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!!