Honduras 2012 (9/9/2012-9/15/2012)

Of all the words to describe the summer of 2012, I choose productive and new. I continued my volunteer position from the school year at La Rabida Children's hospital where I talked to and played with patients staying in the nursing unit. I began volunteering at Community Health, a free clinic for uninsured patients in the Chicago area, as a Triage volunteer taking patient vital signs (height, weight, temperature, blood pressure, and glucose level) before they saw the doctor. I also scored an amazing internship at The Field Museum of the Natural History. I worked for the curator of the Botany department researching lichens and creating a lichen phylogenetic tree. This internship carried me to the end of August but it was not the last adventure of the summer, as I had then believed. 

In June, I learned about the Global Brigades, particularly the Global Medical Brigades. Global Medical Brigades is basically a program that allows groups of students from schools around the USA to choose a healthcare deprived country to serve during each brigade. The program has partnerships with Honduras, Panama, and Ghana. These countries receive a week-long brigade from a school that has recruited other students, nurses, and doctors to set up a health clinic in the chosen country and administer medical attention. 

I contacted the UChicago leader of the GMB but it turned out she graduated and there would not be a UChicago team heading anywhere soon. My friend at Northwestern then suggested I email the Northwestern GMB leader and ask whether I could join their team as they headed to Honduras during the second week of September. I emailed and received a positive response. My only problem then was applying for my Advance Parole and obtaining a Honduran visa since I was not an American citizen. I quickly applied for the Advance Parole and constantly prayed it would come through before the final deadline. As though I was destined to go on this trip, my Advance Parole came through about a week before the deadline, giving me just enough time to get my Honduran visa. I officially have a Honduran visa stamp in my passport, which is pretty cool. 
Within the same week, I was packed with sweatpants, bug spray, and the medications we were required to bring with us to Honduras. This blog is a day-by-day memoir of my memorable, touching, inspiring, and wonderful time in Honduras. 

Day 1 (9/9/2012)

 We arrived in Honduras mid-day. We were greeted by Sophie, our trip coordinator for the week, at the airport. The airport itself was very small and brick-like. We were given water bottles and began our journey in the caravan that would take us everywhere for the rest of the week. Our luggage was packed in pick-ups, covered with cloth, and the cars were driven in front of us. We were assigned members of the army and a national guard for our safety. The national guard, Luna, was a good-looking guy that all the girls were crazy about. The driver of the caravan was   Manuelito, the nicest guy ever.The airport was located in Tegucigalpa (Teguz, short and affectionate) and we were housed two hours outside of the capital. On our way to the housing, we saw many things. The first thing we saw was that the country was made of mountains. Mountains, mountains, and more mountains. Apart from that, the poverty of the country was visible; the houses were stacked on mountains and they were nothing more than shacks. There were many street vendors selling bananas and chips. It reminded me of rural India. The people seemed to be leading a very calm lifestyle. There were plenty of Coke and Pepsi stores outside of which people laid out plastic chairs and sat around to chat. I was particularly surprised to see auto taxis, a popular form of transportation in India. Within the city, the roads were well laid and there were signs, but outside in the rural area, the roads were rocky and unlaid. Furthermore, driving in Honduras is basically driving up and down slopes because everything is located on top or bottom of mountains. 

Our housing was called Hacienda Rapaco. It was a very nice place. Anywhere we had to go, such as our brigade or to the orphanage that we visited on the second day,was at least 2 hours away. Rapaco was full of hammocks and decorations. We were given bunk-style beds to share. I was in a room with girls from Imperial College, London, and then girls from Oregon State University. Since it was the first day, we did not do anything. My friend, Maria, and I walked around Rapaco just taking pictures and taking in the beauty of the place. Lunch was served promptly at our arrival. We ate and then walked around our house. At night, some played cards, some drank, some just talked, and then went to bed in our bunk beds. Thus, we spent our first day just enjoying the hammocks and walking around the area. Surrounding us were huge mountains. 

Meals in Honduras always included rice, beans, and a tortilla. For breakfast, there was often a bulls-eye sort of egg accompanying the rice and beans. Lunch was somewhat more American, especially during our brigade days. Somedays it was like cooked chicken in a special sauce if we were in Rapaco or more like a cheeseburger or sandwich on our brigade days. There were always vegetarian options and for those with sensitive stomachs, American food such as PB&J and cereal. There was always a freshly squeezed juice available  for beverage. The side to every meal was a salad. Dinner was usually something meat-related. I opted usually for the vegetarian dish such as stuffed zucchini or stuffed cucumber or stuffed tomato. One night we had a baked plantain with a sauce that was similar to mayo but was not mayo. It was delicious. The cooks were paid to make 3 proper meals for us everyday and they were also very nice and cooperative. I was very thankful for them. During our stay, one of the cooks had her birthday and everyone got to sing happy birthday to her.

Day 2 (9/10/2012)

Our second morning was very much like the previous day. We awoke and ate breakfast and lazed around. The plan for the day was to visit the nearby kids orphanage and also sort out the medical supplies. During mid-morning, our pharmacist for the week, Louisa came by. She brought her own medical supplies that she knew would be popular during the brigade. We then organized her medications and ours and packed them. We organized them into bags and labeled the medicines. There were medications ranging from blood pressure meds, to vitamins, to inhalers, and everything else. After lunch, we were headed to the orphanage. We got into our caravan. Maria and I took the seats in the front, next to the bus driver. We realized these seats gave us the best views, and therefore, the best pictures. Due to our seating, we were also able to pick music for each of our rides. This became routine and standard. Songs that became popular during all of our rides were Ai Es Tu Peggo by Michel Tole and Wheel Wagon by Old Crow Medicine Show. The orphanage was a different world. Apparently the kids were arranged into houses, in which they had their own rooms which they decorated. There was a common center where the kids hung out. Obviously, futbol was a very popular sport and even 5 year olds were amazing at the sport. The orphanage was called Nuevo Paraiso. The tradition of visiting the orphanage was started by the University of Marquette, that decided that global medical brigades needed to be a continuous program rather than once a year and visiting the orphanage was an eye-opener for the students. The kids were very happy in their homes. The day we went was also the Children's Day of Honduras so we took a piñata and toys with us. The kids were extremely happy and excited. We played soccer and jump rope with them. Each kid received a toy of some sort and some cake. The orphanage also had a park. The thing I realized is that because of a lack of internet and TV, the kids were very in-tuned with nature and outdoor activities. It reminded me of my childhood. 

Day 3 (9/11/2012)

The third day marked the first day of our medical brigade. The clinic was set up in a school. The school/clinic was located in a rural village called El Matazanos, about a 2 hour drive away from Rapaco. So we woke up early, around 6a.m and left the house by 7a.m. Our goal was to set up and start the clinic by approximately 9a.m. We were very effective and often started right on time. When we got to the clinic, it was obvious that the people were anxious and anticipating our arrival. There was already a long line outside. We unpacked our medications and took them inside. Inside the compound, we had 5 stations. 1) Intake - patient information was taken. 2) Triage - patient's chief complaint and vital signs were taken 3) Doctors - we had 3 doctors, 1 gynecologist, and 1 dentist. Students were used as consults to input patient diagnosis and medications received by the doctor and there was a student Spanish interpreter with each non-Spanish speaking English doctor. 4) Pharmacy - The patients that had seen the doctor came to the pharmacy where Louisa and the other pharmacy volunteers arranged the pharmacy and put al the medications in a basket that was then verified by Louisa and handed to the patient. Lastly was the 5) charla. The word charla means chat. There was an adult and children charla. The adult charla was run by a local volunteer. The children charla was run by us, the American student volunteers. It was basically a quick demo of washing hands, brushing teeth, and eating right. We then had the students practice and gave them a toothbrush and toothpaste and floss. We also gave each child fluoride treatment. The goal was to have each of us volunteers rotate through all the stations. Since there were 3 days of the medical brigade and 6 stations, each of us got to be in 2 stations per day, one before and after lunch. I was first in the charla. As I did not speak Spanish well, I was holding up the posters and walking around and making sure the children were brushing their teeth in circular motion and etc. Furthermore, I got to administer fluoride treatment, which was awesome. It seemed that for most kids, it was just a time while they waited for their parents and they did not take it seriously. But I felt that maybe out of the 30 kids, perhaps 5 paid attention and hope they will continue to follow what they taught them about sanitization. I also saw that all the kids had really really bad teeth. They were yellow and rotten. When I applied the fluoride treatment, a lot of the kids said their mouth was burning. I enjoyed the experience. After charla, we had lunch. We brought lunch with us and usually involved some form of sandwich, chips, water, and tea. The tea was amazing and sweet and tart. Lunch was very short (~15 mins) and then I worked in pharmacy. Pharmacy was one of my favorite stations because I got to learn a lot of the medicines. Every patient that came to the clinic was always given multivitamins (adult or child), acetaminophen, and Albednazol(given by the doctors by mouth as an anti parasite). This way we insured they were given the most basic needs. Louisa was very nice and patient and effective. We would put all the medications in a basket and line them up as she would verify the list and then make corrections and then give them to the patients. It can be described as a very smooth assembly line. One of the drivers picked up the verified medications and called out the patients names. This was basically the first day. I did not get too much patient contact but it was still an amazing experience after all. We then packed our medications again and went back to Rapaco, dead tired. According to the count, we saw 300patients per day. 

Day 4 (9/12/2012)

This was our second day of the medical brigade. I had a lot more patient interaction. I spent the whole day in Triage. I spent the morning inside of the room taking down patient history and chief complaint. I worked with Aria. The patients were given a paper at intake and we had to fill out the top portion. Aria asked them questions like "do you have diabetes?, does anyone in your family have hypertension?" and I would write down their answers. We also had to ask if they take medications and if they are allergic to the meds. We also had to ask the awkward question whether the girls and women were pregnant. The people were very enthusiastic to tell us all their problems and did not hesitate to answer all our questions. After lunch, I was outside. I took the vital signs of patients. For all patients, we took weight. For children, we took pulse, weight, and temperature. For patients over 30, we took blood pressure and for patients with history of glucose, we took glucose levels. I got a lot of patient contact during this time. I smelled like a culmination of my own sweat, 300 other patients' sweat, cough, and the heat did nothing to help. I will discuss my response and emotions about the patients later on after just laying out the information of each day. There were a lot of students working there and tempers were running high but we made it through. The nurses ran the triage station and they did a wonderful job. The day went by really fast. During the night, we had reflection. I learned a lot from the meeting. The doctors told us some interesting things. Apparently the people made up symptoms such as cough and cold just to they can stock up medicines for when they actually became sick. This made it hard to differentiate between the actual sick people and the ones pretending. Apparently amidst these people were people with real problems. The people were the nicest and most enthusiastic people I have ever met. They were so grateful for the treatment we were giving them. You could tell this was a big deal for them because they were dressed in their best dresses and heels. Beneath this, you could see their lack of hygiene and it was very sad. One lady had a glucose level of 630mg/dL when the normal level is 100. She went away from the area and it took a while to find her. When they referred her to the hospital, apparently she was turned away because they did not have the resources to treat her. So one of our doctors gave her a pill but that is a short-term response. Another patient, a child, had a butterfly stuck inside his ear. The doctor used wax to remove the butterfly. Apparently these patients could not afford to go into Teguz first of all to have an operation. And the problem in Honduras is that the patients are required to buy the equipment for the surgery. To help them, apparently, we could write a petition and donate, later to be read by a committee that decides who gets the money for a surgery.

Day 5 (9/13/2o12)

I spent the entire day outside in Triage. It turned out that yesterday, we didn't see about 60 patients and so they were asked to return today. I spent all day literally taking weight, temperature, and pulse (using pulsometer). I got a lot of patient contact this day. I saw that the babies and kids started crying the minute the thermometer came near them. I also noticed that if I smiled a little bit, the Honduras people gave me a wide smile. You could see that they were very grateful for what we were doing. I bonded with one particular family. They were talking about me and I think they were talking about how I looked both similar and different from them so I told them I was from India and they were very happy. I also noticed that multiple people came back from previous days which shows their desperation for medicine that they don't have access to. But this also meant that other patients will not have a  chance to see the doctor. In the meantime, the nurses were checking blood pressure. I got to check blood glucose level once.  Near the end of the day, we saw a boy that had a cut in his big toe from which maggots were flying in and out. One of the volunteers cleaned it entirely and bandaged him. I triaged the last person of the entire brigade, a man. It was a sentimental time for me. Right next to triage was a tub of dirty water from which people were washing their babies and also collecting water to drink. Obviously, this was highly unsanitary. When triage was closed, I decided to shadow the doctors. It was a very interesting experience. The doctors took their time to see each patient. There was a student interpreter for each doctor unless the doctor didn't need it. The doctor asked the patient exactly what was wrong and then wrote down the appropriate medications. The patients were very descriptive and did not hesitate. All the patients were given Albednazol pills for anti-parasites. The most amazing thing for me was that these doctors were volunteers and they were completely into what they were doing and happy to be treating the patients. One of the doctors found a 9 year old girl with a heart murmur and spent some time explaining to us students what the murmur was and how it would impact the girl. I was very amazed, inspired, and impressed by the doctors. I realized then that I definitely want to conduct these sort of medical camps to impoverished areas when I become a doctor. The sad part was that there were too many patients and if the doctors had to see everyone, we would have been there til midnight. So the nurses went around the line to see the doctors and picked out the most necessary patients. The rest of the patients got multivitamins, acetaminophen, and cold medicine, something we called  a "wellness pack". The sad result of this was that we had to turn away a lot of patients that were outside waiting. I felt very depressed that these people that had perhaps walked 100s of miles were turned away. In fact, one lady and her son that were treated told us they had to wake up at 4a.m to get to the clinic by noon. The boy was a chubby kid and all we wanted to do was hug him. Finally, I saw an interesting boy when I was shadowing the doctors. The boy was born epileptic and then got meningitis. It turned out that his testicles didn't drop. He was not able to properly function. He had, though, the most infectious and loud laugh. It was amazing. I was moved to tears. This marked the end of the last and third day of the medical brigade.

Day 6(9/14/2012)

 We woke up a little later and we had our pilot brigade: Architecture. We drove to El Canton. On the way there, we stopped at a project that the Architecture brigade was working on, a school. It seemed to be in great progress.It was also the Honduras Independence Day from Spain. In celebration, the school prepared a lot of performances that they asked us to stay for. After they sang the national anthem, the first performance was a dance. It involved boys and girls and they were jumping around in a circular motion. They also grabbed a few of our students and made us dance with them. They also had a few singing performances. Another dance was by 2 boys who were talking about how they were drunk the night before and one of them thought he saw a pretty girl. But the girl actually shows up and she turns out to be really ugly. The final performance we saw before we left was one of a kid wearing a tree and his message was not to cut down trees because they are good for the environment. We then drove to El Canton. On the way, we were going up a hill and the manual driven caravan stopped. We drove a little bit further and then got off and got into the trucks to cross the river. We then reached the spot. Our tree goals were to carry stones up the hill, bring stones from a nearby creek,and make mortar. I was in the concrete crew to make mortar. We mixed sand, concrete, and water. The process was to mix sand and concrete, create a volcano in the middle and add water and keep mixing. We then put the concrete in tubs to carry to the actual site. It was a very physical experience as we did manual labour. I finally figured out my way of using the shovel and got a "good job" from the architecture coordinator. We learned that El Canton is a coffee producing center in Honduras. During lunch, a resident in the area brought ground coffee that he had grown. I had heard from the the other students that the coffee was stellar back in Rapaco and knew that Central American coffee was supposed to be good so I decided to buy a pound for $5 for my parents. Also during lunch, the resident brought a local fruit, which was very sweet and wonderful. The fruit was similar to Sitafal (custard apple) but more orange and less sweet. 

 

Day 7(9/15/2012)

We packed up, ate breakfast, and left. Nothing important. It was a bittersweet experience. I was not surprised by the state of Honduras because I have seen similar and worse in India. However, I was saddened that a country so close to the USA could be so desolate. Rapaco was built for the brigadiers but there itself I noticed the stark differences. The toilet paper could not be put in the toilet leaving the toilets forever smelly. The brigade itself was amazing. I noticed that the people was so grateful. The smallest smile from us garnered a toothy wide smile from them. It makes you realize that when we have a cold, we can run to a nearest pharmacy and easily subside our symptoms. But these people have to live years and years with their symptoms before someone sees them. This has strengthened my resolve to not only become a doctor, but a successful and respectful doctor that practices rural medicine also.