Week of Sunday, July 20th-Sunday, July 27, 2008.
Today marks the 15th day I've been on the island-almost the
halfway mark. This past week started off with the coming of
Howard and Alice Gruber. After a wonderful dinner at the
Argentine Grill with the entire Global Healing team, I went
home to rest up for my second week of work at the clinic.
That week at the hospital was distinctly different with
Howard, Alice, and Robin (nurse practitioner) there. Our
already tiny working space shrunk to the point where every 5
seconds someone was bumping into someone else. Alice spiffed
up the place, AND we got a new 19 inch flat screen computer!
Oh my goodness does that make a HUGE difference! The old
computer took FOREVER to perform ANY action and this new
computer is quick, fast, and never freezes up, saving all of
us lots of time. The air and electricity still go out quite
frequently which is a bummer; especially with a minimum of 6
people in the room rushing about creating heat. I triaged a
1.4 kg premature baby (I forgot how many weeks it was) which
was really very scary for me. I was scared she would break if
I made a mistake! We also saw a little boy with a nasty
infected lip, with swelling from his lip up to his right
eyebrow. The image of Dr. Gross cutting open and draining a
cranial abscess will forever be burned into my brain. On
Wednesday, Robin took me on a tour of the pediatric ward and
we watched the nurses clean and dress a child's fractured hand
(Robin is here to train the nurses and so she was taking
notes and telling me the differences in method as compared to
how it is done in the United States). The 7 children in there
were melancholy and a few were whimpering, but upon giving
them Global Healing teddy bears, we exited the ward leaving 7
smiles behind us.
Wednesday afternoon, we had a small conference with other
nurses and health workers from the Hospital in a separate
building across the way. Dra. Prado gave a presentation on
hypertension and Robin followed with a presentation on how to
properly administer sodium fluoride varnish to children.
Global Healing does quite a bit of community outreach in
addition to managing the pediatric clinic at the hospital;
this coming week we are planning to administer antihelminth
medication and next Saturday marks the 2nd Annual Trauma
Conference. I am really excited for the new pilot program
Howard is starting at the clinic to fight the prevalence of
dental caries. Not a day goes by that we don't see at least 5
children with horrible looking teeth. One child had a dental
abscess near the size of a ping pong ball due to lack of
dental hygiene and the consumption of chatarra! Although we
give out toothbrushes, I am skeptical as to whether the
parents really have the time or patience to force their
children to brush twice a day. I don't even want to think
about whether these kids floss. But, dental hygiene would
fall towards the bottom of my "important things to do" list if
I had to scrape around to obtain enough money to feed my
children. It was really discouraging to see mothers come into
the clinic worrying about their children's constipation and
stomach pains, say they understand they need to feed their
children fruits and vegetables instead of chips and Coke, and
then walk across the street and buy their children a soda and
some candy-a treat for putting up with a doctor's visit. I
have seen this in many underdeveloped countries and it is
frustrating and saddening because most parents can not afford
to buy fruits and vegetables for their children every day.
Something else must be done, possibly from the economic or
government sector, because doctor's can't do much else besides
tell the facts about nutrition and dental hygiene. In the
states, people have a choice to listen to what their doctors
and dentists recommend. Here, parents-especially single
mothers-don't have much choice other than to provide their
children with the food their income will allow them to buy.
Howard explained to us that this dental program is distinctly
different from other varnish administering programs that have
been recently proven successful in other Central American
countries because here in Roatan, the fluoride varnish will be
administered at the hospital by the nurses; once when the
children come in for the 12 month vaccinations, and again when
they come in at 18 months. We have posters to promote this
varnish all over the hospital and we are putting them up in
different barrios around the area. It is really neat to watch
this program develop because the kinks and other issues are
still being worked out. And, there is only supply enough for
300 children for 6 months-so there is half a year to come up
with an additional supply. Yikes. The nurses are stoked that
they are doing something unique to Central America and they
joked around about becoming famous. They are really excited
and hopeful for this program to be successfully implemented.
Friday I got to try out an audioscope for the first time!
Exciting! Dr. Laura shocked me when I was shadowing her
because she handed me the audioscope unexpectedly and said,
"Take a look at her ears. You'll see they are quite impacted
with wax." She taught me how to properly hold the audioscope
to be able to see best, and as I looked into this young girl's
ear, I saw a dark brown wall of wax. After Dr. Laura
prescribed drops of Cerum for the girl's impacted ears, she
let me look into her own ears for comparison. There was such
a stark difference between Dr. Laura's ears and the girl's
ears! Whereas the girl's ears were dark drown, Dr. Laura's
were completely clear and light and I could actually see her
tympanic membrane. I was able to check Alice's ears also, and
her tympanic membrane was in clear view as well. That was a
really cool hands on experience for me.
Another cool close-up experience I had this week was watching
an ultrasound being administered on a 6 month old baby with an
abnormal neck mass. Everyone was clustered around the
ultrasound monitor and with 4 doctors huddled around, there
was a lot of mumbling and hypothesizing and debating about
what the neck mass was or whether it was attached to anything
concerning. I watched the blood vessels in the neck open and
close like a fish does while swimming underwater, and the
consensus was open ended. All the mother could do was wait
until the child was old enough for surgery or until the neck
mass popped on its own-if it ever would.
Dr. Gross is leaving today; I am going to miss shadowing him
and translating for him. He has done so much in his life and
has been all over the world. I knew he was a crazy cool
doctor ever since he told us that he really liked chocolate
covered bees. "They have a nice little crunch," he said. I'm
definitely going to miss him in the clinic. Next week is
going to be a trip; just two doctors instead of three. But I'm
super excited as to what I will see and learn in the next
seven days!
