Thursday, July 29, 2010

Kate Journal #4

May 2, 2010: Week 4

This weekend has been an absolute whirlwind. Contrary to popular belief, the “island time,” slow moving way of life has not made its way into my daily schedule quite yet…yes schedule. My days are not always as planned but go a little something like this…I wake up most mornings around 5:00am to birds chirping outside then at 5:30am to blasting music from my native Roatan neighbor. Sometimes she plays Christian music and belts it out, sometimes drumming, or even Akon “sexy bitch”..very classy. Its become so convenient for waking up that I no longer use an alarm. I start my workout around 5:35am, hospital/clinic work 7:30am-2pm, meeting with Jose who lives next door to practice my Spanish or 10 year-old Aimee, anyone really/or study Spanish, 5-7pm coach soccer and teach English at bilingual school, then eat dinner and head to bed around 9pm. I thought I was a grandma before when I went to bed at 11pm but am starting to realize I am definitely a grandma now.

Friday was a very busy day at the hospital. We had 30 or so patients come in with various ailments although the most common have been upper repertory infections, diarrhea, flu, cough, parasites with occasional malaria, scabies and cuts that have become very infected. I am learning about all the treatments and testing for the most common diseases in Roatan. In the United States we tend to do multiple tests when a doctor has an inkling about a disease, then follow with treatment. In Roatan testing like MRI, Xrays, are not available, or cost too much here so the most cost effective way is to do treatment right away. This system obviously would not work in the United States but saves many families a lot of money on the island, especially since the interventions are very low maintenance and cost effective. Most recently we have seen a lot of young mothers who are on baby 3 by age 19. Global healing is starting to counsel these women to “close the shop down” as we call it especially if it’s a low resource family and educate them on reproductive health resources and correct usage of those resources.

Work at the clinic ended around 1pm, then I immediately started to pack for a weekend retreat in la ceiba with Raul, Maddie and Sain for their last weekend here before they return to the states to finish med school and nursing school. I basically packed sunscreen, bathing suit and a camera plus the clothes on my back for the one-day venture on the main land. We headed to the Ferry for our hour-long ride to La Ceiba to go rafting and cliff jumping in the mountains. I awoke from the Ferry ride red as a tomato as we approached the main land. Before the trip to Roatan I was trying to stay out of the sun as much as possible so my white skin was pretty surprised by the blazing sun burning it to death.

The main land smelled like diesel and like any developing major city it had busy dirt streets, open markets and people everywhere you look. We took a taxi up the mountain for our 40-minute drive to Jungle River. The ride to the cabin was full of bumps and dirt holes, and im pretty sure by the time I got there my butt had about 10 bruises. From the street we walked down a few concrete steps to our cabin literally on the river. There was a beautiful red parrot that greeted us upon our entrance as well as the 2 main locals that ran the rafting business. We immediately stripped off our clothes and ran onto the huge boulders/cliffs that were around 60 feet high to jump into the river. When jumping off large objects I have realized there is a short window of time where I will actually do it (about 5 seconds) so I try not to think and just do. We then ventured down the river climbing up rocks, the sky scraping mountains filled with luscious green trees (anything we could). Raul is my monkey climbing friend so we usually explore most places we go by climbing and jumping, even if its not necessary, and most times its definitely not.

When it started to get dark we headed to our cabin to unwind, read a bit, then eat some delicious dinner. The local owners made us the most amazing chicken in a tomato chile based sauce, rice and red beans, salad, and fried plantains (that according to Raul who is a Mexican born plantain connoisseur were perfect and not too sweet). We played a card came called casino (an awesome game I was taught in college) with some candle light and headed to bed around 9pm. I awoke in the morning to beautiful chirping birds and other unfamiliar animal type noises. For breakfast the owners made us a fried egg omelet (actually fried), with rice, plantains and a crema sauce (kind of like sour cream and yogurt mixed together, sweet and sour). I stopped drinking coffee quite along time ago and have transitioned to matte in the morning but decided to venture out and try the coffee which was the most delicious chocolately creamy coffee I have EVER had. I drank 2 more cups then decided after stuttering on my words that I should stop.

At around 9am we started our rafting venture. A few Canadians joined us that Raul and Sain had met on the mainland while they were diving. I was very intrigued by their Canadian accent, especially the “oooohhhh yuhhhh) for oh yeah after I would say something mildly entertaining, and “yuh we have “bean thur” for been there. I have not traveled enough to know how other countries view our American accents but it CANT be as wonderful as Australian, Canadian or Egyptian. To train us for the trip we followed our guides for an hour up boulders, through hiking paths, jumped off cliffs down river, floated to other rocks to climb up then jump off again, into crevices in the rock boulders to see snakes, and huge spiders that resemble water spiders is the states, native plants that act as medicine for bites, soap, and a remedy for colds….naturalist medicine is just so gosh dang awesome. We then had to swim upstream to get to the other side of the river with our paddle to prove we could survive the trip. I have been rafting before and have never had such an extreme prep for the rapids. Anyone who knows me can vouch for the fact that I look like a cat drowning when I try to swim. I have tried to learn how to swim many times before but keep resorting back to my dog paddling. The life jacket didn’t help much as I waddled across the river gasping for breathe and praying I made it to the other side. I was happy I survived the 20 yard swim haha and 15 people laughing at me the whole 2 minutes it took to get to the other side. Since it was Maddies first time rafting we did tops level 3 rapids. After doing rapids 4-5 with the soccer team this was nothing but nonetheless I managed to fall out of the raft after every drop. My favorite part about rafting is floating down the river with my feet up and life jacket in the water. I jumped off the boat every opportunity I had to float down the rapids.

At the end of our trip we ate a bunch of perfectly ripe and sweet bananas, watermelon and pineapple that jungle river supplied and decided to stay one more night in La Ceiba to get a feel for the real city life that Roatan does not have. We stayed with the Canadians in a hostel in the heart of La Ceiba. I walked around the markets with Raul and Maddie looking at all the wild fruits, vegetables and shops. We headed to the coast to listen to the waves that Roatan also does not have and to watch the 40-50 locals fish off the main dock. While posted up on our log watching the sunrise a little dog sat behind us watching our every move. I turned around and stared this doggy in the eyes, looking at its very infected bulge on its face, and missing 2 toes. We had quite a moment then the dog decided to follow us around for the next 2 hours to EVERY place we went. When we stopped to get a drink or go to the bathroom there it would be waiting outside. I named it Bud and decided for all its hard effort I would feed it some bread. The dog continued to follow us to a random indoor soccer field in the middle of the city. I was so uncontrollable excited to find this treasure and immediately decided to ask them to play. Raul and I jumped in to play for about an hour while Maddie and Bud (doggy) watched us play. I realized at the end of the game that I was wearing the only clothes I had packed and was fully drenched in sweat. I quickly absorbed the fact that I would be showerless and covered in river water, bug spray, sweat and sun tan lotion as I slept in the Hostel that night. The boys we were playing with bought us some bolsa de agua (bag of water) after the game which is a liter of distilled water the locals drink because its very cheap. We chatted with the locals for a bit and exchanged emails. When we told them we worked in Roatan at the hospital and with Miss Peggy everyone knew who she was. After the game we bought a baleadas (home made tortilla with beans, cheese and any topping). I had egg and avocado. The total meal cost $1 and was very tasty, and filling.

After a long day of rafting and exploring we all headed to bed. I woke up at 3am overwhelmed with the heat, and unpeeled my sticky legs to talk with one of the Canadians Shauna who was still up. Shauna who is from Vancouver gave me her life story of working temporary jobs and traveling around the world. Not a bad way to live at all. She was a very friendly VERY talkative gal, maybe a bit too hippie for me, which says a lot, but full of awesome energy and a great heart. I finally went back to sleep around 5am to awake at 6 for breakfast and our Ferry back to La Ceiba.

I am very eager to start my next week, and also excited to get some sleeeeeeeeeeeep.

Kate Journal #3

April 25, 2010: Week 3

I knew watching episode after episode of the dog whisperer with mi madre would pay off some day. I finally stood up to the dog that always starts the barking and nipping at me during my morning run. This is who Cesar Millan calls the pack header haha. In order to counter the dogs dominance in my deepest and manliest voice I yelled stop over and over again until the dog looked confused and just walked away haha…but it worked! I no longer run down the beach with a huge stick looking like a crazy gringo.

Raul's internship at Global healing ended yesterday so hes working for Miss Peggy this week before he leaves which means yesterday was my first day at work alone. It was pretty awesome. We were really busy and saw 25 patients. The air conditioning was broken so I was no joke dripping sweat the whole time. The most startling and sad case we saw today was a young boy with a brain tumor. Global healing puts aside money for special cases like this to send them to the main land, so we worked out a time to send the boy to La Ceiba. His cancer had metastasized (in the later phases, and spread throughout his body), really sad to see. He was only 5 years old with the biggest smile and brightest eyes.

After work I decided to explore Coxen Hole where the hospital is located. I found some wonderful cheap fruit and vegetable stands with pineapple, mango, cucumber, avocado and lettuce. My body has completely adapted to the flora on the island so I tend to eat whatever I want. Because the island is so small I ran into more than 5 patients and their children as well as the girl that lives across the street from me who I make lunch for when her mother is at work.

I went to bed verrryy late last night around 10:30pm haah so I could not wake up for my usual 5am work out. I ran mid day today around 2pm and will never do it again. It was so hott I felt like the sun was burning my soul hahah. I then ran into Jose who lives next door and speaks broken English to me and I speak broke Spanish to him. He always brings something crazy with him or shows me something crazy. Yesterday he climbed up a 40-foot tall cocoanut tree to show me how to pick cocoanuts. He then tried to show me how to straighten my arms and use my toes to propel myself up the tree. I tried for about 10 minutes and climbed about 10 feet up the tree before I realized what I was doing and quickly feel off. The cocoanut milk and skin were not as sweet as the ones I drank in Costa Rica or the states, they had a very unique sour and tart flavor….very good. Today Jose brought over some bamboo looking stuff and kept repeating caña, caña, caña. This went on for probably way too long before he finally yelled azúcar and I realized he was trying to say sugar cane. He shaved the hard shell off and showed me how to bite off the top, chew up the sugar water and spit out the rest. It was delicious and tasted exactly as expected but in its purest form of sugar water.

In the evening Sain, Raul and I started cooking food to celebrate Maddies's 22nd birthday. I not so stealthily quizzed her on all of her favorite things in life last night like what would your favorite day be like and favorite food, drink, what do you miss most from the states etc? I found out her favorite things are breakfast for dinner pancakes, bacon and eggs and loves sauvignon blanc wine, misses kiwi, and grapes, and bonfires with smores so we did all of that for her. I almost bought a Hannah Montana pinata for her but unfortunately because I am a gringo they tried to sell it for $40 which is more than the states. I was very tempted. Very tempted.

Fortunately breakfast for dinner is one of my favorite things as well so I ate until I could not move then started on the smores and wine. We shared our favorite music, movies and books. I started to make a list and am very excited to venture into the world of nerdy sci fi books. I started with Ender’s game and loved it…..neeed moreeeee!

Today the Roatan Hospital had a 4 hour non stop conference on Malaria (all in Spanish) in a 20 by 20 room packed with doctors. I can’t sit still for more than 20 minutes at a time so expectedly after a half hour I panicked and left the room to take a breather. I tried to contain myself after that and focused on Spanish words I could not understand. This lasted for about 2 hours until I started to fall asleep. I have learned a very valuable lesson and will not be attending any more of these conferences. Dang ADHD. Today is my very first day off in the afternoon. I have no idea what to do with myself but am pretty sure it involves a long nap and Jane Austen (you would be proud Tony).

Kate Journal #2

April 18, 2010: Week 2

Today was an awesome day. Everyone bailed on me this morning for running so I ran alone. I started running with a stick which probably makes me look like a weirdo but its worth it since I have been attacked by the same freakin dog about 4 times now. The clinic had some interesting cases today. I saw a boy who had Pica. His neighbor brought him in and explained that she saw him eating dirt and mixing it with sugar to make dirt shakes because his mom works all day and does not feed him till night and expects her to take care of him all day. This was all in spanish so thats what I got from it at least. He was 8 and had not started kindergarden yet. Socially the boy was developmentally delayed and Dr. Sarah explained to me that Pica causes anemia because of iron deficiency (and vitamin deficiency) as well as gripe (flu). She prescribed the boy with vitamins and parasite antibiotics for the worms he most likely had. The boy looked very sick and pale when he came in and didn't answer any of my questions. I tried to do a follow-up to check up on the boy after a few days to make sure the parents use the resources I gave them but they do not have a phone, or internet. A lot of mothers on the main land are single moms employed by temporary jobs such as cruise ships. The are no alternative jobs so the mothers end up leaving the children with neighbors or family members that don't take very good care of the children. There are only 2 day cares on the island that only the rich people can afford. I am learning so much about the culture and how the honduran health system works. There is a substantial gap between the rich and the poor on the island, like many other developing countries, which leaves very few resources for the poor. I am looking into the day cares on the island and hoping they can set up a program for low-income families, or hopefully there is one already available that can be improved on to refer the families to. Its hard to see these kind of things and do nothing.

In the clinic I am working with Raul, Dr. Sarah (born in Iran, lived in Honduras for 11 years, moved to USA for middle school, high school, college and Med school, then moved back to Honduras to work. She speaks 3 languages excluding English and is very cute and Witty). I also work with Dr. Gross who is a 72 year old american attending who lives in San Diego and travels around the world to help as a doctor in third world countries such as Thailand, Malaysia, Haiti, India, etc. He said he has seen the worst things in Northern India, and if I wanted to come see them with him at some point that I was welcome. I am beginning to absorb and process everything I am seeing and hearing to make some sense of it all.

Now its around 3pm and I am headed to the beach to do some thai chi, then look into coaching soccer at this place down the street. My life has no order, changing every 3 months, but I am starting to get used to it. Not sure if thats good or not but i'm adapting.

Kate Journal #1

April 11, 2010: Week 1

My first day in Roatan, Raul (global healing volunteer) showed me around the pediatric hospital and west bay of Roatan. We went grocery shopping and headed to a beach resort where Peggy (founder of Clinica Esperenza) knows the owners so we all played around for the day. We played soccer 3 vs 3, volleyball and laid on the beach....rough life volunteering haha. It was a great opportunity to get to know all the volunteers in a relaxed setting. Everyone I met was wonderful and full of energy. We are all from such different backgrounds and places around the world. I am learning so much from all of them already. After watching a beautiful sunset we went to dinner at the only Thai restaurant in Roatan that I thought was better than the majority of Thai restaurants in the states. This kind of defeats the purpose of being in Honduras but I am sure I will get a lot of authentic food in the next couple months…and well….I LOVE thai food. After dinner Sain (just graduated med school), Maddie (ICU RN), Crista (just graduated med school), Raul (current HEAL intern applying to med school who I will be working with for another 2 weeks) went to karaoke. I sang my first karaoke song ever with Sain (duet) which was aladdin..a whole new was terrible but we got really into to it so maybe that made it better...although probably not. The ride back to the apartments was beautiful. Nurse Peggy owns 1 truck, but constantly drives around 5-10 people so all of us packed into the back of the truck. I sat silently on the way back home watching all the stars that were magnified by the lack of light on the island. I have never seen the stars so bright and clear. I looked for every constellation I know...which encompasses about 5 haha but I fully intend on learning many was breathtaking.

On Sunday when everyone returned from the health fair (listened to the president of honduras and did HIV/AIDS screening) we went to dinner. I ordered literally half of a rotisserie chicken and ate it all! We had fried plantains and a yellow rice mix as well. My roommate Cottie and I watched religiosity and journaled together.

This morning I woke up to run around 5am (sockless) with my NEW NIKE FREEEE's (most amazing shoe in the world and my first new shoe since high school)!!! I ran on the beach till it ended which was about 15 minutes there and 15 minutes back. This does not mean it was a long distance run, it means I was awfully slow haha but I am working on it. I was feeling maybe a bit too adventurous and decided to run it twice so now I cant feel my legs..ooops. Also note to self, do not run next to dogs that are sleeping soundly because they will attack you. I got a little too close to one and it jumped at me and started chomping so I backed off and just starting running into the water like an idiot hoping that the dog couldn’t swim? Eventually the dog backed off after I was chest deep in water. There are stray dogs all along the beach so I am prepared to jump into the water every morning to avoid being attacked.

Today was my first day of triage at Clinica Esperenza and the Pediatric Public Hospital of Coxen Hole. Raul (other global healing volunteer) and I waited for our bus (big van) outside of the volunteer apartments promptly at 7:30am. I had no idea you could fit 20 people inside a van...but hey...its possible. Ten minutes later we arrived at the public hospital fully drenched in sweat. This hospital is far from anything you will see in the states. It was 90 degrees and muggy today and the hospital has no air conditioning. I walked around the hospital with Dr. Gross the American attending volunteer to watch him do rotations with mothers who had just delivered. I learned so much about the normal signs of a newborn through the first trimester. I was terribly nervous and extremely excited as I walked through a sea of mothers and some children crawling on the floor who were waiting to be seen at the global healing clinical office.

Today I saw 15 patients. The children came in with a variety of diseases I had never seen before ranging from chickenpox to scabies and parasites (mostly worms). It is very clear I do not speak fluent Spanish so the mothers that speak English reply in English. I am already becoming more confident with my Spanish and especially my medical Spanish but I still need a lot of work.

I ended the day working in Miss Peggy's Clinica Esperenza counting pills in the pharmacy and cleaning up. Tomorrow I will start working with a few soccer teams around west end (the more touristy side of the island). I am so excited to become enthralled in soccer again, especially with a group of kids who live and breathe the game. My first three days here have been amazing to say the least.

Monday, July 26, 2010

Raul Journal #3

April 4, 2010: Week 3

So I arrive at the clinic early on Monday morning, ready to get to work, and I am surprised not to see any patients waiting in the hallway. There are only patients waiting by the emergency room. I was a little earlier than usual, but it still seemed strange that there was not anyone. Still, I opened up the clinic and got ready for the day as usual. Ten minutes went by and still no patients. I go down to where the patient check-in area and I see it is locked up. I had no idea why. I had still had some work to do in the clinic as the painting had been done on Friday, and I still had to make sure everything was dusted off and wiped down. Soon Dr. Sara arrived, and let me know what happened. Apparently there was a tiny sign on half of a manila folder, near the entrance of the hospital that I had missed. It said ‘No habra consulta externa del 29 de Marzo a el 4 de Abril’ meaning no consults all this week. We had not been given any prior notice of this, so Dr. Sara went to investigate. She found the director of the hospital, who was in the Statistics Department, angry because the Statistics Department decided, on their own; to put up the sign and send all of the patients home early in the morning before anyone else arrived. They took it upon themselves to let everyone have the week off for Semana Santa, even though the Director had previously decided that patients would be seen until Wednesday. Needless to say, we were not thrilled about this development either, as not only had we planned to be there, but our patients were sent home unseen. Dr. Sara then explained to me that this is not the first time something like this has happened at the hospital, which is really horrible, because just because it is a holiday does not mean people do not get sick. And what options do people have, either get sick enough that the emergency will take them, or come back next week! Dr. Sara also explained to me that for chronically ill patients it is especially bad, because if they had an appointment to come in this week, it just gets lost and they do not get rescheduled. They have to come back next week at which point they are wither turned away because they do not have an appointment or forced to wait to see IF they can be seen that day or they have to come back and try again, which throws off their entire treatment schedule as well as their personal schedule. It is really sad that the hospital workers feel that they can just do something like this.

So I had to make the best of a bad situation, since Dr. Sara and I were already there, we went through the clinic and did some housekeeping. I had organized almost everything my first week there but there are always little things that can be done, and it was helpful to go through everything together so that we would both know where everything is and exactly what we have. We also tried to see if we could drag the guy who is supposed to install the automatic door closure device to finally do it, but it seems he decided to take the week off too. For the rest of the week I went to Clinica Esperanza and worked with the doctors there. I got to see some really interesting cases. One young man came in with a large growth on his cheek, probably a little smaller than a ping pong ball. It was small fluid filled sack, and I got to help one of the doctors as he opened it up and removed all the fluid. Well help is probably too strong a word, I got to get him his supplies and hand him tools as he needed. But it was amazing! It is not too often that I get to see something like that live and up close.

The rest of the week, the days we were actually supposed to have off, one of the new doctors at Clinica Esperanza and I went to West End to get our diving certification, which is also one of the most incredible things I have done. Diving is amazing! Getting to float around almost weightless in a completely different world, is relaxing and so exhilarating all at the same time. And I cannot express how unbelievably amazing it is to be able to do something like swim alongside a sea turtle, so close that you could just reach out and touch him, or floating alongside a giant coral reef wall when you are forty feet underwater and see that it still extends at least another fifty or sixty feet below you. That last one gave me a little nervous giggle at first, because it is like standing at the edge of a cliff, but this is like a dream because you can actually go over the cliff and “fly” alongside it. If you ever have the chance do go diving, I definitely recommend it. And the dive shop we went to gave us a good deal because we were volunteers.

So, although the hospital tried to stop me, I was still able to accomplish some good thanks to Miss Peggy and Clinica Esperanza, and I finally got to find out why there are so many divers on this little island, all in all not a bad week. Alright, well I think that is enough from me, Happy Easter to everyone, until next week!

Raul Journal #2

March 28, 2010: Week 2

So I am coming to the end of my second week here in Roatan, and each day I feel really glad that I came. Working at the clinic has been a great experience. The majority of patients that we see come in with some type of parasite infection, mostly ascariasis. However there are also several other parasites and bacterial infections that we see. We have also seen a couple of patients with malaria, as well as other topical bacterial and fungal infections. One poor child had a fungal infection that had gotten so bad it was forming a very large lump near the top of her head. Many of the children also come in with a combination of parasites, upper respiratory infection, and/or fungal infection. Many mothers come in stating the same chief complaints for their children, gripe, cough, diarrhea, and sometimes also fever (although very few if any actually have a thermometer to take their child’s temperature). It is very interesting to observe the doctors as they tactfully extract the necessary information from the mother have to arrive at the correct diagnosis. Even though the mother are sometimes unhappy at first because they come in requesting a specific medication because it worked for someone else, or it worked last time. The doctors have to patiently explain that antibiotics will not do anything for a viral infection or that their child does not actually have the same infection and that another medication will be much more effective. But it has been a great learning experience to see how to deal with these types of issues effectively as almost all the mothers walk away happy when they leave our clinic. Sometimes we see patients again outside of the clinic and they are always very happy to see us and thank the doctor’s letting them know that their child is doing much better.
Working with the children who come into the clinic has been really fun as well. Most of the children are very friendly and happy despite being sick and very few are afraid to be coming in to the doctor. Those that are nervous or afraid usually easily assuaged by some comforting words or a little bribe. I usually tell them that if the help me with a few things they will win a prize, and once I get them to step on the scale, stand by the wall to measure them, and let me take their temperature, I reward them by giving them a sticker, or a sheet of paper to color on, and a pen. Before I came here my parents bought me a bag full of assorted colored pens and pencils, so I usually give them away to the kids that are old enough to use them. And also we have some little chairs and some story books in the clinic that the children are usually happy to play with, and having their own personally sized chairs usually makes them feel very happy and comfortable. It is really great to see their smiling little faces, happy to be there, and saying “gracias” to me, even though I am the one that is thankful to be here, and thankful that the clinic exists to be able to help them.

Well to continue with my overly emotional tone, I would like to say that one sad thing happened this week. The two doctors from the U.S. returned home. Dr. Catherine and her husband went back home Friday afternoon, and Dr. Preetha went home today. It is too bad that I only got to work with them for two weeks, but the two weeks were really great. Now it will be just me and Dr. Sara for a little while, which also has its advantages, because I will be able to spend more time with her, which will allow us to get to know each other better and work together even more effectively.

Another update is that the clinic has been repainted! Well part of the clinic. One of the walls in the front room of the clinic had apparently suffered some water damage some time before I arrived, and the doctor’s had been trying to get someone to fix it but the people who were supposed to fix it were just not coming, and we really needed to get it done, so I volunteered to do it this past Friday that way it could be ready by Monday. It was just a matter of scraping away the damaged portion of the wall, sealing it to help prevent damage in the future, and then repainting it. Dr. Sara and I went to the hardware store to buy the supplies on Thursday, after we were done at the clinic, and Friday I got to work. And since we were going to buy the paint, I took advantage to paint most of the front room as many of the walls had begun chipping or had some minor scrapes, or poorly painted areas where the color that was underneath still showed through the top coat. So the nice yellow room where our computer area is, and where I take the patients info and weigh the children, as well as our informal third exam area is contained, is all bright and new again.
Well I think those are all the major happening of the week, I cannot wait to see what next week brings. Until next Sunday, adios.

Raul Journal #1

March 21, 2010: Week 1

My first week in Roatan was nothing short of amazing. Busy and a little stressing at times, but nonetheless amazing. I arrived in Roatan on Monday afternoon, one of the doctors working at Miss Peggy’s clinic picked me up from the airport and drove me to the condo were I would be staying in Sandy Bay, right next door to Miss Peggy’s home. After settling in and unpacking my things, I got a ride into Coxen-Hole, from my neighbor, so I could do some grocery shopping. After getting a cab back home and eating some dinner I promptly crashed into bed and fell asleep, so I could start my morning bright and early on Tuesday.

Tuesday morning I arrived at the clinic fairly early and waited for the doctors to arrive. I sat out in the hall with the patients of the hospital, the waiting area consisting of no more than a hallway with old wooden benches on either side, between the entrances to the clinics in the Hospital. It was a sweltering hot day and the mother’s fanned their children as they sat waiting to be seen by a doctor. Many had come from far away and arrived as early as 6:30am so they could be assured that they would see a doctor as soon as possible.

The doctors arrived promptly and greeted me and we stepped into the clinic, where they showed me around the different areas of the clinic. After which I proceeded to give them the supplies Mrs. Gruber had sent with me, alcohol swabs, ointments, antifungal creams, aspirators, etc., of which they were very happy to receive. There are currently there doctors working at the clinic, Dr. Sara Sadrzadeh a doctor from Honduras, Dr. Preetha Krishnan a fellow Bay Area resident, and Dr. Catherine Boston from Louisiana. The three of them gave me a brief tour of the hospital and introduced me to several people in different departments, before taking me with them to examine the newborns. Then we went back to the clinic and they showed me exactly what I should do with each patient, were and how to notate all the vitals, and I quickly began calling names. I will not lie, the first day was a little nerve racking, I have taken vital signs before but the being in a different country, with doctors I had just met only moments ago, and doing something that felt so simple and yet so important at the same time, the pressure to not make a mistake felt intense. I didn’t want even so much as a smudge on the patient’s sheet. But after the first few patients I began to relax a little and not feel like someone was waiting for me to make a mistake.

We saw about fourteen patients that first day, which was one of the lighter days we had this first week, a fact which made my first day at the clinic a bit easier. After seeing all the patients for the day the doctors taught me how to input all the information into the global healing spreadsheet and the hospital spreadsheet, and where to turn in hospitals form for the department of statistics. My day at the clinic being done, I took some time to explore Coxen-Hole and familiarize myself where everything was around the hospital before I took a cab home to Sandy Bay. Upon returning to Sandy Bay, I took some time to walk around my neighborhood, and meet some of my neighbors. All in all my first day was pretty great, even taking into account my minor attack of nerves.

The rest of the week at the clinic grew progressively better, as I grew more comfortable and more familiar with the clinic. I continued to arrive early to the clinic, so that I could do some cleaning and organizing of all the cupboards and shelves in the clinic, now what I need to do is make some labels for the shelves and some of the boxes to help keep things organized and make them easier to find. The doctors at the clinic have been really appreciative of my being there and have really welcomed me with open arms. Dr. Krishnan, Dr. Boston and Dr. Boston’s husband showed me around West End, where they are staying, and we had dinner there at a delicious place called Rotisserie Chicken, which so far I have found to be the most affordable place in West End and the food is great. Thursday night, Dr. Krishnan also invited all of us at the clinic out to dinner, including Dr. Boston’s Husband, and Dr. Sadrzadeh’s husband, so all of us are getting to know each other pretty well. Friday afternoon I was also able to visit Miss Peggy’s clinic and see how things run there, as well as get oriented with the pharmacy so that I can help out there in the future.

This first week in Roatan has been, as I said, amazing. I have met so many great people and gotten to do so many great things that I would probably never have the chance to do in the U.S., both medical, and recreational, such as snorkeling! However I seem to have brought some of the Bay area weather with me, as we had two days of stormy weather, which delayed my snorkeling until Saturday. But it was just as well as the first few days I had so much to do I probably wouldn’t have had much time to really enjoy it.

The only problem I have run into, if I can even call it a problem, is with some of the cab drivers who realized I was new to the island and tried to charge me more than the normal fare, I had to haggle with them most of the time so they would not give me the tourist price. However one thing to note is that the prices have gone up from what the orientation packets stated, I have consulted with the locals and they have agreed that these are the correct fares. A cab from Sandy Bay to Coxen-Hole is twenty-five Lempiras, and the bus from Sandy Bay to Coxen-Hole is eighteen Lempiras. I finally decided to try and take the bus on Friday at Miss Peggy’s insistence, and I am very glad I did. It actually did not take that much longer than a cab ride and the people on the bus were much friendlier and more open to conversation, and as soon as they heard that I was here to volunteer at the Global Health clinic and Miss Peggy’s Clinic they were very happy and really welcomed me and even commended me for doing so. It was really nice to feel that sort of acceptance from the locals, especially since I had only met them a few minutes ago.

Molly Journal #11

January 10th: Week 11

We have had terrible weather all week. Many fewer mothers bring their children in when it is raining outside. With the low numbers of patients, we have actually had high numbers of 10-day check ups. These mothers are braving the rains to bring their 10-day-old babies in for check ups. I think that Dr. Bob must be stressing the importance of returning during new born exams because only in the past few weeks have I seen so many diligent moms bringing in their babies right on the 10 day mark. Even if kids with colds are saving up their problems for better weather, these hopeful moms are taking good preventive care of their newborns by bringing them in for check ups. It is good to see some follow through.

This week was our first week with Dr. Sarah, the 2010 Global Healing Fellow. She is very smart and kind, I have enjoyed working with her so far. Dr. Mario is now finished at the hospital sadly. He is hoping to get into a program in Mexico to specialize in surgery.

Because we were slower this week, I got to shadow the doctors on rounds in the pediatric inpatient ward and in maternity for newborn exams. We saw newborn that had aspirated the fetal meconium. A baby may have it’s first bowel movement of meconium in utero. Then because of the stress of birth, the baby may aspirate some meconium mixed with the amniotic fluid causing pneumonia. This particular baby had not aspirated very much and was doing well. She was hooked up to an antibiotic IV and an oxygen tube. The necessity of the antibiotics was questionable, and apparently an overuse of antibiotics is characteristic of Dr. Jacquie. Sarah talked about how the L&D nurses are very unprepared to resuscitate a newborn. She had an experience where a newborn stopped breathing after meconium aspiration and the nurses just shook him to reanimate and wouldn’t use the proper equipment. This is pretty terrifying.

Molly Journal #10

January 3rd: Week 10

We closed this week for New Year’s. Dr. Bob went to California for Christmas, and Dr. Mario went to Tegucigalpa. My sister arrived on Christmas Eve to visit for 2 weeks, so we took advantage of my week off and went traveling on the mainland. We went white water rafting on Rio Canrejal in Parque Nacional Pico Bonito, sunrise canoeing and bird watching in Refugio Cuerdo y Salvo, and explored the ruins of Copan. It was a lot of fun and a great opportunity to see the mainland.

Molly Journal #9

December 27th: Week 9

This week was incredibly slow. We were only open Monday-Wednesday as Christmas Eve and Day were Thursday and Friday. We had very few patients as people were traveling or preparing for the holidays.

Nearly every baby up until about 6 months wears on this island wears a red beaded bracelet. I have asked a few mothers what the bracelet means and they say something like “to keep them safe.” This made no sense to me so finally I asked Mario. She said he had been curios too as it is not a tradition on the mainland. He explained basically wearing the red bracelet protects infants from “mal ojo,” or “the bad eye.” In this superstition, if a baby is looked at the wrong way in the first few months of life they may get sick or die. I suppose the “mal ojo” concept gives people a something to blame for infant mortality.

Infants do not receive names normally until a month or two, or sometimes five. I wonder if this practice stems from a hope to not get too attached to a baby who statistically may not survive. If the baby does not yet have a name, maybe it is not considered a thriving person yet, and therefore not as sad if it dies. Or maybe they are just lazy namers.

Molly Journal #8

December 20th: Week 8

Compared to normal standards, the hospital lobby was nearly empty today. Mario said this was typical for Fridays pretty much up until the time I arrived. Fridays are cruise ship days. Also the wind had picked up and the skies seemed threatening to unleash a tropical storm. This “rainy season” has been surprisingly full of sun and blue skies, so the stormy days keep people at home.

All patients were seen by10:15am after which Dr. Robert and I dug into the nebulizer/respiratory treatments/miscellaneous junk shelf. We found tons of expired inhalers and other meds. It was a shame to throw bags full of medications, but they say the clinic could really get in trouble if caught by the ministry of health. So away they went, only a few months expired. The rest of the shelves contained 8 different organizational systems left by the rapidly changing succession volunteers and employees. There were probably 200 pulse-ox electrodes stashed in various boxes and corners. We also found 4 more nebulizers although we’re yet to find out if they work. We got some organization in the jumble of supplies. Yesterday Dr. Robert threw out shelves full of expired meds in the cupboard of one consolation room. I think it needs to be decided what the plan of action is for the donated meds. If the doctors only write pharmacy prescriptions and never give them away, then we end up with shelves full of expired meds. It’s such a shame these meds aren’t helping kids who could really benefit from them, not to mention the wasted packaging and product.

This week I switched from growth charts by the CDC to ones by WHO. Dr. Bob brought print outs of these and explained how the CDC’s measurements are based on fat American kids, where as the WHO takes into account the less nourished 3rd world countries. The measurements don’t appear to be too different but this hopefully will be more relevant for the population. While I have seen a good deal of quite plump children and parents, there are also the occasional chronically mal nourished kids from the households of 10 children and bad hygiene.

This week I had a great proportion of terrified or angry children. 3 years of age seems to be the time when kids become skeptical, temperamental, and mistrusting. I had quite a few temper tantrums, which normally start before they even walk through the door. But some kids take one look at the scale I am asking them to get on and start screaming. I don’t know why they find it better to scream and fight than just to sand in a particular place. I have learned a few tactics for dealing with the screamers:
1. If the kid won’t stand on the scale, put a chair on it (it weighs 1 pound), sometimes they will sit
2. Give stickers to make a friend or bribe them with stickers if making friends is not a possibility
3. Weigh the mom with and with out the child then subtract the difference
4. Explaining everything before it happens

On Wednesday we had the first supposedly weekly conference since I’ve been here. Louis, a social service doctor presented on nephrotic syndrome. Most of it was straight over my head because it was not only technical medical terminology and in Spanish. Still, it was interesting to learn about this kidney disorder. We are going to try now to have a presentation luncheon each Wednesday.