Adventures in San Manuel

The view from 6600 ft. San Sebastian, outside of San Manuel

I spent the last two weeks in probably the most peaceful, quaint village that I have spent time in thus far, San Manuel, Colohete. My trusty bodyguard, Richard, and I drove the 2.5 hours there and stayed so that I could work in their women's clinic, and learn about all of the other aspects of their health system. I DID miss hot water, and actually drinking water since there didn't seem to be much for sale there, and I ate enough corn tortillas to fill me up for the next two months, but other than that it was an incredible experience. The weather is BEAUTIFUL, and even though we got shamelessly stared at every minute of every day, the people were very friendly. (They were definitely not used to seeing gringos.) I'm pretty sure we know the majority of the population of San Manuel, and some of the surrounding villages as well. 

San Manuel is basically the headquarters of the "health community" of that area. There are 4 "municipalities" and 15 health communities, which means there are 15 villages whose clinics are supervised by the doctors and licensiadas (registered nurses) that I was working with. Some have "cesar" clinics and others have "cesamo" clinics. Cesars, I learned, are attended solely by a nurse and are in very small villages, while cesamos are attended by physicians as well. San Manuel is the only village in that area with a labor and delivery/women's clinic. 

Auditing Honduran charts with Licensiadas Gloria (right) and Katherine (middle)

I learned a LOT in those two weeks, and was able to work in so many different areas. Everyone was so very friendly and SO patient with my Spanish (which, I believe, got a lot better during those two weeks)! I went with the other two licensiadas to audit charts and supervise, I worked in the clinics doing exams on pregnant women and gave consults when it was needed, we drove emergencies to the hospital, I worked in the labor and delivery, and I went with them to two of their brigade/health fairs that they hold once a year in each community... You name it, pretty much I was able to do it. They were so accommodating and wonderful, I learned a lot, and loved almost every minute of those two weeks.

I've REALLY learned to never say never. God must have been having quite a laugh when I said things like, "I will NEVER do labor and delivery. Gross," or, "I will never do pediatrics. I don't like children that much." I wonder what God was thinking when I was trying to give away my patients in my labor and delivery clinicals during nursing school.. Those things make up at least 80% of what I'm doing now. I learn something every day, and I really am enjoying doing a little bit of everything. I must say, though, that labor and delivery is still not my favorite area of nursing. 

Auxiliary nurse, Lorvi, Licensiadas Gloria and Katherine, on our way out to the Cesar in Corante to do some supervising.

El Porvenir

Cristina working on some paperwork. The folders are the charts.

This week I worked in the clinic in a village called El Porvenir with the auxiliary nurse (like an LPN in the US), Pati, and the nursing student, Cristina. 

There are no doctors at this clinic, so when Pati comes across something she is unsure of or when a consult with a doctor is necessary, she writes a referral to a clinic in another village. In El Porvenir she can give away things like Tylenol, vitamins, parasite medications, and antibiotics. She can do breathing treatments when she has the medications, which is not all of the time. 

Pati checking her first blood sugar.

I really enjoyed spending the week there. Pati and I shared a lot of knowledge. She taught me how to do stitches, and I taught her how to take blood sugars with the glucometers we donated. She taught me about how they do pre-natal care, and I taught her some "basic" information that we learned in nursing school. 

I'm pretty sure we took everyone in the entire village's blood sugar. We did a LOT of teaching about Diabetes, and I also was able to teach Pati some pretty handy facts that she didn't know. We also talked a lot about family planning. 

Next week: "camping out" in San Manuel... Hope Richard the bodyguard and I can communicate with everyone:)

Cindy

A year ago, Phil and Donna met a little girl named Cindy Mendez. She lives with her siblings in Choluteca, and has never been very mobile. She was born with clubbed feet, and had "corrective surgery" when she was very young. Phil began visiting the 11 yr old Cindy to evaluate her case.

Cindy's ankles had wounds that were so open and deep that you could see clear to the bone. She spent most of her time sitting in the house watching and playing with her nephews. It was arranged for Cindy to go to Shriner's Hospital in Tampa, Florida, with the Waldrons. Within minutes during her first consultation, the physician told her she had osteomyelitis and both of her legs needed to be amputated, or the infection would eventually kill her.

It's been a year now since her surgery. She has been in the U.S. living with a family in Tampa for her recovery process. She was able to go to school there, and now speaks English just like a little gringa. Cindy is about to be 13 years old, and is one of the happiest, funniest, most light-hearted little girls I've ever met. She has such an incredible attitude, and is a good reminder that I have nothing to complain about!

Last week, Phil and Donna returned to Tampa to bring Cindy home. Laura and I met them in San Pedro Sula to take her home with them. I was able to do some teaching with Cindy's family about self-catheterization, her prostheses, etc., and we were able to discuss her education with the director of the school there. She is great with the prostheses, and is going to be able to keep up with the other kids for the first time in her life!

Donna, Cindy, and the lion.

She was SO excited to go home and see her family! It was such a happy day for everyone. Although, it seemed like it was going to take her a day or two to get used to being without air conditioning again!

Visitors

Well, this has been a pretty crazy month. Wonderful, but crazy!

First, my family came to visit for some international "Miller time." We had a really great week getting to catch up and spend time together. The Stacy family and I took them to the Mayan ruins, they got to see a lot of Honduras, and all sorts of other things. Only once did I think that I lost them when I left them at a coffee shop while I went to the hospital... For the record, they were not lost.


The next week, Paul and Leah came to stay with us! MiMi came to visit as well and stayed with the Stacy's. It was so great to have to of my best friends here and to be able to show them around. They helped a LOT in organizing my new pharmacy (since we're moving offices), and they also helped a lot with Alejandro since we were taking care of him for most of the week. 

The week Paul and Leah were here was crazy. I was visiting patients in two different hospitals here, and even stayed there one night. Paul put together some shelves, we organized, we made some first aid kits for some schools, etc. 

I was sad to see all of our visitors go, but it was SO great to have them all here! I'm already excited to see them again, and everyone else, in November when I come home for a visit!

I need new heavy-box carriers.

Well, the summer is officially over here. It was busy, fun, and occasionally a tad stressful; full of laughter, new experiences, and not quite enough sleep. God has blessed us tremendously. It seems that the end of the summer was made official yesterday when the interns left with our last group, and we have a couple of other friends that are leaving Santa Rosa today. I'm really going to miss them all, and not just because I won't have the interns to carry around my heavy things anymore.. Although that is one of the reasons..

I hate saying goodbye, and I really don’t like change. I am so glad that I’ve had the chance to get to know everyone. Because of my faith, I believe that I will see these friends again; if not during this lifetime, then after, and that is something to be thankful for. Now, we all have the chance to catch up on sleep, and it's time to get back into more of a routine.

These verses came to mind while saying goodbye to everyone over the last couple of days. It's maybe a little long, but I'm including the whole thing.

“I thank my God every time I remember you. In all my prayers for all of you, I always pray with joy because of your partnership in the gospel from the first day until now, being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.
It is right for me to feel this way about all of you, since I have you in my heart; for whether I am in chains or defending and confirming the gospel, all of you share in God’s grace with me. God can testify how I long for all of you with the affection of Christ Jesus.
And this is my prayer: that your love may abound more and more in knowledge and depth of insight, so that you may be able to discern what is best and may be pure and blameless until the day of Christ, filled with the fruit of righteousness that comes through Jesus Christ-to the glory and praise of God.”
Philippians 1:3-11 

Research

Seeing as this week we have a construction group and I’m staying as uninvolved as possible (mostly joking), this week has begun what I like to call my “research phase.” I’ve known all along that my post-brigade-season role will be different than it has been while we’ve had groups every week. There is so much need in so many different places that I could get lost in doing random task after random task, and I don’t want to do that. After many prayers and discussions, I’ve decided that the best way to understand the ways in which I will be of the most use will be to immerse myself in the medical culture here before my distractions consume me and I feel like I don’t have time. So, I spent the week visiting clinics, meeting nurses, and making plans to return for longer periods of time.

I’m extremely nerdy-nurse excited about the next few months. I’m going to spend 1-2 weeks each working with the clinics in the surrounding villages. I’ll work with the nurses, health promoters in the one clinic that has them, and hopefully learn more about the rural Honduran medical system, and the patients that are seen in each clinic. Then, I’ll visit other organizations that have medical outreach programs and see what they do. After this research phase, we'll be able to make more educated decisions while our medical outreach program develops.

This is the clinic in El Por Venir. The nurse that runs it would basically be an LPN in the U.S. She writes prescriptions or can refer her patients to a doctor that is somewhat nearby. 

This is the clinic in San Manuel, Colohete. It is well organized, has doctors and even health promotors that walk around and do education in other villages. I'll be staying there in September for a couple of weeks to work with them, and I can't wait!

This board shows how long it takes to walk to the clinic from each community, and their populations. Can you imagine walking 12-14 hours to get to a health clinic? They have a great "labor and delivery" area, so people walk here to give birth. (San Manuel, again). 

I'm so excited!! It's going to be a very interesting couple of months.

This week in photos.

VBS at Montessori

Fransisco leading a prayer at one of the schools

We are tired!

Photo-op. This one isn't really relevant, I just wanted to add it. Stacy took it!