We Keep a Shotgun in Our Broom Closet (By Hannah McDowell)

That’s right! There it stands, double barrels propped against the wall in the far left corner, sharing floor space with a couple of brooms, two bottles of bleach and an assortment of empty gallon jugs that we use to safely dispose of used needles. I discovered it the morning I needed to sweep the floor when I arrived for my 7:00 to 3:00 shift. The clinic here in Honduras has a wonderful janitress who comes in six days a week and does a superb job of keeping things spick and span. Believe me, that is no small task, given our location at the edge of town, on a dirt road which is alternately either very dusty or very muddy, depending on when it last rained. It takes several-times-daily sweeping and mopping to keep the tile floors adequately clean, and on her day off that job falls to whichever nurse is on duty at that time.

Naturally I was a bit startled at the odd addition to the normal arsenal of cleaning equipment that one might expect in a broom closet. Upon my inquiry to the day guard on duty, he smiled, assured me it was never loaded, and that it has only been used a few times when one or another of the guards has carried it as a not so subtle deterrent to any would-be trouble maker who came around.

That’s not the only difference in stateside vs. Honduran nursing. Something that never ceases to amaze me is the cost of clinic care here. The five pound eight ounce beautiful little girl whom I most recently welcomed into the world at 4:48 a.m. had a non-complicated arrival, and she and her mommy were both able to go home 24 hours later. Their entire bill was 500. “Not too bad,” you say? You’re right, especially considering that we are talking about 500 lempiras, not dollars. At the current exchange rate of 18.9 lempiras for each dollar, that comes to $26.46. Of course, when either mother or baby needs extra attention, the bill goes up: if a bag of IV fluids is used, it costs $3.65, and oxygen at 3 liters a minute for an hour comes to an additional 95 cents. Intensive care for a newborn is another 110 lempiras, or $5.82.

If your child is dehydrated due to several days of diarrhea and vomiting because you failed to boil his drinking water, you can bring him to our clinic for IV rehydration and medication to get rid of whatever bad “bug” he got from the water. We will give him excellent nursing care for $4.23/day plus the cost of his medications and IV fluids. Quite reasonable, especially compared to the $10.58 per five minute visit our collaborating physician charges to stop by and see how he is getting along, and make any necessary changes to his treatment plan.

If you are unfortunate enough to chop your hand instead of the tree limb you were trying to cut up for your wife’s cooking fire, drop your machete, wrap the wound in a rag (hopefully a clean one) and hurry on in to us. We can inject it with a local anesthetic so the thorough cleaning it needs won’t hurt, and you can lie back and close your eyes while one of our nurses expertly puts in the stitches necessary to neatly draw the gaping edges closed. If it’s a small cut requiring only one package of suture, you will be charged $4.76 for the repair job and bandaging. If your machete was well sharpened and you were swinging vigorously, your wound will probably require two packages of suture, but in that case you will get a bargain: instead of paying double, your bill will only be $9.26. If you need a tetanus booster the fee will be 21 cents for the syringe and 11 cents for one of us to give you the shot, since the Health Department supplies us with the vaccine itself free of charge.

Do be careful not to slow down too much at the crest of the hill on your way into town. I’m told it’s a prime spot for gangs of hoodlums to leap from their roadside place of concealment, stop your car and rob you. Just a week or so ago, that very thing happened to a 60 year old gentleman on his way to visit his elderly father. He arrived at the clinic mid-morning, clutching a blood soaked towel to his shoulder. “I wasn’t scared when they jumped out, I was mad!” he blustered, as I kept pressure on the wound while he eased down onto the exam table in our treatment room. “There were three of them. One fellow tried to grab my door, and when I swerved to run him down, another one pulled a rifle and shot me through the window!”

I gingerly slipped his bullet-shredded shirt over his head and carefully peeled away the towel. Pleased to find that the bleeding had stopped, I adjusted the brilliant overhead light to better examine the three inch long and quarter inch wide blue-black tunnel that extended from his shoulder to his collar bone. With infinite care I extracted one small and two rather significant sized chunks of mangled bullet, and tightly bandaged the gaping hole that was left. Twenty minutes later, his younger brother driving, he was on his way to a larger medical center for the x-ray he needed to see if his collar bone had been nicked, and to investigate the suspicious looking bulge on his neck that I suspected might be another piece of bullet. And he didn’t quibble a bit about the $2.65 he had to pay for my care!

There are a few occasions when we don’t charge full price for our services. Twice now I’ve been on duty when the extremely deaf, 96 year old man who can’t afford the surgery he has needed for two years, comes tottering in for his every-week-to-ten-days Foley catheter change. Rheumy eyes blinking, he peers up at me and grins cheerfully as I give him a welcoming pat on the shoulder, then squat down to help him undo the thick black shoestring that he uses to tie the urine collection bag to his leg. When the pus clogged, filth encrusted tube and bag have been replaced, and his dirt and sweat stained clothing readjusted, he reaches into his pocket for the money he has tucked away, and painstakingly counts out his stash. The normal cost of such a procedure is 80 lempiras, or $4.23. I accept the 40 lempiras his trembling fingers slide across the counter, smile, and loudly wish him a good day and God’s blessing. He shakes my hand and thanks me before slowly shuffling out the door and up the dirt road. I turn to the sink to wash my hands, blinking back tears. How very blessed I am with so much that I take for granted! I silently thank the Lord for allowing me the privilege of ministering to “one of the least of these my brothers,” and pray that His love will continue to shine into he lives of the many who walk through our doors.