On Saturday my friend Dianne and I went to a Belizean wedding in San Ignacio (see photo, right). We were invited there by the groom’s brother. I continue to be amazed at the friendliness and open-heartedness of the Belizean people. Even though we didn’t know the bride nor the groom, the family welcomed us with open arms. As the first and last person on the dance-floor, I don’t remember the last time I had so much fun. There were also performances by belly dancers and a woman who danced with fire, twirling flaming torches around while she danced.

This week, I’m working with a team of obstetrics/gynecology specialists from Rochester, who are volunteering their services here for the week. A few poignant, astonishing details about giving birth in Belize: women must bring their own toilet paper to the hospital, to carry with them when they go to the bathroom. They also bring their own towels and give birth in the clothes in which they arrive (i.e. they are not provided hospital gowns). The sheets are not changed in between patients. Actually, there are no sheets, just a mattress. (If you’ve ever seen a childbirth, that detail is truly disturbing.) Today, for the patients who needed oxytocin (a powerful medication that increases the force and frequency of contractions), it was not measured, just eyeballed by the one and only gynecologist at the hospital, a Cuban doctor with questionable desire and/or ability to communicate with his patients or care about their well-being. There are many more such tidbits, some that are even more remarkable. The story about why Cuban doctors are here, I will save for another day.

It’s rainy season here. A couple of days ago, when we got a break in the rain I decided to ride my bike to a neighboring village to go to a yoga class there. The road there was partially flooded, and as I rode through the water, my shoes and feet got wet. I didn’t think anything of it, especially since I was preoccupied by having to put the chain back on my bike 5 or 6 times, as it kept slipping off! The next day, I was seeing patients in the clinic. One man had an ankle problem, and as we were examining his bare feet, I realized there was a stench in the air of dirty feet. But after the patient left, the stench remained. A little later, it dawned on me that it was MY feet that stank! I was horrified when I realized that I was wearing the same shoes that had been drenched in the bacteria-laden floodwater, and this must have been why Dr. Pott had kept glancing at my feet and scrunching up his nose. Not only was I humbled, I learned two valuable lessons: keep your shoes clean, and don’t assume it’s the patient who stinks!

I ate freshly-caught barracuda for dinner last night. My yoga teacher and good friend, Dorman, had been out fishing and gave me three different types of fish he had caught, and I fried one up last night. It was some of the most delicious fish I’ve ever tasted!

Today I was able to complete a telemedicine consultation between a patient in Placencia (southern part of Belize) and a neurosurgeon at Strong Hospital, Dr. Vates. The patient wanted the consultation because he had been told he needed surgery and wanted a second opinion. We were able to transport electronic files of the patient’s MRI to Dr. Vates, who kindly donated his time. It was a good thing, because not only did Dr. Vates recommend surgery, he concluded that the patient is at high risk for paralyzation or death with any minor trauma and thus the patient needs surgery ASAP. The patient is now scheduled for surgery on Monday.

Yesterday evening, I went swimming after a day at the hospital. I was enjoying the sunset, when, BAM! I felt the sting of a jellyfish on my hip. Ouch! As I swam back to shore, I considered the possibilities of how to relieve the sting. I’ve been told of 3: vinegar, windex, or urine. Unfortunately, I didn’t recall having any vinegar or windex... I know what you’re thinking, and believe me, I seriously considered it. Instead, I melted an ice cube on the burning area of my skin, and brainstormed other possible strong chemicals that might alleviate the burn. Marie Sharp's habanero sauce, perhaps? I started making dinner, and suddenly remembered, I did have some balsamic vinegar! I put some on the skin, and the burning and swelling disappeared. Now all that are left are some red lines on my leg that look like chicken scratches.

--Tina

Carnival was last weekend in Belize City! A friend and I hitchhiked and took the bus up to Belize City. Hitchhiking is very common here, and we figured since there were two of us, we'd try. There were many other people hitchhiking as well so we got to meet some interesting people, one of whom was a hitchhiker who said he had fathered many children with different women, and said his name was "Boom-Boom." My friend and I were able to hitch rides for parts of the trip in both directions, but in the end took the bus most of the way, especially since it started raining on us on the way back! The parade was fun -- great costumes and dancing. One of the floats in the parade was for "One Barrel," a popular brand of Belizean rum. In the parades I remember from my American childhood, candy was hrown out to the crowd, but in this one, cups of rum-and-coke were handed out to the crowd!

Yesterday, I was assisting in a hernia repair surgery, when the power went out. This happened twice while the patient was on the operating table. For some reason the backup generators were not working, so the OR was completely dark. For a second I almost panicked for the sake of the patient whose belly was wide open, but then a tiny light emerged from the head of the operating table. The anaesthesiologist was providing a makeshift flashlight using his intubation instrument, which has a light that shines down a patient’s throat when inserting a tube. Genious. But not enough light to finish the surgery. Luckily the lights came back on momentarily, and we completed the surgery. Dr. Pott, the general surgeon, wisely cancelled the next case, which was a cholecystectomy (gall bladder removal). However, the ObGyn doctor needed to do a c-section. As we were scrubbing in, the lights went out again. But this time, they didn’t come back on. Luckily, no incision had been made! Again the anaesthesiologist shed a tiny beam of light so we could at least see the door. I think they had to send the patient by ambulance to the hospital in Belmopan.

--Tina

Scenes from the street in Belize City: a fisherman in his boat at the fish market (left); a fruit stand (right).

Last week, I went with a group of women to Belize City, because one of the women needed a mammogram. For diagnostic tests more complex than an x-ray, such as MRIs, CT scans, or mammograms, patients have to go to a private hospital in Belize City and pay out-of-pocket.

While in Belize City, I went to the public hospital there to see an 18-year-old girl who had been in a motorcycle accident and needed a bone graft, who might benefit from a telemed consult. I was stunned to see that on the entire surgical ward, there was one single container of soap.

In Belize City, we took the opportunity to do

some shopping for things we don't have in the southern part of Belize. I bought luxuries such as chocolate and cheese. And, I bought a used car, for Intervol's use (and my use, while I'm here). Now I can drive to the hospital with AC, without showing up like a drowned rat (see previous post for details)!

Interestingly, there is a significant Mennonite community in Belize. In the photo at right, 2 Mennonite men hauling batteries, of all things.

--Tina