Having Dr. Eileen, Dr. Molly, and Dr. Isabelle in the clinic this week made things much easier for everyone. There was barely enough room for each of them, including Dr. Raymond, to create there own private space to see clinics. I figured that since I was mostly taking medical histories, chief complaint, and administering survey I could just set up my own little space outside the clinic where I could have one-on-one conversations with the patients waiting to be seen. Before I used to just stand the whole time I was asking the survey questions and writing down chief complaints. After using the chairs to actually sit down with each patient, I realized that the conversations were more personal and in-depth than before we used them. This helped the patient sit down, relax, and confide in you. It was nice. I just had to keep a close eye on the chairs to make sure they did not disappear to another part of the building, since we already had a shortage of chairs. Dr. Eileen loved the idea of using the surveys to determine the nutrition of the children, their families, and figure out ways of educating them on better health in case the patient was dropping below normal growth levels. The doctors would always like to see a patient who had already taken the survey, so that they could look up their eating habits when checking their weight and growth levels. I felt like I had a really important role because the surveys were a great help for the doctors in order for them to offer good health advice to the patients and their parents. I felt like a true member of a team.
This week I saw my first bronchiolitis case, which was a 9 month old boy. He was breathing so heavily and rapidly, that I could see the skin under his ribcage cave in way under it. The baby’s brochioles were inflamed, so it was really hard for him to breathe and it was also very difficult for the doctors to do anything because the airways were too small for any muscle relaxing medication. The doctors would just have to continue giving the baby oxygen through a nebulizer and wait for the mucous build-up and all the gunk in his lungs to break apart and get out of his system. I was afraid for the boy, since I could not even breathe that fast for days at a time. I was afraid that his heart would give out pumping so much blood into his system, since his heart rate was way above normal. He was such a trooper, looking into his mothers eyes with such control and calmness as his body moved uncontrollably. That baby was of strong blood. Dr. Molly explained to the patient’s mom how she should sit the baby up and gently pat the baby’s back every half-hour to help with the mucous break-up. The baby is doing much better now that he has a runny nose and is getting rid off all the mucous he had in his system. The nasal pumps were a great help then. However before the baby started getting better the doctors had to deal with a splitting dilemma. The baby had to be under hourly supervision after clinic hours since the nurses were not very attentive to each individual patient, but instead the overall order of things and there was only physician in the hospital during the evening/night shifts. So it was either that the doctors take turns in coming in to watch over the patient during the height of his sickness or they set their boundaries and go on home. In the end the doctors did end up staying longer to watch over the boy and make sure he was getting the proper oxygen levels, but after most of the evening they decided that this was the limit of the care they could give to that particular patient. They decided to check back with him in the morning after they agreed that he was in a more stable condition and was well enough to be on his own until the next day.
I am proud to say that I have surveyed at least 120 patients throughout my stay here in Roatan. All of the information on the excel spreadsheet will go towards finding the target foods needed for patients to have a well-balanced diet, pinpoint problems, and overall helping the patients take better care of themselves. Many patients have been very curious and have asked what the survey was used for and I would say that they were a great way for us (pediatrics clinic officials) to know more about our patients, their nutritional lifestyle, their language, and location in case we decided to develop a class that would benefit them. This was all going to be used in a way to ultimately benefit the patients. They would look with me with approving eyes, in a way like they could not believe that we were going through all of this paperwork in order to help them. After taking the survey some of the patient’s mothers would say ‘thank you’ to me instead of the other way around. I feel that I should do as many as I can because I while I am here I should use my Spanish skills to reach out to as many people as I can before I have to take my skills back to California. I am glad to see that the patients are glad that I am here. When I start speaking Spanish most of the only-Spanish speaking mothers blow a sigh of relief like I have just saved them the struggle of using signals or straining their sketchy English. But most of them also look at me slightly confused because they say I look like I am half Asian, white, or even Spanish. After conversing with them in Spanish they try to persuade themselves that yes, I am Mexican. It’s surprising to me how among Americans I they can easily point me out as Hispanic/Mexican, but among my own Hispanic community I look like another ethnicity. That was interesting for me, especially since the taxi drivers got a kick out of it.
Last Friday we painted the medicine cabinets in the clinic and did some spring cleaning. I created a gorgeous plaque to hang up on the wall of the clinic that read ‘Nuestra Clinica Es Su Clinica’, which kind of spun off from the whole ‘Mi casa es su casa” saying. It was a beautiful plaque, which had a light blue background, with dark pink writing and colorful hummingbirds on each side. It seemed to match with the baby blue cabinets that were freshly painted. I am not sure where we are putting it, but I am sure the patients will love it.
I had a date with the dolphins this week and it was the best snorkeling experience I ever had in my life. I would sometimes feel like I was trespassing onto their territory because they about 7 dolphins would huddle all around me making me feel like a speck in the sand, but then they would play with me and let me touch them. They are magical creatures and it’s mesmerizing to hear the sounds they make underwater. I would feel them torpedo past me as they chased on another around the ocean. They’d scare me every time they snuck next to me trying to take a peak at me, but after my sudden startle I would reach out my hand and pet their soft, humongous bodies. It was truly the experience of a lifetime.
I volunteered at Peggy’s clinic on Friday morning as well and it was unexpectedly busy. Many moms were waiting in line since 6 AM waiting to be seen. I helped translate, dispense meds, pull charts, glucose screening, and talk with most of the women about their health, their social lives, and politics of the island. They are strong-minded women. We spoke about the powerful families that control all of Roatan, Indios being the bottom of the social ladder in Roatan, the differences between the school systems in Roatan in comparison to the ones in La Ceiba, and marital problems, like this woman who ran away from her husband after years of abuse. I met a medical student named Richard who was there from Arkansas for a day to help out. He was a business major as an undergraduate and he assured me that although medical school is very hectic and overwhelming, it was constructed to help you learn and succeed, so eventually all that information will sink in. I can’t get over all of the nice people I have met here. I am unsure as to what makes the culture here so rich and the natives so kind to visitors. It’s not only the natives here that are welcoming, but other visitors coming to the island seem to have a friendly factor that ties them all together. It is very different from the often impersonal ways of people back home. Of course, there are amazing people back in California that I would not trade for the world, but here in Roatan the strengths of human nature seem to magnify.
Unfortunately I have not been able to work on all of the follow up patients as attentively as I had wanted to when I arrived. The group of opthomologists were supposed to come to Roatan today, but Dr. Raymond was unsure of the exact location of where they were going to be because the group had said that they would stop by the Sandy Bay area if they had extra time. ‘Extra time’ were the key words. Also, it was difficult to focus on follow ups when I was focused on survey data entry and analysis, nutritional research, preparing my nutritional class, and trying to settle into my environment all at once. I think this was my weakest point of my role here in Roatan. But my ultimate goal was to understand, appreciate, and help the natives of Roatan and so far I think I have progressed significantly. I loved the experience.
