30 January 2010

A Friday Full of Big Deals

Greetings be to all from the hot southwestern corner of Honduras! The dry season is in full swing here which means lots of dust and heat, little breeze and no rain...for about 6 months. It also means that every once in a while we run out of water here at the clinic. Nothing worse than getting in the shower and expecting to be hit with nice refreshing shower of cool water on a hot day only to find that we're out of said water. Usually it means going down to the kitchen and flipping the pump on and waiting about an hour, which usually isn't too bad. María the cook also finds it endlessly hilarious that I traipse downstairs in my towel. But, I've come to learn that María finds most of our gringo habits endlessly hilarious.

I have unfortunately become very bad at putting up blog posts. Back in the Peace Corps days I had a good excuse...the closest internet connection was a 3 hour, bumpy, muddy/dusty bus ride away. But here that is no excuse, we have wireless internet all around and I can literally sit in my bed and do this. Of course I always thought that it would be nice when I was in Bolivia, but the truth is, I find that it keeps me confined to these walls a lot more than I'd like.

So yesterday was a pretty unique day, even for third-world Honduras. It started out in a fairly ordinary manner, freshly ground coffee on the porch around 6:30am, filling out my little book of things I did the day before. I think I had Jimmy Buffet playing. I made sure all our cars went out on time and sat down for some breakfast...refried beans, scrambled eggs and some white crumbly cheese all washed down with some freshly squeezed orange juice. We don't have a lot of luxuries down here, but delicious coffee and freshly squeezed OJ are two of my most favorites. I made small talk with Dra. Rosbinda at the breakfast table and then headed to my office to start the work day. My commute is not a long one, perhaps 25 yards from where we eat. I share my office with our medical director, Dr. Juan. The room was originally supposed to be storage space so it somewhat resembles a prison cell with air conditioning. The floor is a sorry concrete job and the walls are unpainted. It's not quite as nice as Ainsley Hayes' steam pipe distribution closet in the West Wing, but there is also a ceiling fan.

The first task I need to dispose of quickly is to cancel my health insurance plan. I recently purchased a year-long insurance plan that covers me internationally, so my current plan with Humana does not need to continue. Since they usually automatically withdrawal the money at the beginning of the month, I want to cancel before they take the money out. I hop online and head to my bank account to make sure they haven't done it yet. Imagine my surprise when next to the words "Current Balance" I read "$13.00." Wha wha wha?? "I knew I was keeping it close but not THAT close," I thought. I scroll down the recent activity and notice a check for over $500 written to Duke Energy. I also notice 3 or 4 other transactions which I definitely did not perform. They let you see a scanned version of the checks while you're on the internet but these checks had someone else's name but my account number on them. So much for a quick task. I get on the phone with the nice people at the Westwood-Cheviot branch of US Bank and they give me another number to call and amid many cell phone issues which nearly caused me to smash the phone against one of the prison cell walls. The only thing that kept me from doing that was the fact that without my phone, life would get much harder and I don't know when I'll have a chance to buy another one. Pero ni modo, I got the account closed and a new one opened up and will get the info in a couple of weeks. Canceling my health insurance became less of a priority since the information they had for my account is no longer valid, hence they won't be able to take money out of an account that doesn't exist anymore! I still attempted to get in touch with them but with no luck...for some reason, I can't dial 800 numbers and those are all that Humana had to offer me. So, being robbed: Big Deal.

Amidst being on hold and resisting cell phone destruction, I managed to get a few pictures of some of our scholarship students sent off to their donors and a few emails written. Alex and Brett were in the next room prepping bins for what is to be a crazy month of brigades...5 brigades in total plus a crapload of other people coming down to inaugurate our new clinic in Concepción. It's nice to get ahead of the game a little since we know it won't be long before we're behind. No big deal.

I strolled back to the mess hall for lunch, a little peeved someone felt the need to steal all of my money, but rejoiced in the fact that at least I didn't have too much to lose. I peeled back the tinfoil on the serving plate and almost fell down with awe...CHEESEBURGERS. María had somehow sensed that I was having a rough day and made CHEESEBURGERS. I promptly went in and gave her a kiss on the cheek, which again she found endlessly hilarious. The burgers were delicious and all was right in the world once again. I have been here for 5 months and this is the first time she’s made these...BIG DEAL.

In the afternoon I headed over to Magdalena with Brett and Alex, the next town up the road. You can drive it in under 10 minutes. I had put an order in for a cake to be made that morning and needed to pick it up. When we got back to Santa Lucía, we rounded up everyone in the clinic to have a going-away party for one of our employees, Nora. Nora had been with Shoulder to Shoulder for about a year but decided to go back to school to become a nurse. During her time with us she worked with a girls empowerment program called Yo Puedo, a women’s health volunteer group called Madreguias and most recently was in charge of our women’s health program, collecting data in entering it into our system. There were some nice words said and even a few songs sung by our resident troupe of singers, the nutrition health promoters. We were all happy for Nora but a little sad to see her go, she is a very good worker and extremely nice. Kind of a big deal.

As we were finishing up our last bites of cake, someone came up to the door to tell us he had brought in a kid with a machete wound. It sounds pretty bad, but machete wounds are something we are pretty used to dealing with down here. Rubén was the doc on call and headed down to check on the kid. Turns out this was a BIG deal. A drunken grandfather and taken a swing at his 12 year old grandson, slicing his leg across the lower thigh and knee down to the bone. The clinic buzzed with action. Nurses went back and forth dumping out bloody bins of water, Juan, Alex, Edgar and Rosbinda (two other doctors) went down to assist Rubén with the kid and I got in touch with a driver to come in in order to drive the kid out to the bigger hospital in La Esperanza. This is about a 3-hour car ride but we are very limited in our resources in Santa Lucía. Anything that requires major surgery like this we have to send on in order to save the patient’s life. I pulled the truck out to the front of the clinic, checked the water and oil and put a sheet on the back seat. Rubén then sent our doorman Don Nato to bring the police since this was a pretty big deal. To facilitate them leaving quicker, I hopped in another truck and drove Don Nato to the police station and picked up a few soldiers there. Four 18 year old kids hopped in the truck with M-16s that looked pretty beat up. Seeing guys with big guns is something I am pretty used to in Central and South America, but it was definitely weird having them in my backseat. I drove them back to the clinic where they asked a few questions of the family members that brought him in. Who knows if anything will become of it, but it was a smart move by Rubén. They carefully loaded up the kid and by then our driver Raúl had arrived. We sent him off and that was that. Things got back to normal quickly, like what had just happened was no big deal. But it was. This morning at breakfast Rubén told me the kid will probably lose his foot and even if he doesn’t he probably won’t be able to walk anymore. It is days like this that make me realize why they made this a dry town...but even that law didn’t help this kid.

That evening after dinner, we settled into what has become our Friday night ritual around the clinic. While I was home for Christmas in the states, I bought a small hookah down in Clifton. It has been a huge hit amongst my friends and colleagues here, so we fire it up whenever we can. Tonight we chose the strawberry tobacco over the blueberry. By the end the evening I was there with Brett, Edgar, Alex and Juan. We began talking about how even though work frustrates us and there are people that drives us nuts and things we can’t control, we’re doing some pretty amazing work. We are basically a small group of late 20/early 30-somethings managing health care for thousands of people who would literally have nothing otherwise. People would die all the time without our presence, a great example being that kid from earlier in the day. And it wasn’t so much about tooting our own horn as much as it was that we need to remember that some times. When the meetings grow long and frustrating and the emails seem endless and then we run out of water or the power goes out, let’s try to remember why we’re here instead of letting it get to us. We’ve all got different sets of skills and we all bring something unique to the table. We should all be proud to say we work for Shoulder to Shoulder and indeed we are. And that’s a big deal.