Happy Holidays from the HHA family!

The HHA first-years took a much-needed break from studying the cranial nerves to kick off our fundraising campaign for the 2013 trip.  We spent an evening sharing a potluck dinner and stuffing envelopes for family, friends and past donors. After winter break, we will take a class with public health students in which we will prepare our health education talks, coordinate trip logistics and learn about the cultural context of the communities we will engage with. We have big shoes to fill, and are looking forward to strengthening the relationship that UNC has built with these Honduran communities for the past decade! 

We appreciate all of your support! If you would like to make a donation, please visit: http://tinyurl.com/HHAUNC

Potluck and Holiday Card Fundraiser!

HHA first-years!

A little bit about us:

Front Row (starting from the left):

Jordana (Jordy) Laks graduated from Tufts University in 2012, majoring in Biology and Community Health. As a Spanish-speaker with experience leading medical service trips in Guatemala, she is excited to return to Central America bringing new medical skills. Through HHA, Jordy is looking forward to learning about the health care system in Honduras and collaborating with fellow medical and public health students.

Desiree Coutinho graduated from Furman University in 2010 with a major in Biology and Latin American studies. Before starting at UNC she volunteered in a hospital in the Dominican Republic for a year and spent another year at a small non-profit.

Back Row (starting from the left):

Liza Lichtenfled took a circuitous route to medicine. She studied history and economics at Dartmouth College, worked for a writer in Chicago, spent a handful of years conducting urban planning research in Spain, and apprenticed in a bakery in Chile—all before pursuing medical school.   Liza has an irreverent and generous spirit and is quick to crack a smile. Aside from her studies, she can bake a darn good chocolate cake and run 6 miles slowly.  She is thrilled to be participating in HHA. 

Tyler Warmack graduated from UNC with a degree in Economics and then joined the Peace Corps in Ecuador for two years. After the Peace Corps he finished his medical school prerequisites and is now excited to not only be in medical school, but also to be returning to Latin America with HHA! 

Kyle Roedersheimer graduated in 2009 from Clemson University and for the past three years taught high school Chemistry in inner city Charlotte, NC. He is passionate about helping underserved communities and is very excited for the trip to Honduras. That coupled with his love for the outdoors makes this a perfect experience for him this summer!

Jackie Lee graduated from UNC Chapel as a Biology major in May 2012. As an undergraduate she studied Spanish and is looking forward to using and practicing her Spanish language skills to deliver medical care in Honduras a member of HHA!

Christina Olson graduated from UNC Chapel Hill with a major in Global Studies in May 2012. She has served as an interpreter for SHAC clinic for a number of years and has worked on public health projects in Malawi and Mexico. She is excited for the opportunity to work to engage with women’s health, utilize her Spanish and work with such an inspiring group of fellow students!

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!

..."Cheque."

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!!

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!

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! 

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)

Highlights:

·      --  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. :-) 

Setting up the clinic in Madrigales

Yesterday we arrived in El Corpus, which will be our home base for the next week and a half.  We left Tegucigalpa yesterday morning in a giant school bus and began the trek down south.  The views during the ride were absolutely gorgeous, and we took the four hours to grab some great photos (coming later) and to go over our charla materials.

The first year medical students spent the spring semester learning about and presenting several charlas, which are health talks that we will be giving to the women in the villages.  Erin and Marissa, our two public health students, were kind enough to put together a final packet of the most recent edits.  They pulled together the supplies that we will need to present the charlas, and we received the information packets on the bus.  We also received our pairings for both the El Corpus homestays and the villages.  This worked out really well, because we were able to hash out our plans and ideas on the bus ride, in addition to reading over the big presentation packet.

We stopped in Choluteca for lunch and supplies.  We were able to have our first real taste of Honduran cuisine with assortments of rice with chicken or fish -- and some delicious juices --mango, papaya, or horchata.  We also took some time to grab any last minute snacks or water, since we will be having the rest of our meals in the homestays.

About an hour past Choluteca, starting an ascent into the mountains, we reached El Corpus -- which is a tiny, cobblestone town that is (we just found out) actually known for its goldmining (interesting!). The fifteen of us split up to stay with five different host families, all within very close walking distance.  We had dinner with the families and got to know the area a bit before coming back to our meeting point -- the house of our coordinator, Juana, where the four leaders are staying.  We spent an hour or two going over the plans for the next couple of days and touching base about our homestays.  Everyone was in great spirits, and it was really starting to feel real!  To add to the energy, we found out that it was Juana´s birthday! And we all had a dance party (led by her five year old daughter) and shared some excellent birthday cake.  We were off to a memorable start!

This morning, we got up early and packed a chicken truck (yep) with alll of our medical supplies and journeyed up the mountain to a small village called Madrigales -- where our clinic will take place next week. Riding in the back of the pick-up looking out over the mountains was pretty incredible, and only a few bruises and branches-to-the-face were endured. :-) After almost an hour journey, we arrived in Madrigales at a community center of sorts, where we spent all morning doing inventory on supplies -- THANK YOU AGAIN TO ALL OF OUR FANTASTIC DONORS -- and thankfully we had everything we needed.  We then set up the four clinic rooms, a makeshift lab, a makeshift pharmacy, and a sterilization center.  Everything from examination tables, to stirrups, to sterilized speculums -- had to be fashioned according to the materials we were able to transport.  Some excellent pictures and videos will be posted later that show our creativity!  We made sure everything was set and ready for next week, and took note of any final supplies we may need.

Our families were kind enough to pack us a lunch for the road, so after about four hours of set-up, we broke for lunch.  The rest of the afternoon was spent presenting charlas to eachother to make sure all of us are prepared for what is in store next.

Tomorrow we head out in pairs to five different villages, where we will spend three days presenting our materials and recruiting women to come to our clinic.  We are off to such a strong start, and we are looking forward to the days to come!

We will check back in on Sunday to let you know how it went!

Arrived in Tegucigalpa!

Successful so far!!  All fifteen of us -- along with our personal baggage and our massive amounts of supplies -- made it to Honduras without a hitch!  We are staying in a beautiful little hotel in Tegucigalpa -- with a lovely owner, a gorgeous view of the city, and an internet connection!

View from our hotel
Tegucigalpa

The group flying out of RDU via Miami had some minor delays in Florida, but it actually put us at the perfect arrival time, so that we arrived within thirty minutes of the other travelers coming from elsewhere.  Once we all convened, we exchanged money and grabbed some lunch at the airport, and we were able to share a couple of vans to get to our hotel.

The plan for today is to stay in the hotel and relax and stay safe.  We will be going over the plans for the next few days, as well as distributing some money and supplies between us.  Also -- most importantly -- we will be getting to know eachother over a pizza dinner this evening.  There are three men and twelve women; and we make up a total of two public health students, six rising MS2 students, and seven rising MS4 students (including our two leaders).  The residents and attendings will be joining us next week for the clinic.

Everybody is definitely excited for what the next few weeks have in store, but we are glad to have a day of relaxation and preparation before we begin.  Stay tuned!

Ready to go!

Bags are packed and supplies are all accounted for!!  We depart for Honduras early tomorrow morning and will be in Tegucigalpa by early afternoon!  Some group members are already on their way now, after using the past few weeks of summer break to spend some time in Central or South America to brush up on Spanish and to get to know the culture.  We have a fantastic group of public health students, and rising fourth-year and second-year medical students who will be making their way down.  We will be met later by the residents and attendings who will bring the last bit of supplies.

We will be spending the first night in Tegucigalpa and then on Tuesday we will take a bus to El Corpus, near the city of Choluteca.  Our work takes place in the southeastern part of Honduras near the border with Nicaragua.

El Corpus is marked, just west of Choluteca.

 Tuesday and Wednesday we be setting up in El Corpus and preparing charlas, which we will give to the women in the villages later in the week.  Hopefully we will get a chance to update you as we go along!  We have a group member documenting the day-to-day adventures and projects that we undertake, and we will update this blog whenever we have internet access.  We also will be taking pictures and recording flip-cam videos, and those albums will be available on our website shortly after we return.

Wish us luck and safe travels!!    

Thank you to our supply donors!!!

This post is to thank those who have contributed medical supplies for our upcoming trip.  We also have many generous people who donated money via our Christmas card campaign -- and that "thank you" list will be posted next.  The money that was donated will go directly to follow-up care for women needing treatment for any abnormal pap smears and further medical needs.  The medical supplies are being directly transported down to Honduras for us to distribute to the women and use to fully stock and run the clinics in Madrigales and Los Torreros.  So THANK YOU so much to the following generous supply donors!  We couldn't have done it without you!

UNC Chapel Hill Campus Health Services
Dr. Melanie Mintzer with Generations Family Practice
Sam Hawes of the Office of International Activities at UNC School of Medicine
MedWorld
Adam&Eve
Moses Cone Hospital
Bruce Alexander
Mary Simpkins

THANK YOU!

In the final month before our trip, we are hoping to gather just a few more items! Please email hha.leader@gmail.com if you or anyone you may know would be able to donate any of the following supplies!

200 urinalysis strips

95 cytobrushes

55 spatulas

3 chucks

2 metal sounds

 

Again, thank you to those who have helped us so far!  Please continue to follow us for more updates.

HHA Potluck and Orientation

Last week, all of the HHA participants got together to formally meet, distribute supplies, and receive our assignments for our community locations.  The mix of rising MS2's, rising MS4's, public health students, and attendings/residents made for an excellent group of people and a fantastic meal!

Food and conversation!

 The medical supplies that we have been gathering over the past few months were divided into five different suitcases for HHA volunteers to check through as baggage to Honduras.  We also received the details on the communities we will be serving in-country as well.

The first two days will be spent preparing our "charlas" -- our health education talks that we will present to the women.  The following three days, we split into pairs and hike, bus, or ride horses to rural communities where we will stay for several nights in hammocks and work with the local women during the day.  The charlas are given in an effort to both educate the women of the community on cervical cancer, reproductive health, birth control methods, etcetera.  We then encourage the women to come down to Madrigales, where we will hold a four-day clinic--offering pap smears, general pelvic exams, IUD placements, and additional women's health counseling services.

The community assignments include the following areas: Guasaule, Guanacaste, Papalon, Espaveles, Portreritos, and Los Torreros.  Los Torreros is the furthest away from the town of Madrigales, and in past years the women have had a challenging time making their way down to the clinic.  This year we will be holding an additional two-day clinic in Los Torreros so that all the women who live further away will have similar access to the medical services.

Everyone is getting so excited! We are exactly one month out! Woohoo! Stay tuned! 
    

Follow us! Summer 2012

Welcome!  The first-year students at the University of North Carolina at Chapel Hill School of Medicine are beginning a blog to keep family, friends, and donors up-to-date on the projects that the Honduran Health Alliance will be completing this year!  Every summer a group of students are selected to travel with several physicians, public health students, and third-year medical students to El Corpus and the surrounding villages, near the southern town of Choluteca.  For three weeks, we will work to give health-education talks, run clinics, and provide testing and follow-up care for the women of the community. 

The Honduran Health Alliance is an international alliance of organizations working together in the areas of education, capacity building, health, and development. Program partners currently focus their efforts on women's reproductive health and community development through annual women's health education and cervical cancer screening projects.  For more information on who we are and how to get involved, please check out our website: www.med.unc.edu/hha   

This year, our trip will take place from June 25th to July 15th, and as we wind down our first year of medical school -- we are putting together the final plans for our projects and supplies.  Stay tuned for more details on the preparation process, on who we are as a team, on our generous donors and volunteers, and finally a day-by-day account of our work in Honduras!