All 22 girls in my Hogar sleep together in one room on triple tiered bunk-beds
Some of the girls in the Hogar infront of the Valentine's decorations that my mom sent us.
The external clinic where I work. On the left is the laboratory, pharmacy, and admissions window, and the building to the right has the pre-clinic/triage room, the consult room for the doctor, and a room that we use to do wound care procedures.
One of the most fun days that I had in the past two weeks was going on "Compras" (Shopping) with the kids. Each month, all the children 11 years and older who recently had their birthday or made the honor roll, get to go for a day outing to Tegucigalpa. It reminded me very much of my elementary school field trips, where the kids get to leave school at noon and pile into a big school bus, only this time, I was a chaperone. Upon getting off the bus, I immediately had a child on each hand who I could tell was a little overwhelmed by the big city. Coming from the rural Ranch, especially for those who have spent most of their lives here, the city can be a bit overwhelming, and it can be easy to forget street-smarts like looking both ways before crossing the road. We made our way to Pizza Hut, where all the kids were treated to a very large, delicious lunch and dessert. Strangely, this was the nicest restaurant that I had eaten in since coming here. After that, the 30 or so kids were turned loose to do their birthday shopping with the $10-15 that they are given. At this point it was a little bit nerve-racking as all the kids scattered through the main center area trying to figure out how to spend their money in 1 hour. The most popular stop seems to be the grocery store where the kids have the freedom to load up on treats. The last stop we made was of course to eat birthday cake. All in all, it was a blast to go on an outing with the kids and see them in an environment outside the Ranch, and also get to know some other children better.
As a medical team, have been exploring the idea of starting regular medical visits to the next neighboring rural village of 'Tamal y Queso.' On Wednesday, I got to venture with Tiffany, the other volunteer RN, and two other staff from the clinic to meet with the community and assess exactly what the health needs are and how we can best serve them. We ventured several miles through the woods in a 4-wheel drive truck that could barely make it up the mountainous roads, which were really more of just a hiking trail. When we arrived to the beautiful little community, set down in a valley surrounded by rounded mountains on all sides, we were warmly welcomed into the school where many women were waiting outside and had come as well to see what we had to offer. We entered into a one-room school house where 33 children sat around tables divided up by grades for 1-6, and a little side group of 7 kindergarteners sitting in the annex. We went through each child and assessed their hair for lice or other problems, their teeth for dental health, their skin for anemia or scabies, and their feet for fungus. After that we chatted with the women of the village to learn what their specific health needs were, and what types of education they might be interested in us offering. This week we will meet with our doctor and health director to review our findings and determine how we could make this into a sustainable project On future trips we hope to bring some medication, our medical doctor, and possibly our dentist as well.
For my last and probably most interesting story, which some of you have already heard short tidbits of, I will try my best to give a concise elaboration. Thursday, I was out near the entrance of the Ranch in the external clinic where I normally work daily. This day however, the Doctor was in Tegucigalpa, so the clinic was closed and I was all alone there organizing the pharmacy and just doing some other basic tasks that I wanted to get done while there were no patients to tend to. Suddenly, the guard from the front gate runs into the clinic and is trying to explain to me that there is a lady here giving birth. I run outside to the back of a pick-up and find a 17 year old girl lying there on a cot. At that point she looks pretty calm and doesn't seem to be in any sort of distress, then my eyes move down to her belly, which doesn't seem especially distended either, then I look farther down and there between her legs is a swaddle of blankets containing a newly born baby. Adrenaline kicks in and I run back into the clinic to grab gloves, frantically call Tiffany who was 15 minutes away at the internal clinic inside the ranch, and I grab our emergency birth kit, which now I can't thank Tiffany enough for making and having been so 'emergency prepared.' I climbed into the back of this pick-up truck with this family who had just driven here from about 2 hours away, and couldn't make it to a clinic in time. I was trying to make sure the baby was breathing and suction his nose and mouth, and make sure the mom was not bleeding excessively, while trying to yell directions up to the driver in the front cab so he could quickly get us to the internal clinic where other personnel waited to help. As I squated there, bumping along on in the bed of the truck, the baby was still attached to the umbilical cord and placenta, so I was trying to find the hemostats to clamp the umbilical cord. Once we got the mom and baby safely into the clinic, while Tiffany had the doctor on the phone and was giving me directions. Since we had no umbilical clamp, I took suture thread and tied it around the umbilical cord in two places, then cut the cord in the middle (something I never really expected to be doing unless I was a father, whose child had just been born). We got some oxygen on the baby and loaded mom and baby up into the ranch ambulance (which is really just a rickety mini-bus, with the seats taken out and a stretcher in the back). As we go barreling down the patchy concrete and dirt road to Tegucigalpa, Tiffany is sitting on the stretcher next to mom and baby making sure baby is pink and breathing fine, I am leaning over her holding the oxygen for the baby and occasionally massaging the mom's stomach to make sure the uterus contracts, and the mother's friend is holding the oxygen tank which had been rolling all over the vehicle. After an hour or more of a miserable, scary, boiling hot ambulance ride, where the only window to look out to keep from getting car-sick was the front, we arrived at the city public hospital. It was a good thing that we had gone along with them because the mom was promptly ushered to the gynecology unit, and the baby taken to the pediatric emergency unit, without any form of identification to know who the mom was, or that the baby was hers. So we each stayed with Mom or Baby, until their family had joined them and they were safely reunited and settled into the hospital where they would stay for 24 hours in observation. Needless to say, it was quite an adventure, and surely not an experience that I ever expected to have. But as I am coming to realize, here no day is ever normal or the same. Whether I am at the clinic or with the kids, things can change in an instant. You never know what you will get, but I think I really love it that way.
