Just Another Day at Hospital Escuela

Today I spent the day at the public hospital in Tegucigalpa, Hospital Escuela. This definitely wasn't my first visit to the hospital, nor will it be my last. Today I accompanied a little girl named Sarahi because she had her tonsils removed. Sarahi is three years old, and it is no secret that she one of my favorites. I know that I shouldn't have a favorite but I can't help it. She is absolutely adorable, so sweet, and continuously cracks me up. In fact, her family (she has two older sisters and a brother) are with out a doubt one of my favorite families on the ranch.

I arrived at Hospital Escuela bright and early at around 5:45 am this morning. I found Sarahi and her overnight care giver from the Ranch waiting in line at the bathroom. In the pediatric ward of the hospital each room can house up to 8 patients. There are approximately 5 or 6 rooms of this size. There is only one bathroom stall, and one shower for all pediatric patients. Needless to say, it is not a beacon of cleanliness. My first surprise of the day occurred when a well dressed transvestite stepped out of the shower in the pediatric ward. She (formerly he) was caring for her son who was staying in the same room as Sarahi. This ambiguous mom/dad ( I never heard the little boy address her as either) confused me and made me giggle a little bit all day!



After getting her cleaned up we played a little bit with the other kids in her ward before she was ready to go to surgery. I took her down to the OR and waiting in the hallway with the other parents until she came out. I watched patient after patient be pushed in and out of the OR on cold medal gurneys. No mattresses, no blankets fresh from the recovery room warmer! Finally after about 2 and a half hours they called me to come and push her back up to the peds ward.

She did very well in surgery and very well in recovery. She had some pain afterwards and handled it about as well as any brave three year old might. About two hours after we were back to the room and settled in, Sarahi's mother came to visit. Sarahi and her siblings are at NPH temporarily. They were taken away from their mother about a year ago and she has visited them fairly frequently ever since. I was caught a little off guard, but recognized her immediately because her other daughter, Karla, looks just like her. Sarahi's mother was very nice and cared for her well. However, it was still strange for me to be in that situation. When you work at an orphanage you don't often expect to run into the parents of the children! Also, they were taken away from her for some very good reasons so even though she had permission, I was a little apprehensive about her being there at first.

What surprised me most, is how I reacted to this situation. Like I said, Sarahi holds a very special place in my heart. For the past 8 months I have cared for her in Casa Suyapa and in the clinic. I have watched her grow and play and develop her own personality. I've tucked her into bed, kissed cuts and scrapes, and sung her songs until she fell asleep. I really have grown to love her and so many other kids so much during my time in Honduras. It was great to see that her mother really is trying to get it together and turn her life around. It was also wonderful to see how good and comforting she was with Sarahi. However, I felt very protective of this little girl. It was hard for me not to feel so angry with the mother because of the way she treated, and neglected her four beautiful children in the past. Her children are so smart, and good, and funny. They are all growing and thriving at the Ranch! There is so much that she has missed during the past year. It was so strange being there with Sarahi and her mother. When she cried she often reached for me. When she was in pain, she yelled for Tia Loli, the tia that faithfully takes care of the littlest kids day in and day out. I cannot even begin to imagine how it must of been for her mother to see her baby girl reach and cry for someone else.

I left the hospital exhausted. I did not realize how emotionally draining it had been until I stepped outside. I also left with the realization that I have come to love the kids at the Ranch so much. They make me laugh, teach me, push me to grow, and sometimes frustrate me beyond belief everyday! I have been so blessed that I get to be a part of their childhood, even if its only for a little while.

Back at the Ranch

I have been back from my 4 week hiatus for about a week and a half now. After spending a few weeks in Haiti, and then a bit more time at home in the States I have finally returned to Rancho Santa Fe in the beautifully sunny, yet scorching hot Honduras! We've entered the dry season here. Its incredibly hot and the Casa Suyapans are unbelievably sweaty but I am still very happy to be back in Honduras!

Being home in Holland for a little while. I had some time to see my family and friends, rest and relax, and prepare myself to go back to Honduras. After being in Haiti, I was exhausted! I don't think I was at home long enough to experience any of the reverse culture shock that people talk about. It felt like no time had past, like I had been away for a long weekend! The only times I think I felt culture shock were 1) at a Tim McGraw concert (the epitome of all things America), and 2) at Target. I wanted to buy everything in my field of vision. Even things I have no practical use for now or ever! Luckily I did not give into my desires considering my volunteer stipend only allows for approximately $100 dollars a month. Overall my time at home was wonderful and relaxing! I had the chance to spend some quality time with family and catch up with some of my favorite people.

Top 5 favorite things about being at home
1) Obviously spending time with family and friends
2) HOT SHOWERS! I had to reexamine by unconscious to discover that this did not actually outweigh the joy of seeing my family and friends.
3) My dog Benson
4) Food. All food. Period.
5) Being able to flush toilet paper down the toilet.

Although I was excited, I was also a little apprehensive about coming back to Honduras. I was gone for quite a while and I was not sure if things would be the same when I got back. While I was in Haiti a group of old volunteers and, some of my best friends, finished their year or longer of service and left. Also, a whole new group of volunteers came. I was worried that it would be a difficult readjustment. This uneasy feeling lasted for about a day, but the moment that I saw my kids from Casa Suyapa I knew that Honduras is where I am supposed to be right now! I missed them so much in my time away. They were so cute and funny when they saw me. I was tackled and knocked over with hugs and kisses and asked so many hilarious and innocent questions about Haiti. Some kids told me that they had thought I died! Others told me they prayed for me everyday and the people that I was taking care of. Within a few minutes of being there I felt like I was home. Many of the kids were very interested in what I was doing in Haiti. They asked tons of questions and wanted to see pictures. I showed them a few photos that were not graphic just so they had some kind of idea. After I finished showing them the photos of Haiti a few girls said "and now Ana, the photos of Chile!" I explained to them that I did not go to Chile, but they were confused. There was an earthquake in Haiti and I went, so obviously I went to Chile too since there was an earthquake there! I'm still not sure they understand that I did not go to Chile.

Things in the clinic have been going well. Last week a medical brigade from Minnesota came to our surgical center to do orthopedic surgeries for people who otherwise do not have access to this type of health care. I worked with the brigade as a nurse and translator. It was a lot of fun and a great transition back to life in Honduras. The brigade performed 30 surgeries over a span of four days. Along with people from the community, a few children from NPH had surgery. One being Jesus from Casa Suyapa. Jesus is a little boy with spina bifida who does not have any sensation and very little movement below the waste. His legs were extremely contracted and spastic. He had surgery to release the tendons in his knees so that his legs can be stretched outright. The hope is that with the surgery his legs will be more easily movable, and that he will be able to use the splints he has to walk with a walker. He was such a trooper through the whole thing and flirted with the nurses from admission to post-op. He will be casted for 5 weeks following the surgery. So far he has done extremely well and the surgery seems to be very successful!

I hope to update my blog more regularly in during the remainder of my time here! If you do not see an update from me for quite some time, please feel free to harass me via e-mail!

Also, I posted some photos from Haiti on picasa and I plan to update it with Honduras photos as soon as I have a chance! Here is the link: http://picasaweb.google.com/115605534828513780863

peace,
Anna




“Look at the nations and watch and be utterly amazed. For I am going to do something in your days that you would not believe, even if I told you.” Habakkuk 1:5

The News from Haiti

`

I am now back in the one and only Holland, Michigan after spending the last few weeks in Haiti. It is as cold and snowy as ever but I am so glad to be home, even for a short while! I know that it has been quite sometime since I last updated my blog and I have plenty to write. I am going to start with Haiti, since it is the freshest in my mind, and then work backwards through some of Honduras and Guatemala.

I left Honduras for Haiti during the first week of February. Nuestro Pequeños Hermanos has an orphanage and hospital in Haiti. Because of the earthquake, the hospital was inundated with patients from all over Port-Au-Prince. NPH actually had two hospitals in Haiti, but one was completely destroyed in the earthquake. One volunteer, Molly Hightower, the brother of a voulnteer, and a doctor were killed. This was pretty devastating for the NPH community in Haiti. Thankfully the actual orphanage was not damaged very much! Usually the NPH hospital, St. Damien's, is strictly a pediatric hospital, but due to the fact that so many adults were also injured in the earthquake, we began treating adults as well. Because of the influx of so many patients NPH needed volunteer nurses to go to Haiti and my volunteer coordinator in Honduras asked me if I would be interested in going. I didn't want to leave my little kids in Honduras for so long, and I knew that Haiti would definitely be sad and challenging, but in the end I really wanted to go. So I went, and after an incredibly long flight (Honduras to Guatemala to Costa Rica to the DR and finally a helicopter ride to Haiti) I arrived in Haiti.

Upon arrival in Haiti, I began work immediately! For the first week I was there I worked in the adult tents outside the hospital and in the urgent care tent. The first few days were absolutely insane. It was basically "organized" chaos, and everyone was running around as fast as possible to do anything they could. Still it didn't seem like there was enough time in the day to get everything done! I was caring for 15 to 25 patients on my own, and almost all had severe injuries such as crushing fractures and amputations. Many were post-op, but some were still waiting for surgery. I worked with a few Haitian nurses and two other American volunteers. We all worked 7am to 7pm, 7 days a week, and at night we were completely exhausted! Most volunteers slept in tents outside the guest house, or on the roof of the guest house. I spent the first week or so on the roof before moving into a room.

While working with the patients, it was very sad, and it was difficult not to feel overwhelmed. There was so much pain and suffering! I couldn't look at my patients as people who had been trapped in the rubble or who had been through such tragedy. I just had to see them as individual people, not related to circumstance, and focus on doing one task at a time with compassion. Luckily I was surrounded by an amazing community of fellow volunteers and had the opportunity to process shared experiences with them. The stories of the patients were so sad. There were children who were the only survivors of their entire family, there were parents who had lost every single one of their children, and there were people who had no idea if thier family members were dead or alive. There was so much chaos after the earthquake that even 4 weeks later, people were still looking for family. One of the saddest stories I encountered was that of a young woman that I took care of in the tents. She had been pregnant at the time of the earthquake and trapped in the rubble. She was one of the only survivors from her entire family. For some reason, whoever rescued her did an emergency c-section at the scene with no anesthesia. In the processes, they accidentially cut here bowel and bladder, leaving her with internal bleeding and other injuries. Sadly her baby died shortly after delivery, and obviously she was devastated. Thankfully, she was recovering well from her phsyical injuries but I cannot even imagine the emotional trauma and grief.

I also spent a lot amount of time working in the operating room. Disclaimer: I am NOT an OR nurse and knew very little about it when I started. They needed an OR nurse, had none, and so I volunteered and jumped right in. There was an amazing group of orthopedic surgeons from Seattle that were doing incredible surgeries. We had some of the best equipment in the country so we received patients from other hospitals and the navy ship, the USS Comfort. We did reconstructive surgeries, internal fixations of fractures, external fixation, amputations, and many skin grafts. The amount of people needing surgical treatment was, and probably still is, overwhelming! One day the group from Seattle performed 23 surgeries.



On the anniversary of the earthquake I went with others from St. Damien's to the mass graves to celebrate a Mass for the dead. The mass graves are located about 45 minutes outside of Port-Au-Prince. We went to the location where the government had dumped thousands and thousands of bodies, many unclaimed and unknown. Father Rick, the national director of NPH Haiti, has done so much to bury the dead and give people a respectful burial. The smell at the mass graves was indescribible, and although the bodies have now been covered, bones and body parts could still be seen on the ground. The mass was beautiful, but sobering. It was so hard to wrap your mind around the amount of destruction and death that was all around us. However, even in the face of grieving, the message at the Mass for the dead was one of strenth and hope!



Haiti was a huge challenge, not only for my nursing skills, but also for my faith and character. The people that I met there, patients and other aid workers, were incredible people who lived lives of such genuine compassion. There were two nuns, Sister Lorraine and Sister Magda, that were truly inspiring. They had both worked at NPH Haiti for more than five years in the past, and came back when they heard about the earthquake. These two women were funny and humble, yet full of so much faith and courage. Their lives were an amazing example of what it really means to live a life of service.



It was difficult to be surrounded with so much suffering and sadness, but new hope and joy were also evident at St. Damien's. So many patients seemed to have such strong faith and perserverance. I do not know if I could be as strong as anyone of them if I were in their shoes! Even though there was much sadness and grieving, every day I walked into the tents I was greeted with smiles. It was incredible and somewhat surprising to find joy in the midst of such a terrible situation.



The reality for Haiti is an extremely sad one. On top of terrible internal injuries, so many will need months and months of rehabilitation or remain permanently disabled. There are going to be generations of disabled and people with amputations. Also, the lack of infrastructure in Haiti and astronomical amount of damage is going to make it incredibley hard to rebuild. I hope and pray that the 1st world will not forget about Haiti and move on to what is next! Haiti is going to need so much help for years to come. Please keep NPH and Haiti in your thoughts and prayers!


That's all for now. Hopefully I will be better at updating more frequently!

Peace,
Anna

Long Time Gone.

To all of my faithful followers,

I know that it has been months and months since I last updated my blog and I truly apologize. Life has been crazy and unexpected, but I promise to write a lengthly update the minute I have a chance to sit down. As most of you know, I took a short hiatus from Honduras and spent the last few weeks in Haiti. I am now spending a bit of time at home before returning to Honduras. I hope to update soon with all the nitty gritty, obviously entrancing details of the true life of Anna Ruth Blauw. Stay tuned....

Faithfully yours,

Anna

Chicken Pox Epidemic: Rancho Santa Fe 2009

This weekend the Chicken Pox struck at Rancho Santa Fe, and it struck hard. On Friday evening an 8 year old girl, Ana Gabriela, came into the clinic with some "very itchy bug bites." I took one look at her, handed her a bottle of calamine lotion, and told her she had to stay in the clinic.

Saturday morning the children started to file in, one by one; all itchy, all covered in red bumps. By the time I left on Saturday afternoon the running total was 9, very chicken poxy children. These kids did not just have 4 or 5 chicken pox; they are all covered from head to toe. The worst case has about 14 chicken pox just on his scalp. His abdomen, back, neck and arms are completely covered. Poor little guy was so itchy. Another child has them inside of his ears.

Saturday night I spent the night in the clinic slathering on the calamine lotion, trying to quell fevers, and entertaining itchy children that could not sleep. After they fell asleep they all slept well for the most part and there were no major chicken pox crises in the wee hours of the morning.
Sunday morning we all awoke, I passed out the Tylenol, and applied yet another round of calamine lotion. Someone suggested that I line up all the kids, fill a super soaker with calamine lotion, and hose them down. While efficient, something about this seems a little bit inhumane. I think I'll stick with the old fashioned method. The chosen few with chicken pox still continued to trickle in through out the morning. Surprising, most of the kids have been from the older hogars, between ages 9 and 14 years old. It hasn't hit my little kids Casa Suyapa yet, but I'm sure it's only a matter of time. Also, thank goodness none of the immunosupressed kids with HIV have gotten it! We are trying to quarantine and contain all the kids that have it so far.

I lost track of the total count of the itchy and infirm children, but I'm sure that the number will continue to climb. I can see a lot more calamine lotion and Tylenol in my future this week.

Time is flying! I can't believe it has already been a month since I posted my last blog! I have now been in Honduras for just over 4 months. Some days it seems like I just arrived last week and other days I feel like I've been here for years, but I am just now starting to feel truly acclimated with Honduran life. I keep thinking that I have adjusted, and saying that I have adjusted, but then something else unexpected and new comes along and shows me how much I have to learn. When I first arrived in Honduras I felt like someone surprised me by throwing me into a freezing cold lake and said "swim!" I started drowning. Then slowly I learned how to tread water in this new place, new culture, and new language. I stayed in the treading water phase for a bit; just enough to keep my head above the water. I am just now beginning to actually swim and make progress. I think the next few months will be full of progress and wonderful new opportunities to learn and grow.

All in all, life is going really well. The last few weeks have been crowed with all sorts of insane business. In the past few weeks the Honduran school year has ended, we have celebrated Quinceneras, another volunteer and I have met with officials from the Honduran Ministry of Health to obtain a license for our surgery center, and we have experienced the elections of a new president in an unstable political environment.

With school out, the ranch is a more relaxed place. The kids are not on such a tight schedule. This leaves more time to spend with the kids, but also more time for them to think up mischievous ways to get into a lot of trouble. Some of them are becoming pretty creative.

Quinceneras were definitely one of the high lights of my time here so far. In Latin American culture, turning 15 is a celebrated event. In November we celebrated the 15th birthdays of all the kids at the ranch who have turned 15 in 2009. There were about 50 boys and girls all together. The girls worked for weeks, sewing their own dresses and making their tiaras. Each of the children asked an adult to be their Madrina or Padrino (Godmother or father) for the night. We had a special mass and blessing for the Quinceneros, followed by a fancy dinner, and an elaborate party at the school. The kids had so much fun dancing and playing with one another until 1 in the morning! Most of my kids from Casa Suyapa were asleep on the floor by 9:30 pm.

Another volunteer, Andrea from Minnesota, and I have been working very hard over the past few months to obtain a legal license for the surgical center at the ranch. After many renovations in the surgery center and the external clinic, arguing with people in Spanish, and baking Ghirardelli Brownies for the women from the ministry of health, the surgery center will finally be licensed on December 16th! We are so excited for it to be the 16th. We may or may not be able to sleep after this date.

Honduras officially and unofficially has a new president. His name is Pepe Lobo. A regal name no doubt. Pepe Lobo lost the previous election to the infamous Mel Zelaya and has now returned triumphant. There is still some question about whether or not the elections were legitimate as Mel Zelaya called for all of his supporters to boycott the election. His reasoning was that by voting in the election, voters would be legitimizing the coup that took place in June. The elections took place with out any serious events, protests, or political unrest. Hopefully all will continue to be peaceful over the next few months.

My time with my kids in Casa Suyapa is always the highlight of my day. Last Thursday we celebrated the November and December birthdays. Every two months we have a huge birthday celebration. It always includes delicious food prepared by the Tias, pinatas, and complete chaos. This past week was no different. We also play a very uniquely Honduran game called Chop el Dulce. This game involves blind folding toddlers, handing them a Machete, and then having them try to chop a tiny piece of candy in half. When I first witnessed this game I was somewhat appalled! In the US we give four yearolds safety scissors to cut a page from a coloring book. Here we give toddlers machetes! The game has never produced any serious injuries and the kids and Tios alike absolutely love it! All and all the birthday celebration was complete chaos, but absolutely fantastic. I left Casa Suyapa that night with frosting and cake all over my face.

Yesterday I traveled with two other volunteers from NPH to a little town called San Juancito visit a Peace Corps volunteer who lives nearbye. This tiny town is one of the most beautiful places I've been since I've been in Honduras. Its an old mining town, with very interesting architecture, nestled at the base of the La Tigra National Park. The mountains surrounding it are absolutely beautiful! There isn't much to do in this town but look around, relax, and enjoy the beautiful scenery. Two other local Peace Corps volunteers spent the night in San Juancito as well. It was a great weekend away from the Ranch, so nice refresh ourselves for the coming week, and a lot of fun to meet new people. Also, I really enjoyed learning about other projects and service that the Peace Corps volunteers are working on in our region of Honduras.

Well, that's all from me for now. Feliz Navidad! I hope that everyone is enjoying the holiday season and perhaps the snow. Here it is still 80 degrees and sunny. Its okay to be jealous!

Peace,

Anna

ER: Honduras Finale

I have spent the majority of the last four days at Hospital Escuela, the public hospital in Tegucigalpa. I've been in and out of the ER, the operating room, the children's ward, and the blood bank. It has been quite the experience and has given me a new, and very real look into Honduran life.

SATURDAY: Saturday morning I woke up to a ringing cell phone at 5 am. It was one of the other nurses from the clinic asking me if I could come and take a look at a boy who came in with severe abdominal pain. I went to the clinic to see the boy. He had all of the characteristics of acute appendicitis: sever pain in the right lower quadrant, an extremely high fever, vomiting, etc. When he continued to worsen, we decided him to take him to the Hospital in Tegucigalpa. I rode in the ambulance with him to the hospital. Depending on who you ask, me or the driver Juan Abel, the ambulance ride may or may not have been more dangerous then the suspected appendicitis. Normally, it takes approximately an hour to get to Tegucigalpa from the ranch. We made it through traffic, over twisting mountain roads, and to the hospital in under a half hour. I feared for my life on more than one occasion!

Once we arrived at the Hospital, we pushed our way through a crowd of people to get to the ER. It appeared that they were going to attend to us rather quickly. Unfortunately appearances are deceiving! We waited and waited, and then waited a little bit more. I had to carry the lab specimens to the lab myself to be tested, wait for the results and bring them back to the the ER. On more than one occasion I had to search for the doctor and basically demand that the assess Rodolfo. When we got the results back from the blood test, the white blood count was extremely extremely low. With appendicitis you would expect it to be very high because of the infection. I asked if they could repeat the test, which they surprisingly did. The results were the same. I started to worry that this child might be immuno supressed because of some other illness like HIV or Leukemia. In the meantime, Rodolfo's pain had subsided and he was resting comfortably. I called the NPH director and asked if we could take him to a private clinic to have the hemogram drawn again. We went to clinic just down the street and surprise, all of his lab results were normal. We also had an x-ray done at the clinic and discovered that Rodolfo just had a severe, severe case of constipation. It was quite the day.

From the private clinic we made the trip back to Hospital Escuela. Not for Rodolfo, but for another kid from the ranch who broke his wrist playing soccer. This time, we went in and out in about 30 minutes. A miracle! I had already spent almost 6 hours hounding doctors in the ER, so I think they were more than ready to be rid of me. We finally made it back to the Ranch around 8:30 on Saturday night.

MONDAY: On Monday I also spent approximately 12 hours at the Hospital Escuela. Thankfully this time it was not in the Emergency Room. A little 7 year old boy from Casa Suyapa, Lester Joel, had surgery to remove his tonsils and adenoids. He went into surgery at 8 am and I waited in the "waiting room" with the other family members of pediatric patients who were in surgery. I sat for 3 hours in dirty hallway crammed with other worried parents. The hallway was hot and musty. There was construction going on at the other end so the sound of drills and saws was muffling all of the talking and crying going on in the hallway. The floor was sticky with blood and urine, but after waiting for hours, people sat anyways. Finally when Joel came out of surgery we went back up to the hospital ward. He was in a room with 8 other children suffering from all types of injuries and illnesses. There was one bathroom for the entire ward, not just the room of 8. There was no toilet seat, no toilet paper, and it was absolutely filthy. The nurses never once came to check on my little patient. They never took his vitals or assessed him after surgery. Never once did I speak with a doctor or have anyone give me any information about his surgery. I can't imagine being in Hospital Escuela and not having someone to advocate for you. I am honestly not sure how anyone leaves that hospital without being sicker than they were when they were admitted!


TUESDAY: Tuesday was by far the most successful and triumphant day at Hospital Escuela. They have a rule there that if you are a patient, someone has to donate blood in your name before you are discharged from the hospital. I woke up this morning at 3:30, got on a bus, and went to donate blood. The line was long and the hygiene was still bad, but it was a success. Lester Joel was discharged by 7 am.

Hospital Escuela is extremely scarce for resources. On multiple occasions I had to leave the hospital and go to a nearby pharmacy to purchase tubes and containers for blood and urine testing. Also, they rarely use gloves or other safety precautions when performing procedures. They lack the basic resources to provide safe health care to the public. More than anything, my experience at Hospital Escuela opened my eyes to the drastic disparities that exist here. It was so sad to see what the average Honduran has to go through to find help for their most basic health needs. The patients there are all shuffled from line to line and given absolutely no autonomy over their own bodies. They are treated without any dignity at all.

Even though it is heart breaking and difficult to go to these places, I think it is so important to recognize the suffering in the world. I can't just sit and pretend that it does not exist. Its overwhelming because it seems that its a never ending cycle; there is no way to truly fix it. This can be disheartening and prevent a lot of people from even trying to do good in the world. For me it is even more of a reason to keep trying. I don't think it has to be specifically through labeled service or volunteer work, but just in the way you treat people ever day in even the simplest and most ordinary situations. "Love your neighboor as yourself."