Week 7

On Thursday a hospital nurse came in and gave us free H1N1 vaccines. I gladly accepted because the vaccine was not ready in Oregon when I left. I suppose it is a good precaution, although it’s a little late in the season. Mario said there were only a few H1N1 cases this fall at the hospital anyway. However, I thought it was nice the hospital gave free vaccines to their workers.

It is interesting how the load of patients flows with cruise ship days. Fewer mothers bring their children in when the cruise ships are here because they need to work and try to profit off the tourism. Cruise ship days are pretty entertaining around West End as it is very obvious which confused fat Americans found themselves here for the day.

On our busier days I do not have time to do much other than paperwork for the charts, weighing and measuring. It is getting a little redundant and I prefer when I have a little time to shadow the doctors. Also the range of Spanish I get to use is pretty limited to repeating phrases like “put the baby here for the weight.” There is not much time or opportunity for more conversation. I am also a little disappointed by the lack of Spanish speaking in my life outside of clinic. Everyone in West End speaks English. I thought I would be speaking Spanish all the time here, but it is not the case. Even about a third of our patients speak English primarily.

My parents are visiting and over the weekend we took a catamaran to Utila. It was a 4-hour sail each way. We had great weather and I enjoyed sitting on the boat in the sun and watching Roatán disappear then the little island of Utila appear to the West. We could clearly see the silhouette of the mainland from the boat, especially the peak of Pico Bonito. Utila is a really neat island. It is small, about the size of West End to West Bay, and much less developed. It has a nice neighborhood feel and is kept very clean. Because there is only one town, the ex-pats and the locals seem more intermixed than here on Roatán. The cost of living is much lower, which attracts many young backpackers. It seemed like a nice place to live, although Roatán has better beaches. 

Clinic journals from past weeks

Week 6: December 6th

This week went by quickly as we had Monday off for the post-election holiday. We have been busier in the clinic now with two doctors. We are seeing 25-30 patients per day now in contrast to about 15 when it was only Dr. Mario. Dr. Robert has settled in well here but is still surprised by the short work day. It is always a big rush for 3 or 4 hours, and then clinic is done before noon. With two doctors, I do not have as much time to sit in on the appointments because I am preparing the patients as fast as they get through them. However, both doctors are very kind to call me in to see, for example, an interesting case of impetigo or shingles.

My dentist at home in Oregon, Dr. Bodyfelt, has agreed to donate 300 toothbrushes to the clinic! My sister will bring them in a few weeks when she comes to visit. I am so happy we will have toothbrushes to hand out to some of the children. Even if the supply only lasts a month or two, it will be helpful to those 300 children.

I may have written about this before, but I keep thinking how grateful I am to have a job on the island that keeps me connected to the real lives of the citizens here. It is so easy for ex-pats living in West End to never leave that “bubble,” never speak Spanish, and never understand the poverty that the great majority of the population live in. Surprisingly, I have met ex-pats who have lived on Roatán over 10 years and cannot speak Spanish. I find that very disappointing. There should be more interaction between the true locals and the ex-pat “locals” or long-term tourists.

On Saturday my parents arrived to visit for the week. Sunday we rented a car and drove around the island. We ate lunch at Parrot Tree Plantation, a gigantic fancy resort completely void of tourists. We were nearly the only people there along with a few local families using the pool for the day. The combination the US economy and the Honduran political mess left the Roatán tourist industry really hurting. We also drove to Punta Gorda, the largest Garifuna community on the island. I learned from a taxi driver last week that Flamingo on Sundays is the place to hear Garifuna music. We arrived for just the last half hour of music. We were the only tourists by far and the only white people. Everyone looked at us; I could understand their curiosity at how out of place we were. But we certainly felt welcomed. The music was incredible. There was singing, fierce bongo drumming, and even instruments made of turtle shells. The women would dance in the center shaking their hips like crazy. I definitely want to return another Sunday earlier to hear more music. It was great to be in a true local Roatán community.

Week 5: November 29^th

Yesterday, November 29^th was the Honduran presidential Election Day. Today the hospital and all government businesses were closed for the day-after-election national holiday. Today it was announced that Pepe Lobo is the next president of Honduras, which the US has agreed to recognize. The weekend went smoother than I expected. There were no disruptive demonstrations. The government mandated bars to close for the weekend and liquor sales cut off. Also, Saturday night about 7pm the power was shut off. So without alcohol or lights, the chance of the public getting riled up was low. Islanders admit there was no particularly great candidate but they are happy with Pepe as he is pro-tourism. Also good for tourism- the US has lifted it’s travel advisor to Honduras. Hopefully tourists will come because the local economy was terribly hurt by the political situation.

The new attending, Dr. Robert, arrived yesterday. He is a pediatrician from Wisconsin who has spent half of the past two years doing medical work in Peru. I am looking forward to learning from him in the clinic.

This last week I worked on some organization in the clinic. It is obvious that many people have worked there for short periods of time and created their own partial organization systems, which do not translate to the next person. Having resources is one thing, and being able to find them is another.

I have really enjoyed working closely with Dr. Mario this week. He has been wonderful at explaining to me any disease, medication, or illness I have questions about. He lets me listen in on his consultations and shows me, for example, how to look into a child’s ear and tell if it is infected. I am very much enjoying working with children and leaning about the particular issues here, as well as common health problems with children everywhere such as tonsillitis. I feel lucky to volunteer in a position where I work hands on with the patients and closely with the doctors. Most opportunities, especially back home, do not allow for this great of exposure.

Week 4: November 22, 2009

I have officially been here 1 month. I am glad I have chosen to stay for 3 months, because I am just beginning to understand the island and the culture. More so, I am learning more every day about the common diagnoses in the clinic and understanding the patterns of the medicines used. There are the most frequently prescribed medicines such as Diphenhydramine, Acetaminophen, Penicillin, Piperazine, Mebendazol, Amoxicillin, Salbutamol etc. These all are prescribed for a wide variety of illnesses because there are really so few medications available. Nearly every kid gets the parasite medications as a general precaution. Many come in just to get multivitamins. I have had several people this week ask for a toothbrush. We don’t have any, so I am going to make it a goal to get a supply soon. Giving each child a toothbrush would help also one of the causes of malnutrition here: dental carries. Many children have rotting brown molars, making it painful for them to eat. This leads to malnutrition, which leads to greater susceptibility to illnesses. Clearly I cannot stop this downward spiral but at least giving out toothbrushes is a place to start.

Once a week or so the hospital nurses present information to the mothers waiting in the hallway outside the pediatric clinics. Last week the nurse had a large colorful chart demonstrating the benefits of vaccinations. This week she spoke about H1N1 and passed out pamphlets. The nurses are really just yelling this information to anyone willing to listen in the busy hallway, but it does seem that most mothers do pay attention. I am really impressed by this. However random the presentations are, the information does reach some people. These mothers have already taken the effort to bring their children to the doctor and are made to wait so really it is the best timing possible to convey relevant health information.

Now that I am comfortable in the intern job and the necessary Spanish vocabulary, I can spend more time learning about the diagnoses. Dr. Mario explains to me a lot of the medical vocabulary and tells me about the illnesses, symptoms, and causes. I am surprised actually that we do not see many Malaria cases. I had expected it to be more common. Also, I do not think we have had any H1N1 cases, or else they just don’t test to verify.

In news outside of clinic, we have had beautiful weather this week. I got to eat some fresh caught Tuna, Bonito and Barracuda fish with friends here. I spent Saturday at beautiful West Bay beach. I also finished my advanced diver certification this week. I feel incredibly lucky that this internship opportunity has brought me to such a gorgeous place.

Around the Island

Here's a map of Roatan. I live in West End and work in Coxen Hole. One Sunday afternoon before the residents left we rented a pick up truck and drove across the island to the East end. The island is 30 miles long and only a max of 3 miles wide. This 30 mile drive took an hour and half! The interior of the island is very hilly, the highest is peak 800 ft. The one road across the island winds high into the hills with views of the ocean off both North and South sides of the skinny island.

After getting off the paved road onto the incredibly bumpy dirt road that led

to Camp Bay, we were glad we rented a truck. We also learned that driving a pick up means you give free rides to anyone along the road. We disappointed most of them by not stopping, but had no choice but give a group of kids a ride who hopped right in the trued when we stopped to watch a soccer game.

Finally we reached beautiful Camp Bay. It is the furthest East settlement on the island because the Eastern tip is all mangroves. We were entirely the only people on the beach, which was an incredible feeling. After a day in the sun we went to this restaurant over the water in the photo and ate a delicious shrimp lunch, and played with this ridiculously cute kid.

So far that is the furthest I have explored on the island, but there are so many little towns and beaches I want to visit. Lack of wheels is the issue. I have contemplated buying a scooter, but I guess I have to learn to ride one first.

Underwater Photography

Under the Sea

Here are some of my first attempts at photography while scuba diving. This site is called Seagrape, named after this wrecked boat of the nearby hotel by a dumb captain who took it out during a storm. Here are Rachel and Robby, some of my companeros here. I have to work on my skills to capture some of the incredible fish. The camera is a little distracting from just enjoying the dive and it is difficult to keep up with the group when I want to chase a fish around. I want to get my advanced certification while I'm here which even includes an course elective on underwater photography!

On the left, the sun from above making a rainbow into the water. Next, some grand pillar coral. And below, my dive buddies.

On Monday evening, we went on a night dive with Native Sons, the shop next door. Because it gets dark here at 5:30, it was more of an early evening dive. We met before sunset to prep gear and for the dive briefing. Basically learning, make a circle with your light to signal "I'm okay" and wave it frantically back in forth to signal you need help. I paired up with Nichole, and we promised to stay very close together. We got on the boat just as it was getting dark, jumped into the water, and turned on our torch lights. It was a little bit eerie at first looking down into the dark water and thinking I was about to descend into it, but I left all fears on the surface. We dove at Seagrape, actually the same site as the photos above. However, it was totally unrecognizable in the dark. The reef is a whole different world at night. The diurnal fish go to sleep (sleeping fish look hilarious), and the nocturnal creatures come out to feed. I saw a huge channel crab that must have been over 2 feet wide, spiny lobsters, squirrel fish, and the glowing red eyes of many shrimp. 

All that was cool, but then two incredible things happened. First, Nichole and I swam across a bare patch between reefs. I scanned the rocky sea floor as we swam over, not expecting to see anything. Then suddenly I saw it move--a blue octopus! That may not sound too incredible, but you have to see it to understand. It was obviously afraid of us and our lights so it would swim up then cling to a rock with all its tentacles. It would change from blue, to almost clear, to brown, to speckled, and back to blue. It looked like an alien and moved with completely freeform shape. We tried using the panic signal to get the other divers over, but by the time they came the octopus had hidden under a rock. We were so lucky to see that rare creature. 

Second, toward the end of the dive everyone came back to an open area and the dive master signaled for us to kneel down on the sea floor. We then all turned off our flash lights. We began waving our arms in the air and magically stars appeared. The biophosphorescent plankton reacting. Then we all began to swim up and as my eyes adjust to the darkness I slowly start to see the "string of pearls" appearing. 15-20 feet underwater these tiny creatures swim emitting drops of a luminescent chemical which creates the effect of a growing chain or stars moving through the water. I swam right into the middle of a patch of them and literally felt like I was swimming in the stars. It was unbelievable! 

We all agreed the night dive was one of the coolest experiences of our lives. 

Dolphins!

We went to the Roatan Marine Institute at Anthony's Keys Resort to swim with the dolphins. But before that we got a tour by Dr. Paul at his clinic there which has Roatan's only hyperbaric chamber. He said they are very busy and decompress hundreds of people a year. Mostly these are lobster and conch divers, and very few recreational divers. Luckily a rescue diving class came in and we got to watch as they put 3 guys in and pressurized them to 165 feet to simulate nitrogen narcosis. They began laughing and singing with distorted high voices. Nitrogen narcosis causes people to act dumb, goofy, and be unable to perform simple tasks. To get out of it you just decrease in pressure (go up) a little bit. 

The dolphins were incredible. For a half hour Nicole, Robby, Rachel and I played with a 4 year old Atlantic Bottle Nose dolphin, Kenny and a trainer who had him show us his tricks. We got to pet him, learn dolphin facts, see how fast he can swim, etc. 

 

Next, we snorkeled with the 37 dolphins in the park. They love to play with people and would swim right up under you in groups. One surprised me by sneaking under me and tapping my foot with its nose. The trainer showed us how you can get a piece of sea grass and put it in their mouths (which they open right in front of your face) and they will spit it back out at you. They will play that game over and over. At one point a dolphin pretended to bite me and I got nervous; the dolphin knew he scared me so to make fun of me did it again! Then the trainer told me to relax or they will keep playing like that. Who knew dolphins have a sense of humor. It was really cool snorkeling so we could see what they naturally do under water. 

Rainy season

The first week I was here it was sunny, blue skies, and hot every day, so I laughed that it is the rainy season. But now I see what they mean. The last 2 morning I have woken up at 6 to the thunderous sound of rain the roof. But then the day time clears up. Unfortunately the rain brings out the mosquitoes too. If you forget to put on bug spray here, you will regret it. I've already gone through a whole bottle. 

Last night for Halloween we dressed up as Roatan Taxi's which we felt was quite relevant here. We had license plates and air fresheners and whistles to call out "taxi taxi!"

 People thought it was pretty funny, esp the taxi drivers. Photos to come. We were all shocked that halloween is celebrated in Honduras, but it sure is. Sundowners across from our apartment had a great party as well as several others in West End. There is a fun group of people living here I am getting to know. 

Friday I went on really cool dive. The site was called Hole in the Wall because it is a deep canyon in the reef you can swim through. It was just me and the dive master so he pointed out lots of cool little lettuce slugs, crabs, snails, etc. There were lots of narrow little swim thrus so I making sure my tank didn't hit the coral was a challenge. We went into a cave filled with little silver fish. In one of the narrow swim thrus was a 4 foot morray eel that creeped me out to swim by. 

Also on Friday after clinic we went to the daycare to do check ups on kids who probably otherwise wouldn't go a doctor. The kids were very cute and playful. The doctors had a hard ti

me knowing what to do with them as there was no health history or parent to communicate with. But I suppose its better than nothing. 

Diving and Clinic

Went on my first dive here on Monday. The doctors were doing a certification dive with the dive shop next to our apartments, so I decided to tag along. We went to a site called Overheat Reef in the Roatan Marine Park. Saw stoplight parrotfish munching on coral, 2 huge barracudas, pretty queen angelfish, and thousands of others. The latin names of coral we learned in Belize kept popping up in my head. Couldn't we have just learned the ordinary names? I'm not going to get out of the water and say "Oh boy did you see that Diploria labyrinthiformis?" Great dive, excited to do lots more! 

I have worked at the clinic 2 days now. Yesterday was overwhelming. The Global Healing clinic is one office at the Roatan Hospital Publico, which is a run down building without even running water.

When we walk in in the mornings at 8am the lobby is already filled with sick kids and parents. They don't have appointments, but arrive early in the morning to get a number in line. I collect the charts from admissions and prepare them with the necessary forms for the doctor visit. Then call the patient and parent in, measure their height, weigh them, take temperature, and ask their chief complaint. We have one local doctor, Mario, and the two ped residents from California. Most of the kids have parasites, upper respiratory infections, or are malnourished. 

We get through the patients pretty fast and have been done by 11:30. So I have the rest of the day to hang out on the beach! Went snorkeling in Half Moon Bay today, but got out after realizing I was surrounded by 4 jellyfish!

Now I'm going to a yoga class at a studio down the street in a grass hut structure with wood planked floors, open air, and surrounded by palm trees. Pretty awesome.

Here's a photo just after sunset last night....

My apartment

Above is apartment building and the view from the deck.

My apartment: I am probably the only renter who has been delighted instead of disgusted by these walls... 

Primer dia completa

My first full day here... I slept in because I was exhausted from traveling yesterday. Luckily all my bags arrived. Woke up in my pink apartment and was so excited to walk out side and have the beach right in front of me. Went to the store next door to buy a toothbrush (oops) and coconut bread for breakfast. Last night the doctors and I went to the "Reef Rider" floating bar, where the owner told us we could catch a ride on this bar/boat to West Bay in the morning. So insted of paying for a water taxi, I got a free ride to the most beautiful beach on the island. The water is bright turquiose and clear and white sand extends into the shallow water. I spent all day swimming in the warm water, reading, and eating fresh fish ceviche.

I am really glad to have the resident doctors here now so I have friends to hang out with right away. They showed me around the main strip last night which was helpful. They are fun and young and I think we will make a good team in the clinic.

Tomorrow is a holiday, although no local have been able to tell us yet what the holiday is. The hospital is closed though, so I have another day before begining work. So far things are great.



Here is a picture I took this morning of the beach right across from my apartment. Anyone want to come visit??