On our first morning in Honduras, we leave the hotel, taking with us our luggage and all supplies, and make anearly 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.
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 one blanket and pillow per cot. Some air mattresses may be available.
The San Marcos living area is fenced-in and nightly security guards patrol. We always exercise caution while traveling to and from this site. Many team members awake early and go for a hike or walk in the countryside. If you choose to do this, go as a group, and ask one of our security people to accompany you. Our security people feel an obligation to protect us, and are most willing to join in on a hike. Do not leave the compound after dark.
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 2,561 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 Ignacia 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 and towels are provided. You may also find scrubs available for your use at the site.
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 beds. 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 5:00 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 Third 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.