Hospital Cecilio Castillero
On our last morning in Chitré, we had the opportunity to visit Hospital Cecilio Castillero, a Ministry of Health system hospital that provides services for people living in the Herrera, Los Santos, and Veraguas provinces. The services at this hospital are one step above what we observed at the clinics that provide preventative services and include a major focus on maternal and child health. They also provide outpatient services, including pediatric dentistry, breast, and cervical cancer screening, general surgery, internal medicine, and pediatrics.
This hospital has 135 beds and averages 85 births per month. The maternity ward contains three beds for labor, two for preparation and delivery, four for newborns, and two for women with complications. Once a mother gives birth, she is moved to an OB/GYN ward for post-delivery monitoring. Before mothers are discharged, they are given any necessary vaccinations. There are several services that are similar between the United States and Panama, including providing HIV testing to expectant mothers. However, in Panama, any costs related to maternal health, labor and delivery, and child healthcare through age five are covered for everyone through the Ministry of Health by law.
While this facility is convenient for those that live near Chitré, it can be difficult to access for those that live further away. As a level two hospital, it does not have the resources to provide specialty care such as cardiology, nephrology, or oncology. Patients needing these services are referred to larger level 3 hospitals, such as Santo Tomas in Panama City. It is evident that this hospital is attempting to maximize the resources they have to provide a wide array of services. There is an effort to control nosocomial infections in the hospital, as we were introduced to their infection control nurse, but the facility has so many limitations that the task must be daunting.
This facility, like most we’ve visited in Panama, was not accessible for those with physical limitations and had poor signage with directions for navigation written in sharpie on the walls. There were several private clinics surrounding Hospital Cecilio Castilerro, but those clinics only accept patients who can afford private insurance. This creates an inequity in the community around access to health services.
We want to thank the staff at Hospital Cecilio Castilerro, as well as everyone we met in Chitré. We are taking the lessons we learned here as we head back to Panama City to continue our exploration.
Culture: Tinajas Restaurant
Our first evening back in Panama City we had the opportunity to attend a dinner show at the Tinajas restaurant. Tinajas hosts a space for visitors to experience Panamanian food and cultural dances. The exterior of the restaurant reminded us of an older Spanish-style house, while the area that we were ushered to was designed to look like a back patio with lines of tables in front of a stage. Tinajas’ food selection consisted of traditional Panamanian fair such as tres leches cake and fried plantains. While we ate dinner, we enjoyed listening to Panamanian folk music, which was performed by a band that included an accordion, guitars, wooden drums, and a la guachara, which is an wooden instrument played by running a stick across the carved notches. Then we were introduced to several genres of Panamanian folkloric dances that dated back to as early as the 17th century. One of the dances, El Tamborito, meaning small drums, is the national song and dance of Panama. A few other dances they performed were Cumbia Suelta, Cumbia Amanoja, and Punto Panameno. There were frequent costume changes so that the dancer’s attire matched the period and dance. At one point, the female dancers wore hand-embroidered pollera with decorated beaded headpieces while the men wore formal montunos along with traditional leather sandals.
The cultural component of our day helped provide context to the things in society Panamanians hold dear, which is important for understanding motivations to perform certain behaviors or think in certain ways. For instance, because dancing is such a central part of Panamanian culture, it could be a more welcomed form of exercise than running in areas that don’t have sidewalks or even surfaces. This was evident in our visit in Chitré earlier in the week when working with seniors on the importance of exercise. Most of the ladies that we met indicated they enjoyed dancing and would participate often as a form of exercise. Now we’ve seen evidence of how culture can influence health.