The Honduran staff was a joy to work with…Dr. Maggie Jolly

Posted by on Feb 17, 2015 in News, Projects |

I slipped on a scrub top and walked down the hill to the hospital. It was one of my call days, and the nurses had given the characteristic message on the Ham radio, “Dra. Maggi, Dra. Maggi, tenemos una emergeeencia.” They always seemed to draw that last word out, making it sound more urgent than it really was. This case was simple however, a kid with a rash, and I didn’t expect it to take long. I had turned to Mackenzie as I left, just after breakfast, “You don’t think I need to change out of my shorts and flip flops do you?” “Nah,” she replied, “you won’t be gone long.” How long did your child have this? Does it itch? I had made it about two questions into the interview of the child’s mother when I heard a bustle in the other ER bed. Glancing past the curtain, I saw them hoisting a young man with a rather large blood stain spreading down the front of his shirt. “What happened?” Calmly, “Una balla Doctora.” As I could hear the gurgling from his chest from across the room, I turned to the mother and asked her to excuse me for a minute.  After two painstakingly small and difficult to place IVs, several liters of fluid, a measly shot of IM toradol, and a large bore chest tube placement, the patient was finally stabilized. Quite a rush of adrenaline, when your trauma bay team initially consists of only two generally trained Honduran nurses, other physicians have to be called in by Ham radio, and the Xray tech has to be called in from afar on his bike (we left a voicemail message on his phone and never actually saw him that day). No tension pneumothorax, no other complications, thankfully, and he did extremely well.  The trauma surgeon who came in to help me place the chest tube, a veteran of several tours in duty in Afghanistan, looked at me after all was said and done, stating, “Well will you look at that. You didn’t even get blood on your shorts!”  I think that will be my first and last chest tube insertion while in flip flops, for the record. While one of the most intense, the past three weeks have been spent full of similar intriguing learning experiences.  I was lucky enough to be able to spend them working at Hospital Loma de Luz, a small but comprehensive missionary hospital approximately two hours south of La Cieba, a large city on the North Coast of Honduras.  Typical days were spent in clinic, after rounding on any patients, mothers or babies you had admitted in the days prior. Clinic encounters ran...

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Honduras 2014

Posted by on Dec 2, 2014 in News, Projects |

The baleada is a fresh tortilla, made with a smear of beans, scrambled eggs and topped with a sour-tasting cheese, named after a bullet, given its folded in half and aerodynamic shape. This small, but delicious Honduran cultural delight is certainly something I won’t forget. As the patients got wind of food in the halls, ever so kindly they notified me they would be in the cafeteria eating lunch while they waited for their visit with me. I would often accompany them at the table, discussing a sick family member while passing the pico salsa to place on top of our baleadas. Whether they were dropped off by a friend, paid a small red taxi to take them or walked a far distance, these patients were happy to be seen, were patient with their time and loved to give hugs to show their gratitude. They had the usual medical diagnoses, Diabetes, Hypertension, then the more rare, Batsi-fly infestation, or “Honduran Hysteria” a surprisingly common dramatization of their symptoms, ie faking a seizure or passing out, pretending to be paralyzed from a car accident, though suddenly regaining strength. These people were kind, humble and had so many values deeply entrenched in them, and they exemplified a God-focused life. I really did feel my work at Loma de Luz Hospital in the Northern coast of Honduras was needed, such as bringing a pre-eclamptic, 19 year-old’s daughter in the world, teaching her to breast-feed and to take care of her newborn, placing a cast on the broken foot of an injured soccer player from the neighboring village, sewing up a complicated facial laceration on a young boy running from trouble, and even helping a worried, single mom learn to de-stress by teaching her yoga stretches. These people gave me so much excitement to be a doctor, to use my skills from VCMC to provide honorable, quality health-care and showed me why international medical travel is so important for both the people receiving care and providing it, igniting in me a new passion to continue to do so in my future practice. I met wonderful volunteers while in Honduras, other surgeons, medical students, ER, and family medicine doctors who made me feel I was part of something great. We saw patients together in a multi-disciplinary approach though also donated toys to the orphanage together, frolicked on the beach and in the surf with the kids, went snorkeling, and even made homemade baleadas together. My time abroad was an immeasurable experience. Driving by the small open-aired shacks, with smoke from dinner preparations, roaming chickens and dirty-footed babies running around in diapers, I saw where these patients lived, I also saw how unassuming and appreciative...

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Pop Wuj Clinic & Spanish School in Quetzaltenango, Guatemala

Posted by on Oct 20, 2014 in News, Projects |

With the generous support of the Family Medicine Education Fund (FMED) I had the privilege to work and study at Pop Wuj, a non-profit organization in Quetzaltenango, Guatemala. Pop Wuj is a Spanish school with a medical clinic and several public health outreach programs that students participate in while learning Spanish. My medical work while at Pop Wuj was split between primary care at the clinic and public health community outreach through mobile clinics, a nutrition program and a safe stove building project. At Pop Wuj clinic I saw a combination of the chronic diseases such as diabetes and hypertension, as well as acute illnesses such as diarrhea and parasitic infections. Much chronic disease management was similar to Ventura, but other diseases, such as some parasitic infections, I had not treated before. Many patients who visited the clinic lived in outside Mayan villages and often sought the help of a village healer or midwife before seeking a physician’s help. This added additional challenges and learning opportunities as we sought to provide culturally sensitive, but effective care. The nutrition outreach at Pop Wuj consisted of sites in three villages where children ages 6 months through 2 years old came monthly to be weighted, examined by a physician and given nutritional supplements. Mothers of the children were given prenatal vitamins for themselves, regardless of pregnancy status, children’s vitamins for all other siblings and teaching on family planning. As part of the outreach I helped with the educational program, assisted in examining patients and helped prepare supplies for each trip. I found this an effective public health outreach due to the continuity with monthly visits and the focus on prevention. I would love to use a similar model in a developing country in the future. Finally, the Safe Stove Project at Pop Wuj, was a project where families were taught and assisted in building stoves within their homes with a cooking surface and chimney, instead of using an open fire. This helped prevent prevalent pulmonary diseases in children and adults that are caused by fumes. Safe stoves also served to prevent burns experienced by women and children cooking or playing near an open fire. For the safe stove project I helped present the educational program to women about the health benefits of using a safe stove as well as helped build a stove in a home one morning. Thank you so much for this opportunity to study and serve in Guatemala.  I found my time at Pop Wuj enriching and I would love to return in the future to continue to study and serve. I grew in my language ability and experienced effective medical and public health outreach in a developing country....

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Dr. Connie Leeper Spends Elective In Njinikom, Cameroon

Posted by on Oct 12, 2014 in News, Projects |

I spent my elective in St. Martin de Porres Catholic Hospital in Njinikom, Cameroon.  St. Martin de Porres Hospital is on a Catholic compound that also contains a convent, orphanage, schools and outreach programs.  At the hospital, there are currently 2 married American missionary family physicians, Dr. Brent Burket and Dr. Jennifer Thoene, a Cameroonian general practitioner, Dr. Eugene, a Guinean Ob-Gyn, Dr. Dabo, a Cameroonian general surgeon, Dr. Foku, and a Cameroonian orthopedic surgeon, Dr. Lazare. Brent and Jennifer, with whom I primarily worked, moved to Cameroon in August of 2013. Prior to living and working in Cameroon, they have worked and lived in Ghana and Guatemala. They have 4 children (2 biological and 2 adopted- one from China and another from Ethiopia). They work through an organization called Mission Doctors Association, a Catholic organization. Njinikom is a small town in northwest Cameroon. The majority of people in Njinikom speak Pidgen English or the local dialect Kom. Some people speak and understand English, fewer speak and understand French. Njinikom is in the hills. I landed in Douala after 26 hours of flying and the next day spent about 9 hours driving past banana, plantain, pineapple, and papaya plantations to arrive in Njinikom. My first 2 weeks were spent with Brent and Jennifer on the inpatient medicine service. We were responsible for the male, female and children’s wards and any newborns that were ill. My days on inpatient medicine consisted of rounding on the inpatients with either Brent or Jennifer in the morning, then going to the outpatient department (OPD) once done with rounds. The most common diagnoses seen for inpatients were malaria, typhoid, pneumonia, stroke, diarrhea, tuberculosis and complications of HIV. Diagnoses were difficult as we were limited in the labs that were available (electrolytes, blood count, malaria antigen, Widal test, stool O&P, HIV), in how reliable those labs were, and in the imaging available (ie. chest x-rays taken with patient’s in prone position, EKG, portable ultrasound that was brought by Brent & Jennifer from the US). I realized quickly that I didn’t know who was badly sick in this setting. I was called one night as a 26 year old patient was being resuscitated. The patient was admitted for pneumonia and anemia. His hemoglobin was 5 and he had been transfused 1 unit of blood (whole blood donated by a family member) and was on antibiotics. We had seen him that morning and he was talking and in no respiratory distress. We checked an HIV test which was positive. That evening, when I arrived, he was non-responsive, breathing heavily and hypotensive. The night nurse had put him on an oxygen concentrator. I told the nurse to bolus...

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Honduras With Dr. Christopher Adkins

Posted by on Oct 5, 2014 in News, Projects |

International training is an essential part of a broad spectrum family medicine residency, and thanks to Dr. Starr and the FMed Fund, I was able to partake in a week long international elective in Honduras.  The initial plan was to assist Dr. Starr and other Honduran Plastic Surgeons in performing cleft palate surgery on children.  This plan then changed when I was made aware of a desire on the part of some very prominent physicians and administrators in the University Hospital in Tegucigalpa to form a Family Medicine training program. As a soon-to-be Family Medicine graduate, I was asked to present the basics of family medicine, its benefits to health systems, and ways that the training was carried out at the VCMC Family Medicine Residency Program.  Included in this time was discussion with current internal medicine, surgery, and OB/Gyn residents in Honduras, as well as tours of their hospital and medical school. I was taken aback at the level of representation at the meetings, including the Pan American Health Organization, the Ministry of Health, and leadership in the department of Public Health.  I was able to use the experience I gained as Chief Resident, specifically working with the ACGME guidelines and the leadership of our residency program, to advocate for the essential role of Family Medicine in Primary Care.  I am excited to maintain and grow the relationship the VCMC Family Medicine Residency has with the Hospital Escuela in Tegucigalpa.   ...

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