9 More Days!

It is amazing that after 2 months of being in Honduras I am starting to accept more things as the norm, for example breast feeding. While breastfeeding is thought to be a very private thing in the United States…to the point where we have designated rooms in public areas…here in the Honduras, it is perfectly normal for women to breastfeed in public. At this point I am so accustomed to the public breastfeeding, I am not surprised when a mother begins to breastfeed while I am administering the study questionnaire…in fact I almost expect it haha.

After taking over the NIH study I have recruited 32 patients of my own, each has been very unique with their own personal story. With all this talk of the study and the clinic I thought now would be the time to show you all where I have been staying/working.

(Shoulder to Shoulder clinic in Santa Lucia)

(Birthing room in the clinic)

(1 of 2 exam rooms in the clinic)

(Emergency Room)

(My office/pharmacy)

(The dormitory common room)

(My dorm room)

(My Bed)

Two weeks ago I took a Mountain bike ride up to the cell tower, which is on a mountain overlooking the Santa Lucia Valley. It was a long trip up there, but the view from the tower was beautiful. I took some pictures when I was there, and highlighted the Shoulder to Shoulder Clinic.

(Click the picture to see the arrow pointing to the s2s Clinic/Dorm in Santa Lucia)

This past weekend I went to the weekly market in neighboring Magdalena. There were many booths selling fruits and vegetables, others selling cheeses, and others selling bootleg movies and other trinkets. I was wholly unimpressed by the variety of the market, many of the things for sale were manufactured in Guatemala or El Salvador. The longer I am here the clearer it is that Honduras lacks a distinct national culture. Instead it has borrowed many ideas and materials from the United States and neighboring countries in an attempt to develop its identity. For example, Honduras lacks its own distinct musical culture, clothing, and food…many of these things in the country are borrowed from other countries…80’s music from the U.S. is very popular in the big cities as well as Hollister clothing among the wealthier communities…in spite of all of this I was able to find one woman in the market who made her own pottery, which I thought was very unique.

After the market I finally got the chance to ride a horse. Yes a horse…I have been wanting to do this since I got to Honduras 2 months ago haha. So for my first ride…I was told that I would be starting with the horse named Diablo…fantastic! Despite this…I think I was a cowboy in another life…within 10 minutes I had Diablo running full speed. The ride was great (a bit uncomfortable) but we rode for about 6 hours…at this point the horses were exhausted.

(Diablo and Marc el Caballero)

Be home in 9 Days! :)

Saludos, Marc

So much to write...So little bandwidth

7/5/10

I Met up with s2s and headed out to my new home for the next 2 weeks Santa Lucia, Honduras at the southern end of the country near El Salvador. The immediate town of Santa Lucia is a very nice area with coble streets throughout the entire community…however once you get out of the town it is much poorer and mountainous. On our trip to Santa Lucia we stayed one night in La Esperanza and one night in Concepcion before finally arriving in Santa Lucia. On Sunday morning we had a trial CHI run through, which is Shoulder to Shoulders Child Health Initiative program. The program involves a 5 station rotation: Enema blood test, height and weight, vision, dental, and a doctor consultation. With my experience I was put in charge of the…dental station. We saw 31 students that morning and I distributed tooth brushes, instructed proper dental technique, and discussed the bad effects of sugary food. After this we went left for Santa Lucia. All in all we were in a bus for about 8 long hours until finally reaching the Santa Lucia clinic on Sunday afternoon. The clinic is large with its own “emergency room”, X-ray machine, and an entire maternity ward (pictures soon). I am on the list to shadow a doctor during an overnight shift so it should be very interesting. Tomorrow we are heading out to a small aldea to do our first field CHI program and once again I will be counting cavities and teaching dental hygiene.

7/20/2010

So a lot has happened since I was last able to write in my blog (there is limited bandwidth for the internet here at the clinic in Santa Lucia). I will do my best to catch everyone up on the highlights of the last two weeks, which include why I am now staying in Honduras until August 19^th and my 21^st birthday travels…what an adventure that was! And once again thank you all for reading :)

I spent 2 weeks down in Santa Lucia with a brigade of recently graduated nursing students from Christ Hospital in Cincinnati, A doctor and his resident from UNC-Greensboro Hospital, and an assortment of other professional (Dentists, RNs, Medical students, etc.) The group went on several CHIs in neighboring aldeas and I accompanied them on a few of them, acting as a translator, pharmacist, and pseudo dentist. I was also able to go with a doctor on a home visit to the house of a 58 year old man who was unable to make the trip down to the local clinic. He was a chronic smoker with emphysema and hypertension standing at 5’ 1” and 78 pounds he looked like he was in his 70s.

We also took a day trip to El Salvador because Santa Lucia is only about a 2 hour walk to the border of the 2 countries. Walking to the border I was expected some sort of indication that we were crossing into El Salvador…some type of sign or border guard or something. To my surprise there was nothing, only an old walking bridge connecting the two countries…it was very anticlimactic. After spending a half an hour in El Salvador we turned around and returned to Honduras. On the way back we passed a cemetery that was decorated with very bright artificial flowers, and there was also a funeral going on…which I didn’t realize until I looked at my pictures (look in the back right in my second cemetary picture).

(the river which runs along the Honduras/El Salvador border)

(Click to enlarge the picture of the bridge)

(And there is the funeral in the back right)

I will also be staying in Honduras for an extra 4 weeks than I had originally planned. I will be directing a NIH study that Shoulder to shoulder is currently involved with...running the entire study from down here examining upper respiratory infections in children under 5 years old that come to the clinic in Santa Lucia and Magdalena (another nearby clinic). The job entails recruiting patients, administering a questionnaire, collecting diagnostic data (heart rate, temperature, breathing rate) and epithelial cell samples from the upper nasal passages (es un poco íncomodo), making and freezing 3 epithelial samples, running a flu test, reading the medical charts, and finally entering all the data into two separate databases. It is definitely a lot of work but it has been a great experience so far and I have recruited 5 patients of my own J. I am sure to have more stories about this in the coming month as I recruit new patients.

Finally my last highlight of the past two weeks…my birthday. On Friday the 16^th, the brigade and I traveled the long 8 hour drive back to San Pedro Sula because the group was heading back home the following morning. San Pedro Sula, also known as the murder capital of Central America, is in northern Honduras and not really the best place in the world to celebrate your 21^st birthday…especially after dark. Because of this, our group stuck inside the guarded hotel walls and celebrated my birthday by the pool. It was a very fun night swimming and spending one last night with everyone who I had worked with for the last 2 weeks. But, the adventure starts the next morning on my actual birthday…July 17^th. Going with my usual track record with birthdays, this one was not that great. I spent the day by myself traveling from the northern end of Honduras all the way south back to Santa Lucia. I switched buses in La Esparanza and got onto a bus made for 40 with 60 already on board. So I paid my 90 limperas (less than 5$) and crammed on…standing along with many of the other people on board. After about an hour standing on the bus I decided to ride on top of the bus with most of the luggage (I had seen people do it before and knew it was okay)…So I rode on the top of the bus for the next 4 hours of the ride. This was the adventure part of my trip. Ducking branches and low lying power lines, I made my way down through Honduras with only a few problems…the bus got stuck once and I climbed off…and it started raining for the last hour I was on top of the bus. I eventually make it back to the clinic 9 hours after leaving San Pedro...it was certainly a birthday I will never forget.

(Riding on top of the bus)

(Where we got stuck in the mud)

(Under the luggage tarp while it was raining)

(On top of the bus during the rain)

Until next time! Saludos and thank you again for reading...check in again soon,

-Marc

Last week in Punta Ocote :(

7/1/10

I finally have a good amount of time to write about all the things that have happened this week, sorry Mom for the lack of updates but I am alive J…I started the week with a trip to the dermatologist to check out the rash that I developed on my chest...this was quite the experience. The doctor was a little crazy and came to the quick conclusion that my rash was due to an allergic reaction to swimming in Lake Yajoa 2 weeks ago. His remedy was a injection of steroids? In the right butt cheek and a spray of liquid nitrogen on the rash (along with a cream, a bar of soap, and 3 different unmarked pills which I didn’t take…my Mom taught me well). A few days later the rash is gone…I guess the crazy derma knew his skin problems. This week we focused on wrapping up our projects in Punta and made efforts to make these programs sustainable into the future. Hannah, Marion, and I made a poster to advertise the walking group in the clinic (note the runner in the top right corner)

(Walking group poster)

(Who is that handsome man?)

...and I also made/distributed an exercise information guide for the women to prevent injury and encourage further participation…here it is:

Información Importante Sobre Ejerció

Para los beneficios de salud es importante hacer, por lo menos, 30 minutos de ejercicio cada día.

Para el grupo de caminar:

Hidratación: Manténgase hidratado antes, después, y durante caminando, especialmente en los días de calor.

-Hay que beber mucha agua y traer una botella de agua.

-Beber agua ayudara a evitar el cansancio de músculos y el dolor.

Estirarse: Ayuda a prevenir las heridas de músculos y debe hacerlo después de unos ejercicios breves para animarse.

-Los ejercicios deben enfocarse en las piernas, las pantorrillas, y los brazos.

-Hay que mantener cada estiramiento entre diez y veinte segundos. Evite de botar – cada movimiento debe ser suave.

Los zapatos: Mientras caminar o correr, los zapatos del tamaño correcto son importantes para proteger y evitar dolor de los pies.

El cansancio de músculos y heridas: El cansancio es normal al empezar nuevos ejercicios. ¡No sea desalentado!

-Se puede prevenir las heridas si se hace caso de las sugerencias anteriores.

-Si está herido, ponga hielo en la área afectada y descanse.

A final: Disfrute, socializa, y sea saludable!

(thanks Nate)

This week we also headed up to Sapote (a really poor community of 10 houses which has little to no resources) for another visit. We went to speak with the people of the community and also check out the “governmental food program” (Proheco) that was supposedly feeding the school children. We visited all the houses and spoke with the people about their health concerns in the community…we learned that there had been a death due to malnutrition less than 2 months ago as well as reports of dengue in the community. After talking with the people, Hannah and Rob stuck around to see how the school feeding program worked…it didn’t. Waiting until 1:30 pm, the food never came and the teacher had no answers to why

(Walking up to Sapote)

(One of the houses in El Sapote)

…In addition to the poor support in the schools, Sapote has very little available water for the people in the community. The people here have to make several trips each day down a very steep and dangerous path to a water source/broken well that was built in 1993. Because of the steep path to the water, one elderly women told us that she doesn’t get her own water, she must rely on other family members to get her water…that is when they are home. We went to see this water source (pictures below) and I was saddened to find mosquito larvae and other living organisms in the sole water source for this community. As I previously stated, we plan on working with some water brigade organizations in the future to bring fresh water to this community.

(The walk down to the communities water supply)

(Built more than 17 years ago this small pool of stagnant water supplies the entire community of Sapote)

In most parts of Honduras there is no trash removal or sanitation companies…instead it is commonplace to burn the trash. All of the garbage from the house is burnt from paper and plastic to the metal. Often this burning takes place right in the street in front of the house and releases thousands of toxic and carcinogenic particles into the air. Many people here do not understand the true dangers of this practice which is especially dangerous to the children. Earlier this week, I observed this:

While our neighbor burned the trash from their house, the children played in the smoke…trying to see who could stay in it longer. This is obviously a huge health hazard which could lead to numerous lung, brain, and other internal problems for these children. Salud Juntos will be working on this problem in the future, hopefully bringing education to the people so that something can be done to end or control the toxic pollution of trash burning.

On a lighter note, we went to a feria (rodeo) on Wednesday afternoon and it could have possibly been one of the weirdest experience in my life. I think the pictures speak for themselves, but this was an annual rodeo in the town of Yorito which drew a crowd of a few hundred people. There was a rodeo clown/cross dresser who entertained the crowd between riders, the picture I put up shows him holding the bull’s tongue in his mouth as he held it down…he also had the bull smoking a cigarette, blowing a whistle, and he did a few flips off the bulls tired body…yes, this was animal cruelty at its finest. In an area without movie theatres and malls, this is the acceptable form of entertainment people flock too.

(The bulls tongue is in his mouth)

Also this week I had the opportunity to work on a vision brigade in Coco. We spent the afternoon giving vision tests and handing out glasses to both near and far sighted individuals. We then spent Friday evening in El Progreso, which just happens to be the bull testicle capital of Honduras. There are many resaturates that specialize in dishes serving up bull testicles...so natural we had to try them...and they most defiantly do not top my list of favorite foods haha (they are very fatty with little flavor).

...And just like that my time with Salud Juntos has come to an end. Thank you to everyone at Salud Juntos I had a great time with you all!...This weekend I am switching to begin working with another NGO, Hombro a Hombro (Shoulder to Shoulder). I will be working with them for the next 4 weeks in the province of Intibuca (very close to the El Salvador border). I am very excited to begin working with this organization, it has been around for over 20 years and I will be working with many professionals from the United States. Stay tuned for more, we're only half way done :) Buenas Noches, Marc

Sapote and Vacation in Tela

6/28/10

Friday we headed to yet another poor and secluded aldea named Sapote. Posos, which I claimed was “the poorest and most secluded” place I had visited, paled in comparison to Sapote. Because the main driving road to Sapote had recently been washed out, we again needed to hike over an hour through the mountains to get to this small and needy town. We quickly found out that there was something quite different in Sapote, something that we had not experienced in any of the other aldeas we had visited. Immediately it was clear that many if not all of the children were malnourished and consequentially were severely stunted in their growth (both mentally and physically). Apparently the government has a feeding program to provide the students with food but something is not being done right. It was a very upsetting place…all the students sat in class silently with barely any energy for anything else…this was after the teacher had to go house to house in order to get the students to school (we had become accustomed to dealing with uncontrollable classes full of wildly excited children). Sapote does not have electricity, nor does it have running water…instead the people walk 20 minutes through the mountains to a water source (could you imagine walking 20 minutes just to get a bucket of water?). In addition, many of the children did not know how to brush their teeth…but if they did, will they actually have the water to use the toothbrushes and paste we gave them on a regular basis? What this aldea needs above all else is a water project to bring water to the community…we will be working on this with P4HH in the upcoming year.

(Entertaining the kids in Sapote waiting for school to start)

(The students in Sapote)

After we left Sapote, we left for the weekend on the beach in Tela…and were met by rainfall trailing behind tropical storm Alex (the first tropic storm of the 2010-2011 Atlantic season). Despite the rain we did some swimming and had a great weekend…well most of us, sorry David (food poisoning)…we stayed at a very nice hotel with wifi J and enjoyed some great meals throughout the weekend. On Saturday we went to a restaurant to watch the United States v. Ghana…and unfortunately we all know what happened.

(The beach in Tela, slightly overcast)

(Sopa Marinera at a restaurant right on the shore)

Today (monday) we had a walking group in Coco and in three weeks it has become a very self motivated and hard working core of women, who really want to better their health. I think the hard work we put into educating these women about the importance of exercise has really struck a cord....this program in Coco now has 2 group leaders, a schedule, and health information to drive them into the future.

...In other news, I am in El Progreso tonight to see a dermatologist about a weird skin rash that is spreading on my chest haha. Wish me luck and check in tomorrow for an update. Saludos, Marc

A week in the Aldeas

(5 am Walk)

6/24/10

Sorry for the lack of updates this week but between waking up at 4:30 am everyday (for the women’s walking group, we’re up to 18 women!) and hiking through the mountains (details to come) this week has been extremely exhausting. We continued our dental program throughout the aldeas (Coco, El Medio, El Sapote, Guara, and Los Posos) surrounding Punta Ocote this week. We went to Posos yesterday and it was one of the poorest and most isolated places I have ever had the opportunity to visit. Posos is located in the mountains about an hour hike off the main road through a foot trail that a motorcycle would have difficulty passing through. After hiking in the Honduran heat we reached a small spread out village of 18 houses. In the small school (picture below)

there were only 11 students ranging from 5-12 years old. There were also no facilities in the community…all of the water was collected from rainfall and there was no electricity. The kids were very happy to have us there, some of them were in shock…I don’t think they have seen many gringos in their community. It was a little disheartening when we asked “who brushed their teeth this morning?” and not a single child raised their hand…Hopefully this dental program will set in motion some form of dental hygiene in the area and our efforts will not be in vain. Once we returned to Punta we went to the walking group in Coco and I was happy to see that the program is also doing very well there. Every day the men of the town play soccer while the women would traditionally stay in the house…this walking program in Coco has provided an opportunity for the women to get out and exercise as the men play their soccer games. With these walking programs I am slowly stepping aside and placing the responsibility of the group on the women themselves (in the hopes of making these programs self-sustainable), so this week I selected 2 “presidents” of the group to maintain the organization and lead future walks.

We also have this enormous mango tree right next to our house down here so we have all been enjoying mangos everyday for the last 3 weeks it’s pretty nice…and on the other side of the house we have an avocado tree which is just about ripe.

Tomorrow we are heading to Tela, a beach along the eastern coast of Honduras, for the weekend so I am really looking forward to some relaxation after this busy week. I also finished my second book since being down here Three Cups of Tea which is a very inspiring book about the NGO, The Central Asia Initiative, by Greg Mortenson. Take Care, Marc

Happy 18^th Birthday Kenny! Talk to you tomorrow.