I was wrong about the schedule this morning when I wrote.
Breakfast at 7:15.
Leave at 8:00.
The hotel, a Hilton, is nice by any standard. Large neutral-toned rooms w/ downy beds, and a chandeliered 2-story lobby. We are in an upper crust neighborhood. Houses are walled compounds, some with armed guards outside.
Four blocks from the hotel we turned off the paved road and started our ascent, a steep and rutted uphill climb in the van, toward the slum where today's church clinic was held.
Houses are cinderblock, sometimes painted, roofs are sheeted tin, sometimes shaped and colored to look like clay tiles. Occassionally thatched. Stairways are cut into the hillside out of the dirt. Lush plants, tropical, some coconut palms, some mandarins and bananas.
The ride took 10 minutes. Less than a mile. Maybe 1/2 to 3/4mi.
8:10. Unload up stairs (tiled) of grade and depth that remind me of climbing Chichen Itza. Shallow foot pads. Each step with higher facia than our customary 5-6in. More like 8-9" each, making even the 20 stair climb a little tiring.
Set up. 1 room church. In-take desk immediately to the left of the door. To the right, pews arranged into waiting room area.
8 pews arranged into 4 patient cubicles. On one side the Dr. (there are 4 doctors in all), on the facing pew the Translator (me) and the patients. We see a family all at once and address their symptoms and complaints one at a time starting with the parents and working down the row by age.
Beyond the exam areas, more pews and chairs set up as a Dispensary.
On the alter platform, the Pharmacy.
Post-exam/Pre-Dispensary Waiting area, outside.
I am with one of the pediatricians, but we also see the parent/s who come with the children. Our resources and treatment options are severely limited, but luckily (for us) most people suffer from the same-ish issues. Most of them seem very blunt about their problems. This may be a matter-of-factness based on circumstance. More thoughts on this later. Most have also come dressed in their finest for the examination. They ask for treatments for parasites (intestinal in this case) and skin rashes/bites/sores - recurring, but not made by something I recognize, vitamins, aches and pains mostly from lives lived hard, toting and birthing children and working in factories. Everybody has a cold and most have coughs and bad headaches. Some dizziness. We see a lot of high blood pressure among adults and the headaches we mostly attribute to that. Some diabetes. Some vaginal infections (no exam). Some eye problems from working in dust and smoke. One case, the only one we actively treated, impacted ear wax.
The "Exam" usually involves a primarily verbal relay with me in the middle. I ask Pt#1 for her ailment. She gives me a Symptom or two and I pause her to tell the Doctor. I open both ears and eyes and use them separately to hear, see, translate, summarize, relay between the doctor and the family. The patients have patience. The Doctor has less. I learned some new words for issues I couldn't have picked up elsewhere, as well as some colloquial speech which was at first very perplexing. They use here a construct that literally translates to "it hit me". This is said much as we'd use it in English... That we were "stricken" or "hit" with a illness or a powerful emotion, but for a long while today I kept withholding from the Doctor precisely what these patients said. It was clear (after some weird and alarmed questions from me) that they had not been physically assaulted, but I had trouble trusting my hearing in the cacophony of the space which held easily 40-50 people at a time (approx 25x40 sq ft.) and making a less literal translation.
Between 8:20 and 5:30, I stopped once to pee, and for 10 minutes to eat. The day passed quickly without any downtime and full mental engagement.
Between the 4 doctors, we treated 305 people in 9 hours. As this clinic was urban and air-conditioned(ish) this will be our easiest day.
Packed up and cleaned.
Back at the hotel at 5:50.
I came back to the room, napped like the dead, dined at 7:45.
Tomorrow we have a 10am call time. Then drive to Puerto Cortes on the coast, stopping to check one village (in flux) on the way.
No scabies today. (TBTG)
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