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...

At the fence

What a weekend!

On Friday evening after work, I went to a fundraiser at Paso del Norte Civil Rights Project (aka where Tom works).  They had food, beverages, and salsa lessons on their beautiful back patio- it was a great way to kick off the weekend.

Yesterday morning, I hung out with a School Sister of St. Francis for a while, chatting about the future of the Catholic Church.  She showed up with a bunch of food because 5 nuns are staying at my house this week for a retreat, and she's acting as their hostess.  After a great conversation, I ended up talking to a professor of gender studies from Valdosta State who's staying in El Paso for the summer.  She's known my landlord for a while, so she was over to clean our kitchen with him.  We chatted about women's health for about two hours.  Have I mentioned that I love my house?

After sitting outside for 20 minutes in the 100 degree sun to correct my tan lines for the wedding I'm in on Saturday (great success!), one of my roommates and I went over to the Anapra border fence:

Anapra is one of the poorest neighborhoods of Ciudad Juárez.  I took this picture while standing in Sunland Park, New Mexico.  This was the first time I've actually seen "the fence."  As I've mentioned before, in El Paso, the border between the U.S. and Mexico is the trickle of water referred to as the Rio Grande in the United States (people in Mexico call it the Rio Bravo).  However, as you can see in the map below, the river continues going north, so the border between the countries becomes a land border as soon as you go west of El Paso:

This is probably a good time to mention that "the fence" looks different all along the U.S.-Mexico border, with several places, especially in Arizona, having a structure that looks more like a concrete wall.  The fence at Anapra looks pretty similar to the chain-link fence in my backyard in Massachusetts, minus the fact that it's a few feet taller.  The tall poles that you see have cameras on top of them, and the car tracks are from the Border Patrol cars that closely monitor the area.  

When my roommate and I arrived at the fence, at least 3 Border Patrol cars pulled up immediately to check out what we were doing.  Then the kids who live in Anapra closest to the fence came out to greet us.  My roommate had met them the week before, and once Border Patrol realized that we were there to just hang out with the kids, they backed off a few hundred yards.  

The reason we went to the fence was because my roommate had met a little girl who wasn't wearing shoes last week, so she wanted to return with shoes for her and candy for the rest of the kids that live in the area.  She threw the stuff over to the kids before we realized that parts of the fence have large gaps that would have allowed us to just pass the things through.  

The whole experience made me extremely uncomfortable.  First, I was convinced we were going to get arrested because it seems like throwing things over the fence is probably illegal (however, I've asked about 80 people and so far everyone has said it is only perhaps an offense committed against Customs in Mexico because goods entered the country without being inspected).  More than anything, though, I was uncomfortable being a part of a system of utter dependence.  The houses of Anapra and Sunland Park are like 100 yards apart, and both areas are clearly quite poor.  However, lots of visitors to the El Paso area visit the fence, and the kids on the Mexico side come out and ask for things from the gringos.  We all know that it's not solving anything to give the kids un dolar or shoes or candy, but maybe it makes some people feel less guilty about the privilege of standing on the U.S. side of the fence by giving something to the other side.  

There were 5 kids there when I was visiting; 2 girls and 3 boys, all between the ages of 6 and 12.  I would've loved to have grabbed a ball and play volleyball over the fence, or to chat about what the kids are learning in school, or basically to have done anything.  But instead the girls asked me for literally everything imaginable: my sunglasses, my earrings, my cell phone, my shoes, money, etc.  They were super whiny, which actually made me feel less guilty about saying "no."  It was just awkward to realize that these children have been raised to consistently ask the gringos who go to the fence for things.  I can't blame them, or their parents even.  And I could go into a whole rant about the long-term implications of building of the border fence and NAFTA and whatnot, but that still wouldn't make me feel any less uncomfortable with the situation.  So we only stayed for about 20 minutes before heading back home.

I was very grateful to go out to dinner with the Border Servant Corps volunteers and one of the girls' (Ali) parents right after this experience.  And I was even more grateful to go swimming and in the hot tub at the hotel where Ali's parents were staying.  That's the first time I had been swimming since last August, which is crazy to think about since I went to the beach every weekend for most of August 2010-July 2011 while I was living in Savannah!

Anyway, yesterday morning I went to the Catholic Church that sits in the Segundo Barrio, which is basically like being in Mexico, El Paso.  It's the area closest to the downtown bridge that I often cross to access Juárez, and the streets there are lined with little tiendas selling cheap clothes and goods and blasting music in Spanish.  I love walking around the neighborhood, and it was cool to be there to worship, too.  Two of my roommates, both of whom are not Catholic, came with me, which was really nice.  The church is run by Jesuits and only has Mass in Spanish.  The service was good and the building itself is absolutely beautiful (minus the fact that it still has the old style very white statues of Jesus and the saints around the inside...that always kind of creeps me out and makes me uncomfortable, especially in a room where I'm one of two Caucasians).

Yesterday afternoon, I went to the Pax Christi showing of Inside Job.  If you haven't seen it, I recommend that you do.  

When I got home, one of my roommates had cooked an incredible dinner of tilapia, mashed potatoes, mango salsa, and salad.  We all ate together and then greeted the 5 sisters who will be staying at our house for the remainder of the week.  

I'm so grateful to be here, especially on weekends like this one! :)

Crossing the one-month threshold

Today, as I started whining to yet another friend about the fact that I still haven't received my first paycheck (insert muttering about the bureaucracy of government), I realized that this Saturday will mark my fifth week in El Paso! Crazy!

Yesterday was a frustrating day.  I felt like such a foreigner here.  First, when I got on the bus to go to the hospital, the driver didn't want to let me use my student pass because he had never heard of Emory University. I calmly explained to him that I called the Sun Metro headquarters and that as long as I attend an accredited university within the United States, I am allowed to use a student pass.  It was awkward because I'm not quite sure he believed that Emory was a real place, even though I showed him my ID that says "public health student."

Then I got to the health department to get my TB test (which is one of about 7 tests I need in order to get this crazy hospital clearance).  After being told to go to four different clinics within the department, I finally ended up at the right place:

The woman at the front desk could not seem to understand (1) why I had a Massachusetts license, (2) why I needed a TB test if I didn't have any of the risk factors, or (3) why I didn't want an HIV test.  The test was $9, and since I only had exactly $9 in my wallet I asked if I could pay with a check.  The woman said yes, and then like 15 minutes later called me back up to the desk to tell me that they couldn't accept checks from out-of-state banks.  I explained that I have Bank of America, but since my parents' address is on the top left, she said it wouldn't work there.  Super strange.  Luckily I had the cash though; otherwise I would have made the 30 minute bus trip there for no reason.  

From there, I walked over to the hospital that is causing me all of this stress to get titers drawn.  Yes, that's right; in addition to wanting to know that I've gotten all my vaccines (and that I've had chicken pox), they want to see proof from blood work that I have active immunity.  On Tuesday, I had to get a lab order from my primary care physician in Massachusetts and then call my insurance company to find out where to get my blood drawn in Texas.  Then I went to the lab yesterday, where the registration woman looked at me like I had a million heads.  She didn't understand "why I was from Massachusetts but had Blue Cross Blue Shield of New England" (it took all of my strength not to laugh out loud when I realized she was serious) and she also told me about five different times that she couldn't find my doctor's name (you know, the one in Massachusetts...) on the hospital database.  Finally, she just looked at me and said, "I don't get it. Why are you even here?"  It seemed like a kind of long-winded story to tell the random woman at the hospital why I'm in El Paso and why I don't have anything, other than a library card and gym membership, that says I technically live here.  Therefore, I simply said "To get my blood drawn."  It was finally all taken care of, so hopefully the results will be okay and will make it from this hospital to my doctor (who has to read them), back to my office, and then back to this same hospital so that they finally let my study "begin."

It's weird being in a place, really for the first time in my life, that doesn't attract many people "from the outside."  In my little bubble of El Paso, no one is actually from here; however, in the city as a whole, it seems that most people have either lived here or within like a 50 mile radius for their whole lives.

Anyway, things are honestly going well other than this little mishap with my study.  On Monday, I submitted my one-month progress report to the people funding my project.  On Tuesday, I had my best prenatal care observation/interview yet.  This morning I presented the "emerging themes" from my first five interviews on each side of the border to my advisor at Emory and to the professor at BU who we're working with, and they both told me that they're really impressed with everything.  Then, later this afternoon, I did my first postpartum interview with a woman, which went really well.  And I got to meet her beautiful newborn daughter, which is always exciting!  That's definitely the coolest part about my study- hearing how women are feeling before they go into labor and then talking to them after it's all over and they're holding their baby in their arms :)

Sunday Juárez adventures

This weekend was a wonderful change of pace for me.  On Friday, after I almost cried at my desk 10 different times because of all these problems related to my hospital clearance, it was really nice to go straight from work to happy hour.  I met lots of people who are in El Paso for a variety of different, though equally quite interesting, reasons.  Then yesterday I slept in, went to the gym, did a bit of transcribing, and went grocery shopping before going out.  It was definitely a good day to just recover from a long (yet only 4-day) work week.

This morning, Eric (one of my roommates) and I got up early to head over to Juárez.  We all went to bed really late last night, and it was ridiculously hot today (102º!), but even under non-ideal circumstances it was a great day.

We visited Peter and Betty.  As I mentioned recently, Peter is a Carmelite priest (he's turning 89 in two weeks!) and Betty is a Sister of Mercy (I think she's in her late 70s).  They're both American but have been living in Ciudad Juárez for 17 years.

Eric and I stopped at a bakery to pick up some doughnuts and piña empanadas in El Paso before crossing the downtown bridge into Juárez.  Then we walked a few blocks to downtown Juárez, where we took a bus to near where Peter and Betty live.

(I should probably mention here that Eric knows Juárez really well.  He's lived in El Paso for the past 3 years and has regularly hung out in Juárez during that time.  I should also probably mention that public transportation in Juárez is very safe.  Peter explained that because the violence is related to drugs, and because people who are involved in the drugs have money to buy cars, the people who ride the public buses tend to be outside of the group of people being targeted.  He says that in his 17 years in Juárez, he thinks maybe 2 or 3 people have been killed on public transportation.  But don't worry- I still wouldn't go to Juárez without someone who is very familiar with the area, and I certainly wouldn't ride the bus alone.)

Anyway, Eric and I arrived at Peter and Betty's just in time for our 9:30 breakfast date with them.  We ate and chatted and then Betty gave me a tour of their little compound, which they call Casa Tabor.  (My apologies for not having pictures- I only brought my passport and a very small amount of pesos across the border today...it was such a treat not having to lug around a bag full of the stuff for my study, and I wanted to aprovechar the simplicity.)

Their home is humble but still really nice.  It's full of books about Latin America, and the walls are lined with pictures of martyrs.  Outside, they have a chicken coop, a labyrinth, and a covered area that Betty uses for the autoestima seminars that she does with women in the community.  On the walls of the latter area, there are beautiful paintings that Betty did that surround lists of names.  There's a list of the women who have been killed in Juárez, a list of the men who have been killed in Juárez, a list of people who have died crossing the border in Arizona, and a list of Latin American martyrs.  The lists are nowhere near complete, but they are all still ridiculously long.  She's working on adding to the list of men who have been killed in Juárez, so she asked me to help by writing a few names for her.  She has a list printed from a computer, so my task was to use that and then copy some of the names down onto the wall using a permanent marker.  I only wrote about four names before she said it was time to go to church...she must have known that it would only take about 5 minutes for me to feel completely overwhelmed by grief.  Looking at all those names, thinking about all the nearly unthinkable suffering that is happening...it honestly breaks my heart.  And then I start thinking about the role that the US has in all the violence that's happening...it becomes too much for me to handle, to be honest.

The walk to church was a lot more than I expected.  I was wearing a short-sleeved shirt and jeans (have I mentioned how hot it was today?!) because I hate drawing even more attention to my gringa-ness (Mexican women do not wear shorts...and even capris and skirts above the knee are rare) but I decided to wear flip-flops instead of sneakers so that I wouldn't completely over-heat.  What I didn't realize was that although the main roads in Juárez are paved, many of the roads I would walk on today would be dirt covered in rocks, trash, and lots of broken glass.  Oops.  Oh, and none of these side roads are anything close to being flat.  I loved walking around and saying Buenos Dias to everyone, although it was also striking to see all of the abandoned property and the extremely poor-quality housing.  The scenery isn't anything new, but it's weird looking around and seeing that while also being able to clearly see UTEP's beautiful campus just a few miles to the north.  I don't think I'm ever going to get used to the disparities of this border.

Anyway, the church we went to was super small and cute.  Peter said Mass- he's a very progressive guy and gave the type of homily that many of his fellow priests were killed for in Latin America in the 1980s.  Needless to say, I really enjoyed it.  The music was fun and out-of-key, and the community warmly welcomed Eric and I (although it was super awkward having to go up to the microphone to introduce ourselves).  My favorite part was when everyone joined hands to sing the "Our Father."  Normally, people raise their hands up for the very end of the prayer ("For yours is the kingdom and the power and the glory forever").  However, they raised up their hands during the last line: "líbranos del mal" (it's the "deliver us from evil" part in English, although in Spanish it literally means "free us from evil/badness").  It was super powerful, especially being where we were.  I also really loved that the Mass ended with a prayer for peace in Juárez that everyone in the congregation had memorized.  I haven't enjoyed a Catholic Mass that much in a very long time.

After church, Eric and I walked up a little loma so that we could get a good view of the area.  It was so hot and dry that my mouth felt like sand-paper, and I thought my feet were going to break, but it was so worth it.  We could see almost all of Ciudad Juárez and downtown El Paso, and also had a great view of southeastern New Mexico.  The hill was only maybe 75 feet higher than the surrounding area, but it provided great perspective.

From there, Eric and I went back to Peter and Betty's for lunch.  We had fresh eggs from the chickens and fresh bread that Peter had made.  And I drank so much water.  (Fun fact: the water in Juárez is of a better quality than that of El Paso...the former comes from an aquifer, whereas the latter is basically recycled waste water from further north and tastes like metallic pool water.)  I really enjoyed the conversation- I could probably talk to them forever.

Eric and I headed back to El Paso in the mid-afternoon.  When we were crossing the bridge, we saw five people being deported.  It was quick- the US officials walked the individuals to the actual border, and then the Mexican officials walked them to the repatriation office.  It honestly took me a second to realize what was happening- the only thing that gave it away was that they were walking south on the north-bound side of the bridge.

Tonight I went out to dinner with my all my roommates to celebrate one of their birthdays, and then we had ice cream back here.  I'm really enjoying hanging out with them- Casa Puente was such a perfect place to live for this experience!

Bumps in the road

During my first semester at Emory, I attended several brief presentations by second year students who had just returned from their summer practicum work.  Literally every presentation began with, "Well, I was going to... But then this happened so I ended up..."  Therefore, I should have come to El Paso with the expectation that things would not work out as planned.  And I guess I've known that in research it's best to expect the unexpected, but that doesn't necessarily make it any easier to deal with bumps along the way.

Anyway, it turns out that I don't have the proper clearance that everyone (except for one compliance lady) thought I had in order to be at one of the hospitals here in El Paso.  The problem is that I've already done 3 observations and interviews at said hospital.  So now I'm "on hold" with them, meaning that I'll have to do the second (aka postpartum) interview with those 3 women somewhere other than the hospital.  That's fine, and I honestly only wanted maybe 2 more women from this particular hospital, but now I need to make sure that all my new paperwork and such goes through soon because it could be problematic if I try to publish my findings next year.

For those of you who have been following my blog, this is a different hospital than the one that was giving me IRB trouble a few weeks ago; ironically enough, that hospital has me cleared for everything now, but none of my enrolled women are planning to deliver there.  I think the most frustrating part about this is that I sort of called attention to my study by attending a childbirth class at this particular hospital last Monday.  The class instructor emailed someone to make sure it was okay that I attended the entire course during the month of June, and before I knew it I was getting crazy phone calls and emails from lots of people.  Maybe it's good that we figured this out now though, since it would have been an absolute disaster if we discovered after I left here that I was never authorized to do the study at that hospital.  I just hate that it's causing so many people so much frustration, and I really hope that none of the people from the institution who told me that I was all clear get in trouble.

In the meantime, I'm a little frustrated with the resident I'm supposed to be working with in Juárez.  One of the women I interviewed last Friday was due on May 21, and I emailed the resident on Tuesday to find out if she had delivered yet.  (Thank goodness HIPAA doesn't exist in Mexico yet...)  I still haven't gotten a response, so I still don't know how we're going to keep track of when women deliver at the hospitals across the border.

Actually, I still don't know how we're going to keep track of when women deliver at all.  My method on the US-side has been to text the women periodically to see how things are going.  Even still, the first woman in El Paso delivered on Thursday night and I didn't find out until Tuesday morning...and I can't interview her until sometime next week because now she's at home and really sore/exhausted.  Originally, since I was going to interview the women postpartum while they were still in the hospital, it made sense to try to interview the delivering obstetricians then.  Now I'm not quite sure how that very brief (I only asked the OBs for 5 minutes in the consent form) interview is going to fit in, as they'll probably forget the particular women by the time I can meet up with them.

Additionally, I've been working with some giant data sets that are giving me problems.  Thankfully, Hillary (everyone's favorite SAS instructor) helped me figure out how to convert the Mexican birth certificate data from characters to numbers.  I love people who go above and beyond to help me- it took us a series of 12 emails over 6 days to figure everything out, but it finally worked.  It just took forever to run my code since there were over 2.3 million entries (and something like 60 variables).  Now I have that data set cleaned and ready, but today Jill gave me another data set from the state of Texas that she wants some help with.  It's in a .BH file (which apparently stands for "black hole") and I spent almost two hours trying to open the data.  Needless to say, it didn't work, so now we're waiting to hear back from people in Houston about what to do (any advice would be greatly appreciated!)

While this stuff has been going on, I've been spending the vast majority of my time transcribing the interviews that I did on Friday in Juárez.  As I expected, it's time consuming and frustrating.  The women I interviewed all tended to mumble, and I'm not comfortable enough with Juarense Spanish to catch everything verbatim.  I've been listening to the recordings on 40% speed and repeating sections over and over, but it's still super challenging.  The interviews were all about 10 minutes shorter than the ones in English, yet have taken me about an hour longer each to transcribe.  However, it makes me grateful that I'm the person transcribing in a way, since I feel like when the women mumble and trail off at the end of their sentences a transcription company would probably just notate that it was inaudible or something.  And I've noticed that it's those sentences that are richest in terms of the data I'm collecting.

Sorry that this was such a long rant.  To be honest, I really do like what I'm doing and feel like I'm exactly where I need to be right now.  I feel quite willing to work through and overcome the challenges...I just needed to share my frustrations today.

A weekend of adventures

Anne, one of my closest friends from home (although she currently lives in California), came to visit me for Memorial Day weekend! After a very long work week, I was SO excited to get to the airport on Friday afternoon to pick her up.  And at the suggestion of almost everyone I know, we rented a car for the entire weekend, making planning much less stressful (and much more possible!)

On Saturday morning, we got up early and drove out to White Sands, New Mexico, which is about an hour and a half away.  Since pictures are worth 1000 words:

The landscape is quite different than anything else I've seen in this area!  It was ridiculously hot and sunny there, but definitely worth the trip.  And the ride out there was especially beautiful!

On our way back to El Paso, we stopped in Las Cruces and Old Mesilla.  There wasn't much to do there, but it was fun to walk around and explore a new place.

On Sunday morning, we went to the Franklin Mountain State Park, which is located here in El Paso, very close to Ft. Bliss.  We hiked one of the moderate trails that was about 3 miles round trip.  We got a nice breeze on the mountain and finished before the heat became unbearable, which was nice.  The views of El Paso, Ciudad Juárez, and New Mexico were wonderful, and I also really enjoyed the desert landscape.  Here we are about halfway through the hike:

We spent Monday exploring downtown El Paso before Anne had to fly back to Pasadena.  Overall, it was an incredibly fun and relaxing weekend, full of good conversation and good food.  And it served as a much-needed change of pace for both of us, which is always nice :)

A long day in Juárez

The above picture is taken from Scenic Drive here in El Paso, which I visited on Saturday night with some wonderful friends.  What struck me (probably because Tom pointed it out) most about the view was that El Paso and Ciudad Juárez appear to be one city.  Since it was Memorial Day weekend, the Wells Fargo building in downtown El Paso used its lights to make an American flag; however, that's the only building that I can even attempt to identify here.  As one of my favorite songs, Such Great Heights, says "Everything looks perfect from far away."  In this picture, we don't see poverty, violence, racism, sexism, or any type of injustice.  We just see light in the vast darkness of the desert.

Unfortunately, up close things don't look so perfect.  Real disparities exist across the little river, many of which I've only begun to start reflecting on.

I spent literally all day on Friday in Juárez.  The morning began at 7am when I crossed the Puente de las Americas.  Since there was almost no one else out that early, I took some pictures from the bridge:

The actual border

View from the top of the bridge (El Paso is to the right, Juárez is to the left, and the Rio Grande serves as the border)

After crossing into Juárez, I sat in the Parque Chamizal to wait for Goreti (one of my many helpers) to pick me up and drive me to the hospital.  An abuelita came and sat next to me and we ended up chatting for about 30 minutes.  When I told her that I am studying public health, she immediately whipped out a binder of newspaper clippings to show me that her cousin is the director of surgery at the general hospital in Juárez.  She told me that I needed to go directly to that hospital, introduce myself, and tell him that I want to shadow him so that I can learn about transplants.  She then proceeded to write down her name and phone number, along with his.  I couldn't help but smile, especially when halfway through the conversation she asked if I was American.  Her follow-up question, after I said yes, was if I was married.  I said no, to which she responded, "Be careful, then, that people don't rob you here in Mexico."  I wasn't quite sure how to interpret that series of dialogue, but I certainly appreciated her friendliness.

I spent the majority of my day at the public hospital.  There's nothing quite like driving up to a hospital and seeing lots of people waiting outside to be attended to.  I put on my roommate's white coat (thanks, Josie!) so that I could get ushered into the prenatal clinic where I would be working.  I had to correct several people who referred to me as "Doctora", but everyone official wears a uniform in the Mexican health care system and there's no color associated with "random Master's student doing temporary research."

When I met the resident who was assigned to my study for the day, I asked him how many patients we would be expecting and how things would go.  See, the original plan was that I would observe a prenatal care visit and then do an interview with the woman.  Each interview usually takes about 30-40 minutes, so I was hoping to observe about 3 visits and then do the corresponding 3 interviews, which would have taken me until about 2ish; thus, I told Goreti to return at 2:30.  To my surprise, the resident told me that he had invited 15 women to come to the hospital for interviews.  None of the women had prenatal care appointments; they were only coming for the study.  And they were all told to arrive at 8am.  Awesome.

I awkwardly smiled and then nervously sat down in the exam room that I was assigned to.  Luckily, only 5 of the women showed up for the study.  Two male nursing students (age 18) were given the job of my assistants; they called the women in from the waiting room and then they sat on the other side of the small room where I did the interviews to observe my qualitative study methods.  Two of the women I interviewed asked them to leave for privacy, which was nice for me, too.  During my last interview, they were horsing around and being super annoying...basically, they were acting like 18-year-old boys.  I kept shooting them death stares until they sat down quietly; I was definitely not in the mood for babysitting.

The interviews were rough.  I don't ever recommend that anyone do five 30-minute interviews in a row without a break, especially in one's non-native language.  (Of course the first woman I interviewed was a soft-spoken mumbler, too...I sure hope my recorder can correct for that when I work on transcribing tomorrow!)  Despite many pilot interviews in both Spanish and English, I didn't realize that some of my questions would be irrelevant to this particular population, so that was kind of frustrating.  Most significantly, evidently women in this particular hospital have no concept of epidurals.  They all thought I was crazy when asking about pain medication during labor and delivery; all five women responded to my inquiries with something along the lines of "Of course it's going to hurt...that's just how it is..."

The people who attend the public hospitals in Mexico are among the country's poorest.  The women I interviewed ranged from ages 15 to 17.  They were obviously not well-educated, especially in regards to childbirth.

I felt like I had little rapport with the women; I've grown quite accustomed to chatting with the women in my study before observing their prenatal care appointment as a way to break down some of the barriers between us.  But in this case, I was sitting behind a desk and wearing a white coat when they entered the room, which obviously added another layer of difference between the participants and myself.  When I tried to ask the women how they were and other pleasantries, they were rather short.  I don't blame them; they had come to the clinic and waited just to be interviewed by me, so they likely didn't want to waste time.  (I suspect that at least one of the women came with the hopes of having an additional doctor's visit, but that didn't happen.)

I powered through the 5 interviews, made arrangements with 3 of the women to observe their next prenatal care visits in a few weeks, and then realized it wasn't even noon yet.  So I sat in the waiting room of the clinic for a little while and then sat outside of the main hospital for the rest of the time before my ride was going to pick me up.  It was hot out and I felt absolutely exhausted.  I also couldn't stop thinking about the simple disparities between the bathrooms in the prenatal care clinic and the majority of bathrooms in El Paso.  Despite it being a very large clinic, the men's room was out of service and the ladies' room only had 1 out of 2 stalls functioning.  There was no toilet paper or soap to be found, and the stall door was broken so that it didn't actually close all the way.  Good thing my travels have taught me to carry tissues and Purell everywhere I go!

After Goreti picked me up from the hospital, we went to a mall so I could buy a super cheap Mexican cell phone (it cost less than US$15 and looks like it's from the year 2000).  Hopefully now I won't need to wait for rides there anymore!  Then I went to buy a water bottle but the man working at the stand was super rude.  I hadn't been able to exchange my US dollars for pesos, as that was our next stop on the way back to the bridge.  I asked the guy if he accepted US currency and he said yes, but then when I said I only had a $20, he said he couldn't make change.  That's fair, but when Goreti offered to just buy the water bottle (it cost 7 pesos, which is like 50 cents), the guy basically asked why on earth she'd buy something for me.  She told him that we were friends and verified the cost while she took out her wallet.  He looked at me, paused, and then said it was 8 pesos.  Goreti then proceeded to tell him he's racist and a terrible example of a Mexican.  She left the water on the counter and guided me to another store, where she bought a water bottle from a nice clerk.  Goreti then proceeded to apologize profusely for his behavior.  We talked about how there are bigots everywhere, but I realized that it was the first time that someone was outwardly rude to me for seemingly no other reason than the way I looked.  It happens all the time, especially to non-whites in the US, so I guess it's good for me to experience as a reminder of my privilege.

The icing on the cake for the day was that after I walked over the bridge back to the US (which is about a 10-15 minute walk) in the insane heat, I had to wait in line for an hour and a half to get through customs.  Oh, and there's no shade in the area.  I got quite sunburned, but at least the time standing in line gave me a chance to process my day before I went to the airport to pick up Anne...but that will be the subject of my next blog post!