Belize Medico

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Belize, formerly the British Honduras, is a small country sandwiched between Mexico and Guatemala. English is the official language but up north where I was, Spanish was used day to day. I picked that up fairly quickly as in open your mouth, or take this three times daily.

I worked in the two northern districts (Corozal and Orange Walk), for several years both as a psychiatrist and general practitioner. I also taught a few courses at the Belize Medical College and a now defunct “offshore” medical school called IMU. Since it was inland and a few miles from the coast, I have no idea why the term offshore was used. When people ask me what living and working there was like, I say picture Dodge City KS c.1870 and there you are. The infrastructure is poor, the government corrupt, and it is hot and humid most of the time. However, the people are friendly and empathic and the beer is good. Rice, beans and stewed chicken is their daily fare.

Practicing medicine there challenged your adaptability in finding alternatives to what you might otherwise  take for granted. The  government hospitals could have been used as sets in a Civil War film.  However, you could get x rays, lab tests and even MRI scans and many pharmaceuticals from Pakistan or El Salvador could be had over the counter. This included antibiotics which created havoc with treating some resistant infections as locals could obtain tetracycline in small convenience shops to treat their sick kids.

Sadly some diseases eradicated in Canada or USA are still seen, such as kidney failure due to improperly or untreated strep throat infection. The health system is two tiered: government and private. The latter was more desirable of course but since 45% of the population was impoverished there was restricted choice. Nevertheless as patients they were the best. Always grateful and hospitable. Seldom complained. I attended the care of the father of the former deputy PM who had a stroke and also an elderly man with the same condition. In both cases I was offered tea or beer and snacks. Sometimes I was paid by meals, services and commodities. In the latter case the family lived in a dirt floor shack with one bulb over head and  no running water.This was a common scenario in outlying villages.

I treated in no particular order: dengue fever, botfly infestation, scorpion stings, a dog with snakebite and lots of upper respiratory illness due to overcrowding. Furthermore, due to genetic factors, hypertension, obesity, and diabetes are prevalent, augmented by the Belizean fondness for Fanta. Belize also has the highest regional stats for AIDS, alcohol and cannabis abuse. Life expectancy is 68.

As in the Arctic, healers (curanderos) were commonly sought out and abdominal pain was often interpreted as empacho (blockage). The  diagnosis is made by the healer noting symptoms and checking for direct (but not rebound) abdominal tenderness, feeling knots in the calves, and/or rolling a fresh chicken egg over the abdomen. Empacho is confirmed if the egg appears to stick to a particular area. Remedies include rubbing the stomach or back, or purgative teas of wormwood (estafiate) or camomile (manzanilla).
In the psychiatric sphere I encountered the same conditions-schizophrenia,ADHD, Aspergers syndrome, and depression as seen anywhere else but with a culture specific “flavour”. Symptoms could be the result of evil humors, which explained why the locals shuttered their windows at night or bewitchment spells (Obeah). Depression was sometimes masked as abdominal pain (empacho) and childhood behaviour disorders blamed on mom of course, such as falling during pregnancy or eating “wrong foods”.

As up north talk therapy was accepted and could last part of an afternoon since a 50 minute hour made little sense in a laid back country where time was not a commodity. As in Kingfisher lake Ontario, marital therapy could start at 1pm and end with dinner. Usually rice and beans and beer. This assuming the session went well of course.

As for the dog, it was a non venomous snake, and after holding his paw, cleaning the wound, and offering reassurance  he was back to chasing lizards in no time. The owner cheerfully compensated me with rum and snacks.

 

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One Response to “Belize Medico”

  1. kristina nadreau says:

    pleased t see you are well and active.

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