Before Heading Abroad: Immunize

This past week I stopped by campus health. I had learned about the immunization, allergy and travel clinic, and I wanted to find out what it could do for me.

I quickly moved from the triage section to the immunization clinic located in the northeast corner. It was small with an office like feel to it. A few students waited to be seen. I new it wouldn’t take long before the nurse called me. While I waited, I noticed the posters on the walls. They had images of exotic cultures and lands. Each had text to promote proper immunization before heading abroad. One poster read, “Asia is beautiful, but Japanese Encephalitis isn’t.” These posters were produced by TravelWise.  They had them for various countries. Ironically, the clinic doesn’t offer the Japanese Encephalitis immunization.

The nurse called me in, and asked me what I needed. I told her I was in a journalism class, and I frequently crossed the border into Mexico. I wanted to know if I should get any immunizations. She told me the clinic didn’t work that way. I would need to make an appointment to discuss the country or countries that I would visit. They would put together a packet, by Travex, of all the immunization I would need. I would then meet with them for a 45-minute debriefing, and decide what immunizations to get.

Since I didn’t call ahead, they didn’t have a packet to discuss with me. Fortunately, the nurse said the only shot she could think of would be a Hepatitis A series. However, she said that anyone in the U.S. who eats out should probably get the shot.

So, Butts, unwashed hands and food came into my mind, and I didn’t grab takeout for the rest of the day.

Pushing aside those thoughts, I asked about H1N1 vaccine. She told me the season was coming to an end, but it was recommended for people who would be traveling, especially by plane. I was pretty sure that I wouldn’t be traveling to the extent that I would need it. But, then she said it was free for University of Arizona student, and the batch on hand would be expiring soon. With H1N1 being new to my age group, I decided to grab the shot while at the clinic

My Childhood memory crept into my thought- Oh, this is gonna hurt. Of course, it didn’t.

So, I should be immune against H1N1, and I know how to use the campus travel immunization clinic- all it takes is a destination or two, a call, and an appointment.

St. Andrew’s Clinic

In a little church at the north end of Nogales, Arizona, dumbness struck me upside the head. St. Andrews Clinic was a health

Jesus Munguing is recieving his first hearing aids.

bazaar for children. Children and their parents were shuttled by bus from Sonora, Mexico to the Clinic.  As the kids scurried off the bus, a volunteer handed them tennis balls. The kids played while they waited for their appointments.

Once the doctors had arrived, pandemonium ensued.  Staff shuffled parents and kids to their appointments. With the clinic meeting once a month, they had limited time to see everyone, about three hours. For all the chaos, it was well ordered. I couldn’t believe it.

The Border Beat crew had assembled a group of eight students to go down to St. Andrews and report. In order to prepare, we read previous stories, watched a behind the scenes video, and devised some story ideas. This was supposed to help orient us.

Since I studied deaf culture and American Sign Language as an undergraduate, I decided I wanted to cover hearing, speech, and, to break it up, orthopedics.  However, I spent most of my day in hearing.  There’s nothing like jumping in feet first.

I wanted to learn more about these kids with hearing loss. I wanted to know if they were learning Mexican Sign Language, or if they were relying only on their hearing aids. Unfortunately, that was all lost. The translator would bring a couple of kids into the

Dr. John Cobb inspects a little boy

room, and they were happy- not a transient happy, not the kind they have when they received a new toy, a real happiness, the kind they will remember long into adulthood.  I was caught up. All I could do was record the happiness.

They were receiving the most basic of needs. In the hearing room, the doctors fitted the kids for hearing aids, cleaned and maintained the hearing aids, or took the hearing aids in for major repair.  I was shocked most by the need for batteries. The kids just can’t get them where they are. I kept thinking what’s a hearing aid with out a battery.

My biggest flaw when reporting is getting caught up in the moment. But who wouldn’t when children receive care they otherwise couldn’t. The day was unexpectedly fast, and it was amazing.

Tooth Pull

Well, I went down to Nogales, Sonora, and I checked out one dental place. The interior was clean and professional. The staff member that I talked to was knowledgeable. I have interviewed somebody who has gone. She liked her experience, but I’m a little more skeptical. I wasn’t able to see the back, and I don’t know the laws in Mexico. Thus, I don’t know what actions I could take should something go wrong.  So I won’t be going there to get my tooth pulled.

Today, I will get my tooth pulled in the U.S.

The tooth on the far right is one being removed

I was able to get my financial aid status changed. They said I could take out more loans. These loans will pay for my uninsured dental extravaganza. I would wait, but my tooth is hurting me. It’s a constant dull throb, with intermittent spikes of pain, especially when I swallow.

Getting my tooth pulled is the cheapest way to fix this problem, $209 to $358. I was told if I paid in cash, I could get 5 percent off. That’s kinda funny considering I was quoted a range.   Saving the tooth would be too expensive. First, I would need a root canal and some bone restructuring. That would cost $1990. Second, I would need a Buildup and Crown. that would cost $1224. Third, I have other teeth that need fixin’. That summation would cost as much as another crown.

I would prefer to have all my teeth, but I will do what I must. In the future, I will get an implant. It will cost more than the crown would have. Perhaps by then, I will be comfortable enough to visit Mexico for a dental appointment.

HIV in Rural Communities

I met Carol Galper, EdD, CHES, Assistant Dean for Medical Student Education at the University of Arizona School of Medicine, last year. I was fortunate to run into her on a plane where we talked about HIV.  Galper is one of those people who’s seen the epidemic from the beginning, and she has been advocate ever since.

Recently, I was sitting with her at a coffee shop at the Arizona Center in Phoenix.  She was involved with continued medical education for HIV patient treatment for Dentist. I told her I was covering border health for Border Beat, and she bombarded me with scenarios that I would never have imagined.

You’re in Yuma Arizona. You’ve come in contact with a friend’s blood. You know that they are promiscuous and have unprotected sex. You ask them if they’ve been tested for HIV.  The scoff, and say they are negative. But you’re just a little unsure. You know you should be fine, but you want to be safe. However, it’s a small town and everyone knows about the HIV clinic. What do you do?

People in rural community drive miles to larger cities to get tested, Galper said. They fear the stigma in the small community and the possible leaking of the results.  The same goes for people in Mexico, and many cross the border to receive treatment.

No one should feel they have to drive hours out of their way for piece of mind. The best tool of preventing infection is absolutely no exposure, but should you be exposed, time is of the essences.  Post exposure prophylaxis only works if it’s administered right away, preventing the virus from getting a foothold.  However, it’s not a guaranteed to prevent HIV.

The best way to fight HIV is knowledge and communication. Dialogues must be opened and people must educate themselves and others. I know plenty of people who live long, normal lives, and they get married and have families. Their lives are different. Wishing they never contracted the virus, they live.

Educate yourself and others.

Ice on the Range

Mount Wrightson is the talles peak in the area, 9200 ft.

The snow sprawled down the side of the mountain. I stood at the base looking at the peak. That’s not where I would be going today. I would be going midway up to saddle back and then back down. Mount Wrightson is the tallest peak in the Santa Rita Mountain Range.

A portion of the range that captures their beauty.

Wrightson is 44 miles from Tucson and 88.6 kilometers (55 miles) from Nogales Arizona, as Google puts it. Interstate 19 boast the only signs that are in kilometers. Recently these signs were in jeopardy of being changed.  For now, they remain one of the man made sight on the drive down to the Santa Rita Mountains.

On my many drives down to Nogales from Tucson, I’ve pulled my eyes off the straight stretched out I19 to look at the Santa Rita Mountains. This mountain range provides some of the most beautiful sights along the route from Tucson to Nogales. I had to take an opportunity to hike the super trail. I looked at the snow on the side of the mountain and knew I would hike through some of it.

At the start of the trail, I saw a marker for group of Boy Scouts who lost their lives on the mountain. That got me thinking of the two immigrants that I interviewedin Mexico. They had tried to cross the mountains in Sasabe, Arizona.  I would be hiking this mountain as a healthy alternative to the gym while they had been trying to cross a mountain range to get home to their families. My healthy alternative could have been their death.

source Google Maps.

source Google Maps.

The Pozo Verde Mountains, near Sasabe, only get up to about 4000 ft. while I would be hiking above 6000 ft and Mount Wrightson peaks at 9200ft. But, I hiked with life and death in mind. When I reach the saddle back and saw the memorial to the Boy Scouts, I thought about what they must have endured, and then I thought about what it must be like to cross the desert without the appropriate gear.  There are a group of people who put there health on the line to find a better life.

Israel, Palestine and Health

Craig Metcho, Hali Nurnburg and Ben BenLulu watch Fuchs talk about her time in Isreal.

In a the multipurpose Harvill Building at the University of Arizona, a handful of students gathered to listen to Katherine M. Fuchs, national organizer for US Campaign to End the Israeli Occupation. The campaign is a coalition of 320 organizations that adhere to their principals.

Fuchs stood at the computer in the front room ready to share her images and stories from the West Bank with the student who occupied 10 of the 100 chairs in the room.  Sitting in the chair, looking at the photos and listening to her speak, I couldn’t help but wonder how slanted this presentation was. She had traveled to Israel with Interfaith Peace-Builder to examine how U.S.  Policy and presence was affecting the conflict between the Israel and Palestine.

Fuchs gave a conversational account of her trip to Israel.

I was curious about health care, and how the conflict was affecting Palestine health care. The first thing she began talking about were the births at the borderlines between the west bank and Israel. Palestinian ambulances weren’t allowed to cross the border. However this wasn’t anything new to me. I had quickly read up on healthcare in Palestine before attending the event. However, what was shocking is that my sources were from 2006 and 2007. Seems things haven’t changed in four years

If the government feels the treat is significant to have the walls up, then they need to address the issues caused by the wall for those who are not a threat.  I’m not there, so I can’t say whether the wall is necessary or not.

One of the things Fuchs talked about was women’s health care in Israel. “Israel has better health care than we do,” she said However, she began talking about Ethiopian women in Israel, and how they receive birth control. I was drawn to this topic because she talked about Depo-Provera.  My Mother had taken the shot when I was younger.

Fuchs was concerned about birth control, but the type that was administered. She said the shot wasn’t as good as other types of birth control. She was pointing out the dichotomy between the Israeli Jews and other Israeli people. Since I’m not a women or a doctor, I don’t really think I should form too strong an opinion on the topic. The shot lasts for three months and has just as many side effects as any other drug. My mom is fine. So I need to  know more.

The Israeli-Palestine conflict generates many issues to be examined, and each issue such as health care has and equal number of issues to examine.  Hearing Fuchs speak made me want to hop a flight to Israel and see what’s going on for myself, and share what I find with out any filters or lenses.

Vaccines Before You Board

I heard the jets of airplanes zipping in and out of the airport. Travelers huddled around their gates. Knowing that the plane would be cloistered, I walked around my terminal and explored. I was only flying from San Diego (san), California to Tucson, Arizona (tus), an hour flight, but I like to stretch and walk.

Every time I fly I think about the close confines of the plane. A person is inevitably coughing somewhere in the plane. Or, the person sitting next me seems to be unrestrained by the boundary outlined by the seat, and I find an arm in my side.

When I saw the vaccinations being offer at the San Diego Airport, I knew they were on to something. Not only are the planes a breading ground for spreading diseases, but also with security sanctions, people often spend an hour or two waiting for flights.

I walked over to the tables set up in the corner and talked with Paige Titus, a registered nurse with Pacifica Medical administering the shots.  While I was only traveling over domestic borders, I was intrigued. I’ve never gotten a flu shot, only the basic immunizations.

Paige said they had a late start because of the shortages of H1N1 vaccines, but now that the vaccine was readily available, they were in full swing.  In addition to H1N1 vaccines and seasonal flu vaccine, they had Hep A and B, typhoid and T-dap.  She said they would be at the airport until the flu season ended.

I was curious about getting a flu and H1N1 vaccinated. She said I could do one with a nasal spray, and I could do the other as a shot, or I could do both as a shot. The nasal spray comes in two doses for one vaccination, one for each nostril.

If I chose to get the shot, I would have to wait around for about 15 minutes to see if I had any reaction to the vaccine. Everyone has to do this, but since I never had a flu vaccine before, the observation period was critical for me.

I decided I would hold off on the vaccine. I needed to get home without any unplanned events. And I knew campus health services offered vaccines and immunizations that would be affordable for students.

Doing the Dental Deed Down South of the Border

The fence seen from the border check station. Anyone with a passport or passport card can cross to visit the dentist.

Toothache? Tough luck for those who are uninsured. But for many who live near the border, they have a chance to slip over the border for a cheaper bill. And the dentists on the other side of the border know it. If you cross the border, the streets are lined with dentist.

This is particularly interesting to me. I don’t have dental insurance. As a University of Arizona Graduate student, I’m only offered health insurance.  And with a big gapping hole in my molar, I’m investigating this border crossing techinque.

I crossed the border stopped in to Gabriel Tardagulia, D.D.S.  office. The front room was as cozy as any U.S. doctor’s office. Plants surrounded plush chairs. Photographs of teeth adorned the walls, and the standard dental fliers were in English.

I chatted with the Smyrna Saláis, the administrative assistant. In between Calls and helping patients in and out of the surgery room, she answered as many of my questions as possible.   She told me that 60 percent of the clients came from the U.S. I was surprised. My initial guess would have been around 20 percent. When she said they had seen people from California, Colorado and Arizona, I thought yeah, okay.  So, it not just people living on the border.

She started naming some prices:

$30 for an exam

$160 for X-rays

So I got a little curious about what I would need. About a year ago, I bit down on a hard bit of food. At that moment, the sound of a chandelier crashing down from the roof of my mouth sent the sharp sounds of shattering glass echoing through my head. Jabbing my tongue into the fractured tooth, I was able to gauge that my last molar was missing a fourth of the tooth.

Not so pretty. The last molar in the uper right corner is my fractured tooth.

My number 15 tooth, that shattered molar, needs some work. At my dentist’s office in the U.S., it would cost me $3214 to fix my tooth. At Dr. Tardagulia office in Nogales, Sononra it would cost me $2500, according to Saláis. The price quoted for the dentist in Sonora is for a complicated case. The price could be lower if the procedure turns out to be simple, possibly $1900.

This is an alluring prospect. However, I’m comfortable in the U.S. I grew up with the laws, I understand how regulations work and who to report any malpractices too. So, this avenue needs more pursuit, which will come in future blogs.

Crossing the Line, My First Story

Last Wednesday, Curtis, a fellow graduate student, strutted into the graduate offices and asked, “Who wants to go to Nogales.” Nogales, Sonora. Not Nogales, Arizona. I piped up a little, “I do.” I was in for a new kind of experience.

I grabbed my passport out of my backpack- always nice to have available, one never knows where his day might take him. We jumped in Curtis’s red Jeep, and drove down the I-19, which lead us directly to Nogales and the border.

Driving into Nogales, I noticed the hills- the kind I expect to see in California. Among the sparse desert landscape, homes encrusted the hills. Then, I notice a buttressed metal fence dividing the landscape.  I couldn’t help but think that wall was designed to break the flooding masses of Mexicans trying to cross.  In reality, its silly design is probably just trying to keep it from tumbling down the hill.

With a quick left, the sight was behind us. We parked in the McDonald’s lot a couple of blocks from the boarder. Paying a security guy $4, we displayed our pass in the window and locked the car.

On foot, we head the rest of the way to the boarder. Nogales, Arizona looked like an old desert town one might see anywhere in Arizona. Despite many new additions, the place was straight up from the decades long before I was born in the 80s.  The huge brick facades of department stores lined the streets.

The road ran from Nogales Arizona over to Nogales, Sonora. A large building build over the road divided the road into many paths for those crossing the border. On foot, we crossed over to Mexico through a rotating door made of metal. With nothing to impede us, we move on to our first destination.

Curtis was stopping off at a radio station. I was tagging along looking for my border health story.  We quickly found the radio station a few blocks south of the border.

The station doors opened to an elaborate marble staircase. This is not what I expected to find. A few steps up to a platform and the stairs divided and wound back behind us to the lobby of station. Nice.

Curtis did his thing, in Spanish of course, and we headed to the bar to meet up with a local. We sat down with Enrique. He spoke English, so I was able to join in the conversation.   We talked about Nogales, the people and visitors.

After Curtis and I caught up on local news, we asked him where we could find people who had tried or were trying to cross the border. He told us that many people that had bags, were a little dirty, and looked a little worn out were likely to be trying to cross the border. I sat back. Randomly stopping people could prove fruitless and time consuming.  Then he suggested Grupo Beta. Grupo Beta is a Mexican humanitarian aid effort to help stop migrant deaths in the desert.

Enrique said the group was about 10 blocks away he suggested a bus, but we decided to walk. We walked along the boarder until we came to cemetery, and Curtis pointed down the street. “Down that alley,” I said, producing Curtis’s favorite quote of the day.  After we passed the cemetery, the street wasn’t as occupied as the rest of the town.

After telling Curtis I’d only go so far for a story, we stopped at a family own store, randomly placed among residential housing. It turned out that we went the wrong way. On the main street, we made our way toward the group. We stopped to ask directions once more. After that, the group was easily found.

We dropped in on the group. Curtis told me that really wasn’t polite. Understandably, the Nogales group chose not to talk to us, but they gave us the headquarters’ phone number. Having traveled a long way, two migrants approach us and told us they wanted to tell their story.  They were hungry, so we went to grab some food.

At a little taco shop, Curtis became the interpreter and we began our interview. I was amazed to learn of their travels. Two ordinary guys, 26 and 20, went on a crazy adventure to get back to their families.  Although they were breaking our law, I was impressed with their courage and determination to get back to their families.

The sun had begun to set by the time the interview finished. The men headed back to their waiting post, while Curtis and I headed back to the border. We stopped off at the to bar to calm our nerves. As we headed back to our home side, Curtis point out our privilege. We were crossing in the city, and they were out there trying to find clandestine ways to get home.

While I didn’t find a great health story, I found a great human story that told me a little bit about what I wanted to know. Word of mouth was the way these men had gotten their information about the dangers crossing the border. I can’t wait to find out more on this specific topic.