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We here at Paramedics For Children had the pleasure of having Doc Matt come down and visit with us here in Copan Ruinas Honduras. Dr. Matt quickly became the favorite of all the locals who found him to be not only a great physician but an instant friend of everybody that had the pleasure of meeting him. Although his term of service is over with us, I am sure that we will be seeing the "good Doctor" return in the near future. |
My Copan Ruinas Experience
by Dr. Matthew Agresta
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Whithout question, my month-long experience in Honduras greatly exceeded my expectations. As a 3rd year Family
Medicine resident I embarked on a trip to Copan Ruinas in April month to study spanish and volunteer in the Paramedics
For Children clinic. Located in the far north-western corner of this mountainous Central American country, Copan
is an historic cobblestoned city which has much to offer the budding international health enthusiast. There, I
discovered a gem of a clinic experience that I won't soon forget. As I have proceeded through my medical training, I have gone down the usual path; from classroom learning to hospital-based rotations. Yet, as I looked towards the end of my residency in Salt Lake City, I knew something was lacking; an international medicine experience. With that in mind I began researching Central American countries with the goals of both learning spanish and volunteering in a clinic. Through a friend I learned about Project Honduras (www.projecthonduras.org) which is dedicated to sustainable aid and development in Honduras. There, on a list-serv, I found my answer. In January 2006, Roger Harrison, President of Paramedics For Children (PFC) had posted a "Want Ad" which fit my goals perfectly. After a simple e-mail, I was signed up as the first "Volunteer Doc" in the PFC clinic Three months later I arrived in Copan ready to throw my skills in the mix and volunteer at the newly established clinic. With more than a little apprehension (and minimal spanish language skills!!) I arrived at the clinic on my second day in town. My concerns quickly floated away as I was greeted by Dr. Javier Largos, a pleasant, well-dressed young physician who staffs the clinic. With the help of my hired translator, Oscar Zuniga (oscarleonel10@yahoo.com), |
| I set right to work. Much like my Family Medicine clinic at home, the patients were varied and interesting. At
a comfortable pace I had the privilege and pleasure of treating everything from asthma exacerbations to UTI's and
muscular strains. There however is where the similarities ended. Unlike in the US, practicing medicine in Honduras requires a keen sense of the economic realities of the patients. In a country where the average daily wage is just over US $3 the provision of affordable, quality healthcare is a whole new challenge. Paramedics For Children has, I think, found a unique model which works for the people of Copan. As described elsewhere, the clinic is funded in a large part by donations which covers the overhead of the clinic, allowing the physicians to keep expenses low. In turn, the physicians charge only 50 Lempiras (˜US$2.50) for a consultation. In a town where the average physician fee is 200 Lempiras, this model makes quality medical care available to all. As I look back on my month in Copan Ruinas I am struck by how much I enjoyed my experience, and how I long to return in the future. The true pleasure lay in the experiences of the patients, each unique and individual. Many of my patients had walked upwards of 3 hours from the remote aldeas ("villages") surrounding Copan, arriving as early as 8 am. These campasinos brought their children, their parents and grandparents for basic and advanced medical conditions, in the hopes of obtaining relief from their illnesses. |
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Among the common illnesses (asthma, GERD, fungal rashes, eczema, UTI, back pain..etc) were the uncommon. One concerned
mother brought her son in because he child had become sleepy and uncoordinated. Our history revealed the patient
had previously been treated for hydrocephalus with the VP shunt. On exam the child had an enlarging and mishapen
head and was suffering from a shunt malfuntion. With the help of Dr. Largos we were able to refer this patient
to the definitive surgical treatment that his life depended on. Another child had lost the ability to walk after
developing a severe case of juvenile arthritis. Many children came in suffering from diarrhea and various stages of dehydration. In this third-world setting, the causes of diarrhea are varied, from viral and bacterial to parastitic. With each, we focused our efforts on first correcting the dehydration, and secondandly identifying and treating the causal agent. Finally, and most importantly, we aimed to educate patients on the prevention of diarrhea, namely, having children wear shoes to prevent intestinal parasites and drinking purified water or boiling water prior to consumption. In the end, the larger picture is a public health opportunity waiting to be had. Most of all, I enjoyed the entire experience of Copan. As a student at a local Spanish school (www.ixbalanque.com) I stayed with a local family. With them I developed and refined my spanish skills, and enjoyed the typical Honduran fare (lots of eggs, beans and tortillas!!). Around town I consistently ran into people I had met through the clinic and felt accepted into the life of Copan in a way that the typical tourist would not. From the doctors in the clinic, to my patients to the people of Copan Ruinas, I learned more about myself and Honduras than I ever would have thought possible in one short month. I surely will return. Thus, I would recommend this experience to any physician or health professional with the following advice: |
| 1. Come with an open mind and willingness to learn from the patients 2. Be prepared to be affected by the stories of life offered by the patients 3. Set aside political and religious ideas and use your medical knowledge and skill to the best of your ability 4. Be prepared to have a good time and enjoy the scenery, the food and the people 5. Take a ride into town with Rodger and Spike in the Kawasaki Mule 6. Ask Rodger for a horseback ride to visit the remote aldeas 7. Eat a meal at the Via Via or Tunkull restuarants for an interesting mix of international travelers/residents 8. Take a day to visit Agua Caliente (Hot Springs) 9. Brush up on your dermatology and gastroenterology skills 10. Bring along some Cipro….just in case!!! Anyone wishing to contact me further regarding my experiences in Honduras with Paramedics For Children, please do not hesitate to e-mail me (matthew.agresta@hsc.utah.edu) or talk with Rodger Harrison. Matthew Agresta MD |
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