Another work day at the clinic, the fifth day in a row for me. Usually we don’t work much more than 3 or 4 days in a row, but with the death in the family of Miriam, the schedule is a little off right now. Miriam had the schedule completed for April, but now it needs to be re-worked to give her and me some days off. I was supposed to work Monday through Friday this week, but since I picked up Sunday for Miriam, it would make 9 days in a row for me unless there is a change.
Dani, the little boy with vomiting and diarrhea, was still in the clinic this morning. He had a rough evening after I left with quite a bit if diarrhea, but no fever or vomiting. He had no diarrhea or fever during the night but did vomit once. Dr. Maldonado came in and ordered Lomotil and to continue the IV.
An elderly lady was admitted for low blood pressure and vomiting. She was placed on IV antibiotics and nausea medication. She felt much better after just 1-2 hours and was discharged around 1:00 pm.
Kendrick coame over with Tiffany around lunch time and visited with me for a little bit. We had a few minutes together on the porch of the clinic
Other than that, the clinic has been quiet. There have been only 3 babies born here in the last 6 days. There are some newborns in the families at the local church. I will be visiting them to give out Baby Layettes. Also, Miriam’s sister-in-law Iris has a 3 month old girl to whom I hope to give a Baby Layette.
The mother that was not able to deliver here on Thursday came back with her bay to receive a Layette. She had a little boy, about 7 lbs. He received a layette from Becca and the mother’s bill was covered by the Sis. Rita.

Today is Sunday, and it was my day off. Knowing this, I stayed up a little bit later last night working on the blog and uploading some text and pictures. I set my clock, expecting to get an extra 2 hours of sleep, but had a wake-up call around 06:00 am from Daniel. Miriam’s mother-in law had passed away in the night. I was asked to take the day shift to cover her hours.

Fortunately, Mirna also agreed to come to work with me. Some of you may remember the PowerPoint presentation of Honduras. In it, I show a picture and short video of Maria Ester at the radio station, teaching a Sunday School class for children on the radio. Mirna is the sister of Maria Ester. She and her family are active in the local church.

Our only patient (so far) today is Dani, the young boy of 15 months who was admitted yesterday for fever, vomiting, and diarrhea. His parents attend one of the mission churches, and his mother is a Sunday School teacher there. She told me that she usually had a class of 26 children, but had to find someone else to cover for her since she was in the clinic with her son. She has also been sick with the same complaints, and we medicated her while she was here with oral medications.

Both are feeling better now. The little boy, Dani, will receive a second dose of IV antibiotics around 1:00 pm, and we will then call Dr. Maldonado for discharge orders if he is still feeling well.
So far, Dani is much better and is smiling, playing, and singing. He wanted to play with my stethscope so I gave it to him. As soon as he got it, he put it around his neck the same way that I had been wearing it. We told him that he was a “Future Doctor of Honduras.”

When we called Dr. Maldonado, he said that the little girl that we sent home yesterday worsened again during the night and that he had sent her to the hospital this morning.
I had another hand wound come in today for suturing. This one was fairly simple so I cleaned and sutured it by myself.
Immedicately after I finished at the clinic I went with Sarah, Zach and some of the students to the Children’s Services at Agua Helada. After the teaching portion the children finished their memory verse craft today and then we put away the visualizations. Larissa helped by picking up the items from the floor for us.
After the service, we walked down the road to the house of one of the people in the church. In order to there, we had to cross over a branch of the river via a home-made bridge. They had a dinner fixed for use of tortillas, refried beans, cheese, and a small piece of chicken. I couldn’t eat the cheese because it was not pasteurized, but everything else was very good.

After we got back we went to the visitation for Miriam’s mother-in-law. It is customary to have a wake with the body during the night followed by an early morning funeral. By law the person has to be buried within 24-36 hours of death because the bodies are not embalmed. The funeral is to be held tomorrow morning at 7:00 am.

Here is a picture of Miriam with her mother-in-law in 2001.

Mirna had Saturday School today (a way to finish High School while still working during the week) so today Elizabet worked with me at the clinic. Elizabet is one of the older Institute students who hopes to go to nursing school. She is a Garifuna, a separate ethnic group in Honduras who speak their own language and have a separate culture.

We had several walk-in clients (glucose checks, injections, blood pressure checks) but no admitted patients until about 1:00 pm when a small boy was admitted. He had been coming to the clinic for injections of antibiotics, but was not improving. He was admitted for fever and vomiting.

Here is a picture of Dani before Rosemary started the IV (before he started crying). After the IV he cried himself to sleep. He is receiving IV antibiotics, anti-parasite, and anti-emetic medications while here.

I left the clinic right at 3:00 pm (a little early) so that I could travel with Sarah, Zach and some students to a mission church at Agua Helada (literally translated as Cold Waters). I asked if there really was cold water there, and they said that yes, we did go through a mountain stream on the way.

Sarah is giving a Children’s Meeting this weekend at this church. In the pictures, note that not everyone is a child (there was a grandmother there who did all the motions of the songs and helped with memory verse), and that there ia a “second congregation” of men outside who are attracted by the songs and story but don’t thought there were too “macho” to attend a children’s service.

The children started a small memory verse craft, which they will complete tomorrow.

Larissa took a little break during the service to play outside. There were cows nearby and she kept on pointing to them and saying, “Gow. Moo”. She also blew some kisses to her daddy, but she wouldn’t perform on command so I couldn’t get a picture.

Night arrives early here, and it is completely dark by 7:00 pm. We ate at the Meltons tonight. After dinner, I worked read a bed-time story to Kendrick and Kaleb at their house, then did the same with Larissa at her house. After Larissa went to bed, I worked on the blog a bit before going back to my place. I was tired and looked forward to an extra hour or two of sleep in the morning (something that I did not get – read tomorrow’s blog!)

Admitted patients:

Here is the baby who was delivered yesterday. She was dresed and ready to go home. The first picture is how her mother had her dressed, with her gift. She and her mother went home today. She was given a baby layette from Nevaeh’a Bennett, and her bill was paid for by Nell Bedford.

Here is a picture of the elderly patient with asthma.

She also went home today. A potion of her hospital bill was paid for by Elaine & Harold Lauer. Both she and her grandson were very grateful for the help because they were very worried about the bill. They had asked about going home yesterday because of their concern about the bill. She wanted a picture of the two of us together, and I was able to print out a photo for her to take with her with the PictureMate that I brought with me. Before she left, she allowed me to have prayer with her. It was in Spanish (and therefore very simple on my behalf) but God knows her heart and her needs. I believe that she is Catholic because she was wearing a Catholic medal, but she was very appreciative of the prayer.

Walk-in services provided:
- 1 small child for an injection of antibiotics
- 1 small girl for an injection of antibiotics
- 1 man who wanted medicine “for discharge” without a prescription (we sent him to the doctor)
- 1 lady who wanted to pay on an outstanding bill
- 1 man who wanted acetominophin (2 tablets)

- 1 man with a machete wound to the index finger of his left hand, severing the tendons. The doctor was unable to come to the clinic and the man said that he could not go to the hospital because he did not have the money to pay the bill. He asked if we would take a cow as payment! I started to clean the area around the wound, and was about to ready to inject liocaine when Esperanza arrived early. She did not want to repair the injury,but the man insisited that he could not pay to go to the hopital. She was willing to try to repair the wound, although she explined to him that is she were not able to reconnect the tendons tat he would never regain movement in he finger. He said to do what ever we could. She did an excellent job and when she was finished, he was able to bend his finger. She splinted and wrapped the wound, dispensed antibiotics and ibupophen (for pain) and sent him out. He was very happy to have received treatment. Esperanza is the only staff member that is not an LPN. But she has had the most experience with deliveries and general nursing that she is actually consider the “expert” on many procedures, especially those that require sterile technique.

Some things are just different here and it requires some thought to do a procedure that you do without thinking in the States. For example, when I prepared the birth control medication for injection, I pulled back on the syringe to test it prior to use. Well, unbeknowst to me, the syringe had a safety "lock" on it to prevent re-use of the syringe (a very common thing to do here). So when I tested it, I activated the lock and was unable to use the syringe for the actual injection. Fortunately (for me), the clinic carries syringes without this safety feature, so I was able to use another syringe to draw up and administer the injection.

Doing a bladder catherization also involves a little extra thought. In the US, everything comes in a kit; you open the kit and everything you need is there. Here, everything is packaged separately, so you need to pull the bowl for the iodine and open the package so that you have a sterile field. You then pull the catheter, the sterile gauzes, the catheter bag, and the syringe with solution to anchor the catheter and place these on the sterile field. Then you pour the betadine and place a little lubricant on the field. Now you are actually ready to put on gloves and start the procedure. Add to this the fact that I don't yet know where anything is stored, and you can see why anchoring a foley catheter is a big production for me!

I am working in order that Maribel can have a much needed vacation. Fortunately for me, Maribel didn't know that I was scheduled and showed up for the day shift. She helped me over the hump at the beginning of the shift then left around 0800. After that Mirna (the receptionist) was there to help with the language and with obtaining any needed supplies (she knows where everything is!) The picture I have is of Mirna in the pharmacy area. Mirna is in Saturday School in order to finsh hgh school. She would like to study to be a Lab Tech when she finishes high school.

Admitted patients:
- 1 maternity patient who pushed x 2 hours yet was still unable to deliver. We sent her to Santa Barbara for a c-section.
- 1 mother who delivered this morning at 5:00 am, her third child a 8#-8 oz. girl
- 1 adult: a 71 yo female with respiratory difficulties/asthma, here for IV antibiotics, steroids and prn respiratory treatments.

Because the clinic is open 24 hours a day, we get just about every body who has an ailment or needs medication. We usually sell medication by the single dose or in smaller doses (enough for a week) because that is was the people can afford. I have the most trouble with these walk-in patients because I usually cannot understand what they want. This is where Mirna is of great help.
Although we may use a general over-the-counter medication (for example Mortin) for general pain, they often feel that they need a different pain medication for each different ailment. They are so convinced of this that they swear that one medication works much better than the other, even though both medications are exactly the same, just a different brand. But because they have a different name, they feel that they are different medications. So I am trying to learn what their preferences are for the different aches-and-pains. They also have some medications here that are not in use in the US.
The other problem with walk-in patients is they will often come for suturing. Any injured patient is usually brought to the clinic (not the doctor’s office). So the machete wounds, the farm accidents, all of them come to the clinic. I am comfortable with suturing a simple wound, but I know very little about more involved repairs of the tendons. Today a man was brought to the clinic as a walk-in for repair of a machete wound to his wrist. Dr. Maldonado wouldn’t even attempt to repair it because of the damage to the tendons.

An example of some of the Walk-in services provided today:
- 1 student to buy 50 cents worth of cough lozenges for a sore throat
- 1 man to buy 1 dose of pain medicine for tooth pain
- 1 man to buy 1 dose of cough syrup
- 1 young women for an injection of monthly birth control medication
- 1 older man for an injection of Vit B mixture (a very common injection, thought to calm "the nerves", also needed due to poor nutrition and/or alcoholism)
- 1 elderly man with a h/o BPH who was unable to void, with an attempt to place a urinary catheter which would not pass due to an enlarged prostate.
- 1 man with a wound to the wrist which severed the tendons. His co-workers said that he had bleed for about 45 minutes before they put a tourniquet on his arm in order to stop the bleeding. We called Dr Maldonado to repair the wound, but when he saw that he man could not move his fingers, he felt that the patient needed to have surgery at the hospital. So we wrapped the wound and sent him out.

Today was the day to get settled in. I spent part of the morning working on unpacking my suitcases, then went over to the clinic to see if there were any babies. There was one baby and mother, who were getting ready to go home. The baby boy pictured received a Baby Layette from Austin B. and Nell B. covered the expenses of his stay. I bathed and dressed him in order to get him ready to leave but wasn’t at the clinic when his father came to get them. Mirna (the receptionist) took the picture of the mother and family for me. Mirna practiced taking pictures of Larissa and me, so some of these pictures a a little fuzzy! I had lunch with Sarah & Zach and then helped out with Larissa in the early afternoon. Tiffany and Daniel were in San Pedro Sula until about 5:00 pm, so I wasn’t able to get started at the clinic. I did go over to the clinic during the evening shift for a little while and visited with Miriam, the head nurse. By this time there were no admitted patients and we had time to talk. I will probably be working mostly day shifts when the receptionist is there to help me with the billing, the language and the walk-in concerns (individuals wanting medicine or injections).
I will be covering shifts for Maribel so that she can have vacation. Miriam also may need to take some time off. Her mother-in-law is quite ill, and has been moved to Miriam’s house for care. Her daughter is here as well to be with her. Miriam needs to stay close to home in case her mother-in-law worsens. They do not think that she will live much longer. The picture I have of her and Miriam is from 2001. She didn’t want me to take her picture at all, but allowed me to take one with her & Miriam.
The Institute students had PE today and Zach was in charge. The girls played kickball while the boys played soccer. I took a few pictures of them as well as some of the flowering trees. The bougainvillea is in full-bloom and very beautiful. Orchids are actually parasitic plants. The one pictures here on this tree has a very small flower. I tried to get a good close-up but with the fading light, it wasn't in clear focus.
When the Meltons arrived, we had dinner together at the Robberts house. Afterwards I played some with boys before it was time for bed. Mornings come early here, and nights as well. The sun has been up for about an hour when my alarm goes off at 6:00 am. Also Honduras is 2 hours different than Indianapolis, so my sense of timing is still readjusting. I was very tired and had no trouble falling to sleep tonight!

Some surprises...

The first surprise of the day was that an embargo was in effect for travel to Honduras and I could not take an extra suitcase with me, nor could I pay to transport luggage heavier than 50#. I had a mad scramble in the airport, moving items from one suitcase to the other. Fortunately I had packed the “must-go” items in the bottom of the first 2 suitcases, and just had to figure out what to leave behind. I was glad that Cindy came with me inside the airport and could help take the extra suitcase home.
I arrived in Honduras about 10:30 local time. It took quite a while to get through Immigration, but Daniel met me in Customs and I didn’t even have to open a suitcase. This was an answer to prayer!
Both the Robberts (Sarah, Zach & Larissa) and the Meltons (Daniel, Tiffany, Kendrick & Kaleb) met me at the airport. It was good to see Sarah again, and nice to meet everyone else for the first time. We had lunch together, then ran a few errands before the Robberts and I headed back to San Luis (about a 2 hour drive over some very rough roads through the mountains). The Meltons had more work to do in San Pedro Sula and will come to San Luis tomorrow.
By the time we had the car unloaded, it was starting to get dark. We carried my bags to the small house where I will be staying. I unpacked a little, but left most of it for tomorrow. The second surprise of the day was the temperature. It is usually very warm and humid in San Pedro Sula (mostly 90s or more) and more like 70-80s in San Luis. Today it was cold enough in San Luis that I went to bed with 3 blankets on! I brought a sweater (which I didn’t think I would need) but I’ll probably wear it tomorrow.

I picked up the last of the Baby Layettes from school today and took pictures. Here are the latest additions:Kaylee with her layette.
Brooklyn with her layette.

Austin B. had help from the Phillips in preparing the layette that he gave.

Caleb wasn't there, but his brother is showing off his layette.

Almost all the Layettes are ready to go

I have 14 layettes so far, with a few more to come tomorrow. I'll need to finish packing tomorrow and then weigh the luggage to be sure that I am not over the 50# limit for each bag. Tara had a layette for a girl, with extra clothes and t-shirts.
Kaitlyn had her layette ready to go, for either a girl or boy.

Austin is hoping for a boy to get his layette. He worked extra around the house in order to earn money to buy the clothing.

Latina fell asleep before we could get her picture, but she had her layette packed. She also worked extra chores in order to earn the money for the baby items.

Linda with her layette.

I started laying out things to pack today and realized that I had enough for one full suitcase. I filled it up, with the gift packages on top. I will need to re-organize the items, since the gifts may attract unwanted attention when I go through customs. I have had problems in the past with Honduran customs officials wanting to "share" in the gifts that I bring. Pray with me that I will have an easy time through customs.

Through the generosity of several in the church (Aaron, Artie, Elaine & Harold, and Steve & Melissa), I will be taking an extra suitcase with me. So I will have 3 full (50#) suitcases, as well as a carry-on & a tote/purse. I usually take my laptop and my camera in the carry-on, as well as an "emergency pack" of toothpaste, toothbrush, deoderant, extra contacts & solution, etc. that I may need if I get held over an extra night. I will have quite a time getting everything up to the airline counter. It may look like I am moving there to stay!

Coming back, I will pack one of the smaller suitcases inside a larger one so that I only have 2 (much lighter!) suitcases to get through customs.

More Baby Layettes

Angel and Grace gave me their Layettes at church tonight. Beside theirs and the ones from the Frys, I also have two from the Bennett grandchildren, two from the Dudehoeffer grandchildren, and one from Becca.
Here is Grace with her Layette.



Angel is a "Pink Girl" so of course her layette was pink!

Cameron has a blue layette from him and his cousin Jesse.

Navae'h brought another pink layette.



Becca broke the mold of pink from the girls, choosing instead a bright blue blanket for her baby.

At the end of Prayer Meeting, the church had a special time of prayer for me. I felt a little bit like Paul and Barnabas when the church sent them forth on their first missionary journey (Acts 13:3). I appreciate the support that I have received from the church, both monetarily and in prayer.

St Patrick's Day at the Fry's

When Sarah heard about the trip, she wanted her girls to be involved as well. Kayla and Karissa used money from their chore jar to purchase the items for "their" babies. They were very proud to help out a Honduran baby and wanted to see them. I will be bringing back pictures of their babies for them to see.

I drove up to visit them and we had a good time. We made leprechaun traps (we didn't catch any, but they did leave us some candy) and had some play time at McDonald's PlacePlace. Latina came with me so that she could play with the girls. We all had a good time.


The girls wanted help with wrapping their layettes and tying them with a ribbon. They were very excited to share something with a baby in another country.

Just before bedtime, the girls put the finishing touches on their Layettes and wrote their cards. Latina also wrote out a card for her Layette.

Kayla wrote this card herself. As a kindergartner, she is learning to spell phonetically. Her card says, " Kayla. I love your baby soo mush. I with that I kcood see it. Kayla Fry. Love." She showed her love with lots of hearts. I am not sure what the red-faced person is--- maybe the sun? I hope it's not supposed to be the baby!