Belize it or not!

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After a rocky start with a missed flight due to snow, we are officially in Belize. Saturday we flew into Belize city and took a water taxi to Caye Caulker, a tiny island off the coast of Belize. The day we were there went quickly but the time was well worth it. It is a completely different way of life; barefoot kids, wandering dogs and all travel done by foot, bike or golf cart. From there we took a small 12 seater plane to Punta Gorda, where our clinic is. It was the most enjoyable flight experience of my life, complete with a layover that included a bar on the tarmac and the Caribbean sea a hop, skip and a jump from us.

Views from the plane on our trip over gave us an idea of what clinic life might be like (yes, we could see the ground the whole flight). The clinic is a small building with makeshift exam rooms, and closets for a pharmacy, a lab and an office. My group's first day was on mobile clinic-we all pile into a van with huge boxes full of meds in ziplocks bags and miscellaneous supplies. We arrived at our mobile clinic by 8:30am or so and already had a group of patients waiting for us. Many had walked from nearby villages knowing that our group would be there on Monday. The heat seems sort of unbearable at times, particularly when cramped into the van or when closed into a small exam room. Scrubs are not meant to be worn in a tropical climate, especially when air conditioning is hard to come by and fans are the primary source of coolnesss.

The medicine that we saw today wasn't all that different from home, except for the expectations of the patients and for us as providers. When a patient came in with fever we had to think of much more menacing things than the common cold, giving someone ibuprofen means saving them a morning's walk to return to clinic next week and that you can't give insulin to everyone with diabetes because they don't have refrigerators. Just because we know what to do doesn't mean we can - coming up with the best alternative means recognizing the limitations they have. The biggest struggle today was the people's neverending politeness. In most situations this would be a wonderful characteristic, but when eliciting a history from a patient it is hard to make sense of their answers in context. "Did you feel completely well before three days ago?", "yes'm", followed by: "Has this been going on a long time?", "Yes'm". I caught on to the extreme agreeableness with my first patient when she "yes'm"-ed me to completely contradictory statements. So you are saying you are in pain but you do not feel pain at all? Yes, I can see how that might be a problem. It requires much more work on our part to come up with a diagnosis in the absence of patient information and diagnostic tests.

This afternoon we toured the Punta Gorda hospital. It was a completely eye opening experience. The hospital had no air conditioning (except for in the maternity room) and I spotted a mini lizard in the pantry. Paint was falling off in chunks but all the nurses were wearing crisp white uniforms. The gas station on the way home had run out of gas so we had to take an hour delay to wait for a refill. We spent the time sitting on the edge of the ocean. Doesn't get much better than that.

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Photos

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Our hotel for the night in Caye Caulker, personal hammock included.

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The view from the hammock.

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Our plane from Caye Caulker to Punta Gorda

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I spent half the time looking out the window and half reading the controls in the cockpit...I basically was co-pilot

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Right outside our mobile clinic. Not pictured: roaming neighborhood pigs and roosters.