A Travellerspoint blog

January 2012

Week 2 and Cayos Cochinos

rain 70 °F

We're back at LdL after a long weekend doing clinic and hanging out in the beautiful Cayos Cochinos, a group of small islands just off the coast here (a bit closer to mainland than Roatan and Utila). We went with Dr. Renee and a few other girls who acted as nurses/pharmacists.

We set out early Friday morning in a small boat from the beach just across from the hospital and made it to the Cayos about an hour later. We were greeted by sunny, cloudless skies, turquoise water, and white sand beaches. After settling into our digs for the weekend, a beautiful house overlooking the sea (!) owned by friends of the hospital, we set off in another, smaller boat to the other side of the island where there's a makeshift clinic. It was built by a nurse from Texas decades ago, and she still comes a few times a year, but now Renee also works with her to see patients in between times. The clinic is nothing more than a tiny, open air, one-room cement building, but the location is amazing. It's right on the beach with beautiful coral reef a few feet away. Boatloads of tourists hoping to snorkle showed up more than once while we were inside working. And luckily, island time is a little slower than usual so we had plenty of time to snorkle and relax in the water in between patients! We did clinics on Friday and Saturday and saw probably 50 patients between the three of us.

On Sunday we went into the Garifuna village of Chachawate and the other three girls (who happen to be teachers) put on a Sunday school class for the kids in the tiny church there. It was fun to play with the kids some. The village is really interesting too. The island is only about a half mile long and a quarter mile wide but houses 300 people, and even has a couple of hotels and restaurants though there's no fresh water, plumbing, or electricity! It's surrounded by a bunch of private islands of about the same size that house 1 family each or so, so it's kind of a strange juxtaposition. After grabbing lunch there, we went back to our island for more snorkeling and relaxing. We saw lots of beautiful fish including parrotfish, angelfish, squirrelfish, cowfish, etc. and some lobsters and rays too. Unfortunately we also saw (and felt) more than a couple jellyfish so we didn't snorkle quite as much as we'd have liked to.

After the great weekend, we came back to the mainland yesterday morning and are back in action in the clinic and hospital. This weekend an anesthesiologist and plastic surgeon are here so there are lots of cases in the OR. Today Mariel got to scrub in and first assist on an abdominal hysterectomy, which was a lot of fun. We're looking forward to more surgeries and other interesting stuff this week with them.

All of this vacation and fun cases has been a nice break after some tough days last week. On Wednesday, clinic was interrupted in the morning by a code blue (cardiac arrest). We ran over to find the patient was the 7-year-old girl who had been admitted a few days before for fever and abdominal pain. She had been in another hospital in La Ceiba for a week or more before coming to us because she just didn't get better. It was Tuesday that the team figured out she was infected with the worm Strongyloides, an uncommon but not unheard of parasite down here. They had begun treatment with mebendazole and were awaiting the arrival of the drug of choice, ivermectin. Late Tuesday night, though, she had begun to have some breathing problems. By morning she was doing even worse and, we soon found out, going into shock. After several rounds of CPR throughout the morning, her body finally couldn't take any more and she passed away. Ben and I were among those taking turns doing CPR and it was really difficult to lose her, especially after the other sad cases we were part of last week. Therefore, the Cayos trip was much appreciated and helped us to get back in a good place to work with other patients.

Es todo para ahora, esperamos que todo pase bien con todos de ustedes!

Posted by vagabundos 18:43 Archived in Honduras Comments (0)

1 week in

sunny 85 °F

Hi everybody,

Well, we're at the one week mark of our 8-week rotation here at Hospital Loma de Luz. Things are going really well and we're enjoying our time here, both in the hospital and out. We've already seen some interesting and some sad cases.

Mariel saw a little 7 year old girl with a huge, hard mass in her abdomen that is most likely an advanced cancer. Her grandmother cares for this little girl, who is also severely developmentally delayed, and did not seem to grasp the severity of the little girl's disease. When I tried to gently explain to her that the diagnosis was serious and she might not even be a surgical candidate, though, the tears flowing from her eyes revealed that she probably knew more than she would let herself believe. Sadly, the girl was seen back in June and had an ultrasound that was suspicious for this sort of thing, but they didn't get the recommended CT scan until a week ago - most likely because of the huge expense of the scan. Who knows now if whatever she has would have been treatable back then. All I could do today was to offer her a surgical consult and the assurance that we will help her in whatever way we can, body and soul.

Also in our four days of work last week we collectively saw 3 cleft lip/palates, in kids aged 18 months to newborn. Discovering the cleft in the newborn was sad, but not as sad as the 18-month-old little boy who has never been able to be understood and will likely have permanent speech and possibly hearing problems. The hospital has limited support for these kids, but luckily there are a few ENT specialist teams who come down every year to do several cleft surgeries over a short amount of time.

For every sad story here, though, I think there are many more happy ones. We've been a part of a few births already, and they went very well. We've also been able to help make diagnoses for hospitalized patients that they have waited weeks in other hospitals to be cured of before coming here. The hospital is surprisingly well-stocked once you learn what they have, and everyone working here really cares about the patients. The care here is so good that the missionaries and their families come here, too, even for surgery (this just happened yesterday!). We've also seen people with grave diagnoses who finally get the care they need and deserve here.

Besides seeing a lot of varied pathology, we're getting better with our Spanish and getting used to working more autonomously. Writing prescriptions yourself is a lot different from just knowing what drug to use, it turns out! We're also learning a lot about how to practice medicine in a resource-poor setting and with very underserved patients (and affirming that we love it). We're also getting plenty of chances for suturing, abscess I&D, learning ultrasound technique, and lots more.

When we're outside of the hospital, we're learning too. We took a bike ride through several of the nearby villages and got a good sense of the way folks live around here. It looks a lot like rural Mali, somewhat surprisingly. Lots of outhouses without plumbing and outdoor kitchens with dogs and chickens running everywhere. It's been interesting to see what a missionary community looks like, too. They are somewhat isolated, since most of the houses are behind the guarded gate of the hospital drive, but also get out into the larger community a lot, too. There isn't a church here so most attend community churches in the different nearby villages and make a lot of connections with locals there. Besides that, there is a weekly Thursday night get-together for all the missionaries. We've been invited to lots of houses for dinner, coffee, ice cream, and gone on lots of outings with different people, too. They are a really fun group - we're loving how risk-embracing they are! (within reason, of course) :)

That's all for now. We'll keep you updated!

Mariel & Ben

Posted by vagabundos 12:29 Archived in Honduras Comments (0)

Hospital Loma de Luz


Hello faithful readers!

We've made it to Hospital Loma de Luz. Actually, we made it yesterday - 1 day behind schedule due to some very inconvenient gastroenteritis that kept us stuck in Guatemala City for two nights after a very unpleasant ride from Xela. We're recovered 100% now, but sadly missed out on seeing the Copan ruins. Some other time...

Yesterday we spent the day checking out the nearby city of La Ceiba and getting groceries there to take out here, as we aren't really in any town (and all the surrounding towns are pretty small). After that, we made the 45 minute trip, from highway to paved road and finally to dirt road, and arrived at the hospital. It's on a dirt road that runs parallel to the ocean, about 1/4 mile away. There are small villages dotting the road every 5-10 minutes of driving, and lots of people going between them on foot, horseback, bikes, motorcycles, and sometimes cars. There are also a few buses everyday that help to bring patients in from the many surrounding small towns. All in all, it's very rural. Patients come from these small farming and fishing communities from the coast to way up in the mountains.

The hospital sits on a hill overlooking the road and the beach, along with staff housing and a few other buildings here and there. The hospital itself is fairly small, though it still boasts a high volume general clinic, OB and gynecology clinics (with ultrasound capability), 2 delivery rooms, 2 operating rooms, 15 or so inpatient beds divided into communal rooms for men, women, and children, and an ER which is much more a room than a department. All of these areas are arranged in a big square with a courtyard in the middle, which is covered and acts as a sort of open-air chapel.

Up another hill near the hospital is the staff housing. We live in an apartment that is part of a larger building with common spaces and more apartments for other visitors. Our little two-room apartment has everything we need and is private, which is nice after living with a family for a few weeks. We cook all of our meals ourselves, which is great after not cooking for ourselves for several months! A few other visitors are living here now too, and the permanent staff live in a nearby communal building, up the hill further in their own houses, or in villages.

As for our daily life, we come to the hospital at 8am or so to begin seeing patients in clinic. Some people have appointments ahead of time, but many just show up and hope to be seen, so it's very hard to know what a day will be like. After a full day of clinic, caring for hospitalized patients, and maybe some babies and emergencies, the day winds down around 3pm, since the buses stop running at that time and many people have very long trips back to their homes. After that time, the on-call physician takes over. We'll be starting to take call a few times a week along with one of the docs, too. While on call, you handle after-hours clinic visits, emergencies, and deliveries, so it should be fun! We have some weekend call, but other weekends we are completely free so we should be able to do a little traveling and relaxing.

Today after clinic we threw on our swimsuits and walked 5 minutes down the dirt road to find the path between cow pastures that leads to the beach. It's a wild, natural beach - very different from the manicured ones on Roatan, etc - but really beautiful. The waves were surprisingly good for the Caribbean, and we still have to figure out if there's any snorkeling here. Apparently there is a reef nearby, but it is out a little ways and we need some flippers before we try to go out. The weather is great, 70s at night and 80s during the day, with lots of humidity - so much so that most fabrics feel moist all the time! I still think it's a good tradeoff, given the low tonight in Iowa City is 4 degrees (!).

We'll be sure to keep you posted with any interesting stories and photos, and we'll definitely snap some of the hospital and grounds at some point.

Mariel y Ben

Posted by vagabundos 18:39 Archived in Honduras Comments (0)

Last days in Xela

We're in Xela again after spending the weekend at the beautiful Lake Atitlan a few hours southeast of the city. We took a 'chicken bus' there on Saturday morning, arriving at the tourist Mecca of Panajachel around lunchtime. After a meal of grilled chicken and decidedly non-Guatemalan mac n cheese, we took the 45-minute boat ride to Santiago Atitlan. It's a far less touristy city on the lake with much more Mayan influence. We had a great time biking around the lake and visiting little Mayan towns where it was tough to find a Spanish speaker! We also had a chance to paddle on the lake in a canoe and take some nice photos, which I promise to post sometime soon. :)

This week has been filled with studying Spanish and checking out the sites in and around Xela, like the very interesting cemetery and bustling markets. Mariel also had the chance to spend some time doing exams on children and babies at the orphanage in town, which was a very good experience. We had our graduation dinner and received our mini diplomas from the school on Wednesday, and tomorrow we say goodbye to our great teachers and awesome fellow students. We've learned a lot that will make working in Honduras and the US easier. We also have our last dinner with our wonderful host family tonight, as we will be heading out of town tomorrow afternoon to Guatemala City. On Saturday, we bus from there to Copan, where we hope to get a little time to check out the amazing Mayan Copan ruins. On Sunday, we head from Copan to San Pedro Sula where we will meet up with someone from the hospital and ride with them to Balfate. We plan to start working on Monday.

Again, we will post photos as soon as we get time in between all these bus rides. Until then, hasta luego!


Posted by vagabundos 17:36 Archived in Guatemala Comments (0)

Eternal Students

Hello from Xela! We successfully made it here by bus on Monday morning and promptly started our studies that afternoon our respective teachers at Escuela Miguel Angel Asturias. We have classes in the morning for 5 hours each day, and in the afternoons typically the school puts on activities for us and the other five students here now. Yesterday we all went on a short walking tour (in Spanish) of the historic center of Xela, and today we all took a microbus to a beautiful park with natural hot springs in the mountains outside of town. It's actually pretty cold here, and nobody really has heating or truly hot water, so the hot springs were much appreciated.

The school is intense and the teachers are very good, but it's still very relaxed and self directed, which is ideal. We have definitely learned a lot already and hope to improve our spanish a lot more over the next week and a half, and hopefully in Honduras too!

Here in Xela, we live with a family who works with the school and has hosted many students over the past several years. It's been really fun getting to know them. Mostly we intact with our 'mom' Silvia, but we also live with her husband and their two daughters, age 18 and 21. We eat all of our meals there, and lucky for us Silvia is a great cook and they are all very nice and chat with us happily. It has been interesting to see firsthand what middle class looks like in a place like Guatemala, which is something we haven't been exposed to as much in the past. We have a warm bed, good food, and are very safe in the house, though it is small and they don't have many extraneous belongings.

Well, that's all for now - we have homework! Will post photos sometime soon.

Posted by vagabundos 16:32 Archived in Guatemala Comments (1)

Bienvenidos a Guatemala

Hola from Guatemala! Ben and I are here for 2 weeks to brush up on our medical Spanish at an immersion school before heading over to the Carribean coast of Honduras where we'll be working for 2 months at a small hospital.

We arrived in Guatemala City yesterday morning and have been relaxing here since then. We were going to try to head for our Spanish school in Quetzaltenango but it turned out that most of the town, buses included, was shut down today so we got a chance to relax. The zoo was very open and drew a ton of local people, so we followed along. It was a pretty good zoo and we had a lot of fun!

Hopefully we will update you tomorrow from Quetzaltenango once we settle in with our host family and maybe squeeze in a lesson. Happy new year to everyone!

Mariel & Ben

Posted by vagabundos 18:07 Archived in Guatemala Comments (0)

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