Sunday, July 6, 2008

Honduras: What We Did There Story

Day 1: Arrive after traveling for 21 hours. Sleep. Eat dinner. Pack Meds.

Packing Meds: There were dozens of suitcases filled with all different types of medicines and creams and vitamins. We spread out signs on tables around the room for Antibiotics, Antiparasitics, GI, Heart, Asthma/Allergies, Pain Relief, Vitamins, Topicals, and Donations. All the medicine bottles were stacked on tables, under tables, near tables, etc.

Yeah! Done! No? Oh.

Medicines then had to be grouped in grocery store bags by generic name and amount. The 400mg Albendazole had to be separated from the 200mg Albendazole from the 200mg Metformin. 2-4 people each took charge of one type of medicine. The sorting seemed to go quickly.

Yeah! Done! No? Oh.

Next we had to sort medicines by dose. Cue the little sandwich baggies. My first experience with this was working in the vitamin area. For vitamins we poured 30 vitamins into a little baggie, sealed it, then wrote the name (adult vitamins, children's vitamins, prenatal vitamins) in Spanish the expiration date, and the directions (take one pill every day for 30 days) in Spanish ("Tome una pastilla cada dia para 30 dias"). Rinse. Repeat. For the first Brigade we needed 400 baggies of children's vitamins and 300 adult vitamins.

Some of the instructions were more complicated, "chew two pills after eating when you have stomach pain," "take 2 pills every 4-6 hours as needed for pain." After all this was done the little baggies got put back into the grocery store bags, labeled, and shoved back into the suitcases. The suitcases were labeled with what type of drug they held, and then loaded up onto the back of a truck.

Yeah! Done! Yes! Bedtime = 12:30am

6:30am the next day was breakfast. We left on the bus at 7am, arrived at the site at 9am.

I already explained triage - the job I did where we asked what their symptoms were and if they had any allergies. We sent the kids under 12 to be weighed (many medicine doses depend on your weight), and those over 35 to get their blood pressure taken.

They left triage and waited in the line to be seen by the doctors. We had two doctors and Stephan doing physical exams. I was too busy to see much of that process, but it involved very few actual procedures. Sometimes Doc Mike would take ear wax out of ears, or redress a wound, or clean out a sore. Mostly, though, they just looked the person over, and the docs would write on their papers what the diagnosis was, and which medicines they needed. The first day the docs spent about 2-3 minutes with each patient. And you thought American healthcare was fast!!

They left the doctors to wait in line at the pharmacy. This is where most of the kids who didn't speak Spanish were hanging out. They'd get all the papers from one family and start filling the prescriptions. Each patient had their own grocery store bag with their diagnosis/prescription paper in it. The bag would get filled with vitamins, tylenol, antiparasitics, whatever the docs had written down... as far as it could be read. There was lots of running around, running into things and people, and asking the pharmacist just what was needed in particular situations.

That first day I know we ran out of adult vitamins. I'm sure we ran out of other stuff too. That was hard. How do you tell a mom that we're out of children's tylenol and have nothing else to treat her baby's fever? It would be another month before another brigade came through if they were lucky. Sometimes the pharmacy was a sad place to be. We would throw in some donated items when they were appropriate (toothbrushes to people with toothaches, sweaters to babies who were sick, combs to people with lice).

Once the whole family's bags were ready to go the pharmacist or another person who spoke Spanish (one other student that I know of) would go out, find the family, and explain each and every medicine to whoever it was for, or whoever in the family would understand.

Yeah! Done! Yes! We left that site about 4pm and packed more meds that night. Rinse repeat, two more times, as needed.

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