Two Months

I know I look beat - but this was taken today
after a LONG, tiring day..

We opened the clinic on the 21st of February - so actually it's been just a tad over two months since we've been open, but as it's the last day of April, it seemed like a good time to let everyone know what's been happening:

I KNOW I KNOW I KNOW it's NOT all about numbers, but the stats of what we are seeing truly are interesting!  I actually am trying to already look ahead at my Masters Program to see how I can start incorporating this information and start to determine what I'm going to do for my program - so here's where we stand:

540 medical consults (340 this month alone)
Average of 17.9 patients each day we are open
12 pregnant women we are following (monthly prenatals, blood pressure, weight, etc)
35 less than the age of 1
137 less than 5 years old
71 geriatric patients - of these, we treated 63 for high blood pressure, and 30 for Type II Diabetes (so obviously some for both)

So - there's some interesting things - and mixed in the middle of that we've had a few emergent cases (diagnosed appendicitis and sent to the hospital, lacerations requiring stitches, toe nail removal - my favorite, broken bones, etc.).  So - we are keeping busy, and obviously definitely being utilized.  With the opening of Sunday's, I was sure this would drop our weekly patient numbers, but that has NOT been the case - people are finding out we are open on the weekend, and that allows for workers who would not normally be able to come for fear of missing work, to actually be able to come.  We still have days we are turning people away, simply because we don't have enough time in a day.  But we do have to keep to our hours - or we would be open WAY past dark...

Madison's WAY cool logo for our clinic

Beating my head against a wall

I've been working in Honduras for almost 5 years.  I have PREACHED healthy eating habits, risks of high blood pressure and high blood sugar.  If you are over the age of 40 here and are NOT a diabetic, I'm actually shocked!  The statistics for my patients in the village I work in are SO high.  People know...they KNOW because people around them die all the time due to problems directly related to hight blood pressure and diabetes.  And yet...after ALL my preaching...after ALL my education, there is still the thought that a magic pill will take care of everything and nothing in their lives needs to change.  So here I sit.  I'm so torn.  If people would change the way they eat, their lack of exercise, lack of any fruit or vegetables in their life, NOT drink the 2 liter bottle of Coke every day (the average Honduran in the two villages we have clinics average 2 liters of Coke a day), then their lives would change dramatically.

And then I sit back and think about how similar things are in the States.  Really, the reality isn't much different.  People know the risks, and yet still they behave / eat / don't care for themselves.  But then comes the difference...a first world country v.s. a third world country.  A diabetic coma here pretty much means death...stroke protocol - non-existent...rehab - minimal...hospice - nada!

So...I hit my head against a wall because I know how much small changes can make in the lives of so many, but most people just don't want to make the change.  Again - NOT much different that the States - this I know - but TOTALLY frustrating for a health care provider to realize or accept.  This all came from a sweet lady who came to clinic today with a blood sugar of 570!!!  (normal is 80-120).  Her mother JUST passed away about 3 months ago directly related to diabetes, and her uncle not to long before that.  She KNOWS the risks, but "just hadn't taken her medicine because she felt fine."  So Dr. Roger took the time to really speak to her heart, and hopefully made an impression that it won't happen again.

The 21st Century Arrives in the Jungles of Honduras

The clinic has been open for almost 2 months.  We've been improvising with medical records for awhile because we knew eventually we would want to use electronic medical records.  I searched and searched and searched for the right one to use.  Finally found one that is going to be perfect for us!  On top of that, getting internet out in Armenia Bonito was going to be a challenge.  None of the internet providers were able to provide what we needed.  We ended up finding a company in the capitol city, Tegucigalpa, that came down and set up internet for us.

Today we used both for the first time - internet, and our web based medical records.  WOOHOO!!!!

Population what?!

School of Public Health, Population Medicine Masters program

I've been wanting to get a higher education.  I've realized I've come to a place in my career where I can't go any further in helping the community I've come to serve without some additional education.  My first thought was to be a Nurse Practitioner - I quickly realized that was an impossibility given I live in Honduras, Nurse Practitioners don't even exist here, and there is no U.S. school that will allow me to do my observed clinical hours in a 3rd World Country - and trust me...I've looked!  So this also left out the possibility of becoming a midwife as well - those darn clinical hours!  As a midwife, it would limit my scope of education considerably, and as we don't plan on delivering any babies at our little clinic (at least for now).  I wanted something that would help me improve the community - that's mostly why I'm here afterall - not just to provide a band-aid, but to get to the core of the problems.

Then I found the Masters program under the School of Public Health called Population Medicine.  What in the world?!  What does that even mean?  I'm looking at this program, and it's so specific, I am guessing only a handful of people even HAVE this masters degree...but the more I looked at it, the more I realized this is EXACTLY what would serve me well.  Here is what the program looks to teach:

o Apply epidemiological methods to the prevention and treatment of acute and chronic diseases
o Use basic and advanced statistical methods to correctly interpret data
o Incorporate effective management approaches into public health settings
o Promote the use of clinical preventive services
o Evaluate and minimize risk in lifestyle diseases
o Apply population medicine skills in community settings

Um...yeah...RIGHT up my alley - basically, what I'm already doing, but now I'll KNOW how to do what I'm doing :-)

I started today, and can't be more excited.  It's a total of 56 units, and given the time requirement for each class, and let's face it, the expense (Mike is also pursing his Masters Program) I am going to be restricted to only taking one class at a time.  My first two classes are anything but exciting, but I'm in...I'm going...and I can't WAIT...