Sunday, March 30, 2008

Boating Misadventures...

Our young friend Gabe (14) is an avid spear fisherman and finally took my friend Ashley and I out to the coral reef near here to learn how to fish. For some reason this fisherman insisted on starting out at the insane hour of 6:30 am on a Saturday. I protested loudly, but still went along. Gabe and his sister Hannah (10) met us on the road with the tractor and trailor and we headed for the water. The little green metal boat was fitted with the outboard motor and the small air filled raft was lashed to it to drag behind. We got about halfway to the reef when the engine cut out and wouldn't start again, so we rowed the rest of the way. We had a splendid time snorkeling about and looking at the coral and fish. Unfortunately, most of the coral is dead and the fish were pretty small and the water was kinda murky because of a few waves now and then. We didn't get any fish, but we had fun anyhow. The funniest moment was when Ashley opened up the massive umbrella and said, "look I'm like Mary Poppins!". At that moment a little breeze caught the umbrella and pulled her right over the side of the boat! :) She screamed and splashed and the rest of us nearly fell out too we were laughing so hard!

Finally we started rowing back and singing songs. (the motor still wouldn't run for more than about 30 seconds at a time) We were still about a half mile or more from shore and singing boisterously when the drama began. We were not paying any attention to the large wave approaching from the rear. At the moment the wave hit the little green boat, Hannah decided to stand up in the boat and clap her hands. So the boat lilted, then tipped, then rolled almost all the way over. It righted again but was filled with water and started sinking immediately. Ashley and I jumped out of the raft and swam over to hold up the boat. It was all a blur of kicking madly to keep the boat and motor from sinking to the bottom of the ocean, while throwing all the snorkeling gear, spear guns, clothes, towels, etc. into the raft as the cooler floated away. Gabe got into the raft and leaned over the edge to unscrew the motor from the metal boat while Ashley and I swam with all our might to keep the boat near the surface. We somehow got the motor into the raft and after multiple failed attempts at flipping the boat to get the water out, we finally hoisted it mostly onto the raft and flipped it. That worked pretty well and we bailed the other five gallons of water out with little plastic cups while still treading water next to the boat. (note to self: bring a bailing bucket next time) Once the major drama was over and the cooler had been rescued, we put on life jackets and flippers and pushed both boats all the way to shore. Talk about a hard swim!

So, our near disaster turned into a great adventure, AKA 'Missionary Impossible'. I just thank God that no one got hurt and we didn't lose anything!

Mice

Wow, I can't believe I just killed a mouse with my bare hands!!! OK, its not so bad as it sounds. I actually killed it with my fist and my flip flop....but I didn't touch the mouse directly. It's 11:30 at night and I've been chasing this darn mouse around on and off for the last half hour. It ran across my counter, then behind the stove, back on the counter....sooooo annoying. Finally I heard it under a little piece of cardboard and I just jumped up and slammed my fist down on top of the cardboard. I heard it shaking around and its tail was sticking out, so I took off my flip flop and slammed it down on the cardboard a couple times. It stopped moving so I quickly scooped it up and threw it over the balcony. I felt like shouting out to its relatives wherever they may be lurking, "let that be a lesson to you!".

Who needs a mouse trap when you have a fist and a flip flop?

Tuesday, March 25, 2008

Easter Sunday



What a busy and blessed Ressurection Sunday! The night before we dyed easter eggs and I must say the MKs were VERY creative with the wax crayon drawings!

Easter began with a sunrise service on the beach. The moon was very bright when we arrived and was soon overshadowed by the rising sun. We had a bilingual worship service with our Honduran staff and friends and then many people shared and gave testimonies.

After church we had a huge potluck with awesome food! We ate so much that I was dragging when we were trying to hide all the eggs for the Easter Egg Hunt. At first some of the teen MKs said they were too old for an Easter Egg Hunt. I insisted that you are never too old to have fun! Once it got started they were of course the most competitive and very optimistic, carrying around huge buckets to put their eggs in!!!

Hannah and Cory were the winners, (with a few donations from their older siblings).

Then the youth insisted we play capture the flag because it is an Easter tradition. Many of you know that I don't particularly enjoy running, however, when you are chasing someone to put them in jail I guess it can be a little fun! I must admit it's a bit embarassing when the 10 year olds can outrun me half the time....

After getting all sweaty in the hot sun, we headed to the beach to end our Easter day watching the sunset. It was pretty awesome to start the day praising God at sunrise and then thank Him for His sacrifice for us at the end of the day on the same beach.

Cancer all around us...

I have three patients who are waiting for pathology results to find out if they have cancer or not. Most likely they do. Cancer is even worse here because there are so few resources. They have to go to the big city and try to get into the ONE Cancer League program that many have not been accepted to. I'm not sure what their criteria are, but we have had a few people come to us after being refused there and we basically offer them unofficial hospice services. Since no one has medical insurance, pretty much the rich can get chemo and radiation and the others just suffer. Its so frustrating to feel like you are practicing medicine with your hands tied behind your back. You can talk until you're blue in the face, but you can't reach out and do anything. I guess that's when we have to pray and ask God to do the reaching out...

Tropical vacation....with blankets

I had a couple days off and I was invited last minute to go to the Cayos Cochinos, the little islands just off the coast here. The other times I have gone, it has been a tropical paradise. HOWEVER, this trip started off with a very windy morning and the roughest boat ride I've ever had. The small boat was slamming into the waves the whole time and the water was pouriing over us. I would have sworn it was raining buckets there was so much water. EVERYTHING was soaked! I finally put on my swimming goggles because I couldn't open my eyes due to the stinging salt water!

We finally arrived looking like a bunch of drowned rats and the wind got worse and the temperature dropped. The only clothes we had were shorts and t-shirts and they were all wet. Some of our clothes never did dry off! That night it rained. Fortunately, we were staying with our friend Lori who is a wonderful hostess who provided us with plenty of towels and blankets. A hot shower never felt so good! We cuddled up under the blankets to read, talk, watch videos, play games. It wasn't until the last day that the sun finally came out and we were able to go snorkeling. There were tons of pretty parrot fish, and one of the locals caught one to eat. So sad to eat such a pretty creature!













The best part of the trip was that I was finally able to meet Jan, a nurse who volunteers on the islands three months every year. She has been going there for 34 yrs! Now that's dedication! She is a really cool lady and very organized. We had a nice visit and asked how we could help her take care of the Garifuna people on those islands when she is not there. Currently most patients come over individually on canoes to Loma de Luz for appointments. We have wanted to start a monthly program there but we were under the impression that Jan did not want to work with us. However, this time she said she was very glad to have our help and wants us to come out again while she is there in the next couple months to see how she runs things. Hopefully this can be a good partnership to provide more consistent care for the Garifuna people.

So, we spent some time being cold and disappointed, but in the end God worked it all out and brought about a wonderful result. We now have contacts for ongoing clinics and public health on the islands and we also had a smooth boatride back to the mainland with a gorgeous sunset!

Sunday, March 16, 2008

ENT team


There are some conflicting views here regarding the usefulness of short term medical brigades. I have heard that some teams come for a “medical vacation” and really don’t help out all that much. They would rather hang out at the beach rather than tackle difficult cases that we need help with. Some surgeons come and operate and then leave without good instructions of what the follow up care should be. Some visiting teams need so much hand-holding that the rest of the clinic and surgeries are paralyzed because the team needs so much looking after. These are the complaints I have heard about some teams that have come in the past.

However, this week we witnessed one of the hardest working surgical teams ever! A group of ENT surgeons came here for a week and hit the ground running. They saw many clinic patients, did multiple surgeries and some of them very complicated. Three nights they operated until after dark! One was a ten hour case. They consulted on Bob and helped with his tracheostomy care, one of the nurses helped us organize a better recording system for the techs taking care of Bob. They left a detailed list of patients and follow up care that was needed. They were enthusiastic, hard working and incredibly encouraging to all of us! I was fortunate enough to be able to hang out with them a lot since they were staying here in Staff Housing and they were not only talented medically, but also had servant’s hearts and were very fun people! My friend Kaalan (from medical school) was the team leader and it was great to spend time with him again and see how he has grown into a talented surgeon, a patient teacher, and a man after God’s own heart. I drove the team into the city today and it was hard to say goodbye. I will miss them. So many patients were blessed by the surgeries and expertise that they provided and the whole community was blessed by their presence here. They are a team we would definitely love to have here again! I thank God for sending such a wonderful group to us.

Tuesday, March 11, 2008

Visa trip

Every 90 days, the government of Honduras has the courtesy to kick us out of the country for at least 72 hours to renew our visas. Don't ask why. Maybe just to make our lives more difficult? They are very good at that!
I should have been very excited about going to Costa Rica with my dear friend Amy, but I was too stressed out the week before to even participate in the fun of planning the trip. (craziness of visitors, lay midwife meetings, complicated medical cases, putting a dog to sleep, Don Goyo getting electrocuted, Erlin dying....) However, once I arrived and spent some time hiking in the jungle and laying on the beach, I loosened up plenty! Now, I am so grateful for the break and the time to spend with Amy.
We stayed in a really cool hostel overlooking the beach at Manual Antonio national park and then headed up to Arenal Volcano (which is still active). We stayed in a hostel called Gringo Pete's for only $4 per night. What a steal! Then we found a local eatery with the "plato typico" of beans and rice and chicken and fried plantains and tortillas for only $2. I wish all of Costa Rica was that cheap! We played in the hot springs and Amy swung from the Tarzan rope over the river and we saw all four types of monkeys in Costa Rica. Then we went up to Poas Volcano which is a huge crater with a lake. We went to a series of 5 waterfalls (my knees nearly pooped out on me with all the downhill!) and a butterfly enclosure and saw toucans and hummingbirds and poison dart frogs and more monkeys. Very good time. Not to mention all the interesting people along the way from the noisy Israelis, to the sleep talking roommie, to the recluse, park ranger, gardening guy who was great company, to the stuttering Floridian, to the cute "Global Routes" team leader, to the British girls planning to create a written language from a "click" language in Namibia.... No lack of interesting characters.

For all you coffee addicts or afficionados or whatever you call yourselves....you must go to Costa Rica. When you arrive in the airport, there is free coffee in the gift shops and chocolate covered coffee beans to try! There was awesome coffee at each hostel we stayed at and any major gift shop or touristy area. I drank more coffee in one week than I have all year and I didn't buy a single cup!

Another Death...

Things sure do get personal here in Honduras. I mean, I know its all about building relationships here, but that makes it so much harder when things go bad.

A 22 year old lady named Keylin has tetralogy of fallot. For the nonmedical among you that is a combination of several severe heart defects. Keylin was one of my first patients when I was on call here. She about scared me to death because she was so hypoxic and then I nearly put her into pulmonary edema trying to rehydrate her. (some of you may have heard of that crazy call night) Anyway, I've known her since the second week of my stay here. Turns out she was pregnant. That is most often a death sentence for a person with her heart condition and we doubted if she would even make it half way through her pregnancy. However, even in that hypoxic state, her baby miraculously grew and her heart tolerated the stress of pregnancy. She was having preterm contractions at about 30 weeks and after many hours of hard work, Leon (our cardiologist) and John (nurse midwife) got her into the hospital in the large city of San Pedro Sula. She has been cared for there and received nearly weekly visits from John and his wife, Penny. Somehow, she made it to term and delivered a healthy baby boy. That is amazing considering her condition!!! We were all so excited. Then this morning I saw Penny crying in the hall. Keylin died early this morning just three days after delivering her baby. We don't know all the details yet, but with her heart condition she most likely had a pulmonary embolus.

It is just crazy. We never thought she would make it through her pregnancy but she did. We thought for sure the baby would not grow in that hypoxic environment, but he did. We all breathed a sigh of relief when the baby was finally delivered and all was well. Now our breath is taken away at the shock that she has died.

Monday, March 10, 2008

Stereotypes

I don't like stereotypes. Making broad generalizations about people is usually inaccurate and closed-minded. However, there is usually a grain or two of truth in stereotypes. Like the stereotype that every Latino is named either Jose or Maria....

At our February meeting with the lay midwives, I asked them to introduce themselves again and tell which community they are working in. There were five women at this particular meeting. The first lady introduced herself as Maria Theresa, the next was Maria Santos, the next was Maria Elizabeth.....they all started to giggle. I exclaimed that there were three Maria's in a row. They giggled even more. We continued around the circle and every single woman's name was Maria. Incredible!!!!