Saturday, June 16, 2012

The Doctor is in...

The work of a medical brigade starts months before the first patient is seen.  The brigade team in the US begins planning, recruiting doctors, nurses, dentists, lay helpers and once, an optometrist.   They estimate what kinds of medications they need, order them at a steep discount, and then have "packing parties" at which they package and label all the meds into little dosage bags.  Patient record cards are printed up by the hundreds.  Of course, like any team, they plan the travel logistics, prepare mentally and spiritually, meet to build fellowship among the team.

3 of our translators!
On the Honduras end, work also starts weeks in advance.   We contact people at each clinic location to let them know we are coming.  Making contact at Colonia Emanuel, a small village on the side of a mountain, typically involves driving out there to find the contact people.   We purchase some of the medications here and Bibles to hand out.  We make up the detailed schedule - a complex logistical exercise, find and hire translators, organize transportation, prepare Casa LAMB and all the other details that go into preparing for all our teams.

Finally, the team arrives with more medicine filled trunks than team members.  After a delish lunch (thanks to Dulce!) the team gets settled in their rooms (thanks to Gloria for preparing them all!) and then they get to work.  The meds need to be sorted and organized into selected trunks for the next day.  Then we take a quick trip to La Colonia (grocery store) to pick up a few more essentials (clorox, scrub brush, buckets for the Dentist, paper towels for the pharmacy) and favorite snacks and a fun cultural experience for the team.
Waiting to be seen

The locals at each clinic location are also preparing.  They hand out tickets to see the doctor and dentist.  The tickets are free but necessary for crowd control.  One of the most difficult parts of a medical brigade for me is the people we won't be able to see.  Each doctor can see about 75 patients a  day.  They each see everything from newborns to "ancianos" (very old people) regardless of their specialty area.  Sadly, there are so many more people in need.  Every day at each location, unticketed   people wait in the hot sun or pouring down rain, often holding sick babies, in hopes of getting in.

We are up early the next morning ready to go!  We arrive at the first clinic location, Pastor Felix's church in an inner city barrio.  We rush in with the trunks and begin setting up.  A plastic table and chairs form each doctor's examining area.  The dentist lays out his (scary) dental tools and is ready to pull teeth all day long.  The pharmacy is a scene of controlled chaos as the team unpacks and arranges the large ziploc bags filled with the tiny dose bags of medicine.  Very quickly the pharmacy team becomes expert in what each drug treats.  Of course, we only give out what the doctor has circled on the back of the patient record cards!

The registration desk is manned by local volunteers to take down the names and ages of the patients while a member of the brigade takes blood pressure.  Another member of the team takes a photo of each patient and prints them out while they wait to see the doctor!  This is an enormous gift for each person and family.   The local volunteers manage crowd control, making sure we have enough patients ready to see a doctor to keep the flow going but not too many.  This is a delicate balance to maintain the flow, come to a good stopping point for lunch and end of day, while also keeping the waiting throngs under control.  They do an excellent job for which the brigade team is very grateful.

Before the first patient is seen, we all, local volunteers and brigade team, circle up to pray. We pray for God's guidance, for strength for the team, for the patients we will see and those we will not.  Finally we give thanks that we are able to serve God in this way.

The doors open and the patients fill the rows of seats waiting to be seen.  Each doctor sees an entire family together.  Sometimes there is only one person, sometimes as many as 6.  They crowd around the doctor and translator, taking turns sitting in the chair closest to the doctor.  Often the translator has a baby in her lap while the mother is being examined.  Or, one of our brigade members is holding a baby (truth be told, we race for the chance to hold the babies!) and showing the baby off to the rest of the team.

Grace is happy to see her friend from last year!
7 days old!

The dentist begins pulling teeth.  You would have to give me valium and a straight jacket to pull my tooth but these patients sit waiting patiently for the long needed relief the extraction will provide. Keenan, our dentist pulled teeth all day, every day!  Kudos to the entire dental team who dealt with blood, crying children, and stubborn jaws for the entire week.  Me?  I say, "too icky."

Often I would look up from what I was doing to see the doc, translator, and family holding hands, heads bowed as they prayed together.  A powerful prescription administered on the spot.

After seeing the docs, patients go to the dentist if needed, and get reading glasses or sunglasses.  The "anteojos" (literal translation is "before eyes!") are another thing we don't fully appreciate.  Reading or sunglasses are out of reach for most people.  Now, they can read again!  Or, people who work outside have protection from the blinding sun!  And, the teenagers can look cool!  Finally the patient arrives at the pharmacy to receive a bagful of medications.  Everyone receives vitamins, worm medicine, toothbrush and toothpaste and a card with a blessing printed on it.  The "pharmacists" add the prescribed meds to the bag, explain how to take the meds in spanish and send the patient on his/her way with a smile.

Waiting for her meds
Several things always strike me during these clinics.  One is how many people suffer with ailments so easily treated.   We see people who have been ill or in pain for a long time.  A dose bag of ibuprofen or amoxicillan puts a quick end to the suffering.  Which brings me to the second point.  There are so many people who cannot afford the medicines they desperately need.  Sometimes it is as simple as hemorrhoid cream for a taxi driver (if you have ever had a hemorrhoid you know how crucial treatment is especially if you spend 12+ hours a day driving) and other times as serious as a diabetic or heart patient with no meds.  Medications are inaccessible for many people.  For example, you can purchase 2 Tylenol for 2 lempira (approx. 10 cents) at a local pulperia (convenience store) but even this is more than so many people can afford.  You can only imagine what an entire bag of medications mean to their health and their spirits.  We saw a number of children, as young as 7, who came alone to see the doctor.  Most likely their parent(s) work but sent the child.  School was out of session so often parents have no option except to leave small children at home unattended.  I had to fight back tears as I was explaining to a  solemn 7 year old how to take the bag full of meds (including antibiotics) that the doctor had prescribed.  "Take one of these 2 times a day. This one, 2 tablets every 4 hours as needed.  I teaspoon when necessary.  Chew only one vitamin every day. Take one of these three times a day."  I can only hope the meds got home to a parent who could figure out all the instructions.

Another gift the doctors give to their patients is attention.  They smile at them, listen patiently to their ailments, take notes, and then provide detailed explanations of the ailment and treatment prescribed.  Many patients exclaim that this is the first time they have understood what is wrong with them or why they are taking certain medications.  If you read an older blog, In God We Trust, you know how important it is to be listened to, to be seen, to be loved...because it is clear that the doctors and the entire brigade team love each person there.

Cortisone shots

Each day, in the morning,  we plan on  leaving the clinic site at 4:30.  Every day we actually leave the clinic site at about 5:30.  There is always one more sick baby, or sick anciano, or sick adult who just got off work...This is the hardest thing of all, turning the last few people away.  We leave that up to the local volunteers but our hearts are heavy knowing what is happening outside.  The team is exhausted and we have more work at Casa LAMB to prepare for the next day.  It is getting dark and our clinic sites are not well lit so we really just have to stop.  Lord, watch over those of your children we cannot see.  Provide for them, heal and comfort them.

After two days at Pastor Felix's church, transformed into the medical clinic, the team moves on to Flor del Campo.  The soccer court atop the El Cordero school has been transformed into the next clinic.  It is the same drill the first morning with different but efficient local volunteers, including some of the Alonzo Movement kids.  Our first patients are the children from the daycare.  All of them sit on the floor at the foot of the doctor (in this case, Dr. Laurie Harrell) with their caretakers providing the medical history for each one.  We also see the LAMB employees and their families, the CAP ladies, and other people involved in our ministries first.  Of course, there are many from the community seen too.

This brigade team included 4 men who came along to paint the entire El Cordero school and the offices in Flor!  It was great to be in the same place with them, to admire their work, and to share stories with each other.  Several Alonzo Movement boys were helping them paint. We laughed at the horror of one of our painters as he saw an Alonzo boy standing on the ledge of the balcony on the other side (the wrong side!) of the fence overlooking the concrete floor below.   

We also had a prayer team in house. One of the members is a doctor who saw patients on the second day in Flor.  The other 2 prayer team members, a father and daughter, would pray intensively for individual patients.  Another unexpected gift for several of God's children.

After two days in Flor, we headed up to Colonia Emanuel.  Col. Emanuel is an impoverished village in the mountains about 1 hour's drive away.   You pray for no rain because the dirt roads are difficult in the best of weather but treacherous in the rain.  (Yep, it rained both days we were there.)  This time we set up in a small house that had been completely emptied for our use.  We had two doctors, a dentist, the photo and eyeglasses station, registration, and pharmacy in there and not an inch more room!  The house is made of a single layer of 2x4s with a tin roof (that has only a few leaks in it) and a concrete floor.  Each room has a single, bare lightbulb and an open space built into the wall as a window.  No glass or screens.  The people in Col. Emanuel are much sicker than the other locations.  I can only assume it is because they have little access to medical care in between brigades.   There were so many sick babies -- infections, rashes all over their little bodies, vomiting, diarrhea, fevers... Lots of need for antifungal cream, too.   We ate lunch in the little church.  One room, dirt floor, sacred space given over to us for some rest and food.  Well, us and 500 flies...

So, there you have it.  Months of preparation in the US, Casa LAMB, and each clinic location.  2 days in each place.  Approximately 1300 people seen, treated, photographed, smiled at, prayed for, and loved.  Next year's brigade already scheduled.  16 exhilarausted people back in the US sharing the good news of being Jesus to so many in Honduras. 


  Thanks be to God.