A fluoride clinic was held at IHNFA Child Care Center. Fluoride treatments, toothbrushes and toothpaste were provided to all of the children (age one year to 12 years) attending the morning program –approximately 35 children. The director of IHNFA was taught how to apply fluoride varnish and she applied the treatment to a number of children under our supervision. She was trained to do this so that she could provide fluoride treatment to children in the afternoon program and children in the day program who were not present. Fluoride varnish, sterile gauze, gloves were provided to treat all additional children along with a large supply of toothbrushes and toothpaste. The H2H-T physician provided a medical consultation for a woman with chronic sinusitis who works at IHNFA. Medications were obtained and purchased and treatment recommendations were provided for her in order to assist in decreasing her symptoms. One of the children at IHNFA was noted to have impetigo during the clinic, and an antibiotic ointment and instructions on how to apply it was provided to IHNFA staff in order to treat this child’s infection.
A second fluoride clinic was held at the school at Lancetilla. 50 toothbrushes and toothpaste were distributed to all of the students, and fluoride varnish was applied to all the students at the school that day – approximately 20 students between the ages of 5 – 14 years old. Due to the luxury of having a Spanish interpreter, a significant amount of time was spent with the teacher and the students talking about dental care, tooth brushing, and the importance of not drinking soda or other sugary drinks. Materials were left with the teacher so that she could apply the varnish to the approximately 15 students that were not at school that day.
The Pediatric Clinic was held at the Puerto Arturo Health Center on 2/19/10. Forty-two patients, mostly pediatric patients, were seen by volunteer Dr. S with Honduran nurse Elba. Dr. S. saw a garden variety of problems including impetigo, nail fungal infections, colds, asthma, eczema, vitiligo, and parasite infections. Each time Dr. S. saw a patient he tried to ascertain what Elba would do for the problems before offering an opinion. This seemed to be a good way to get started on a long-term relationship.
Elba was asked what would help her at the clinic and the following items were requested: a baby scale, an adult scale, a cabinet for medicines, a gooseneck lamp, sheets to cover the exam tables, and a nebulizer. All were purchased and given by H2H-T….except the sheets. These are still on the list.
Women’s Health Clinic
The Women’s Health team (three nurse practitioners, one nurse, Dr. Alvarenga and his two assistants) provided five consecutive days of clinics to test for cervical cancer (and necessary follow up) and conduct breast exams. This is the fourth year that H2H-T has been conducting these clinics. They worked where the need was the greatest and poverty was at its highest – in very crowded, hot and non-ventilated rooms in the following health centers: Clinica de las Mujeres, Quatro de Enero, Puerto Arturo, Buenos Aires. The most unique experience for the team was to travel via boat for over an hour to the health center at Rio Tinto island. Over 169 women were seen and treated; and without these clinics, many cancers would not have been detected. Especially gratifying was the return to our clinics of two women who had been diagnosed by H2H-T in ’09 with cervical cancer and pre-cancer. They both sought treatment in San Pedro Sula soon after their diagnosis and are now disease free.
A generous anonymous donation of $1000 was given for the purchase of cryotherapy equipment. This is equipment which enables women with pre-cancer to be treated right at the time of service. The equipment was purchased and brought to Honduras. Unforeseen was the difficulty in acquiring the nitrous oxide tanks necessary for providing this “freezing” technique, as well as a confusing bureaucratic detail which does not allow doctors to offer this service without additional licensing. This equipment was not left in Honduras but Dr. A. has the desire to pursue this avenue further and hopes to make it possible in 2011. Offering this service in Tela would be a breakthrough in treatment options for women, as they now have to travel over an hour by bus to obtain this very simple service.
Rehab Therapies Center
As the Center has matured over the years, the H2H-T Rehab team took the opportunity to re-evaluate the role they would play in continuing to support the Center. It was agreed to strengthen the role as consultants regarding the care of the children and adults. The focus would be on problem solving with the staff, with an emphasis on self care, issues regarding feeding and nutrition, dressing and hygiene, and enhancing communications.
The patient focus also is on movement activities such as walking, the use of ambulatory aids and wheelchair management to foster the concept that independence is achieved through the use of many devices and not only when one walks on their own two feet.
The week’s activities included:
Children pre-identified by the staff were seen with their caregivers by the H2H-T team, including two children who were selected to participate in a conference arranged with the Vermont Interdisciplinary Leadership Education for Health Professionals (ILEHP) group at UVM using SKYPE on Thursday morning.
The team and staff made home visits and in the afternoon visited CURE International in San Pedro Sula to discuss children referred for surgical interventions.
Saw children and adults and advised on their programs, presented a staff in-service session on feeding/nutrition, dressing and seating arrangements for children with disabilities, and held a Parents meeting covering the same in-service material.
In addition to the morning ILEHP presentation, the team met with individual patient groups, that meet regularly, to discuss their disabilities and their special needs.
The team drove to La Ceiba to visit the “Crila” facility that is similar to the Center.
H2H-T 2010 project: a local carpenter is building a playground at the Center for the children with a system of climbing and sliding activities, a seesaw and a swing system to enhance therapy through recreation
The H2H-T Rehab team felt this trip was the most successful. Communications were open and candid. The staff has matured and has gained confidence in their treatment and outcomes. The Center currently serves 60 children and 40 adults and provides services five and a half days per week.