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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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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The Lake Clinic, Cambodia

Posted by on Sep 29, 2014 in News, Projects |

The Lake Clinic was started in 2008 by Jon Morgan, an American nurse with an MPH who had been the director of the Angkor Hospital for Children in Siem Reap, Cambodia for many years. The goal of The Lake Clinic is to provide healthcare to rural communities on the Tonle Sap lake. This is one of the largest lakes in SE Asia and provides one third of the protein for the people of Cambodia in the form of fish. More than 1.5 million people live on or around the lake, some in unique floating villages that drift with the rise and fall of the waters. For the past six years, TLC has been taking medical teams by boat to eight of these villages to provide healthcare. The full-time Cambodian team consists of a doctor, dentist, midwife, registrar, cook, boat driver and clinic coordinator. Volunteer doctors are extra. They spend three days on the lake running a walk-in clinic and try to visit each village about once a month. I had the privilege of going on two trips to the lake as well as one trip to the Stung Sen river where TLC has a second team that goes every week to a remote village. Clinic starts Monday morning just before dawn when the whole team meets at the office in Siem Reap and piles into a van with all of our gear. We drive out to the lake and then take a boat to the village. The trip takes about 4 hours, a difficult and cost-prohibitive journey for most locals. Once at the clinic (a 20×20 room built by TLC with a bathroom out back), we have lunch and then unpack. There are boxes of charts, carefully filed with histories going back more than 5 years. The dentist sets up her equipment. We lay out the pharmacy and hang curtains to create “rooms” to see patients. Clinic runs for a half day on Monday, then a full day Tuesday and another half day on Wednesday before we head back to town. We can see as few as 30 patients in a day or as many as 200 depending on the size  and needs of the village. The staff have been coming here for six years and know the patients well. There are a lot of musculoskeletal complaints as the people spend all day hunched over fishing nets in tiny boats. I saw the usual colds as well as diarrhea, likely related to poor water quality. TLC has worked hard to educate people about water safety and has even set up water filters in some villages, but it’s difficult to get people to use them and change age-old habits. Most...

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