Hillside Staff

The work that we are doing now in southern Belize is possible because of the Hillside Health Care International.  Everyday, one of us has a team who sees patients in our main clinic in Eldridgeville, outside of Punta Gorda and the other one takes another team into one of the remote villages to set up clinic there.  We have 6 - 8 medical students, 3 pharmacy students and occasionally a couple of physical therapy students that rotate with us for 4 weeks at a time and are the extra hands in the work.  We also occasionally have short-term providers like physicians, physician assistants and nurse practitioners who volunteer anywhere from a week or more.  (Although as it heads into winter in the U.S., we have had a lot of inquiries from people who would like to volunteer during January or February!).   We also have a  physical therapist, pharmacist and nurse from the U.S. who are volunteering here for 1 year each.  Our nurse works with us (Bill has mainly taken this role) to care for our 50 - 60 homebound patients around the Punta Gorda area.  Our pharmacist helps me keep our pharmacy running smoothly.  She and I are working right now on a system to keep our pharmacy stocked with a very basic formulary from donated medications and ones that we can buy inexpensively from other organizations that provide medications at lower costs to mission clinics.

None of this would be possible without our Belizean support staff who are with us day after day.  Because the organization is small but we are covering a huge geographical area as well as large patient base, many of them are crossed trained to check blood pressures, draw blood, translate for Q'eqchi' or Mopan Maya and act as a liaison for us in the Maya villages.  They work with us in our main clinic but at least 2 accompany us everyday on mobile clinics into the villages - even the handful of clinics we do every month that require an overnight trip, sleeping on the floor without electricity or running water.  Wages are not high in Belize when compared to the U.S. but jobs in the Toledo district are scarce and they all seem very thankful to work for Hillside.  One of the goals of Hillside is not only to provide a few jobs for the local people but to provide training as well so that they become qualified to provide excellent healthcare to their fellow Belizeans.  Hillside is currently paying for Alva and Alfia to take an online pharmacy tech course from the U.S. (it is not available in Belize) so that they will be certified.  Floracita has recently completed hands-on training with our physical therapist and is now doing restorative therapy work with our homebound patients.  Jennie is in nursing school on a scholarship from Hillside with the understanding that when she finishes her degree, she will come back and work at Hillside for at least a few years.  Victor did well on his high school exit exams and has expressed that he would like to be a physician.  We have started talks with him about Hillside providing a scholarship for his university coursework which is required to apply for medical school (there are very few Belizean doctors but the government does pay for them to be trained in Cuba if they qualify).

Last week the president of Hillside's board and our Stateside director came down for the week to see how things were running now that we have taken over as the medical directors.  It is nice to report that they thought things are running as smoothly as they can in a third-world country with limited resources!  At the end of the week, they provided us with a rare treat of lunch out with all the staff and spending a couple of hours together away from clinic duties.  Hopefully these photos will allow you to better envision our team here in Belize.

Hillside Staff (left to right)
Top Row:   Victor (clinic intake and translator), Everett (head of maintenance), Annette (physical therapist volunteer)

Back Row:   Randy (night watchman), Rudy (driver and community liaison), Celia (nurse volunteer), Amelia (housekeeper), Leslie (clinic intake and driver), Bill, Angela, Alva (pharmacy supervisor and tech)
Front Row:   Joyce (clinic administrator), Polly (administrative assistant), Alfia (clinic intake, supervisor and translator), Floracita (physical therapy tech), Carmelita (clinic intake and translator), Jennie (clinic intake, translator and nursing student)
Not pictured:  Natalie (pharmacist volunteer) (she is the Caucasian woman in blue scrubs at the far end of the table in the first photo)

~Yes, Bill does joke that he came to Belize so that he would not feel so short~

First Times

One of the adventures of travel is the ability to experience things outside of your comfort zone. There can be many first-time experiences as you discover your new surroundings.  Some firsts are anticipated or even expected while some catch you by surprise.  Some first experiences are lost in the sheer monotony of the repeated experience.  I really don't remember the first time I realized that an ant was crawling up my arm as it is an everyday, frequent experience in this new environment.  While there are far fewer first-time experiences these days, I have had a few notable ones recently.

While seeing patients in a remote village, I performed my first full pelvic exam on a woman while she was lying in a hammock in a dark Maya hut using a headlamp for light:
When out in the villages, we often see patients in an open room or out under an open thatched roof.  If we cannot find a private area for an exam, we will climb into the back of the Land Cruiser and use the back bench seats while covering the windows with sheets.  During my encounter with this woman, I realized that I really needed to do a pelvic exam to rule out some concerning things based on her symptoms.  She refused to be examined in the Land Cruiser and said that she would only let me examine her in her own home.  So a medical student and I set out  to follow her across the village.  We eventually came to her thatched roof hut.  It was a typical Maya hut with no electricity, no windows and with hammocks strung from post to post that function as both couches, chairs and beds.  She was much more comfortable in her own hammock and home and although technically challenging, she allowed me to do an adequate exam.  Definitely a first for me.

In the remote villages, transportation is an important factor in our delivery of healthcare and sometimes I am amazed by the people's ability to get around despite the lack of vehicles or decent roads.  Seeing a wheelbarrow ambulance was definitely a first for me:

While out in another remote village, a woman came to the clinic where we were seeing patients and asked me to come and see her mother-in-law because she was too sick to walk.  Again, a medical student and I gathered up some medical equipment and walked across the village to a Maya hut.  When we arrived, many of the family had gathered around an elderly woman lying on a wooden platform bed.  She had been hospitalized in Punta Gorda several weeks earlier with abdominal pain but they did not know what was causing it so they sent her home and told her to come back into town when a radiologist came down from Belize City (once a month) with an ultrasound.  That appointment was still several days away when her abdominal pain began increasing and she developed a fever.  The family debated taking her into Punta Gorda but knew we were coming the next day and so decided to wait for us to evaluate her.  On exam, she had a temperature of 102 with a low blood pressure, high pulse and what we call an acute abdomen - tender with guarding as well as rebound tenderness.  She definitely needed surgery.  I was also able to feel a large, firm mass in the right lower quadrant of her belly.  We needed to get her to a surgeon right away. 

This village is so remote that there is not a road that goes into it.  After a almost 2 hour drive, we park the Land Cruiser and have to carry all of our medications and clinic supplies across a river and then a half mile into town.  I told the family that if they were able to get her to our Land Cruiser then we would take her into Punta Gorda to the hospital where she could then be loaded in an ambulance for the 2 1/2 hour drive north to Dangriga where there is a surgeon.  I was not quite sure how they were going to do it but as we were carrying our things out of the village, here they come pushing her in a wheelbarrow.  Her sons pushed her all the way to the river and then carried her across to our Land Cruiser.  We were able to put her in the front seat and take her into the hospital for care.

Another first-time has nothing to do with medicine but is equally notable in my book.  It is my first experience of gourmet food in Belize:

Hopefully no local Belizeans will read this and take offense because there are some fabulous cooks around here and rice and beans from them is definitely better than rice and beans from an average cook.  Also, while I love the hot, corn tortillas they make on an open fire in the villages, I have missed a variety of foods and complex flavors.  It can be very depressing trying to buy groceries or plan meals as the largest grocery store in the whole district is about the size of a convenient store in the U.S.  There are plenty of bananas and pineapples but there are few vegetables and basically produce is only sold at the open air market on Monday, Wednesday, Friday and Saturday mornings.  The boys will often talk about the restaurants they wish we could go to or the familiar foods they are craving.  After the first month, I have not allowed myself to think about food from the U.S. and have worked on learning to make cookies and treats with what we have here and perfecting my Belizean rice and beans.

Then Juan came to visit.  Juan is our chef friend from the U.S. who has been living in Honduras for the past 6 months volunteering at an orphanage.  He has made us wonderful meals in the past and I wrote him several months ago about my cooking quandary and asked his advice.  He caught the ferry from Honduras over to Independence, Belize and then rode a bus into Punta Gorda for a visit this week.  We have really enjoyed showing him some of Belize and I love his reaction to our food situation.  We of course fed him rice and beans his first evening here and then the next day while I was at clinic, he and Will walked into town to shop for food.  Even he was amazed by our limited supply of food choices but took the challenge in stride and made us a wonderful gourmet meal for dinner tonight.  I was able to find a bottle of wine in town to serve in our one wine glass and we had quite the feast:  mac 'n' cheese fritters topped with roasted whole onions covered in coconut curry sauce.  A first for Belize but it was awesome and beats rice and beans any day!!!

Settling In

Things are continuing to move along in Belize and I am sorry for my lack of communication but I have been working at really settling in.  Our things have been unpacked and settled in the house for awhile and I know the clinic and mobile routines but it is the mental adjustment that we really are going to be living here for at least the next 2 years.  It is one thing to spend a few weeks working in a strange place with inconveniences but at some point there comes a realization that you are not going back to the known, the comfortable anytime soon.  Even though I have moved frequently in my life, it has never been easy for me.  This move has also been particularly challenging both mentally and physically.  

It has not helped that Quinn has struggled in his new school.  Fortunately, a new couple arrived from the U.S. a week ago to work with us for the next year.  She is a pharmacist and they have three boys (the youngest is only 7 weeks old!). The older two boys are aged 6 and 4 and Quinn bonded with them immediately.  They enrolled in the same school as Quinn and even though are not in his class, it has given him a bit more confidence and security.   He is also not quite the novelty that he was and the other kids seem to be more accepting of him.  It is still a daily challenge to help him adapt to such different surroundings and culture.

This week I was upstairs in the kitchenette at the clinic and noticed something taped on the cabinet that I had not seen before.  It is simply written but seemed very applicable to me:

When the space is cramped,

and the shower is cold,

and my sunburn really stings,

When my stress is high and my patience low,

and I'm sick of rice and beans.

When mosquitoes sting and sand fleas bite,

and I spend the night a-itchin'.

When the sight of bugs and the threat of lice

is enough to set me twitchin'.

When the mud's waist deep,

and the power goes out,

and the water's just a drip,

and I wonder why I ever thought

I'd enjoy this sort of trip.

When several women share the shower;

wash undies in the sink,

And an internet that's often down

Is my only Stateside link.

When I want to scream, and I want to cry,

and I'm ready to complain.

I'll remember that in all these things,

I'm to praise His Holy Name.

I will set aside my petty needs;

and pray for a servant's soul.

And a mind that doesn't dwell on me

will be my greatest goal.

And when it's done, I'll see I changed,

but only through His grace.

For when I served the "least of these,"

I saw God's holy face!

- By Jackie Schmidt (founder of Hillside)

In the Maya village of Jalacte