A tale of two clinics....

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 wor

ms 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 mag

ical 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 h

orns 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!