July 22, 2010.  Isla Roatan, Honduras.

A Little Boy Holding His Developmentally Delayed Younger Sister

Our passage from Jamaica to Roatan was without incident. We had a following wind and sea, so we made pretty good time, although the last few hours were literally a race against the sun. As we approached Roatan, we made contact with Barefoot Cay, and they said, if we got there in daylight, they would send a panga out to guide us through the narrow channel to their dock. If we couldn’t get there in daylight, they suggested we stand offshore, and they would bring us in the next morning. Needless to say, we pushed hard to arrive in daylight. We goosed the engines, and I tried to squeeze another knot or two out of the steering wheel. We arrived at twilight, picked up the panga ahead of us and followed it in to the dock, parking the boat as the full dark of the new moon began to descend. What a relief! Coming into an unknown dock in the dark in a 144,000-pound vessel is always a little tense. We tied off the lines and shut down the engines and unclenched after another successful crossing of just over 800 miles. It is beautiful here—we are incredibly fortunate that Barefoot Cay is hosting us at their dock. It is the perfect place for us to use as our base here in Roatan. Besides being a gorgeous facility, it is located about a third of the way from the island’s west end, so it is central to everywhere we are working. I had originally planned to give everyone a week or two off to rest and recover from everything we saw and did in Haiti and to get some maintenance done on the boat, but our destiny had other ideas.

On arrival, we rendezvoused with four incoming volunteers—two nurses, Annee and Sirin, who have just finished their Masters degrees in nursing, an EMT named Martin, who is in the middle of applying to medical school, and Ash Leigh, an Occupational Therapist. A few days later my old classmate Maddie, an educator in one of the toughest school districts in south central Los Angeles, also joined us. Our initial plan was to work with the Clinica Esperanza, but in the two weeks we have been here we have expanded our mandate. Within 5 days our new volunteers and Haiti team were working in Clinica Esperanza, the Centro de Salud in Los Fuertes and the V.O.M Clinic, a PT/OT clinic for children with cerebral palsey, movement and behavioral disorders, and people with injuries or post-stroke deficits.

We are also the new flight crew for the Aeromedical helicopter, the only civilian emergency medical helicopter service in Honduras, available not just for tourists, but also for members of the community here. Sirin—who is also a CPR/BLS/EMS educator—is working with Maddie and the local Fire Department to do life support training for the fire and ambulance crew, some of who started working as firemen when they were 14 years old and have little formal training.

We have arrived in the middle of a nationwide Dengue Fever outbreak, so we have plenty of work to do. I did learn a couple of great clinical diagnostic tricks for Dengue. It is a hemorrhagic fever that causes bleeding. Like many terrible diseases, it has very non-specific initial signs-fever, malaise, aching, tiredness, etc. You can put a blood pressure cuff on someone’s arm, pump it up and leave it for two minutes. If they develop petechiae (little bleeds) on their arm, it is probable for Dengue. Also, intraocular pressure seems to increase, so gentle pressure on the eyes, with eyelids closed, produces a lot of tenderness in Dengue patients. I’ve had a few confirmed cases already, so we give supportive care and help people try and ride it out safely, but Dengue is not called ‘Breakbone Fever’ for nothing—it HURTS!

What has struck me most poignantly here is that, although Honduras is a poor Central American country, EVERYONE we have met here and every business we have connected with seems to be involved in some way with ensuring there is some access to health care for themselves and their fellow islanders. Barefoot Cay supports Clinica Esperanza. The local gym (which we are allowed to use as guests of Barefoot Cay) is organizing an American Gladiators-style competition to raise money for Esperanza. There is an island marathon being planned for the V.O.M Clinic. The Rotary Club here supports the Los Fuertes Clinic. Many of the islanders pay about $10 a month to support the helicopter service. It is amazing. Honduras is a place which has little. It has been very hard-hit by the economy in the US. It received terrible press when their military arrested the previous president and essentially evicted him to avoid him seizing power. But the people here are an surprising example of what we are trying to promote—taking personal responsibility for health and access to health.

It just goes to illustrate what I have always observed—people who know true need also understand the value of helping each other in a way that people living in more prosperous countries can never know. And especially here, on a 30 mile long island, it is like being on a boat with 60,000 people—everyone is in the same boat, and only by pulling together, can they survive the storms and squalls of fortune.

It is inspiring to see, and I am proud and humbled that we get to be a part of it.

Tags: barefoot cay, ben labrot, clinica esperanza, floating doctors, honduras, isla roatan, jamaica