Lia (July-Aug 2017)

When I arrived in Roatán an employee of Clinica Esperanza picked me up from the airport. He drove a bright orange van, the back of which bounced frequently, hitting the pavement as we dodged potholes. I took in my new home for the month on the way to my apartment, as we made our way down the singular road that runs the length of the island. On Roatán the resorts neighbor the poverty. The contrast between the two was visible just in the drive from the airport, as we passed huge hotels that sat just adjacent to smaller convenience stores and houses in need of repair. This contrast was perhaps most exemplified in the pediatric inpatient room of the hospital, where necessary equipment and medications are often in short supply and mothers sit by their children’s beds in donated cruise ship chairs. The juxtaposition between vacation and the crude reality of poverty exist so close to one another on the island, yet the two rarely intersect.

            My days at the hospital began with rounds with the pediatric doctor. We began in the emergency room, and then made our way through the pediatric inpatient room, the NICU, and then to examine the newly born babies in the maternity ward. Should a child be held in the isolation room, we would put on thick masks and visit them too. Following this, we would make our way to the pediatric clinic, where I would help triage the patients before they were seen by the doctor. I measured the height, weight, temperature, and head circumference, if appropriate, before each patient saw the doctor. Through seeing so many different areas of the hospital, I was able to see a variety of diagnosis, ranging all the way from TB to healthy checkups.

One of the most rewarding parts of spending time in the hospital is seeing kids the whole way through the process: from admission until the time that they are well enough to get to go home. I distinctly remember an instance in which a 1 and a half year old little boy was discharged. After having felt so sick and having been so upset for much of his time in the hospital, when the doctor told his mom they could go home that day, his little face lit up. He ran right up to me to be picked up just after, and pointed to the door expectedly; it absolutely melted my heart. There were other times when moms that I recognized from the NICU would come for a well check-up in the clinic, and I would share in their excitement as I weighed their baby and we marveled over how much they had grown.

There was one day in particular that a visiting doctor was seeing HIV positive children in the clinic. I remember this day distinctly because I was so impressed with how the doctor spoke with each child, navigating what can be such a delicate situation. Some of the children, who were younger, were not yet aware of their diagnosis. During visits such as these I sat with the children outside of the patient room so that the doctor could speak with the parents. One little girl in particular was very excited to speak to me because she could practice her English, which she was learning at school. She told me that when she grew up, she wanted to be a doctor, and spent the visit asking me all kinds of questions. Her school, a Canadian non-profit, was one that I would later visit to volunteer. During my visit, just after I got to the school, when I was standing inside filling up a water bottle her head popped through the window, and excitedly yelled my name. She ran inside to give me a hug. Later, one of her friends would shyly walk up to me too, tapping on the pant leg of my scrubs, before giving me a quick hug and then running back to her friends. One of the most memorable visits that day, however, was with a boy who was aware of his diagnosis. He was 12, and in the 6^th grade, which is the last grade during which children can attend school for free on the island. After this, either parents must pay for education, or children may stop going to school altogether. The doctor talked with the boy about his interests, and what he wanted to do when he was grown up. She talked to him about the precautions that he would need to take when dating, and emphasized the importance of remembering to take his medicine daily as prescribed. Most importantly however, she reminded him firmly that he was just the same as any other 12 year old boy, the only difference being that he had to take his medicine. She made sure that he knew that he could live a wonderful life, despite his diagnosis, and that he should not shy away from pursuing any of his dreams.

            The hospital is notably different from what we picture a hospital as in the U.S. The system is all paper, and every patient’s chart is kept in a manila folder, stacked in impressive numbers in a room just next to the hospital entrance. It’s not abnormal for papers to be lost, or for some of the information on a patient to be missing. There is water damage visible on the ceilings, holes in some of the walls, and tiles missing in places in the floor. The rooms are small, and privacy is lacking as most patients’ beds are sit right beside one another. Most important, however, is that the hospital sometimes lacks needed medications, or equipment needed to treat patients. In cases such as these, patients need to be transported to the mainland, to either San Pedro Sula, or to the capital, Tegucigalpa. The trip is unimaginably long and incredibly expensive for many families, something especially daunting to face while caring for a sick child. The doctors and nurses, however, don’t let any of these challenges phase them, and approach any situation complicated by a lack of supply with calm determination and care. It is visible how much they care for all the patients who they treat, and they treated me with the same kindness. My very first day at the hospital the pediatric doctor made sure I had her phone number, and let me know that if I ever needed anything I could text her. She even sent me a message the day I left, asking if I was home safe in the U.S.

            In my time outside of the hospital, and the clinic, I explored the island with other medical volunteers. Of everything we did scuba diving was by far my favorite. Imagine flying, underwater, in Finding Nemo. It’s as good as it gets. There was never a dull moment, and I’ve been wanting to return ever since my plane landed here in North Carolina; they weren’t kidding about the island fever.