IV. Multi-Day Clinic in Nance de Risco and Rio Oeste

Monday of our first week finally arrived which meant it was time to head out to clinic! We run clinics every week to different Ngäbe villages in the surrounding area and we make sure to visit the same village every 3 months so we can follow up on care. This week was a multi-day clinic week which is when we go to villages that are so far from base that we stay overnight so we can run multiple days of clinic.

Clinic in Nance de Risco

The morning starts with some coffee on the dock of base watching the sunrise before breakfast. After breakfast all the volunteers grab their travel bags and head to the pharmacy to start loading the cayuco. Because we want to be as close to a fully functioning mobile clinic as we can, we bring a literal boatload of supplies including medications, wound care supplies, giveaways (i.e. toothbrushes, soap, hand sanitizer), and boxes of enriched rice for malnourished children. You get a weightlifting workout working at FD.

Everything underneath the blue tarp is cargo for clinic.

Once the cayuco is loaded we all pile into the boat and set off for our first destination. This week our first village was Nance de Risco. It’s a beautiful village nestled in the mountains. To get there we have to take a boat to the main port city (Almirante) then hop in multiple vans that take you up winding dirt roads to get to the village. As soon as we arrived we started to unpack the vans and get straight to work setting up our clinic.

Every clinic day starts with a huddle where the clinic manager (Jack) gives announcements and assigns roles for the day. Nica and I started our day running the intake station which entails getting basic medical history from each patient, collecting vital signs, and asking the patients briefly what they want to discuss with the provider.

Pre-clinic huddle

After a lunch break, Nica and I got close to finishing all the intake patients and began to transition to a provider role which we had been so excited about since our first time coming to floating doctors as first-year medical students in 2019. We finally got to use years of studying and work to provide for these patients in the highest capacity we could. We saw everything from bread and butter hypertension & diabetes to tropical GI parasites and festering wound care. And a plethora of OBGYN care. One of the new improvements that we noticed was the incorporation of public health education for the communities. This included teaching villagers about prevention of dehydration and lifestyle management for chronic conditions. These charlas (discussions) have the potential to make long lasting impacts in the communities.

A snapshot of our clinic in Nance de Risco
Finishing up patient notes for my first patients as a provider.
Nica filling out patient prescriptions/instructions
Bringing a (very heavy) box of fortified rice to a patient’s home immediately after seeing them in clinic.
Nica assisting with a home visit for a long time patient of FD. Permission for this photo was obtained from the family and patient.

After a long day of clinic, we begin to pack things up and start winding down our day. The next goal on everybody’s mind is to get the sweat and grime off with a clean shower. Well the closest thing we have to that is a river running through the village. We all pack up our shower gear and hike to the river for a refreshing dip.

Bathing in the river in Nance de Risco.
A dip in a beautiful section of the river in Rio Oeste. The mini waterfall in the back of the picture felt divine after a long, hot day of clinic.

It’s finally about dinner time and we are starving. At every multi-day clinic we have a family who we hire to cook our food for us for the days we are there. We bring our own ingredients in a Yeti cooler. Meals typically consist of a grain (rice or quinoa), chicken, and beans or lentils. The food is always excellent and there is a local hot sauce called Bocas Sauce that is delicious and a staple of spending time with Floating Doctors (or in Bocas del Toro in general).

We also got a special treat in the Rio Oeste village where our amazing clinic manager Jack is from. Rio Oeste is a large producer of cacao and sells incredible, fresh cacao in numerous forms (nibs, baking bars, tea). The cacao was incorporated into all of our meals there which was incredible.

Lunch time in Nance de Risco
Coconut rice, lentils, yucca, chicken, and picante Bocas sauce. A typical meal for a multi-day clinic. And a very tasty one at that.
Two of the best chefs in all of Rio Oeste who prepared objectively the best food of all the villages that FD visits.

Last but not least it’s time to sleep. Earlier in the day we had set up our hammocks in local ranchos or buildings so we could sleep through the night. I can’t say it’s the most restful sleep ever but it really is an experience you never forget. Although we all could’ve done without the loud barking dogs and roosters at odd hours of the night.

Setting up hammocks for the night in Nance de Risco
My bed in Rio Oeste 🛌. It may not be glamorous but you can’t beat views like that the first time you open your eyes in the morning.

After two days in Nance de Risco and one day in Rio Oeste (three hammock nights total) we finally head back to base. We round the week out by doing some chores around base (restocking the pharmacy and supplies for the next clinic, filling prescriptions, etc.) Then on Friday we are free to head into Bocas town to enjoy the weekend to ourselves!

Filling prescriptions for clinic next week


  1. Clive O'Connor says:

    Great Humanitarian Work JB and the Crew. Excellent Community Service: Bravo to everyone.

    From the poor PI Clan, who can use some of your help

    Do you guys do extended tours to SE Asia ?
    PI (Philippines Islands) should be on your (next) bucket list.

    Liked by 1 person

  2. Dawn Selim MD says:

    PS … it was 68 yrs, not 60 !!!

    Liked by 1 person

  3. Dawn Selim MD says:

    Thrilled w/ the work of FD ! Also much experience for the 4th year medical students [ Christopher & Nica ! ] It takes me back some 6o yrs when I was in Med school at the Christian Medical College, Vellore,So. India where, an experience that stay w/ one forever. similare work was done in the villages. However glad I did not sleep in a hammock or ride in a canoe!!
    Dawn Selim MD

    Liked by 1 person

Leave a Comment

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s