(written 7 Oct 2023)
I am a family practice doctor, but haven’t been practicing. I’ve been working on getting a Master in Public Health from Liberty University as well as working on the INMED program. I’m excited to start seeing patients again alongside some great physicians at Clinica Esperanza.
My sister, Michelle, and I arrived about a week ago and we’ve enjoyed our time here. Michelle is bilingual, and it’s been fun to get to learn more about the people here as she’s able to communicate more with them. Most people working with the public speak some English, but for many of them, it seems Spanish is their “heart language” and they are happier and more talkative when speaking Spanish. We’ve met several people who have moved from the mainland to Roatan; most often seeking safety and better work opportunities.
It’s HOT! Daily temperatures are in the mid to upper 80’s. With high humidity, the “feels like” temps are 90’s to low 100’s. It’s the beginning of the rainy season, but we haven’t had rain, just beautiful, sunny days.
There is a national holiday this week, so we volunteered at Clinica Esperanza for 2 days then had the rest of the week off. I worked mostly with Dr. Nathan. He sees the many patients who have diabetes. I’m impressed with the level of care provided even though the situation is not ideal. The medications available right now at the clinic (that I know of) are metformin, 2 sulfonylureas (one is glibenclamide, which I hadn’t heard of before), pioglitazone, and NPH insulin. Glucometers, lancets, and strips are not always available, even for patients on insulin. (They use Reli-On from Walmart, which volunteers and visitors bring over from the US.) Even for those on higher doses of insulin, there are not always supplies available for regular testing. The clinic was out of Hemoglobin A1c tests this week also. There is at least one other outpatient lab on Roatan, I think there’s more, but I still have a lot to learn about what is available on the island. Yet, patients, Dr. Nathan, and the clinic staff all do their part to achieve as good control as possible with the limitations present.
Patients receive many prescription and over the counter medications from the clinic, including vitamins and acetaminophen. Although one can walk into a pharmacy here and buy antibiotics and medications without a prescription, the cost is too high for many to afford. They are available, but not accessible to everyone due to cost.
In spite of challenges, the people of Roatan are friendly, patient and welcoming. There is road construction in progress and only one lane open right now, which is about 1 1/2 lanes in width. Cars, trucks, and buses slow down and go around each other to get through, small motorcycles weave in and out of lanes. I haven’t seen lights, stop signs or speed limits, yet no one honks or appears irritated or upset. Drivers just make way for others as they go. They make do with what they have and are kind to each other. It’s truly been “un placer,” (a pleasure) (as one local at the Roatan Chocolate Factory (!) taught me today) to be here. (PS: Somehow in the high heat their chocolate doesn’t melt or get messy, it just gets creamier like fudge!)