Nueva Capital, Tegucigalpa, Honduras
29 Enero 2015
0515 hours

Gehlen Mission Honduras Medical/Dental team followers.  Hello and happy day.

Currently it is 16.2 C or about 61 F with a light drizzle in the air.  The winds we up again during the night but I doubt many of this team really cared or were away of it including this writer who had his best nights sleep in many days.  The earlier blog last night said much about this.  Today's forecast is for clouds with a high of 25 C or somewhere in the low to mid 70's with a low of 12 C or about 54 F.  Since today all of our clinics are inside the weather should not be a factor.

Richard Seivert, the Director of Mission Honduras LeMars will be arriving today to join the team and then help unload the Mission Honduras LeMars container that will be in Tegucigapla later today in the afternoon or probably in the evening.  This container has 16 pallets of needed food and other supplies.  I know many of the boxes will come to the Nueva Capital area through the Cerro de Plata Foundation.  It surely is needed!

Yesterday, like the earlier blog written last evening said, was very busy, not from the standpoint of patients, but because of the disease states the triage team and the doctors saw and treated.  Although we were told that many of these people came from the exact same area as the other days, the medical evaluation form tells us a different story.  Many of these people we from a different area in Nueva Capital or from a different zone.

I have not had a chance to review the medical charts developed on each patient, but I agree with the earlier statement of at least 300 or so patients needing the medical element, and 53-55 dental patients with about 120 extracted.  Today we will meet with the school administration about the clinic's that will be held for the school kids.

I (and I know for sure every team members can say the same) will just rely a short story.  Before I begin with this, I want all of you to know how helpful the local Bomberos (Firemen) were today.  They are  based here in Nueva Capital and about 3 minutes from the school.  There were 5 Bomberos helping today. They helped with crowed control and lifting and directing patients.  This is a very valuable resource for us during this mission and for others in the future.  I spent time speaking with each of them.  Many are working towards becoming a paramedic and we let them help us in the medical area to the degree we could.  Many of these guys, like so many in the USA, had served with the Honduran Army.

So, this elderly woman was found in the line by the triage nurses.  Really struggling to breath.  She was carried immediately to the clinic area by the Bomberos.  During the treatment process I found out that she lives quite far away, and part of the area the road, if one existed, was impassable and she would have to walk or be carried by her family.  I have no idea how she was able to walk to the school and then stand outside waiting for us to open the daily clinic.  She got better after various nebulizer and other medical treatments.  Then the challenge.  She was still very weak and would not be able to make the long and difficult walk home.  The Bomberos said they could help but their  firetruck would not be available until until in the afternoon and then could only get so far towards here house.  I made the decision to have Julio take her and her family home in out Toyota 28D pickup,  Everyone said we could only get her close.  Well....Julio drove her right to her house where a road did not really exist.  Our Toyota is high and has the rugged tires for mountain travel.  The Bomberos were impressed and told me the truck was very tough.  I told them I know because Julio and I have been in many of these types of situations during the years.  The lady and family were very happy.

When I think about this type of situation, I and I know others on this team, know full well why we come to areas like Nueva Capital.  There we so many incidents of need and help yesterday, but I will leave it here.

Many of the team are still sleeping.  Yesterday was busy.  We hope to get other photos and parts of a daily diary from one of the doctors on our team posted later today.  God bless and peace to all.

Mr. Francis

Buenos Tardes from Nueva Capital!

Today was another busy day at the clinic filled with more deworming, daily vitamins, and a few unexpected incidents.
One man came to us with pneumonia and COPD, but left us in an ambulance. The Bomberos helped carry him from the doctor's office to the ambulance on a stretcher. Then we had to stop sending patients to the dentist office because there were so many people who wanted to see the dentist.
We saw around 300 patients today all of which were very grateful and patient. Doctor Tom Morgan reported that today's patients were more chronically ill: diabetes, respiratory issues,and hypertension. Many patients were diagnosed with anxiety and depression; we have also seen a few cases of domestic violence. Nurse Diana says "Another excellent day filled with patients." She cannot stress how great it feels to be here, and to be helping the needy people of Nueva Capital. Nurse Claudia reports that triage was more organized today, and the flow of people was excellent. Hello to everyone in Sioux Land from the crew!
Tomorrow school starts at Santa Teresa which means that we had to move all the doctors offices and the pharmacy to the basement of the school. There will be 1600  students from which only the most ill or needy will be treated by the doctors. Other students will be given daily vitamins, and deworming medications. We are all excited to see all the children in their school uniforms, and we cannot wait to meet them all!
Here are a few pictures from today. One of which is a blind boy who plays the piano!

Hello Jay Cooper!  We are learning to enjoy cold showers!  Hope you are well!  Good luck in upcoming track meet!  Love, Kelly and Mom

From One Doctor's Journal / Six Patients / Revealing

Maria is healthy. Vigorous. Brown eyes alert, darting. Watching her 5 children, the 6^th at breast.

Today, she just wants to know they're OK.

Basically, they are. Her care shows. All I can add is some vitamins and a dose of worming medicine.

Now it's Mom's turn.

Cursory history, Unrevealing. Ritual physical exam.

Heart sounds funny.

During the major contraction cycle of her heart, there is loud noise.

There should be silence or near silence.

But there's not.

Heart disease? Congenital abnormality? Ethical quandary?

She came to us healthy.

Now what?

Arrangements are made to get a cardiac ultrasound done in town.

Wish I had my machine that I use Os, so casually Stateside.

Then I could tell her she'd be fine, the extra sounds come from a not-serious problem.

That she'd be here to dance at her girls' wedding.

She'd see her sons grow to young men.

But for now, uncertainty.

She came to us healthy and left sick.

Somewhere there exists a dissonance.

….........................

She is old.

Impossibly old.

Especially for Honduras.

But there she is, smiling a toothless grin.

She just came to be checked.

No complaints.

A review of her history: hemorrhagic stroke, a special stroke where blood leaps from its boundaries and invades the brain. A clot.

She had had surgery to remove the clot some 8 years prior.

I looked again.

Good movement.

Bright countenance.

Both arms function well.

Walks without a cane.

Rankin disability index? Zero. Nada. Zilch.

Blood pressure a bit high for her age.

That's it.

A few blood pressure pills garner me a “God bless you.”

I think I'm the winner here.

Though I sure don't want to bet against this old lady walking proudly out the door.

…...........................

Weary.

And cold.

It is unusually cold here in Comayaguela, Honduras.

To us Iowans, though, it seems about right, maybe April.

In January.

She is cold, though.

She comes in the exam room, 2 children in tow.

Miserably cold, shivering.

We shut the door; she is still shivering.

My translator sizes up the situation and acts.

Wrapped in a blanket, the patient visibly relaxes.

She tells her story.

We make a few interventions.

These won't change her life, maybe just ease it a bit.

Now it's time to part.

She's reluctant to leave the shelter of the blanket.

But she smiles, rises, proffers a handshake and a thanks.

I think we have the thanks part backwards.

Thanks for the blanket.

…...................................

The pharmacy is impossibly crowded.

People wait in line, patient.

More patient than any American crowd!

They wait for hope.

We, the Americans, represent Hope.

Hope that our medical people know what they're doing.

Hope that our medicines work.

Hope that we can help lift a bit of the burden of the joy of living.

Hope.

From the Americans.

To the Americans?

To us flow the other two: Faith and Love.

1/26/15

…......

16 years young.

She had no specific complaints.

Asked the routine “Could you be pregnant?”, her answer was swift and sure.

“No!”

“You seem very sure.”

“I am.”

“Why?” Intrigued.

“Because I'm going to be a doctor.”

She went on to describe her plan.

2 years high school.

A year off to make the money to go to college.

Then on to the Autonomous University of Honduras.

Six years study to her goal.

She wasn't sure in what area of medicine she wanted to concentrate.

We talked.

She was determined.

We talked about the gap of a year off, how it could be a trap.

She listened well and considered.

I think she'll make a good one.

I hope she comes study in the States.

I'd like to see her grow up.

….................

“Duele en pecho.”

It hurts in my chest.

“When?”

“When I work or walk steep steps.”

“Pain in the left arm?”

“Yes, and to the neck and back.”

“Short of breath?”

“Only with the pain.”

“High blood pressure?”

“No.”

“Diabetes?”

I was on familiar Spanish ground now.

“No.”

“Smoke?”

“Yes.”

“Not any more.”

He grinned from ear to ear, clearly enjoying the exchange.

“What work do you do?”

“Construction.”

“Hard work! Of what did your parents die?”

“They didn't.”

“How old?”

“73 and 80.”

Wow!

“Cholesterol?”

“I don't know.”

I put him on low dose aspirin and sent him for heart testing.

He gave a round of hugs on his way out the door.

….........

 Yours from Honduras;

Us

Hola Rapid City, RCCSS, Dan, and Kaci!
Kelly and I are sunburned and getting our tails worked off, but are experiencing something we could never have imagined! The people of Honduras are so genuinely kind and grateful and loving, not to mention patient!  We work as the aides, so we do whatever we are told to do.  We do the weighing and measuring and determine the children's Z scores (which is an indicator for malnutrition).  We get to cuddle lots of babies - so we are in heaven.  Most of the patients are so happy just to receive a 30 day supply of vitamins and some de-worming medication.
The days working the clinic are non-stop!  No opportunity to sit down or relax, but we usually have from 7pm till whenever we go to bed to relax.  Last night, Kelly stayed up and played cards and spoons with the boys who live and go to school here.  We also have Mass every night, followed by vespers with the boys (it's beautiful!).
The poverty that we saw on our drive from the airport to Santa Theresa school in Nueve Capital was unimaginable.  The houses are mere shanties erected on dirt - no water, electricity, or bathrooms.  But the people we are seeing who live in these shanties are very happy and healthy for the most part!  It shows that although they don't have much, they really care for one another and look out for one another.
We are very, very safe and very comfortable.  We are also clean, thanks to our 30 second, freezing cold showers (after which we feel very warm....seriously)!

9th and 10th graders:  hope all is going well in school - miss you all!
Kaci:  How was your tournament in Sturgis?  I miss you terribly, and can't wait to see you!  Love you so much peanut!
Dan:  How's Mr. Mom?  Love and miss you terribly!  Hope all is well!  Thanks for blogging back!

Adios for now.  It's going to be a hot one today - no wind and lots of sun!  God Bless!
Carol

28 Enro 2015
0517 hours
Nueva Capital, Honduras

Mission Honduras LeMars Medical/Dental team 2015.  Wishing all a happy morning.  It was a quiet night for the team.  It was the first night without heavy winds.  It almost seemed balmy in the area I was sleeping on the floor.  It was generally a nice day yesterday.  Sunny and warmer than the day before.  Many of the triage bunch got sun, one or two more than others.  Then about 1600 hours it clouded over, winds came up and it cooled off.  The temperature is currently about 15.2 C or about 59 F.  It is supposed to be similar in temperature to yesterday, or about 77 F.

The patient traffic flow problems encountered the lst day were solved.  Our meeting on Monday evening provided needed solutions.  The day went well.  Since the lst day of school  is Thursday there were many people and kids milling and running around.  This proved to be just a nuisance.  We had 4 members of the Tegucigalpa, Honduras Bomberos helping the team with crowd control.  They also received a number of needed supplies, like nebulizers, sutures, suture trays etc.  They were very happy.  This type of cooperation is needed.  They know most of the people.

The team medical element saw 292 patients and the dental element 64 patients with 104 teeth pulled.  We kept having trouble with keeping enough translators.  All in all, I had to ask 6 patients to return at 0800 hours today to see the doctor because we had no translators. They had to return to the city.  They were understanding.  It should be another day similar to the last two days.  We have used many more tablets of Acetaminophen and vitamins.  I was able to purchase (with Mata Sosa's help) more of each.  Hopefully delivery will be today,  We should have enough of all other medicines.  The diseases here are not the same as in la Montana de la Flor (MDLF) and since this is our lst mission here it was difficult to estimate medicine usage.

The team continued to see cases of lack of food and poor nutrition.  A number of people were referred to Hospital Esquela (the large public hospital in Tegus) for further care.  In some cases $$/limpera's were provided for bus fare and food for the trip.

I will always remember an elderly man, with his elderly wife and I presume a grandchild, that had asthma and needed care.  He was given 2 different nebulizer treatments and other medicines.  He was then given a nebulizer and received instructions on its usage.  The grandchild was instrumental in receiving these instructions.  He was very thankful and seemed without words when he knew it was a gift and he could take it home and use when he needed.  So for all of those that donated nebulizers just remember this elderly man.

I hope to be able to send photos along with this post.  If not we will work on this later today.  The internet is real slow in the evening.  If not I will have Dick send them along.

Thanks again to all.  Have a wonderful day.  I am in the kitchen having coffee and watching the cooks prepare breakfast.   God bless.  Peace to all.

Mr. Francis

Clinic Day 2

Hola!

Today was a very hot, sunny day. Although it was very warm it did not stop the hard work. The nurses treated around 300 people and sent about 138 to the doctors. Only the truly ill went to the doctors. Most of the people we saw only needed daily vitamins, and deworming medications.

Something that impresses us is the relationship between mothers. A mother would hand her child to another family, leave, and return to find their child taken care of by the other mother. The women seem to care for all of the children no matter whose family they belong to.

Another thing that surprised us was how much a toothbrush is worth to a family. When we pull out the toothbrushes, the people swarm!! A toothbrush here costs $2.50 and a visit to the doctor only costs 10 cents. Now compare that to the US, where a doctors visit would cost around $25.

The dentists today served 56 patients, and pulled 108 teeth. The last 5 teeth were pulled by the light of a head lamp due to the lack of light in the dentist room. We made many people happy by removing teeth that have been bothering them for some time.  They didn't enjoy having the teeth removed but they knew that they would not have a tooth ache next week.

The dentists and assistants have the best clinic on the mission.  We have two young translators that are so very caring with our patients and helpful, Roberto and Regina Sosa.  Brother and sister.  They are very dedicated to their fellow Hondurans.  Our space is perfect for our needs.  Walls of windows on two sides
 so lots of natural light.  The space faces just the right direction so the wind was not blasting through. We have the chicken pen just outside our door so we are well entertained.

We are ready for another busy day tomorrow. 

All the patients have shown amazing gratitude and patients for our care.

We look forward to the patients coming tomorrow, and we cannot wait to see what is in store for us over the next three days of clinic.