Panama's clinics

My experience in Chitre was rocky at first because of the lodging situations, but the clinics we visited was well worth the frustration! My clinic, Monagrillo, was small, but extremely resourceful. The staff of nurses was excellent and nothing but kind towards us. They were helpful when we needed information and understanding of the language barrier between us. It really shocked me to find out how the clinics work here in Panama. The nurse's role carries so much weight, they basically take care of the patients by themselves. It was also very interesting for me to find out that nurses here to pap smears. The techniques for giving IM and SubQ injections was also quite different from the way we are taught back in the U.S., but I'm assuming that it works for the Panamanians here. I wonder how the infection rates are here because they do not use alcohol prep to wipe the area of the injection, they use water. Also, they rarely have soap in the bathrooms (along with toilet paper). It makes me curious because I would think that infection rates would be very high. The clinic that we visited yesterday in Panama City was also quite eye opening for me. When I heard that only 5 RN's were staffed within the ENTIRE building, it was hard to comprehend, especially because that clinic alone offers services to 44,000 inhabitants. I know that Panama gives free healthcare to everyone and in order to be able to provide that care, they must make sacrifices, but these conditions seem pretty unbearable. I do understand that I come from a completely different culture, so my view point is going to be solely based on what I know from American culture. I see that the way the healthcare system, the clinics especially, in Panama work for this culture and it is honestly the best situation for everyone.