June 16th, 2017 by Sean Mark
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Yesterday I had my last day working at Clinica Esperanza. However, I didn’t let that stop me from having new and inspiring experiences. I had the opportunity to venture out into the community with Dr. Stacy who is the leader of community outreach for Clinica Esperanza. She runs a program that works with local community health workers who live in various poor rural communities throughout the island that have poor access to medical care. Dr. Stacy is originally from Roatan but she studied medicine at a medical school in Cuba where there is an emphasis on health promotion and prevention of disease. After her schooling, she had to fulfill two years of service in Honduras to obtain her license to practice. She spent one year in rural communities and one year in the hospital to see which one she liked more. After these two years, she decided that preventative medicine was her passion so she joined the staff at Clinica Esperanza to pursue this passion.

As we were driving to the community for the day (called Mud Hole) I noticed that the road turned from a paved road into a dirt road with many rocks and potholes (ironic I know). We pulled up to a small convenience store where we were dropped off by our driver from the clinic. Dr. Stacy and I grabbed our two backpacks that had a few medical tools and a few medications including vitamins and albendazole which treats parasites. We found our local health promoter (called a “promotora” in Spanish) who actually owns the local convenience store. She had a folder with her that had all of the homes of her community mapped out and it also contained forms with health information about the children who lived in the neighborhood.

Here is Dr. Stacy and the local Promotora walking through the community from house to house. Dr. Stacy is on the left and the promotora is on the right. You can see the folder with the promotora, the scale in the tan bag, and our medical equipment in the backpack.

Here is the dirt road to the town of mud hole.

We started walking through the community going from house to house talking with the people. Our main goal for the day was to weigh all of the children in the community 5 years and younger with a portable digital scale to make sure that the kids were growing appropriately and getting the nutrients they needed. If we encountered a child or an adult who was sick, Dr. Stacy would have me perform a brief medical evaluation and then we would counsel the family about what they needed to do to care for their sick family member. We passed out children’s vitamins to several families and we gave deworming medication (albendazole) to others. We kept a record of all the things we did so the community health worker could keep track of the health of the individuals in her community. Dr. Stacy was also familiar with the people of the community and she would check up on the adults whom she knew had health problems such as diabetes or high blood pressure.

Here is one of the houses we visited with a rooster and chickens in the yard.

Here is one of the kids about to get on the scale to check his weight

After getting the child’s weight on this digital scale, we would calculate what his or her expected weight was and then compare the two numbers to see how the child was growing.

Here is Dr. Stacy making a balloon for one of the children who was too scared to step onto the scale. With some of the children we encountered a lot of doctor anxiety and they didn’t want to come near us. After she inflated this balloon, I made it into a dog shape and we were successful in motivating the child to get on the scale.

It was neat to see how the program worked to care for the needs of the community. I really believe we need to have more of this type of work in the United States where we actually visit people’s homes to better address all of their needs instead of what we see on the surface when they come into a hospital or clinic. Just like when I visited the poor village with Pastor David, I saw that any good community development movement requires people on the ground that live in the community and are invested in its improvement.

After walking around the community for several hours, we called for our driver to come pick us up and headed back to the convenience store. Dr. Stacy discussed the things we had done with the local community health worker and told her the things that still needed to be done after we left. After we got into the car to drive away, I talked to Dr. Stacy more about her community health projects. I learned she coordinated public health efforts for 10 communities like the one we went to and she is hoping to adopt several more in the near future. I was inspired by this comprehensive approach that the staff at Clinica Esperanza had for caring for their patients and the communities in which their patients were living. They were able to mobilize local health care workers in each community that could keep a close watch on the health of the communities and recognize any problems early so they could be addressed right away to prevent escalation. I hope to use this same approach in my future career in medical service and community development.

Here is a picture with Dr. Stacy, the local promotora and I after walking around the community. The door to the right is the convenience shop the promotora owned. The clinic gives food supplies to the promotora to sell in her store as a reward for doing the community health work.

After we got back from our trip to the community, I walked around the clinic to take final pictures and help out where I could. I also wanted to wait for the founder of the clinic, Ms. Peggy, who was flying in that afternoon from a short trip to visit family in the United States. Thankfully, Ms. Peggy decided to stop by the clinic before heading home and I had the chance to meet her. She had brought two suitcases full of supplies from the US for the clinic so I helped her unload the supplies and put them where they needed to go. Ms. Peggy was greeted lovingly by all of the clinic staff who had obviously missed her during her absence. She really serves as a leader and mother for the staff of the clinic. When she found out I was leaving the next morning to return home, she invited all of the volunteers to go out to dinner that night at local restaurant to thank me for my service and have more time to visit.

Here are some of my last pictures of the clinic and the staff. Here is Javier one of the Honduran general physicians that worked at the clinic. He just recently graduated from medical school in Tegucigalpa.

Here is Melvin the security guard at the clinic who also helped out with general maintenance. We had good talks over lunch in Spanish and English because he is trying to learn English.

Here is Kandi the head nurse of the clinic

Here is Dr. Rocky, one of the general Honduran doctors I worked with at the clinic.

Here is a picture of some of the staff at the clinic. On the left is Kandi followed by Dr. Ashley who is another doctor I worked with. The one in the middle is Ginelle an attorney in Honduras studying non-profit law. The two on the right were part of the nursing staff who helped with point of care testing and treatments.

That night at the restaurant I got to hear a little more from Ms. Peggy about the vision for the clinic and the exciting things God had been doing. She really made it clear that it was a work of the Lord that provided the means to make the clinic a reality. She is an older woman and pointed out that there is no way “an old lady like me” could have done this without Jesus. It was encouraging to hear and see all that the Lord had done in her life as she yielded to his leadership. After telling her how my wife Kirsten and I have a passion to do missions together using medicine and education, she even gave me suggestions about next steps with people she knows in Honduras and other places. It was a blessing to talk with her and brainstorm about what the Lord is calling me to next. I pray I will grow up to be like Peggy and not let my age or any other excuses prevent me from serving the forgotten people of the world. We only have a short time on this earth to live for the glory of God and we have to make every year count. I pray that Jesus will give me strength to love him and serve him until my last breath.

Here is picture of my final dinner in Roatan. I even got all the volunteers and Ms. Peggy to do the “Sean Mark” pose with two thumbs up. Mr. Dee is on the end being the rebel ha ha.

June 16th, 2017 by Sean Mark
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Hello again everyone! Thank you so much for following my story and partnering with me in this missions trip. I am currently in route from Honduras to the United States but I wanted to share a few more of my experiences before I write my farewell post. Last week I had the opportunity to go with a church group to minister in a very poor community in a rural part of Roatan. I was very excited about this experience because although I have had opportunities to minister to the healthcare needs of the people of Roatan, I hadn’t had the opportunity to focus completely on the spiritual needs of the people and minister with a church group.

Here is a picture of one of the main roads through the village

The community we drove to lives down in a valley close to the ocean on a small area of land. Water flows from the ocean into the middle of community and can frequently lead to flooding when the tide is high. There are no bathrooms in this community so human waste gets into the water and then flows into the houses occasionally with the tide. To try to compensate for the height of the land, the people dump their trash everywhere and then put dirt on top of the trash to lay the foundations for their houses. The stench from the village is terrible due to the abundance of human waste present and one of my fellow volunteers even vomited the first time he smelled it. As I walked through the village it seemed like the houses were literally built on top of a sewer. You can imagine how poor the quality of life and health is for the people living in this community.

Here is a picture of the abundant trash and sewage water in the community

Here is a picture showing the bridges we had to walk on to go in between the houses and walk through the neighborhood. These bridges can become submersed when the tide is high.

This picture is a little blurry but it demonstrates the poor quality of some of the houses in the community.

David Granada and his wife Heather are full-time missionaries and church planters who live in Roatan. They have adopted this poor community and David serves as the pastor of the church he planted there. He was our guide and leader as we ministered. David has served in missions all over the world including Asia, Africa, Central America, and the United States. He and his wife are originally from Santa Monica, California but they have now moved with two of their four children to Roatan. It was great to talk to David and hear about how the Lord had been working through him in this community. When he first visited the village, other missionaries told him that he would not want to minister there because there were many people that were caught up in drugs, alcohol, and other sinful habits. David saw the community with different eyes and heeded the call of Jesus to minister to the people.

Here is Pastor David and me at church where we first met.

As we walked through the main village road, all of the people we saw greeted David with smiles. He knew all of them by name and you could tell that he had invested in their lives. We stopped by a woman’s house who had recently been hospitalized after surgery for a stomach tumor which had burst in her belly. She was having a hard time sitting around her house recovering because she is normally someone who serves the whole community with meals, chores, and other favors. David and I spoke with her about her troubles and then we were able to pray for her for rapid healing and strength through this hard time.

Here Pastor David with the woman that had recently been hospitalized who we prayed for and ministered to. She started weeping after we prayed for her because we was so thankful and has been going through a lot lately.

We walked back to the church building as many people from the village were beginning to gather outside. The children of the community happened to be out of school that day so the church was surrounded by many youth and their parents. The day started off with a worship service in the upstairs part of the two floor church building. While the people began to worship the Lord, the volunteers in the bottom floor of the church began to busily make sandwiches to feed lunch to the 200+ people who had gathered. I was invited by Pastor David to come upstairs and witness the worship of the people. I was so blessed to see people who have so little in this world still worshiping the Lord so passionately.

Here is a picture of the church building with the people of the community as we were walking back.

As I attended the service I was surprised to see that the church was led almost exclusively by people from the community. David informed me that many of the people up front leading used to be in lifestyles of sin but Jesus redeemed them to be leaders for Christ in their community. David explained that this is the model that the Lord gave him for church planting. He didn’t want the church to be led only by gringos (white people), but he has encouraged local leadership and buy-in from the community from the beginning. This way even if David leaves, the church will still be sustainable because the people of the community have ownership and an investment in it.  Seeing this model in action really gave me vision for my future in ministry. I saw that community development and church planting requires local leadership on the ground-level to be raised up. It was encouraging to see how Jesus provided these people to Pastor David for this church.

Here is the inside of the church with the people worshiping the Lord Jesus. The people knew all the words of the songs by heart and the lady in front was leading them passionately in Spanish.

As I was enjoying worship, David called me aside to come outside to his truck. In the backseat of his truck he had a mother from the community with a small child less than a year old who had a terrible rash. The rash was causing many areas of his skin to peel off and he was not able to sleep much at night because it was so itchy. I drove with Pastor David, the mother, and the child to the local Pharmacia (pharmacy) where a local doctor was practicing. David had brought me along because he knew I was a physician and wanted to get my opinion as well. As we drove I put on my doctor hat and started asking the mother about the rash. Due to absence of other systemic symptoms, it became apparent that the rash was likely an allergic reaction to a new food the mom had recently started. I spoke with the doctor at the pharmacy and we agreed the patient needed anti-histamines and short course of corticosteroids to help the rash resolve. The mom felt better to have an answer and treatment. David paid for the bill for this mother who otherwise would have not been able to afford the doctor visit or the medications. It was rewarding to show the love of Jesus to this woman and her child as we cared for their basic needs.

Here is a picture of the rash on the boy’s back as his mom holds him still. It was much worse on his legs and diaper area where his skin was peeling.

We drove back to the church as the service was just ending. The children and families were all lined up outside the bottom floor door waiting for lunch. I went inside to see if the volunteers needed any more help and I saw a few hundred plates with sandwiches and bananas spread out everywhere. There was also juice in cups for the kids which was a special treat for them. As the doors opened the kids came in one by one starting with the smallest to get their food. All of the small children ate inside at little tables while the big kids and adults ate outside. We passed out all of the food until all of the people of the community were fed. David told me this meal was special for the people because many of them only eat one or two meals a day that usually are small without much nutrition. It was fun to see the joy on their faces as we gave them this gift.

Here is everyone waiting outside the church for the food to be served.

Here is a picture of all the sandwiches prepared for the people of the community. You can see the cups of juice and water set up on the back table.

Here are all the plates and cups set out for the small children to make sure they got fed.

Here the volunteers are passing out the meals and drinks.

After lunch, David and his wife Heather started bringing me any kids with medical problems or injuries. I tried to do the best I could with the small first aid kid they had. After cleaning a few wounds and putting on a few band aids, I had the opportunity to play with the kids for a short time. The small girls lit up when I told them “Jesus loves you” and “you are beautiful.” Pastor David informed me that this community is plagued by fatherlessness due to promiscuity and drug addiction. He explained that simple acts of affection such as playing, patting a head, or words of encouragement from a male figure can really impact these children. It was fun and rewarding to minister to the kids in these simple ways.

Here are some of the kids I played with after bandaging up their various cuts and bruises. They loved smiling and being crazy for pictures.

After play time we loaded up the vehicles and drove away as we waved goodbye to the people of the community. I thanked Jesus that I was able to not only help these people in need but also to witness how the gospel can transform a community and produce songs of joy even in the midst of great poverty. I pray the Lord uses me in the future to transform communities by the practical love of Jesus Christ and the power of the gospel.

June 13th, 2017 by Sean Mark
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Greetings from Honduras! It has been a great week of new and exciting experiences that have given me vision for my life and future career. One of the eye-opening experiences from this week was on Thursday when I had the opportunity to spend a day at the public hospital of Roatan. As I mentioned in an earlier post, I met a pediatric emergency medicine physician at church on Sunday named Dr. Eric Scher who traveled to Roatan to work at the public hospital and teach the young Honduran physicians who work there. Through our conversation at church he found out I was going into Emergency Medicine so he invited me to come and work with him at the public hospital. I was very excited for this opportunity because I knew that the public hospital had an emergency room and saw many sick patients. Little did I know what adventures the Lord had in store.

This is the outside of the public hospital in the middle of the major port of Roatan

To preface my story I want to explain a little bit about how the hospital system is run in Honduras and in Roatan specifically. Honduras has a government-sponsored public health care system that serves all of its citizens freely without regard to social status. However, because these public hospitals are funded by the government and serve many poor patients, they typically have little resources and many patients to care for. In Roatan there are two hospitals on the Island, one public hospital funded by the government and one private hospital that is much nicer and is funded through revenue from wealthier citizens or tourists who use its services. Many of people of Roatan cannot afford the private hospital so they have to go to the public hospital for their healthcare needs.

When I first arrived at the public hospital with Dr. Scher, I was immediately surprised by how it was set up. It was an open air building in the middle of town with a concrete roof and occasional doors to separate certain healthcare areas such as the ER or pediatric unit. Dr. Eric walked me around to see the different areas and then we went to the pediatric unit to check up on some of the patients he had been seeing.  He was adored by all of the pediatric unit staff because he had a made it a focus to make relationships with all of the staff including the nurses and administrative workers. I helped Dr. Scher and the staff carry in some supplies that Dr. Scher had bought for the hospital. I thought these supplies might be some new technologic gadgets that would help speed up patient care but instead it was two paper towel dispensers and two soap dispensers for two areas where there was actually running water (a good part of the hospital is without a source of running water). Before these were installed, hospital staff would only have hand sanitizer for hand sanitization if it was available. These dispensers allowed staff to better cleanse their hands between patients and prevent spread of disease. It was a simple thing but it made a big difference for the hospital staff and patients.

Here is Dr. Eric showing the new paper towel and soap dispensers he bought.

The first place we saw patients was the pediatric unit which included a small NICU. In the NICU, it was interesting to see how the staff took care of these tiny babies with limited resources. For instance, in the US, all of these babies would be hooked up to cardiorespiratory monitors and most likely would have 1 or 2 nurses watching over them. In the NICU in the public hospital, they only had a few monitors so they had to decide which babies needed it the most and then try to take care of the rest without monitors. The babies were watched by an administrative non-medical staff member on the pediatric unit most of the time who could see the babies through a glass partition. Doctors and nurses would stop by at various times throughout the day. It was very interesting to see how they handled newborn care with limited resources.

Here is the back door to the emergency room

After seeing all the patients in the pediatric ward, I had the opportunity to stay in the ER of the public hospital for about an hour and a half. It was crazy how many sick patients I saw in that short period of time. First I saw a patient who was involved in a motorcycle accident and had a lower extremity deformity where one leg was shorter than the other and his injured leg was turned funny. The Honduran doctors got an X-ray because they thought his femur (leg bone) was broken. As I looked at the X-ray with the young Honduran doctors who had just recently started the practical part of their training, they said the femur was not broken. I looked closer and noticed that although the femur was not broken, it was not in the right place. I pointed out that the patient had a dislocated hip to which the Honduran doctors said…..”Oh I see it now you’re right.” We took the X-ray to the orthopedic surgeon on call who agreed the hip was dislocated and told the Honduran doctor in the ER to get some diazepam ready to put the hip back into place. Diazepam (valium) is not the usual drug I think of when doing a major procedure such as a hip relocation because it isn’t a very strong anesthetic. I asked the orthopedic surgeon about it and his reply surprised me. He said he would prefer to relocate it in the operating room but there is only one operating room in the hospital and it would take too much time to get it set up. Then he said they could use stronger drugs but that would require an anesthesiologist which there is only one in the hospital so it would take a long time for her to get involved. So due to limited resources and personnel, we were stuck with IV diazepam and brute force. The orthopedic surgeon graciously let me help put the bone back into place. We gave the patient the sedation and I help pressure on the patient’s pelvis over the injured side while the Honduran ER doc held pressure on the other side of the pelvis. The orthopedic surgeon applied traction to loosen up the muscles and then gave a swift pull on the bone. The hip bone popped right back into place right under my hands! I said praise the Lord because it could have been much worse and the patient tolerated it well.

Here is the setup of the ER at the hospital. You can see that each patient is separated by a curtain. The man in the black scrubs is the ER attending. There were about 7-8 beds in the ER but they stayed busy.

The next patient I saw was a patient that came in with shortness of breath, a history of heart failure and asthma, and swelling in her legs up to her knees. Her oxygen saturation was 85% on 4 liters of oxygen which for non-medical people means she was not getting good oxygen to her body. She had wheezes in her lungs so we started a breathing treatment for her asthma. We tried to get a blood pressure but we had trouble hearing the sounds. I felt her pulse and it was weak so I wondered if the blood pressure was low. We got an EKG and spoke with internist on call who  agreed to come see her. He took the blood pressure and then turned to us and said, “this patient is in cardiogenic shock” (meaning her heart wasn’t strong enough to pump blood to her body). We quickly rushed to a small closet-shaped room which was the pharmacy to get medications to help with her blood pressure. The patient was very sick and near death but we were able to intervene and preserve her life.

Here is the EKG machine they used for my patient. The design interested me because it used suction with a bulb that you squeeze to stick the leads onto the patient. In the United States we usually use adhesives but obviously disposable equipment like this is more expensive and harder to sustain in Honduras.

The last patient I saw was one of the sickest patients I have ever seen and he had a sad story. The patient had been diving to 70 meters (over 200 feet) to fish for lobster for a commercial fishing company. The boat accidentally started to drive away with a hose that was attached to the patient. The hose yanked the patient up towards the surface very quickly which is not safe when someone is diving at this depth. When the patient reached the surface, he had a severe case of the bends which is also called decompression illness. When we saw him in the hospital, he was paralyzed from the neck down unable to move his arms or legs due to damage to his brain and spinal cord. The only treatment for this condition is to get the patient into a hyperbaric chamber. Unfortunately the only hyperbaric chamber is for tourists who dive and it costs roughly $80 per treatment which is a lot of money in Honduras. Not only that but the patient was from one of the poorest people groups in Honduras and he was away from home without family. The boat owner should pay for the damages his negligence caused but unfortunately he went into hiding after the incident. There were a few guys at the hospital who claimed they were “a friend of a friend” who owned the boat (trying to distance themselves from liability) and they said they just wanted to help the guy out. However, their story about the events of the patient’s injury kept on changing and it became apparent they were lying to us. They had found a way to pay for several treatments at the tourist hyperbaric chamber but they didn’t want to pay for more. This patient needed at least 25-30 hyperbaric treatments to get his body function back which you can imagine would be very expensive.

We were confronted with a hard situation. This guy really needed the hyperbaric treatments but because he was poor, he did not have access to the treatment. The boat owner who had probably been taking advantage of this patient’s diving skills while paying him a small wage was now trying to avoid any liability. This situation really gave me perspective of what medical care can be like in the third world. It is sad what can happen when patients are poor and they don’t have anywhere to turn. We did not know what to do as we looked at the patient who seemed to be in distress and dying. Dr. Eric finally offered to pay for several of his hyperbaric treatments at the tourist hyperbaric chamber. We took him to the chamber only to get there to be told the patient was breathing too fast and needed a chest X-ray before he could be treated. So we had to ride in the back of the ambulance with him to the other side of the island to the private hospital to pay for a chest X-ray (because they are the only place on the island to get a chest X-ray after noon) to make sure he didn’t have a collapsed lung. As we drove with this poor man who could not communicate, I said to my fellow doctors “we need to pray for this man.” I led as we prayed in faith for a miracle for this man and for God to provide a way for him to be healed. The chest X-ray was normal so he went back to the public hospital to stay for the night to get the hyperbaric treatment in the morning. I went home heavy-hearted wishing there was more I could do for this man. I have no idea what will happen to him after he receives the few treatments Dr. Eric paid for. I am not sure what has happened since I saw him but I still pray the Lord will bring healing to his body and provide a way to pay for his care.

Here is a picture of the ambulance that transported the patient. It is definitely not equipped the same way ambulances are in the United States. It is more a transport truck rather than a portable critical care unit like the ambulances are in the US.

Here is Dr. Eric talking with the hyperbaric doctor (Dr. Paul) at the hyperbaric chamber clinic

Here is a picture of the three of us (Dr. Eric, Dr. Moya, and myself) riding in the back of the ambulance with the patient to the private hospital.

These experiences really opened my eyes to how blessed I am in the United States even with the broken health care system we have. We are blessed to have a safety net so that anyone can walk into the emergency room and receive care until their acute disease is resolved regardless of their financial resources. The day at the public hospital with Dr. Eric also showed me a model of mentorship and discipleship I want to implement in my future international medical service. Dr. Eric met with the young Honduran doctors every day to teach them what he knew and mentor them in their medical practice. He cared about each person and tried to know all their names so he could have a relationship with each one. He was able to have incredible influence on them because he cared about being their friend and colleague. He realized that when you do international service, it is not about what you do but about what you leave behind when you leave. It is the indigenous people that you teach who will care for the patients after you leave and who ultimately determine the quality and duration of your impact. This is the type of focus I want to have as I use my medical skills to help people across the world.

Here is a picture of the teaching time with Dr. Eric and the young Honduran physicians

Here is a picture of our group from the teaching time.

Here is a picture of me next to Dr. Moya (the ER attending physician), Dr. Eric, and then one of the young Honduran resident physicians who helped me in the ER.

It was a day filled with times of sadness and times of inspiration. I know that Jesus is working all of it for good as I love him and seek his perspective. These experiences helped me to see the great need for better medical care in foreign nations and it also showed me a model for bringing about that change. I am thankful I am able to see these things so that I can seek the Lord for his heart for the nations as I start my residency training. I pray he will give me his heart of compassion and give me guidance and wisdom to make a difference in the world.

June 10th, 2017 by Sean Mark
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Hola de Honduras! It has been a busy week here in Roatan and I have much to write about but I will try to take it one day at a time because the days have been so jam-packed. This last Tuesday I worked in the clinica Esperanza with Dr. Suzanna to take care “Los pacientes Diabéticos” (The Diabetic patients). I have really enjoyed working with Dr. Suzanna because she is very good with her patients and she lets me help out a lot in the clinic. She is also a strong Christian which is great because we both have similar values when it comes to taking care of patients. This was really demonstrated on Wednesday when we were taking care of a particular diabetic patient.

This is Dr. Suzanna who takes care of the all the diabetic patients at the clinica esperanza

The patient was in her 60’s and had a history of uncontrolled diabetes. When she came into the clinic her random blood sugar was greater than 300 (normal is usually less than 180) and when I looked at her chart I noticed this high number was her usual presentation when coming into clinic. We performed a point-of-care Hemoglobin A1c test (to measure her blood sugar for the past 3 months) which was greater than 13 (for non-medical people, this means her diabetes was very uncontrolled). She was starting to feel some of the damage to her body manifested by numbness in her fingers and neuropathic pain in her feet. She spoke English more than Spanish so I was able to talk to her extensively about changing her diet, her exercise regimen, and her home medications to get better control of her diabetes. After she agreed to changes these things, she then started to explain how she had been going through a lot lately with being the primary care giver for her elderly 91 year old mother as well as the periodic caregiver for her grandchildren. She started to cry as she explained how much she needed good health to take care of all of her loved ones. I sensed she needed more than just the counseling and medication changes I had already explained, she needed grace from the Lord Jesus to carry her through physically, emotionally, and spiritually. I asked her if she wanted to receive prayer for her life struggles and she gladly accepted. I placed my hand on her shoulder and began to pray in English while simultaneously I saw Dr. Suzanna (who had been in the room the whole time with us) grab the patient’s hands and start to pray in Spanish. I prayed for the Lord’s strength, grace, and healing for this patient in the mighty name of Jesus. When I finished my prayer she opened her eyes which were full of tears and tenderly thanked Dr. Suzanna and I for providing her with the wholistic care she desperately needed.  She left the office encouraged and empowered to be healthier and follow Jesus by faith

After this patient encounter I felt like Jesus was showing me that this is the model for healthcare that He wants me to walk in as I mature into a better physician. Medical knowledge and diagnostic skills are important but unless I learn to care for the whole person including their mind, body, soul, and spirit, I cannot minister to them in the way Jesus would if He were their doctor. The Lord has been speaking this to me for a while about my practice in the United States but this patient really showed me how natural it can be and how much impact it can have in the life of the patient. I pray that Jesus continues to give me wisdom and grace to obey him as I continue my training in Medicine.

After working at the clinic on Wednesday, I had the opportunity with other the volunteers at the clinic to visit a local poor Honduran community just down the street from the clinic. It is called “la Colonia” which literally means the colony. Many Hondurans have immigrated to the Island of Roatan to flee the violence on the mainland and try to make a better living for their families. The colonia is made up of many poor families who have settled in the hills/mountains of the island. They have built their houses on very small lots that are on steep hills because this land is the cheapest. Their homes are made of whatever materials they can find and are very humble dwellings. Because they are built on the side of hills and mountains, they frequently fall prey to damages from erosion and flooding.

Here you can see how the houses are all built on the side of the mountain

Here is one of the houses of the Colonia

Here you can see how the houses are built up into the mountain

Here is a picture of the houses in the Colonia

Here you can see how steep the hill is. Most of the trail did not have stairs.

Our guide through the Colonia was a local Honduran young man named Oscar who has lived in the Colonia for 10 years. He guided us to the top of the mountain and told us the history the Colonia.

The road to top was steep and long

This is on top of the mountain overlooking the Colonia and Sandy Bay where the clinic is located

Oscar told us that when he first moved to the Colonia with his family, there were not very many families living there yet. He and his family made their first home out of pieces of plastic. There was no running water and the living conditions were poor. He was a young Honduran boy without a good education and without much hope for a better future. However, American missionaries came to the Colonia and decided to build a large water basin on top of the tallest mountain so that water could flow to all of the houses that were built on the side of the mountain and in the valley. Life for Oscar improved and he made friends with these Baptist missionaries who returned regularly to the Colonia. Then another missionary group came with a medical team and ran clinics in the Colonia. One of the doctors in that group saw potential in Oscar and decided to pay for him to attend an excellent private American school in one of the expensive tourist areas of the island. This support from the doctor allowed Oscar to get a good education in English which opens the doors for many economic opportunities because the major industry of the island is tourism from Americans and Canadians who speak English. This education also made it possible for Oscar to apply and be accepted to nursing school at the local public hospital. He is now training to be a nurse and has plans to continue his medical training to eventually be a surgeon. This boy’s life was changed completely because of the love and kindness of foreigners who came to his community to witness of the love of Jesus Christ. Oscar is now an active member of his church as well thanks in no small part to those Christian missionaries. These missionaries are an example of how I want to use my resources and skills in the future to help the poor of the world.

This is Oscar explaining the history of the Colonia and what the Christian missionaries did for the community

There was a cross right next to the water basin demonstrating a beautiful picture of the gospel

The writing on the large water basin on top of the mountain reads “No está aquí, pues ha resucitado” and the translation of the famous scripture is written in English as well “He is not here, for he has risen.” These missionaries understood that community development is more than just building wells and providing healthcare, it is caring for all of the needs of the people including spiritual needs. The greatest need the human race has is to know Jesus Christ and the power of his resurrection. We encounter him first at the cross as we repent and are set free from the power of sin. Then as we believe in his resurrection and abide in him by faith, we can partake of the living water of His kingdom. This gospel message was beautifully demonstrated on top of this mountain with the cross and the water basin. Although the people of the Colonia need many things in this world, the missionaries knew the things of this world will never satisfy the hunger in their soul for relationship with Jesus. The pleasures of this world are fleeting, but the pleasures of heaven are everlasting. Jesus said when we drink of the living water from Him we will never thirst again because he is the only thing that satisfies. When we know Jesus we are set free from the power of death and this freedom is an eternal source of hope and joy. If you are reading this and do not know this truth I encourage you to search it out and ask Jesus to show you his love.

Although I saw great poverty and sad situations in the Colonia, I was encouraged by Oscar’s story and the power of the gospel. The gospel is able to give hope to the hopeless no matter the circumstances. Anyone can know the love and power of Jesus Christ no matter how rich or poor. The work of the missionaries was also a beautiful practical demonstration of the love of Christ to the people of the Colonia. Throughout my career as a physician I hope to provide the practical love of Jesus through my healthcare and resources but also to provide the power of the gospel that brings hope to the hopeless.

Here is a panorama shot on top of the mountain that shows the north side of the island on the left and the south side of the island on the right

June 7th, 2017 by Sean Mark
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Hello everyone! It has been an exciting several days since my last blog post. The Lord has been giving me his favor in many areas so I will try to summarize it briefly while still giving you a taste of my experiences.

On Sunday, I had the opportunity to attend a local church called “R Church” that many of the American staff of the clinic attend on a regular basis. Their services are in English and there are actually many missionaries that go to this church as well. They had great worship and the preacher taught about knowing your purpose and pursuing it in the grace of God which I could really relate to. This whole trip has been about finding my life assignment from the Lord and seeking the Lord’s grace to walk it out. By the Lord’s favor, I was able to meet several important people at the church which are going to help me do more ministry while I am here in Roatan.

This is R church

It was nice to worship the Lord in my native tongue lol

The first person I met was a Pediatric Emergency Medicine doctor from the United States named Eric who started a pediatric clinic on the island years ago and has been coming to the island regularly ever since to work as a doctor. He works at the public hospital on the island which is similar to the county hospitals in the states – it has fewer resources and the people who don’t have the means to go the private hospital go there to get their medical care. Eric quickly figured out I was interested in Emergency Medicine and he said he would try to make a way for me to rotate in the public hospital ER so I can understand emergency care in a low-resource third world country. He has now connected me with one of the attending physicians in the ER and I will likely be able to rotate there in the next few days Lord willing. Please keep up the prayers for this. I really think this would be a great opportunity to experience ER care in a low-resource environment with the poor of Roatan.

The second person I met was the pastor of the church who coordinates regular outreaches to the poorest neighborhoods on the Island using food and sports to minister to the children and share the love of Christ. He told me I could come with him to these neighborhoods this Friday to give food to the kids and witness to them. I am really excited about this opportunity to share Jesus with the poorest people of the Island.

Next I spoke with a missionary couple who has been working as missionaries for over 20 years in Latin America. They are now working at the clinic I am working at and they are living right across the street from me – only God can arrange things like that. They have a heart for ministering to the clinic staff and the patients we see with the love of Christ. They have raised their own support for years similar to the model in YWAM. We talked for over an hour about our own God stories and all that Jesus has done in our lives as we have obeyed Him. It was encouraging to talk with like-minded believers who were willing to give up everything for the sake of the gospel and who followed Jesus with faith and obedience. I am going to have dinner with them later this week so we can pray and dream with God about how to minister to the clinic staff and patients.

The couple in the center is the missionary couple I talk about who have been working in Latin america for 20 years. The older gentleman to the left is Mr. Dee who is a strong Christian who witnesses to everyone he meets. The guy in his swimsuit on the right is Marshall who is also a strong Christian from Ohio who wants to do missions with agriculture.

On Sunday night, I moved into the house of a Spanish-speaking Honduran family who regularly hosts clinic volunteers. I wanted to stay with them from day one but they only had a room available starting on Sunday. They have a beautiful family and they have been helping me practice my Spanish every day. It is such a blessing to feel like I am living with a family again after several days staying alone in the backpackers hostel. The mother of the family is named Doris and she is an amazing cook! I am trying not to gain weight but she always fixes me tons of food and it seems rude to not eat it all. She makes me a big breakfast, a lunch to take to the clinic, and a big dinner each day. She also has been washing my clothes every day. Being hosted by such a kind family has been a great blessing. Doris is also a strong Christian and it has been a blessing to be a house where I can play worship music.

This is the house of the honduran family I am staying with

These are home made enchiladas that Doris made for dinner last night – I am so blessed!

This week I have been working in the clinic with a Honduras doctor named Dr. Suzanna who sees all the diabetic patients in the clinic. Diabetes is a chronic disease that is hard enough to manage in the United States, much less in Honduras with fewer resources. Dr. Suzanna is passionate about diabetes because she wants to be trained to be an endocrinologist in the future. She does a great job coaching the patients to change their lifestyle while taking medications so that they can improve their overall health. Dr. Suzanna only speaks Spanish and she talks fast so that means I have been growing a lot in my Spanish comprehension and communication this week. Between the 8 hours in the clinic I spend hearing and speaking Spanish as well as the time I spend communicating in Spanish when I come back to the Honduran family’s house, my Spanish skills have really been improving. I now am starting to think in Spanish whenever I want to talk and it is sometimes a struggle to talk only in English. Even as I am writing this blog, I am thinking about words in Spanish while I am trying to write in English so pardon any mistakes in my grammar or sentence structure lol. This has been a huge blessing because becoming more proficient in Spanish is one of the main reasons I chose a country in Latin America for my mission trip. I pray the Lord will use my language skills to minister to the Hispanic population in the United States and the whole Spanish-speaking world.

I have much more to write but I will leave it at this for now because it is getting late and I am very cansado (tired). My next blog will be mostly about my trip to “la colonia” today where I saw extreme poverty as well as how those who love Jesus can make a difference in seemingly hopeless places. So please stay tuned! Here are few pictures from that trip to keep you interested…

June 3rd, 2017 by Sean Mark
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Today was my first day working at Clinica Esperanza in Roatan, Honduras. I was greeted this morning by the clinic coordinator and given a tour of the clinic facilities. Clinica Esperanza offers a diversity of services to the people of Roatan including general medical evaluations, primary care, pediatric care, Ob/Gyn, and dentistry. It is equipped with many exam rooms, a small birthing center for uncomplicated births, ultrasound, a pharmacy, a laboratory for basic lab work, and electronic medical records. The staff members are all very friendly and gave me a warm welcome on my first day.

The clinic coordinator deputized me with this volunteer t-shirt

I started the day shadowing with Dr. Ashley Flowers to learn how the clinic is run from the physician’s perspective. She is a Honduran trained general physician who speaks both Spanish and English (like most of the staff at the clinic). We worked in the general medical clinic area which sees a mixture of primary care follow up as well as urgent care patients. We saw a number of common medical issues that are also seen frequently in the United States such as Diabetes, hypertension, headache, cellulitis, and back pain. We also saw several pregnant patients who receive all of their prenatal care at Clinica Esperanza. Most of the patients spoke Spanish and I was pleased when I was able to understand a good amount of their conversation. Dr. Ashley was kind enough to explain in English the parts I didn’t understand.

After seeing a number of patients and starting to get a hang of the clinic procedures, Dr. Ashley allowed me to see one of the English speaking patients on my own. Although the island is part of Honduras, it was actually owned by the English at one point and there are many families that have been on the island a long time that still primarily speak English. I was a little shaky at first trying to figure out the electronic medical record but after a few pointers from Dr. Ashley I was able complete the patient encounter without problems. It was surreal to sign my name Sean Mark M.D. at the bottom of my notes for the first time. I ate lunch with several of the clinic staff and I was able to practice my Spanish with them. It has been such a blessing to be in an environment where I am forced to speak and understand Spanish. This type of immersion experience is what I have been waiting for ever since I took my Spanish classes in college.

The clinic serves as a safety net medical home for many of the Honduran immigrants that live nearby in “la colonia” which is the name for their neighborhood that translates to “the colony”. Many of the families in this neighborhood live in poverty.  The cost for a general medical clinic visit is 100 Lempiras which is a little less than $5 so that it is affordable for nearly everyone in the community. The clinic also has teams that go out into the nearby community to do health promotion and disease prevention work among the people. I am excited to have the opportunity to serve the poor in the clinic but also in their homes during my time here.

This evening I have had time alone in my room at the backpacker’s hostel to think, pray, study my Spanish. I have been using the notes from my old Spanish teacher, Mr. Metzger, who actually lived in Honduras for a number of years. It has been a blessing to have time to relax and reflect on all the Lord has done in my life the last 6 years during medical school. Sometimes in the busyness of kids, work, and American culture we forget to reflect and thank Jesus for his faithfulness. I am so grateful for how he has led me by his strong hand. I praise the Lord for his goodness and look forward to all he has in store during this trip.

June 2nd, 2017 by Sean Mark
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My name is Sean Mark and I chose to do my service learning experience at Clinica Esperanza in Roatan, Honduras. I just graduated medical school less than 2 weeks ago from the University of Missouri-Kansas City after 6 years of studying hard and working long hours. Ever since I started medical school, I have felt a calling on my life to serve the poor and marginalized people of the world both in the United States and abroad. Doing missions work was one of the main reasons I decided to go into medicine in the first place. I married my high school sweet-heart just before starting medical school and we now have been blessed with 4 beautiful children under the age of 5 years old (crazy I know but they are so fun!). My wife comes from a missionary family where she has traveled to every continent except Antarctica doing missions work. I have dreamed about traveling to do missions work but have not had the opportunity the last 6 years due to my busy family and school schedule. However, my time to serve has finally come and I am excited to lay hold of it.

Here is my beautiful family at my medical school graduation.

I have attended INMED conferences, gone through the INMED course, and studied public health but I have never had an opportunity to travel to another country outside the U.S. to use my medical skills.  This trip is a dream come true for me as so many of my aspirations are finally being realized. Although I know this is just the beginning of my lifelong career of service, I am excited for all this trip has to bring and what God is going to show me during this time through my experiences.  My wife and I have been praying over this trip for months and we are expectant that it is going to be a significant time for our entire family where we gain a great heart of compassion for the poor and afflicted of the world.

The first day has been a world wind of excitement and anticipation. I woke up at 3:15AM to get to the airport in time for my departure. I only got a few hours of sleep but I was so excited it didn’t seem to bother me. I drove to the airport with my mother-in-law and newly married sister-in-law with her husband. They prayed over me on the drive which gave me a greater sense of anticipation for what the Lord is going to do on this trip.

When I sat down for my first flight, I found out I was seated next to a medical student from MU who had just finished his first board exam (USMLE STEP 1). I can remember so vividly studying for that exam with my wife being pregnant with our third son Caleb. The Lord provided and gave me grace in such a supernatural way during that season and by his grace I was able to score in the top 5% of the nation. Speaking with this medical student made me remember how much the Lord has done for me and how he has led me every step of the way.

Here is the medical student (middle) I met on the flight with his wife (right). They were traveling to Belize for vacation.

I had a short lay over in Houston and then boarded my flight to Roatan. Everything on the trip went smoothly which was a blessing. I went through customs and immigration without any issues and found my driver at the airport ready to take me around town. His name was Mr. Dee and he was a delight to talk to and hear how the Lord sovereignly led me to come to Roatan and serve in the clinic. He actually drives all of the volunteers for the clinic so he can minister to them and try to share the love of Christ. We stopped at the grocery store and I quickly realized the currency system is very different in Honduras and the conversion from Lempiras to dollars is not exactly simple (23.5 Limps to $1). However, I did my best to convert as I shopped to avoid a large bill at the end.  I was not sure about my accommodations at the Roatan Backpackers Hostel so I tried to stay away from perishables and get lots of PB&J. Many of the food commodities that are cheap in the U.S. are expensive on the island such as name brand cereal or tortilla chips ($9 for a medium size bag). Thankfully my bill didn’t turn out bad in the end

Here is the picture of the airport in Roatan. It was small with a few runways and best of all – outdoor boarding and exiting from the plane. I felt the island heat and humidity right away :).

Mr. Dee then proceeded to drive me around town and show me some of the sites including the coral reef area of sandy bay and the clinic I will be working at during my time here. I was quickly introduced to some of the key clinic staff and told to report for duty the next morning at 8:30AM. I dropped off my large duffle bag full of dental supplies at the clinic which was greatly appreciated (thanks to my generous father Richard Mark who is a dentist in Independence, MO for donating these supplies).

Here is the sign for Clinica Esperanza founded by Ms. Peggy

Here is the Orange van Mr. Dee drove me around in on the island. It is one of 3 orange vehicles in all of Roatan

Mr. Dee then drove me to the Roatan Backpacker’s hostel where I will be staying for at least the next few days. The owner of the hostel is very kind and hospitable. The hostel is organized like a close-knit community with the owner living amidst all the other apartment rooms. There is free Wifi which is a huge blessing. I rented a small private room so I have had a little peace and quiet to pray, talk with my wife, and reflect on the day’s events. I can already tell that this trip is going to be marking time in my life. I have already seen small glimpses of poverty around the neighborhood where I am staying and I’m sure I will see much more once I start working at the clinic tomorrow. Although these types of environments are not always aesthetically pleasing to the flesh, I know that Jesus has a big heart for the poor and has compassion for the afflicted. I have been studying his compassion in my bible today and praying for the Lord to give me his heart. I hope during the next few days he answers my prayers.

May 26th, 2017 by INMED
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Hello! My name is Sean Mark. I am a Medical Student at University of Kansas City School of Medicine , and I’m starting my INMED service-learning experience at Clinica Esperanza in, Honduras beginning in June 2017.