Tuesday, October 07, 2008

Alex journal 4

This past month in Roatan has come and gone so quickly I can hardly believe I will be leaving in three days! I feel like I’ve only started to settle in to my surroundings here, and now I have to start packing again. The truth is that a month is really not long enough to make a difference, particularly since it takes you long to establish relationships and find your niche. Nevertheless, the connections I have made here in Roatan are good for networking, especially since I hope to work in Global Health during my career. I hope I get the opportunity to come down and volunteer again in the future, perhaps while in medical school or residency so I can have a more active role in seeing patients rather than just triaging. Not that triaging patients and interpreting has not been a huge help, because it has, I just want to be able to experience everything from the perspective of a physician.

I also wanted to talk about the opportunities to do research here at the RVPC. Before coming down to Roatan, I learned that the population of the island is very diverse. In addition to the Hondurans immigrants from the mainland, Roatan has a mix of ethnic groups quite unique to the island, such as the Garifuna, whom are descendants of escaped African slaves, and the Miskito population. One thread that connects all these groups, I found, is their belief in complementary alternative medicines, also known as “remedios caseros” (home remedies) or “bush medicine”. My research project while here was to see how many of our clinic patients also prescribed to these other treatment modalities.

What I found was that nearly everyone on the island believes in non-western treatments to a certain extent. For example, teas made of manzanilla (chamomile), eucalypto (eucalyptus), romero (rosemary), or anise were said to aid with digestion and help relieve stomach problems. Many of the locals with abscesses would come in with a leaf from a specific plant covering their abscess with the belief that the plant’s enzymes would help it mature and draw out the puss. While I found that many of these alternative treatments might have some scientific validity, given that many of our modern day medicines were discovered via their uses in ethno medicine, there were others that I thought were overwhelmingly based on superstition. For example, nearly every newborn we saw in the clinic wore a red beaded bracelet that was to protect them from the evil eye. When I asked the mother’s whether they believed in curses, the evil eye, and whether the bracelet really worked, some said yes confidently, but many said they weren’t sure and that they just prescribed to the practice out of tradition or because some relative had told them to.

While I may not have had the time to do a full-blown research study, I learned a lot about the alternative medicine beliefs held by people in Roatan. For example, despite being quite popular amongst the people visiting the clinic, most said they still had confidence in the abilities of the doctors and that they used alternative medicines mostly as a complement to western medicine.

Overall, my experience here in Roatan has been great! I’ve learned a lot about tropical medicine, infectious diseases, and the challenges of practicing medicine in a resource poor environment. I only have one more day left in the Global Healing clinic (there is a nurse’s strike on Monday, a common occurrence here in Roatan) so I’m looking forward to my last day shadowing the doctors and interacting with the patients. Cheers!