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Hospital Loma de Luz and Blackfeet Community Hospital

A comparative study

rain 75 °F

This afternoon coming home from clinic I was thinking about our past three weeks here. We've definitely seen a lot of strange things, plenty of bread and butter family med things, a few sad things, and a lot of happy things. We have had the opportunity to do lots of things, like repair a machete wound (which Ben did today), suture up kids after dog bites and falls from horses, remove nodules, first assist on major surgery, sprint from bed to help do CPR in the middle of the night, manage our own clinic patients, and learn some ultrasound.

But today what I was thinking was about the many similarities between life in and out of the hospital here and in Browning, Montana, where many of you (whoever you are) may know that we did a 4-week elective last fall. Since Indian reservations in the US have a lot of the problems that most Americans associate with so-called third world countries, like poverty, joblessness, lack of decent food, violence, and stray dogs, comparing the two reveals a lot of similarities. We encountered a lot of these problems firsthand in Montana, and definitely see a lot of the problems we've seen in places like Mali and Mexico there, do I began to compare many aspects of Loma de Luz to the Blackfeet Community Hospital and noticed some interesting stuff. So without further ado, here is the ULTIMATE BATTLE: LdL vs. BCH!

Category 1: Medical Facilities
Loma de Luz is definitely much smaller than BCH with a lot less clinic space. The inpatient wards here consist of 4 smallish rooms with curtains between the 5 or 6 patient beds. BCH on the other hand had large, private rooms. I think there were also more than 2 working IV pumps at BCH... As far as clinic facilities, LdL and BCH both have most of the things we need to run our clinics. Clinic rooms here are private and have nice exam tables, oto and ophthalmoscopes, and halfway computerized charting. Prescriptions are computerized and there is a formal pharmacy, which is really nice. Our clinic rooms even have air conditioning, so life is good. Clinic is a bit disorganized since few of the patients have appointments, but the same fan be said for BCH. One downside here is the lack of sufficient clinic rooms which generally means that one of us has to work out of the ER, which is a big room with 3 beds and emergency equipment inside. (BCH definitely wins the ER contest since that was the busiest part of the hospital and one of the busier ERs in the state of Montana!) On the plus side for LdL: the middle of the hospital is an open-air, covered pavilion that is very pleasant to walk through. The ORs also have windows, which is really amusing to me. Still, since the OR also has functional anesthesia equipment and disposable sterile gowns, the win for facilities has to go to Blackfeet Community Hospital.

Category 2: medical problems
When you're a med student, you always want to see the stuff you learned about the first two years of med school. Diabetes is interesting in a cerebral sort of way, but really can't hold a candle to Fournier's gangrene (caution while googling that one) or a machete wound with open fibular fracture. We saw exciting and interesting things at BCH and learned well the impact of diabetes and alcohol on native peoples. Esophageal variceal bleeds and fulminant hepatitis are a lot scarier in real life. We also got to deliver some babies, comfort and collect evidence from victims of rape, assist in the OR and open a bunch of abscesses. Here at LdL we've seen some of the same brand of stuff, but also had a much broader clinic experience, with some adult chronic medicine, some routine peds visits, and a lot of followup visits on our own patients, which is incredibly valuable and usually hard to get at our stage of training. We've gotten to be a part of a lot of hospital care and been the primary decison makers there at times, and also have gotten a lot of experience in emergencies and code blue (CPR) situations. Because of that, Loma de Luz wins this category.

Category 3: living arrangements
Let's see, our government apartment in Browning had an extremely bad odor, one twin bed, and two chairs for seating in the entire place. It was dirty when we moved in and we had to sleep on an air mattress for four weeks. Here we have our own small apartment in a bigger staff housing building with a nice common space besides our non-smelly apartment. We have a hot shower, a clean and cool bed, good fans, and a full kitchen. Clearly Loma de Luz is winning here. Food availability is also an issue in both places, though, to varying degrees. In Browning, there is a grocery store, but it's small and overpriced, and anything fresh is a little sketchy. We generally made a weekly pilgrimage to Cut Bank, a town about 45 minutes from Browning, where we had a much bigger selection of groceries. The town doesn't have much besides that and a Dollar General, though, so it's pretty limited. Here, we're actually located between two small villages so there's nothing nearby except a little restaurant at the hospital's front gate that serves fried chicken for lunch (or hot dogs if you come too late). Everyone makes a weekly trek to La Ceiba, about 45 mins-1 hour away over very bumpy dirt roads. The grocery stores are pretty decent, but fresh vegetables are often a little limp looking and better bought at a farmers market. Still, the nice thing about Ceiba is that you can find most anything you might need: replacement flip flops, floaty toys for the sea, bootleg American movies, etc. The clear winner of this category is.... Loma de Luz!

Category 4: surroundings
This one will be tough. Glacier National Park, just 12 miles west of our aforementioned apartment in Browning, is full of breathtaking mountain vistas, beautiful clear, blue lakes, and amazing wildlife. We camped and hiked and biked in stunning places that always looked like calendar photos to me. We saw moose, mountain goats, pikas, and a lot of wild dogs (oh wait, that was in town). Despite all this, Glacier is up against a tough rival: the Caribbean. We walk through the jungle to get from our apartment to the hospital every morning and have a great ocean view as we do so. Lush green mountains jam-packed with trees and beautiful, fragrant flowers are everywhere. Just today we saw 2 toucans and 3 howler monkeys - from our house! The dirt road we do our morning runs on is like a movie set to me, and getting to swim in the warm sea on our own basically private beach after a five minute walk is pretty hard to beat. Loma de Luz for the win!

Definitely more than a few similarities! The truth is we love both places, despite the unique challenges of both. But still, pretty fun game. :) Next week we should have some killer photos to share since we're going to Roatan this weekend to hang out with Mariel's dad for a few days and snorkle. Hasta luego!

Posted by vagabundos 19:21 Archived in Honduras

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