I want to share a story from today. There once was a patient that I will refer to as “D.” D has schizophrenia that is poorly managed. In the past, he has wandered off by himself, and either has been violent with others, or others have been violent to him. His mother had tried other medications, but he wouldn’t take his medicines. His mother, out of desperation for his safety, chained him to their house. He is known to the clinic, and the psychiatrist (who comes once every 3 months), had prescribed him an IM 30 day anti-psychotic (I forgot the name of it), however it never actually got to him. The patient’s mother asked Ms. Peggy for help to get him to the mainland to see a psychiatrist there. Ms. Peggy found out that he never got his medicine, and decided to see D herself, and give him the medicine. So Ms. Peggy, one of the nurses, the patient’s mom, and myself drove to the house.
D was having a good day, and was very cooperative, and allowed Ms. Peggy to administer the shot. Ms. Peggy spent a lot of time talking to the D’s mother and brother about schizophrenia. Ms. Peggy told me that psychiatric disease is heavily stigmatized in Honduras, and it is very difficult to get help. What makes it even more difficult is that there are no psychiatrists on the island. The one that comes every 3 months comes from the main land. There is very little understanding and social support about psychiatric disease. There are a few things about this incident that had a large impact on me. The first was how bad things must have been for the mom to resort to chaining him to the house. He has his own little room, but still. I could not imagine how emotionally difficult it was to do that.
The other was Ms. Peggy’s response. She saw a problem, saw a cost efficient solution, and went out and did it herself. She actually gave the shot herself, and spent a lot of time educating the family. It was incredible to see how much she takes control of a situation and makes things happen. Ms. Peggy has had success with her schizophrenic patients using this medicine. Hopefully it works, and D can come to the clinic himself to get follow up.