Posts Tagged With: San Marcos

Cutest kid in Honduras

Cutest kid in Honduras

David communicated with me solely by pounding on the hood of the truck and blowing raspberries (or whatever you call it when you vibrate your lips together to make a “brrr!” sound).

Here he is, chillin’ with Dad.

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A Visit to Isletas School

One of my favorite days from my trip to San Marcos last year was the morning that we spent at a local school teaching about oral hygiene and distributing toothbrushes. When it was announced that we would be visiting another school this year, I jumped at the chance to be part of the team that went.

A small group of us: Randy, Helena, Lauren, Bill, Nicole, Linda, and two of the soldiers and I boarded our truck to head up the road on Tuesday morning to the Isletas school. I think that it was my first time riding in the back of a truck, so I have to admit even that part was pretty fun :). The truck would only take us so far; the rest of the way we had to hike up a dirt path.

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Upon our arrival at the school, there was a buzz of excitement among the students. Last year, the students the San Marcos Abajo school had assembled in the main yard for our presentation, but this day we learned that the Isletas students had a performance planned for us. We were seated on a raised platform in the courtyard of the school while the students sang, performed a drum line, and even acted out a little song for us.

One older boy stood out as sort of an elder statesman of the school. He was one of the lead drummers in the drum line and was the boy chosen to perform the courting song for us. During the drumming, he coolly put on a pair of sunglasses, and after the performances, he came up to me to shake my hand and ask my name. He also arranged a small group of boys to accompany us part of the way back down to the truck afterwards. I am confident that he is on his way to becoming mayor or president or something!

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Then came time for our presentation. With an interpreter for time’s sake, I introduced myself and said that I was a dentist. I asked the students, “Who can tell me what a dentist does?” It broke my heart to hear one boy yell, “Saca los dientes! (You pull teeth!)” Back at home, when I ask this question, most kids will answer “You clean teeth.” This is how different the expectations are between these two populations. I tried to segue that into something more positive by saying that yes, dentists do extract teeth, but we clean and fill them and try to keep them healthy so we don’t have to pull them. So we talked about brushing twice a day (I was nudged that I shouldn’t add “with toothpaste” because many of these kids don’t have that) and limiting sugary foods, which is another huge problem. Lauren then spoke about proper hygiene: handwashing before and after eating, after using the toilet, etc.

And then the anticipated event arrived: the distribution of new toothbrushes! We dotted each brush with a little bit of fluoride (a million thanks to Kathy Gentile at VOCO for the donated Remin Pro!!!!) and had the kids apply it and brush for one minute. Any kid would love to be able to spit enthusiastically with the full blessing of all adults present, so they had a ball with this:

Once we were done, the staff had a surprise for us: a handmade necklace for each team member. The kids had gathered the natural materials themselves.

We headed back to the truck and San Marcos in the hopes that some of our message would make an impact and that maybe the CapeCARES dental clinic will have a few fewer patients next year.

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Extracurriculars in San Marcos

Our visit in Honduras was not all official medical and dental business. Here are some of the fun things we did before- and after-hours.

Hiking

Gordon and Warren organized early morning hikes for anyone who was interested. On the first day, the idea of getting up at 4:45am to hike in the dark sounded muy loco to me, but I did join them for some of the easier hikes on subsequent days. On the second day I walked with the group (and an accompanying soldier), we walked past the very nice home of a local family. A couple, likely in their 50s, approached their gate: they recognized us as part of the medical brigade. The woman had a bandaged foot and was limping a bit. She asked Warren to look at her foot, which he did. After his consultation was over, her husband walked over to a tree in the yard and brought Warren this as a thank-you gift:

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While I would often curse myself at the beginning of each hike for not staying in bed, by the time the sun started to rise, the views became worth it.

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Yoga

Heather and I took it upon ourselves to teach Teresa yoga so that we could stretch out our muscles that were tight from hiking and (for me) lawn chair oral surgery. Our first session occurred after dinner in the dark on the porch near the storage room. We had a lot of fun, but probably not as much fun as the local kids watching the stupid gringas contort themselves into weird positions wearing headlamps in the dark.

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Sampling local products

As said before, a Salva Vida (or Port Royal, which I don’t like quite as much) at the end of the work day was a nice way to unwind.

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Group toothbrushing

In the mornings and before bed, many of us would gather around the main water cistern to brush our teeth, sometimes inadvertently to the entertainment of locals watching on the other side of the fence.

Sorry guys, no photos of that one :).

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Back to San Marcos

Norma was back to pick me up at the hotel lobby at 9 the following morning. We drove back to Toncontin airport and headed for the United desk, which was supposed to open at 9:30. Surprise! No one was actually there until almost 10:00, but I was able to finally get my bag, which had arrived unscathed.

Norma, her sister Susi, and I headed onto the highway in our rented SUV. Normally, the road to San Marcos takes about four hours , but on that Sunday morning with minimal traffic, we made it there in pretty good time, passing through Nacaome where the CapeCARES team had stayed the night before and then through Langue, the last major town before the road turned from pavement to rocky dirt. The last stretch of road that winds through the hills to San Marcos is so bumpy that I consider it a “sports bra road.”

20140310-091349.jpgBehind a truck on the highway

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The town of Langue

It was a happy feeling to finally drive up through the gates of the complex in San Marcos where we would be spending the rest of the week. I saw lots of familiar faces: Maria, Vergilia, and Marle, the women who work in the kitchen cooking our meals every day; Juan Carlos, one of the jefes of the village; Tomasa, who launders our clothes and attends all of the Catholic celebrations in the chapel; and Maria Norma holding her cousin David, who still has my vote as the cutest baby in the world.

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I got a warm reception from everyone on the team. Five of the team members had been there with me a year before: Randy and Gordon, both dentists; Warren, our physician; and Helena and Diane, who work as support staff in the pharmacy and dental clinic. We had a great team of nurses this year: Lauren, Teresa, and Heather, as well as Jen, a respiratory therapist. Bill and Bob also worked as support staff in the pharmacy and at triage. Two high school students from the Discovery School in Tegus, Nicole and Valerie, were our interpreters, along with their chaperone, Linda, who assisted me in dental. In addition, CapeCARES had hired three Honduran military guards, Carlos, Johnny, and Darwin, who would be accompanying us for safety all week. I had arrived just in time for lunch, and then it was time to get to work.

I’ve written an article about our setup in San Marcos, but for those of you who don’t happen to subscribe to a Cleveland-based Slovenian newspaper, I’ll give you the rundown. Our medical clinic and pharmacy are set up inside the main building, and the dental clinic operates on the porch. Just off that porch are the women’s dorm rooms, where we sleep in cots. The men’s dorm and the food storage room are on the opposite side of the building. For meals, the medical and pharmacy tables and chairs are pushed to the center of the main room and covered with tablecloths for dining. Within the gates of the complex are also a water tower, a set of connected stalls with latrines and two simple showers, a chapel, and an open-air kitchen.

20140311-140613.jpgTeresa in the women’s dorm

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20140311-200608.jpg The main gate
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20140311-203459.jpg Bathrooms and showers

20140311-200925.jpg Breakfast time

20140311-200657.jpg Bill in the pharmacy

Wake-up time comes early in San Marcos, especially if you have been kept awake by any of the following:
1. Barking dogs
2. Fighting dogs
3. Crying babies
4. The bus to Langue blaring its horn from the road at 4am
5. Frequent rooster crowing. I am used to the normal crowing, but this year one rooster emitted the weirdest sound. I finally found a way to describe it: look up the song “Creep” by TLC. There’s a repetitive horn loop playing in the background: “buh-BAH!” Now imagine that horn dying a long and painful death: “buh-BAaaaaauuuhh.” Now imagine that over and over again between the hours of 2-5am. Bring earplugs. 🙂

“Office hours” are from 8am to about 12-12:30pm and then from 1 to about 5-5:30 pm (or whenever we finish with the last patient). In dental, we had three chairs set up this year: one for fillings and two for extractions. Lack of electricity changes how we do a lot of things: sterilization of instruments is done with pressure cookers twice a day, diagnosis has to be done without the use of xrays, and our “drill” runs on a gasoline-powered compressor (which this year also became popular as a charging station for cell phones. What a difference a year makes! Last year, no one used a phone. This year, all we had to do was turn the generator on, and within minutes 3-5 people would come running in the hope of claiming a spot on the power strip!)

20140311-093649.jpgDental supply table

20140311-200201.jpg San Marcos restorative department

20140311-200230.jpg My “office”

20140311-200245.jpg Sterilization department

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I did extractions all week. Because of poor dental health education, infrequent use of fluoride toothpaste (whether due to lack of access, finances, or interest), high consumption of sweet sodas and juices, and what seems to be absolutely no social stigma against loss of teeth, it was not uncommon for us to extract 3-5 teeth for one person. Many people walk for several hours to get to our clinic and appear to come with the mindset that they want to get as many teeth removed as they can. Many people, even including younger people in their teens and 20s, have full or partial dentures with gold teeth added, which are very popular. One day, I extracted the four front teeth of an 18-year-old boy because of rampant decay; at home, I would have treatment planned him for root canals and crowns on all those teeth, but that’s not an option here. It’s a very different way of practicing dentistry.

The clinic setting is a bit different, too. My patient chair was a reclining lawn chair, which was SO MUCH BETTER on my back compared to the upright plastic patio chair I used last year. We are on a porch, so in the late afternoon when the sun is on the other side of the building, we have to rely more on headlamps and flashlights. And (my favorite part), once every couple hours or so, you would hear this increasingly loud chorus of chirps. Sure enough, coming around the corner and through the clinic would be the local chicken and her twelve little chicks. I was so entertained by this that I would always run and get my camera to take pictures if I wasn’t with a patient (after several rounds of this, Gordon told me that I might have a problem!)

Dinner time is usually around 5:30 and for me was either preceded or accompanied by an end-of-the-day beer. I have come to really enjoy a local Salva Vida after a long day. After dinner, it is already dark, so other than finishing up some daily paperwork, the rest of the evening is free. However, given our early wake-up time and the heat of the day, I usually found myself in bed before 9pm (which never/ happens at home!)

More on other activities in my upcoming posts!

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