Outreach to Crawfish Rock

Note: this is an extremely long post! Sorry for the length but I wanted to tell the story properly and its hard to shorten it much because even this hardly does it any justice! :) Enjoy the read and feel free to stop reading at any point if it gets boring or redundant.. blogging is as much for me to share my experiences as it is for you to enjoy them!

So Wednesday was a big day for us at the clinic! Well a big day for me at least.. and man, it was long (13hrs), exhausting and sweaty.. but absolutely AWESOME! We did an outreach clinic to Crawfish Rock which is a fairly remote community so many people can't get to the clinic when they need urgent care, little alone on a monthly basis for follow-up for chronic conditions like diabetes or hypertension. Dr Patrick left me in charge of gathering all our supplies and packing all the gear we needed for the trip. I was super pumped for the responsibility, plus it just fits my desire to organize and make sure things are packed really logically. He gave me a basic list of what to pack, but I added some extra stuff I figured we might need too.. and man, am I ever glad that girl guides taught me to be prepared! We ended up needing almost everything I packed extra of, and there were definitely things I didn't pack enough of (we went through a pile of supplies and medications!! Way more than anyone expected!)

So let me start this story at the beginning.. our drive. So we packed all our gear in big tupperware bins that we secured on the back of this rusty old king cab 4x4 truck. The truck has certainly seen better days, and would never pass inspection by North American standards, but it was pretty decent by Honduran standards! Only a hole rusted in the floor so the front seat passenger could see the road and brakes that hardly worked on a good day. So we rounded up our crew (basically half the clinic staff and pretty much everyone who didn't get a chance to go the brothel on Tues) Laura & I for RNs, Annie our pharmacy student, Deidre the med student, Steve our med resident and Dr Patrick (you'll remember him from my previous brothel post). Dr Patrick is our fearless leader for all outreach clinics and he has travelled to Crawfish Rock the last few times and knows the people. So we set out with all 4 of us girls squished into the back seat, and Steve riding shotgun with Dr Patrick. We drove a short way outside Sandy Bay and then turned onto Mudhole Rd. We had heard that Crawfish Rock was an isolated community and that the drive could be very treacherous, hence the strapping our gear onto the back of the truck.. but we had NO CLUE what we were getting ourselves into! The beginning of Mudhole Rd is a typical dirt road, but for some of the girls, Annie specifically who grew up in New Jersey, this was a totally new experience. But the road very quickly turned into a crazy rutted nightmare! It was nuts! The road basically goes up or down on a nearly 90 degree incline.. and the ruts in the road are sometimes several feet deep. We drove through basically the jungle part of the island! The views were spectacular (and I don't even have good pics.. hopefully I'll get some copies of the ones Annie and Steve took with their snazzy cameras and add them here too) and seeing some of the most beautiful parts of the island almost made the drive enjoyable. But man, we bounced and jostled our way to Crawfish Rock. 

view out the window as we drove up to Crawfish Rock

 

this gives some sense of the height but none of these pics does the real thing any justice

  

Poor Annie was soo sick when we got there! So when we arrived we stopped just inside the community at Miss Rosa's house. She is the towns matriarch and she 'gave' us permission to hold the clinic in the town. She said she had been praying we'd come to help her people and began shouting out praises to God when we showed up. She has some absolutely awful ulcers on her feet (diabetic foot ulcers) and really needs an amputation, but she refuses. Once before she had terrible ulcers and she moved into Sandy Bay to be nearer to the clinic and a nurse visited her daily to clean and dress her wounds until they healed, but unfortunately they are back. We tried to convince her to come in to Sandy Bay again so we could treat her feet but she wouldn't hear to it. We cleaned her feet up the best we could and left her granddaughter with supplies to continue dressing it for at least a month (prior to our visit she was using traditional remedies (aka: bush medicine) on it, but this wasn't doing the trick.. although I'm sure it made her feel better). Another interesting note here for the nurses who read this.. her BP was well over 200.. but she ran out of meds so wasn't taking any. Plus she said she only takes her 'pressure pills' when she feels bad, and right now she feels fine, therefore she said I was lying about her pressure being high! :) And its not that uncommon to see BP's over 200 and people be completely functioning! lol. Their bodies just adjust here.. I'm sure its not good for them, but they have no choice so they just keep on going. 

Welcome to Crawfish Rock!

this is just past where we set up the clinic but many locals don't attempt the road but take the sea instead

 

Once Miss Rosa gave us permission to set up, we continued down the road a bit further to the local school and set up there. Laura & I did registration/triage and I don't know if I have ever taken so many blood pressures or blood glucose tests ever before! Then we would send them on to see Drs for a quick and basic consult (since we didn't have much portable equipment it was pretty much based on whatever the patients could self report). Then the Drs would write prescriptions that Annie would fill at her pharmacy table. So what I just described was how it 'should' work.. but instead we just had tons of people going every which way.. we tried our best to do it that way but there were kids running all over the place and people just kept coming out of the woodwork! The line to get in was NEVER ENDING! We just worked and worked and worked! Once we finished registration, Laura & I moved over to help Annie dispense medications. Poor Annie who was already not feeling well after the drive was in the midst of a swarm of people all insisting they were here first. Everyone was terrified we'd run out of medication and they wouldn't get theirs. And honestly, we did run out of some things.. but we were able to find something similar or that would still work to treat whatever their diagnosis was. We became very creative and ingenuitive! Plus we learned sneaky ways to get kids to drive 10mls of nasty smelling/tasting de-worming and parasite medication! By the end of the clinic we were all starved, hot, sticky and ready for a nap. But we still had to pack up and drive back to the clinic. We stopped in French Harbour (local city) on the way back to grab food at a local burger place so that we could keep from starving! lol. 

this was early on too, so the chaos was only just beginning!

you can see the little table where we were doing registration, with the BP cuffs hanging off it.. that was my post!

   

Laura and I dropped everyone off and drove back to the clinic to drop off all the stuff. We just had everything put back in the clinic when we realized that we had scheduled another health fair (like a mini outreach clinic) at SOL foundation, a local drop-in youth centre for 5pm.. and it was already 4:30. So Laura and I restocked and repacked the gear for the next health fair. We called the organizer and she said it would be like 30-35 people, so we estimated an hour at most. We recruited help and ironically the only ones who agreed to come were the people who spent all day in Crawfish Rock (plus the other pharmacy student Mado and a new RN volunteer, Hannah).

this is the pharmacy girls doing health education at the SOL foundation

this is only the first 15 mins, and look at the crowd already! It only gets bigger from here!

 So we got to the SOL foundation's site (basically a soccer field) and set up. Kids and their parents started showing up so we began doing heights and weight for all the kids and blood pressure & blood glucose for all the adults. We wrote all their information down on cards, so that the next time they can bring the to the health fair to track their progress. The Drs set up and did quick consults and referred people to the clinic while the pharmacy girls did health education, mainly around dental hygiene & gave out tooth brushes. And again, the people kept coming and coming and coming! We saw well over 100 kids and many of their parents! It was crazy!! We didn't start packing up until 8:15pm!! By the time Laura dropped me off at home it was nearly 9pm... so I had put in over a 13 hr day! 

Like I said earlier, I was hot/sweaty, hungry and absolutely exhausted, but with a huge smile on my face! I was bursting to tell everyone how great my day was and I just have this sense of accomplishment when I think of how many people we helped or were impacted by our day!

It was pretty hard to get out of bed before 6am this morning though, I must admit! But today at the clinic it was even more rewarding when I did triage on several parents from the SOL foundation health fair. They had come to the clinic for follow up for things we had told them at the health fair (like for a consult about high blood pressure etc). It just made my day that our one day, has such a long lasting ripple effect! :)

Sorry for the length of my post, but I've been just dying to share my day with the world.. hope you enjoyed a glimpse into my experience doing outreach in Roatan!