The Roatan Medical Hospital

“Hello, Mr. Peter?  I need to go to the hospital now,” Jolien said in her soft but excited voice.  I don’t know how many times we’ve asked her to drop the Mr and Miss from in front of our names, but it apparently was not enough.  However, now was not the time for a reminder.

It was after eleven in the evening and we had just gone to bed when the phone rang.  We quickly got ready and drove to the bottom of the hill, navigating along severe bumps and around haggard shanties until we came alongside hers.  From behind the hanging sheet that was her door, she stepped carefully into the dark and around the trunks of large cashew trees; her mother provided stability with her outstretched arm.  Once mother and daughter were safely in the truck, Pete navigated the bumpy road into town as fast (yet, as gently) as he could.  Jolien lay with her head in her mother’s lap, loudly moaning from the strong contractions that were consuming her every five minutes according to the dashboard clock.

This wasn’t the first time that we visited the hospital on this tiny Honduran island.  A few weeks prior, we had gotten a call from Jolien just after midnight, asking for a ride.  She was sure that her baby girl was on her way, and took us up on our earlier offer to be her ambulatory care.  We stayed with her until the wee hours of the morning, but that time it was not to be.

The state of the hospital was no less shocking to see this time around. Once through the padlocked and guarded entrance, we slowly led Jolien down the fractured cement and dirt path to the emergency room.  Inside we found many mothers with small, sick children and a teenage girl clutching her left arm.  A nurse recorded Jolien’s blood pressure and weight before leading her to a bed behind a yellow and white curtain, set brightly against the cracked and dirty pale blue walls.  She shared her little suite with a man seated at the foot of the bed, hooked up to an IV.  A cockroach scuttled across the floor near my feet.

A young doctor came in several minutes later and uttered a grunt of disgust when he saw Jolien. Here she was again, after he had already sent her home earlier in the day and given her instructions not to return until the following morning. The fact that her contractions were close and she was obviously in considerable pain did not seem to register with him.

We walked Jolien out to the open air, dimly lit corridor and sat together on a hard wooden bench and debated our options. Do we make the drive home (almost an hour, round trip) and return at seven a.m. as instructed? Of course we offered to make the trek both ways with her, but the thought of her being so far away from any kind of care made us all nervous. Our anxiety was compounded by the fact that at that point, several other ladies surrounded us and all told a story about different doctors sending laboring women home until it was almost too late. Apparently, they wanted nothing more to do then catch the babe at the moment it came out, and then release the new moms less than a day later.

In between contractions, Jolien took to walking up and down the dusty corridor, while the local ladies all offered her encouragement when the pains would come. One lady instructed her to stand with her feet spread, hands on her knees, and push through the pain. “Push down on, push down on,” she coached in her island English. Jolien continued this for a few minutes, and then sat back on the hard wooden bench to rest.

After nearly a half hour of rocking, crying and squirming, Jolien began to tremor from the pain that wracked her body. Her mother Francine went back to the emergency room and spoke with the doctor. FInally, they agreed to get her on a drip to help with the pain. But after that, she would have to leave and come back the next day.

Francine and I each gave Jolien one arm to lean on as she rose from the bench. A strong contraction came through just then, and she pulled both of us near to the floor as her legs gave way. She groaned, regained some strength and stood, but could not bring her feet to move.

Jolien moved forward slowly with us then, carefully side stepping the cracks in the uneven floor and the pile of discarded equipment outside the emergency room door. The nurse casually motioned to a plastic chair just behind the desk, and proceeded to fix Jolien with an IV, obviously annoyed by Jolien’s constant writhing. The disinterested nurse, making no effort to help, instructed Jolien to return to the bed that she was once on. Francine helped Jolien settle into the bed as she continued to shudder with convulsions. Pete and I watched on helplessly before returning to the corridor.

Francine followed a few minutes later, shaken with concern for her daughter. She expressed her sincere gratitude for our patience, and said that the drip should take no more than an hour. We assured her that we would wait to give them both a ride home afterwards, and to return in the morning, if that’s what needed to happen.

Time passed quickly through wonderful conversation with Francine.  After going back in to check on Jolien at 2:30 am, she returned to tell us that the drip had finished, but Jolien had protested the return home and they were going to stay. While Pete helped Francine program our cell phone number into hers, I went in to say goodbye.

Apparently, Jolien didn’t have to put up much of a fight to stay. The doctor had since left, and the only nurse on duty sat reclined in a plastic chair, a bed sheet wrapped around her head to impose the darkness required for napping. Jolien appeared achingly tired. “How are you doing?” I asked gently.

“I’m doing a little better. I just can’t take that road,” she whispered.

“Of course, ” I responded. I leaned in to kiss her smooth forehead, her rich black skin glistening in the enduring warmth of the day and her obvious strain. “Take care of yourself, and please get your Ma to call us if you need anything.” She weakly smiled back at me and turned her head into the pillow as another contraction began to take over her body. I squeezed her hand and left.

Pete and I said goodbye to Francine and made our way to the entrance where we waited for the guard to unlock the door and let us leave. We were both exhausted, frustrated with the state of the hospital, and fearful for Jolien’s well-being. But there was nothing left to do but hope and wait.

**********

Twelve hours later, I held the 6 lb, 4 oz baby Julie carefully in my arms. It had been a long time since I held a baby this young, and never had I held one so small. She lay completely still and content, but it wasn’t long before I had to return Julie to the bed with her mother. The heat radiating from her little body was making mine a sweaty mess in the steaming hot room. Pete, having returned from his errand of getting both Jolien and Francine some warm food (neither of them had eaten anything), then took his turn. He slowly lifted little Julie with great care, and obvious joy. Before that day, he had sworn off holding babies less than six months old (scared of his own clumsiness), but this time he couldn’t resist the tiny bundle.

I sat on the empty bed beside Jolien’s and strained to listen as she recounted the events of Julie’s birth. Cell phones rang ceaselessly around us in the small room with four other patients.

Her story instantly made me livid and fearful for what could have happened the night before. Less than three hours after we had left, an emergency cesarean was ordered when it was discovered that Jolien’s blood pressure had skyrocketed and Julie’s heartbeat could not be heard.

It was likely that the baby, or Jolien, or both, would have perished.

And there Jolien was, immobile and still cringing from pain, reporting that the doctor insisted she go home the following day.

Somehow she said it all with a broad smile, as she watched Pete rocking slowly with her daughter. Somehow the scars would heal, and the pain would be forgotten. Somehow, Jolien and Julie survived it all. Somehow, in this medical hospital, they just may have gotten lucky.

 

52 Comments... Read them below or add one of your own
  • Heather Coates
    May 4 2011

    Oh Dalene this is heartbreaking…I wish I had your courage to go to these places, I feel with my training I could make a small difference. Very well written like everything else I have read. So proud to be your cousin…you and Pete take care!

    • May 4 2011

      Thanks so much Heather – that is all so sweet of you to say. You definitely could make a difference, and I KNOW you have more courage then you think…xoxo

  • Patricia
    May 4 2011

    Omigosh! What a beautiful, sad, and happy story! <3

    • May 4 2011

      Yes, sad and happy. Infuriating, largely. It still makes me so angry to think about what could have happened…

  • Sharon
    May 4 2011

    Great story Dalene!….so sad that it is true though….but at the very least it had a happy ending!

  • May 4 2011

    Fascinating story. It certainly makes you grateful for the healthcare system we have in the states / canada (although Canada wins for access!).

    I wonder how this experience would be if men gave birth?! I am certain more attention and care would be paid – especially in the developing world. Grrr.
    The NVR Guys recently posted..Most Memorable Mileage Run Moments

    • May 4 2011

      Sadly, I think you are right. It’s all about the machismo down here especially. At home, I’ve sometimes spent over 12 hours in hospital waiting rooms to see a doctor, and while I whined about it the whole time, I won’t again. This was all too shocking to see.

  • Wow, that sounds scary but it’s great there was a happy ending. It’s eye-opening to hear about these kinds of hospitals in other parts of the world!
    Scott – Quirky Travel Guy recently posted..LA In Songs

    • May 4 2011

      It was definitely an eye-opener for both of us. And while right now it is a happy ending, I still worry in the back of my head about any kind of infection that could rear it’s head. It’s not like the place was clean. That still scares me.

  • May 4 2011

    That is so scary! I feel so bad for the mothers – way to make an extra stressful time scary and unbearable! So glad to hear mum and baby are doing well!
    Andrea recently posted..Montevideo’s Locks Fountain

    • May 4 2011

      Yes, for Jolien to have to finally demand to stay in the hospital – why does that HAVE to happen? Talk about stress.

  • Mom
    May 4 2011

    OMG . Yes this was an awesome writing & tears flowed free & I am so happy that Jolien & Julie survived but I must be honest & say I am feeling very, very ANGRY right now. Angry that these doctor’s & nurse’s were so uncaring to the suffering of another human being. I realize their work environment leaves much to be desired but that is no reason to lose your empathy for others. Perhaps they are in the wrong profession.

    • May 4 2011

      Yes Mom, it made me very angry too. To be fair, Francine did tell us that there are some great doctors and nurses working there, we just didn’t happen to meet one that night. It was awful how dismissive they were.

  • May 5 2011

    Such an amazing story, Dalene! And you & Pete were no doubt a most helpful part of it.

    That does it! “S-L-O-W” travel is the BEST!

    • May 5 2011

      It’s those times though…where we really wish we could have done more. We felt so helpless at some points, and thank goodness Jolien took a stand and refused to leave.

  • May 5 2011

    What a beautiful story! You had me in tears! I’m so happy everything worked out for Jolien and the baby. Wow.

  • May 5 2011

    incredible story (and really well told). So proud of you for staying by her side and helping her through it all.
    Michael Hodson recently posted..Ruins- ruins- ruins!! Spectacular Jerash

    • Peter
      May 6 2011

      Thanks Michael. We wouldn’t have had it any other way, and just wished we could have done more.

  • May 5 2011

    Wow, what a story! Just think if you hadn’t been there… Fate!
    Sophie’s World recently posted..Around the World with 40 Lonely Planet bloggers launched today!

    • May 6 2011

      Jolien and her mom are two of the sweetest people we’ve met on the island, we were happy to help! I also took them home from the hospital, and maybe for my own selfish reasons….I wanted to cuddle that cute baby again! 🙂

  • May 5 2011

    As a father of two kids, I can relate to the experiences of having a child. However, it does make you appreciate the health care we do have here. I just did the March for Babies this past weekend to raise money to help premature babies. We can do stuff like this here and get outstanding care. And then you see scary, eye-opening experiences like this in other countries. It makes you very thankful.
    Jeremy B recently posted..The essential visitor’s guide to Slovenia

    • Peter
      May 6 2011

      Yes it does. I will be hard pressed to complain about the health care I get at home from now on.

  • May 5 2011

    What a great experience to of had and so nice for you to offer them so much help! Too bad the hospital hadn’t been in better shape but great that mother and baby were fine in the end 🙂
    Cailin recently posted..My South Shore Adventure in Iceland Part 1

    • May 6 2011

      Yes, and I guess that is all that really matters, is that they turned out fine. Pretty scary at the time though!

  • May 6 2011

    Oh good lord! Makes me very happy I never had to use the hospital when I was there. And why the padlocked gate? I stay in Nepal about 4 months each year and this is one of my worries. If I get sick or have an accident, the health care is not very good. I would have no choice but to fly to Thailand if it was serious.
    Barbara Weibel recently posted..Free Photo eBook – Around the World with 40 Lonely Planet Bloggers – Available for Download

    • Peter
      May 6 2011

      I’m really not sure about the padlocked gate, my guess it is because the hospital isn’t in the best of areas. It is a worry for a lot of expats that live here too, but I guess they decided it is worth the risk! There is supposed to be a new hospital in the works, hopefully it does get built, as they obviously need it.

  • May 6 2011

    Dalene what a heart wrenching story, I have goosebumps just reading it. I’ve been in hospitals like that, but never so close to a situation like that. Thankfully Jolien recognized she wasn’t going home and had wonderful friends like you to stay with her and support her.

    Best wishes to Julie!

    • May 6 2011

      Thanks Jillian! Yes, I am so glad that Jolien stood her ground, she said that the nurse had even called her “stubborn” (before she went for her nap!)

  • May 6 2011

    About half way through your post, I started fearing for Jolien. Thankfully it turned out well but what an ordeal to go through at such a special time in life.
    Natalie recently posted..Animals Of Turkey -Photo Essay

    • May 6 2011

      No kidding…there is enough stress and pain in those moments, to have to fight to stay in the hospital…well, I didn’t even think that would ever have to be done. Scary.

  • May 6 2011

    Wow. What an incredible story, it gave me goosebumps! I’m so glad Jolien and baby Julie are okay and healthy. Sending love and millions of good vibes your way.
    Sheryll recently posted..An Offer I Can’t Refuse

    • May 6 2011

      Thanks Sheryll! I will be sure to pass them on… 🙂

  • May 6 2011

    Oh my gosh, thank goodness you were there. And thank goodness that awful, lazy doctor went home when he did. That is so horrifying to think that that’s the care they receive in Honduras, at least in some parts. You really have to be independent and demand what you want. But how do you do that when you don’t know what you need?

    • May 6 2011

      Very good point. If Jolien were to just have blindly followed the instructions, then, well, I don’t like to think about what could have happened…

  • May 6 2011

    I had read this the other day, just didnt get a chance to comment.

    It is amazing to draw parallels from what we all know living in prominent countries, then when we see the similarities in these other countries, sometimes, it is mind boggling.

    Glad to see you guys were an integral part of what is an event that Jolien will never forget

    • May 7 2011

      Nor will we forget this. It was one of those travel experiences that will definitely stick with us.

  • May 7 2011

    What an amazing story — and thank god it had a good outcome. It’s easy to forget how often women die in childbirth, even today, in less developed parts of the world.
    Theodora recently posted..Travels with a Ten Year Old

    • May 7 2011

      Thanks Theodora. I actually looked up Honduras’ death rate at birth statistics and they aren’t the worst – they are about middle of the pack. Made me feel somewhat better about new moms that go there in the future, but I still think in a way, luck may have been on Jolien’s side.

  • An incredible story, well written. I can’t believe the lack of compassion the doctor seemed to have at the hospital. I couldn’t imagine sending someone in labour home, especially when they have an hour car ride over bumpy roads each way.

    It’s great that you guys could be there to help out.
    Mike Lenzen | Traveled Earth recently posted..Traveling in Your Own Hometown – A Pat LePoidevin House Concert

    • May 9 2011

      It was pretty unbelievable. And it’s not like they needed the bed for someone else. Either they are instructed to be that way, or it was just plain laziness in not wanting to deal with it. I think it was the latter.

  • May 9 2011

    Eeep, what a story! Wow. So happy it has a good ending though. Julie is adorable. 🙂

    • Peter
      May 9 2011

      Thanks Candice, and yes Julie is such a beautiful little girl. She was the first baby (<6 months)I have ever held, and it was pretty damn cool 😉

  • Nicole
    May 10 2011

    So glad for the happy ending! 🙂 Always good to go with your instincts when you’re the patient or advocating for the patient!

    • May 11 2011

      Totally agree with you Nicole. I’ve even had to do that in Canada, where I wanted some tests done that the doctor didn’t want to order. I was right to do so, and it made me angry – why should I have had to demand it? Valuable lesson learned (and here again) – we’re in charge of our own health, and can’t always leave it entirely up to the professionals.

  • Wow, what a callous way for the hospitals to treat women in labor. I realize the medical system is probably sorely lacking in funds and resources, but the doctor seemed to have had so much more disregard for Jolene than was warranted. I’m glad to hear she made it through okay with a beautiful and healthy baby!
    Christy @ Technosyncratic recently posted..Saying Farewell to Mayhem

    • May 12 2011

      I could understand how working conditions do not really promote or warrant much in terms of motivation, but they really went above and beyond to be assholes. It was so disturbing. Francine and Jolien both insisted that the hospital does have some good doctors, but they weren’t working that night. Jolien did say that the doctor who came in to perform the cesarean was good though.

  • Cam
    May 15 2011

    Wow! That is quite the story! Very thankful for Canada’s health care system right about now
    Cam recently posted..Pictures of Mayan Pyramids in Tikal National Park- Guatemala

    • May 15 2011

      That’s exactly how I feel. Makes it hard to complain after seeing what the third world has to offer…

  • June 13 2011

    Rough night, but I can imagine you guys must felt so blessed to be there that night, being with Jolien in one of the most precious moment of her life.

    • June 14 2011

      It was a pretty incredible experience. But one that I hope we never have to repeat!

  • Shirlene from Idelish
    August 13 2011

    What a story! It’s heartbreaking to see that the nurses and doctors have lost the compassion that should’ve been the main reason one becomes a doctor or a nurse! Happy though to know that Jolien and Julie made it through. They are both strong women!

    • August 14 2011

      That they are – VERY strong. 🙂

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