Our flights leave Sunday. It's Saturday. How was I supposed to react? Wasn't it Monday, like, two days ago? What if I don't want to go home? I'm scared to go back! Should I be thinking about my last day here? Or should I be thinking about how to manage my first days back at CMU? What if I go back and am unhappy compared to how I feel now? I decided to think about my time left in Honduras. There will be time later for the worries and emotions of school. Korey and I decided this would be a perfect day to throw a frisbee off the side of a mountain. Part of the trench we were building was on the side of a hill, or what I would call a small mountain compared to my Midwestern hometown. Korey and I had bonded during the trip, especially during many of the
bus rides. We agreed that there are some aspects of Central American life that we would like to see translate into our lives back in the states. Myself, I love the relaxed attitude throughout the region. I like that time is more often improvised in Honduras than in the US, where everything is scheduled. I know Korey loved the hammocks, as did most of our brigade group. People always talk about the importance of balance in life, and our time in Honduras illustrated for me that
sought-after balance. The trick would be to bring that balance into my life at CMU. But, like I said, right now we were still in Honduras, and Honduras is where I wanted my mind to be for that last day. Rather than digging the trench, my job on the last day was to lay down the piping. I was glad, because digging trenches is not my forte. The water system withdrew water from a pozo, a well, which was by the church. The water would be purified and pumped into the reservoir at
the top of the 'mountain' where Korey and I had been throwing the frisbee. From there, water was distributed to the community, driven by gravity. This means the reservoir had to be higher than any of the houses it would be connected to. The community members would only have access to the water a couple of times a week, and they would have to pay a low monthly fee to run and maintain the system. Despite these limitations, the community was very happy to have this pozo and system
put in place.
Laying the piping was not as physically demanding as digging a trench, but it had to be done correctly and quickly the first time, or else the PVC glue would dry with the pipes in the wrong position. We were a few brigaders, girls, working with a few brigade staff members. Joel
was one of the staff members. I was excited to be working with him in part because he seemed cool, if quieter, and in part because he didn't speak much English. I was excited that I could only speak Spanish with him. We also worked with Mario. He told us about his recent wedding
and it was adorable. We were able to finish what had been started of the piping that ran down the 'mountain,' and get a good start on the piping on the side of the road, running towards the community. The rest of the group had been covering the piping we were laying down, and our final task in the community was to finish covering all the piping we had laid.
With the piping laid and covered, we met with members of the community at the pozo. A water well drilling rig, essentially a giant drill, had been set up and was drilling for water. Joel explained how it worked to me at one point, and this is what I remember: The drill could dig about 300ft deep (or it might have been meters…) by adding 30ft (or meter) cylinders to the desired depth. It drilled through the earth, using mud to extract the chipped rock and earth. The drill would push air into the hole, to avoid creating a vacuum.
Finally, clean water started to come up from the drill, and it was exactly like all the inspirational videos you see about access to water in underdeveloped areas. People put their hands and heads under the stream. We were told the water was about 70-80% purified, which was better than the water the community had access to. We said our goodbyes and thank yous at the pozo. A community leader talked about how much this meant to him. I spoke about how much this meant to me as well as to the group, and thanked the community for welcoming us whole-heartedly. I also thanked the brigades staff for working so well with us, and the other CMU students for the fun we had and the support they provided.
Back at the compound, Vilma gave each of us a bowl or cup made from jícara, a fruit that makes a delicious juice, with a hard carcass that can be dried and used for things like bowls and cups. We had an excellent reflection that night. We talked about the implications of our work and the impact we were making. People questioned how much of an impact we were making, and in what ways. We talked about how this experience will influence our careers and our contribution to the world. We all agreed that this had been a wonderful trip. We were leaving in the morning. We would take with us a rich, new memories. In particular, I was happy that I would still have these eye-opening
friends with me back at CMU.
- Holly Stein, Brigader
In the spirit of 'work hard, play hard,' our brigade group spent the first half of the day on Friday digging the trench, and the second half swimming. Tintin and I had been working well together for the past couple days. By this point, we knew what we were doing. So to spice things up a bit, we decided to sing to each other. I started out with the piocha, the pick-axe, while she softly sang in Chinese. We switched. She lifted out the dirt I had loosened while I sang her a Spanish children's song about a small mammoth who learns to fly. The morning drifted by. We hit a patch of rocks, and the community members who were working alongside us stepped in with a barra, a pry bar. The friendliest of the community members was Martín who had spent nine years in the US and was eager to practice his English. Seeing as Tintin did not speak Spanish, this was not a problem. I enjoyed talking to him. However, this common story, going to the US to work and then finding yourself back in the Honduras, takes on a new perspective when it is told in Honduras, rather than in the US. In this context, we had the foreign habits, language, and lifestyle.
We left the community after lunch. Soon we were on boats heading for Isla el Tigre, Tiger Island. One of the Brigades staff members showed us that there was a picture of Isla el Tigre on the back of the 2 Lempira bill. On the island, we found ourselves in the back of trucks, driving on roads that twisted up and down, past houses, through towns. The ride was pleasant, the breeze was soothing, the company couldn't have been better. We enjoyed our bonding time at the beach. We might have spent that time working on the trench, and that is something many of the brigaders brought up at our nightly reflection. It brings into question our role as brigaders. Another afternoon of difficult manual labor would have left us physically and mentally exhausted. Instead we took the time to relax and reenergize. In my opinion, this afternoon off was much needed and a productive use of our time. Happy, healthy brigaders makes for a sustainable program.
The day ended with our second and final noche romantica. This was a small party put on by the hotel where we were staying. Friday was probably the day that most resembled a steretypical college spring break trip, with an afternoon at the beach and a carefree evening spent enjoying each other's company.
- Holly Stein, Brigader
Yesterday was more of a relaxing day because we only visited the community and discussed how we were going to implement this new water system. Today was a work day.
Our main task was to dig trenches for the pipes along the side of the road. We all grabbed shovels, pickaxes, and gloves, and went to work straightaway. We paired up so that we could take turns pickaxing and shoveling. The trenches had to be about 2 feet deep and 1 feet wide, which was much easier said than done, especially in rocky areas.
It was extremely interesting how the community members who worked with us reacted to us being there. Of course, it took us a while to learn how to dig the trenches in the most efficient way possible. They would complete the same amount of work we would in half the time. They made it look so easy! At one point, eight of the community members came over and watched one of us attempt to pickaxe, chuckling to themselves. It must have also been different for them to see all the girls participate as well, since none of the women in the community was there to dig.
We dug in the morning, took a break for lunch, and then resumed digging in the afternoon. All in all, it was just hard work. Fact: temperatures were actually hovering around 100 degrees Fahrenheit while we were working! Despite the physical strain and hot temperatures, we all managed to pull through and finish our own trenches, which covered quite a long stretch of the road.
We also played soccer with the rest of the community after we were done. Junquillo had a women's soccer team that played against us and another brigade (who were also working in the community at the same time). The guys had their game too. It was great to finally be able to interact with the kids from the community and cheer together from the sidelines of the field. The girls ended up tying 1-1 and our boys lost 1-2. Either way, it was a great and relaxing way to end our day.
- Anna Zhang, Brigader
Day 5 marks the start of the second half of our hybrid brigade. The past three days of running clinics was very rewarding but now it’s time for the water brigade. We all knew what we were getting into when we started the water brigade. It was going to be touch manual labor digging trenches. But that wouldn’t be until the next day. Today was all about becoming familiar with the water project and get a grasp of the big picture of the project.
After breakfast, we set off to the community of El Junquillo, where Global Brigades was building this water system. The design plan for the system was something like this. A well would be drilled and mated to a pump system. The water from the well would be pumped through a network of pipes laid about 2 feet underground to a water reservoir tank at one of the highest elevations of the community. After the water is treated and tested, gravity would distribute the water from the tank to the houses. The idea was that the pump would only have to be turned on several hours a week.
To kick off our tour of El Junquillo, we were brought to the top of the mountain where the reservoir was going to be placed. They showed us the line where the trenches for the pipe would be dug and a stake where the tank would be built. When we got back to the bottom, they showed us where the well would be built and the tool they’d be using to dig, a large red truck with a towering shaft and drill.
After lunch we split into two groups to do house tours. This gives us an opportunity to observe the way the local community members do their day to day tasks. We were very grateful that two community members volunteered to show their homes to us. The homes several rooms ranging from a living area with hammocks, bedroom, and kitchen. One thing that confused us was that there were two ovens in the kitchen. Our host explained to us that a previous volunteer group came to their community and installed newer eco ovens. The problem with the old ovens was that it filled the entire house with smoke which can lead to numerous health issues. The newer ovens had a vent that brought all the smoke outside and heats the oven more efficiently.
- Allen Kim, Brigadier
Today was the third and final day of the medical portion of our brigade. We went to a new community called Apacilagua that had a breathtaking view of the nearby mountains.
Again, we had the same stations as before: Triage, Dental, Gynecology, Pharmacy, etc. I think one of the biggest differences between Apacilagua and Pueblo Nuevo was the organization. It was a bit hectic at Pueblo Nuevo because both we and the community were new at this. At Apacilagua, we had a much bigger space to work with and community members who have gone to previous Global Medical Brigades clinics. It was much more organized here.
In the end, we learned from the DI system that in one day at Apacilagua, we served approximately four hundred people, almost twice as much as the people who came to Pueblo Nuevo over the course of two days. It was an amazing accomplishment and brought the total of how many people we served on the brigade to roughy 950!
- Anna Zhang, Brigadier
We went back to Pueblo Nuevo today to continue the medical portion of our brigade. Since today was the second day, we all felt much more comfortable because we knew what we were doing and what we needed to change from yesterday to make the whole clinical process as smooth as possible.
We had the exact same stations as yesterday, only people shifted around to try new stations.
I did, however, forget to mention the DI station earlier. At this station, we inputted patient information into an online system. The system also told us, that over the course of two days, we saw roughly 500 people at the clinic!!!
Our evening reflection, during which we gather as a group daily to discuss the day's events, that night was extremely positive. Everyone was proud of the work they'd done and shared stories of shadowing experiences as well as of the people they met. Although today was the last day we had at Pueblo Nuevo, we were all super pumped to visit a new community, Apacilagua, tomorrow because we now know how to run the clinic as efficiently as we possibly can. We had all grown very close to each other at this point, and were excited to see what we could do together at Apacilagua the next day.
- Anna Zhang, Brigadier
Today was the big day.
It was the first day of the medical portion of the brigade. We had been preparing for this day ever since our first meeting back in September. We've been hosting Rite Aid drives to collect medicine, contacting local pharmacies and doctors for donations, and counting pills. We've reenacted and gone through every station at the clinic and practiced Spanish with each other to make sure we knew what we were going to say.
When we arrived at Pueblo Nuevo bright and early in the morning, there was already a large group of people waiting for the clinic. We set up as fast as we could and began to see people about an hour later.
We had several stations that the patients had to go through. The first station was Triage, where we basically conducted a pre-evaluation. We asked about symptoms and pains, and took down blood pressure for the adults and weight and height for the children. The patient would then see the doctor. We worked with two physicians: one was a volunteer from Global Medical Brigades, and the other one, Dr. Pacheco, is actually the father of one of our brigadiers! We would have a brigadier shadow the doctor by observing and helping form diagnoses. From there, the patient had several options. He or she could see the gynecologist, dentist, or retrieve their medications at the Pharmacy. In gynecology, it was interesting to see how the patients trusted us to work with the gynecologist. At the dental clinic, both the dentists, Paul and Kevin, actually allowed us to assist with tooth extractions and fillings. Furthermore, they took the time to occasionally pause and explain to us exactly what they were doing. We also held dental charlas for the kids. We gave out toothbrush and toothpaste packs and taught them how to keep their teeth healthy and strong. The last station the patients would visit was the Pharmacy. We had suitcases and boxes filled with medications sorted in one of the bigger rooms. As brigadiers, we were responsible for putting together prescriptions by finding them and giving them to the pharmacist to double check. We would then distribute them to the patients waiting outside.
As predicted, the first day was quite busy and hectic. It was, however, a great start to the medical portion of the brigade. We all couldn't wait to come back tomorrow.
- Anna Zhang, Brigadier
On Saturday, we spent a large chunk of our day counting and sorting the medication that we brought to Honduras. This is one of the longest processes as we prepare for the clinics and must take place in country since we are prohibited from bringing bulk medication that is opened on to the plane. Almost all the medication that we brought were in bottles that had pills in multiples of 40, 60, 100… you know, the standard over the counter stuff you get from the pharmacy. Our task was to pack little zip lock bags with enough medicine to last a patient for three months. This supply should be sufficient until the next brigade visits them. Each bag is labeled with the name of the medication, quantity, and prescribed dosage.
Just to reiterate, this process took a lot of time. All 28 of our brigades and the doctor we brought along spend hours that Saturday counting and sorting. I don’t know the breakdown of all the medications that we had to sort but the first medication I was tasked with was Ibuprofen. Four of my fellow Brigaders were recruited to help count the Ibuprofen with me. Even with five of us working together, it took us a little over an hour to count, bag, and label all the Ibuprofen. And Ibuprofen was only a fraction of the medication that we brought along. This process really gives me an appreciation for the hours that we spent running pharmacy drives in front of Rite-aid. Above that, we really have to thank everyone who supported our cause and donated medication for us.
In case you’re not a pharmacist and not familiar with the tools that they use count medication, check out the pictures below and you'll see us using these blue trays. They’re called pill counting trays and they’re very simple to use. Pour the pills from the bottle onto the flat area of the counter. Using a tongue depressor to count and slide the pills into the cylindrical area on the left side of the counter. When the desired number is reached, close the cylinder lid, pour the excess on the flat area back into the bottle, and slide the counted pills into the zip lock bag. Sounds easy, right? Well yeah, it was. But why does it have to take 29 people many hours to complete? What if we automated parts of the pill counting process to make it faster and more efficient? This could have a huge impact on future brigade trips. Instead of spending the entire first day counting medication, we could spend the first evening counting and sorting all the medication. Then we’d have the entire first day in country working a clinic. We’d be able to see hundreds more patients on the trip. That’s hundreds more patients that would be able to see a doctor, dentist, gynecologist, and receive medication.
So first things first. Does this technology exist? Simple answer is yes, it does exist. Doing a quick google search of ‘automatic pill counter’ will yield machines from all different brands and manufacturers. Click these links and you’ll come to a quick realization that it’ll be difficult to deploy these in low resource areas of the world. The cheaper models cost around $3000 and probably require a trained professional to maintain. Something like this would be difficult to utilize on our brigade trip.
I posed the problem to the pill counting team I was working with and we came up with several ideas. The first idea was to use a scale to measure the weight of the zip lock bags to determine the number of pills inside. A second idea was to use something that we all carry around in our pockets, our smartphones. Images captured by the camera can be used segment the pills and give the user the number of pills on the counter. Both ideas are simple and cost effective. These would be an interesting projects to pursue and if it were to be implemented, it would help future brigades impact more people.
- Allen Kim, Brigader