I am certainly having a lovely time on Roatan so far. Began my diving class yesterday and have done all confined dives and two of the four open waters so far, so I should finish that up this week - I have my own instructor, and it has been a fabulous experience so far.
Things at the clinic continue to be busy but under control. We have been seeing 20-25 patients (usually plus some follow-ups) each day, which means that Charles usually has to hurry towards the end of the day so he can finish in time to get to his other job. Things are running smoothly though.
Eileen left me with some educational posters that she made earlier, and so I had them laminated on colored construction paper this week and they are ready to be used in the clinic. They are about breastfeeding, dental hygiene, and general kids nutrition, and scabies treatement. Basically they are a series of 5-6 notebook page size illustrations with a little bit of writing/information. I think the idea was that the doctors could use them while doing patient consults if they think it would be useful to go over the information - such as, if the kids has scabies, go over the posters for scabies treatment and prevention. All of the posters are in Spanish too. Hopefully they will be a useful educational aid in the clinic.
I also noticed that at least one day a week, the nurses do a little mini class in the hallway, teaching the moms that are waiting about breastfeeding usually. It is a highly amusing demonstration involving many poster-sized pictures of breasts, but the moms really seem to pay attention and like it. The only problem is that they send the kids to another part of the hospital during this time, so we can't see any patients for a while because they are all off playing elsewhere.
There are two people here volunteering at Peggy's for a couple of weeks (a nurse and a pre-med student, both in their mid-20s) who would like to come and see our clinic and possibly help out a bit. I tentatively told them that would be okay with me, but I wanted to run it by you guys too. I don't know that there's really a lot for them to help with at this point, other than that they could possibly do some of the admin stuff for a bit which would free me up to do more surveys. Anyway, I was thinking maybe they could just come by towards the end of the morning and see how things run, I could show them
around a bit, but then they wouldnt' be in the way at all. Let me know what you think.
Progress on my water survey has been a bit slow this week. Monday I dropped off a bunch of copies of the survey to Peggy, because she wanted to have her students administer it in clinic this week. I went through it with her housekeeper, Irma, who also lives in La Colonia, and it seemed like she understood all the questions and everything. However, I stopped by again Tuesday to see how it was going and Rob and Ginger, the two students that were going to do it, had decided that the way it was currently designed they didn't think I would really get truthful and/or meaningful answers from people. They thought people would be too embarassed to say that they don't have soap, etc, don't always have money to buy purified water, etc. So, while they didn't have any other suggestions, the end result is that the survey is not going to be done at Peggy's at all anymore. While I agree with their criticisms completely, I don't really know how to fix the situation and get people to be more comfortable answering things honestly. Rob and Ginger seemed to think that the survey was also generally much too sophisticated for the people in La Colonia - that they wouldn't really understand the questions, and would just look to me for the answers and tell me what they thought I wanted to hear.
All of this said, I have still managed to find out a lot about the water infrastructure on the island, and specifically the water systems in La Colonia. I went to see the new purification system in Polycarpo (one of the three colonias) with Chuck, the water engineer/missionary who owns the hotel where Peggy's clinic is, which was very cool. I feel like I have a much better understanding of the water situation in general, and I have begun to keep notes and write up what I find out when I talk to people. I am hoping that when I have more time in clinic (ha ha, if that ever happens), I will ask some of the basic infrastructure questions from my survey to our patients from other parts of the island, so I at least know the basics of the water systems elsewhere - like Los Fuertes, the different barrios of Coxen Hole, Flowers Bay, Gravel Bay, etc. I think I will try the survey in our clinic and just see how it goes, whether I think people are understanding and answering honestly or not, and then reevaluate whether it is worthwhile to try to do it on a larger scale. Any thoughts you guys have on this would be appreciated as well.
Dr. Leonel arrives one week from today, next Sunday, so he will start in clinic that Monday. Dr. Charles, however, is going to be gone that entire week for his graduation, so it will just be Dr. Leonel and I in the clinic until the following week when Charles returns (and Alissa arrives as well).
We had a very sad case this past week, a follow-up from last week that Dr. Eileen was able to see while she was in clinic on Monday - an 8 month old baby with advanced AIDS and several opportunistic infections. Due to a miscommunication, the mom was told that Eileen wasn't there and so she left, but Eileen later found her at Valerie's clinic. She decided that the only way the baby was going to get the care she needed was to take her to the hospital in Ceiba, so they took the afternoon ferry, got the baby admitted, and Eileen was barely able to make it back to the island on a flight that evening so she could make her early morning flight back to the US the next day. It sounded like the doctors in Ceiba were very helpful and accomodating, and that the baby's mother was willing to take her there monthly for treatment if necessary, as ARV therapy typically isn't available for kids here on the island.
