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Ahuas, Gracias a Dios, Honduras: Travel Nursing in a Rural Hospital

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Dr. Ovelio, Hannah Patzke, and patient in la sala operatoria at Clinica Evan- gelica Moravia. Photo courtesy of Hannah Patzke

By Hannah Patzke

“Ispara ai klakan, doctor. Latwan, doctor. Latwan!”

“The machete cut me, doctor. It hurts, doctor. It hurts!”  I heard the cry ringing through the halls of our tiny rural hospital in Ahuas, Honduras, and I knew I needed to get ready to scrub into surgery.  Already that week, we’d had three people come in with serious tendon damage from machete wounds.  

Machetes (or ispara as they are called in Miskito) are the tools of choice for many laborers here in La Moskitia.  Farming, cutting grass, harvesting yucca, splitting open a coconut — everything is done with the machete.  Boys of barely 4 years of age are already wielding these giant blades to cut grass.  

Our first case of the day was indeed 4 years old.   The machete had sliced through his palm and severed his fourth and fifth fingers.  His pinky finger was only barely attached to the ring finger.  

The ring finger had been amputated completely through the bone, but a flexor tendon was still attached, and there was some blood flow to the digit.  Somewhat miraculously, the pinkie finger also had capillary refill, although we could not see how.  

The doctors scrubbed in, and I monitored the tiny patient and administered ketamine as needed.  Despite six years of Intensive Care Unit experience, I felt a small surge of nausea watching the torn fingers flop about as they were bathed in Betadine.  It was the first time something has affected me like that since nursing school.  

Soon my interest overcame this slight weakness, and I was amazed yet again at the skill the doctors here possess with tendon repair.  Each finger had multiple points of reattachment, and sometimes the tendons were not readily obvious.  Torn ends had to be sought out from where they had retracted into the tissue.  

It took three hours, but at the end, both fingers were attached and pink.  The child spent several days in the hospital receiving antibiotics, and then was sent home with his mother and physical therapy instructions for his hand.  I hear from the nurses that he is able to use all five fingers.

My experiences volunteering at the Ahuas hospital were unpredictable and diverse.  One day I might work in the clinic helping the nurses with vitals and triage all day.  The next I might spend monitoring women in labor or doing administrative work. 

I could tell a hundred stories of the various compelling experiences I had during that summer.  Does volunteering in a developing country actually make a difference?  I do not know.  The people I was able to meet and help were warm, grateful and welcomed me into their lives.  All I know is that my life was certainly changed for the better.

Hannah Patzke is a first-year student in the Advanced Practice Public Health Nursing program.

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