Sunday, June 1, 2014

Public hospital

So, I want to record my first experience in the public hospital. When we arrived at the Pediatric emergency room, it was just a small waiting room with several desks for doctors to see patients. The line was on a bench and that was how you were seen. If you arrive around lunch time, forget being seen for at least 2 hours. If it's a true emergency, you will probably die before anyone gets around to seeing you. They have many medical students all over the hospital to help, but they all have to be supervised in what they do, even-though they are a huge help since there is such a lack of personnel. They lack so much staffing for as many patients as they see. If you don't know how the system works, you can be yelled at easily by the secretary, and even called a liar.
When they brought us to see the oncologist, the medical student took us through the actual pediatric ER where all the patients were. Yajaira started crying hysterically as I wanted to as well. There were so many kids on ventilators, someone breathing for them, tubes going everywhere and screaming constantly. They only accept 3 children in the pediatric ICU, so the rest are admitted to the emergency room, where they have way less than ICU type care. Also, the pediatric unit upstairs was full as well as the cancer ward. So many sick kids that sometimes they are 3 to a bed. 3 sick kids in one bed!!! Horrible! The doctors start the IVs, draw blood for labs, etc. They have like 2 nurses for about 30 inpatient kids in the ER. This is where they wanted to admit Yajaira to keep her overnight. I am so glad we got to take her home. I think just the stress of being there would have made her even more sick.
The general ER overflow is in the hallway that goes to the lab and X-ray area. If you have a bed, it surely doesn't have sheets or a pillow. If you don't want to sleep on a plastic bed mat, you have to bring your own sheet. There are many sick patients and just not enough staff or space to attend to them.
So, my perception of the public hospitals was that the healthcare was free. This is not the case. If you are poor, this is where you go, but it is not free. Many things that the doctors order require money, and sometimes lots. Any hardware for orthopedic surgeries, you could  pay up to $1000 for. An x-ray we had done cost like $2.50. The CT scan they ordered costs about $70. They had one done in La Ceiba at a private hospital and it was like $225, so it's significantly cheaper, but not free. Medications that the hospital doesn't have, you have to purchase.  Honduras doesn't have many medications right now, including no medication in the entire country to treat Tuberculosis, so patients are having to buy more than usual.
So, many people bring their family members from far away (3-4 hours) to the hospital and they admit them. Only one person can stay with the family member on the ward, so everyone else lives outside sleeping on cardboard boxes or straw mats under the trees until their loved one is release from the hospital and they can take them home. Many of the bathroom stalls have no doors, and sometimes the shower stalls also. You can't find toilet paper or soap anywhere, so if you have to go to the bathroom, you better bring your own.
If there is a woman in labor, only she can go into the hospital, mothers, and husbands, etc have to wait outside to see the list of deliveries to see when their wife delivered and their child was born.
There are guards at every entrance and they only let people in if you have a specific reason to be there. I didn't have any problems with the guards thankfully and they let me in usually whenever I asked.
With Yajaira being associated now with the Children's cancer foundation, her Chemo drugs will be free and they will also help her with bus fares, and testing. It's a wonderful program that I am so happy to see that it exists. This is truly a wonderful gift to the children of Honduras.
This is just a small glimpse of what I saw that past week. I am sure it doesn't even begin to touch the reality of what is.

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