sick.

Since I last wrote you we had an internet malfunction. Last night the internet was so slow. It wouldn't load anything and we were scared that we had overused our quota for downloads and uploads for the month and perhaps may be doomed to no internet for the rest of our stay. But it seems to have resolved itself and hopefully will remain online until I leave.

Yesterday Kara and I went on home visit with Pat. It was interesting to see how many of these patients lived. Most of the patients were elderly and homebound. They suffered from diabetes and hypertension. The homes were often in a state of quasi-disarray and not as nice as most American homes. I realize though that many of the patients I have taken care of in Minnesota especially at HCMC lived in similar conditions or even worse. The plight of the family-less elderly person in America is often a sad one, and I wonder if they even have it worse as it seemed that at least the people here had not been abandoned. They still had family and friends who cared for them, even if they were poor themselves.

The biggest thing in my life however right now is the gastrointestinal bug that had hit me with a vengeance. It is not nearly as bad (yet... fingers crossed) as what I got on my peds rotation last year nor the food poisoning I suffered after eating Shawn's chicken last winter, but bad nonetheless. I skipped evening clinic today and may not make it out to mobiles tomorrow, especially as the bathroom situation in the villages is not always amiable to bouts of gastro. I am also missing out on birthday celebrations for Matt, one of the Brits, who is turning the ripe old age of 21. I know, its not a big deal for him.

I should probably go back to resting, and drinking water. Hope none of you are afflicted with what I have,

presentation for the local college students

Clinic was very busy today. Go, go, go. Sick kids with upper respiratory infections, rashes (there seems to be a plethora of rashes here), and other things. After clinic we went to the University of Belize - Toledo Campus to present on Diet, Exercise, and Stress Management to the local college students. It went well, although they weren't as interactive as I am used to from my days of teaching mainly elementary aged students. It was like pulling teeth to get them to respond to questions. I think it went well overall and I don't think I spoke too fast, as I sometimes have a tendency to do. Afterward we went to town in hopes of getting iced coffee but the shop was closed as she had just moved. :( I finally tried Charlette's across the street - tortillas, fried chicken ( it is always fried chicken down here) and beans. It was good, especially the home-made tortillas. Tomorrow we are heading out to mobile sites or to home visits. I am not sure which I am going on. It should be good either way.

We discovered the local movie rental store, which rents movies for about $2 US dollars but you have to be careful as the entire movie is not always on the disc and others are obviously taped in the theater. No quality control here.

That's all for now. I now go back to trying not to scratch my mosquito bites.

Cockscomb Wildlife Sanctuary

Cockscomb Wildlife Sanctuary, the world's only jaguar reserve, is about a three hour bus ride ride from Hillside. After Matt made a quick call Saturday morning to make sure we had a place to stay, we walked down our gravel road to the bus stop. When arrived at Maya Center, the village gateway to Cockscomb we discovered that all of the hotel owners where gone for the morning, which meant no place to stash our stuff before heading into the park. Oops. We pondered and decided to take a taxi in and perhaps stay the night in the jungle in the parks cabin. The back-up plan was to pay to stash our stuff for the day in the park and then either take the bus back to Hillside or find the hotels open on our way out and stay. We headed in after a quick grocery stop and decided to stay the night for $5 a person. Not bad. We hiked to a waterfall, swam, and then hiked up Ben's Bluff (named after one of the original jaguar trackers in the park) and viewed Mountains. It was a pleasant day, at least for me. When we got back to the cabins, decisions split about what to do... Emily didn't feel well and decided to head back to Hillside. Eventually Kara and Tim decided to go back as well. Matt was in a world of indecision but eventually decided to stay with me.

Matt and I did a couple hikes after they left, including a night one in hopes of seeing a jaguar. Of course we didn't but we could hope. We did witness the evening howling of the howler monkeys but only glimpsed the braches moving as the monkey jumped from tree to tree. Today we hiked to Twin Falls. It was so hot and humid. I cannot remember the last time I have been drenched in so much sweat. And the sweat refused to evaporate because the air was so humid. In the end, I think the hike was worth it. We came upon a beautiful fall in the middle of the jungle and had it completely to ourselves unlike the falls the previous day. We hiked out, ate same mac and cheese for a short of brunch and then bunkered down to hike out 10 km. It wasn't bad except for the heat and the fact that my patagonia courier bag is grossly mis-proportioned for me. For some reason the model I got for the trade-in of my old pack which was malfunctioning is sized for a giant. The highest it can go on me is my butt, and is not the most comfortable way to carry a load. I ended up deciding to carry it with the strap upon my head like a sherpas. It was a thousand times more comfortable, and not nearly as awkward as I though it would be. I need to do something to fix the straps, though, either trade it in, return it, or take the sewing machine to it.

That was my weekend in short. Take care.

canoeing down the rio grande

Clinic seems to always starts out like it is going to be extremely busy as people show up a half hour before we start seeing patients. Thus we get "slammed" when we open our doors. But it soon slow downs. I saw an entire family today all afflicted with scabies. Scabies is everywhere it seems here. After clinic we headed to local a resort. Matt, Tim and I went exploring along the resorts trails. It is a little disorientating to wander in the rainforest without any changes in terrain. We went for the whole turn left at every intersection and ended up at the base of the lodge far from where we thought we were going to be . At least we didn't get lost. Jimmy can smile about that.

We went to the lodge to meet a Belizean who Emily met in town and promised us a canoe/kayak trip. We canoed down the Rio Grande looking for monkeys, crocs, birds of all shapes and sizes. The river was very calm and an easy paddle. It made want to get a kayak once again... oh wait I have never gotten over wanting a kayak.

Conversations with my fellow students here have made me realized how strange and sheltered my childhood was. I knew this before but I haven't been confronted with the fact for awhile. I need to remember that my childhood was different as I talk to patients, especially teenagers. I know I don't really understand the world of "normal" teenagers. But maybe that is good thing as I won't make any assumptions about life as a teenager. At least I hope I don't.

Jimmy is packing up our stuff, getting ready to move out at the beginning of April. It is going to be strange to come back to nothing. Hope all is well at home.

valentines and my half birthday

Jimmy and I refuse to celebrate Valentine's Day, but ever since we met we have celebrated my half-birthday which is Feb 13th. Kind of a leftover celebration from childhood, as I was unable to celebrate my summer birthday in school, so got to bring in treats on my half birthday. Yesterday was the first time we haven't been together to celebrate my half-birthday. Jimmy was a little distraught when he discovered this, but he made a way to make the day special by writing me a poem. It was sweet.

Back to life in Belize. Yesterday started out with a trip to the market where I stocked up on fruits and tried a Belizean fruit called Caimito or Star Apple. It was super sweet and maybe a bit overripe as it is suppose to taste like grapes according to the internet. :) Clinic was slow. Although I had an interesting run-in with a patient who was probably an untreated schizophrenic. He grabbed my face and then tried to grab mg again while leaving. It made me very uncomfortable. At least nothing worse than that happened. Last evening we went to watch traditional Garifuna dancing and drumming in PG. We also tried it ourselves... well I was forced to but it was fun in the end.

Today mobile clinic was canceled, no not because of Valentine's day, but because our medical director's back still is not better. Thus we headed to Blanco Grande National Park to hike and swim. The others all jumped off the cliff, but I couldn't do it. You would like that I would be okay with heights and falls after rock climbing, but I am not. A little strange. Tonight holds perhaps dinner in town. Pat, a nurse practitioner from the States, has offered us a free lift into town. Free rides are always nice. That's all for now. I think we are heading to Cockscomb Wildlife Sanctuary this weekend. I'll tell you about on Monday.

a day with a cuban doctor

We went to San Jose village today. Our medical director at Hillside was unable to go with us as his back has been giving him grief. We were gearing up for a day off, when word came that government doctor at San Antonio had few patients and would come with us, Thus, we headed off to the village once again on bumpy dirt roads. Belize like much of Central and South America has quite a few Cuban doctors. I was interested in seeing how they function, having been told that medicine is quite good in Cuba and that their training was supposedly comparable to ours.

Clinic turned out to be quite frustrating. Some of it was probably due to a language barrier, The Cuban doctor's English was not perfect, but it also had to do with philosophy. We are so use to asking complete histories, doing full exams and then presenting them to our preceptor (the doctor overseeing us). We set about to do this but quickly found that the doctor only wanted cheif complaints and then s brief physical finding. He had no time it seemed for more. A patient would complain of headache/backache and they would get Tylenol. They would complain of cough and have some coarse upper respiratory sounds and they would get amoxicillin. I felt that we were giving drugs out like candy. He seemed to want to give everyone Tylenol and/or Benadryl. It was crazy. It reminded me of my experience of being a patient in India back in college when complaints were given and then drugs were doled out. It was crazy to be a part of and definitely made me appreciate the American, British, and Australian doctors that come here and provide an alternative to this type of care. It was also shocking because it was not what I had expected coming into the experience. Maybe Michael Moore wasn't completely right about medical care in Cuba in "Sicko."

Finally made some real coffee, but the beans were a little bitter. I will have to see if Jeff's one of the administrators here at Hillside who also happened to be roommates will Will Shortz of crossword fame, home roasted coffee is better. Hope all is well at home and that the cold weather soon ends for you.

snake scare

Today was another clinic which I spent seeing scabies and trying to erase viruses on the volunteer laptop (which we were unsuccessful at). After clinic, I heard screaming from the Admin building. Turns out there was a snake hiding in the rafters. We rushed to see the neck that turned out to be quite small and not nearly as exciting as we hoped it to be. It looked like a Belizean version of the garter snake. We headed into town today and found this fabulous coffee shop run by an American. I am so excited to finally have real coffee after days of instant Nescafe. We ate dinner in town and it was fabulous (and cheap). It is a little strange as it seems that often eating out ends up being cheaper than making food. Probably because everything we know how to make is imported from the US and elsewhere. Hence food is more expensive here than home. Except for fruits and vegetables.

Tomorrow we head to a large village of 1000 to 2000 people. It suppose to be busy. I am interested to see what life in a larger village. I hoped you all enjoyed the pictures I posted yesterday. I will try to post some more later.