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| Hillside Clinic |
Sue Writing on August 16, 2010
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| Sue Speaking with Women at Salvation Army Retreat |
It has now been 2 weeks since we arrived in Punta Gorda (PG), Toledo District, Belize and started working at Hillside Clinic. And it has been a very full 2 weeks. We arrived with a new group of medical and pharmacy students, 6 medical students from the UK and 2 pharmacy students from the US. Len and I started right in the first day, we spent the morning in orientation with the students, meeting the staff, some of whom we know from our previous visits and some new. That afternoon Len and I and Penny (Hillside’s administrator) went to Cuxlin Ha, a Maya village near the clinic which is also a “resort” with a hotel and pool. I had been asked to give a talk to a women’s retreat sponsored by the Belizean Salvation Army. There were about 20 women, mostly in their 40’s or older and they were great. We had a lively discussion ranging from menopause, diabetes, hypertension, heart disease, to thyroid disease, asthma and sickle cell anemia. They had lots of questions, were fairly health savvy and when they realized they had a doctor in front of them who was willing to answer questions and give them information they took full advantage of the opportunity. The rest of the week was spent in the clinic and going on mobiles (mobile health clinics where we go out to more remote villages to see patients rather than the patients coming to us) as well as doing educational presentations with the students.
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| Sue Precepting Students at Mobile Clinic in Barranco |
Last week saw the start of camp, run by Hillside clinic for the children of Eldridgeville, the village outside of PG, in which the clinic is located. Every afternoon for 2 to 3 hours, after spending the morning in clinic, half of the students and a preceptor get to entertain 20 to 30 local children ages 5 through 14. Have I mentioned it is about 90+ degrees and 100% humidity? Camp involved water fights, football (soccer) games, musical “bums” (instead of musical chairs), bobbing for craboo (a local fruit with a sour taste that the kids love) and ended with sweaty and exhausted medical providers and happy children. It continues this week as well.
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| The Health Building at Barranco where clinic is held |
We have seen some interesting patients at clinic. We made the diagnosis of new onset Leishmaniasis, a parasitic disease transmitted by the bite of sand fleas. Unfortunately it is hard to treat, even in the US. One mobile clinic this week was particularly interesting. We went out to a lovely village on a large stream. When we arrived we were immediately asked to make a house call to see a young woman who was bleeding. On exam, in her home (a thatched hut), she was indeed hemorrhaging vaginally. I had a student and our driver transport her to the nearest health facility, a Ministry of Health clinic about 40 minutes from the village where she could be stabilized and transported to the hospital. I then walked back to the health outpost where we were seeing patients and on the way stopped and made another house call on a young girl with Downs who the clinic follows. I made the unfortunate decision to sit on a hammock at her house for which I was rewarded with multiple flea bites which are still bothering me 5 days later.
In the first 2 weeks I have seen 2 children with Downs (not unexpected given that women have children into their 40s), 2 children with cerebral palsy, and one child with a cleft lip and possible congenital heart disease. I have also seen scabies, impetigo, wheezing, colds, shingles, abscesses and cellulitis, lacerations, scorpion bites, lots of type 2 diabetes and hypertension, and started one patient on methotrexate for Rheumatoid Arthritis. In addition, I did an ADHD consult the first week I arrived. Yesterday, Sunday, 8/15/10, a few clinic staff, myself included, drove out to one of the more remote Maya villages for their first annual health fair. It seemed to me to be very successful. There were booths from Hillside, the Ministry of Health, Peace Corps volunteers doing HIV education and 2 or 3 other agencies. There were lots of villagers who had lots of questions. On the way home we stopped at a lovely waterfall to go swimming and for the first time in 2 weeks I actually felt chilled for a short while.
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| Sue and Len at Hillside Staff party |
The staff at the clinic has been very welcoming. We knew some of the staff from previous, including Evert, the grounds manager and all around handy man, Amelia who does the cleaning, Sophia, a Mayan translator, and Rudy, a driver extraordinaire. I always feel more comfortable on mobiles when Rudy is driving. Other staff members include Penny, an American ex-pat who has been here for 14 years, who is the clinic administrator; Betty, an American nurse who has been at the clinic for about a year and does home visits and acts as “house mother” for the students; Aprill, born in Belize to American parents, who does the student scheduling and is very pregnant; Alfia, a young Maya woman who does patient intake and translation who is delightful; Jenny, also Mayan and also lovely, who works in the pharmacy and is planning to go to nursing school; and James, Maurice and Allan who help around the clinic and act as night watchmen. Dan and Maria Thibault, American nurse practitioners down here for 3 to 5 years, are the medical directors of the clinic. In the last year they have done an amazing job of organizing the clinic and the students’ educational experience. This past Saturday the staff arranged a welcome lunch for us and 2 young doctors from the UK, Cristina and Graeme, who will be at the clinic for 3 to 4 months. The lunch was at the home of 2 ex-pat Texans who have renovated a 100 year old home and made it into a Bed and Breakfast on a spectacular piece of property near the clinic. They have a beautiful pool and served a delicious lunch and it was a very pleasant afternoon.
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