Semana Santa and 4am Mornings

As I write this, I sit in the pitch black, although it is only 7pm, because the power has gone out yet again. I am trying to keep the bugs from swarming my computer screen, since right now that is the only light in the whole house. Since coming to Honduras, I have a new appreciation for our electrical services and technology back in the states, because over the past few weeks, the power outages here have been a daily occurrence. It is often conveniently while I am trying to serve up dinner to the girls in my hogar, when suddenly I can no longer see a single thing in front of my face. Then the Tias scramble for their cell phones to try to dimly light the mess-hall. Another popular time for the power to go out is right when I am trying to cook my dinner, and then, sorry… no dinner for me until the power comes back on, or there is always the back up of PB&J sandwiches.

If you were to ask me what the best thing about this month is… I would have to say Mango Season. The last few weeks, the mangos have been sweet, ripe, and plentiful. Today, for part of lunch, I got handed a huge mango as the side dish. And they come in all sorts of shapes and sizes. On most of them, we just eat the skin and all, a good way to add more fiber into the diet here. The ripe mangos are a big treat around here as most of the kids raid all the mango trees months before they are ripe, when they are still green and hard, called mango verde, and they eat them with salt, oil and vinegar.

The week before last of Semana Santa was quite a fun and exhausting week. The first Sunday was our girls’ camping trip. At 4am we loaded up three buses with sleeping cots and thermoses of food and piled in 100 girls, caregivers, and a few volunteers and headed west toward the El Salvador boarder to a town called Caridad. They say that the devil wears shorts here, and I have found this to be true. Luckily for the early start, the 6 hour ride over was pretty cool. For the three days that we were there, we stayed in an indoor/outdoor sort of community meeting hall. To celebrate Palm Sunday we joined Caridad in a procession that started up a hill by a school and we marched all the way down into the center singing songs and waving our palms. The procession began with mostly just our NPH group, but by the time we approached the church so many community members had joined, we had tripled in size.

The second and third days were by far the most fun, and a relief to get out of the heat. We spent the whole day down at the river swimming and playing on the ‘beach.’ I think we must have looked like an inflatable circus with all the floaty toys we had and the shrieks and splashes of the kids. The river was wide and deep, mostly damned off by a rock bridge so that there was no strong current. We roped off a swim area to better keep an eye on the kids who couldn’t swim, and for the older ones who could swim, there was a perfect multi-tiered rock wall to jump off of. Among the children there was a certain sense of liberation and excitement that came with this vacation, maybe just what you would expect to see with any group of kids on spring break. It was overall a blast to spend time with the kids outside of the Ranch and their hogar and have a lot more unstructured play time.

              

The rest of the week, the clinic was closed, so I spent each day with my hogar. The days were filled with mass almost every day, and a variety of other religious activities. In our free time, we did beading or other crafts with the girls, and they would always ask me to bring my laptop so that we could watch movies. It beats me how they enjoy it so much with 20 girls crowded around the tiny screen and speakers of my laptop. They beg the volunteers to do ‘turno’ (taking a turn sleeping in the hogar and being the responsible adult at night) so that they can stay up late and watch movies. They all pull their sleeping pads off their triple-tiered bunk beds and pile them on the floor, like a giant sleep over. When I woke up in the dim light of the morning and all were still sound asleep, all I could see was a tangled pile of little girls scattered about the floor.

              

Easter morning was another early start, as I dragged myself out of bed at 3:30am and everybody congregated on the boy’s side of the Ranch. We began with a bonfire and some songs and prayers. Each with a candle in hand, we processed toward the outdoor chapel in the blackness of night. It was a neat experience to sit through Mass from about 4:45 to 6:45am as the sun came up. I don’t exactly know why the Ranch has a tradition of early morning Easter mass, but rumor has it that that is when Jesus rose from the grave. Whether that is true or not, it didn’t stop the little girl in the row behind me from snoring through a good chunk of the sermon. As we processed out, every kid received a milk chocolate bar, which is rare here, and a real treat for them. And that was Easter… we were done by 7am. I worked with the girls the rest of the morning until their caregivers came back from vacation at noon, and then had the rest of the day off. I took that time to enjoy a nice Sunday chat with my family back at home and here about their outstanding Easter meal in comparison to the rice and milk that I received for dinner that night. Although I did miss my family traditions back home, it was fun spend Easter with the kids and have some unique experiences like 4am mass.

 Processing into Caridad with members of the community for Palm Sunday.

 Outside of the church after mass in Caridad.

 The view of the river where we swam each day on our camping trip.

 This is where we slept for three nights, with cots sprawled all about the community center.

 Some of the tias and older girls enjoying some watermelon for snack.

 One of our Semana Santa activities, visiting each station on the way to the cross on Black Friday.

One of our young actors depicting Jesus on the cross during "The way to the Cross."

Aldo, a recent addition to the NPH family.

Fires, Food, Lice, and Losa

I am ready for some rain! Right now we are in the hottest and driest months of the year. This also means that forest fires are running rampant, and the sky has been a thick layer of smoke and haze for the last several weeks. When I go running around the ranch, I pass large patches of forest that are now blackened after recent fires have passed through. Today on my journey into Tegucigalpa, I could barely see the hills off to the side of the road because of the poor air quality. This may also explain why my cough from my cold two weeks ago still seems to be lingering.

I can tell I am getting used to the food here because my cravings for my ‘American favorites’ are diminishing, and I actually get excited when some of the better ranch meals are served, such as casamiento (rice and beans mixed together) or a side of salad (cucumber, which I never liked in the states, green tomato, and a few pieces of lettuce or cabbage). However, my love for cooking has also grown, possibly because I take advantage of any opportunity I have to prepare my own food the way I like it, which only comes once or twice a week. Among the volunteer community, we have Cena Amistosa (family dinner) in which we usually have a themed meal where everyone cooks together or brings something, potluck style. This is always a nice chance to spend time together as a volunteer group. Another special meal occasion is Proyecto Familiar, a program started by a former volunteer to enable sibling groups to spend more time together and prepare a true family dinner. Most volunteers take a turn in cooking with the kids a couple times each month. The kids absolutely love Proyecto because they get to cook food and eat as much as they want; two things that they don’t get to do much of otherwise. NPH is a great place for families because siblings can come here together and know they will never be split up or taken away. Family groups of 4-6 children are not uncommon. The problem is that since there are so many families, they only get Proyecto about every 8 months. I really love Proyecto because I get to know the kids as a family unit and in a smaller group.

Here on the ranch, since everyone lives in a community, lice are very prevalent. It is kind of just a fact of life, and not something that any of the kids would be grossed out by or make a big deal of because that is just how they are used to living. I am very proud to announce that after 3 months here, I am still lice free. One of my very least favorite Saturday activities is ‘de-lousing.’ For the girls, they can’t understand that this is a rare and strange activity for me, and that I feel a little bit like a monkey when I do it. What delousing entails is sitting a girl down in between your legs and slowly searching through their hair for little pearly white eggs that are firmly attached to the base of the hair strand. The only way to get them out, since we have only one lice comb to share amongst 22 girls, is to pinch it between your fingernails and slide it all the way down the hair follicle until it comes off the end. The girls generally like to report to the others how many eggs you found in their hair. If there are many, it is likely that there are live lice as well. So, you put a t-shirt or towel over your lap to cover your clothes and try to obtain the fine-toothed lice comb to brush them out of the hair and onto your lap. At this point they are unhappily scrambling around because they have just been evoked from their hairy hiding place, so you have to kill them by squishing them in between your fingernails. Ideally, everyone would partner up, so I would only have to de-louse one person, however, sometimes that doesn’t work and I end up delousing a handful of girls. I’m itching just writing this.

Tableware, or Losa, in Spanish, is a strange thing here on the ranch. Every child is given a plate/bowl, cup, and spoon or fork as their own which they have to present at every meal in order to eat. Even though everybody is supposed to have their own, there is a severe shortage of losa on the ranch. No matter how many times new losa is bought or gifted to a Hogar, pieces seem to disappear shortly thereafter. I think it is a vicious cycle of things being lost and/or stolen, but I am convinced that there has to be a hidden treasure of plastic plates, cups, and spoons here on the ranch at the rate they disappear. Even my own losa got stolen, but was luckily returned to me several days later. To avoid their spoons from being stolen, some children basically guard these items with their life, and you often see many children walking around with them in their back pockets. One evening on our way to dinner, one of the little girls in my hogar, Fatima, pulled me into the garden, where she began rummaging through a lush flower pot. When I asked her what on earth she was doing, she informed me that this was where she hid her spoon after every meal to keep it safe. I couldn’t help but laugh at what lengths the kids will go to to protect their possessions.

This coming week is Semana Santa, or Holy Week, which means a lot of different things here on the Ranch. School is closed and the children who have had good behavior and have family who can come pick them up are able to go home for the week. This will vary for each child based on whether they have any extended family and whether the family can afford the voyage to the Ranch and has any sort of visitation privileges. Some children have the option to go home, but prefer to stay at the Ranch, possibly because of a negative home situation. All the employees here get all or at least part of the week off which means we volunteers step in to pick up the slack, as well as all the NPH high school and university students studying in Tegucigalpa come back here to work for the week. For most of us, we take over working in our Hogars as Tio or Tia. While I know I have an exhausting week ahead of me, I am excited to get an extended period of time with the girls to just relax, play, and get to know them deeper. Tomorrow we leave with all the girls on the ranch who are about 8 years old and up to go camping for three days. For some reason, someone decided we needed to leave at 4am, so I suppose we will be loading up school buses in the dark. I’m not sure what ‘camping’ with 100 people looks like, but I will be sure to let you know how that goes in my next blog entry.

One of my favorite cuties... Fernando.

Fotos for Fun

 A day in Santa Lucia. Pictured with Micaela, another NPH volunteer.

 My pre-op and Phase I nursing group in the Surgery Center during the March Brigade.

 My favorite patient of the week!

 With two other NPH volunteers, Jason and Deedee

 Baking cake with two adorable girls for proyecto familiar. These were the two children who I spoke about recently loosing their father.

 14 of us squeezed into a tiny pickup truck with all of our supplies for our medical brigade to Tamal y Queso. It was quite a ride.

 Our doctor saw every student in the school and examined them for various illnesses.

 Inside the one room school house. Jason giving antiparasite medication to each kid, and a month´s supply of multivitamins.

 In front of the school.

 Loading back into the truck.

 Marcela and Norma, two Honduras who I work with in the clinic.

 Making birthday cake with some of the girls from my section Estrellas de Belen, for the January, Febuary, and March birthdays.

 Natalia... oh so cute.

My roommate Caro, from Austria.

Brigades and Visitors

I apologize for such a long gap in updates. I have had a very eventful March with very little time to write. I am doing well however, and excited that I made it successfully past my 3 month mark here, which also coincided with a fabulous and long awaited 4 day visit from my mom and sister. It was so much fun to show them around the Ranch, and even a little bit of Honduras, so that they have a better picture of what life is like for both me and the kids her as well. My mom brought me an entire suitcase of goods that I had been missing from the states, such as peanut butter, chocolate, magazines, clothing items, and some crafts for the girls in my hogar. They tagged along with me to my Hogar one night and took lots of pictures and met all 22 kids in my section. Another evening we cooked dinner with a family of four sisters and ate together, their family and mine. The next day my mom came with me bright and early to help open the clinic and stayed all morning assisting with various tasks such as finding patient charts, and counting up and bagging medications to dispense to patients. Tasks, as she pointed out, that would never have been allowed in the states. To make sure my family got the 'true, authentic Honduran experience,' we ventured out for an overnight getaway in public transportation (picture crowded, old, rickety, discarded American school bus) to pass through Tegucigalpa and visit two colonial towns a few hours away. This was personally a nice little get away for me, and allowed for the perfect quality time with my mom and sister. We ate some good food, walked around, and bought some souvenirs. The four days came to an end all too fast, but I excitedly await their return when my whole family can come in August.

At the Ranch we have one of the most state of the art surgery centers in all of Honduras that currently is used only 4 times a year when medical brigades of various specialties come. I always feel like I am transported back to the US when I walk into the center because it looks so nice compared to any other medical facility I have seen in Honduras. Mid-March we had an Orthopedic medical brigade of 60 people from the States (comprised of Surgeons, nurses, families, translators, and other auxiliary personnel) come to operate in our surgical center. In the first 2 days we did 200 consults and 58 surgeries during the following 4 days. I worked at least 12 hour days, sometimes more for the entire week as both nurse and translator, assisting with communication with patients and helping them feel at ease, and also playing nurse helping with pre-surgery sedation and recovery post-op. When things were slow in the recovery room I was able to pop into some of the Operating rooms and watch the surgeries. It made for a very exhausting, but fulfilling week. It was fun to do some 'hospital' type nursing for the week and get to know some new faces and learn a lot from the surgeons, other nurses, and anesthesiologists.

Another successful development was last week, after a month of planning, we formulated our own little medical brigade comprised of many of the healthcare personnel from the clinic and some fellow volunteers to return to the neighboring rural village of Tamal y Queso.  We piled 14 of us and our supplies into a small pickup truck and bumped along the one-track mountain road. Since this was our first visit where we were actually providing healthcare and education, we decided to begin with a manageable population size and just treat the 42 school children, whom we had all done preliminary assessments on during our previous trip. We brought along our physician and our dentist who assessed each child. We taught hand washing skills, dental hygiene, and all the kids received a toothbrush, toothpaste, multivitamins, and antiparasite medication. We also brought a well-equipped first aid kit to donate to the school and educated the teachers and some mothers from the community on basic first aid skills such as wound care, hand hygiene, choking response and the Heimlich maneuver, how to use basic over the counter medications, etc. It was such a rewarding experience to see direct results of healthcare implementation and also be able to focus more on primary/preventative healthcare. We hope to continue a supportive relationship with this community and with each visit expand the demographics of the population that we are able to care for.

I feel like I probably don't talk about the kids as much recently, since I have accustomed myself now to my environment and they have become a part of my life here. And sometimes the quirky or cute things that they do don't always strike me anymore like they did when I first got here because it has become common. And although my daily 'job' is not directly working with the children, it is for them that I came, and from them that I can often renew my energy. So I would like to share a few stories about the resiliency of one family. One night after coming back late from the surgery center during the brigade, we got a radio call that one of the abuelos from the grandparent's house, was not well. By the time we got there, he had passed away minutes earlier. Although he was grandparent' age, he lived on the ranch because he was chronically ill with emphysema and had two young children of his own here whom he could not care for, 8 and 11 years old. The older of the two, Yeimi is in my Hogar. My heart sank when I saw him knowing that this meant two sweet little girls were now parentless. I had the opportunity that night to help take his body up to the clinic and help preserve it and prepare him for his funeral. An experience that I had not yet had. A few days later, I attended my first funeral, and it was interesting standing in the cemetery and being surrounded by an overwhelming majority of children who had already experienced the pain of losing a parent or loved one. A week after the death, I had the opportunity to spend an evening with another volunteer and the two girls cooking dinner together and playing. Despite the recent events they were so joyful and the older one took great care in being like a mother to her slightly younger sister. They would lovingly talk about things their dad would do or had taught them, not with sadness, but with joy for the memories of him. It just made me feel so much hope for these kids that they are able to face and overcome such obstacles and still go on loving life.

My family with a family of four sisters that we spent an evening with cooking dinner. The two smallest are in my hogar.

In the clinic pharmacy room with Coto, my 'year of service' assistant.

Bagged water... slightly more sustainable than bottled water.

Each day is an Adventure

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.

Surgery and Forest Fires

Forest fire on the ranch from a short distance away.

Baking a cake with three sisters and another volunteer.

Enjoying a weekend in Tegucigalpa for the going away party of three volunteers who finished their year(s) of service this month.

This week I began my first official work week on my own, without my fellow volunteer nurse, Tiffany, by my side. All went well, and with each day I gain more confidence in my Spanish and nursing care, and pleasure out of my work. Each Wednesday is spent at the school completing the yearly Well-Child checks on all the children, or as many as we can get though in the morning. I help assess the height, weight, vital signs, and test the vision of each child before they see the doctor. I think it is wonderful that NPH offers such good preventative healthcare in addition to caring for many chronically ill children. Tiffany and I have also been planning and presenting lectures to the medical staff each week on different nursing care topics, such as how to administer medications, start IVs, what is Hypertension?, and Diabetes, knowledge of medications that we are dispensing in the clinic, etc. The majority of the nurses who work here have only a high school nursing licensure with a very basic healthcare education. Therefore, I am glad to put my bachelor's degree to use to help provide continuing education for these nurses since many of them carry great responsibility in their healthcare roles.

This weekend was also my first weekend being on-call for the clinic and any medical emergency that might arise. We have a Doctor on-call, whom we can contact with any questions and there is a Honduran nurse who is in the clinic day and night with the kids. However, I still feel a lot of responsibility and a little nervous being the only licensed healthcare employee here for over 400 people. I get to walk around with a pretty official looking radio, I come into the clinic to assess new patients, and am available for questions or to help out with whatever is needed. Last night, for example, one of the children had to go to the hospital, so I stayed to manage the clinic while the other nurse accompanied the child to Tegucigalpa.

Another new addition to my last few weeks has been getting to know my Hogar of 22 girls, ages 10-14 years old. All the children here are divided up into groups of 20-30 kids, based on their age and developmental level and they live with that group in individual buildings called Hogars. The volunteers here have essentially two jobs. We all work our day jobs during the week, as teacher, nurse, office personnel, etc. and then we have an evening and weekend job, spending time in Hogar with our assigned group of kids and supporting their caregivers. The two hours that I am with them each night is spent finishing up chores, eating dinner, brushing teeth, and changing into pajamas. In the little time that is left before lights out, they love it when I bring stories to read or a new board game to play. I am really excited to have this age group of kids because they still love to play and have fun. They can be very loud and crazy at times. They love attention and hugs, and are great to practice Spanish with. Over this year, my patience will be tested as well, as I try to earn their respect and work with the attitude that comes with this age. I look forward to getting to know each one of them individually and trying to be a good positive role model in their lives.

Maybe one of the most interesting memories of the past two weeks was getting to assist with surgery and fight a forest fire all in the same day. Here at the ranch we have one of the most advanced surgery centers in the whole country of Honduras donated by an Orthopedic surgeon and his family from Minnesota. They come down about 4 times a year for about 10 days at a time to perform surgery for the people here. While the medical teams aren't here, the center mostly goes unused. However occasionally we have a retired surgeon from Tegucigalpa who comes once every couple weeks to perform some basic topical surgeries and cyst removals. Being one of only 2 RNs here, I had the fun pleasure of assisting in the surgeries, such as holding the retractors or cutting the stitches.

Meanwhile… we are in the very dry season here in Honduras and forest fires are not uncommon. Many Saturdays, the boys at the Ranch are out early in the morning working to clear a 6-10 foot area of brush along the entire perimeter of the Ranch.  However, despite their prevention efforts, the most recent fire did enter onto Ranch property. One night when I was leaving Hogar, there was a crowd standing along the sidewalk, watching the ridge of the hillside blazing. Some of the younger girls were crying because many of the older boys, their brothers, had already been sent up to the fire to start trying to put it out. I returned to the volunteer house to grab my camera and headlamp, and ventured out with two other volunteers to get in on the action and see what a forest fire looks like up-close and personal. About a mile up the hill we got to the scene. For those of you who have never had the adventure of fighting a forest fire with limited training and resources, here is what you do… you try to find a big, preferably still leafy branch, and beat the fire until it mostly goes out. If that doesn't work, you holler at the kid running around with a hose and water tank on his back. By the time we got there the flames had died down, and it was mostly just a vast area of charred ground on all sides, with isolated bushes and tree trunks still burning. I was trying not to melt my tennis shoes on the smoldering ground. The ash and smoke was thick in the air. It was quite an adrenaline rush, especially to be the only woman there working alongside all the other male Pequenos and employees.

One last funny little cultural idiom… pertaining to teeth brushing. Contrary to the majority of Latin America, there is a fervent passion for brushing teeth here. The kids must brush their teeth 3-4 times a day. It is not uncommon to see a child walking around with their toothbrush in their back pocket, or an employee walking around the office brushing their teeth after lunch, as if it is nothing strange at all. I'm not sure how this trend began, but I must say, I think our kids as a whole have the healthiest teeth in all of Honduras.

Coffee at Bedtime

Even though it has been just a few weeks since I have written, I feel like so much has happened and time has just flown by. I am starting to feel the Ranch becoming my new home. Sometimes it is actually easy to forget that I am in Honduras until some funny cultural difference strikes me and brings me back to reality. One night, all the kids were out on the basketball courts for dinner with the normal chaos that ensues when you put 350 kids together of all ages. We sat in the dark eating our dinner… the (dreaded) favorite, Sopa de menudo, which is a chicken broth soup with all the internal organs and left over parts of the chicken (liver, heart, and kidneys included). The kids are especially excited if they get a chicken foot in their bowl to suck on.  After our meal there was a giant caldron of coffee boiling over a fire. And sure enough, a little while later, the coffee (with 30 pounds of sugar in it) was served out to all the kids, big and small, and they loved it! This was one of those cultural moments when I just had to laugh and say “why wouldn’t you serve coffee to a bunch of small children right before their bedtime?”

As part of our orientation last week, we got to take a trip to the nearest town called Talanga, 30 minutes by bus from here. We visited the Comedor Infantil, a lunch soup kitchen for impoverished children 2-10 years old who would maybe not receive any meals otherwise. It is a project that was started 1 year ago by a Passionist volunteer and will now be supported by NPH and coordinated by one of our own new volunteers. It was a very valuable trip to get to see how other children live outside of the Ranch. While the children here at NPH don’t get to live with their families, they have all their basic needs provided for them, and limitless possibilities in education, such as the opportunity to attend high school and college if they so choose.

It seems like several times a week there is some sort of special event. On weekends there is always something going on, from movie nights to talent shows and dance competitions. The kids will choreograph a dance routine in small groups and perform it in front of everyone. As a whole, they can all dance impressively well, and even the little ones can really move their hips while dancing Punta. By the end of the night, it is not uncommon to have a small child asleep in your lap. Recently we had the Graduation celebration for all the graduating kids from kindergarten up to university, before the start of school this coming week. Thursday we celebrated the Patron Saint of Honduras, Suyapa, starting with a giant procession and a catholic mass at 7am. Last Sunday was Visitors Day where all the kids who have any extended family or even parents who cannot or are not allowed to care for them come and see their children for a day. This happens 3-4 times a year. As volunteers we are in charge of all the kids who do not get visitors for that day, and try to make it as fun for them as possible, with swimming, field games, cake, and movie watching.

Monday marked the start of my actual job training, and to be quite honest, it has been a bit overwhelming. Orienting to a new nursing role is difficult. It is even harder and sometimes just downright frustrating to be doing it in another language that I am still trying to understand. Besides our Health Coordinator and one Doctor, I am one of two licensed nurses here. To summarize my job description, I am in charge of running the External Clinic at the Ranch. I walk 15 minutes to work from our volunteer house to the entrance of the ranch where the clinic is located. I get there at 7am and by then there is already a line of about 30 people waiting to be seen. These patients may travel for 2-3 hours by foot and by bus to get to the clinic by 5 or 6am to receive an affordable medical consult. We charge $1.50 for the visit, and all medications are $1. We also have a full functioning laboratory in which patients can have all sorts of affordable blood tests taken and results analyzed on the spot by our Microbiologist. Because we only have one Medical doctor and she must work in the internal clinic in the afternoons seeing the Ranch children, we only allow 20 patients a day to be seen at the external clinic. One of the hardest parts of the job is to turn someone away after they have already paid the bus fare and possibly traveled many miles to get here, starting in the wee hours of the morning. Upon arrival to the clinic first twenty patients receive a number on a first-come-first-serve basis, and some may wait 6 hours until they are seen. That is just how the Honduran health system works.

My job varies slightly every day depending on what other help we have in the clinic. I help admit the patients, find their charts, take vital signs and a short history or reason for the visit, and do patient care such as wound care procedures or taking out stitches. I also help to fill the medication prescriptions that the doctor writes in our little on-site pharmacy. Now you may all be thinking, “well Heather is not a Pharmacist,” and that was exactly my thought as well. According to our US standards, this would not seem exceedingly safe, and even much less so when I can’t be present and there are two young assistants with no formal medical training are left in charge. Therefore I am now on a quest to try to relearn everything that I have forgotten from my nursing pharmacology class to better educate both myself and others to make this a safer system. I am excited to gain from this clinic experience many different leadership and administrative skills that I did not expect to come away with, but will ultimately be glad to have.

I would just like to thank everyone who has been sending me emails and encouraging notes over the last 6 weeks here. It is very helpful to know that I am so loved and supported by my friends and family!

 Children from Talanga at the Comedor Infantil, playing before lunch time.

The view from our volunteer house in the early morning.