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FIELDNOTE_0419_NALUWAN_MOLLY

Today's visit started with all of us students going down to the canal that runs parallel to Naluwan to collect shells.

Fieldnote _0415_Naluwan_MOLLY

I arrived earlier than the other students and had some time to interact with Ivan and his family before the others arrived.

Fieldnote _0412_Naluwan_MOLLY

Also this week we spent time with the elderly in the community. Me and Charles had a conversation with a man in a wheelchair that Charles also talked to last time.

22 feb- Naluwan Art

Art at Naluwan created by the former chief of the tribe.

(The gouverment refused to accept this as art.)

Art from Naluwan

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I looked into how EMS operates in situations that are beyond protocols, standing orders, and medical control. I also looked into how story cases are used by other medical professionals. Further I looked into how “evidence” based approaches are formulated for studies and research.

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1) “…what would happen if race and insurance status no longer determined who had access to the standard of care?

…in addition to removing some of the obvious economic barriers at the point of care, the clinicians and researchers considered paying for transportation costs and other incentives as well as addressing comorbid conditions ranging from drug addiction to mental illness. They also implemented improvements in community-based care, conceived to make AIDS care more convenient and socially acceptable for patients. The goal was to make sure that nothing within the medical system or the surrounding community prevented poor and otherwise marginalized patients from receiving the standard of care.

The results registered just a few years later were dramatic: racial, gender, injection-drug use, and socioeconomic disparities in outcomes largely disappeared within the study population [35].”

2)            “This model [PIH’s model], with conventional clinic-based (distal) services complemented by home-based (more proximal) care, is deemed by some to be the world's most effective way of removing structural barriers to quality care for AIDS and other chronic diseases.”

3)            “While some interventions are straightforward, we also have to recognize that there is an enormous flaw in the dominant model of medical care: as long as medical services are sold as commodities, they will remain available only to those who can purchase them.”