We left Missoula, Montana on February 8 of this year and flew to Seattle where we boarded a very full plane to fly all night to Miami. We arrived, exhausted, in Miami and waited to catch our flight to Tegucigalpa, the capital of Honduras. As we approached land I looked out the window of the plane to see what appeared to be the shortest runway I’ve ever seen! This airport is located right in the middle of the city, with businesses not far from the end of the runway. I later learned that the landing strip in Tegucigalpa is one of the most difficult approaches in the world!

My first trip through customs was without incident and we were met by several men to help us move the 22 crates we brought with us. These crates contained all the supplies we would use over the next two weeks. Soon the Save the Children trucks arrived and we loaded ourselves and our gear into three Nissan crew cab trucks for the four-hour drive to La Esperanza.

The city of Tegucigalpa sits in a large valley, similar to where I live in Missoula Montana. The big difference is how far we had to travel uphill to get out of this valley. During the trip to La Esperanza we travelled in and out of, or down into and up out of, three large valleys; making most of our trip a true “uphill battle”. When I wasn’t closing my eyes in fear I was completely mesmerized by the scenery around me. There were mountains and trees in every direction. The colors seemed so different than at home. The greens were greener, the blue of the sky bluer, the yellows, oranges, pinks and purples of the flowers and plants more brilliant. But as you looked down at the roadside trash was everywhere! There are no landfills in Honduras, just streams, ditches and roadsides where people dump their trash. One of my team members who had been there three years previously told me this was an “improvement.”
We finally arrived at the Save the Children Compound in La Esperanza, tired but thankful. The literature I received from MMA prior to making the trip said; “In La Esperanza, we sleep in an office building on cots” so I expected a building with more than one floor and an office set up. What I got was a single story L-shaped building with a basketball court at one end of the yard, storage area behind the building and a fence enclosing it all. We unloaded the trucks and began our set up. Within about two hours of our arrival we had all chosen our space in the conference room area, set up our cots and arranged the small school desks we would use as furniture, and settled in. The first sound I remember hearing was the rooster crowing outside the window of where we would sleep, it was 4 in the afternoon! What was up with that rooster? Soon the dogs started, and thus was the chorus we would hear throughout our stay in Honduras.

After a walk to downtown for dinner, the sleep I had craved for the past 36 hours finally came. The morning arrived quickly and we were all up and packing supplies for our first day of clinic. We were transported once again in the Save the Children trucks to a school in a small village about a 30-minute drive away. There are no paved roads here, just dirt roads with ruts in them so deep that it requires 4-wheel drive to make the trip. When we arrived, a flurry of children, with waving hands and smiles greeted us and at that moment I knew in my heart and soul that this was going to be one of the most rewarding experiences of my life, well worth the eight-year wait I had to get here.

We unpacked the crates and began to set-up the “clinic”. We had child sized tables and chairs to set up in four stations in one room. Another room served as our “pharmacy”. Meanwhile, Emilia, the Save the Children nurse, was busy registering the families who had arrived. Our patients ranged from newborn to 90 years old and each of them was as thankful as the first to be seen. We were a team of two doctors and two physician assistants and with the help of our translators we saw 153 patients that first day of clinic. Every family received vitamins and either ibuprofen or acetaminophen. We treated almost all the patients we saw for parasites. Most patients complained of “tos ferina” or cough, “gripe” which is cold symptoms and “dolor de cabeza” or headache, which was consistent throughout the next 9 days of clinic. This is the only healthcare some of these people have ever or will ever see so we did our best to provide for their current complaints and help to manage later complaints. When we were done we packed up what we had left into our crates, put them back in the trucks and headed back to La Esperanza.

The next 9 days all evolved pretty much the same as the first. We arrived at each village, set up in the school and saw on average 175 people per day. At the end of it all I couldn’t tell you where I had been on which days even though I still have a copy of our schedule. I can’t remember which community was in which direction.  What I can remember is that each day I was glad I was there making a difference. Most days we saw simple things, an otitis media, or perhaps bronchitis. A few women presented with stasis ulcers to the lower legs, and I diagnosed several people with hypertension. The question in all of this is will these patients have any follow-up? The way the system is supposed to work is when a patient needs follow-up the Save the Children nurse helps to write a referral and explains to the patient where and when to go for follow-up care, then MMA leaves money to pay for these visits. There just seems to be no good system of documenting who really follows up.

There are several patients who will forever be etched in my memory for a variety of reasons. Those I’ll remember for their smiles, the kindergarten class who sang to us, the strength I saw in the face of the 80-year-old grandmother who is raising her 4-year-old granddaughter because the mother died in childbirth, the mother of 9 children, the two sets of twins. And then there are those who I will worry about when I remember them. The 18 month old little girl who’s pregnant 20 year old mother didn’t realize anything was wrong, she just knew this was her daughter and she loved her. The child was deaf, did not speak at all, did not appear to track visually, and could not sit or stand. The only history her mother could offer was that she had a seizure at 2 or 3 days of age. I wonder if the baby her mother now carries will be dealt the same fate as this little girl or will the brief time I spent with the mother help her understand that if this happens again she needs to seek medical attention. I am comforted by the memory of the love I saw in the eyes of this young mother, but torn by the knowledge of the types of services this child could have access to in America or elsewhere in our world. This is the lesson I struggle to learn, as do many others who are health care providers. We cannot and will not cure all those we see but rather we will do our best to provide, educate and enhance the lives of those we touch. This fall my husband and I plan to enroll in Spanish classes in preparation for my return trip to Honduras with MMA in 2010. I can’t wait.