Sreyla: Last Mobile and BBQ
Trip Start
Jun 05, 2011
1
24
25
Trip End
Jul 05, 2011
Punta Gorda, Toledo, Belize
Thursday, June 30, 2011
The June 2011 Hillside crew is a random collection of doctors, physician assistants, and pharmacy students from the UK and different parts of the U.S. We were able to come together in 4 weeks and develop some unique relationships with one another through our shared experiences. It's been such a pleasure working with everyone. My team worked well together: taking turns seeing patients, sharing clinical skills, discussing pharmaceutical and patient care options. Through these discussions I was able to learn a little bit of how medicine is practiced in the UK. And as I had mentioned in an earlier post, I particularly enjoyed having a pharmacy student on hand to confer with about dosing and drug interactions. I think I’ve gotten a little spoiled this month in that respect.
I believe that I’ve grown a lot as a future medical provider. This month I’ve had to practice with limited medical resources and rely heavily on my physical exam skills in order to properly diagnose and treat patients. I came to Belize imagining all the wild tropical diseases that I would see but in reality I saw mostly ailments that you would find in any U.S. family practice, from chronic back pain to Type II diabetes. However, when I did find things that needed further investigation, i.e questionable masses, lesions, or pain, there were so many barriers to getting the studies that we needed. Many of the studies that we needed were just not available.
One lady I saw on a mobile clinic was clearly having some coronary problems with episodes of chest pain and shortness of breath. But there was nothing we could do except supply her with some aspirin and a strong urging for her to go to the clinic in Punta Gorda. However, a bus ride to Punta Gorda can cost up to several days wages for these villagers. And once they get to Punta Gorda Hospital there’s not much they can do there either because the nearest cath lab is 3-4 hours away in Belize City, which costs even more to get to.
Other problems we had were with language barriers and poor patient compliance. Having a language barrier in any situation is always difficult. But trying to elicit a good history from patients who have a very broad concept of time makes for an interesting conversation. Here’s a pretty common dialogue I would have on a daily basis:
Me: Did you have a fever?
Patient: Yes. I have fever.
Me: When?
Patient: Last month.
In addition to that, patients would respond to everything they don’t understand with "yes."
Me: Did you stool today? (FYI: people here use “stool” as the common word for feces)
Patient: Yes.
Me: When?
Patient: Yes.
Me: (to the staff) Can I get an interpreter?
Anyway, today there were only 2 students on Mobile clinic when there are usually 4, myself and Rosie. I was a little nervous at first because it seemed like a lot of responsibility, but I was pleasantly surprised to find that we whipped through the 24 patient queue quite efficiently between the two of us. This was such a huge contrast to my first day in clinic when it took each of us (4 students) an hour to work up a patient and we could barely get through 12 patients in a day.
At the end of the day we had a farewell BBQ with Mr. Rudy as our BBQ grill master. He cooked up some of the most delicious ribs, chicken, and fish that I’d ever had. Not only that but we had some amazing side dishes provided by the amazing cooks in our student crew. A great way to end our last full day at Hillside.
