"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" - Nelson Mandela
I have made a point to closely shadow the nurses who I have been working with for the last three months. I have watched procedures with them (and helped with some!), watched them interact with patients of all ages, chatted with them about all sorts of things, and asked them for advice as a future nurse.
One of my first days working with nurses, three months ago, one of them told me the quote above: Never lose the sweetness of your character. She told me that some days are so frustrating and that sometimes people can be completely rude and ungrateful, but that is shouldn't keep you from offering a smile and kind words
This Saturday, after over three months of living and working in Roatán, I am heading back to the States. I feel more ready than every to go to nursing school, and I'm excited to say that I'll be starting my classes for my nursing degree at Regis University in May. There have been some very hard, frustrating days. But this advice from my friend will always stick with me. I have also had so many good experiences and learned so much. I am so grateful for all of the amazing people who helped me get here and who I have met during my time here. It's been a great 14 weeks!
This week, I had the pleasure of assisting with a nutrition class in the community of Mud Hole here on the island.
Elizabeth, a Registered Dietitian from Canada, has been here for 3 months conducting research about what foods the locals eat and how they prepare it.
In response to her research, Elizabeth designed a simple, interactive, and free nutrition class for the residents of Mud Hole. Since I speak Spanish, she asked me to come help teach the class.
We chatted about distinguishing between healthy and unhealthy foods, the Plate Method, how to eat healthy on a budget, and the effects of soda on our bodies. We even served a healthy snack of carrot sticks with lime and a pinch of salt. It was a blast!
I'm a big believer that a healthy diet is one of the best ways to prevent disease and promote health in our lives. Props to Elizabeth for all her hard work preparing the class. It was definitely a success! It was great to participate in a class that taught simple changes that can have big impacts -- As a nurse one day, that is definitely what I want to be about! Check out Elizabeth's blog to see all the work and research she's done: http://dietitianinroatan.wordpress.com/
For the last two weeks, doctors who work for the public sector have been on strike here in Honduras. More than 700 doctors from 27 public hospitals around the country are demanding pay they have not received since the earlier this year. The strike was called by the Colegio Médico de Honduras, which is like the association for doctors. They are demanding that these doctors be paid back pay, paid for the time that they have been on strike, and receive an increase in pay.
Last week, the Honduran government declared this strike illegal, saying that the doctors' association did not follow the correct procedures to declare their frustration to the government. The president questioned the ethics of these doctors, saying that those who are suffering most from this strike are the Honduran people who are missing their appointments. The doctors, while agreeing that the Honduran people are absolutely taking a hit by the strike, responded by saying, "We doctors have to eat, too." The strike is complicated; the in's and out's are a bit confusing due to lots of finger pointing and questions about who's to blame, if the government has money to pay, etc. etc. Everyone is clearly frustrated. What I think is important to emphasize is that this is not the first time this has happened here. Apparently, this happens all the time. I work with a doctor who works at the public hospital in the mornings as an emergency room doc (the emergency services are still running, thank goodness) and at Clínica Esperanza in the afternoons. When I asked him about the strike he told me, "We have to go on strike. We have to go on strike any time we want to get paid." He hasn't been paid in over six months for his work at the hospital and that this happens all the time; they go for months without pay, they go on strike, they get paid (usually just their normal salary - no increase for their paycheck being late or anything like that). Some people have been without some or all of their pay for as long as a year. My response when he told me this: WHAT!? How do they live?? He said a lot of doctors build up a ton of credit card debt because that's what they have to live on while they wait. He's lucky enough to have another job in a private clinic, so he can always have some income. Some doctors do the same, work in a public hospital as well as a private one, but some do not.
Early last week the government told the doctors' association that if and when this is resolved, there is no money to give them any increase in pay whatsoever, and that they will not be paid for the days they have been on strike. Oh, by the way, last Tuesday, the Honduran national soccer team tied Jamaica, qualifying them to go to the World Cup in Brazil next summer. It was a crazy night -- we went down into town to watch the celebration. The president of Honduras declared the following day a holiday for everyone who worked in the public sector to celebrate the victory. Hmm... the president can afford to give a vacation day to all public employees, but is unable to pay doctors? Forgive me if I am being naïve, but something doesn't quite add up. As far as my work in the hospital, it has not been as affected. Two weeks ago I showed up to the hospital and opened the clinic, only to find out that all our patients had been turned away under the assumption that the pediatrician that I work with was also on strike. Dra. Cerritos came in at her normal time, frustrated, because she was indeed planning on seeing patients all day -- her salary for her work in the hospital is paid for by Global Healing, the organization that brought me here to the island. Technically, she is "on strike" for her other work in the maternity ward, for which she has not been paid, but since babies aren't going to wait until the strike has ended, she, like the emergency room doctors, has continued with her work. Aside from that first day, and the holiday declared because of the soccer win, we have been able to see kiddos regularly thanks to the consistent pay that Dra. Cerritos receives from Global Healing. Yesterday, doctors agreed to return to work for two weeks after the government agreed to pay themfor their work through June or July (I heard saw a couple of different statements about the exact date). After two weeks they intend to go on strike again if their demands have still not been met.
At least once a day, if not two or three times a day, a parent asks specifically to see Dr. Cerritos. We currently have a doctor here, Dr. Mark, who is doing a rotation and has been here for three weeks. He also sees patients, allowing us to see twice as many a day, but some parents simple say no. They want to be seen by Dr. Cerritos.
I was curious, so I started asking parents why they wait, even if it means waiting an hour or two longer. One woman told me, "Dr. Cerritos know the entire history of my son. She has known him since he was born. When he was born, he and I were both very sick. I nearly died. She has been with us from the very beginning and she will always be my child's doctor". Another mother told me she really believes Dr. Cerritos is a great doctor. She told me she has also been coming to this clinic since her daughter was born. She trusts Dr. Cerritos because she checks everything: "She doesn't just look at my daughter then write a prescription on a piece of paper. She looks all over her body. She makes sure her whole body is healthy." These parents are just like all parents all over the world. They want the best for their kids and they know that a consistent pediatrician is important. Parents always ask me questions about their kids' weight, height, is it normal? We use CDC growth charts to keep track of height and weight for kids as they grow up, and they are a great tool to show parents how their child's growth compares to an average child and at what point they should be concerned, and I always tell them they should bring any concerns up with the doctor. Usually, we see moms or grandmothers bringing in their kids, but every once and while, I see dads, brothers, sisters, aunts and uncles.
We've had a couple very sick kids over the last week, and with them come some very scared, nervous parents and family. One little teeny tiny preemie baby was here, just a couple of weeks old and only 5 pounds. He had a cough and had a lot of difficulty breathing. Dr. Cerritos listened closely and carefully and spent a lot of time with this little baby. It broke my heart to see that little baby and his mother, who looked so sad and scared. She sat there with her baby in her hands and cried. Dr. Cerritos had the baby admitted to the pediatric in-patient unit in the hospital. Another kiddo came in with x-ray results showing a fractured skull. Upon hearing this from the doctor, the sister (who was the one who had brought the little boy) gasped and covered her mouth with shock. She held back her tears as Dr. Cerritos signed a pass for her to take the ferry to the mainland; she needed to go to the hospital in San Pedro Sula, today, as soon as possible, to see a neurosurgeon there, and it was important that they admit the child today. The fear (and sometimes guilt) that comes up for these family members is heartbreaking. They just want their child to be healthy.
Last week a sick baby was in here for a long time with Dr. Cerritos with a very high fever. She was admitted to the hospital. This week, her mom came into the clinic, carrying her baby girl with her. She was beaming. Her baby was doing much better and they had been able to go home. She wanted to come thank Dr. Cerritos for her care and to show off her happy, healthy baby girl.
It is so good to see parents who care about their kids. I'm hoping to find some materials for parents to read while they are waiting those 2-3 hours and make a reading shelf to put in the waiting area. It will (hopefully) include coloring and reading books for kids along with educational materials for parents. If anyone knows how to get a hold of books, magazines, pamphlets, or flyers in Spanish about family health, I'd be interested to hear! I know these parents want the best for their kids; they seek out good pediatricians and stick with them and ask good questions, and better informed parents will have healthier kiddos!
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 goesa su corazón.
