Some of the Honduran patients standing in line at Clinica Medica to see the team of U.S. medical personnel had been on waiting lists for years. It was an eye-opening experience for Lauryn Przeslawski, DO, a third-year ob-gyn resident at Metro Health in Cleveland, Ohio, and member of the healthcare team that traveled to Honduras on a medical mission coordinated by the Luke Society.
There was a woman with severe vaginal prolapse, so pronounced that her uterus nearly reached her knee. In the U.S., it was a condition easily remedied after a vaginal tear at childbirth. But with multiple deliveries, and in the absence of consistent medical care, a routine medical issue can become a significant abnormality.
“To see some of the conditions there, and to see the lack of resources, truly puts things into perspective,” says Dr. Przeslawski.
In Honduras, for every 1,000 patients there are 0.37 doctors to provide care to them, according to the Centers for Disease Control and Prevention, The World Bank reports that of the 8.7 million residents of Honduras, 63 percent were below the national poverty line in 2015. At Clinica Medica, there is only one physician present year-round.
Dr. Przeslawski’s attending, Steven Lown, DO, a 23-year ob-gyn, has made two prior mission trips to Honduras through the Luke Society, a Christian-based group. For each Honduras International rotation, Dr. Lown selects a third-year ob-gyn resident. The eight-day rotation is designed to meet the Accreditation Council for Graduate Medical Education (ACGME’s) six core competencies: practice-based learning and improvement, patient care and procedural skills, systems-based practice, medical knowledge, interpersonal and communication skills and professionalism.
According to the rotation objectives, residents are expected to gain valuable insight into the following areas:
- Awareness of the medical limitations within an underserved region of the world
- Improved surgical skills, including more complicated cases not commonly encountered at a community hospital
- Experience working with non-English speaking patients
- Learn and improve non-verbal communication
- Learn to evaluate surgical candidates to determine what is most appropriate
- Experience triaging surgical candidates
- Experience with more complex pathologies
A modest clinic
In the small clinic where the team saw patients, there were just two patient rooms, two consult rooms which nearly opened to the outside, along with an older model ultrasound machine. There were also two operating rooms and one recovery room.
“On the first day we saw 30 to 40 patients, as many patients as we could,” Dr. Przeslawski says. “We prioritized those candidates who needed surgery. We performed surgery over the next three days for about 20 of those patients.”
Standing in that line outside were women who’d come from miles away, many by foot. The woman with the severe vaginal prolapse was able to be helped. For years, she’d worn long dresses to hide her condition, which had gotten progressively worse.
“In many cases, a woman would have a baby, experience a bad tear, and never have the resources or access to get it repaired,” Dr. Przeslawski says. “After multiple births, the prolapse would get worse. In those cases, something simple becomes severe. It was devastating to see people live like that.”
Power of being heard, touched
“We were able to help her and that was a great thing, but there were others that we could not,” Dr. Przeslawski says. “One woman’s blood pressure was too high for surgery so we were unable to help her in that way. But she was, like so many others, just thankful to be seen. To be heard.”
Despite the language barrier—nearly all the patients spoke Spanish only—they understood being cared for, Dr. Przeslawski says.
“As a DO, it doesn’t matter if you can communicate in the same language. The power of touch is global. It’s compassionate care. It’s the sort of holistic medicine and training that I learned throughout school. It’s about helping the mind, body and spirit.”