Las Aventuras en la Salud

Home Sweet Home (Hogar Dulce Hogar)

2008-12-11T13:10:00.000-08:00

I apologize for the delay in posting, but wow, returning to the States is a whirlwind! Heang & I arrived back home one month ago, but I don't think that either of us have actually had any static "home" time ever since...we're now on the "interview trail," traveling around to interview with various residency programs.

Applying to medical residencies is a little (well, a lot) different than applying for jobs in any other field. There's a centralized application service for everyone applying for first-year positions in most specialties that can be submitted in September and October. Once your application goes out to the programs you designate, they can offer you interviews, which will occur during the months of November, December, and January. In February, you decide which programs you liked best and rank them in order of preference; simultaneously, the programs rank their applicants as well. On one specific day in March (this year, it's March 19, 2009, at exactly noon Eastern time), every applicant in the country finds out where they "Matched" and will be spending the next 3-5 years of their lives. Sounds complicated, but the Match has actually simplified the whole residency-application process. I like it.

So, at the moment, we're in the interview phase. It's nice to be back in the US for a while, but I think we both wish we had a moment to breathe. :)

Merry Christmas, everyone!!

El Norte

2008-11-01T16:02:00.000-07:00

Just the other day, I was comparing seasons with Kelvin, our librarian. I described the difference between fall & spring, and he explained how those two concepts don't really exist here, as Honduras only has two seasons: winter and summer. Both are scorching hot; the only difference between the two is that in winter, it rains every day, and it summer, it never rains. Technically, though, there is one tiny little "season" that heralds the end of winter and the beginning of summer, bringing us to a grand total of three Honduran seasons.

They call it "El Norte."

Last Saturday was winter. El Norte arrived last Monday, and yesterday, ya se fue, lasting its usual five days. Today is summer.

El Norte is five days of fall-like weather, with lots of wind, mild daytime temperatures, and chilly nights. I actually wore a long-sleeve shirt for the first time since arriving in May. Being a mountain girl at heart, I loved El Norte. But the Hondurans? Not so much. Here in the rural areas, hot-cold folk beliefs persist. Hot = healthy, cold = sick. The streets were deserted, and the clinic was practically empty, as no one wanted to go outside in the "chilly" 70-degree weather and risk coming down with the gripe. Those who did come out wore knit winter caps despite the sweat pouring down their cheeks.

But a slow clinic means time for other projects...and time for fun...like Lucas' first Halloween!!

Background: The Morris family had been here for two years, working for Shoulder to Shoulder as volunteers. Andy is a family doc, and Laura helped bring the library project to fruition. They have a two-year-old son, Lucas, who, as you can tell from previous posts, is the cutest Spanish-speaking gringito ever. The town, the employees, and all of the volunteers absolutely adore him. The familia Morris left Wednesday, to start their new life in the States...but not before we got Lucas ready for that most cavity-inducing holiday known to man, Halloween.

At dinner on Sunday, Laura mentioned that her parents had brought an enormous bag of Halloween candy, and asked if we volunteers would like to "trick-or-treat" at their apartment so that Lucas could see Halloween from the giving end. The catch? We have to dress up. And we have all of about ten minutes to prepare. But naturally, we agreed. We'll do anything for Lucas. Or chocolate. Especially both. :)

So...this is what ensued:

Cast of characters (ranging in age from 20 to 30):
Me
Heang
Gabe (an undergrad from Brown)
Yani (the director of our Nutrition grant)
Abby (family medicine R2 from U Cincinnati)

Mad scramble up the stairs to Apartamento a la Derecha, where we all live, like some un-glamorous version of The Real World. Everyone dashes to their rooms. I grab a pair of enormous round glasses from a pile we'd been saving for patients, throw on a small-brimmed yellow sailor hat, and declare myself a bug. Heang grabs a sheet off her bed, says, "I know!..I'll..." as Gabe bursts in with his bedsheet already over his head, saying "Nope! Too late! I'm a ghost!" "Oh, fine!" says Heang. "I'll just make a toga!" In thirty seconds flat, she's a Greek goddess. I decide I need antennae. What can I use for antennae?! Looking at our mess of hygiene products, I notice the Q-tips. Bingo. Crammed them into the holes on the top of my hat, and ta-da! I'm a big-eyed bug with Q-tip antennae. Laughing hysterically, we catch up with Yani, who has a scarf on her head and a boho blouse, looking like a very fashionable hippie. Heang tops off her goddess attire with some leaves in her hair (commandeered from the lime tree outside the front door) as Abby arrives from doing dishes and Laura lets us know that Lucas is ready. So, we throw together that easiest-of-costumes (or second-easiest, I guess, as it's hard to be easier than a bedsheet ghost who doesn't even have eyeholes), the mummy. A few times around with the toilet paper, and we are trick-or-treat ready.

In summary, we were a bug, a mummy, a ghost, a hippie, and a Greek goddess. In ten minutes flat. It was the fastest Halloween-costuming ever. And a lot of silly fun.

Mis Palabras Favoritas

2008-10-26T10:18:00.000-07:00

When we first arrived, five months ago, speaking Spanish all the time gave me a headache for the first few weeks. Everything I said was a struggle, and had to be carefully thought out. But then it got easier; now we can switch between the two fairly easily, and I'm starting to realize that I'm really going to miss all of the Spanish once I get back to the States. Especially since some things are simply better said in other languages. So, here are some of the things that I'll really miss saying once I get back home...and that might accidentally find their way into otherwise-English sentences anyway.

1. Vaya, pues. Hondurans use this command (which means "Go, then!", literally) for almost everything. Goodbye? Vaya, pues. You're welcome? Vaya, pues. Other countries apparently mock them for it (I hear Costa Ricans are pretty harsh about the phrase), but I love its informality.

2. ¡Ya! means "already." We use it for "already," "ready," and "done." When everyone's loaded into the truck and we're ready to pull out, all we say to the drivers is "¡ya!" and away we go. If you want to ask if someone is ready, you simply say "¿Ya?" and they reply "ya." And away we go. :)

3. Aprovechar is the verb meaning "to take advantage of." Aprovechar is perhaps the most appropriate word to sum up the Honduran way of life. Hondurans do what they can, when they can, because you never know when you'll get another chance. Life stops down here if it's raining, if the road's out, if the power's out, etc., so when you have the opportunity to do something, you do it.

4. Entonces. This just means "so" or "therefore," but I like it because it has three syllables and entonces gives me time to think about what I'm going to say next, if my Spanish is faltering.

5. Aguacate, pronounced AH-GWAH-KAH-TAY. Means avocado. This is one of Lucas Morris's favorite words, and hearing it in a two-year-old voice is beyond adorable. Dinnertime is going to be really boring when Lucas isn't around to narrate.

6. Como no. Despite how it sounds, "como no" (like no) means "yes." Sort of like how we say "why not?" I like this phrase just because it's completely baffling to me.

7. Cheque. This is an English-ism that the Hondurans have picked up. They use it for "check!" but it sounds like "check-ay". Other modified English words we've noticed: watchiman (watch-ee-man) for "watchman", osmil (ohss-meel) for "oatmeal", and "ride," which they pronounce just like we do.

So, if you're around me in the weeks after I return, and one of these happens to slip into my vocabulary, forgive me...it may take some time to switch completely back into speaking English all the time.

Vaya, pues. :)

Things I Love About Honduras

2008-10-25T15:55:00.001-07:00

(Call this the companion piece to "Things we Miss about Home" from way back in July).

1. pupusas & baleadas
2. lots of places to go hiking
3. still having a flip-flop tan in November
4. watching torrential downpours (almost every day!)
5. cold showers on hot days (almost every day!)
6. meeting new people on brigades etc.
7. beautiful, beautiful mountains
8. beautiful, beautiful children
9. everybody's sweaty, so it's okay that I am, too
10. being "Doctora Jessica" instead of "Dr. Weeks"
11. riding in the back of the trucks
12. 80's rock ballads (Journey, Kansas, Boston etc.) are still popular, and no one cares if you sing at the top of your lungs
13. It's papaya season!
14. Hondurans recycle everything...not by sending everything to a factory, but by actually re-using bottles, boxes, and cans.
15. our staff at Hombro a Hombro: Javier & Tino (our drivers), Don Beto & Don Nato (our watchmen), Maria (the cocinera)

Etc, etc, etc.

I'm starting to get nostalgic, I think, since we're getting so close to leaving. Hard to believe that, in just a few weeks, we'll be in suits & heels, going from interview to interview, instead of in scrubs, going on brigades or working in clinic. But I suppose it's time...and I'm actually looking forward to a little cold weather.

Bye-bye, Big Brigade!

2008-10-23T16:24:00.000-07:00

Well, the big brigade from UNC & Cincinnati has departed, and we're back down to our base number of long-term volunteers & staff. It's been a hectic two weeks, but they really accomplished a lot with their time here.

I'll make the summary as brief as possible.

This brigade:
1. saw 2,135 kids over the course of ten CHI brigades (the largest one consisting of 420 kids in one day!)
2. ran an education-centered diabetes clinic for patients at the Magdalena clinic
3. distributed 40 water filters
4. attended to 20+ housebound patients through home visits
5. staffed the clinics in Santa Lucia, Magdalena, and San Antonio on various days
6. reorganized the Santa Lucia and San Antonio pharmacies
7. performed 30+ cytological exams for the Women's Health project, many in a field clinic
8. ....and lots more. These are just the highlights. :)

Samples of my favorite moments from the brigade:

1. Watching John S. from ECU entertain a crowd of children on the first brigade day while they waited on us to set up. The kids were practically crawling all over him, and he chatted and played with them until time to start.

2. Dave from Cincy's dental charla. When we do the dental education charla, the only requirements are that you a) teach the kids how to brush, b) talk about why teeth are important, and c) talk about how to protect your teeth. A kindergarten-teacher-voice helps keep their attention...but evidently a mad-scientist act and vigorous humor-filled demonstrating helps keep their attention even better. I've never heard so many giggles, or seen so many kids smile while brushing their teeth. Way to go, Dave. :)

3. Riding in the back of the trucks in the rain.

4. Getting to see Dan (a MAHEC attending) and Benjamin (a MAHEC family med R3 & ECU alum) again...Dan & Benjamin came on our brigade last year to Colomarigua, on the trip that decided us on returning to Honduras to work...seeing them again was like coming full-circle on our experience here.

I heard no scorpion reports from the brigade members...but Mark found #8 in our apartment the other day, walking down the hall as if he owned the place. I believe his demise involved a hammer, but fortunately was not present to witness the event. :)

Scorpion Update

2008-10-11T10:14:00.000-07:00

Luckily, I have been spared the privilege of serving as scorpion-killer-in-residence, as I have not personally found any recently. However, that doesn't mean they haven't been lurking...

Scorpion #3: Was present on Javier-the-driver's mosquito net when he woke up one morning. He kept it in a little jar to show everyone.

Scorpion #4: Was in the Morris apartment, next door. So Dr. Morris took care of that one.

Scorpion #5: Dr. Morris & I were seeing a patient in Consultorio #2 during a power outage at about 1am, when the son of our patient started laughing--at the very large scorpion clinging to the wall about six inches from our patient's head. A tennis shoe made short work of that one.

Scorpion #6: One rainy night, Heang & I were in our room, on the upper level of the dorm building. The other volunteers were downstairs in the comedor. Through the rain, I heard shrieks and a loud, repetitive "whack"ing sound. Sounds like a scorpion, I thought. And it was--Stephanie, the med-peds resident from UMichigan, demolished that one with her flip-flop.

The mega-brigade arrives tomorrow. Our advice to them will be, watch out when it rains. And always check your shoes. Number 7 is waiting. Bienvenidos a Intibuca, folks.

The Bambulance

2008-10-10T15:25:00.000-07:00

I remember a Surgical Grand Rounds from med school where the "golden hour" of trauma response was discussed. The "golden hour" is the term we use to describe the ideal amount of time under which a trauma victim should receive treatment (i.e., there should be a maximum of one hour from traumatic event to transport to treatment destination). The information presented in Grand Rounds indicated that, in rural areas of the U.S., this goal is often not reached due to transportation factors: long distances to the nearest level-one trauma center, long distances to reach the patients initially, etc.

If the goal is that hard to reach in the States, imagine how hard it is in rural Honduras! Or, actually, I'll describe it for you.

Patient: Sr.C, from Bañaderos, San Antonio (the next municipality over from Santa Lucia). Fell from a tree at 1pm. Arrived at the clinic at 4pm. Assessed as having multiple open skull fractures, but with a patent airway after suctioning. En route to hospital in our ambulance by 4:30pm. Three hours to La Esperanza, with stops to suction and reposition. Arrived at hospital ED 7:30pm. Stabilized again, given IV fluids, en route to Tegucigalpa (where the only trauma surgeons or neurosurgeons are) in Red Cross (Cruz Roja) ambulance by 8:45pm. Likely arrival in Teguc around 11:30pm. That's a total time of around 10.5 hours from injury to treatment. Golden hour, ha.

I'd describe more cases, but they're all fairly similar. Essentially, with any traumas, it takes people about three hours to find a car, find enough people to carry them, and make it to the clinic. It takes even longer if they come by foot in a "bambulance." We can handle minor traumas: machete wounds, tendon repairs, simple fractures, but anything more serious has to go six hours to Teguc. That means our "golden hour" is something like a golden nine hours, minimum.

And what's a "bambulance"? It's a long bamboo pole (we have bamboo here, interestingly enough) with a hammock tied to it. The patient lies in the hammock, and people carry the ends of the bamboo pole. Pretty ingenious, actually. Works well, and shields the patient from the jarring movements of being transported by foot.

I'm on call tonight...hopefully no ambulance rides lie in my immediate future. :)

The Road

2008-09-25T19:31:00.000-07:00

Imagine you're on a rollercoaster. One of those old wooden ones that ratchets you this way and that, unexpectedly. But a really, really slow old wooden rollercoaster. That's kind of what it's like to travel on the roads in a developing country, at least in a mountainous developing country like Honduras. You're suddenly aware of every bone in your body rattling and scraping against every other bone in your body. You can't keep your teeth together, or else they'd chatter the entire time. Your back gets hot from the friction of your clothes against the car seat, and you marvel at the fact that the ride didn't rub a hole into the back of your shirt. Sometimes, even though you're only traveling at 10mph, you have to hold on just to stay in your seat. Once you finally leave the car (truck), your body still has this vague vibratory sensation and you can't quite walk straight. I'm not complaining, really, just trying to properly portray the experience for everyone who's accustomed to a world where even the "back roads" are paved.

Heang & I rode around for five hours today, doing promotion for the mega-brigade that arrives in two weeks. The "mega-brigade" is our term for the monstrously huge group of people (50) that will be here for two weeks, working on various projects (the usual brigade size is around 20 people). They'll be doing 12 Children's Health Initiative brigades for us, so this requires a lot of planning, organizing, and publicizing on mine & Heang's part before they arrive.

And so today we rattled around for five hours. Apparently, the roads start the rainy season in fairly good shape, with plenty of gravel and maintenance, but after months and months of rain, they're all rivets and rock. I'm amazed at how well our trucks hold up...it'd make a killer advertisement for Toyota if they could see how badly we abuse those trucks, and how well they survive. :)

Pediatrics 101

2008-09-18T19:57:00.000-07:00

This is probably not going to be the most politically correct of my entries...but sometimes I think I should share my frustrations down here alongside the successes, just to paint a fair picture. So, here goes.

Vignette:
22-day-old female presents to field clinic of children's health brigade with one day of fever and poor feeding. (Really, that's enough of a picture to paint, but I'll give you the rest anyway). Mother denies cough, vomiting, diarrhea, rashes, cyanosis (turning blue), etc. She feels that the child is less active than usual. Uncertain vaccination history. Birth was vaginal and without complications. Vital signs reveal temperature of 103.2 degrees F and tachycardia. Exam significant for lethargy--we witnessed Mom attempt to breastfeed baby, with baby completely unwilling to eat.

So, how does one proceed from here?

I'll tell you how one does NOT proceed from here. One does NOT blow off Mom's concerns, say the baby has "acute diarrheal syndrome" and send them home.

Unfortunately, this is what happened. Eventually.

First, Heang, Becky (2nd-year family medicine resident from Connecticut), and I agreed that we needed to get the baby to the hospital in La Esperanza for a sepsis workup. Why? From the American Academy of Family Physicians Key Recommendations for Practice: "Any child younger than 29 days and any child with a toxic appearance, regardless of age, should undergo a complete sepsis workup and be admitted for observation until culture results are obtained or the source of the fever is found and treated." (Evidence rating A). What comprises a toxic appearance? In this case, the fever, tachycardia, lethargy, and dehydration (which we confirmed later when we finally got the baby to cry, but she had no tears to shed). What's a sepsis workup? It's basically checking, through tests, everywhere an infection could live, since babies can't tell you where things hurt or what's wrong with them. A sepsis workup involves a complete blood count, a urinalysis with culture, blood cultures, and cerebral spinal fluid cultures (obtained through a lumbar puncture). After drawing samples, one should start IV antibiotics and observe for 48 hours.

We knew that the hospital in La Esperanza doesn't usually draw cultures...they just treat empirically. But we still wanted the baby to be treated in a hospital environment, where ventilation was available if necessary. So, we piled Mom & baby into the truck with all of our brigade workers (in total, we had 13 people in this truck), and carried them back to the clinic in Santa Lucia. We bolused the baby with some fluids, administered antibiotics (since cultures weren't going to happen anyway), and send them on to La Esperanza with a detailed referral for further treatment. Or so we thought.

The next day, Heang rode to the hospital to deliver a stroke patient. When she got there, she checked with the hospital doctors to see about the status of our baby.

"Despachada." said the doctor. (i.e., discharged)
"Despachada?!" said Heang, incredulously.
"Despachada," said the doctor. "Sindrome agudo de diarrhea." And stared at Heang with a look that clearly said, duh. Acute diarrheal syndrome.

We were horrified. For a number of reasons. For one, this is not a term we use in the States. It's apparently not a term they use here, either, because our Honduran doctors weren't familiar with it. They diagnosed our baby with a made-up disease?! But according to Google (that lovely authoritative medical reference, ha), it's sometimes used to refer to Rotavirus (a particularly nasty viral diarrhea that runs rampant throughout daycare centers during certain times of year). For another, the baby didn't even have diarrhea! And what about the fever? And the lethargy? Ay-yi-yi. So many things wrong with this picture.

So (wow...this is turning into a really long story, huh?), today, Heang, Stephanie (fourth-year Med-Peds resident from UMichigan), and Ruben went all the way back out to San Jacinto to find the baby. Who was still about the same, but alive. Mom was really glad to see us...she had been very worried and didn't trust the hospital's decision to send them home. The crew delivered some more antibiotics, observed the baby for a bit, and decided to come back again on Sunday to check her progress. We feel that the outcome will be positive, but could have been disastrous.

I said this entry wasn't going to be terriby PC...mainly because yes, I am criticizing the health system. They made a bad call on this one. And others that we've seen, but I don't have space to rehash them all. They have no resources. Insufficient training. Poor compensation. And make terrible decisions--which reinforces the patients' distrust of doctors in general. I know the underlying reasons for the pitiful health system are multifactorial--social, financial, cultural--and I don't know what the solution is...I certainly don't consider myself an expert on health systems, or on Honduran culture, and so would be ill-qualified to make judgements or suggestions concerning them...I guess my point is that, some days, it's just really frustrating. That's all. That's where we live, that's what we have to work with.

I'll end this post with a positive story, just so I don't depress everyone...I took care of the most adorable little 6-year-old girl with a dog bite yesterday, who, once she realized I wasn't going to hurt her and stopped crying, smiled at me for the rest of the visit...and then her dad asked if there were more places like us around here, because, in his words (translated), "This is the best hospital in all of Honduras." Technically, we're a clinic, not a hospital, but whatever. That was my "real doctor moment" for the week...those moments where I actually feel like a doctor, and like we're actually doing some good. :)

Dia de Los Niños

2008-09-10T15:26:00.000-07:00

It's fiesta time in Honduras...September is notable for two big events: Independence Day (the 15th) and Dia de Los Niños, the 10th. Children's Day. Today.
Basically, Dia de Los Niños is one big birthday party. In rural Honduras, birthdays are only celebrated up until about age 3, and even then they're mainly parties for the adults. So, instead, every kid's birthday is celebrated on the same day. What does this mean for us?
Chaos. Utter chaos.
Since our prenatal clinic today was slower than usual, Heang & I decided to help out the librarian, Kelvin, instead, since he was busy planning the party for Kids' Day. He seemed unconcerned about the party, really, since supposedly there was to be another party, thrown by the alcaldia (mayor's office) at the same time. Maybe thirty kids, he said. Great, we thought. We'll play musical chairs, there's a piñata, and we could even do some face-painting.
About a half-hour before the party was to start, Kelvin came looking for us, appearing nervous and making sure that we were still going to help out. We assured him that we were, and thought this was a bit strange...after all, Hondurans usually aren't picky about punctuality (forty-five minutes late is right on time by their standards), so why was he wondering where we were, a half-hour early?
We had our answer as soon as we saw the swarm of kids. Thirty? More like a hundred and thirty. We set up our chairs, attempted to get the kids to line up (apparently an entirely foreign concept, this "line"), and went to work. Four choices: a flower, a fish, a heart, and (my personal favorite) a blue star like those found on the flag of Honduras. With only thirty kids, we had planned on more complicated drawings, like those we used to do back in Burnsville (my hometown) as volunteer face-painters on the Fourth of July (watermelons, flags, little people, baseballs)...but that's not really possible with kids literally climbing over you to get their turn. All in all, we probably painted about 150 cheeks, since some kids came back after sweating the first one off.
Then came the games--we ran several different games at once, to keep the kids occupied. Then the cake. And the "bolsitas"--little bags stuffed with candy. And the piñata. Also stuffed with candy. Which led us to discuss the role of the clinic in this celebration. Shouldn't we be more like that house on Halloween that gives out raisins and toothbrushes? Couldn't we take a stand for health and do health-related activities, stuff our piñata with whistles & bouncy-balls, and give out pencils and stickers? Anyways, it's something to consider for next year. Dia de Los Niños appears to be a day when everyone "looks the other way" as far as health is concerned, but maybe there's room for both fun and healthy choices. Or maybe I'm just being too judgemental about the whole thing.
After all, when my birthday rolls around, I want cake.

Las Maestras

2008-09-03T18:38:00.000-07:00

Today was a good day. Yes, we're a little sad about having to leave our families & friends behind yet again (after our lovely mandatory visa-renewal vacation to the States last week), but at the same time, we have lots of big projects coming up and are eager to get started.

I've written before about the Children's Health Initiative, and our trips out to the local (local meaning less than a three-hour-drive away) schools to do preventive health screenings & interventions. For the fall, CHI is our main project. Last winter & spring, we had lots of brigades full of doctors, residents, med students, nurses, midwives, partridges & pear trees coming down to help with CHI brigades. They did a tremendous job knocking out all of the CHI trips for the beginning of the year...but here we are in the fall, with fewer brigades than anticipated coming to help with the second annual visit to each school. We have several long-term volunteers in Santa Lucia right now, so we thought that perhaps the long-termers could do a few trips on our own, so that the kids seen in the beginning of the year will get their follow-up on time, but everyone has their own projects going on as well, and there simply aren't enough of us to cover all of the stations...so our solution was to recruit the local health-promotion students (high school here consists of vocational tracks only--computer science, health promotion, automotive mechanics, nursing, etc.) to fill in the gaps.

This idea had a lot of potential pitfalls: the directora of the school might not want to participate, the students might be apathetic, the schedules might not line up, and so on...but somehow, it's all worked out.

And this is why (finally got down to it, huh?) today was a good day. In order for the students to help out with CHI, they needed to learn some basic skills: how to measure heights & weights, how to apply dental varnish, how to draw hematocrits, and how to test vision. So, today, Heang & I were teachers at the colegio. We lugged our box of lancets, eye charts, measuring tapes, and a centrifuge across town (across town, though, really, is like 600 meters), and set up shop in one of the classrooms. Initially, we were a bit apprehensive--we've all had teachers that can really spice up a classroom, and...well, teachers that don't. :) We were afraid of being part of the latter group, but the class turned out to be a lot of fun--the students were enthusiastic and participatory, eager to try out the skills we taught, and even offered to help out on additional CHI brigades once school's out for them. We're really excited to work with them this month--they'll be helping us out with six CHI brigades in total, which really wouldn't be possible without them. Exito!

The Library

2008-08-17T20:08:00.001-07:00

When I was a kid, libraries and bookstores were my favorite places. Shelf after shelf of crisp pages that could keep me busy for hours...I think my parents would agree that my nose was pretty much always buried in a book, one hand in my hair, twirling as fast as my eyes moved across the pages...okay, so not much has changed, really. (I'm trying to quit the hair-twirling thing, though, I promise).

Anyway, a friend of mine once commented that you can really tell how developed a nation is by the availability of books to its citizens, and that they are directly proportional, i.e., people in more developed places have more access to books. This observation certainly holds true here in Honduras. For all of the home visits that I've been on, and all the little towns I've been through, I have seen not a single book in a home nor a single bookstore. I'm sure they have them in the cities like Teguc or San Pedro Sula, but here in Santa Lucia we might as well be a paperless society. It would think it unimaginable, were I not seeing it for myself. What would I have done, as a kid, without Judy Blume, C.S. Lewis, or E.B. White?

I don't know who decided it would be a good idea for us to open a library, but way to go, whoever you are. Here at the clinic, we have a library of children's books, in Spanish of course, and a daily story hour and art project for the kids of Santa Lucia. It's yet another thing that we take for granted at home, the ability to read a book recreationally, that they don't have here. You might wonder why we bother providing books for kids as part of a medical outreach, but as always, it's all about education. And we're here to try to make a difference in the overall picture, which includes helping the kids get every educational opportunity we can provide. I don't have data to support whether having a library is an effective way to get kids excited about learning, but it can't hurt...and I saw how involved & intent the kids were the day we read them "Where the Wild Things Are" for the first time, so that's proof enough for me.

(If you want to help out with the library, Shoulder to Shoulder has a wish list on amazon.com!)

As for the bookworms living above the clinic, Heang & I are doing a fair amount of reading ourselves, particularly when the power goes out...some recent ones that one or both of us really liked include Three Cups of Tea (can't remember the author, but it's about Greg Mortenson), The Namesake (Lahiri), The Kite Runner (Hosseini), The House on Mango Street (Cisneros), Everything's Eventual (King), Mountains Beyond Mountains (Kidder), and Freakonomics (Leavitt). If you're looking for something to read, we'd recommend any of the above. Any suggestions for future picks? We'll have the chance to stop by a bookstore soon...but only because we're heading back to the States for a week. ;)

Comida Hondureña

2008-08-16T12:22:00.000-07:00

At the clinic, we have a cook (not because we're lazy or anything, just because there's really only one little kitchen for about 20 people living/working here). Her name is Maria, and she's awesome. Occasionally we have to request some changes (like, please don't butter our toast, or, could we get that interesting cheese on the side?), but for the most part, she does a tremendous job cooking for lots of people all day, every day. We get a mix of Honduran classics and improvised versions of American dishes that some of the long-term volunteers have taught her over the past few years (like pasta with tomato sauce, hamburgers, pizza). Honduran food is different from the Mexican dishes that we stereotypically associate with eating south of the border, though, so I just thought I'd give a rundown of the comida tipica:

Pupusas: These may traditionally be El Salvadorean, but we're practically in El Salvador anyway, so same difference. These are small corn tortillas stuffed with a fresh sharp cheese found throughout Central America. (in Costa Rica, I remember, they called it queso fresco, but here it's called guajada, and tastes a little saltier), and topped with a purple cabbage slaw. Pupusas are essentially a Honduran version of grilled-cheese sandwiches.

Tacos: Not what comes to mind when estadounidenses (i.e., we) think of tacos, these are filled with mashed potatoes and chicken, then deep-fried to a crisp and topped with red sauce.

Baleadas: The crown jewel of comida Hondureña, the baleada is a fresh flour tortilla, grilled, then filled with pureed red beans, cheese, and mantequilla (which, although it means "butter", is actually a thin creamy sauce that can be put on almost anything). You can actually find Honduran restaurants in the States that feature baleadas, in the style of Subway or Pita Pit.

Gringas: Yup, gringas. 'Cause they're white, we think. Flour tortilla like that of the baleadas, with cheese and chicken inside.

Fried Chicken: Apparently Honduras is quite famous for fried chicken as well. Heang says there's a Honduran fried chicken restaurant in L.A. that gets crowds that wrap around the block. We've seen Maria make it, and she lets it marinate all day in spices before frying it crispy and dark...and somehow keeps the inside moist.

Desayuno: Typical Honduran breakfast consists of beans, eggs, tortilla, avocado, guajada, mantequilla, and fried plantain...if they're lucky. Most of our patients subsist solely on beans, tortillas, and guajada.

Pescado: Means fish. This is hands-down our favorite meal. When we ate at the lake, we got to do the whole pick-your-own-fish-out-of-the-cooler thing, then it's brought to you whole & fried. But at the clinic we have to settle for fillets from the freezers. Sigh. The fish is good, but what makes the meal extraordinary is the tajadas, thin-sliced fried green plantains. In Nicaragua, they called them tostones, but basically these serve the same purpose as french fries (and really, I think I prefer the tajadas/tostones).

So, that's the rundown on Honduran food...overall, we really like it, although I can't say that we don't get really excited for pizza night--probably more because it reminds us of home than for the actual taste. :)

Return to Colomarigua

2008-08-11T15:33:00.000-07:00

For Heang & me, our first exposure to Honduras, back in September of last year, was through a brigade to a remote town called Colomarigua. Along with about twenty other doctors, residents, and medical students, we lived in Colomarigua, sleeping on the floor of the school, taking outdoor showers (covered, of course), and eating meals prepared over a fire. We held clinic in Colomarigua for about ten days, getting to know the community, playing with the kids, and basically falling in love with the place. Colomarigua is the reason that we decided to come back.

So, naturally, we were thrilled to have the opportunity to return to Colomarigua last Friday, to do dental varnishing on all of the children in the school.

We were apprehensive, though...would they remember us? Would we still be as enchanted by the place? Or are we now jaded by our experiences in other parts of the country?

We pulled up in our trucks and were greeted by a crowd of kids. As soon as we saw familiar faces, the excitement returned and the apprehension vanished. There's Alan! Look at Eusebio's hair! Nery still doesn't have any teeth! It felt like a homecoming, which really, it was. :) For those of you who came with us, they asked about you...Marixa wants to know how you're all doing, Miguelito, Miguelon, Benjamin, "Bandera", "Camisa", Kelly, and so on...I think she was a little surprised that we speak better Spanish now (she used to love to mock us), and was shy at first, but she's still our Marixa. Spunky and smart as ever.

The day went really smoothly as far as work goes, too. My group did the education portion of the varnishing, which basically involves acting really, really excited about brushing your teeth, and then Heang's group did the actual application...I have a terrific picture of her basically holding one kid down so we could get his mouth open. Sometimes you have to strong-arm them. Moms of the world, you know what I mean.

So, answers to the previous questions: yes, they remembered us. Yes, we were still enchanted by them. And no, we haven't been jaded. It's still our Colomarigua. And it still feels like home.

We Miss You, Laura!!

2008-08-02T17:44:00.000-07:00

When Heang & I arrived in Santa Lucia two months ago, we were greeted by eight undergraduate students from Brown University. Seven of them left after being here for three weeks, but one, Laura from Boston, stayed for the entire summer, a total of (I think) nine or ten weeks, to work on a mental health project (interviewing families of suicide victims & composing a curriculum for teaching health workers in the area about depression, anxiety, and suicide). Point being, she's been here the whole time we have. For every story about a brigade, a "fiesta de ojos", or the lake trip, she's been there, working hard alongside us & cracking us up with her unique sense of humor & terrific stories. Why am I writing all of this? 'Cause Laura left this morning, to do a bit of traveling with her parents before heading back to college...so we just wanted to give her a little "shout-out" for all of her hard work, and say that we miss you, Laura!! And we hope to see you again soon. :)

Now who's going to watch "LOST" with me??? :(

Gas is $4 a gallon?!?

2008-07-25T10:00:00.000-07:00

Sorry it's been a while since the last entry, but we've had a run of power outages. Not that it's anything unusual, we've just had more of them that last longer. Makes it difficult to blog, email, read, cook, see patients...pretty much do anything, really.

Last weekend, we had an opportunity to visit a "decentralized" clinic in a town called Taulabe, near San Pedro Sula. It was going to be a fairly long trip (about a 5-hour car ride), so we made a weekend out of it & spent a couple of nights at Lake Yojoa. Even though technically we went for work, we still called the trip a vacation, since it got us out of Santa Lucia (and the heat & humidity) for a few days, and we got to do a few touristy things...we visited a waterfall (Puhlapanzak, which I think is actually the largest waterfall I've ever seen), rode paddle-boats in the lake (terrific view, but apparently paddle-boats are purely a gringo activity...the guys running the boat place had to dig the boat out of a swamp before we could use it), wandered through an archaeological park with a few Lenca ruins (and when I say few, I mean few...it's a work-in-progress; most of the ruins are actually still underground & haven't been excavated yet...but they give you a nice map showing you when you're standing on top of them, according to our rifle-toting guide--who was actually a bored park guard wanting to go for a walk). The highlights of the weekend, though were the food (we ate fresh fried tilapia from the lake in little comedors where you get to pick your fish from a cooler, and we found ice cream!) and the hot showers.

The clinic in Taulabe was really interesting...the government pays for health care here in Honduras, but it's a pretty pitiful system...so, for community groups interested in doing it themselves, the government offers contracts for "decentralization." They pay the community group, and the community group provides the health care. The Taulabe clinic does their job well. They don't offer a lot of services, really (patients with any sort of wound, fracture, or complicated illness are simply transported to government hospitals), but they're working very hard to tackle some of the most significant causes of mortality: diarrhea, pneumonia, and perinatal complications. They're focusing on education, which is terrific...it's nice to see a group that originated in the community working this hard to improve everyone's health.

Having not been near a gas station for 2 months now, I had no idea gas was so expensive. Four dollars?! Seriously?! We always talk about how that affects small businesses, rural workers, commuters, etc., but I'd never thought before about how much it affects small nonprofits like us...we're dependent on transportation for a lot of our projects, so gas prices are really hurting us, too. Yikes.

Fiesta de Ojos

2008-07-13T18:22:00.000-07:00

Yesterday marked the first in our series of "Fiestas de Ojos", which is our nickname for our trips to La Esperanza (the capital of Intibuca, which is the state we're in) to take kids who need glasses to the Lion's Club for prescription fitting. It's a follow-up thing...when we do all these brigades, we identify kids with issues that need to be dealt with--kids with poor vision need glasses, anemic kids need to be dewormed and supplemented with iron, etc. So, yesterday we followed up on the kids with poor vision. It sounds pretty simple to accomplish, but really, it's been one of the more complicated projects we've worked on (and I actually can't take any credit for it; it's been Heang's project, which was a flawless success, and I'm bragging about it because I know she'd never admit herself that she did an amazing job. Way to go, Heang!!).

Think about how easy this would be in the States: Pick up a phone. Hi, Mrs. Jane P. Normal, I'm just calling to let you know that little Susie's vision needs to be checked. It's free, just take her to the Lion's Club. Okay, great. Talk to you later.

Here, though, there's no phonebook. Not everyone has a phone. We don't really know where anyone lives. And getting transportation to the city is a huge hassle (four hours on a bus). So, Heang had to send letters to all of the schools that had kids needs needing glasses, and call their teachers (or go in person) to explain it all. Then, we sent trucks for them on Friday night. They spent the night at the clinic on Friday, then we all got up at 3am to head to the city...arrived at 7:30, fed everyone breakfast, went to the Lion's Club, ran errands, got lunch, then headed 4 hours home on the bus. And we can only take so many kids at a time...so we have two more of these adventures scheduled. It's a lot more complicated than it should be, but there's really no other way.

The kids were really cute in their Harry Potter specs. :)

Moooooo...

2008-07-05T18:32:00.000-07:00

In Greenville, NC, where Heang & I went to med school, there's a lot of traffic (as those of you who live there know!): protected-greens that last two seconds, the train that passes through at the least opportune times, and that light at Arlington and Stantonsburg, yikes.

Needless to say, traffic is a little bit different in a place where all the roads are gravel, one car-width across, and riveted with tracks from heavy rain...but it's there all the same. I will say, though, that when "traffic" consists of having to wait for the herd of cattle to disperse enough for us to be able to drive through the middle of them, it makes me laugh a lot more than any train in Greenville ever has (those usually result in a lot of eye-rolling and heavy sighs). Score one for Honduras!

Some Really Terrific People

2008-07-02T09:21:00.000-07:00

Okay, I said a while back that I'd tell everyone about the doctors-in-residence down here at the clinic in Santa Lucia. So, since tomorrow is James' birthday, I thought now would be a good time...

There are three U.S. family physicians who have been living here in Honduras for the last two years. The O'Deas (James & Christy) are both family docs, and have three really great kids. Dr. Morris (Andy), his wife Laura, and their son Lucas (who is about 1 & a half, speaks only Spanish, and absolutely made my day last week when he learned my name) are here as well. Both families gave up everything back in the States, wrote letters to everyone they knew asking for support, picked up and moved here to work for free. For two years. To come here, live in rough conditions, and try to help people who can't afford to help themselves. It's beyond admirable. And they're all really humble, hardworking, fun people to be around...so I just wanted to give them a "shout-out" for all their hard work. And say thanks!!

Happy early birthday, James. :)

How to Kill a Scorpion

2008-07-01T11:32:00.000-07:00

Scorpion #1: Chase out from behind TV, then smash with shoe.

Scorpion #2: Consider precarious position of scorpion high above bathroom stalls. Throw flip-flop at scorpion multiple times without success. Move with broom into corner. Try to squish in corner. Fail. Watch scorpion fall into sink. Blast scorpion with absurd amount of DEET, then flush down drain with water. Blast drain with DEET. Create drain plug using aluminum foil. Hope for success.

I'm hoping that this entry is NOT to be continued....

Things We Miss About Home

2008-06-25T15:31:00.000-07:00

(by Jess & Heang)
--feeling clean after a shower
--taking a shower without spiders-in-residence
--ice cream
--smelling like something other than DEET
--road trips that do not involve bumping your head on the ceiling
--text messaging
--air conditioning
--cold milk
--consistent electricity
--and, most of all, friends and family.

On the brighter side, though, a couple of the docs went to the city this past weekend...so we now have brownie mix, curry paste, and "Marshmallow Mateys" (knockoff Lucky Charms!). :)

El Agua Limpia

2008-06-24T15:18:00.000-07:00

Pop quiz: what technological advances have made the most significant impact on health (i.e., caused the greatest decrease in mortality) in the developed world over the last century or so?

Answer: As usual, simple things are the most effective...depending on what source you use, the answer to that question is either a) sanitation & clean water or b) immunizations.

Here in Honduras, the majority of citizens receive their vaccinations from their local Centro de Salud (run by the government). However, they lack clean water & most don't have in-house toilets ("servicios") or even latrines. With diarrhea as one of the primary causes of mortality in the developing world (especially child mortality), basically every nonprofit/NGO working in the developing world is attempting to fix the clean water problem, and we're no exception.

Last week, Heang & I started our series of charlas (which literally means "chats", but are more like interactive lectures) with various community groups on the importance of clean water, and how people can purify their water in the absence of filters. STS/HAH (in conjunction with Potters for Peace) is working on getting filters out to everyone we can, but it's pretty expensive & labor-intensive...so, in the meantime, we're teaching classes. Did you know that it only takes two drops of bleach per liter of water to kill most microorganisms that cause diarrhea? Yep! It's easy, quick, cheap, and effective. Good for those of us in the developed world to know as well...'cause as we saw with Hurrican Katrina a few years back, we can quickly revert back to undeveloped conditions.

Giving the charlas is fun--the ladies in the community groups are motivated, intelligent, and really sweet, so they're a lot of fun to interact with, and a lot of times they teach us things that we didn't know about the area.

Other stuff we've been up to: painting the inside of our clinic in San Jose, taking call, working prenatal clinic, traveling to field clinics, pharmacy inventory, child health initiative brigade preparation...and on our day off, we hiked up to the cell phone tower & worked kitchen duty. New development: we're kinda hooked on "LOST", the TV series...none of us ever watched it before, but some of the docs have it on DVD, and we don't have anything else to watch. So that's our evenings: "LOST" if there's power, reading by candlelight if not. (Exciting, huh? Ha.)

We're rapidly approaching the one-month mark! Yea!

Comida (aka food)

2008-06-18T16:34:00.000-07:00

Well, it's happened. I've finally gotten tired of black beans and rice and chicken...I was fine during our two weeks in Nicaragua, eating at the comedors every day, but we've now surpassed the two-week mark, and I'm starting to lose my enthusiasm for dinner. The clinic employs a cook, Maria, who cooks all three meals for employees & volunteers since there are usually a lot of us. And she does an amazing job, even occasionally making stir-fry or pizza (we had pizza two nights ago, and it felt like heaven)...but we still have beans, rice, and chicken at least four times a week, for one meal or another. And I shouldn't complain--we're lucky to have what we do; it's more than our patients have...but boy, could I go for some sushi right now. :) At least the snacks down here are good--Honduras makes a cream-filled cookie like nobody's business!! :)

When Democracy Goes Awry...

2008-06-17T21:04:00.000-07:00

In the year 2008, one would think that surely societies don't exist where it's still possible for people to win elections by buying votes...but here in severly rural, severely poor western Honduras, the mayor of our little town did just that very thing only a few years ago...and rumor is that he'll do it again next time. Power in the hands of people who seek it for the wrong reasons is a dangerous thing...especially in places where those they represent are too uneducated & too fearful to do anything about it.

Happy Father's Day!

2008-06-16T06:27:00.000-07:00

Okay, so father's day was yesterday, but today I just wanted to recognize parents in general. I know that neither Heang nor I would be here with the example, support, and love of our parents. So, thanks, Moms & Dads, for all you do. :)

Children's Health Initiative

2008-06-11T18:53:00.000-07:00

Big day today! Today, Heang, myself, the students from Brown, and some HAH staff traveled around two hours away to do a children's health brigade, part of this really big project that STS has going right now.

Basically, our "Children's Health Initiative" (CHI) is a grant-funded program designed to provide low-cost, evidence-based interventions to improve the health of children in our area of Honduras. In the span of a year, we have to see 3,000 kids...twice. During a brigade, we see an entire school's worth of children, sometimes in one day, sometimes over several days. Today's brigade was relatively small, with about 50 kids showing up (not bad; the school has almost 100, and school's out this week...so overall a good turnout). Each child is tested for anemia, vision problems, and malnutrition, and receives dental varnishing, vitamin A, multivitamins to take home, and treatment for parasites. Children found to be severely malnourished or underweight are eligible to be enrolled in a feeding program for supplementation as well. We also have a consultation-station where we can address basic infections & other minor maladies.

Each of those interventions that I mentioned have the potential to significantly reduce child mortality in our area (the mortality rate in Honduras is something awful like 28%) and increase productivity and school attendance...for example, would you really want to go to school if your stomach hurt all the time from parasites? And studies have shown that iron-deficient kids have more trouble learning than kids who have normal levels. The cost for these interventions is staggeringly low...vitamin A is around 4 cents per kid. 4 cents!! Amazing.

These brigades are going to be a large part of what we do here...they're really important, have the potential to really make a difference, and they're fun, too! Kids are great.

The best part of the day, though, was when Dr. O'Dea, during a slow moment, caught a stray chicken...with a lasso & bread for bait. One minute, I was seeing a patient, the next, there was a chicken hanging by its legs in my face. My surprise, and the fact that I jumped about six feet backwards, was highly amusing to our patients. Medical care AND entertainment! What more could you ask for? :)

Shoulder to Shoulder

2008-06-10T19:13:00.000-07:00

So, my mom says that people have lots of questions about the setup down here...so here's a quick overview. If you want the details about the organization & its history etc., try www.shouldertoshoulder.org, the official website. As for what it's like where Heang & I are...we are located in Santa Lucia, Intibuca, Honduras. It's a little town on the western side of the country, very near the El Salvadorean border (in fact, we were in El Salvador for about ten seconds the other day, en route to a village we were visiting). Intibuca is one of the poorest areas of Honduras, and Honduras is the third poorest country in our hemisphere. We work out of a clinic that was established more than fifteen years ago, thanks to support from Shoulder to Shoulder (STS), the parent organization, and the efforts of Hombro a Hombro (HAH), the side of the operation that actually runs things here in the country.

There are three full-time docs from the U.S., all volunteers (who are some really terrific people--I'll have to tell you all about them later), and one Honduran doctor who is an employee of HAH. We have a small staff, too...Hondurans who manage a lot of the projects that HAH is working on (like folic acid supplementation, building a library for kids in the community, providing water filters for families)...and they're really good at what they do as well. Also, there's a constant stream of rotators--medical students, undergrads, and residents working on various projects or in the clinic, usually staying for around a month. Right now, there are eight undergrads from Brown University here with us--really motivated, caring, enthusiastic students. So, we're not lonely by any means. STS/HAH is a really well-run organization, from what I've seen.

Okay, I'm fatiguing from all the writing...more to come later about how many people we serve with the clinic, our resources, info about the various projects, etc., etc., etc. :)

Clinic life

2008-06-08T10:58:00.000-07:00

I get lots of questions about how we live while we're down here...so, thought I'd post a brief description. Clinica Hombro a Hombro has hostel-style accommodations above the clinic, with two rooms for women & two rooms for men, with about 4-5 bunk beds in each room. Currently, Heang & I are sharing one of these rooms with a resident from Pennsylvania, Mandy. The bathroom has three shower stalls and three toilets, and no hot water, so all showers are army-style, as in turn the water on, rinse, turn the water off, lather, turn the water on, rinse, and so on. As I mentioned before, we sometimes have electricity, sometimes we don't. There's no air conditioning, but the ceiling fans make a big difference in the heat! Compared to what most people here have, it's pretty nice. Compared to your average college dorm, it'd be unacceptable. But we like it. It's simple, and as those of you who were with us in Nicaragua at Hostel Cerro Negro know...we can deal with simple. At least here we always have water!

Lack of Power

2008-06-05T16:49:00.000-07:00

When I say power, I literally mean power, like electricity. Every day since we´ve been here in Santa Lucia, it has rained...and subsequently, the power has gone out. Sometimes for hours, at the longest, for a day and a half. So, my advice to anyone traveling to the developing world is, though candlelight is romantic, buy a headlamp. Trust me. You might look like a cartoon mole, but you´ll be glad to have bright light and free hands when you´re trying to do something.

We finally made it!!!!

2008-06-04T11:51:00.000-07:00

First off, let me apologize for not updating this thing sooner...I'll try to do better!

Heang & I have finally arrived in our "hogar dulce hogar" (home sweet home) for the next six months, Clinica Hombro a Hombro in Santa Lucia, Intibuca, Honduras. We flew in on Saturday morning to San Pedro Sula, then spent all day driving the bumpy, mountainous roads to the clinic. So, no we weren't involved in the Teguc crash, gracias a Dios, but thanks for your concerns!

We've been busy so far...on Sunday we prepared for a children's health brigade that's arriving this week, Monday we helped build a bio-sand filter to serve the new clinic that's going up in nearby Concepcion, yesterday we distributed folic acid supplementation to a group of community health workers as part of an ongoing project, and today we've been helping in prenatal clinic with the expectant mothers. So, a lot of variety as we get oriented to how things work here in Santa Lucia. It's been an adventure, though, too...the power was out from midnight Sunday 'til midday Tuesday, then went out again, then came back on late Tuesday evening, so we're doing lots of reading by candlelight & headlamp.

Gotta head back to clinic now, but more updates to come, I promise!

Next phase . . . almost!!

2008-02-10T11:11:00.000-08:00

Hola!! I don't have much of interest to report, really, but thought I'd say hello to everyone anyway. :)

Heang & I have three days of class left (yea!) before we head into the one-week 'vacation' phase of our trip. We're headed out on Thursday to visit Cuzco (Machu Picchu), Arequipa, and Puno (on Lake Titicaca). It'll be a whirlwind, but we'll get the opportunity to put our new-and-improved Spanish skills to work as we travel around the country.

We do miss our families and friends, though, and had an episode of homesickness last week. . . which we effectively medicated with pizza and ice cream, so we're doing great now! :)

Chau!!
Jess

Strangers in a Strange Land

2008-01-31T12:37:00.000-08:00

Okay, not really. We are strangers, but Peru is definitely not a strange land. We're in Lima, the capital of Peru and its largest city. Lima is terrific--it's something of a combination of Washington, D.C., and New York City (if we were to relate it to the States), in that it's both the center of government & history, but also has all of the big-deal events in music, arts, & culture. We're living in Miraflores, a very pleasant neighborhood beside the ocean. Nearby is a neighborhood called Barranco . . . I'd compare it to Greenwich Village, I think. Neither Heang nor I have ever lived in a city before, but we've found Lima to be very liveable and safe.

We're almost finished with the second week of our language program, and feel that we've learned a great deal already . . . we're understanding better when people talk to us, and our vocabulary is expanding daily. Our teachers at ECELA (the language school) are really good, and we get plenty of personal attention because there aren't a lot of students yet. ECELA has locations in Argentina and Chile, with 40-100 students at each one. The Lima program is brand-new, so we have the benefit of using the same materials as the established programs, but are among fewer students. Right now there are four of us, total: Heang, myself, and two students from Germany. This means that we only had to pay for the group classes, but practically have private ones . . . it's just Heang & me in ours! We have two weeks of class left, and one week of traveling (because you can't go to Peru and NOT go to Machu Picchu, right?).

We've done some fun things, too: going to the beach, visiting some nearby ruins, taking salsa classes, and trying all kinds of new food . . . such as ceviche, fish 'cooked' by marinating it in lime juice, salt & cilantro (don't worry, it's fresh fish, and we've had our vaccines!).

Anyways, thanks for checking in on us . . . Peru is wonderful, and I'll try to update everyone more frequently from here on out. Ciao!!

Welcome!!

2007-12-18T14:07:00.000-08:00

Hi, everyone!

We've had a lot of requests for information on what exactly we're up to lately, so we figured this format would be the easiest way to get the word out. We've never "blogged" before, so bear with us!

I'm Jessica Weeks, and Heang Lim & I are currently fourth-year medical students at East Carolina University in Greenville, NC, and will be graduating in May (yea, class of 2008!!). After an amazing experience volunteering on a medical brigade with the Shoulder to Shoulder organization (see www.shouldertoshoulder.org for details) last fall, we decided to postpone our residencies for a year to work as volunteer physicians in rural western Honduras.

We're leaving soon after graduation, but in the meantime there's still lots to do!! On the top of our list is fundraising, of course, to pay for our transportation, food, insurance, etc. We've already been blessed with a good start thanks to the generosity of Higgins Memorial United Methodist Church in Burnsville, NC, but still have a long way to go. A big THANK YOU in advance to anyone reading this who is considering donating--every little bit helps!! Details on how to donate will come later . . . we're still working on how to make it easiest for everyone.

This Saturday, January 19, marks the first big step in our trip preparation with . . . another trip! Yep, we're headed to Lima, Peru, for four weeks of language school to make sure that we're able to work effectively in Honduras. We both speak decent Spanish now--sometimes--but neither of us could competently practice medicine with our skills at present. Then we're heading straight from Peru to Leon, Nicaragua, for a two-week cardiology rotation, where we'll put our new-found skills to work!

Needless to say, it's an exciting time for us, and also a very busy time. Thank you all for your support and interest in our work . . . we truly appreciate you all!! Feel free to post questions & comments, or email us if you want. We'd love to hear from you. :)