Friday, May 2, 2014

Honduras Part II

Day Five: Monday, March 17th

We walked to a school that was about 15 minutes away from where we were staying. The school day is split into two halves. The first half of the day is for kids that live within a 2 hour walking radius. They come in the morning so they will have plenty of time to get home before it gets dark. The second half of the day is for students who live within the small town. The school only goes up to about 8th grade so most of the students were from 11-15. But there were a few that were older since they would take breaks from school to help out at home or some would have babies and then return. The oldest we saw was 22.

The Entrance
The gym in the middle with classrooms and trees surrounding

We had two rooms set up for our screening day. One room had height, weight, and blood pressure screenings. The other room was where we did an adolescent health screening or interview. The group of students from the US started with height, weight, and blood pressure. We knew we would be slow at doing the health screening since we did not speak spanish. It was pretty chaotic at first because everyone had their own vision of how the screening was going to work, but we worked it out and got a good system going. We actually were going faster than the other group so everyone but my professor Karin, Gabby, and me went to help out with the adolescent screenings. We only had one translator between the three of us. I got small sentences in Spanish down so I could do my screening without a translator. However sometimes the students stared blankly at me and that is when I knew I butchered it. 


The room where we did our interviews
The group of students
Next I went up to the adolescent health screening room and did some interviews. Here are some questions we asked: 
  • How often do you eat foods such as iron, calcium, chips, and pop? We talked about the importance of eating healthy and avoiding chips and pop. 
  • How often do you exercise or watch TV? This was not a problem at all for them since they usually had to walk so far to get to school and almost all the kids said they played soccer when I asked if they had a hobby. 
  • We touched on sexual health and the importance of abstinence at their age. We also talked to girls about their menstrual cycle to make sure everything was normal. 
  • Do you have stress in your life? Are you feeling sad more than normal? Do you have someone you can talk to when you are stressed or sad? There was a few that were sad because their dad left to go to the United States to work and send back money for the family. Most were coping well with it but there was one boy that seemed to be struggling so we referred him to the clinic.
  • We touched on Drugs and Alcohol and the importance of staying away from them and trying not to be associated with the groups that are involved with them.
In the middle of all that we walked home had some lunch and then went back for the second half. My ears started hurting from putting my stethoscope in my ears from all the blood pressures I did. Not to mention my butt hurt from sitting all day. Overall we did 191 screenings from 8am to 4pm. We had a couple more days planned to go back for more screenings, but we were so efficient that we did all of them and did not have to go back. At the end we got to watch them do a square dance. 



That night the power went out for about 10 minutes. Luckily it came back on so we could take our showers for the night and then off to bed after a long day. 

Day Six: Tuesday, March 18th

It was time to start home visits today. So we jumped into the back of the trucks again to head to another small town. I remember riding in the back of the truck with the dirt flying everywhere, we were all smiling and laughing so by the end of the hour ride we had a nice layer of dirt on our teeth. 


Side-note: When we arrived there was a line up of dogs getting ready to get their vacancies. The dogs here run around like strays and are just skin and bones. We had a dog back at our clinic named Josue. He actually has some meat on his bones since the clinic takes care of him. He was not originally the clinics but Becca, one of our translators, started taking care of it. Apparently he has been through a lot. He has been hit by a car a couple times, has fleas, an ear infection, rotten teeth, and partially blind in one eye. Every once in awhile he would randomly yelp but there was no one around him. I think he would just scratch his ear and hurt himself. Before we went on this trip our teachers said we weren't  allowed to touch any dogs. So we just air petted Josue.

Josue
Air petting Josue

The first house we stopped at was for a 102 year old woman. I was really surprised to see someone that old there since the life expectancy in Honduras is a lot lower than ours in the US and in the US we do not hear of people being that old too often. When we got there the family just swarmed around us to listen to what we had to say. There was probably about 10 of them. We decided to go around and take everyone's blood pressures. It was like a mini clinic with all of us in our own corners teaching about blood pressures. During all this commotion, the next door neighbor, who was 99 years old, walked over. I worked with my professor, Marti, and another nursing student, Tiffany, to assess the neighbor. She said that she was taking Lasix for blood pressure which was odd to me since Lasix is usually something used to get rid of fluids not for blood pressure, but it still made sense. However dehydration was such a big deal in Honduras I was still confused. When we did a Head to Toe assessment she had crackles in her lungs which indicated fluid build up. She also said she had chest pain while she walked and slept in a recliner at night since it was easier to breath.  We figured out she had congestive heart failure. It felt so cool putting all those puzzle pieces together. Usually we just have a background of our patients in the US and know what chronic diseases they have. But figuring it out ourselves felt awesome.

How the houses looked
There was a bunch of animals everywhere

The next house we went to I could not tell you anything that was going on with the elderly patient we saw because I was so distracted by all the little kids running around and what looked like 6 week old puppies. So cute. All I wanted to do was pet the dogs, but we weren't aloud to touch any dogs. 

A Honduras dish one house was making
Taking a break between home visits
We got back to our place around 2:30 pm and had the rest of the day to relax. We washed our clothes out in the sinks since we were running out of clean clothes. Since we sweat so much every day from how hot it is there, our clothes were pretty gross. Then we played a card game called Egyptian rat slap. I got out right away but slapped my way back in and won. No big deal. Then I taught them the cup game but dinner was ready so we never actually got to play. That night we had Hamburgers and Fries, which didn't taste exactly right but it was still good. Then we just wrote in our journals, debriefed about the day, and went to bed. 

Day Seven: Wednesday, March 19th

We started out our day driving an hour and a half to another small village where we would do some more home visits. We parked at a school where the students from Honduras were going to do something. The students from the US set out our journey to a home visit. It was about a half hour walk to see a women who was 8 months pregnant. Turns out she wasn't even home. Her kids said she went down to the river to shovel sand in order to make some money... at 8 months pregnant. So then we walked a half hour back to where we were originally and then 15 more minutes to the next house. We still got to walk along the mountainside road which we have not been able to do yet. So we got some nice pictures of us. 


The next house was a 15 year old girl who was a couple months pregnant. We did a lot of teaching about a healthy pregnancy, what foods she should be eating while pregnant, and some exercises. The next house we went to was an 86 year old that walked around with a walking stick and was hunched over at the hips. He made us sit in the nice chairs while he sat in this small stool that was basically on the ground. He said that he was on a "death diet" because his doctor said he was not allowed to eat anything good. When we left he thanked God that we came and prayed protection over our travels. 

We then took a 2 hour truck ride to a restaurant  where the clinic was going to buy us some food. It was at the hottest time of the day and the sun was very intense. Most of us got burnt from that trip. The restaurant was super cute and nice. It had a spiral staircase to go upstairs where they had a deck area with hammocks. We got "Licuados" which was a strawberry milkshake. Super good! The prices there were super cheap. It was about 1-2 dollars for a meal.


Then we went on a walk through the town of Camasca. We walked by a police station and learned that they are not open on Sundays. We stopped by a bilingual school that the clinic, Hombro a Hombro, started. It was super small with just two classrooms but it was just starting up and they were still building. There were kindergardeners singing (or screaming) to a song. Then they stopped and practiced their english by saying "Good Afternoon". 

A motor taxi we found. These were becoming popular there.
Gabby, Tiffany, Steph, and Me

When we got back we went to the local store and got some more snacks. Micheal got a fun sized bag of  chips (churros in spanish). It had 550 mg of salt per serving (21% of daily value). There was 7 servings in that fun sized bag. Which meant that was 3,500 mg or 140% or your daily value of salt. Crazy. No wonder why we were teaching so much about laying off the churros. That's pretty much it for that day. 

Day Eight: Thursday, March 20th

We set off to another small town in the morning. This time on the truck ride over we brought my wireless speakers with and listened to some music. It was really cool and fun driving through the mountainside while blaring music. Unfortunately my speakers did not last the whole ride. We tried improvising by singing our own songs, but for some reason we only knew the beginning of most songs. We got desperate and went to disney songs, which I sadly know more than the other songs. We were all also burnt from the day before so we were coving up. For some reason people looked at us funny.

 

Once we arrived at our destination we were at a very very small clinic that had two exam rooms and then a small waiting room. Pregnant women were coming in for their check ups. While the 5 Honduras students started with check ups, the 5 students from the US started doing teachings in the waiting room. We taught about nutrition, exercises, warning signs during pregnancy, and breast feeding. The moms were very quite and did not engage much but you could tell they were still listening. When we started doing our exams it was difficult because the clinic had a process and paperwork that we did not understand. It took us 4 times as long to see a patient then the other students because they knew the process. Eventually we just gave up and let them do everyone while we went out to some more home visits. 

One house we went to was this man in his 80's that ran around trying to find chairs for everyone. It took probably 10 minutes for us to make him sit down because he wanted to make sure everyone had a chair. During our exam we figured out that he would get hypoglycemic during the day because he would have a high sugar breakfast and then get dizzy later on in the day when the sugar left his system. He also had a scar from when he was a kid that he wrapped with a bandana. It was actually doing more harm than good by wrapping his foot so we told him maybe he should not wear it anymore. He took it right to the heart, took that bandana off, and threw it into the dirt. When we were done he started crying because he appreciated us coming so much. He said it was like God himself came down to talk to him. He insisted that we have some coke (which is really big in Honduras) but they washed their cups in the water that was not sanitized so we had to decline. He took his wallet out and we thought he was going to try to pay us but he pulled out a $20 US bill and smartly said "I wonder where I could have gotten this from." He was super cute. 

We went back to the clinic to have a PB&J sandwich then off to the next home visit. At the next house there was a turkey that was being slightly aggressive towards us. He would puff up his chest and run at us but the owners would shoe it away. They said that the turkey does not like the color red. We look over at Stephanie who is wearing bright red scrub pants, a scrub top with some red in it, and bright red backpack. We found the problem. The wife of the patient ran around with a broom yelling and screaming at the turkey with such a vicious face. Then she turned and looked at us with a shy yet big smile and said "De nada". 

Steph drinking water from a bag which is normal in Honduras
The Turkey that didn't like Steph
After the visits we went back home. We tried visiting the internet cafe that was in town but it was closed. We went to a store where I bought a 5 bags of chips since they were only 15 cents each. As soon as we walked out with all of our chips, the students that we had previously screened came back from a field trip. You know the ones we told not to buy chips while we all had our hands full of them. We quickly shoved them in our bags. Then we went back had dinner, talked about our plan for the next day, then off to bed.  

I know this was really long, but would you believe me if I told you I did not even put everything in here that I wrote in my Journal? Well there is one more part to come which will wrap up the trip!


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