Health clinic visit

Thursday, 6-16-11

Today the St. Boniface delegation went to visit three health clinics in Berlín. Otilia, who is a former member of the Pastoral Team, works at the clinics and agreed to show them around. The first clinic we visited is in the main part of Berlin and very close to the house. It is a free community clinic and provides only the most basic services If someone needs more advanced treatment then they are sent to a hospital in a nearby city. It is funded by the Ministerio of Salud (Ministry of Health) which is a government organization. The people from Berlín go to the clinic as do people from the surrounding cantons.

When you walk in you go to the registration area first. You fill out a paper that asks for personal information such as your name, age, parents’ names, and other details. All the information is put in a file and stored in their file room. After that you are assigned to one of three waiting rooms. There are three doctors at a time in the clinic and each has their own waiting room. They each see about 60 patients a day. There are several other rooms at the clinic such as a pharmacy, recovery room, vaccination room, rehydration room, sterilization room, and a psychologist’s office. None of the rooms are very big and the pharmacy has only basic medications. Sometimes they have to send patients to other hospitals because of the lack of medications.

The doctors and health promoters at the clinics also make house calls. The municipality of Berlín (including the cantons). The municipality is broken up into 6 areas and people are assigned to those areas. They go to homes to administer flu shots and try to educate people about their health. They also go into the schools to do vaccinations. After our brief tour we headed off to our next destination.

The clinic in Berlin

Plaque in honor of Luxembourg who financed the building

Otilia in the clinic

One of the vaccination rooms

Poster about diarrhea, which is

something very common in children

Signs explaining the different areas the clinic serves

Otilia with the St. Boniface crew

A little boy at the clinic

Freddy, Cecilia's nephew

The next place we went was a small clinic in the canton of San Jose that opened 3 months ago. The clinic serves the cantons of San Jose, San Lorenzo, and Concepción. They also serve the caseríos of Zapote, Menéndez, and part of Alejandría which are all a part of the canton of San Francisco. The clinic is open 1 day a week to serve people in those areas. It has some of the same services and programs as the big clinic in Berlín such as vaccinations, pregnancy help, and basic exams. There are 6 people who work at the clinic and three of them are health promoters. The health promoters are the ones who go into the communities they serve to educate people and give vaccinations. In total, the clinic serves 600 families, which are about 200 per health promoter.

One obstacle that the health promoters face is that they don’t have a specific car to drive when they visit people in the cantons. They drive only when they have gas. Otherwise they have to walk, which is hard enough considering the conditions of the roads and the distance they need to walk. But when they have to carry equipment to houses it’s even harder to reach people. Another obstacle they face is lack of funding. While the Ministry of Health provides the medications for the clinic, everything else they need is up to them to acquire. After hearing the nurse and Otilia talk about the clinic we moved on.

The clinic in San Jose

Health comes to your family

Poster with the different vaccination pictures on it

Vaccination schedule

Poster about eliminating mosquitoes

Table inside the clinic

Jerry with Otilia and a nurse

The final clinic we were visiting was in the canton of San Lorenzo. This clinic was recently opened by Otilia who is a health promoter and lives in San Lorenzo. The focus at this clinic is pregnant women, children under 5, and people who have a hard time leaving their homes. She educates people about health such as how to take care of themselves, knowing when they should take medication, and knowing what kind of medication they should take. She can also give people vaccinations they need or injections after they return home from the hospital.

Otilia is paid by the Ministry of Health because she works at the Berlín clinic; she doesn’t get paid for her work at the little clinic. Her bosses gave her permission to open the little clinic in San Lorenzo but it’s not an “official” health clinic. There is medication stored at this clinic for emergencies and accidents. As with the clinic in San Jose, Otilia gets around as best she can. She’s able to use a car but sometimes she has to walk.

We also discussed what happens when someone needs to go to the hospital or has a serious accident. People in the cantons get to the hospital any way they can. Most people do not have a vehicle. If they can get a ride from someone else that person can take them from San Lorenzo to the hospital. Otherwise, they have to first get to Berlín, either by walking or maybe a motortaxi will pick them up. From Berlín, they can take a bus to the hospital. And occasionally an ambulance can be called to pick someone up.

Thankfully, each canton has a health committee who plans ahead for accidents and emergencies. The health committee is trained by a health promoter. One thing the health committee does is keeps track of pregnant women and when they are getting close to delivery. If someone gets hurt when they’re working on a finca (coffee farm) they can call the health promoter or owner of the finca and the owner can take them to the hospital.

In front of the clinic in San Lorenzo

The health committee of San Lorenzo

Listening to Otilia

Cot inside the clinic

Sign about hygiene to prevent diseases and sickness

Medications stored in the clinic

Chatting with the community

When we’d finished talking about the clinic they opened up the Catholic church in town so we could look inside. I’ve seen the church several times but I’d never been inside before. It was a small but beautiful church. Someone told me that they went inside the church once and a bunch of bats flew out. I looked up at the ceiling for some but didn’t see any. Bummer.

As we were leaving the church the health committee came walking down the hill carrying a large guacal full of enchiladas for us. Yum! They gave each of us two enchiladas and some Coke. It was their way of saying “thank you” for visiting the clinic. The enchiladas were absolutely delicious but most of us could only eat one. We chatted a little longer and then said goodbye to everyone. It was time to get back to the house for lunch!

Inside the church

The altar

Looking out the front door

Everyone inside the church

Old pews

The church bell

Window of the church

Guanaba (Guanabana) growing in a nearby tree

Carrying our snack

Enchiladas

Cute little boy

Speaking on behalf of the health committee

Passing out the food

In front of the clinic