Friday, August 23, 2013

Clínica Esperanza



In the last post, I wrote about Global Healing and the Roatán Volunteer Pediatric Clinic, where I’ll be interning most of the day during my time in Roatán. After RVPC closes in the afternoon, however, I’ll be volunteering at Clínica Esperanza.

When I was in Roatán in May, I went by Clínica Esperanza (“Hope Clinic”) on a whim to see if I could just check it out. My mom, my friend Elyssa, and I walked shyly into the reception area (me first, mom and Elyssa no hablan mucho español…), but once we were inside we found there was no reason to be shy. The receptionist greeted us warmly and found Karla, the sweetest, kindest, friendliest nurse I’ve ever met. She spoke mostly in Spanish, but tried to speak some English to help my mom and Elyssa understand (mom was very thankful). Nurse Karla gave us a tour of the facility and told us a little bit about how it started. Peggy Stranges, an American nurse who had previously volunteered in Roatán, permanently relocated to the island in 2001. Nurse Karla told us that when Nurse Peggy arrived on the island, locals learned she was a nurse and came to her for medical advice, and thus the idea for the clinic was born. It began in the basement of her home, and then was moved to a church, then eventually moved into it’s own freestanding facility. And folks, this facility is really quite lovely.

Clínica Esperanza’s services include a walk-in medical clinic, women's health center, pediatrics inpatient hospital, birthing center (brand new!), and adult and pediatrics dental clinics with support from a laboratory and pharmacy. They also have outreach clinics and community health education programs. All of these services are low-cost/no-cost to their patients. It's about $5 for a visit, but Nurse Karla told us that no one is ever turned away because they cannot pay. Sometimes they just pay a portion if they can. Sometimes they pay nothing and say they will pay later when they have the money, which sometimes happens and sometimes does not. The clinic runs on donations and has a permanent staff (like Nurse Karla, who is from Roatán) and volunteer doctors, nurses, and students who come and go. This is a great, brief video about Clínica Esperanza and Nurse Peggy:



I feel very fortunate to be able to see two different kinds of healthcare outreach during my time in Roatán. The clinics seem so different (the public hospital where RVPC is located is a concrete slab of a building the bustling “downtown” area, Clínica Esperanza is air conditioned…). I am less certain about what I will be doing with Clínica Esperanza, but I’m really interested in learning more about the outreach programs they offer; public health and health education sounds right up my alley. I also hope that I can lend my language skills to any volunteers who don’t speak Spanish.

Like RVPC, Clínica Esperanza is always looking for medical and financial donations, so if you’re interested in learning more about how you can support the clinic, contact me or check out ClinicaEsperanza.org.


Oh yeah… two weeks from tomorrow I’ll be on a plane!!

Tuesday, August 13, 2013

Global Healing, RVPC, & HEAL



This whole business with Roatán, Honduras came to be because earlier this summer, I was accepted as the HEAL intern for the Roatán Volunteer Pediatric Clinic. The clinic is run by Global Healing, which is an organization that goes into developing parts of the world to establish programs to promote health care reform where modern medical care is often not available. What is key about Global Healing is that they aim to create sustainable programs. It’s not just about short-term interventions, but it’s about creating long-lasting relationships with the communities they work in to become self-sufficient programs. Global Healing has programs in Georgia, Armenia, Dominica, Moldova, Nepal, Haiti, Ukraine, and (ta-da!) Honduras.

Global Healing came to Honduras in 2003, opening the Roatán Volunteer Pediatric Clinic. The clinic is based out of the Public Hospital, of which there is one on the island of a population of around 65,000. With the government only able to support one permanent pediatrician, the hospital could not meet the demands of the pediatric outpatients, and often patients were turned away. So Global Healing stepped in to relieve this demand. The clinic is staffed by volunteer physicians from the US, and there are year-round rotations for pediatric resident physicians as well as a Health Education and Advocacy Liaison interns (HEAL - that’s me!). The RVPC provides perinatal care, newborn care, and inpatient pediatrics.

The HEAL intern serves as the Clinic Coordinator, locating resources (i.e. meds, specialty referrals, etc.) for patients, helping them through the logistics of utilizing these resources (i.e. locating funding for trips to the mainland for follow-up care). Interns assist in setting up the clinic before patients arrive, triage as patients and their families come into the clinic, collecting patient data, and interpreting for Global Healing physicians.

I will also have the opportunity to work with long-term patients individually, coordinating care among many health care providers and locating resources where there may not seem to be many – this is the aspect of the internship that most excites me. I am excited to get to know patients and families better to be part of creating a care plan that is best for them, and I’m hoping to get to know the community and the culture well so that I can learn how to personalize care for every person.

In an effort to help the clinic, I am now trying to gather donations of all sorts to take with me. Below is the list of things that the clinic always needs. I’ll be collecting in the Denver/Boulder/Colorado Springs area until I leave – please contact me or leave a message below if you’re interested in donating

25 days and counting…!




Non-prescription Medications & Supplies
  • Infant and children's acetaminophen
  • Infant and children's liquid cold
  • medication (e.g., pseudoephedrine)
  • Ibuprofen (liquid or infant drops)
  • Benadryl (liquid preferred)
  • Hydrocortisone ointment or cream
  • Topical antibiotic ointment
  • Selsun Blue shampoo
  • Anti histamine ointment or cream
  • (anti-itch cream)
  • Eucerin or other moisturizing creams
  • A&D, Desitin, or other diaper creams
  • Vaseline petroleum jelly
  • Cetaphil lotion
  • Oral calcium supplements
  • Children’s vitamins
  • Debrox ear drops
  • Clotrimazole (Lotrimin) ointment
  • Saline bullets
  • Individual alcohol rubs
  • 3cc & 5cc syringes
  • Nizoral shampoo
  • Nix (lice treatment)
  • Silver Nitrate applicators
  • Urinalysis dip-sticks
  • Glucometer / glucometer strips
  • Thermometers (no mercury)
  • Ear thermometer w/covers
  • Infant nasal suction bulbs
  • Pulmo-Aide or other nebulizers

General Donations
  • Infant formula
  • Preemie, infant, and baby pampers
  • Combs
  • Shampoo, Conditioner, & soaps
  • Toothbrushes & toothpaste
  • Sandals, shoes, flip flops
  • Clothes
  • Socks
  • Children’s stickers
  • Small Toys and Stuffed Animals
  • Writing Utensils
  • Spanish & English kids’ books
  • Notebooks
  • Child backpacks
  • Crayons and coloring books
  • Hand Towels
  • Kleenex, Paper Towels
  • Nail Clippers
  • Sports Equipment: Soccer Balls
  • Pumps for balls
  • Flashlights (ones that do not need batteries)

Clinic Supplies
  • Antibacterial hand gels
  • Paper towels
  • 409 disinfectant sprays
  • Plastic Ziploc bags
  •     (little ones most needed)
  • Print cartridges (HP cartridges 21 and 22 for HP Deskjet D1460 printer)
  • Printer paper

Prescription Medications
  • Ceftriaxone for injection
  • Any oral antibiotics (liquid preferred)
  • Amoxicillin
  • Augmentin
  • Azithromycin
  • Clarithromycin
  • Erythromycin
  • Cefazolin
  • Other cephalosporins
  • Penicillin
  • Dicloxacillin
  • Ciprofloxacin
  • Metronidazole
  • Topical Bacitracin
  • Topical Neosporin
  • Nystatin ointment
  • Cortisporin otic suspension
  • Erythromycin ophthalmic ointment
  • Albuterol/salbutamol liquid for nebulization
  • Albuterol etered dose inhalers (MDIs)
  • Permethrinor Lindane (for scabies)
  • Topical Sterids
  • Oral steroids
  • Prednisolone
  • Prednisone
  • Dexamethasone
  • Dexamethasone for injection
  • Inhaled steroid MDIs
  • MDI spacers

Wednesday, July 31, 2013

Honduras and Roatán


This is Honduras and the island of Roatán, just north of the mainland:



Honduras’ history is, well, tumultuous.  The country, with it’s numerous military coups (the most recent being in 2009), has had a history of fairly consistent political instability, corruption, and power struggle. The country is known for its gang activity (but hopefully steps are moving in the right direction) and for the brief but violent 1969 Guerra de Fútbol (the “Soccer War”: rooted in immigration and economic issues between Honduras and El Salvador, the first acts of violence of the war occurred between fans at a World Cup qualifying match between the two teams).

True, Honduras is known as a violent country. But that is not the only thing for which it’s known. The Maya civilization thrived in the western part of the country, and there are ruins to visit in Copán.  There are many tropical national parks to explore. The country’s economy is largely dependent on its export of bananas and coffee, and, in more recent years, on tourism.

And tourism, of course, is how many know of the island of Roatán.

The Bay Islands, which include Roatán, Utila, and Guanaja, are considered culturally worlds apart from the mainland with a mixed heritage of African, Carib, and European.  In the 1700s, the islands were a hotspot for English, Dutch, and French pirates. The islands were under the control of Great Britain until 1859, when they were ceded to Honduras. English is still largely spoken on the islands, but because of the recent increase in tourism, many people from mainland Honduras have come to the islands in search of work speaking Spanish, which is becoming more and more prominent.

I had the opportunity to visit Roatán this May with my family and friends. It is beautiful. It certainly has that laid-back “island” feel.  The island runs on tourism, and it shows. There were large, gated hotels and resorts all along road leading to the east end of the island and countless billboards and signs advertising ziplines, restaurants, and diving (Roatán is world-renown for it’s diving. The Mesoamerican Reef is the second-largest barrier reef in the world). 

Alongside these hotels and billboards, however, sits dilapidated homes and shops. Police officers randomly pull people over for no reason but to demand payment in order to pass (the folks who own the houses we stayed at paid the police a monthly “fee” so that they would not stop the cars that carried those who rented from them … aka, us). I don’t know if I am wise enough or smart enough to make any kind of conclusion or judgment about these kinds of situations, but I see them. In any case, I’m sure this will be something I will continue to think about after I spend more time there.

In the meantime, here are some more photographs to get an idea about what I can expect… countdown: 38 days!

Thursday, July 18, 2013

a su corazón

I did it. I joined the millions of folks posting their thoughts and experiences on the internet and got a blog. I’m a little surprised at myself, but I want to be able to share my experience working in Roatan with all of the people that are supporting me. So… here goes nothin’!
I thought I would take this first post to explain the title of my blog and quote above. Nelson Mandela is reported to have said “If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart” during negotiations with the Apartheid. 
I absolutely agree with his statement.
I spent the last four years studying Spanish and Portuguese. I studied in Brazil and in Chile and in the USA with professors from all over the world. One of the most profound things that I have learned is that language is fundamental to who we are. It is not only formed by grammar structures and vocabulary (and believe me, I’ve taken plenty of classes that covered those areas), but it is composed of our culture, our social and economic background, our age.
When I think about going to work in health care in the future, I believe that my background in language is going to be absolutely essential to providing care.  I want to connect with individuals and communities in their language, which not only varies around the world, but also varies in the United States. It varies depending on culture, social and economic background, and age. Sally Okun, an RN who started a health-oriented social network, recently discussed the importance of learning the language of patients (what she calls the “patients’ lexicon”) in a wonderful Ted Talk at TedMed this year. Check it out:

I am excited to go to Roatan to better my Spanish, to bridge the language barrier between volunteer physicians in the clinic and patients, and to ultimately help provide better care for patients and their families. While I’m there, I think I’ll get a better idea of what Nelson Mandela said and that I will truly learn what it means in health care to speak with someone in a way that goes a su corazón.