There are no words to express these pictures...

In between patients...

Seeing our patients...

Bienvenidos! Arrival and Rey's celebration!

Team Comments...from the mountains!!

3/26

Bienvenidos!  We made it to Honduras with no difficulty with check-ins or luggage whatsoever! We were tired since we all met up at 3:45 in the morning, but very happy and relieved, we made it to our host’s home, Heifer, with delicious dishes waiting to be consumed by us! Yummm!

That night we had some delightful festivity to honor Mr. Reynaldo’s Aponte’s 20 years of amazingness here in Honduras. Really though, I’m sure he and the outreach team had helped probably at least 10,000 men, women and children for the past 20 years! It was a great celebration and it really puts in perspective what we are about to do the next few days.

Later that night, the real party started, we began organizing and sorting the medications in little packets. :) Thank you all for your donations…we have so many medications!

3/27

Road trip!! As Ms. Penny Cooper had said, she is very impressed we were all ready to go by 0600. I think that made us the best team so far. ;)

We visited the hospital in Las Esperanza today and let me tell you their staff was very nice. Being a nurse from the states, I felt very fortunate to have the resources I have. The nurses here had 15 patients with 2 nursing assistants.  Patients bring their own medications in the hospital to be treated. The high-risk pregnant women stay in the hospital and can actually cook their meals on wood burning ovens! We were told, this hospital is government funded and it doesn’t cost families to come here to be treated!

We got to Itubuca and were greeted warmly by the mayor of the region and the director of Heifer. We discussed our itinerary for the next few days and apparently people living in far villages are traveling in a truck to see us! We set up pretty much the whole clinic today and slept early since after all…the next couple days will be busy!

Lights out!

PS

Penny and Dawn killed a fairly large scorpion. No big.

3/28

And so it begins.

I must tell you, coming from someone who barely speaks and understands Spanish I was very surprise that by the end of the day, I was able to ask them about their problems, how long have they been having it or even give instructions in Spanish! Broken Spanish but nonetheless they understood it.

One of the things that absolutely touched my heart was when Ashley, Sarah and I, Karla, were teaching this boy about his medications and asked if he had any other questions. His response was, “No, thank you.” To me that meant so much, because I felt that we were really making a difference in their lives and not just putting a band aid. He even asked Ashley and I for our pens for school and well we gave it to him with no hesitation. 

Ellen, Penny, and Heather had a family of five. Mom was blind and father had visual difficulty and is illiterate. The kids’ ages are, 5 and 2 years old and 2 months ago. All of them had different types of infections and the most difficult part was teaching and making sure they receive appropriate interventions.  After pulling resources and coordinating with the pharmacy staff, AKA, Rosa, Monica, and Michelle, they used visual aids by using different colors on packets for the medications as well as emphasizing the different shapes and sizes of the pills. Even though they had spent over an hour with the family, it was an hour well spent.  Everyone really worked together to make sure this family receives their treatment.

Everyone worked tirelessly today and it’s a great way to end the day on top of the hill hearing cows moo and roosters do their cock-a-doodle-do…and yes they do them even in the late afternoon.

Rosa sends love to Igor, Andrea and Natalya! <3

3/29

Saturday. It sure didn’t feel like Saturday! We were up and early! Brett and I, Karla, were even able to squeeze in a nice little run up and down the mountains before opening a clinic! We even joined Michelle for a quick yoga stretch. Alicia and Dawn also went for a lovely short hike (see pictures! Won’t see anything like that in Durham, NC! Or well maybe ;)

I’d say, today went by much smoother than yesterday even though it was much busier. I’m not sure whether it’s because we all became very comfortable with our assessments and diagnosis or maybe it’s due to our Spanish…it’s getting better! Kun-wei and Ellen are doing marvelous in their Spanish!

I think what I like most about today is seeing the teamwork and patience of everyone including our patients. We would have group of 3’s and only one person fluent in Spanish and yet, for example Heather, shows no frustration with talking, explaining to the patients, and teaching us with Spanish. Our patients get a laugh with our broken Spanish. They even smile and correct our grammar!

One of the things I wanted to mention was the project the ABSN students, Travis, Monica, Ellen, Brett and Michelle, are doing that is absolutely making a difference here in Honduras. They are promoting dental hygiene! Where’s a dentist when you need one! But yes, those toothbrushes you folks donated are making their way through the rural villages of Honduras and they love it! One of the patients today struck Monica, Reynaldo, and Ashley when they presented a toothbrush to a nine years old boy and he did not know what it was. Of course they made a game out of it and taught the boy how to brush his teeth and how often he has to do it a day but nonetheless we can only really imagine how many more children or people have never really heard of what a toothbrush is. I hope what we have reaches those who need them most. Things like these definitely make us step back and really appreciate what we have in life.

Can I just tell you all about our meals?  So delicious! It’s so hard not to get seconds. Really! So fresh and tasty! Got to love our host for preparing all our meals. They have been so wonderful!

3/30

Sunday Funday Honduras style! :)

            To enrich our cultural experience we decided to join the village to their church. It was an interesting experience; men sit on one side, and women and children site on the other. When they noticed we had started flocking in, they had cleared the first two rows in the men side and let us all sit there. Mind you there are 17 of us (14 women and 3 men). This just shows how welcoming they have been to us!

Hola, it’s Ashley here with my two cents about our awesome church experience. Like Karla said, the men cleared two rows for us so that we could sit down even though there were other women standing in the back for the service. To be one hundred percent honest, this was the first time that I felt like we were making a difference in this community. It just really made me reflect on the experiences at church back home and how Americans sometimes have this “think about me first” attitude. It was just so refreshing to be with people who have little to nothing, but would still give you the shirt off their backs without a second thought.

Brett here with a guest post! This afternoon 3 of the ABSN students, Monica, Michelle and I, worked together as a team seeing our own patients. It was an incredibly uplifting and empowering experience, and we worked so fluidly as a team. It was so wonderful to work together with these brilliant nurses-to-be. We were able to all pitch in and switch roles throughout patient visits, so that each of us took turns interviewing or assessing our patients, explaining medications, or requesting consultations from the providers! Everyone’s Spanish is improving so much, but we still made a few pretty hilarious mistakes, such as when I asked our patient if he noticed his rash getting worse when he got hungry. I meant hot! He looked at me as if I spoke.. well, broken Spanish. One of our favorite patients came in with two other preteen girls, and she was incredibly confident, not something you see often in preteen girls anywhere, but especially in Las Mercedes.

This is an excerpt of our conversation:

Nursing students: Buenas tardes, como podemos ayudarle hoy?

Patient: Good afternoon.

Nursing students: GOOD AFTERNOON! Tu hablas ingles! Muy bien!

Patient: Washington.

Nursing students: Ok…

… Later on, discussing a rash on her shoulders…

Nursing students: Que se vestio para trabajar?

Patient: Nada!

Nursing students: Mande?

Patient: Washington.

I think we had a little bit of a language barrier at times, but we got there in the end, our patient received excellent, at times laughter-inducing care, and we all learned a lot from each other.

All in all, we were so grateful to be given the autonomy to run our own mini clinic this afternoon. Let’s do it again tomorrow!

3/31

That sure went by fast! Can’t believe it’s Monday! It was a very busy morning and a fairly relaxing afternoon. It’s unfortunate that we are running out of toothbrushes, lotions, cough medications, etc. and we still have half a day left.

I worked with Rey and Alicia today and I would say that my favorite patients would have to say the grandparents who brought their cute little grand daughters. Wait, how can I forget about the two best friends who told us they wanted to be nurses. Soon as I heard that my heart melted! Or what about the two little girls who accompanied their mother and played with Penny’s stethoscope. If only you can see those pictures! ;) By the way, the grandparents came back later that day and gave us potatoes that we ate for dinner.

One thing I want to just emphasize is how welcoming they have been to all of us. Ashley, Heather, Michelle and I had a chance to visit a lady who had an infant last night. And wow…that was eye opening. The family didn’t have much…and yet they are so happy and so content. As Ashley had put it, what they have you can see as you walk in to their home.

            Totally blog-bombing on Karla here—it’s Ashley again. To further the experience at the home with the newborn, I just wanted to comment on how different it is here compared to our culture when it comes to childbirth. The mom had delivered her baby at home and upon assessment, we noticed that she did not even (getting graphic here—not for the weak stomached) have underwear or pads to catch the bleeding; this kind of broke my heart a bit. Throughout the trip at the clinic, I did not stop to think about where these people were coming from because appearances can be so deceiving, especially when people dress their best to come see us. The trip to the house tied the whole rural Honduran picture together for me that yes, these people are extremely poor and have to work so hard for the simplest of things that we take for granted like a proper stove to cook on, or a floor to keep the bugs out.

04/01

Another blog-bomber, Michelle here, to share my experience taking corn on the cob to tortilla! Shout out to my wonderful teachers Martha and Gloria. They both prepared so many amazing meals for us. You wouldn’t believe the vegetables and fruits here.

The tortilla making process began last night. Well, let me correct that actually. Technically the process began a few days ago when the freshly cut corn was put out in the sun to dry. When I asked how long it takes for them to dry, Gloria simply said, “Well just when they’re dry, that depends on the sun I guess.” The women showed me how to remove the dry kernels using our fingers or using the bare cobs. Disclaimer… not as easy as it sounds. We added water to our “cubeta”(bucket) of corn and then sifted in lime stone powder. We washed the corn and removed dirt and leaves and set the corn the stove to cook. Again, just until they knew it was ready, no set time. We pulled it off the stove and it sat overnight.

In the morning we carried the cubeta of corn to the local store to wash again in the outdoor sink, and grind inside the store. We first used a hand grinder with a hand-urned wheel type mechanism to crush the corn. To smooth out the mixture, we added water and then ground the corn on a big stone grinder. This would finish the dough for the tortillas, made of only corn, water and a little bit of lime powder. Between Martha, Ellen and I it took about an hour to grind just half the corn. Ellen and I got quite the work out, and Martha was moving right along! Mind you, she is a tiny woman, maybe five feet tall. She told us, “This is what I do starting early in the around 4:30/5:00am until the evening, every day. We eat tortillas every meal”. I asked if she ate things along with the tortillas, and she said sometimes they have rice and beans, but usually just tortillas. It was really an amazing experience to learn how to make tortillas, experience a bit more of the culture, and spend lovely time with one of the local women.

The pharmacy group

The pharmacy group setting up the clinic in Las Mercedes.  More pics to come!

The bus ride

The team is spending the day in transit. They left Las Mercedes at 7am and have stopped periodically to enjoy the sights. They stopped in Esperanza to eat and shop in the market, which included some cool basket woven bowls. Dr. Clements says the team should arrive in Copan around 4pm. Then more clinic in the morning!

Dr. Clements says the students should have internet access in Copan, so check back very soon to find some of their blog posts and pictures uploaded here.

A few days, but big impact

The Exploring Medicine team has been super busy the last few days seeing close to 500 patients! On Saturday, they saw 150 patients. On Sunday, they saw another 120 patients. This morning they held their last clinic session and saw the remainder of the patients. It's been such a few short days, but the team has been able to accomplish so much and really make an impact in the lives of their patients.

It's been great to hear the students interacting with the patients in Spanish. Their language skills have improved a lot in just a few short days!

Last night, the village welcomed a new baby! A Duke nursing and med student were able to visit the mom and baby this morning, along with a trained nurse who is assigned to the village. The mom and baby are both healthy and doing well. Dr. Clements says it was a great opportunity for the students to see firsthand and they learned a lot.

Two other great things to report: the weather is spectacular and the food is delicioso -- as they say in Spanish!

This afternoon, the Honduran partners are hosting a ceremony to thank the team for their hard work during their visit. The partners have also expressed gratitude for the clinic in this community. Construction of the clinic began five years ago and has been fully operational for three years. Beginning this year, a Honduran nurse will be based at the clinic year-round to see patients in the village and surrounding areas. The Exploring Medicine team will leave medicine for the nurse to dispense as needed.

Tomorrow, the team will be headed to Copan by bus. They will spend the first part of the day in clinic there and then finish off the day with some sight-seeing of the Mayan ruins.

A powerful thing.

It's been a busy day so far.... the team saw 60 patients just this morning! Word of mouth is a powerful thing. It seems like news of the Duke team arriving has traveled fast -- which is pretty incredible. Students did basic health exams for adults and children and have started to distribute some of the donated supplies they brought with them from the US. The team took a short break and are pumped about starting a second round of clinic this afternoon.

First day of clinic

After setup of the clinic and a good night's sleep, the team of Duke nursing and medical students began their first day of clinic at 8am this morning. The team is excited to begin the work they came to do, to see the first patients coming in (by the truckloads), and doing some good for this rural community where few adults and children see a doctor regularly throughout the year.

They made it!

Team lead Dr. Dennis Clements was able to get cell reception to call from the mountains! The team made it safely to Las Mercedes and they are setting up the clinic tonight. They've brought with them tons of donated supplies and toiletries, including soaps and shampoo, toothbrushes and toothpaste.

Clinic Day #1 is on the horizon.....

Along the way, a tour of a local hospital

On the road to their final destination in Las Mercedes, the team stopped to tour the local hospital in La Esperanza. So far the trip has been great and students are getting a taste of what health care delivery looks like in rural Honduras.

The team just got back on the bus (with all the health supplies and luggage loaded on top - pics to come! ) to finish the trip to Las Mercedes, which is about one more hour. Students will start seeing patients later today or tomorrow.

Honoring 20 years of service

Last night, Dr. Dennis Clements and the rest of the team were joined by Honduran partners to honor Reynaldo Aponte for his service. Aponte has been traveling to Honduras to collaborate with the locals and provide health care for the past 20 years. Reynaldo accepted the award from the president of Heifer Honduras. It is dedicated people like Reynaldo who are making an impact in the world and changing lives.

Today, the team is traveling into the mountains from Tegucigalpa to Las Mercedes, where they will work in the clinic --- the health facility was a dire need for the rural community where people typically did not see a doctor because the closest facility was hours away by foot and couldn't afford to dedicate a whole day to make the trip. The clinic was spearheaded by leaders of the Exploring Medicine group including Dr. Clements, others at Duke, and Honduran partners.

The students are looking forward to their first day of clinic!

The team has arrived

The team has safely landed in Tegucigalpa! Beinvenidos a Honduras! The team will have a celebration for Reynaldo tonight --- for his 20 years of service in Honduras. Tomorrow, the team will be driving up into the mountains and could start clinic as early as tomorrow night.

In the meantime, check out the experiences of the 2013 Exploring Medicine team.

RDU airport

At RDU airport waiting to depart for 10 days in Honduras.  Arrived at 4:30am

It is a rainy Sunday - 3 days before we depart.  The packing day went well on Saturday - Reynaldo has photos.  The bagels and coffee kept us awake long enough to pack about 20 bags of medicines and supplies for the trip.  We will be donating $1000 for eco-stoves for the community and we will of course be seeing patients every day from up to 11 villages around Las Mercedes where we built a clinic a few years back.  We understand that the clinic is staffed all the time now - which is exciting and we are looking forward to seeing how it is working out.  We are an additional resource to the local people - not THE resource.  And we hope to leave behind both our spirit and our support for their community and their people.  Las Mercedes here we come.

Dennis

Welcome To Exploring Medicine 2014

The purpose of the course Exploring Medicine is to promote understanding of  the cultural background of the people of Honduras and how that impacts the delivery of medical care. Throughout the semester, topics were discussed to facilitate understanding of how art, history, literature, music, geography, ethics and religion influence the practice of medicine in the Latin American culture. The classes provides a multidisciplinary faculty from Duke and UNC and included time working on medical Spanish to improve the understanding of the culture and facilitate encounters and interactions with Hispanic patients in our own environment. The trip focuses on areas of rural Honduras and provides global outreach through Duke Global Medicine.  Join in following us during out trip!!

Dawn Kennedy