Wednesday, July 18, 2012

Thank you to all!

The 2012 HHA Team

Thank you to all of our friends, families, and donors for your unbelievable support.  The Honduran Health Alliance 2012 team had an extremely successful trip this year, and we could not have achieved what we did without the generosity and kindness of so many.

The official count is in, and we saw 333 women in clinic and reached over 400 women with our charlas on domestic violence, nutrition, birth control, and cervical cancer.  We provided 140 women with a full year's supply of oral contraceptive pills, in addition to administering numerous Depoprovera injections and inserting IUD's.  We performed over 200 pap smears, and provided follow-up care for 20 women who had abnormal pap results or irregularities found on exam. And finally, nearly a third of the women seen during our clinic week were new patients who had never been served by the Honduran Health Alliance before.  

The organization itself and the number of women we are accessing are growing immensely.  The work we are doing in Honduras is truly making a difference.  Over the past ten years, there has been a notable shift in the way these rural women are able to make decisions regarding family planning.  There is now a sense of empowerment and a new-found comfort in prioritizing discussions of maternal health and women's health in general. 

The opportunities for medical students, in terms of clinical training and medical Spanish, are equally impressive.  Each student saw over 50 patients in one week and received an unbelievable crash course in not only patient care, pelvic exams, pap smears, and clinical presentation -- but also in methods of diagnosis (empirically and through microscopy), database entry, and pharmacology.

Please continue to follow the Honduran Health Alliance in the upcoming years.  We are so excited to see how this project will continue to grow!  The remaining supply inventory has been documented and stocked in-country.  But next year's crew will need just as much support and generosity!

Supply queens.
Please stay tuned for photo updates to the website, in addition to a video compilation that is currently in the works!  Thank you again for all of the love and support!!!  That's a wrap for this year!


Friday, July 13, 2012

Results are in!

The HHA team was able to take a much needed break as we were waiting for pap smear results to come back from ASHONPLAFA in Tegucigalpa.  We spent a day or two in the nearby city of Choluteca, where we were able to visit some local markets and stock up on supplies.  Then we headed to Amapala for two days to unwind with some sunshine and some hiking.
The mini vacation was perfect.  Amapala was beautiful... we stayed in a gargoyle themed hotel... which was definitely unique, but we were the only tourists on the island, and that made for a really relaxing time.  It was also really excellent to get to spend more time getting to know eachother.  Up until now we really had been working together as a medical team, and so it was nice to have a chance to just chat and relax.
On Wednesday we came back  to El Corpus, and Thursday morning we all set out to our respective communities to deliver results to the women.  Not only were we able to provide them with fast results, but we also laid out plans and finances to help the women that needed follow up treatment, such as ultrasounds or biopsies.
Tomorrow we are going back to the clinic one final time to do a full day of inventory on supplies.  And then early Sunday morning we hop on a bus to Tegucigalpa, where we will catch our flight back to the U.S.  It really has been an unbelievable trip, and we are so excited about the fantastic amount of experience we have received, all of the excellent work we have accomplished, and the great relationships that have developed within the HHA team. 
We will be home soon!!  Thanks to family and friends for all your thoughts and support!!

Monday, July 9, 2012

More Photos :-)

Hiking through Los Torreros after clinic

Making school desks into exam tables

Women waiting to be seen in Los Torreros

Nearly 90 women were seen on the first day of clinic in Madrigales

Elena (MS4) and Sara (MS2) take a patient history

Shan (MS2) presents to the Attending as Ben (MS4) oversees

The residents with their host family in Los Torreros

Another view from the chicken truck!

Sunday, July 8, 2012

Picture update!!

On our way to clinic in the back of the truck!!

We finally got to a place with internet strong enough to post some pictures!! Photo credit goes to Ingwe! Enjoy! But there are definitely more to come!!

Side angle of the chicken truck.

Traffic on our way to work.

The Public Health Team keeping it organized!

Taking patient histories and playing with babies.

Converted school room in Los Torreros

MS2s and MS4s in Madrigales

Our fantastic Residents and Attending!

Stacy setting up a clinic bed in Madrigales

Medical students reading slides and urinalysis results to come up with a diagnosis

Los Torreros!

We just spent two days in the beautiful village of Los Torreros!  In past years, the HHA team only spent a day in Los Torreros. This year we decided to spend a night there as well so we could have two clinic days in the area.  The ride up the mountain was pretty ridiculous -- though the views were spectacular!

View from the chicken truck.
We rode in the back of the truck with all of our clinic supplies and travel packs for two and a half hours, through Choluteca and up a rocky road to the tiny mountainous village.  As soon as we got there, we set up four clinic rooms and got to work.  Our set-up was in the local schoolhouse, so a couple of the third years can say that they successfully placed IUD's with patients on clinic tables made out of school desks. 

We saw over forty patients that first day, and the community was kind enough to make us a meal for the evening.  At the end of the day we split into a couple of groups and spent the night with several different families -- hanging our hammocks in the living room.  The generosity of the people was just astounding, and we were definitely grateful for a roof over our heads!  
On our way to our host family's house for the night!
The next morning, we got up and had breakfast back at the clinic, and set up for another day.  That day closed out our week of clinic work -- and by the end we had seen over 300 patients in clinic, placed 4 IUD's, completed over 200 pap smears, gave charlas to nearly 400 women, and diagnosed and treated everything from chlamydia and gonorrhea, to women with high-risk pregnancies, to a lady thrown from her horse in front of the clinic!   

On top of that, all of us have had such a phenomenal learning experience -- from taking vitals and history, to performing physical exams independently, to making diagnoses via microscope slides, to formally presenting to residents, to prescribing antibiotics, to keeping incredibly cool in high pressure situations with very limited resources.  We also have created such an excellent working and traveling relationship, and it has made this project so rewarding on many different levels.

Now we are awaiting pap smear results before heading back to our communities later this week!  Stay tuned! 

Thursday, July 5, 2012

Quick check-in… Power is back! (Wednesday Post)

Sorry for the delay in posts!  The power has been out since this past weekend in El Corpus.  The past few posts were written in a Word Document, so please catch up on what we’ve been up to!  We finished our third clinic day, and we now have seen women from Espaveles, Guanacaste, and Papalon.  The last two days were definitely calmer than the first – we saw fifty to sixty women each day, as opposed to the ninety women on the first day!

Since the electricity was gone for the first few days, we have been spending post-clinic time updating the databases on the computers.  We stuck to paper medical records the first two days, so we have a good deal to catch up on, but spirits are still wonderfully high! 

Thursday should be another crazy day, with TWO communities to see instead of one.  On top of that, it has been a very dry winter here, so women that usually cannot make the journey due to the height of a river (between their village and Madrigales) will most likely be able to make the trip this year.  We’re ready for another big day!  And then on Friday we head to Los Torreros to set up another clinic for two days – to access the women that are further away.  We’ll check back in after Los Torreros!

And HAPPY FOURTH OF JULY!!! We are off to shoot off some fireworks!! 

Sparklers for the Fourth!!

12 hours + 90 women = First day of Clinic! (Monday Post)

·      --  The power is out on the mountain, and has been for a few days, and could be for the majority of the week.
·      --  Because the power is out, our clinic had no electricity.
·      --   Because the clinic had no electricity, six young medical students learned how to do full pelvic exams and pap smears using only headlamps for light.
·      --   The HHA team performed headlamp-exams and pap smears on nearly NINETY women on the first day!! (That’s three times the normal amount!)

So yes, the first clinic day was a success.  We were serving the Espaveles community, and we knew that there would be a good amount of people due to the great turnout at their charlas.  But I don’t think anything prepared us for turning the corner in our chicken-truck and seeing a line of at least fifty women at 7:30AM waiting to be checked in… some of whom had been lined up since 5AM.

The line never seemed to get shorter throughout the day.  We hit the ground running, beginning exams before 8AM and didn’t get back to El Corpus until well after sunset.  There has never been a first day that took this long in the history of HHA!  We told the women at the beginning of the day that we would stay until every single woman had been seen, and we kept our promise. 

We were split into pairs again – one MS2 with one MS4 – and each pair took one patient at a time.  Together they would do a full history, take vitals, listen to the heart and lung, isolate the chief complaint, determine which tests were needed, and prep the patient for a pelvic exam in one of our four clinic rooms.  The pair would then find an available resident and formally present their case.  If the resident signed off on their plan, she would then enter the clinic room and oversee the students as they performed a pelvic exam, bimanual exam, pap smear, and/or wet prep.  When they were through, they would assess the results of the exam and wet prep and come up with a treatment plan.  One student would run to our make-shift pharmacy, while the other cleaned and prepped the clinic room for another patient.  Pap smears were secured (with hairspray) on slides and logged to be sent to ASHONPLAFA in Choluteca to be read.  The student pair would then have a final meeting with the patient to tell them the results and advise them on any medication or follow up they might need.  Pap smear results will be expedited and then we will personally deliver the results to our villages next week—meeting individually with each woman.    

For a first day, in the dark, with three times as many patients as expected, we fared surprisingly well.  Every patient was seen, all supplies were restocked for tomorrow, all patients were properly examined and counseled, and all slides for Pap smears were documented and recorded.  Our leaders spent the day sterilizing speculums and restocking the rooms with instruments when needed.  KUDOS to Megan and Rachel for taking the tough jobs and keeping everything super organized and flowing smoothly.  The public health students worked “Intake” and logged (and placated) every single patient that walked through our door—keeping everything in order and being incredibly patient and upbeat and resourceful.  We also have three wonderful residents/attendings who got into town under the cover of darkness (literally) on Sunday, and spent all day today overseeing the rising second and fourth year medical students and answering all of our questions.  I’m sure it was an extremely long day for them as well, but a MAJOR shout-out goes to Rupal, Ingwe, and Stacy who were such professionals all day, and absolutely amazing leaders and role models to all of us.  THANK YOU.

And last but not least, all of the medical students that had been waiting to get their hands dirty for quite a while – we certainly jumped right into it.  And we definitely are impressed with the amount that we learned in a single day, but I think the best part about it was the amazing energy put forth.  It was a crazy day, and everybody had a fantastic attitude throughout. 

Go heels.

Charlas in the Villages! (Sunday Post)

This past Thursday through Sunday we split up into pairs and dispersed to six different rural villages surrounding the little town of El Corpus.  The purpose was to recruit women in these rural areas to come to our clinic in Madrigales this upcoming week.  Our leaders coordinated with the “promontores” (or health promoters) in the villages beforehand, to make sure we were set with lodging and had a little venue to give our charlas over the three days.  By word of mouth, most of the women in the areas and in the surrounding villages knew to make their way to our talks in the mornings where they would hear “charlas” about nutrition, domestic violence, birth control methods, sexually transmitted infections, and cervical cancer.

The six groups reached between fifty and ninety women per community!  Charlas were usually given over a two-to-three hour period in the mornings—beginning around 10AM in some communities to give the women time to walk from several villages over.  Half of the charlas were given the first morning, and the other half were given the second morning, for the most part.  There were several communities where the groups of women were different each day, and the HHA students in those areas were encouraged to repeat their talks up to three or four times – especially the STI/Cervical Cancer charla, which was revised this year, and the information was new and extremely helpful.

Each group received a packet of supplies, posters, and materials which could be made into helpful guides and interactive tools during the presentations.  Everything from a detailed list of the efficacy of birth control methods, to anatomical posters, to the standard condom-and-banana combination was brought to these villages in our backpacks – via horse, or, bus, or hike, or all three!  The talks were all very well-received, and there was a significant interest in the women’s clinic for the upcoming week.  Each community was assigned a specific day to attend the clinic, and those that attended the charlas received a ticket to be able to be among the first women seen.  This organization would allow for a more distributed patient flow, and it would make the distribution of results easier if different villages were seen on different days.

Our journeys to the villages varied greatly, as did all of our accommodations and environments.  Every single HHA student definitely had a unique and memorable experience no matter where they were placed, and every group game back arguing that their location must certainly have been the most beautiful, with the greatest people.  Suffice it to say that everyone is very proud and excited to see the women they spoke with at our clinic on their respective days!

Some crazy tales were told—of sleeping in hammocks, long and breathtaking hikes, uncomfortable saddles, epic makeshift-soccer matches, challenging shower situations, rambunctious barn animals, possibly-rabid bats, escaping chickens, emergency ciproflaxin, beautiful sunsets, and definitely some fantastic relationships with both the women of the village and the ever-energetic children. :-)