Monday, July 23, 2012

Israel Journal #1

Week 1: Entendamonos
Empiezo este discurso en espanol en honor de la cultura Latina que me va rodear por el proximo mes que anteriormente solo conoci de Mexico. Aunque no soy de familia Hondurena, todavĂ­a puedo disfrutarla y llamar este pais mi hogar. Inlcuso, este discurso es en honor de toda la gente que voy a conocer, ayudar y, si Dios quiere, toda la gente que ayudara en el futuro como medico. Ya cuando leen esta nota, jamas sera la misma persona. Pero no necesariamente es algo malo. Al contrario, yo me considere un humano un poco mas completo.

I arrived in Roatan on Saturday morning, July 14th in a state best described as a hodgepodge of different feelings. I was excited to start on an experience that I hope will continue to blossom as I forge my own path in life and also a little nervous because I want to give my best to the people of Roatan Global Healing. I’ve never been on any island before but as the plane ascended onto the tarmac, you could already tell that the island was picturesque to say the least. Deep blue ocean wrapped around the lush greenery on the island littered with buildings topped with Spanish roof tile. Dee, who I will be staying with for my trip, greeted me and took me on a short tour of Coxen Hole and Sandy Bay. In Coxen Hole there was a greater density of cement homes, some without windows, some homes along our way looked like they were half finished. Some homes were made entirely of wood and a few were in pretty poor shape. We traversed a few dirt roads until we reached the main highway which is a two-way paved road. Before arriving here, I was not sure what the island would look like. I’ve read that Honduras is considered a “developing country”, but even then I wasn’t sure what image to associate that term with. After the little tour throughout Coxen Hole and Sandy Bay, I realized that to a significant degree the population is poor. Although I am not a stranger to being low-income in the US, this was poverty at a different level. I have always held this belief that your character is not determined by the amount of money that you make, and after my first week at the clinic I have already determined that this is not just true in the US but even internationally.

I was anxious to meet Jena, who is the HEAL intern at el Hospital Publico de Roatan, and curious enough I met her while snorkeling right after I came from the airport. This alone tells me just how relaxed it is to live on the island. Curiously, I don’t even keep track of time. As for snorkeling, with a little push from Dee I got used to snorkeling even though I was really apprehensive about going out so far from land. The reef itself was very vibrant with its curious formations and the vibrant sea life. At the end of it I was happy that I wasn’t afraid to step out of my comfort zone. I have a feeling that I will be doing plenty of that during this internship.

Monday was my first day at the clinic and everything went extremely well. Jena met with me in front of Miss Peggy’s home and we hailed a taxi to el Hospital Publico. Right before we arrived at el hospital, Jena made a comment that it would not look like how I would imagine and oddly she was right. El hospital publico is a modest, largely single floor building with a lot of different clinics inside and a large ward which comprises the Emergency department. I imagined that the hospital would have a general waiting area and a little more organization. There were a lot of people sitting on benches and standing in front of the registration office. Rather than having waiting areas, the hospital has benches where the patients can sit as they wait to be attended. Jena and I made our way to the Global Healing clinic (Clinic #10) and the work began. That is where I also met the two attending physicians: Jess, who is a resident at Stanford, and Lenia, who is completing what is the equivalent to residency in Honduras. Jena is an excellent teacher and she gave a lot of terrific advice which helped me adjust to my duties. One of my duties as an intern is to triage patients for the Global Healing clinic at el hospital. Jena first demonstrated all of the questions to ask the patient’s parent(s) and where to place their records for the attendings. For the first couple of patients I fumbled a bit but as I kept working I felt as if I was getting better. And according to Jess, I got much more efficient at triaging by the end of this week. One observation I have made about the types of sickness that the children here have is that there are generally more cases of communicable diseases whereas a resource-rich country like the US has a significant number of children with chronic illnesses.

After my time at el hospital which has been ending generally around noon, I also have been going to Clinica Esperanza and volunteering there. For the most part, it looks like the clinic is fairly full with volunteers so I would like to include another activity in my afternoons. I am hoping that I might be able to do health education at the library or maybe plan a study comparing the health beliefs of children with diabetic parents and children with non-diabetic parents. I have started tutoring a few school kids at a nearby after-school program and that has also been very fun. 

Friday, July 20, 2012

Jena Journal #2

It’s hard to believe that today is my last day at the clinic and in Roatan. Where did the 5 weeks go? Yesterday I introduced Israel to the clinic and he has already settled in nicely. He’s very meticulous in his work, a quality I’m sure will serve him well as a doctor. With him here, I’ve been able to spend a lot more of the past two days shadowing the doctors, which has been fun and informative. A few of the patients these past few days have been repeats, and I love it when they recognize me and that I get to see the follow up. Most of the kids look so much better!

 As I’ve shadowed the doctors, I have noticed that they always make sure to go over basic health practices with each patient, beyond the specific complaint (things like “wash your hands” or “try and keep their wound clean”). I didn’t see the necessity of such common sense advice until last week, when I learned the importance first-hand. I spent most of Thursday and Friday in bed with an upset stomach and a diagnosis of parasites and dehydration. Apparently I needed one of those basic reminders: “make sure to drink a lot of water”.

 There have been lots of newborns in the clinic these past few days, so I’ve had the opportunity to see a lot of illnesses common to that age. The most striking was the little baby who had swollen nipples and a “baby period”- I never would have thought mothers could pass their hormones on their babies. There were also a few rashes and a couple babies with a yellow tint in their skin. However, there were very few cases where the doctors prescribed more than vitamins, as most conditions just disappeared with time. Sometimes the body’s ability to autocorrect amazes me.

 It’s fun to think back over the past week, and over my whole time here. I have really enjoyed my stay in Roatan and at Global Healing. I’ve seen a new side of medicine, met lots of great people and practiced my Spanish (and, of course, enjoyed the beaches of this little island immensely). I am excited to go home, but it is hard to leave - this isn’t the first time in my life I’ve wished I could teleport. 

Goodbye Roatan (at least for now), Jena

Jena Journal #1

It is crazy to me to think that I have been in Roatan for almost 4 weeks now, and even crazier to think that in a little over a week I’ll be back home. How the time has flown! There are many things that I am looking forward to in the States, chief among them being air conditioning and no sand fleas, but I also wish I could stay on this little island paradise for a bit longer. It is a great balance between work and play: I generally spend my mornings in the Roatan hospital, my afternoons in Miss Peggy’s clinic, and my evenings exploring the island with other volunteers. Overall, I’d say it’s a pretty great life.

 The hospital has certainly been an eye-opening place to work: without running water or air conditioning, it isn’t what I’m used to seeing in the States. The contrast was driven home for me last week when a premature baby under the RVPC doctors died because the hospital didn’t have access to the ventilator he needed and his family didn’t have money to take him to the mainland. It was frustrating and confusing to see something so preventable take a life, and made me appreciate even more the efforts of organizations like Global Healing and Miss Peggy’s clinic.

 On a lighter note, the hospital has also taught me a lot about what I like and dislike about medicine. I know now that I could never study dermatology (I feel like I use half a gallon of hand sanitizer every time a child comes in with a rash), and that I love the feeling of fixing a problem and seeing immediate results (which mostly manifests when I give a feverish patient acetaminophen, but still, it’s something). I’ve also been able to expand my Spanish vocabulary. I learned the word for “breastfeeding” early on, as not knowing made for some awkward charades, and I’ve used the word for “kidneys” and “gall bladder” more than once. I’ll have to try to slip those into a regular conversation someday…

 The hospital has also given me a good idea of what life as a pediatrician looks like, at least here in Honduras. I get to triage all of the patients that come through the clinic, and then shadow the doctoras after, so I see a lot of the diagnoses and the treatments that are given. The most common ailments seem to be ear infections, fever, and rashes (bug bites and fungal infections being especially common). It is also interesting to see the different styles of all the doctoras. During my time here, I’ve had the chance to work with four: one a native Honduran, two volunteers from the US, and one resident in her last year at Stanford. All four have been fantastic, and quite different. I noticed one focused a lot on basic health recommendations, while another paid most attention to the specific problem. Bedside manners also varied: some focused more on the child, while other mostly addressed the parents. Yet, somehow, all of the methods and manners worked. I’ve seen that there isn’t one perfect way to approach a patient, but rather a way that works for each doctor. It’s a good lesson to learn.

 The afternoons in Miss Peggy’s clinic are lots of fun. As an unofficial volunteer, I usually end up helping in pharmacy. The pharmacy orders tend to come in spurts, so in the down time the other volunteers and I do everything from quizzing each other on medicine names to deciding which Harry Potter houses we belong in. I am also always careful to keep an eye out for banana doughnut man, who will single-handedly be the reason I gain 300 lbs in my time here. Life is short, right? In the evenings, the other volunteers and I explore the island. While here, I’ve tried iguana (gross), choreographed and performed a dance to Backstreet Boys at karaoke night, eaten more baleadas than I can count, and have snorkeled a lot. I’m excited to see what the rest of my time at Roatan will bring, even with only a week left. Pretty soon I’ll be introducing the new intern, Israel, to the clinic and to the blog! Get excited. I know I am.

 Until then, Jena