Description of Balfate and Report on Hospital Loma de Luz (January 2001)

This description of Balfate written in January 2001 in an email to a writer who was writing an article for a magazine.  A Report on Hospital Loma de Luz for the year 2000 is attached.

These were not originally posted in Thoughts from Honduras, but are included here as they give a very detailed snapshot in time. 

 

Sarah

 

I will try to answer your questions.  Let me know if I don’t give you the info you want.

 

We live in Balfate, a small town of about 400 which merges with two other villages to form a community of about 1200.  It is located on the north central coast of Honduras, 37 miles east of the city of La Ceiba.  La Ceiba is a good-sized city of 150,000 where we do our shopping and email.  We have to ford three rivers to make the trip, which takes about 90 minutes and requires a 4-wheel drive vehicle.  During the rainy season we often can’t travel by car.  We can, if necessary, take canoes across the rivers, if the current is not too strong, and walk between the rivers until we get to drivable road where we can catch a ride.

 

Balfate is equivalent to the county seat for our area and is wealthier than the mountain villages but is poor by our North American standards.  It has government offices and the local high school.  Most villages have their own grade school, but few children who live out in the country go on to high school.  To look at our town, it would remind you of a very poor neighborhood in The States.  There are a couple of nicer homes, most being cement block, some made of mud and thatch roof, and a few of wood frame, which were built 30 years ago when Standard Fruit Company, known to us as Dole, was very active in the area.  Our home would remind you of a summer cottage on the beach.  It is about 30 years old, rustic, very nice for the area, but in need of constant repairs.  We have a generator which we use during our frequent power outages to keep our refrigerators and freezer working.

 

Balfate does have bus service to La Ceiba when the weather permits.  There is electricity and community water, which is piped directly from a stream without treatment.  We use a shallow well and filter our drinking water.  There is even a “cable” TV system offering four stations, mainly showing soccer games, soap operas and game shows.  This originates at the home of one family who has a few satellite antennas.  They run cables to anyone who wants to pay for it.  Most individuals can’t afford it, but many of the general stores in the area have cable to attract customers, who come to drink Coca Cola and watch TV.  Unfortunately, there are a few bars that do a thriving business.  We also have a couple of pool halls, local open-air bingo in the town square, a numbers racket, and occasionally prostitution.  These all make a negative impact in a society that is so poor that it barely feeds itself.

 

There are many other villages up in the mountains that consist of clusters of family units of maybe 50 to 200 people.  They have no electricity or running water.  The people are subsistence level farmers, growing beans, corn, rice, platanos (cooking bananas), yuca, and raising some chickens, pigs, and if they can afford it, cattle.  There are lots of wild fruit trees that also supply food.

 

We are building a hospital in this area to serve an estimated 20,000 people within a day’s walk who would have very little ability to receive medical care otherwise.  There is a government hospital system, with a clinic in Balfate that is undersupplied and poorly staffed, as well as a government hospital in La Ceiba, that the people avoid because of the poor service, and tremendous wait to receive care.  Most of the people near us just stay at home, suffer, and sometimes die rather than go to La Ceiba.

 

Currently we run clinic two days a week, seeing about 40 patients each day.  The patients often walk four to six hours to reach us and have a variety of acute and chronic illnesses.  The most common chronic illnesses we see are diabetes, hypertension, environmental allergies and degenerative joint disease.  Acute problems consist of machete wounds, parasitic infections, and many of the common things we see in The States like common colds and ear infections, but usually more advanced.

 

On nonclinic days we sort medical supplies and equipment sent from The States, bag medications, and train our Honduran employees.  One day a week usually includes a trip to town to buy groceries and other things needed at the clinic and for home repairs, and to do email.  One morning a week I meet with the pastor of our little church for Bible training.  I also spend time in studying Spanish, preparing sermons and Bible studies in Spanish, keeping up with continuing medical education, and endless household repairs.  

 

I think you will find some specific accounts and plans for our clinic in my “Thoughts from Honduras.”

 

My wife spends her days homeschooling our three children, preparing for teaching Sunday school and Bible clubs for children, and maintaining the home.  She also is involved in hosting an endless flow of visitors.

 

For relaxation, I garden, attempting to discover what vegetables and fruits I can grow here in Honduras.  As a family, we go to the beach to walk or swim, ride bikes, and most recently the boys and I enjoy their new archery sets.

 

I will send you a copy of my recent report for the hospital that will help you understand our progress.

 

I hope this helps!

 

David Drozek

 

 

Report and Projections for Hospital Loma de Luz, December 2000

 

Having begun the clinic in February 2000, we now have registered more than 2200 patients.  As of November 2000, 134 first time decisions for Christ have been made, 24 decisions to reconcile with Christ, and 245 expressed interest in a Bible study.

 

The clinic is open Mondays and Wednesdays. Usually people arrive as early as 6:00 AM to secure their spot in line.  In good weather, when only Chrysti and I are working, we see 30 to 40 patients a day.  We usually turn a few patients away after our gatekeeper, Abdulio, assigns the initial appointments, usually 30, based on first come first served.  Within those who receive appointments, we triage patients based on illness.  Those seriously ill are seen first, followed by diabetics, those who need wound checks, and then those who need only medication renewals for chronic problems.  Other patients with new problems follow.  Often additional patients with acute problems show up as the day progresses and are worked in to the schedule.

 

Our chaplaincy staff currently consists of 20 area pastors.  Each clinic day we have a pastor scheduled to counsel with the patients.  Each pastor has been instructed of our non-denominational status and encouraged to avoid promoting their personal beliefs that are outside the spectrum of the Cornerstone doctrinal statement.  They have been given copies of our doctrinal statement in Spanish, as well as a standard of conduct for pastors, written by Luis Chavarria.  They are particularly encouraged to avoid negative comments about Catholicism and other denominations, but rather to concentrate on the important positives of evangelical Christianity.  The pastors are supposed to assess the spiritual need of the patients, and offer appropriate counsel and prayer, with encouragement to follow up either in their own local church, or in one of the churches nearest them represented by our chaplains.  When a decision is made, or a desire for Bible study is expressed, the patient’s name is passed on to a local chaplain for follow up.

 

In theory, this system should work, but in practice, I believe it falls short for various reasons.  First, because the culture is so accommodating, many people will “say the prayer” to please us, without any real intention of seeking a change in their life.  Second, our pastoral staff has very little training or experience in evangelism and discipleship.  Pastor Luis, who directs the chaplaincy program, lives in La Ceiba and has many other obligations that make his regular presence difficult.  What actually goes on between the patients and chaplains is usually unobserved, and when it has been observed, often reflects an insufficiency on the part of the pastors.  We really need an on site, full time, well-trained national or missionary to oversee the chaplaincy program and area church development.  This is probably our most important and urgent need!

 

Another concern is that we are beginning to draw patients from the city that could well afford private care in the city.  This was especially evident during the eye surgery brigade.  Many people from La Ceiba drove their own cars here and “bumped” the poor from their opportunity to receive care.  This also places us in competition with the private medical community in La Ceiba.  To remedy this, we are formulating a financial policy based on income, property ownership and geographic location of residence.  We will take care of the poor from wherever they come from.  We will limit our geographic sphere of influence to anyone who reaches us without crossing the bridge at Jutiapa.  If they come across the bridge, and have financial ability to receive care elsewhere, we will turn them away.  Alex is preparing carefully chosen wording for a sign to be placed at the gate asking those who live outside our area and can afford care in the city to seek it there.  We feel that even those who are wealthier within our immediate area should be eligible for care since they are within the sphere of influence of our partnering churches.

 

Medical brigades have been helpful in many ways.  They have met needs beyond our usual scope, have seen large numbers of patients in a short time, often identifying chronic needs and helping us establish relationships to meet those needs, have been instrumental in restocking our supplies and providing equipment, and have broadened our support base.  Also, drawing large numbers of patients daily has pointed out flaws in our patient flow system, allowing us to adjust and improve our efficiency.

 

Looking ahead, I believe we are ready to move into a five day a week clinic.  When either Dr. Faull or Dr. McKenney is able to assume two days of work in the clinic, I could run the other three days.  I think there will be several advantages to going to 5 days.  Many days patients leave at 2:00 to 2:30 with out being seen, because the last bus of the day will be leaving.  They simply cannot afford to miss the bus and be stranded at the hospital, especially if they are very ill. Also, even on non-clinic days, patients show up, often from quite a distance away, and we find ourselves spending the morning seeing unplanned patients, doing so less efficiently since we are usually trying to do other tasks. If we open five days a week, I think we will initially see less patients per day, but be able to see all the patients that come for appointments before the last bus leaves.  The volume will undoubtedly grow, requiring at times that two doctors see the clinic patients in the morning.  If we finish by midday, the afternoon can be used for preparing for the next clinic day, administration and teaching.

 

When two doctors have worked in the clinic simultaneously, bottlenecks have become evident.  Checking patients in and filling out their patient questionnaires, due to the low literacy rate, needs to be done individually with the assistance of one of our employees.  One person cannot handle this station when two doctors are working.  Pharmacy also becomes a bottleneck for the doctor, since he must seek the medications he wishes to dispense.  Even though we have a fairly well equipped lab with capability to do many helpful tests, because of the time required to do them, we often “pass”.

 

To help remedy these “bottlenecks” we would like to hire and train additional staff.  We have three people in mind who have expressed a desire to work with us.  One, Pastor Samuel from Lucinda, would take over the logistics of the chaplaincy program, as well as run the eyeglass clinic (more about that in a moment).  Rigo, one of our chaplains from Rio Esteben, who is also bilingual, is interested in the lab technician job.  Lisette, a young lady from Balfate is interested in an “Aid” position.

 

Pastor Samuel is about 50 years of age, a high school graduate, and very intelligent.  He is enrolled in the United Brethren seminary in La Ceiba, and according to Roger Reeck, is an outstanding student.  He receives 100% on all his exams.  He appears to have the mathematic capability to run the eyeglass clinic.  We have the clinic set up, thanks to Brent Hambrick, with protocols, a focometer, and a limited supply of glasses.  I would like to receive another shipment of glasses before we begin, since I believe we will exhaust our current supply rapidly, and find ourselves and the patients frustrated.  Maybe these could be placed on the McKenney’s container?  The distance glasses are free, and come 1800 per lot from the Lion’s club, premarked to be used with the focometer.  We only need pay the shipping.  Reading glasses cost 60 cents apiece.  The eyeglass clinic should be self-sufficient financially, if we charge 15 Lempiras per pair of glasses.  This is a great deal for the locals, will add to the services we provide, and provide Pastor Samuel with a full-time job.

 

Our lab is currently sharing space with the pharmacy.  Leon Greene left us well stocked with reagents.  I believe that we would need to purchase very little.  Betty Palfy is interested in coming to visit for several months and train Rigo.  I believe this will be an ideal time, since Rigo can learn, as the volume is still slow. Betty will be here as we begin to consider laying out the lab and have valuable input into arranging things. Betty is versatile and could stay in the staff-housing complex.  I suspect she will be agreeable to coexisting with teams, when the need arises.  We will set up a small apartment area for her to be used when the teams do not need the space.  I believe we should offer the living space to Betty free of charge, since she will be giving us valuable service at her own expense.  

 

Both Sonia and Elmy, our current employees, have expressed interest in learning more skills.  We would like to hire Lisette, a single mom from Balfate, to join them in learning.  Chrysti had a long discussion with Lisette regarding our standards and expectations.  Chrysti and I both feel comfortable with hiring her. All three ladies would then receive training in basic nursing skills, preparing them to serve as “Aids”.  Chrysti is preparing an outline of items she feels would be beneficial for them to learn.  These skills would include vital signs, glucometer use, dressing changes, medication dispensing and surgical assisting.  All three will also learn office skills, and be fairly interchangeable, in the likely event that someday they will leave to pursue marriage and a family.

 

As the clinic begins each morning, all of our employees would help patients fill out their paperwork, thus minimizing the initial down time for the doctors waiting for the first patient.

 

To expand the clinic as described, I anticipate that it will cost us approximately $1500 per month.  This takes into consideration the employee salaries, and the income generated from our modest patient fees.  I suggest that we begin to solicit “Partners in Medicine”, individuals, churches and other organizations that would become regular financial contributors.  This will avoid the competition with construction for funding, avoid fluctuations caused by irregular donations, and allow us to operate on a fairly predictable budget, limited by our contributions.

 

Please let me know your thoughts and questions.

 

For The Kingdom,

 

Dave Drozek

 

 

 

 

 

 

 -----Original Message-----

From:         Staff, Rounds [mailto:staff@exchange.oucom.ohiou.edu] 

Sent:          Monday, January 08, 2001 4:19 PM

To:             'drozek@missions4Him.org'

Subject:     even more info

 

Hello, it's me again.  I believe Kevin has been in contact with you about

expanding the original story I did and include this one in the Ohio D.O.

Since it is difficult to get in contact with you, I figure I will give you

all the questions I have at once.  First of all, can you walk through a

typical day in your life...How many patients you see, how many hours you

work, working conditions, what other technological advances you are lacking

(we know e-mail and phones are few, what about medical technology?), what

you do to relax after a day of work, what types of things your family does

for fun, and basically anything else about your life that we don't already

know! :)  We want the reader to feel they have just spent an entire day with

you, so any relevant information will be very helpful.  Could you also

include an update as to where the progress on the hospital stands.  Have

more people arrived to begin implementing it?  How is the missionary work

going?  Are you succeeding in teaching the Word to those around you?   What

programs are set up to accomplish this?  Also, I would like to interview

some colleagues and your wife.  Would it be possible for you to give me some

names and contact information?  Hopefully this will be all the information I

need; I know it is difficult for you to communicate.  I truly appreciate all

the time and energy you have put into this as well as not being bothered by

my poking around your personal life.  I hope to hear from you soon, and good

luck!

Sarah