Day 2: Independence High School

Julia Tao
This morning, everyone got on the truck to eat breakfast at the Shak, and everyone wore their green shirts and name tags today. After breakfast, everyone got on the bus and drove for an hour (while the doctors lectured the group) to Independence High School for clinic. We were a little late and there were a lot of people waiting already (nearly 100 people were standing in line), so we all set up very fast and started taking in patients. We later learned that many of these patients had started waiting hours before the clinic opened, and many of these patients were not seen until late afternoon. This first day we learned that the wait number cards (small laminated cards with the name of a doctor, their specialties, and a number 1 through 36) did not work very well due to the fact that many of them got lost after being given to patients. My team (Dean, Kenneth, Emmaly) was in Station 2 today, so followed I followed my grandfather, Dr. Chau-hui Liu. Kenneth and Emmaly worked in pharmacy, and Dean followed Ms. Huynh, the Occupational Therapist. There was a young mom who came in with a benign lipoma on her left buttock and wanted to get it removed because it hurt her when she rode her bike. We went into a private room to perform the surgery, and Dr. Chau-hui Liu and I put on sterile gloves. He started by sterilizing the lipoma with iodine wipes and then he wiped it all off with alcohol pads. Next, he injected lidocaine all around the abscess (it was a saltwater needle, but he sprayed out all of the saltwater and took lidocaine from a glass bottle instead). Then he starting cutting it out with scissors because he didn't have a knife, while I helped to staunch the bleeding with sterile alcohol pads. After that, he got out the suture kit and sutured it up -- I cut the strings for each stitch at 1 cm up. Finally, he wiped it all off, put 3 bandaids on, 1 gauze, and then 2 more bandaids. After the surgery, we ate lunch, which was rice with beans, chicken,  fried plantain slice, some spicy onions, and potato salad. There was a dog there that stole and ate a whole box of someone's food! After lunch, I kept helping Dr. Liu. I helped with some translations (There were some people who spoke only Spanish, so I had to try to translate Spanish to English in my head and then to Chinese--it was very hard!). There was also another small surgery of a man's finger to remove a woodchip--and he didn't want anesthesia! At around 3:30, we started packing up the place -- pharmacy was really backed up, so everyone helped them after we finished packing the other areas. When it was all done, we went onto the bus and I talked to nurses about the wait number conflict to try and fix it and decided that intake should have 1 paper with tick marks to track number of patients each doctor has gotten. Then we would write the doctor name and the patient's number onto the patient form. After clinic, we took the bus back to Placencia and ate dinner at Wendy's. The Duong family arrived today, so I added Jacqueline Duong to my team and Alex Duong to Team Nate Cheng. After dinner, we went to the pier again to watch/do fishing. Kenneth and Dean decided to go back because Kenneth had lost his reel in the water. So we went back and got supplies from their room, and when we went back out, a dog named Star followed us all the way back to the pier! (We didn't find the wallet unfortunately). There were two large tarpons in the water but no one caught any. At the pier, I ran into Kerwin and another person who came with him who said that he was also running a medical mission from Mexico, and wanted to know how we were doing. Cas and I talked to him and gave him the ABC facebook site. Afterwards, we walked back to our rooms and went to bed.

Matt Cheng
On the first day of clinic in Independence, about 100 people had already been waiting in line at Independence High School. I had been helping with the intake station in an open-aired gym with no AC. I helped to fill out forms and take vitals on our patients. Some information that I took includes their blood pressure, their temperature and their weight. In all, there were probably 300 people that went through our “hospital”. This was the first time I have worked hard for 7 hours straight with a 10 minute lunch break. In addition to most English speaking Belizean patients, there were some Spanish speaking patients from Guatemala and Honduras. 

Emmaly Nguyen
Wake up. Go to Grandma’s house. Do some math or SAT practice. Eat. Go to sleep. Repeat. This is what I thought my summer was going to be, same as every other. A few months before school ended, my mom came to me and asked if I were interested in a medical mission in Belize, and I agreed.
Time flew by, and before I knew it, I had arrived in Belize. I stepped off our bus, and in front of me stood a ginormous, open gym. Our first clinic was at Independence High School, and there was already a line of people waiting to see the doctor. The doctors had their own mini offices, the students had their stations (we rotated stations every day), and the smaller kids were in charge of the gift station. I was in a group with Julia Tao, Kenneth Yang, and Dean Alamy (we had another group member, but she was coming a day later). Our station for the first day was Pharmacy, with Mrs. Nguyen (my mom). It was a little hectic setting up, so Julia and Dean shadowed doctors, while Kenneth and I did Pharmacy. The job was to give the patient the needed amount of medication, and to write down instructions on how to take the medication on a notecard. I’ll be honest, I had no idea what to do. I looked at what the doctor had prescribed to the patient, and my mind went blank. I had looked at the shorthand doctors used, but I was so lost. Kenneth and I were confused, but luckily my mom was there to help. Some problems that we encountered during that clinic: 
     □  Doctor shorthand takes some time to understand. It’s not that it’s difficult to understand, you just need to do it multiple times before you really get it.
We had no idea where the drugs were. The drugs were lined up behind us, but we didn’t know which drug was where. The student to adult ratio was 2:1, so it was difficult for my mom to help both Kenneth and I at the same time.
    □  We had no idea how many drugs to give if the doctor didn’t say so specifically. For some drugs like ibuprofen, amoxicillin, you usually give 30 tablets/capsules, but unfortunately Kenneth and I didn’t know that so we were just very confused.
     □  My mom was the only pharmacist and was swarmed with tasks. Like I said before, the student to adult ratio is 2:1. Not only did she have to help us decipher the doctor’s prescription (and sometimes handwriting), she had to check to make sure that we wrote down the right instructions. She was so busy, she didn’t even get to eat lunch.
     □  Our waiting system did not work. The first day, we saw about 200 patients, and our pharmacy was slow, having only one person who actually knew what she was doing. We tried giving out numbers, but we only had numbers #1-30. Our plan was to reuse the numbers, but it just created a mess. People were complaining (and I don’t blame them) about how they waited for a long time, and when we tried to explain our system, some argued back, so my dad had to keep an eye on who was coming up to receive their medicine. Even when we were closing up the clinic, we still had about 20 people waiting because of the number problem.
     □  Doctors didn’t know what medicine the pharmacy carried. This issue didn’t occur too often, but it was a  hassle to go back to the doctor and ask them to prescribe something else. 
     □  The Pharmacy station couldn’t receive any help from others. To really help our station, we would need people who knew what they were doing. Kenneth and I were getting better at pharmacy, but knowing how long it took us to finally get it, it wouldn’t help if people came and tried to help. Also, my mom can only handle 2 kids, so it would just be more of a burden on her.
This day was probably the most impactful on me, because I honestly learned the most from this day. I learned that my mom’s job being a pharmacist isn’t easy, especially if people aren’t willing to be patient. I learned how to transcribe doctor shorthand (it’s much easier now), and the basics of pharmaceuticals. I also learned that the medicine I am giving out can change people’s lives. Honestly, this day made me feel like I was actually making a difference. It gives me a good feeling, knowing that I can use my position in the world to help those who need it.

​Ethan Nguyen
The first day was personally my favorite day by far. I got to learn many things I wouldn’t have ever known. This trip had taught me how to take the following vitals needed: weight, height, temperature, blood pressure, heart rate, blood oxygen, and respiratory rate. I also learned that any of the people that came were in need of a dentist and most have never seen a doctor. The dentist wasn’t going to show up until the very next day. This affected me because I wanted to help these people who needed medical assistance but we were not allowed to give more than a thirty day supply of medicine. Through the rest of this trip it tempts me even more each day to become a dentist so that I can help more third world countries.

Dr. Tao
     Our first day of clinic.
     After endless number of patients, around 12:30pm, I apologized to the patient’s mother in front of me for making them wait.  “It’s ok,” she said.  Out of curiosity, I asked how long they’ve waited.  “Since 6 O’clock this morning.”  “I am so terribly sorry!”  “It’s ok.  Thank you for coming to our town to help us.”
     Xitlali was my student shadow for the day.  Turns out this town have many immigrants from other parts of Central and South America.  Xitlali spoke fluent Spanish and helped translated for me.  After a full day of seeing countless number of patients in the humid heat, this girl is still enthusiastic to learn and still smiling.  So proud of her!
     Just to get an idea of the level of health awareness in town and to show the students the importance of patient education, I asked every single kid what vegetables they eat. “Onions and carrots.” Some said. “No vegetables, only rice & beans.”  Others said. One mother told me that they can’t afford to eat vegetables.  Yet, when asked what they like to drink, many of them said sodas.  Interesting.  Later I learned from another local, when I treated him to a dinner where I had requested the chef to make sautéed spinach for us, that spinach actually grows like weeds there.  But since parents don’t feed their children spinach, not many people know it’s good to eat spinach.  Hmmm, we’re definitely going to expand our resources on patient education in the future.

Kenneth Yang
It was our second day at Belize and our first clinic location. Our first location was at a high school gym that took hours for us to get to. As soon as we arrived, many Belizean patients were waiting for us to setup and help them out. We had four different stations, but that day, Emmaly, my friend, and I were at the second station, pharmacy. It was a tough job at first, looking for all the medicines, translate the doctor’s shorthand, and checking up with our one pharmacist to see if we got the prescriptions right, but as time went on, I got used to it and partially knew my way around the place. To be honest, having two people doing pharmacy with 50 people in line really does not get the job done efficiently. Towards the end the line was a mess and people started arguing about who’s here to get their medications first. Julia came over and asked if there was a better strategy and we thought of making cards that are numbered 1-100 and give them to education. Once education finished teaching the Belizeans how to improve their health, they would give the patient a number and come to pharmacy. Eventually we had to make cards all the way to 200! The fact that everyone was working hard and concentrating on giving the patients the best diagnosis and prescription we could give as a clinic was incredible. When we got back, my friends Adam, Dean, Gabriela, Michael Lee, Michael Wong, Ryan Tao, and many other people started fishing with us. Most of us, especially ryan, caught a lot of fish and we decided to keep some.