I've had a good week here in Roatan, so I hope you've had a good week back in the States. I began the week showing my girlfriend, Maya, the ropes in Peggy's pharmacy, which was fun as it added a slightly "new dimension" to our relationship. Work in the pharmacy is going well, although I am definitely a lot less inspired when I cannot interact with patients every day. Tuesday was another day of working in the pharmacy, and it brought a rude surprise when I realized that I had been entering data wrongly into the computerized inventory system for the last two months. The inventory system is still very new and lacks a few key features (like a way to view the actual inventory of any given drug), but we have been making an effort to accurately input data from every prescription filled for the last few months. When I realized that use of the inventory was very inconsistent, I became a little frustrated at the effort that we had put into the system. Although we will not be able to calculate the inventory of drugs in the pharmacy at any given time, the data for which drugs have been given out over the course of the last few months should still be fairly accurate, so all is not lost, but this error was a bit of a blow. I am realizing now that Peggy's Clinic is in the middle of a very important phase of its development as it formalizes a lot of the systems that it has depended on in the last seven years. Everything from the pharmacy inventory to the clinic's financial bookkeeping is now more important than ever, and where a lot of "under the table" jobs worked fine up until now, those jobs will have to come into the light of day in very transparent ways for the Clinic to continue to grow. I hope that I can help in some of this transition.
From Wednesday until Friday I greatly enjoyed going back to work in the Global Healing Clinic while Christine took a short vacation with her family. The clinic is a lot busier now than it was when I worked there before. For the last two months the clinic has been staffed by just one or two doctors, so the current staffing of three doctors seems very busy. Coincidentally our patient load seems to have increased, so I'm happy that we have so many doctors attending all of these patients. I have also really enjoyed being able to interpret for Sara because that brings me in a lot closer contact with the medical care that our clinic is actually delivering. While it can be a little stressful sometimes to triage all of the patients and translate for Sara, I am constantly reminded of why I came here to Honduras.
One interesting case of the week was a ~1 year old boy that came into the clinic with a ranula. During triage I weighed the boy and was surprised to see that he weighed only 17 lbs because he looked like a big chubby baby, but then I realized that he was not really fat at all, he just had a drastically swollen head and neck. Dr. Jennifer diagnosed the boy as having a blocked sublingual salivary duct that was causing the saliva to build up in the salivary gland and in the tissue around the boy's neck and jaw. I was surprised that the boy had no difficulty breathing, but he was already unable to eat and needed urgent corrective surgery before the condition worsened to block his airway. We sent him to seek care in San Pedro Sula because the hospital surgeon was not comfortable with such an unusual surgery, but I was confident that the patient would get the care he needed because I knew that his father works for the municipality and therefore has "social security," a form of government health insurance. Although I was disappointed that the public health system that cares for the Honduran poor could not solve this patient's problem, I was quickly reminded of how familiar this situation is to the American medical system. I have to acknowledge that although Honduras has a national health system that aims to protect each person's right to medical care, the Honduran government is not really able to guarantee that right. Alongside that I acknowledge that the United States government officially recognizes very few "rights" concerning medical care, despite the fact that the US has many more resources at its disposal than the Honduran Ministry of Health. Of course I recognize a far bit more complexity in the situation than I mention here, but the situation is nonetheless worth verbally acknowledging.
