No HOPE

Tuesday

Wierd dreams again last night - anyone would think that I'm on antimalarials - which I'm not (thank God for Dr Behrens). Dr John summons me very early on - what a sweetie, he noticed that I was in a state about the burns girl and went down to the hospital after the Apocalypto showing and checked out how she was getting on. They had deroofed the blisters (?) given her antibiotics an pain relief and bandaged her up an she was asleep when he got there. Unsure about the tetanus though....

So as the mobile clinic is cancelled today and we were unable to convince Miss Joyce to reorganise Monkey River we continue to perfect our masterpices for the HOPE presentation, and create the questionaire for the study on diet and well being. That is until lunchtime when the bomshell is dropped that the HOPE presentation is OFF ! After all our work - now don't get me wrong...these things happen but you have to check out the posters - they are awesome, especially compared with the meagre efforts the other groups managed. Rats. On the up side Dr John LOVED the mobility poster - its his thing you know - old folk and safety, he came over all misty eyed over it, so not all was lost. Not to be put off Farnaz and Rachel wander down to Miss Janice's to get ideas for suitable healthy menus for old folk just in case we can reorganise the talk.

Dinner at Marina's tonight down in town. It's an East Indian place and we pretty much all had Shrimp curry and Dr Kirk and Laura ferry us back home whilst we cross examine her about how an osteopath can also be an MD.

Well Man, bend over.....

Monday.
Quite a varied clinic this morning. First a little girl with badly infected insect bites, then an 11 year old with DIB located at her throat area with Dr John thought might be subacute tonsils. Next a middle aged large expat Brit running a marine NGO comes for a well man check (his wife gets off more lightly for her well woman check) and painful arc syndrome. He gets his prostate checked by Dr John 'Family Guy' style bent over the couch...man his prostate is deep in and Dr John shoots from the hip.... Next I have a spanish speaking lady - so I have to dash back to the treehouse for my Spanglish notes from my SSM. Not bad consultation although I couldn't remember how the referral process went in English or Spanish so that went a bit wrong but on the whole, I think Marisol would have been pleased...and Dr John was quite impressed. I find out after the clinic finished that Sophia paid me a compliment - she wished I could stay for a year! Wow that's praise especially coming from her.

Afternoon sees us starting our projects for Cherry Mae and we go into full fledged art attack with the posters. Suddenly a Mayan family in headscarves appear below shouting for help so I go and see what's up. They bold up a screaming 2yo with the most awful scalds on her arms. I am torn an shocked - I know I should get wet dressings on her but I'm not allowed to do anything to help according to the clinic so I have to tell them to get to PG ASAP and get a damp towel around her arm. They want we to take them in the van but I have no keys and I don't think Evert would be amused if they came to him, so I have to get them to hitch. That's so shit. I am in bits for the rest of the afternoon and when everyone come by in the evening for Apocalypto I tell them about her and ask whether I did the right thing - because I still not sure if I did.
Apocalypto was grim - I had to leave after 20 minutes as the screaming was terrifying me and made me physically sick. Ian (aged 6) sat all the way through it and had no nightmares either! Mystifying.

Burning Burning Burning

Machaca Lodge.

I bloody hate sandflies!

Saturday. Snake Cayes snorkelling trip

I'm so glad I'm a pharmacist...

I finally got to clerk another patient today; a fisherman with a cervical radiculopathy. Clinic closed really early today on account off all the villages being cut off by the torrential rain we had last night, but Andy the driver at the last minute brought back his daughter with her infected insect bites back for another look see as her chest had got bad and they hadn't managed to get the antibiotics at PG hospital either so nothing had got better and had infact got worse. Now she had coarse crackles thoughout her chest and a fever....the nebuliser than we eventually find doesn't work despite us having located all the tubing and even the drugs and dilutant (which took nearly 15 minutes) so I raid the dispensary. Despite being a card carrying asthmatic she doesn't have an inhaler - so I get one of those and miracles upon miracles find a infant spacer (rare in UK let alone Belize) and some Augmentin syrup to replace the Cephalexin Dr John had wanted and we were all done and taught how to use everything. I hate this having to send sick patients 5 miles into town for drugs we don't have and that even PG may not have for them to bounce back here the next Day no better. We need a full time pharmacist who can advise on available alternatives rather than just a tech good though she is. Failing that a phone connection to Pg to at least check for stock before we send them. Still, this ones sorted at least.

Early finish so we all pack up to head for the swimming pool at Coral Inn BUT IT'S SHUT!! And we're all so sweaty and needy but no go so it's off to the sea to play in Jeff's new inflatable kayak - great fun and super warm water, if a little greasy.... Girls all get pretty for our night out at Earth runnings a haven of architectural charm and funky chairs in an otherwise charmless town...the proprietor is an architect, a singer, a singer and a Rasta with a beautiful voice. Rum and pineapple....happy now....

Otoxcha, so it must be Thursday

Aghh....the potholes. Thunderstorms aren't just an annoyance, they wash away bridges, flood roads and houses and help the giant lorries create gigantic craters in the dirt roads connecting all the tiny Mayan villages with the outside. Otoxcha is the furthest village that we serve with our mobile and understocked clinic (still no atenolol or any other betablockers and God help anyone with prostatism...) We arrive with the usual fanfare but find instead of a nice clinic building like tuesday we find a decrepit hut, unlocked and filthy. Had to be seen to be believed, even Sophia was shocked and she's seen alot. Still the punters arrive and to spare Sophia for interpreting I take over the BPs and BM seeing as I'm well practised after Wednesday. Oddly only established diabetics get BM's, not those at risk, apparently because we're running out of sticks. Great. And the scales are crap and can vary Dr John's weight by 12 pounds. On the up side there is a useful little chart for Paracetamol and Ibuprofen doses left by some plucky previous British Med Students..pip pip! Lucky we're got some of that then, although we nearly run out again, but its a parasite town today. Scabies and worms for everyone.

Priorities are odd here too. At the last minute a lady appears asking for some antivomiting mediciation for her daughter who had been vomiting for a month solidly all throughout the day and had lost her appetite and lot of weight. So did we visit her home - potential seriously ill person (even if she was pregnant?) No we go off to lunch at a local man's house and tell them to go to PG hospital. Right, like they have transport. Utter madness.

After the chicken soup and tortillas and still with an unpleasent taste in my mouth from this wierd 'service' we provide we hit the one home visit that is booked - an old diabetic lady that lives with her family in a large thatched house. She has a charcot joint so can't walk far, but despite immenent blindness and further damage to her limbs she is still drinking sweet tea and has a Bm of 485 (70-120). So the message has got through here too. Not.

Worst thunderstorm yet. Started early this time at 9pm rather than 2am - guess thats an improvement!

The 3rd Annual Health Fair

PG takes its health and Christianity very seriously and uses one to reinforce the other really rather well. They have little and alot in common with another...little when you consider how many churches there are compared to the number of clinics and hospitals, and alot when you realise how many volunteers run both compared to locals. Americans run masses here either through the Peace Corps, the Red Cross or various ministries and Hillside of course. Cubans seems to be the driving force behind everything bar radiology at PG hospital but the Taiwanese are just about to try and restore the balance (yes the Taiwanese - I know, like they has a fabulous economy - maybe they know how to do things on a tight budget?)

Anyway back to the fair. This was mainly aimed at the schoolchildren from all of PG's schools in an attempt to catch them early and to take home healthy living messages to their parents to entrench at home. You had to feel for them, the official opening took over an hour of various dignitaries declaring things open and thanking all the sponsors, all whilst the poor kids were standing to attention. Farnaz and myself had been pressganged into being nursing students for the morning and to take BPs and BMs and give information on hypertension and diabetes. No given the choice do you think many kids would be up for having their BM read given that it involved pain and blood....THEY ALL WANTED IT! Bizarre...it must be a magical thing...we did pick up several new potential diabetics in the kids and with the adults and identified some appalling lapses in control in the already diagnosed. The blood pressures were not as poor as I had predicted, but there weren't so many Garifuna adults in attendance. Those that were were definitely on the side of well porky, and the Maya carry all their weight around their middles so are at a huge risk for diabetes...

We had an introduction to the healthcare system in Belize with Cherry-May the Ministry Nurse - very frustrating as so many holes in the service and those that do provide it don't communicate at all so it's really inefficient. Then in the afternoon its back to the clinic for evening surgery and birthday cake as it happened to be Emma's birthday. Damn, no present - we didn't know. Still God appeared to as he put on a most excellent light show for her enjoyment (but sadly forgot to cancel the orchestra which was seriously loud and carried on till the early hours.....)Boo!

First day #2....

Tuesday.....haven't we done this all before?! No warnings about hurricanes this time happily and we jump on board our mobile chariot picking up Sophia our Mayan interpreter along the way in San Antonio to XXXXX along some of the bumpiest roads in Christendom (NB that is until we did the Otoxcha trip). Deep deep into the jungle we go past little thatched huts of varying vintages and stages of decay, chickens, emaciated dogs, pigs and the odd duck....with schools full of children in matching uniforms all beautifully presented despite the limited washing facilities...ie. the river... Two hours later with a fanfare of horns we arrive at our clinic and set up shop. A steady stream of customers appears and we set to work with only one interpreter and working in pairs to avoid missing anything...always means there is one left out if there are 5 of you though. I reverted to type and helped with the pharmacy side of things, well someone has to! I did see one lady who was convinced she had worms, so we treated her for them as 75% of the population are infested. She was still breast feeding which made matters a bit more complicated. Thank God for the BNF.

We have a new Doc as Dr Laura jumped ship and was spirited away by flying monkeys when the hurricane hit. He is Dr John a retired FP from Wisconsin - a smashing chap, very old school but dying to teach so we can forgive his odd moments of vagueness and selected deafness!

Home James and don't spare the horses!

Oh what a night!

A few Jungle Jims, the odd beer, some tacos and then the music started...the rest as they say is history.....

Rio to Livingstone

Messing about on the Rio

The Fatman Cometh....

Casa Perico. Lovely looking place but the bedrooms hide a dark secret....the fatman....!
Farnaz and I were allocted to a huge double room with 3 beds attached to another cabana, but despite having brand new netting on the windows there was an enormous gap above the wall into the eaves between us and the unknown resident next door. We only became aware of this person late at night when we heard eerie repetitive whispering and muttering, shuffling, dragging footsteps pacing up and down the room and other mysterious and frankly scarey sounds that kept awake much of the night. We just had to move, who knows if they could get over the top?! So we get the OK to move to the room behind Heather and Rachel, and finally at breakfast we see the one other resident of Casa P - the fatman; Ray. Conspiracy theorist, obsessive compulsive and all round nutter. I could go on about his theories about the US poisoning everyone with a brand new strain of Mycobacterium, or the benefits of Grapefruitseed extract that the US government is too scared to investigate, or colloidal silver...but, damn I just have. He has stand up arguments with a few people here over the next few days, and you would think that he would be bad for business....he's been there for four months and still askes why there are so many mosquitos around but still dosen't wear long trousers just drapes his net over his large legs, and expansive abdomen. There are quite a few beardy wierdys here in the swamp......

The Road to Rio....

Thursday. Belize has offcially been spared the Felix and warnings are downgraded to Tropical Storm. PG is all safe but very low on staff as all ran for the hills (metaphorically - Jeff to Dallas, Laura to Houston) so nobody is around to watch over us and as a result we get an official very long weekend. Flores is declared dull despite the sun being extra shiney today and plans made to voyage south to Rio Dulce. Out of the blue I get a message from Ben and Hazel saying that they are en route to Flores... typical! I miss them entirely. No machete men out today, and we make it to the bus terminal in good time and get thrown on a Marie Elena chicken bus (rather than the 1st class coach we were expecting) to Rio. Its a good trip all in all, nice scenery of little and large round lumpy hills that could easily be hiding the next big lost city, mountains and sun with added entertainment by batty dancers and latterly a new looking Zorro film which sadly we miss as a very quick 4 hours later we are poured with the drizzling rain into the wet streets of Rio into the waiting arms of hostel hustlers desparate to get us to Casa Pericco which luckily is where we wanted to go!

The Rain, The Rain.... (with apologies to Iris Murdock)

Tuesday and Wedneday. And the heavens opened and poured forth. With thunder, lightening and a small gale or two. But nothing special compared to Nicuragua which got moshed by Felix. I´m not really the best person to write about Tuesday as I took a cetirizine for my bites (spelling corrected by Karen a still practising pharmacist) which is supposed to be non drowsy and was monged for the WHOLE day - out of it completely. Did manage to stem the tide that gushed under our hotel door though. Flores was officially a river on a lake - unique!

The others were zip lining and Tikaling....and apart from being held up by men wielding machetes demonstrating about the crappy government (elections are on Sunday) were damn wet when they returned. Films were better though....Little Miss sunshine and Night at a museum.

Team Scarlett

Panic ensues.....OK if Joyce is scared then it must be bad and the nunnery where Ben and Hazel had been sent for Dean is deemed unsafe. We prevaricate for a while then head off to the airport to see what the flight situation is whilst discussions abound about getting a boat going south (into the path of the hurricane yeh right....) or via bus (coz thats the fastest way out and the roads aren`t gonna be blocked by rain and other cars...OK...). The good news is that there is a flight to Belize City and possible Flores going in 2 and 1/2 hours which we all can get on so we book it (but still prevarications continue!). After waiting what seems like an eternity Jeff reappears with the bus and we go back to pack what we only unpacked the previous day in the fastest time ever then hare back to the airport with the shortest of goodbyes to all the staff that we`ve only just met....Oh I hope they`re gonna be OK - there is literally no where to run to.

Stressed phone calls to relatives occur leaving many of the group in tears, but stiff upper lips return and we board our magic carpet to Belize and beyond after a nasty meal at BC airport whilst the others try and book flights to Houston. One makes it, another doesn`t at the last minute which is a decision greatly regretted later.

I never thought that I would go back to Flores...not because its not nice - it is, it´s just I thought there would never be a good reason to. A mere hour after fleeing Belize City I am there again wandering the streets with clumsy wheeled suitcase in hand trundling over cobbled rocks (too big for stones) taking in vistas long since consigned to memory but none the less very familiar. After some debate over where to stay half the group decamp to ´Los Amigos´ hostel just up the road from a cafe I used to frequent in days of yore, whilst my splinter group head for a hotel which is only slightly more expensive at 4 quid a night but has its own shower, beds and view of the lakeside roadworks (with built in alarm clock for 7am). Despite not sleeping at Los amiogos we spend a significant amount of time there courtesy of the cosy sofas, palm trees, kitten, dogs and fabulous veggie food. MOvies next door...Notes on a scandal...nah don´t fancy it...maybe tomorrow. No-one is bothered about Felix coming here, but we all watch the news obsessively for news of PG. It looks like it is to hit Nicuragua and Honduras first.

Gone with the wind.

Holy smoke Batman Jeff Fox is there to meet me at the airport! Apparently the message that I wasn`t coming did not get through, but Tropic Air told him that I was coming the day after...now that`s good service. Jeff is a truly lovely chap - tall and gentle about 55 with a beautiful Phillipino wife Ivory who is 37 and mum to Xavier (1) and Ian (5). They are volunteers with the Catholic Mission Board so I better mind my language and anti-Catholic tirades! PG is a tiny place with a triangle for a town square, a strange grid like street plan that isn`t really grid like and lots of shacks that don`t look very wind proof (with only a few bunkers that do). Hillside is a good 5 miles outta town up a hill (odd that) and is a concrete building and a wooden `tree house` which is to be where I am to live with some Leeds medical students (Heather, Fahnaz and Rachel) wheras Emma the other GKT student is above the clinic. We also have Maureen a slightly neurotic Canadian Physio student with us but the nursing students have canceled due to fears about Felix. A rather aborted welcoming party occurs (due to lack of cake or drink) and we head to bed for our early start the next day.

We had been warned that the weather was stormy this time of year but nothing could have prepared us for that nights entertainment....the thunder (ALL night) was SO loud it shook the treehouse, lightning hit trees and felled them taking the phoneline with them, and the wind worked better than the fan to chill an otherwise steamy night. Needless to say even with earplugs and my mossie net I like the others got little sleep, leaving us unprepared for the bad news we were to receive the next day.

Monday started with Joyce the adminstrator cancelling orientation and giving us grave tidings....`Felix is coming and he is now a grade 5 hurricane. PG only has shelters that protect up to grade 3. We cannot protect you and we suggest you take steps to protect yourselves. He will hit Tuesday evening/Wednesday am so you need to be safe by then. And the airport might close.` Oh crap.

How the other half live !

Belize like most countries is one of contrasts. It seems you are either really rather rich or very poor. The Roes are the former. They are also incredibly welcoming and generous. I am invited to spend the weekend with them visiting their cabana at Honey Camp and at their beach house on St Georges Caye - how could I say no?! A quick call to Tropic Air and my flight is delayed till the next day and a message left on the answer phone at HHc. Honey camp is so cute - its up country towards the Mexican border by a lagoon and consists of some trees, a thatched veranda and a weatherbeaten Airstream type caravan. The storms that followed hurricane Dean did hit here, but not badly and the most damage is to tall trees which aren`t tall any more and the rest are being eaten by huge stripy caterpillers!! We stop off at `Victor`s apparently the best restaurant/ take away in Belize for tortillas, PilBil (spicy pulled pork), shrimp cerviche and a venison thing very yummy...even the cerviche! and a few beers. It seems there is a very relaxed view to drink driving here..... Anyway we go for a swim in the lagoon, not via the pier which is pretty much submerged under the water dumped by Dean, but which provides a playground for Ziggy the Silky Dog to zip up and down on without the need for him to swim (big wooss). Then a few more beers/wine and Roz is flat out in the back of the jeep for the way home happily sozzled! I go out with the kids, the cousins and their boyfriends that night to Old Belize: a terrible tourist trap that exists merely for the cruise liner trade which is a bit light due to the immenent hurricane pitched to hit on Wednesday...everybody is pretty laid back about it so I don`t get worried. I manage to last till 10.30 that night!

The next morning I`m the first up at 6am again and spend some quiet time reading and hanging under a fan in the breeziest part of the house next to a giant smelly vanilla candle...heaven. Then its all hands to the pump and we`re off to the Caye on a speedboat (because everyone has one!) Speeding down the river then over the sea to the cayes everybody is whipped by the warm winds and the dogs get their fur whipped about in a hysterical fashion. The sea is still really muddy from Dean but just as we hit the cayes it changes to azure and become the embodiment of a postcard. The beachhut is reached via a wooden pier with a useful cabana to one side and can sleep about 20. Property is pretty cheap here compared to the UK, Honey Camp would cost about 20K and Ladyville less than my house by some measure. So why do I live in the UK? Less mosquitos I guess! Am already up to 15 bites which are blistering alarmingly.... We eat, drink and are merry than pop over to a nice swimming spot with a shallow sandy bottom and splash around; Roz had her 50th party here with a floating BBQ and 80 friends in the middle of the ocean on a sandbank. Then back on the boat, over a soggy lawn as its rained again watching the hired help fit the storm shutters to the windows to protect against whatever Felix brings. And back to the airport where I finally catch my last flight to PG. It`s been a fantastic start to the elective so far!

And we`re off.......

I have rarely felt so little excitement about leaving for a trip. There are a few reasons for this; my next door neighbour is rapidly being consumed by her lung cancer which the day before I left made the final trip up to her brain rendering her unusually vague and confused. Less than a week I thought knowing I was to leave the next day and not being able to be there to support John through this last stage. At least the son appeared, summoned by our other neighbours for her swansong.

Then there is the fearful anticipation of the job itself and not being up to the challenge, together with the absolute certainty of being bitten viciously despite all my anti-bug sprays. And the guilt of abandoning Snowbelle (sigh). And just to complicate matters there is a REALLY tight connection time at Houston between my flights which could knacker everything if it does not come off.

So even whilst I am accelerating down the runway leaving England`s green and pleasant land I am still morose, that is until I watch Blades of Glory....man that is a funny film! And I start to lighten up (thank god I hear you cry!) so by the time I get to Houston (having eaten a bizarre interpretation of a chicken tikka massala) I am mentally prepared to push and cajole my way through the system to get my flight....which I do only after being sent the wrong way twice and sprinting through the terminals to make the gate by seconds (phew). And my luggage made it too - incredible.

The air here in Belize has no smell, unlike Africa but is like a warm sweaty blanket enveloping everything...its gonna take some getting used to. Nobody to meet me....not that it matters, two locals check who I`m meeting and Marilyn ( whose sister was married to Mr Roe`s brother for a while) rings them at home to summon them to pick me up - now that`s a small town! Roz plus Viv (one of the quads) appear in a screech of dust and whisk me about quarter of a mile back to their fantastic pad where I meet the others (Nicole also dark haired like Viv, and Lou & Andrea the blond quads). I am relocated swiftly to the Manatee club for a few beers and great Lebanese food (go figure...) and introduced to some of their friends and relatives (who it appears live in the same enclosure as Roz and co.) But my 8.30pm local time (3.20am home time) I am bushed and need bed. I still wake up at 6am - how does that work?!