KAREN: I don't want to interrupt you.  I'm waiting for you to finish your thought before I throw another question at you. Because I always have questions.  You were talking about teaching the doctors to work with health aides.  Do you feel like they listened to you and trusted you when you said this is going on with this patient or that patient?

JESSIE: Hm, mm. Sometimes I feel like they expected too much of me.  There were things I felt like I couldn't do there in the village that they expected me to do.  I mean, you get to know the things you can do and can't do.

KAREN: Do you have an example?

JESSIE: Well, let me see.  There was a -- I remember one guy that I was checking. It had to do with private parts, you know, where his scrotum skin was torn back.  And the doctor wanted me to suture it. 

And I told him, “I can't do it.”

And he said, “You're working in the health profession now, you can't feel like, you know --” 

I guess he thought that was because it was a private part, I didn't want to.  It's not that. That's a very sensitive area, to me, it seems like.  What if I do something wrong.  And I thought at the time, he needed to go in to have that taken care of. 

Finally, convinced him to have him go into the hospital. The next day -- it wasn't our doctor.  We have doctors assigned to the villages.  The next day I was talking to our doctor and I asked him, “How the guy was doing?” And I said, “Did it seem like something that needed to come into the hospital?”  And he said, “Yes, definitely.” I said, "I kind of thought so." 

But, it's different things like that. It's different doctors. We only talk to the doctors that are assigned to the village.  They don't work 24 hours a day like we do. So we have to talk to the doctor that's on-call during the night or on a weekend. 

KAREN: So during the day, you had the same doctor every day during the day that you could call when you had a question?

JESSIE: Yes.

KAREN: Did you call them whenever, okay, here's a patient and you call or was there a set time of day? How did you report on patients?

JESSIE: Some said that maybe instead of calling for every patient that we saw, we should kind of write it down and then set a time like maybe two or three in the afternoon when you call the doctor and then talk to him about all these patients.

But it doesn't seem like that's going on now. With the PA's there, you don't have to call the doctor as much, it seems like. You can go to a PA and ask them, and they'll let you know if they think, "I think you should call the doctor on this."

KAREN: So, you guys did decide to do that, call once a day thing?

JESSIE: We were for a while.  It doesn't seem like that anymore.  They call when they have to.

KAREN:  What did you have to teach new doctors who came in about how to work with health aides?

JESSIE: Just let them know what we can do and can't do. I don't know if we ever taught them anything. Maybe we did, maybe we didn't.  To learn how listen to us more.  And kind of -- some doctors are so good about it. And some are abrupt.  Sometimes you get a feeling like "Why are you bothering me with this." But most of the doctors are pretty good about listening.

I guess I should say that most of the health aides now are taught about things that doctors would like to know. Instead of just blurting out, you know.  I remember when sometimes I would just blurt out, but now they have different things they want you to say to them.  The age, their symptoms, their vitals.

KAREN: So, the doctors want it in a very systematic, specific way instead of just -- "I have a kid with dripping ears!"