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!