San Marcos

On our first morning in Honduras, we leave the hotel, taking with us our luggage and all supplies, and make a nearly 2-hour drive to San Marcos, (called San Marcos of Langue, Department of Valle). On the way, we may make a stop for additional supplies and a “cultural market stop” for interest and souvenirs. When we refill fuel in the trucks, there is opportunity to buy extra water bottles, juices, snacks and optional beer.

 

Upon arrival at the site, all team members help take supplies from the trucks and set up medical, dental and pharmacy areas. Personal luggage goes into men’s or women’s dormitories. We set up the clinics under the doctors’ and dentists’ directions. Clinic hours are determined by medical personnel and usually start shortly after 8:00 a.m. and end shortly after 5:00 p.m., with about a 45-minute lunch period.

 

In advance of our arrival, village leaders organize the scheduling of surrounding villages in order to facilitate efficient care. Once we are operational, people come from 3 or 4 different villages each day. The local people at the site register the patients to be seen for the day. The clinic workloads are set by the medical and dental personnel.

 

Patients are given registration cards with their names on them at registration. If they have been to the clinic previously, their card will include their medical history since they began coming to us. Patients are then triaged according to their medical and dental needs. At the conclusion of treatment, the specialist lists the treatment given and the medication, if any, prescribed. Pharmacy personnel provide the patient with his/her meds.

At the end of each day, we tally the number of patients seen, breaking down as to sex and age grouping as well as aldea or village. At the end of the week, we provide this information to the Honduran Government.

Cape CARES purchases 5-gallon water jugs of potable water. There are small coolers at the site from which we can take water for drinking purposes. We all need a water bottle; we recommend you put your name on it so you can use it throughout the week.

 

We are served meals three times a day by local women who prepare the food on site. The food is very good and local – with excellent cooked vegetables, fresh fruit, tortillas, eggs, beans, chicken and some extras for Americans such as cereal and peanut butter. Laundry service is provided daily. Items to be laundered are picked up by the laundress daily and our clean clothes are returned that same evening. There are showers (water availability varies, however) and toilets separated for Cape CARES personnel and all others. Bedding is stored on site and consists of canvas cots, sheets and a blanket and pillow each. Some air mattresses may be available.

 

The San Marcos living area is fenced-in and nightly security guards patrol. Though we have never had an incident, caution is highly recommended while traveling to and from this site. Many team members awake early and go for a stroll or long walks in the countryside. If you choose to do this, always go in a group and stay together. Do not leave the compound after dark.

 

Los Encinitos

Cape CARES has been providing services to Los Encinitos since approximately 1990. Los Encinitos is a small, relatively isolated, "aldea" or neighborhood of Sabana Grande, (a good sized town, south of Tegucigalpa). The homes are widely spaced out and there is no village center. The nearest neighboring aldea is Rincon, about 1.5 miles away. The elevation is about 2561 feet, and its coordinates are N13.72644 W087.20831. The last 10 miles of our drive leading to Los Encinitos is on a very rough dirt road. Pine trees and scrub oaks are the predominant vegetation in this arid location. The trip takes approximately one hour from Tegucigalpa and usually includes a stop in Sabana Grande.

 

A local nun, Sor Maria Diaz, who has lived there with her family all of her life, hosts Cape CARES. Sor makes our 3 meals per day and arranges to have our laundry done for us. The turn-around time for laundry is about one day, so packing clothes for 2-3 days is sufficient for most people. On our last night, we sometimes go out for a 'farewell' dinner in Tegucigalpa - some people dress up a bit for that. Most people wear scrubs throughout the day at clinic. Bedding, towels and scrubs are provided.

Sor has built a small compound that started out as an orphanage. There are two dormitories - a men's and a women's, both equipped with a primitive shower and toilet, and single cots. Other buildings include medical and dental buildings, a chapel, kitchen and dining area, as well as several other structures. The buildings are constructed primarily of cinderblock, with concrete floors and sheet metal roofs. Because of the relatively enhanced infrastructure and length of time of in-service, this is Cape CARES most developed site. While very rustic, it is comfortable. The site has limited electricity from the grid; rain cisterns and local wells provide water for washing.

 

Drinking water is imported. We suggest you bring a water bottle which you will be able to refill daily at the site. We suggest you use this water for brushing your teeth.

 

Temperatures are generally in the 60's in the early morning and can get up into the 90's in the afternoon, depending on the season. It is often quite windy, with seasonal rainfall occurring mostly between June and October.

 

The brigade spends a ½ day setting up the clinics, typically in the afternoon of the day they arrive, and see patients from 8-5 daily beginning the following day. The patients arrive by foot, donkey and, more recently, by vehicles. They begin lining up outside the gate of the compound around 6:00 a.m. as they are seen on a first-come first-serve basis. They are given registration cards with their names on them at registration and files are kept on site for all registered patients. If they have been to the clinic previously, their card will include their medical history since they began coming to us. Patients are then triaged according to their medical and dental needs. At the conclusion of treatment, the specialist lists the treatment given and the medication, if any, prescribed. Pharmacy personnel provide the patient with his/her meds.
The medical clinic provides a 3rd world version of family practice, following patients over many years and treating for a variety of acute and chronic conditions as well as screening and referral for more serious conditions.

 

Our dental clinic provides an unusually broad variety of services for such an undeveloped area. Oral surgery encompasses about 50% of all visits. Restorative and hygiene account for the majority of the remainder of visits. Some dentists have successfully accomplished endodontics and bonded bridges. We have a good selection of hand instruments for exodontias, operative and hygiene. Dentists need to bring their own 4-hole hand pieces, and each team generally provides its own restorative materials, although backup of most everything is stored on site. Air pressure is provided by a gas powered air compressor. The units are portable ADEC, and instruments are sterilized by autoclave. There is a backup 7500 watt gas generator. The clinic has four portable units to provide hygiene and restorative treatment as well as 2 other portable chairs for OS and exams.

 

 

El Algodonal

Upon arrival at the hotel, we bring the supplies in from the trucks for the night and load them again the next morning for the trip to our clinic. We are based at the hotel because there are no facilities for lodging on site. The ride to the site from the hotel is approximately 40 minutes. We are served breakfast at 6:30 a.m. and leave shortly after 7 a.m. to arrive at the clinic by 8:00.

 

We have been going to El Algodonal two times per year since February 2000. There is no health center in this area and no medical personnel serving the people here. They have to travel quite some distance just to see a nurse in the area. We set up clinic in an old, one-room schoolhouse. A local family is very helpful and offers their house as a place to store our supplies when not on site. The local people bring the supplies, desks, and chairs to the clinic for us, and help set up the clinic. We use the main room for patient treatment and the pharmacy. The veranda has been used by the dentists. An additional room on the east end of the building can be used as an office. (We can give donated school supplies to the school as a thank-you for the use of the building and furniture. We welcome donations of school supplies from team members.)

 

There is no power and we do not have any dental chairs at this time. We use a small stove and a pot to boil water for sterilizing dental instruments. We provide a case of dental instruments as a supplement for any instruments that each dentist might take.

 

The majority of the people come the first three days. Patients are given registration cards with their names on them at registration. If they have been to the clinic previously, their card will include their medical history since they began coming to us. Patients are then triaged according to their medical and dental needs. At the conclusion of treatment, the specialist lists the treatment given and the medication, if any, prescribed. Pharmacy personnel provide the patient with his/her meds.

We break for lunch at noon for a half hour. Since there is no place to cook or buy lunch at the site, we bring non-perishable snacks from home.

If time allows, we visit schools in the outlying aldeas. Since they are quite a distance away, we drive to these areas. We also make house visits for elderly and handicapped patients who are unable to come to the clinic. Our day ends at 4:30 so as to be on the road before it starts to get dark. We leave the equipment set up in the rooms; if we have dentists on the veranda, we bring the dental equipment inside. The place is secure and is watched over by the residents. We cover everything with tarps to protect the supplies from the bat droppings in the night.

 

At the end of each day, we tally the number of patients seen, breaking down as to sex and age grouping as well as aldea or village. At the end of the week, we provide this information to the Honduran Government. We also take inventory of all supplies and remaining medications at the end of the week. This provides the next team with information as to what to bring on the next visit to the site.

 

Back at the hotel, we have dinner which we ordered off the menu earlier that day.