The healthcare environment in Chitre is basic or even rudimentary in many ways. Do not confuse basic with backward. Their emphasis is on prevention not technology.  The nurses seem to be a very cohesive group. Many of them at the clinic level have years of experience. It was explained to me that the new nurses start in the hospital setting and then are required to spend years in the countryside honing their skills. By the time they are assigned a position in the community clinics they are very experienced. They are able to handle a great variety of patients assessing, ordering labs, performing routine vaccinations and as an example of the difference in healthcare systems the nurse’s in women’s health perform PAP smears. If the patient requires a physician’s services all the assessment is prepared for his or her review.

I was impressed with the personal interactions that the nurse’s had with their patients. They see them regularly and are able to take the time to get to know them.