Roatan

One of the ironies of travel blogging is that when we have the most to write about, we generally have the least time to write about it.  It has been an adventure adjusting to Roatan, to say the least!

The first day Jens and I arrived at the hospital, the main hallway (which doubles as the waiting room) was packed from wall to wall—men and women, mothers with sick children, and so on.  Someone else later described walking through here as reminiscent of running the gauntlet.  We had been picked up at the ferry dock the day before by a member of the hospital staff, so it seemed like they had made arrangements for us and would be expecting us the next day.  However, once we arrived and started asking around for who we should talk to and how to get started, nobody seemed to know who we were or why we were there.  A staff member in the main office was explaining that we should leave and return the next day once they could speak with the director.  Fortunately, one of the doctors suddenly made the connection between us and the participants from last year.  He was able to explain who we were, and the pieces started coming together from there.

The hospital is almost easy to miss as you pass by.  While it has over 40 beds and occupies a good amount of space, the yellow concrete easily integrates with the surrounding housing, tiendas, and other structures of Coxen Hole.  Most of the floors, doorways, and halls are discolored and tattered from years of wear and tear.  Many areas of the hospital are without AC, and the departments and rooms that have it use wall units.  The hospital has departments for pediatrics, OBGYN, emergency care, psychology counseling, an OR, along with others I’m bound to overlook.  There is not, however, any intensive care area in the hospital.  Patients pay a symbolic fee that varies but is generally less than $1 US.

Despite the rough start, the experience here has gotten much better.  In these first two weeks, we’ve tinkered with some nebulizers, incubators, and pulse oximeters, and managed to get their only ultrasound machine back into usable condition.  We expected to encounter some biomedical technicians at the hospital, but in essence the two of us became the biomed repair team upon arriving—running off what little training we’ve had. The hospital has a maintenance technician, more for general repairs throughout the hospital (fixing the leak, replacing the lights, etc.) and another who comes sporadically doing similar work, but no staff member dedicates a significant amount of time to repairing or working with medical equipment.  A small room behind pediatrics has become our workshop, more or less.  Every day it feels as though we are becoming more acquainted with how to be effective in the environment and the staff more comfortable of working with us.

We have been fortunate enough to make the connection with a non-profit group at the hospital, Global Healing.  Based out the US, the organization hosts a clinic at the hospital that has been an invaluable resource in getting started at the hospital.  It’s a small clinic, with only 3 staff members.  Two are doctors doing a residency along with a third intern.  They have given us tips on how to be effective in the hospital, introduced us among the various departments, and shared their wireless internet (the only one available in the hospital).

And, of course, Roatan . . . .  which is gorgeous and everything it was cracked up to be.  The beaches and clear waters have an almost bizarre comparison with the developing nature of much of the island. The island is around 30 miles long and never more than 2 miles wide.  The oceanfront is within walking distance of any spot you can stand on throughout the island and the water is as clear as any I’ve seen.  Standing in water up to your neck, you can still look down and see your feet on the sand below.  The two nicest beaches open to the general public are in West End and West Bay.  Our hotel is just outside West End, within walking distance really.  The hotel owner was nice enough to drive us around the first day and stop by the beach during the rounds, so we got a glimpse on day one.  Most of the internet cafes are along the shops at West End, overlooking the beach.  Making Skype calls on a laptop with the oceanfront just a few meters away is definitely new on me.

As for the living quarters, we are not with a homestay this time around but a hotel instead.  Our room consists mainly of two beds and a TV stand.  I was a bit spoiled from the previous month in Costa Rica, when our homestay mother cooked our breakfast and dinner, the outside temperature never left the comfortable range, and our dirty laundry would mysteriously vanish on occasion, only to appear a day or two later folded and clean on the shelf; it wasn’t so different from home, really.  So, of course, Jens and I had to make the adjustment.  It turns out we are very lucky in comparison to our comrades.  While the water is not drinkable on the island, we are fortunate to simply have running water, flushing toilets, laundry facilities in the surrounding area, and less heat than much of mainland Honduras.  Getting updates from the others during a visit last weekend made me realize we are as lucky for the basic accommodations as for the scenery.  Some are doing laundry by hand and only getting running water to shower, while using the shower water to fill buckets for flushing the toilets later.

Of course, I was hoping to share some pictures of the hospital and Roatan, and I have some great ones on my camera.  However, where this camera is, I have no idea.  It might be close to my wallet, personal cell phone, and the EWH cell phone that were also stolen from my backpack.  Yup..... it really happened.

This happened over the past weekend, while our group was out for the night.  All of the other Honduras participants were ready to see what the Roatan hype was all about, and everyone made the weekend visit to the island.  We were out at a bar in West End, which happened to have a pool as well.  While we were all in the pool and swimming, I had left my bag at the edge, containing more than I really needed to get by for the night.  Someone snatched it up, took it behind the building to dig out the valuables and leave the bag and umbrella (They weren’t as interested in that). 

I lost all my debit and credit cards, camera, and two cell phones, but the timing was really a blessing. It happened while others were here, and they helped me make a few phone calls to get things sorted out.  It happened that the following day, one of the trip coordinators made his visit to the hospital.  He was able to purchase a new cell phone and cover some other meals already on the agenda.  My family also managed to get the cards canceled from the US and wire some cash to Honduras from home.  It looks like I will be running off straight cash for the remainder of the trip.

Also, we’ve heard enough warnings about the water and food in Nicaragua and Honduras that the trip would be lacking something if we didn’t get the slightest bit sick.  And I’ve recently gone through my first bout of stomach and digestion upsets.  I’ve had some indigestion and stomach pains for about 4 or 5 days now, topped off with a little diarrhea.  Fortunately, EWH has provided every team with a first aid kit.  I couldn’t help but laugh a little the first time I saw it, not with the standard Neosporin, gauze, alcohol pads, or different-sized band-aids, but instead Immodium, Pepto Bismol, Tums tablets, Rolaids, and Ibuprofen.  I am now, however, very glad to have them!  Jens also went through a bout of the same, although his was shorter-lived.  Let’s hope we have both finished the last of it for the trip.

Thank you for reading, and hopefully I'll get some pictures up next time.

Marching Orders

Vamos a Roatan! Earlier this week every team received a debriefing on our hospitals and travel itineraries, and today I’m leaving for Roatan.  The majority of our group, all of the Nicaragua-bound participants and some heading to Honduras, left in the wee hours of the morning today, around 2AM, but six of us who will be working in the La Ceiba area are heading out early this afternoon.  Roatan is just off the La Ceiba coast if you check out the map in my first blog post.  Last night we took a final snapshot of our household with our host mother, below.  She’s been very good to us throughout.

My hospital partner for the coming weeks is Jens(Yens), another BME student from Aalborg University in Denmark.  He and I seem to have the lengthiest travel itinerary.  We’ll leave with the others early this afternoon to fly over Nicaragua and into El Salvador.  We have a shorter than short layover of about 20 minutes there before flying into La Ceiba, where we’ll stay in a hotel overnight and then hop on a ferry to make the cross to Roatan on Sunday morning. 

I still have a lot of unanswered questions about Honduras--the food, what the living area will be like, what a given workday will be like, etc., but we should learn a lot in the coming days.  Also, I received a few statistics comparing the US and Honduras, and thought I would share them here:

3 Weeks Down

Hola!

This has been a great but awesomely busy week.  Yesterday morning we made our third hospital visit, this time to the main children’s hospital of San José. This was easily the nicest of the three we’ve visited thus far in Costa Rica.  The visit was mainly a tour without the hands-on repair work of the first two visits, which they didn’t seem to have much need for anyway.  Almost all the equipment we saw was nearly new and in excellent condition.

Our second hospital visit was last Friday to a hospital in the city of Turrialba.  Like our trip to San Ramon, we took a tour of their facilities and spent some time with some broken equipment.  I spent the majority of the afternoon with an old mercury sphygmomanometer, in which the mercury in the column seemed to jump up and down during every reading.  We found a couple leaks in the device, the second of which was a crack we noticed a little too late to do much with.

To clean the mercury in the device, we tried a tactic from one of our classes, running the mercury over white notebook paper to catch some of the suspended debris.  Of course, mercury sphygmomanometers are nearly non-existent in the US and are being phased out worldwide because of the element’s toxicity.  We played it safe the entire time, without any personal contact.  This was my first time working with mercury, which is some strange stuff, almost otherworldly—a fluid metal that only reminds me of the terminator in Terminator II who can “flow” back to his original form after an injury.

In Spanish class this week all of us gave presentations on a piece of medical equipment completely in Spanish—Powerpoint, speech, and all.  Mine was Wednesday, and I presented on the pulse oximeter, for measuring pulse and oxygen saturation in the bloodstream.  The device uses a combination of red and infrared light to make these calculations, and explaining how one works is a challenge in plain English, all-the-more so in Spanish.  Fortunately, many of the Spanish words for medical equipment and circuitry have similar spellings.  “Oximeter,” for example, is “oxímetro,” and “infrared light” is “luz infrarroja.”

In these courses, we don’t work for any sort of letter grade or college credit, but simply to be effective next month, and the need for what we’re learning feels much more immediate and tangible than most of what I’ve studied elsewhere.  We’re starting to wrap up some of the more technical, electrically-based labs and shifting focus toward mental preparation for next month with labs on working in the developing world, training across cultural barriers, identifying the needs of the hospital, and so on.  Next week we should get more details on how we’ll be getting to our hospitals, where we’ll be staying, conditions there, etc.

I haven’t described much yet about the local cuisine here, which is distinct but also very different from the spicier Mexican foods, which I had originally suspected to be universal throughout Latin America.  Fruits are ubiquitous.  We have not yet had a meal at our homestay that has not included some sort of fruit-juice drink.  Pineapple, mango, and papaya are the more popular ones.  Papaya was new to me, which is somewhat similar to the mango in color and taste, but has a much softer texture.  

For lunch, without any vehicles, we are mostly limited to what is within walking distance of the school.  A small convenience store and restaurant known as “El Tipico,” only a block from the school, has become somewhat of the default lunch spot.  I've eaten here at least twice a week every week thus far.  For 2,000 Costa Rican colones, or about $4.00 US dollars, we get the meal in the picture below, with fried plantains, chicken or fish, a small salad, and red beans with rice. Costa Rica is very well known for its red bean and rice.  This is probably the flagship staple of the country, even more so than fruits.  Some seem to poke fun at the stereotype.

Also, last weekend we had a great trip to the Manuel Antonio National Park, which contains a national park alongside some of the prettiest beaches in the country.  I was a little surprised to find monkeys swinging in the trees next to the shoreline.  Monkeys and beaches have always held very disparate places in my mind, but by the same token, some of the Costa Ricans seem surprised we don’t have them running around the U.S.  One of them is in the picture below, along with a lizard next to one of park trails.

The waves of the beaches caught me a little by surprise.  This particular beach was on the Pacific Coast of the country, and the waves were a lot stronger than most of what I’m accustomed to in the U.S.  The rip currents are also strong enough that the coast guard heavily patrols the area in a boat just off the shore.  It's great for body surfing or surfing, but probably not the ideal family beach.

It hasn't taken long for me to accumulate more pictures than I can share in blog, so to share more I've created a Flikr page, which can be found here: http://www.flickr.com/photos/tomburkhead/.

I'm looking forward to finishing class this week and sharing more soon.  Thanks for checking in.

hasta luego!