Where do I begin? My experience in Roatan has been amazing, although much different from what I imagined. The people are incredibly kind and giving and I only wish I could do more for them. Unfortunately, due to my lack of knowing Spanish and because I am frantically trying to finish my medical school application, I cannot contribute as much to the clinic as I would have liked.
The clinic is in a slight state of turmoil. When I got here there were two residents (Mollie and Isabelle), one attending (Eileen) and the Honduran fellow (Raymond), but things have dramatically changed. The residents left last week and Eileen left today. Raymond’s last day is Thursday, but only because they convinced him to stay a few days longer (his official last day was June 30th). He will be working at Miss Peggy’s clinic in the future, but is going to San Francisco July 18th-24th. Global Healing hired Charles as the new Honduran fellow, and he is supposed to start Monday- but Eileen was skeptical of this. I met Charles when he was interviewing and he seems like a nice enough guy. He is from the island but has never worked in the hospital. I think our main role in the clinic will be to help Charles and to keep things under control. With only one physician and one that has never worked there, things will be a little chaotic (they have no one coming from the states during July and August). To help I have been basically triaging patients. I call them in, take their temperature (and if they have a fever give them ibuprofen), weigh them, measure them, mark their growth chart, and enter all of their information into the database. Then when the physician is ready, I bring them in. I also have been getting supplies for the doctors. I tried administering the surveys, but without knowing Spanish this was impossible. I tried doing a few in English, but found that it was slowing things down and it was better that I focus on triaging patients and improving the patient flow.
As far as patient follow up, I have not done any. I am not sure which patients to focus on and have not heard of any specialists coming to the island. Raymond and Eileen said they went through our follow-up list and said no one was critical and most of the patients have not expressed interest in following through on their own care (they didn’t show up to the ferry, didn’t come back when they were supposed to etc.). I added a few new cases to the follow up list: two are children that need to have an audiologist review them and one is a girl that has epilepsy like symptoms. Unfortunately, they all speak Spanish and I don’t think I can help them much.
There have been a few very interesting cases on the island that have worried the doctors. A baby was born to some missionaries with a severe cleft palette and conjoined extremities (EEC or ECC syndrome). Eileen went to La Ceiba with the family and we are trying to help them find specialists in the states that can help them (but without insurance this may be tough). Also, we had a scare because one of the other missionaries that was pregnant was past due and refused to come to the hospital to deliver the baby- actually she wanted to have an underwater birth in a tub in her shack. The doctors thought that her water had been broken for over 36 hrs and were freaking out- They spent all night at her house waiting for the baby. In the end everything worked out well, the water broke for real (the first time was a false alarm) and the baby was delivered in an hour.
I’ve also learned a little about how the pediatric ward functions and I am a little appalled. Although I haven’t gone on rounds, I have peaked my head in there a few times. I can’t believe who they keep in there and who they send home. They have kids that are basically ok- with a little cellulites that they’ll keep for days, but then they’ll have really sick kids that they’ll try to send home right away. We had a little 7 month old baby presumably with AIDS in the ward, that had terrible thrush and PCP among other things and the doctors sent her home really quickly. Eileen was really upset about this and sent the mom to Valerie’s clinic and has been checking on the baby. She is now doing really well, but I have learned a lot about the politics at the hospital and am disappointed. This baby should have never had AIDS, but the mom was not detected in time. She had tried to get an HIV test done when she was pregnant but could never find the person that was suppose to give her the consultation. She didn’t find out she had HIV until 2 weeks before the baby was born, when it was too late to take AZT effectively.
Eileen has been looking into improving the screening and treatment process for people with AIDS on the island and I think it would be great if we could help with this. Apparently, no one is really responsible for the moms with AIDS and because the way they are stereotyped and treated moms don’t want to get tested. Apparently they are opening a new clinic up in October specifically for this purpose, but we’ll see if it actually happens.
I went to La Ceiba last weekend with Eileen and met this really interesting man named Pepe. He is supposedly the first Honduran conservationist. I think he works for the US consulate now on watershed stuff. He knows a lot about water law and situations and is willing to work with us on this in Roatan. He is a really kind and generous person, he took us kayaking at his river house and gave us a tour of La Ceiba. I recommend we keep in touch with this guy- especially if people have environmentally focused projects.
Other than that we have been painting, sorting supplies, and cleaning the clinic. It looks really nice now. Unfortunately the printer is very broken- we need to get a new one. It won’t even print a single page. As for the computer situation the computer and internet in clinic are working great, and Ben was able to get Jenn’s computer to work. Unfortunately the internet at Casa Calico is broken, so we can’t guarantee that it can connect to the internet (although who knows when they’ll fix the internet). Let me know if you have questions about anything.
