It’s orange season in Belize. Oranges are one of the major Belizean exports, along with bananas, shrimp, and sugarcane. The great majority of the oranges are not eaten, but are made into juice for exportation. One of my patients makes his living making fresh-squeezed orange juice with his 2 kids, and selling it to stores and to individual people. Yesterday, he brought Dr. Pott and me each a gallon jug of it. Delicious!

In addition to business as usual this week, I’ve been helping out with a large group of volunteer health care workers who are here from the U.S. Sixty-four doctors, nurses, and other health care workers are seeing patients, doing surgeries, etc. for the week. This gives me the opportunity to see other types of specialized surgeries that I would otherwise not see, e.g. urologic surgeries and ENT surgeries.

Photo: One of the many orange trucks filled with ripe oranges.

Like much of the rest of the world, Belize has been unusually cold (temps in the low 60s!) for the last several weeks. We did have 2 days of “normal” weather (sunny, 85 degrees) over the weekend, so on Saturday I took a boat out to a small island, Tobacco Caye, to enjoy the sunshine. In general, Belize is laid back, but Tobacco Caye is even more laid back. I snorkeled on the coral reef and hammocked, then returned at the end of the day.

Photos:

Top: Tobacco Caye, Belize

Middle: Pelican, resting

Bottom: View from my hammock

Yesterday Dr. Pott and I performed yet another leg amputation, along with a skin graft and 2 hernia repairs. I also paid a home visit to an elderly gentleman in Hopkins. In the past this man has complained to me about weakness on one side of his body that I think is due to vascular disease from his 60+ years of heavy smoking. Up until now, he’s refused to go to the hospital, but even if he had, there’s not much treatment we can offer an 83-year-old with this problem, other than quitting smoking (which he declined to do). On this visit, he showed me a mass on his breast, and he finally agreed to let me take him to the hospital next week to see Dr. Pott, so that we can remove it. I'm hoping it is not malignant.

The elderly woman that the man lives with saw me and exclaimed, “Oh, she’s gaining weight!” with a congratulatory tone. (Not exactly what I wanted to hear...) Here, larger women are considered more attractive.

Photo: While in Guatemala, I visited an ancient Mayan ritual site. Here, a shaman is making offerings (e.g. coca-cola) to the gods.

Photos: Carrying heavy loads, Guatemala.

Dr. Pott is back at work, which means I am back in clinic and the OR with him. My work with him doesn’t have anything to do with my telemed project, but I do it simply because I love surgery, and I learn a lot from Dr. Pott. Now that I understand some Spanish, I’m able to assist the Cuban surgeon, Dr. Cruz, as well. Yesterday I assisted Dr. Cruz in amputating a man’s leg.

If it weren’t for the Cuban doctors, our hospital would be extremely anemically staffed. The majority of the hospital doctors are Cuban, as are the operating room staff. The resulting language barrier can make working in the OR a little extra challenging and frustrating. For example, when Dr. Pott, who speaks English, asks the Spanish-speaking scrub nurse for an instrument, he often gets the wrong one, or sometimes just a blank stare. Luckily his Spanish is proficient so he can ask a second time in Spanish.

Speaking of Cuban doctors, Cuba provides doctors for many third-world countries who are short on doctors. As incentive for Cuban doctors to provide service in countries like Belize, the Cuban government offers $50/month to doctors who choose to do so. Although the term of service is 2 years, the $50/month payment is a pension they get for the rest of their lives, and is in addition to their base salary of $35/month. Yes, $35/month is the salary of a Cuban doctor. Belize gets many doctors from Cuba, not only because Belize doesn’t have many of its own doctors, but because from the point of view of the Belizean government, Cuban doctors are cheap labor. Belize provides the Cuban doctors with a stipend of $250 per month, while a Belizean doctor gets paid $3000 per month. Thus Belize saves a lot of money by hiring Cuban doctors. It pains me to imagine how the Cuban doctors must feel, getting paid 1/12 the salary of their Belizean colleagues.