I forgot to write this in my last journal but what has struck me most while working within the health care system here in Honduras is how eager these medical professionals are to help. Perhaps it’s just the Global Healing docs, but the rule seems to extend to others I’ve met through Peggy as well. For example, my first day I assumed that I would have to turn patients away after the nurses had already given out the maximum number of appointments for the day. However, I asked just to make sure about a particular patient, and Dr. Karina said, sure, just have them stick around. The same thing happened with Dr. Charles and another patient. When other doctors close their doors early, either Charles or Karina is happy to see these patients, to follow up on their lab results, or to prescribe medications. And they do this without a single complaint, they act as if this is their duty as a medical doctor, and I guess it is. It just makes me wonder about the way our health care system operates in the United States where doctors refuse patients regularly and patients go unseen who have “the wrong” medical coverage. It makes me think back to times when I’ve volunteered in the ER through SCOPE and an on-call orthopedic surgeon would be in the hospital seeing patients but would refuse to see a patient because he’s not on call for their doctor. Maybe the problem is elsewhere, with the insurance companies who make things difficult, like the patients who come to El Camino’s ER but have to be sent over for Kaiser if they are insured by them. Wherever the problem lies, it is completely absent in the Global Healing clinic. We see patients who don’t have appointments, even adults sometimes! This willingness to help anyone and everyone, to make sure that everyone is an equal recipient of care, is an attitude I hope to carry back to the States with me.
On Sunday Melissa, Suzanne (a nurse staying upstairs with Peggy through December), Kenfor, and I hiked up to the Carambola gardens. The plants were beautiful and the view from the top was incredible. We all went to dinner together in West End and came back early to rest up for a busy week in clinic.
This week in clinic was quite busy. Each day we saw over 20 patients. A particular patient that stands out in my mind is a young boy who was admitted because of lymphadenitis, a huge swelling below his chin. He was incredibly well-spirited but had been in to the clinic 3 times and had shown little to no improvement with various antibiotic treatments. Charles was concerned that he might have a potentially fatal disease called Ludwig’s Angina. I got to see him again on Friday when Karina allowed me to come on rounds with her. Other patients in the pediatric ward include three severely uncomfortable looking abscesses (one in a patient’s armpit, another on a nipple, and a third on a girl’s arm), a possible case of TB, and a baby with high fevers and eyes that were nearly swollen shut. That same day I also went to get Galaxy Ferry tickets for a mother to take her 16 year old son on a follow-up appointment with a nephrologists on the mainland. The only problem with Karina seeing this patient and making the referral is that she had not seen any of the diagnostic workups or reports done by previous physicians and so knew very little about the boy’s medical history. Discontinuity of care seems to be a very serious issue here.
Yesterday (Saturday) we picked up Dr. Rom, a new attending, at the airport. A whole vanload of us came to greet him and he seems youthful, enthusiastic, and very comfortable practicing medicine in a third-world setting. The clinic is going to be quite busy this week with three attendings, but we’re hoping that we can see every patient who comes to the hospital this coming week, and not turn anyone away. This means I will have to get to work a bit early to triage additional patients, but I think it will be very worthwhile and rewarding to see so many patients treated each day. Additionally, Charles leaves for San Francisco for a board review conference next weekend so for the remainder of my time here we will be back to just two docs in the clinic.
As for work outside the clinic, Charles, Karina, and I finished a rough draft of his proposal to do public health talks in local churches, high schools, day cares, and over the radio. Hopefully, we can get started on developing ideas and collecting information for these talks soon. On Thursday, we plan on going to the day care in Coxen Hole to give a short lesson on sanitation and hand washing. I also hope to finish my dive certification with Suzanne this week, as we have only 2 remaining dives.
I can’t believe another week has passed here in Roatan and that only two more remain! Life here does move slowly-island pace so to speak-but the days also seem to blend into one another, so that before you know it, it’s Sunday and another busy week in clinic is on the horizon.
