Thursday, July 06, 2006

Melissa Journal 1

I wish I hadn’t waited so long to start writing about my days here…now I’ve lost my first impressions. But they would have been a little foggy anyway since I was in a bit of a haze the first few days here. Less than 24 hours after my last final (medical school year 1), I found myself sitting next to Ms. Peggy in her truck getting my first “tour” of Roatan, including the store that sells the best (read: cheapest) eggs and so-called Crack Alley. I think I was most impressed by the amount of construction taking place on the island. Every turn on the road from Coxen Hole to Sandy Bay there is a new compound of homes/condos being built. I’m sure it’s doing wonders for the employment rate, but it’s a bit strange to also realize you’re in one of the poorest countries in the Western hemisphere. Peggy’s house was strangely empty when we arrived – which I don’t think has been the case since! Always full of wonderful people. But it gave me a few needed minutes to settle in.

Lots of goodbyes followed over the next few days. First Deb and Anu, the two residents who were here for 3 weeks before I arrived. Then our short-lived friend Anna from Missouri. Then Jerry. I realized that Peggy’s house is quite the revolving door of people – thankfully just as many people arrive as leave so she’s always got good company! For someone who has lived within 30 miles of San Francisco almost her whole life, this is a lifestyle I could never imagine having for myself. Not sure how she manages it so well and continues to thrive. I feel so fortunate to have the opportunity to live here at Peggy’s house – it’s really the only way to get up to some kind of speed about the state of health care on the island. For interns who are only here for 5 or 6 weeks, it’s really crucial because it can be difficult to transition projects during the 1-2 day overlap. The downside is that it can become pretty overwhelming pretty quickly – there are so many projects in different stages and Peggy always needs lots of help!

So how have I been spending my time outside the clinic? So far doing lots of planning. Dr. Patrick is here for 3 months from Arizona helping Peggy to fundraise for the new hospital she is building and to develop a few grant applications for funding of special projects. We’ve created a cervical cancer screening questionnaire that we’ll be taking to the communities of La Colonia and Diamond Rock next week. We hope to survey 100 women in each community so that we can get some idea of how many women have ever had a pap smear or who might by chance even have them somewhat regularly. Karen and I are also working on a public health education project at the daycare in Coxen Hole. We’re headed over there tomorrow afternoon with Dr. Charles to teach the staff about water purification and the kids about handwashing – fun fun! We had big plans to do some dental hygiene (complete with a self-assembled coloring book of dental superheroes) but it turns out there was a traveling medical team in there a few weeks ago delivering toothbrushes etc. However, the kids aren’t using them yet because there’s no way to label them and store them at the center–Global Healing label-maker and ziploc bags to the rescue! I hope to be able to talk with Irma soon about the La Colonia community health educators to make sure that we are up-to-date with all of our data collection and two try to find two more volunteers. And Flowers Bay HTN/DM project is on hold for the moment while Dr. Amanda spends some time thinking about how she wants to utilize her newly trained volunteers. Island pace…

OK, I hit one page and Jenn tells me that’s my duty. I’m sorry I’m not one for public posting of my writing/reflections. But hopefully some of the above was interesting/instructive for old/new interns. Next installment, perhaps I can focus on some of my thoughts about the clinic at the hospital – the new attending from New York arrives on Saturday. In closing, I feel so privileged to have the opportunity to experience a bit of life on Roatan, to see health care practiced in the true definition of an underresourced setting (and I thought community health centers in San Francisco had a rough time!), and to occasionally beat Jenn and Karen at a game of Nertz while we watch the sunset.