Panama: May 22-28, 2016
May 29, 2016
Vietnam: May 29-Jun 5, 2016
June 6, 2016


Over hill, over dale?
Not for this IMR team!!  Over
mountain over stream?  You bet!!

From our team leader, Sarah:

Yesterday was a fun day as we had the opportunity to provide
care to a remote village in the mountains. We took our vans and rode for 1.5
hours to a gas station where we swapped over to 4×4 trucks with covered backs
to travel an additional 40 minutes through the mountains to our location. By
the time we got there, the place was filled with patients waiting to be seen.
The women’s different color dresses were all colors of the rainbow. We
determined where each station would be set up and got started seeing patients.
It was apparent that they had less access to healthcare and follow up due to
where they lived.

After seeing all patients for the day and after a nice
thunderstorm settled in and cleared, we were back in the trucks to return home.
Jordyn and Savanna held our pharmacy down and quickly dispensed all medications
ordered. All stations worked well together and efficiently to provide medical
care to every patient.  It was amazing to
see how much they have grown as a team in just a few days.  Each person on the team has learned many
different roles and can work efficiently where needed.  Seeing their teamwork as they help each other
to treat our patients well is a beautiful sight for a team leader!

Upon arriving back “home,” the team quickly headed for bed –
they had an early morning today, getting up at 4:30 for the ride back to the
Panama City and a visit to the Miraflores Locks!  Here they will learn about the history of the
Panama Canal and hopefully, see one of the “big ships” move through the lock,
rising and falling as if weighing nothing (instead of 100 tons)

We thank you, Family and Friends, for all your support!!  Thanks for reading our blog.  We will sadly say goodbye to Panama tomorrow…but will be happy to be home with all of you.

This update is from our Paramedic, Courtney:

 “We hit the ground
running with clinic starting the afternoon we arrived in a Ngobe work camp. The
numbers may have been small but our work was impactful, seeing patients with
little accessibility and great need. We then spent most of the week in a
village near base, where we saw many village schoolchildren and were able to
teach lots of community education.

Our last day of clinic was easily the most exciting, both
due to the 4×4 off road truck rides and the huge crowd awaiting us when we
arrived! Many said they had walked long distances to see us and we had a higher
acuity (level of illness) than many of the patients we’d seen thus far. Today
also was a great day of being able to impact a community with limited accessibility
and providing great learning opportunities for our students.

It’s been a busy week of wearing many hats. I spent the week
working in triage, but I also provided well care to patients and performed
procedures. The ability to do this was thanks to our great students and
translators who quickly picked up the triage work and flow and helped keep
things moving.

This week has been another great experience working with
awesome providers and students, as well as learning about Panamanian culture
and the individual villages we visited (which were very diverse in themselves).
I look forward to my next trip!”   We love our alumni at IMR!!

And we thank the internet for these facts about the Panama

1. The French first attempted to
build a canal through Panama in 1881. However, due to a high number of deaths
and other issues, they abandoned the project in 1889. The United States started
construction on the Panama Canal in 1904 and completed it in 1914.

2. The US began negotiating the
rights to build a canal with the Colombian Government when Panama was under
Colombian rule. When negotiations fell through, The US Government and President
Theodore Roosevelt encouraged the Panamanians to revolt and declare independence
from Colombia. Panama declared its independence on November 3, 1903, and the
USS Nashville was deployed to prevent Colombia from interfering with their

3. After declaring independence, Panama granted the US control of the
Panama Canal Zone through the Hay-Bunau-Varilla Treaty. The US paid Panama a one-time
sum of $10 million for the rights, as well as a yearly lease.

4. Over 25,000 people died building the Panama Canal, mostly from
disease. Approximately 20,000 died when the French attempted to build the
canal, and over 5,000 died when the Americans successfully built the canal.

5. The first ship passed through the Panama Canal on August 15th, 1914. The Canal recently
celebrated its 100
th birthday on August 15th, 2014.

6. The US operated the Panama Canal from its opening in 1914 until
December 31
st, 1999, when full control of the Canal was handed over to Panama
as part of the Torrijos-Carter treaties, which were signed in 1977. From
1979-1999, Panamanians were given increasing responsibilities for canal
operations, until full handover.

7. The Panama Canal operates using a system of 3 locks. In order to
cross from the Atlantic to Pacific (or vice versa), ships must travel through
Gatun Lake, which is 85 feet above sea level. The locks raise and lower the
ships from sea level in order to travel the lake.

8. The Panama Canal has 3 locks. The Miraflores and Pedro Miguel
Locks on the Pacific Side, and the Gatun Locks on the Atlantic size.

9. Ships pass through chambers in the locks that raise or lower the
ship approximately 28 feet. The Miraflores Locks have two chambers, the Pedro
Miguel Locks have one, and the Gatun Locks have three chambers.

10. It takes ships on average 8-10 hours to travel the Panama Canal.
This compares to 2 weeks if a ship tried to bypass the canal and travel around
South America.

11. Only Panama Canal Pilots working with the Panama Canal
Authority are able to captain a boat through the Panama Canal. When a ship
enters the canal, they are boarded by a pilot, who has full control over the
boat until it exits the canal.

12. The locks each have two lanes that allow multiple ships to pass
through at a time, but they cannot handle large vessels going opposite
directions. In the day time, the direction of the locks are switched every 6
hours and priority is given to larger ships. This way large ships can complete
their journey in the 8-10 hour timeframe. At night, two way traffic
accommodates smaller ships.

13. All tolls for the Panama Canal must be paid in cash, and must be
paid at least 48 hours in advance.

14. Ships (with a few exceptions) are charged a toll based on their
weight. The average toll for a ship to travel the canal is $150,000, but it can
get much more expensive for the largest ships and additional surcharges. 

15. The cheapest toll ever paid to travel the canal was 36 cents in
1928 by Richard Halliburton, who swam the length of the canal.

16. The most expensive regular toll was paid by the cruise ship the
Norwegian Pearl, which paid $375,600 to cross the canal.

17. You can take your own private boat through the canal for a fee
ranging from $800-3200. You will share locks transit with a larger ship, since
it is not affordable for the locks to be operated for this cost.

18.  13,000-14,000 vessels pass through the Panama Canal each
year, at a rate of about 35-40 per day.

19. The 1,000,000th ship to pass through the Panama
Canal was the Chinese freighter the Fortune Plum, which passed through on
September 4
th, 2010.

20. Ships specifically built to the largest specifications possible to
transit the current locks of the canal are called Panamax ships. The can be a
maximum of 950 ft long, 106 ft wide, and hold the equivalent of 5,000 20 ft
shipping containers (TEU). (between 62,000-85,000 tons!)

21. A second set of locks are currently being built to accommodate
larger ships. When finished, they will operate simultaneously with the current
set of locks and be able to accommodate ships over twice as large (12,000 TEU
vs. 5,000 TEU). The new locks are expected to be operational in the beginning
of 2016.

22. The Panama Canal takes in
about $2 billion a year in revenue, and approximately $800 million goes into
Panama’s General Treasury each year.

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