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.