Saint Mark's Church

Our final day running the clinic began as the previous three had.  We awoke early, had a nice breakfast, and then were escorted to Concepcion del Norte by our driver Norman.   As usual, we were met at the turn-off to Concepcion by several armed guards, who have been with us throughout our time here.  We are told that the principal worry is that our predictable travel schedule along a long, remote road makes us easy targets for robbery.  We are very aware that our hosts are taking extra precautions to ensure our safety.  We have come to regard our guards as members of the team, and at no time have we felt even the slightest bit unsafe.

The line of families had already formed before we arrived, just as it had every day.  And, as in the previous days, our patient Alberto was at the front it, waiting to have his hand inspected.  And it looked much better.  The swelling had nearly completely resolved; there was only minimal pus on the packing; overall, he was feeling better, and his appetite had returned.  We taught his mother how to dress the hand, gave them exercises to work through to maintain his range of motion, and gave him an extended course of antibiotics.  His infection posed a serious risk to his hand – had it been left untreated, it could have threatened his entire upper extremity.  And while the wound is still in the healing process, everyone agrees that its dramatic improvement will likely result in complete resolution and return of function. 

This morning also brought a mother with a small child – 18 months old – who had a large, infected abscess on her face, just behind her right eye, where a mosquito bite she’d scratched became infected.  This condition required another simple procedure with a scalpel – no anesthesia this time, as evidenced by the cries of the poor girl.  Though we know it hurt when we drained the abscess, she will be much better off for it.  By the time we had filled prescriptions for antibiotics and given the mother instructions, the girl was sleeping in her mother’s arms.

Like our patient Alberto’s hand, this girl’s injury is now healing.  We feel blessed to be a part of these significant transformations in their young lives –and in Alberto’s case, we are glad that we have been able to watch the progress day by day.  In a similar way our team has gone through a dramatic transformation as well.  We all traveled down here not entirely sure what to expect, and yet have worked to meet every challenge thrown our way.  Some of us learned to triage and manage a crowd of needy patients; some of us treated individuals well outside our scope of normal practice; some of us stretched our linguistic and translation skills; some of us learned how to work in an ersatz pharmacy.  All of us learned to trust one another, and to be grateful for all what God has given us.

We have done all this because we have had to; because it is what is asked of us when we volunteer to go on a trip like this.  And it is what is needed of us if we are to help those whom we came to serve.  We hope we have become different people through this mission, and as we move on in our lives, we pray that we will hold on to all that we have learned. 

By our preliminary estimate, we have treated over 500 individuals, most of whom were children.  Tomorrow we will take a much-needed rest – we will travel to Copan to visit the Myan ruins before heading home Saturday.  

Father and PJ:
"Hey Prest."
"What Mullen."
What follows are some playful jibes that sting only if you don't know how much they love each other. Father Mullen picked the right man to lead us on this mission.

Dr. PJ Prest has  slender fingers that match his long, handsome frame. His face is gentle, his spirit is kind and his disposition, even and poised.

In western medicine, there are two camps. The "cutters" and the "medicine men." Cutters are notoriously narrow in their vision; they see a problem and they cut it away. Medicine men are more holistic in their approach; they see a problem and they solve the problem within the context of the sum total of the patient. Cutters and medicine men are as polarized as the Jets and the Sharks.

Dr. Prest is a rarity. He sees a problem and has the skill to cut it away; but PJ has the spirit of a medicine man. With a heart of gold and a keen sense of social responsibility, PJ has held us together, maintained our direction and made certain that every move we make as a team bears the mark of Christ.

Hats of to PJ for his outstanding abilities. We're blessed to know you, buddy.

Day three of our clinic began as the others have – an early breakfast at the hotel followed by the beautiful trek to Concepcion del Norte.  It had rained heavily last night, but while the ground was muddy the clouds had cleared, and a strong sun promised a hot day.  The power that supplied the church had been lost, and so the two fans – one in the clinic proper, and one in the pharmacy – which had helped keep the temperature somewhat under control, were non-operational.  But no worries – we shrugged our shoulders and set to work. 

And the crowd came.   Over 110 of them came, mostly as families.  Alberto returned this morning, proudly saying that his hand continued to feel better.  The swelling had indeed improved – it looks like his hand will be OK.  Stacie treated a man who complained of ear discomfort – when she took a closer look, she saw that an old, dead bug had apparently gotten lodged there in some wax!  Throughout the day there were many of the kind of straightforward treatments for parasites, infections, headaches, and allergies that we have seen a lot of, since they are part and parcel of an impoverished lifestyle, but there were also more demanding cases too: a child with epilepsy who needed her medications adjusted, a boy whose sprained ankle needed wrapping, and a women to whom we gave a pregnancy test that proved positive.

Our team continues to excel, treating patients with efficiency but, most importantly, with compassion.  As one member commented, because our treatments are limited, perhaps the most important gifts we can give them are time, attention, and compassion.  We are so accustomed to striving for efficiency in our lives that we sometimes have to remind each other of the need to adjust our outlook and value these very gifts that we have in greatest supply.

And so we will continue on.  Our clinic runs one more day…

Early this morning the rain had ceased and in its place were some low clouds and wispy mist which danced around the tops of the mountains.  The vegetation still dripped with water, and somehow seemed even more lush.  This landscape is gorgeous. 

Before we departed I saw our driver Norman – who works for the diocese – combing over his van with a checklist.  He takes his job very seriously, and I am grateful he does.  Padre Hector refers to Norman as his “Little Turtle,” in reference to his slow driving.  But he has ever reason to be slow on these roads.  They are narrow, filled with sharp turns, and laden with potholes.  He takes his time for our safety. 

We have had to employ Norman in the clinic.  Though his English is limited, he has been an enormous help at the triage station helping Marco, Mary Beth, Bob, and Susan manage the crowed and begin the treatment process.  Last night, when we explained to Norman that he was now a real part of our team and that we would be paying for his meals, he had to fight back tears as he barely got out a prolonged thank you. 

Today’s work went exceptionally smoothly.  Alberto – our little boy with the hand infection – was there to greet us as we arrived.  He felt much better, he said, and his hand only hurt him a little bit overnight.  The swelling was much improved – we re-packed the wound, gave him a dose of IV antibiotics, told him to continue with the oral antibiotics we gave him yesterday, and to return tomorrow for another look. 

There were plenty other people in need of care today …a 98 year-old woman who had lost her vision due to an infection; a young woman who had brought her 14-day old boy for a check-up; and a local woman who runs a daycare/orphanage who had with her 11 small children – and who said she’d bring more tomorrow.  We even had a young girl who benefited from osteopathic manipulative treatment!  And of course there continued the barrage of parasitic infections, gastritis, asthma, malnutrition, and all manner of chronic conditions long since ignored in this impoverished country.  

Through it all we worked calmly and swiftly.  Without any panic at all, we treated 171 patients today.  In two days we have already exceeded our four-day total from our mission here three years ago.  We had to make a run to the nearby pharmacy to re-stock our shelves of some basic things (hydrocortisone cream, children’s Tylenol, etc), and that is but a symptom of the incredible volume of people we are seeing.  The need here is immense, and we are more ready than ever to face the challenges these next two days will bring. 

(Sorry for the delay - the internet was down due to storms!) 

We awoke early and traveled the rough road to Concepcion del Norte.  Upon our arrival, crowds of people were gathered outside the tiny Episcopal Church.  Over 50% of the population of Honduras is under the age of fifteen, and the mass of patients reflected the youth of the country. 

Our team came together quickly.  Three of us manned the triage station; one served to direct traffic; four practitioners worked in stations; two served as translators in addition to the two translators provided by the diocese; four set to work in the pharmacy; and one floated, and helped where he could (guess who?).  The amazing thing was that the team functioned beautifully – you’d have thought we’d been doing this for years. 

And the patients came.  They ranged from nine months to 100 years (literally).  We treated loads of parasitic infections, gastritis, asthma, as well as the predictable aches and pains and rashes that come from an impoverished, ambulatory society.  But we saw some other conditions as well…an old blind women who hadn’t had anything to eat or drink in 4 days – we gave her a couple liters of IV fluids and a lot of multivitamins.  We encountered a young woman who was a victim of domestic violence – we offered some counseling and support.  And there was an older gentleman with advanced Parkinson’s that we really couldn’t do anything for, except show him compassion and offer some comfort.  Through it all we tried to show the grace that has guided us here, and the patients we saw showed extreme gratitude for our efforts.  At the end of the day, after we had already cleaned up and were preparing to leave, a mother showed up with her 10 year old son whose hand had been injured some days ago and become badly infected.  We decided that the best thing to do was open the wound to drain it and begin a course of antibiotics.  So we quickly set up for the procedure.  Our nurse anesthetist administered local anesthesia, our surgeon wielded his scalpel, our other docs and pharmacist organized the meds, and within minutes the boy’s wound was drained, his hand bandaged, and the danger that the infection posed was drastically curbed.  We’ve asked him to return for follow-up tomorrow.

In all, we treated 193 patients – more than twice the typical daily load from our last trip here to Honduras.  We are pretty tired, but we are energized by the need, and by each other’s gifts, and so inspired to do even more tomorrow. 

The rain that typically falls in the evening has started beating on the roof.  Now, off to bed!