VHI Honduras: When the Patients Can’t Visit the Doctor, the Doctor Visits the Patient

The roosters don’t crow at dawn in La Entrada, Honduras. It’s more like 4:00 am. I’m not sure why this is. Perhaps the locals have set their alarms ahead due to their busy schedules. Maybe it’s that these fowl wake-up-callers have lingered too long over the piles of coffee beans that are found just about anywhere in this northwest region of the country.

In any event, rising early has always been a prerequisite for VHI volunteers (some do it better than others). It’s especially important on those programs that include our “roving eye clinic” teams. In many cases we travel over an hour to reach the small, isolated villages that are nestled in the high country outside of the metropolitan district—La Entrada boasts a population of some 25,000. “Over the river and through the woods” is more like “through the rivers and around the rocks” on roads that would give the most demanding Colorado high country jeep trails a run for their money. While the journey can be rigorous at times, it’s always worthwhile. I’m sure Senora Reina would agree.

Portrerillos is about an hour and a half from La Entrada. Navigation to the small village required crossing three small streams, one of which required that we leave the van and walk over the “bridge” that was, apparently, unfit for vehicles with four tires.

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Seventy-five or so patients were waiting for us when we arrived in Portrerillos; more were to follow. It’s the hope, of course, that we will be able to restore or improve a good many patients’ vision when we visit small remote villages like Portrerillos, and it’s also the aim to discover surgical candidates who might not otherwise be able to make their way to a doctor.

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We set up shop in one of the classrooms at the local school. Patients of all ages filed in, one at a time. Most were provided some form of vision correction; a few would require more attention. One, a young woman of 23, diabetic, was blind with cataracts in both eyes, a perfect candidate for surgery. But when asked if she could come to the Manos Amigas clinic for surgery on Thursday a look of worry crossed her face. “I can’t afford the surgery,” she said, “and I can’t leave my baby.” Reina had a friend with her. She advised, “It won’t cost you. You can’t afford not to have the surgery.” Dr. O’Rourke, who had diagnosed Reina’s condition offered, “If you have the surgery, I’ll take care of your baby.” Reina agreed to the surgery, though the doctor was spared the babysitting chores.

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Senora Reina made it to the Manos Amigas clinic for surgery on Thursday, and she was waiting for us when we showed for post-op rounds on Friday morning. Grandma was taking care of the baby, and her husband, who’s grin reminded me of a kid unable to control himself on Christmas morning, sat by her side. Reina smiled weakly; she was nervous, of course.. When the patch and shield are removed it’s always an anxious moment for patient and for the surgeon. Dr. Chang, the surgeon, and Dr. O’Rourke, the referring physician, took turns examining their patient. And then…there was a smile, a facial expression we hadn’t seen from Reina in the few days we’d known her. And then there were the tears. No waterworks mind you, just enough to know that all was good with Reina, that the trip to Portrerillos was well worth the time, the effort, and the expense, and that when the opportunity presents itself it always a good thing to have the doctor go to the patient when the patient can’t go to the doctor.

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