Monday, April 28, 2008

Rose Journal 6

It's been a pretty uneventful week at clinic. Monday Esteban was sick so Dr. Sabio was seeing patients on his own. The nurses tried to give us thirty charts but we had to tell them that there was no possible way we could see that many patients with just one doctor. I felt bad having to do so, but it would have been impossible for us to tend to that many patients and give them all a proper level of care. They ended up deferring those kids to other clinics, so at least they got seen by someone. Dr. Sabio saw around eighteen kids single-handedly and we ended up being at clinic until around two o'clock.

Tuesday was yet another feriago (holiday) and the clinic was closed. Apparently the holiday was to commemorate the British coming to Roatan centuries ago. It was kind of a nice surprise to have a day off as I didn't hear about it until right before I left on Monday. I was able to catch up on my sleep a bit and spend some time over in West Bay, marvelling at how gorgeous this island is.

Wednesday was pretty non-eventful. There were all the usual case of gripe, diarrhea, scabies, and intestinal parasites. There was also a kid with a fractured leg and another with trauma to a finger on their left hand. Elsa did a lot of triaging that day which gave me a change to observe a little bit. It's been really nice to have Elsa around because she is so eager to help out and I think her triaging is more effective than mine because, of course, she is a native Spanish speaker.

Lidia finally returned to work after her surgery on Thursday, which was so great! It was difficult to have new doctors in the clinic without here because they were always asking questions about the inner workings of the hospital that I had no idea how to answer. So Thursday Dr. Sabio, Esteban, and Lidia were all working and things went really fast. I could hardly triage fast enough to keep up with them. We only saw seventeen patients and were done with clinic by noon.

Friday was a bit more interesting. We admitted two little girls, one to the hospital and one to the emergency room. The girl we admitted to the hospital had a giant abscess and an awful ear infection. The little girl that went to the emergency room was suffering from a high fever and seizures. It was incredible to watch the family that brought her in. There was five of them in all: her brother, mother, two aunts, and father. They were all so concerned it was heartbreaking. Lidia had gone into another part of the hospital for a minute and when she started seizing they ran over to my desk with her, shouting frantically. I have so much sympathy for anyone that has to watch their loved one have seizures. No matter how many times I've seen a grand mal seizure it's always equally as terrifying.

So that pretty much sums up my seventh week here. I can't believe I've been here that long! Hopefully this weekend I'll be leaving the island for the first time since I got here and sailing on a catamaran with some friends. I'm really excited for that, I hear it's a lot of fun!

Saturday, April 19, 2008

Rose Journal 5

Another BUSY week at clinic #12!

Ever since Dr. Sabio and Esteban arrived we have been seeing more than our usual amount of patients, very steadily. No more early days where we have very few patients and get out before noon! I think that this is partly to do with the fact that our current doctors ask just about everyone that comes through here to come back to the clinic. They are very thorough. It's kind of nice to see the familiar faces of returning patients everyday.

Monday was a holiday, which I did not know about until the Sunday before so I was nicely surprised. It was apparently Day of the Americas, something I had never heard of before. When I tried asking several people about it they all told me they had no idea what was supposed to happen on this holiday. Perhaps it's just an excuse to take off school and work. Either way, I enjoyed it very much and spent the day catching up on sleep and school work.

Tuesday and Wednesday were long days, with lots of patients and many complicated, time consuming cases. This included a kid with a possible case of Tuberculosis that needed a chest x-ray and a child with very severe sickle cell anemia. There was also a sweet little boy that had such a bad case of lymphadenitis that he had to be admitted to the hospital. Apparently he had been on antibiotics for three days and the thing was growing, not shrinking. One really interesting thing about that boy was that eleven years old he was hardly 29 pounds and not quite up to my waist in height!

Elsa taught lectures on Tuesday and Thursday to a group of nurses and even a doctor. The lectures presented all sorts of general information on how to educate patients with diabetes. About eighteen people in total showed up and as far as I can tell, they were a success.

Thursday was a national strike day which, of course, included the hospital workers. Apparently farmers, teachers, and all sorts of other employees nationwide were striking for more funding and benefits from the government. During clinic I could hear people shouting into megaphones outside my window, although I could never really decipher exactly what they were saying. The strike of course meant that the clinic was really quiet and we saw only patients. The bad thing about the strike is that it makes it impossible to get patients charts and as a result, the examining sheets from that day will never make it into their records.

Everything returned to it's normal busyness on Friday. We saw around 20 patients, all with fairly common and treatable illnesses. We had quite a few ten day check-ups and almost all the babies seemed in good health. Unfortunately a one month old girl also came in with a heart murmur that we had to refer to Tegucigalpa. However I also saw probably the cutest baby I have ever seen at clinic today and that cheered me up quite a bit.

This weekend I plan to do a lot of nothing and hang out at the beach. I have reached the last month of my stay and it's strange to think that I only have four more weekends here!

Rose Journal 4

It is interesting to think of my weeks here broken down in numbers like this: journal entry #1,#2, etc. It makes my time here seem all that much shorter. Lately the days have become so busy that I hardly have any time to think! For some reason clinic hours have been really long, and I usually end up staying at the hospital until at least 1:30 every day. I think perhaps this team of doctors is slightly more methodical.

This week has been sweltering hot and the clinic remains to be one of the only offices in the hospital without air conditioning. It is a relief to step out into the relative cool of the hallway. I just looked up the weather on Yahoo and it told me that it was currently 86 degrees Fahrenheit in Roatan... yeah right! It's at least 95 degrees in the shade.

We've referred a lot of patients to the emergency room and surgery this week. One little girl had a foreign object so firmly lodged in her nose that one of the doctors caused some accidental trauma trying to remove it. A baby went to the ER for a serious case of croup and different respiratory problems. Three patients were referred to Dr. Sanchez for surgery: one for a herniated groin, one for frenum of the tongue, and another for a one centimeter ball growth on the penis. We also sent a little boy to La Ceiba to get an echo.

This week Esteban's father, Dr.Gershanik, and his Nurse Practitioner, Yakelis Anzola have been lecturing the nurses and Social Service doctors on neonatal resuscitation. I think it's quite interesting to them that babies who would still be in incubators back in the states are allowed to go home here. A few days ago we had an premature infant that weighed just 1.7 kg come into the clinic for a check-up. The baby was so tiny, but fully able to breastfeed! A less successful story is that of a preemie currently in the emergency room. It was 2 pounds at birth but had dropped down to 1 and was admitted, severely malnourished and dehydrated. Yakelis was able to get an IV going yesterday but it fell out during the night and because the baby was without IV for several hours, it dropped back into it's previous state. Hopefully they will be able to find a vein again but doing so is incredibly difficult because of the infant's small size.

Friday morning we were met with a giant stack of charts as both Dr. Jackie and the Cuban doctor were out today. We've never seen so many patients on a Friday! In fact, the whole week has been steadily busy. One patient of interest on Friday was a four year old boy that had been dropped on his head while he was an infant. He had petit mal seizures and was also microcephalic. His development was really delayed and he appeared to not speak more than a few words. It's so sad to see a kid like that who just doesn't get the care he needs. We were referring him to a neurologist in San Pedro, but who knows if he'll actually end up going.

On a brighter note we've seen so many happy and healthy children through the clinic this week, just getting routine check-ups. On Friday we had almost entirely little girls, including a set of 9 month year old twins that were absolutely gorgeous. There's nothing better to cheer you up than holding a plump, healthy, giggling, slobbery baby