Week 2: Y Ya Siento Flotar Mi Gran Raíz Libre Y Desnuda
The island has a particular quality that makes it easy for me to be contemplative, and the events from this week have provided me with much fuel for contemplation. Aside from the typical cases of otitis media or respiratory viruses, last week a baby was presented as having severe vomiting. At the time it was suspected that the baby possibly has pyloric stenosis, which is when a muscle under the stomach is enlarged and causes vomiting. The only cure for this is to get surgery and apparently the mother was quite distraught at this news and she opted to wait for another week before making any decisions. This week she brought the baby in and there was much of the same, so Jess referred her to a surgeon. I can’t even begin to imagine the stress the mother must be under. To hear that your baby needs surgery is not a light matter and one thing that I was wondering about was if the mother was more worried about the cost for this procedure. The thing about surgery is that sometimes, especially when it is life-saving, it tends to make people put a value on their health, which I believe is invaluable. If say a sick person did not have the necessary funds to pay for a procedure, needless to say that would be a very troubling situation. But imagine in Roatan where according to the locals, the average daily salary is $15; the cost of a surgery would be very intimidating. That’s why if I ever become a surgeon, I would work my best to keep financials from dictating what surgeries I can and can’t do. I certainly would not be averse to doing a surgery for free, if possible, because no patient deserves to be turned away just because they couldn’t afford a procedure, or rather just because they couldn’t afford to stay healthy. As I always say, I would be a physician even if it meant my salary was a piece of bread and a glass of water for each day.
This week was bittersweet as the clinic saw a change in the attendings. Jess left on Thursday and it was sad to see her go because I was getting to know her better and she definitely seemed to enjoy her work with the children here in Roatan. She is an ambitious person (she had to be if she majored in biomedical engineering as an undergrad) and is thinking about going into pediatric oncology. At any rate, life can be like that sometimes where cherished moments are transient so we must strive to make the most out of every moment of the day. On Jess’s last day working at the clinic, she, Tami (from Clinica Esperanza), Kristen (another attending physician from Global Healing) and I went to visit a couple of Jess’s patients in Policarpo or “La Colonia” which sits right across from Sandy Bay. To get to Policarpo, you have to traverse several steep dirt roads that veer off from the paved road. What I witnessed that day was very insightful to say the least and aside from my time at el hospital publico, it has been one of my favorite Roatan experiences so far. In the states, I am familiar with poverty (which I would now consider simply as “low-income”) but the conditions in Policarpo are of a different plane. One of the young girls’ families that we visited had a small makeshift kitchen outside of their house because it was built without windows. An upstairs section of their house was recently built and this section does have windows. The oven that they were using consisted of a slab of concrete with a shoe box-sized space carved in. Yet, even though the family lived in conditions which would be considered dire in the US, the family was happy as could be. The little children would just shower you with their love that you came to visit. They were not too shy to give me a hug although they didn’t know me. This type of happiness is something I am actually quite familiar with. From my upbringing, it is my understanding that when you suffer hardships with others, whether they are family or not, but you still maintain your optimism and you celebrate the fact that you still have each other, a special bond forms. This type of bonding is what I saw here between the young children and their mother. The message this special relationship proclaims is that despite our lack of necessities, we still have love and with that we can move mountains. As we said our goodbyes to this family, we headed further up the hill to see another patient who’s name is Michelle. Once we reached the top of the hill, there was an amazing view of a neighborhood that I had previously not known was so vast across the hills. Many tin roof homes littered the hillside, a definite change from the Spanish tile roofs I saw from the plane. When we found her, she was with her brother and another friend, Jenny, who is an adorable, playful kid. We then met Michelle’s mother and she told us about how she has been helped a lot by Ms. Valerie, who runs an HIV clinic on the island. Michelle’s house was recently built and there are a few renovations being made. At the top of the hill, they have a sizable tank of water to go along with their plumbing. Their bathroom is physically outside the house, and to go to the bathroom they have to walk a narrow path around the house. Also recent is an electricity post that was put near the entrance of the house. Aside from these commodities, the kids are going to a private school on the island run by Americans. The type of outreach that just captivated me was the medical care that was being offered to Michelle’s family. Michelle had a younger sister who had a congenital heart defect and her health was deteriorating rapidly after she was born. She was in the hospital for 3 months until she was set to go to the States for a heart transplant. Unfortunately, Michelle’s sister died before she got a chance to go to the US to get a surgery. Despite this tragic event, seeing and hearing about the great things happening to this family made me extremely happy that other people would be so giving to a population essentially on the periphery of global society. There are many wonderful people like that here on Roatan, including Miss Peggy, and being around them makes me very excited because it is this exact altruism that I would like to evoke in the future as a physician. After playing around with the kids, we headed to Clinica Esperanza for the rest of the day. Reflecting on this experience, I am quite unsettled by the fact that before now I had taken so much of what I had for granted. At the time I was uncomfortable knowing that the mentality I had in the US was to work for income so that I may obtain whatever silly material possession I desired. Now my mentality is to share my wealth with my extended international families so that they may have equal footing on par with my own.
Since Jess is gone, Kristen, a physician from Washington DC who has been working with Global Healing for a while now, will be taking over her clinical duties. I was able to shadow Kristen this week and she has exceptionally great bedside manners. Children that I triaged who were quite a handful would be calm during their consultations with Kristen because she handles herself very well. The interaction that she has with parents is also great because even though some get grumpy by the wait they have to endure in the humid waiting area, they leave their consultations happy and satisfied. I cannot wait for the other cases I will be able to shadow Kristen for.
After my time at el hospital publico, I have been going to Clinica Esperanza and to tutoring at Casa Mazapan, but on Friday this week, I went to a local daycare, Roatan Daycare, to get to know the children to start my health workshop initiative. Even though the kids were quite a handful, I had a lot of fun getting to know them and the daycare workers or “las profas”. The children in the daycare vary in age from 2 to 7 and the parents have started to pay in order to keep the daycare running. Previously, the daycare was free to single mothers who had to work during the daytime and had no one to look after their children. On Friday there was a total of 29 kids staying at the daycare, which consists of a play room kitchen, a general playing mat, a nap room, a kitchen and another play area along with a shower room. When I arrived it was nap time for the children and I had the opportunity to speak with la profa about Roatan and Honduras including the food, the lifestyles, the Roatan public school system, my experiences and about Roatan politics. One of the first children to wake up was an adorable little man with some pretty big cheeks, reminiscent of my own cheeks at that age. His name is Eldon and he has a respiratory complication which requires his meds of suero and salbutamol to be administered via nebulizer. Fortunately, his medication has been effective so far and he is no longer kept awake at night by his constant severe coughing. Unfortunately however, he could probably be improving at a much faster rate if not for the fact that the daycare is in need of a nebulizer mask. Several other children in the daycare also require use of the nebulizer and apparently during the raining season in October-November, there is a greater need for the nebulizer. Rather than being projected directly to their noses via a mask, the hose administering the meds have to be held in front of the children’s faces, leaving a majority of the medicine vapors escaping to the atmosphere. From where I was three feet away, I was able to inhale some of Eldon’s medicine. I spoke to Miss Peggy about this and fortunately she was able to secure a mask for the daycare and I will be taking it to them on Monday for general use. That is it for now, blog, and I will return with further thoughts.
Adios.
Israel
