The adventures continue

I'm back in El Paso after a beautiful four-day weekend in Philadelphia for the wedding of two of my best friends from college.  It was a whirlwind, and now I'm exhausted, but it was incredible to see so many wonderful SJU folks in a celebration of love and friendship.

I feel like such a loser talking about the weather in my blog, but another major bonus of being in Philadelphia was soaking in the refreshing air.  The high temperature on Saturday for the wedding was 79º and there was just enough humidity for my skin to soak in a little of the moisture that it has been missing so much.  Unfortunately, when I landed in El Paso last night and checked the weather, this is what I found:

Anyway, this morning I went over to Ciudad Juárez to do observations of prenatal care visits.  I left my house at 7am to walk downtown and over the Stanton Street bridge (which is only one-way...weird!)  Then my bud Goreti picked me up and brought me to the hospital for 8am.  I went into the prenatal care clinic and got settled, trying to figure out what I needed to do as I fought sleepiness.  Thank goodness people are so accommodating to the silly gringa.  They evidently thought I was going to observe all the appointments this morning, when in fact I was only trying to observe the ones for the women enrolled in my study (who I've already interviewed).  Two of the five women in my study did not have appointments this morning, so I asked if I could look at their medical charts.  One of them gave birth 10 days ago and the other one either didn't show up for her latest prenatal care visit or was referred elsewhere.  The charts were absolute disasters- a mixture of hand-written and typed notes in no logical order.  I asked the director if I could write the women's phone numbers down so I could contact them myself and she looked at me like I had 5 heads...Of course you can take down the women's personal information when HIPAA doesn't exist. 

I ended up observing two of the three anticipated visits this morning.  Evidently the other woman just didn't show up.  For the second of the two appointments, I had to go over to the hospital next door to ask the director of urgencias if the patient had been admitted because we couldn't find her chart.  The patient had been admitted, but it was a week ago, so she sent me back to the clinic to tell them to look again.  I arrived just in time to find the patient (along with her chart) halfway through the visit.  

I finished up at the hospital by 10am and luckily had my handy-dandy Mexican cell phone to text Goreti for a ride back to the bridge.  There was an obnoxiously long line for U.S. citizens, but at least there's shade on this particular bridge.  Funny story: some random woman told us that there was a third "middle" line for U.S. citizens, so I walked down with a small group of women.  When we got to the official, he told us that we were mistaken.  I was prepared to walk back to the end of the line (which had grown significantly longer in the 5 minutes that I gave up my spot), but one of the women in my little group decided we should all cut the woman who gave us incorrect information.  This involved some arguing with both the woman and the other people in line behind her, but the leader of our little group of strangers wouldn't give up.  The line only took about 40 minutes to get through, and the time passed quickly because a cute abuelita asked me to use my phone to look up places in El Paso where she might be able to buy colostomy bags.  My life cracks me up.  Here's a picture of the line I was in- the little door at the end of the makeshift tunnel is where you enter customs, and it takes about 10 more minutes from there to swipe your passport (twice!) at fancy machines, talk to an agent about where you're going and where you've been, and then get your stuff scanned through an x-ray machine (no pictures are allowed in the building though):

I'm starting to get a little nervous about the progress of my study.  I leave El Paso 8 weeks from today and only have 1/3 the number of necessary participants enrolled.  I was supposed to start up at a second hospital in Juárez this week, but that was pushed back to July 9.  I received word that I was officially approved at the first hospital in El Paso that was giving me problems, but that doesn't help me at all since none of the women I'm working with so far are planning on delivering there.  Last week, after much tribulation, I received all my blood results and background check for the hospital that's giving me the most trouble in El Paso, so hopefully I'm approved there before the end of the month.  More than anything, though, I need the OBs on the El Paso side to refer more women to me.  They have all expressed that it's been difficult finding women who are giving birth for the first time before August 1, but I kind of suspect that the study isn't their top priority, either.  If things start moving along, I should be okay- I just don't want to be scrambling for interviews during my last two weeks of work.  One day at a time, I guess...