join this team to further my community-based project in hopes of delivering better tailored care, and I encourage others to join the cause so no child ever has to cope with sadness and fear alone. Whether one is a volunteer, student, or professional, we can all make a difference in our unique ways as long as we have hands to serve, ears to listen, and a passion to help.

From clinic and beyond, I made many new friends and strengthened bonds with others. To continue Floating Doctors’ mission to improve the health of all, my group and I volunteered at Asilo, a nursing home in Bocas town, to address patient’s non-clinical needs—painting their nails, massaging their hands and legs, bringing water. When I entered the nursing home, I was surprised by the conditions of these elders- they were so frail and weak. My eyes watered up as I realized that many of them were either the same age or even older than my grandparents, who I am tremendously attached to. When I asked an elderly woman if she wanted to color or get her nails painted, she reached her hand out. As I held her hand in mine for a couple of minutes, her face relaxed and she closed her eyes. She reminded me of my grandmother, who would hold my hand as she watched TV or laid down because she loved having someone physically close to her. I sat with this woman for a while, just holding her hand without saying a word. This is the true power of a simple touch, something that many people may disregard but is immensely valuable.

Here I also met my new friend, Richard Garret from Queens, New York. I introduced myself and asked how his day was going in Spanish. To my surprise, he responded back in English—another lesson: never assume what one can and cannot do. From Turtle Beach to Summer, he gave me an oral tour of the entire town and listed all the places I should visit. When I asked if he goes to Summer, a dance bar, often, he enthusiastically said yes. Just like me, he loves to dance. We spent the next thirty minutes talking about our passion for dance. I shared with him pictures and stories from my previous dance competitions. Before I left, we took a picture together. He told me to show this photo to my family and tell them that I made a new friend at Bocas. He gave me a hug and told me to come visit him when I come back to town.

The Asilo opened my eyes to the struggles of the elderly in Panama and more significantly, the importance of addressing a patient’s non-clinical needs to provide holistic care. Sometimes medical mission trips get caught up in providing preventive and surgical care but forget that health encompasses much more than the physiological. Floating Doctors is unique and successful because it improves health at the clinical, social, and personal level. And this is what has, is, and will always pull me to Floating Doctors

As my story comes to an end, I want to leave with a final lesson: Dr. La Brot always says that in order to serve, we must learn from those that we serve. No matter how superior my knowledge or skill may be, I can never provide the best service or obtain the best outcome if I do not listen to my patients. While living in an open church and eating with locals in wooden huts at Cayo de Agua, I witnessed the lack of infrastructure and services. But through these activities, I also learned about the community’s lifestyle, needs, and wants. This helped me understand why certain medications and preventions were utilized in situations that we normally wouldn’t in the US. Learning and applying these social, cultural, and economic determinants of health in practice has been a humbling experience. I remain driven by the knowledge that easing the service gap can mean drastic change for neglected populations, which motivates me to continue my path in global and community medicine. I cannot wait to return back in January to help further the Floating Doctors mission! Thank you to Dr. LaBrot and his Floating Doctors’ team, the Ngäbe-Buglé and Asilo communities, and my wonderful colleagues for making this a memorable experience.