Week 4: El Porvenir Es Del Pueblo
Despite the tumultuous weather this week, I at least started the week off well. I went to Clinica Esperanza to get my ear checked out and fortunately all that was wrong with it was from otitis media. The amoxicillin I have been taking is making improvements and I no longer have a runny nose. At the time I was getting my ear checked, Dr. Janice took advantage of the opportunity to teach my fellow volunteers what the inside of a normal ear is supposed to look like. My left ear was red on the inside and a little convoluted whereas it is normally a white color. During my time here in Roatan, my perspective has always been of the observer and to get a chance of being the one observed was enjoyable despite the circumstances because it provided an educational experience for me and the other volunteers.
On Tuesday, Hurricane Ernesto passed by north of the island and we ended up getting a few tails. It’s been a while since I’ve been through a hurricane so I was a little anxious at first that I had to ride into Coxen Hole and not know whether the roads would be flooded afterward. I also expected a short day at the hospital but oddly, it was actually much busier than normal. The pre-clinica area was a lot less crowded but other than that everything else was business as usual. We received about 23 expedientes and unfortunately could not start attending them early enough because the attendings had to cover in the pediatric ward. By the time they arrived, the people outside were getting quite impatient. It’s quite understandable however because the people here face a lot of pressure having to take time off of work to go to the clinica and on top of that, they will likely be spending money on medications afterward—not to mention that on this day there was a hurricane outside. One can see that in an area that has low resources like Roatan, there is a severe need for medical providers even when the people would risk getting a consult in a hurricane. Sometimes I wish I could fast forward already to my residency so that I can start helping people myself, but really I have an important task as well to reinforce what the attendings do. When you speak to people coming in for a consult in a respectful tone and show that you are there for them through your body language, they really receive this in a positive manner. This makes an otherwise distressful encounter that less stressful and encourages the patient to follow through on their half of the work including adherence and arranging follow-up care.
But sometimes even then there are the few occasional cases of neglect. One patient was brought in this week because a bone mass has been growing from his mandible. The patient’s mother said that the child was under the care of his father for the past year and a half and he did not want to bring him to get checked. The attendings were sure from the size of the bone mass that it was probably more than a year and a half that the mass has been growing. Fortunately, despite being late to bring the child in, there was a surgical brigade from Massachusetts in the hospital and the next day he would be taken in to get a biopsy. So despite the late timing, the child was able to get some help to begin his treatment process.
Another case that I heard about this week was of a baby with a respiratory illness in the pediatric ward. All that could be done to get the child breathing was tried and unfortunately the baby passed away. Kristen talked to me later about the case and she said that had this case been in the United States, the baby would have survived. I salute the physicians who choose to work here in Roatan so much because they are fighters. They come in knowing that they will likely not have many of the resources they need to provide for their patients. Yet despite this, they choose not to give up the good fight for their patients and they work hard at the issues they confront. This is the type of physician that I will certainly strive to be and I am so delighted that I can find this image in the physicians that I come in contact with everyday here at the hospital. For example, Kristen has learned in what cases a urine test or blood sample would provide the most benefit. She would like to order these for all patients, but sometimes the patients don’t come back to get the results and then again the process for getting something like a urine sample doesn’t provide a culture test as well so the efficacy of finding an unbiased result is questionable.
On Friday this week, Kristen, Lenia and I all made a trip down to the daycare to dispense albendazol and multivitamins, do teeth varnishes and to get height and weight measurements of the kids. Aside from my trip to Policarpo to see how the real Roatanians live, this was my most exciting experience outside of the clinic. We arrived at the daycare when the children were in their nap time. We had all just eaten a big lunch so even we were beginning to get a little drowsy ourselves. One by one the kids woke up and they moved straight across from us where they kept the pillows to lay down. As the lights were turned on, they woke up just a little more and we began our work. I took heights and weights as Kristen and Lenia attended the more serious cases. Before we began, we were hoping to put on some hand sanitizer but then noticed that there was none in the daycare. Kristen said according to the CDC, there should be copious amounts of hand sanitizer in any clinic so it has become a priority of mine to get them a sizeable container of it. The most severe case was of a little girl who had pain while urinating. Las profas mentioned that her urine would come out brown. Kristen said that the brown in her urine could possibly be from blood and so she wrote the little girl an appointment slip so she can come into the clinic next week. Right from the outset of our mission at the daycare, I was exposed to the beauty of the entire event and of all that Global Healing stands for: to provide help for those who do not have it readily disposable and whose needs are not being met. If we would not have been to the daycare that Friday, I can only imagine how long it would have taken for the little girl to get necessary aid and for the rest of the little kids to get their heights and weights checked. The other beauty of being able to provide for the daycare lies in who the help is being given to. The children of Roatan will be there to take up the reigns of this island once they are old enough and the trajectory that the island will take is ultimately up to them. While I can only guess from my own childhood that the stresses of their parents trickle down to them occasionally, because of the limited resources on the island that isn’t too wild of an assumption. What a better way to ensure that the legacy of this island is not in jeopardy than by providing the children a glimpse of altruism and love for fellow man by doing free consults at the daycare.
