Friday, September 10, 2010

Anatomy 101

Michelle, Carrie, Sherria, and me

Having spent the last week translating 8 hours a day for a medical brigade, I feel all the sudden like I have a new command of the Spanish language and an ability to identify common Honduran ailments. This entry takes us back to the quaint town of Ojojona which, for those of you who remember, was the site of my 7 week business training. During training, our group befriended a local philanthropist of sorts, Don Ricardo, who, in addition to running an Italian restaurant, setting up a B&B, and having some sort of high position with the Belizean consulate, is also the founder and director of Amigos of Ojojona, a foundation dedicated to improving the pueblito. It was also he who 5 years ago randomly met a group of doctors from Pittsburgh and created with them a yearly medical brigade in Ojojona where people from all over the municipality could come and receive free medical consultations and medications. Don Ricardo had contacted our training group this year to come and translate for the doctors who spoke no Spanish, so 6 of us arrived to help out. Don Ricardo graciously provided all our food and lodging in his serene Ojojonan villa.

Medical brigades are very common here in Honduras, but the scale and organization of this brigade, or brigada, was larger than I imagined. Don Ricardo had hired 13 army officers to stand guard as well as drive three big army trucks to surrounding aldeas to pick up patients daily at 4 am. They set up big tents in front of the centro de salud (health center) where med students from Teguz did initial processing and vitals before patients were admitted to see one of 9 doctors (actually one was a nurse, the one I worked with). Included among them were a pediatrician, gynecologist and ophthalmologist. We also had a group of dental students one day who pulled teeth all day (literally, I’m not sure they did anything else). In addition to the doctors and us translating, there was an entire staff of Hondurans in charge of setting up the center, feeding us, managing the lines, helping with tricky cases and in general keeping order, although the extent to which they completed these tasks was only mildly satisfactory. All of the people who came from outside Ojojona were housed and fed, although the doctors stayed in a posh hotel in Teguz. The doctors also brought with them cases and boxes of medications to hand out, the value of which I heard was somewhere near $15,000.

Sunday began with a getting-to-know-everyone BBQ where I bumped elbows with the ambassadors to Spain and Panama as well as foreign service workers from the U.S. embassy and the recently arrived doctors from Pittsburgh. It was a little bit of culture shock to be talking with people from the U.S. who had little experience with or time in Honduras. While some of the doctors had been to Ojojona with the brigade before, some hadn’t. It was interesting to try to explain to them all the funny, interesting and ridiculous things about Honduras that we have come to know and tolerate in the last 6 months.

Monday through Friday we worked feverishly 8 hours a day to see close to 1000 patients. The little old men and women were cute, the little kids even cuter, and the sicknesses, problems, and issues we encountered and shared were sometimes disgusting, but always interesting. By the end of the week you could identify one of three types of patients. The first someone aptly named “trick-or-treaters,” the people who come complaining of every ailment known to man just to get as much free medication as they can. Most of the time they just had a cold/flu or head/back pain (and who wouldn’t here if you worked in the campo or made tortillas for a living). I never could quite figure out if they really didn’t know that something like Tylenol or Ibuprofen that they can easily buy at the pulperia would cure their average daily symptoms, or if they already knew this and still just wanted to get the free stuff. People are surprisingly enamored with a 30-supply of vitamins as it turns out.

People waiting in line

The second type I would call the “treatables.” These were people with mild to moderate health issues, yet still things that could be treatable with what meds we had. Things like ear/chest/sinus/urinary tract/yeast infections; skin issues such as fungus, rashes, scabies, lice; internal parasites/worms, acid reflux, high blood pressure etc. A part of this treatment, which I believe could have been emphasized more, was prevention and home management advice. If you keep your feet dry, you won’t get fungus. If you boil your water, you won’t get parasites. If you don’t eat spicy food, you won’t get heartburn etc etc. These were probably the people we helped the most, although getting them to change their habits to stay healthy in the future is questionable. I had to patiently explain to a 19 year old guy, and then subsequently to him and his 19 year old wife that they both had an STI that would just keep passing between them unless they both stopped having sex and took their antibiotics for awhile.

The third type of patient was something like “severe/terminal” and this was the saddest group of all. Kids with heart problems, asthma, malnutrition; women with severe depression or cancer; men with lung and respiratory problems and even schizophrenia. Most of these people had come to the centro de salud because they had already been to a hospital in Teguz and couldn’t afford the medicine and tests that the doctors had ordered. They came looking for things we couldn’t give them, xrays, echocardiograms, MRIs, specific medications. We could do so little for them, except refer them to specialists in Teguz where the cycle would just continue. It was heartbreaking.

We sped through all our Ibuprofen, Tylenol and heartburn meds in two days then had to buy more. After then we started only giving out 10-12 pills of pain killers per person, probably less that 1 week’s worth for them. I started to wonder if it was even worth it. We also took on the hilarious job of taking packages of prenatal vitamins and blacking-out the word ‘prenatal’ so non-pregnant women and men would agree to take them. My ‘exam room’ was one of three set up in a small room using wood frames and bed sheets to separate the spaces. This actually made it easier to yell across the room to another volunteer to get help with translating words you didn’t know. I learned how to take blood pressure (although I’m horrible at it) and checked many a person’s blood sugar levels. I had the chance to visit my host family a few times. They were so surprised and happy to see me. They repeatedly told me how much everyone had missed me, how everyone was always asking about me, and how I was the best host daughter they’d had (the only one they’d had to be exact). Many of the patients I saw were people who had hosted trainees or were neighbors of someone who did and so it was fun to chat with them and fill them in on what I’ve been up to. It felt good to come back to Ojojona, a place that I knew, to serve the community and get a new perspective.

Scratching 'Pre-natal' off of the vitamins

My exam room

I met so many fantastic people, exchanging emails and facebook info with a med student, our only Honduran translator, and our line manager. The doctors were great, including the head doctora at the Centro de Salud. We enjoyed a farewell dinner Friday night at an Argentine steakhouse in Teguz and were all I think a little sad to say goodbye. One of the doctors even delighted us with his Elvis impersonation (see below). We’re already making plans to reunite next year.

*Pictures courtesy of Carrie Perdue, Brett Johnson, and Sherria Snyder

1 comment:

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