Not all villages that Hillside serve have road access. As Ron mentioned in his previous post, 3 of the villages in the Toledo area are especially difficult to access. Those villages include Punta Negra, Graham Creek (2.5-hour drive + 3-hour hike), and Machakil Ha (2.5-hour drive + 2-hour hike). Luckily, we don’t need to travel to these villages on a regular basis. For the Disability Awareness Program, we make a special effort to go to every school in the district, and thus the excuse to go for a good hike in the sun and heat. Figuring out the ideal time to go to Graham Creek or Machakil Ha revolves around the timing of one’s trip. In the rainy season, the trails are often covered in thick, deep mud, which make the hike very slippery and difficult. After the rainy season, if one waits too long, the weather is much too hot to complete such a long hike there and back with materials in stow. March appears to be the ideal month to travel to either of these two communities.

I had been dreading the long drive and hike to get to Machakil Ha, and had requested if we could possibly get a driver that day. Unfortunately, the initial answer was “no.” The morning of our early departure, I was very happy to find out that one of the maintenance men (Omar), could indeed drive us out to Dolores, where we would start our hike. The drive that normally would have taken me 3 hours, only took Omar 2.5 hours to complete. He even managed to drive us down and through a river bed to help cut down on the hike time, not a feat I would have dared to attempt.

We had our rehab tech, teacher from NarCIE (the division of the Ministry of Education that works with children with disabilities in the schools), 1 student, 1 short term volunteer, and 1 public health student in tow. It had been a last minute decision to include the public health student, and she had us all a bit worried, when we found out half way into the hike that she had never done any hiking in her life before… turns out she was a real trooper.

The hike was long but fairly straight forwards (unlike the Graham Creek trail). There is one high wooden make-shift bridge along the way, that looks way above the small river flowing below it. However, the school principal later informed us that in the rainy season, even if you are standing on the bridge, the water is up to your knees.

 

 

The heat never completely goes away here in Belize, so even if it could be considered somewhat of a cooler season in March, we were all still relieved when we finally arrived into the small village.

The Hillside students “crashed” outside the door of the classrooms and we revived ourselves with a small snack and some drinks.

The children in the school happened to also be having some yearly examinations done that same day by a man that came in from the Ministry of Education to do the testing. We waited for one class to be completed and started our regular DAP program with first the younger mixed aged classroom. I am always impressed by all of the hand-made colourful posters that the teachers make for the classrooms. Not very high tech, but very informative. The kids in the early grades were very bright, listened well, and answered the quiz questions all very well, especially when they knew there were some small prizes in store.

As Hillside does not get into these very remote villages very often, the public health director had requested that we also assist with dental education and fluoride treatment for the kids while we were at the school. We usually do a small education session to the kids about brushing teeth, what foods to avoid, split up to do the fluoride treatment, etc.… Many kids have never owned toothbrushes and thus we are grateful for the donors of free toothbrushes which are distributed to the kids. Despite the various flavours of fluoride, none of the kids seem to approve of the sticky coating it leaves behind, and despite numerous reminders not to spit it out and not to rinse their mouths immediately after the fluoride treatment is applied, the kids none the less, often seem to run outside and spit out what they can.

After completing the class with younger grades, it was close to noon and the principal had invited us over to his house for lunch. For a small fee, his wife made all of us some delicious hot caldo (free range chicken soup with cilantro and colantra) and fresh corn tortillas straight off the comal. By this point in time, most of the students were quite exhausted from the long drive, the heat, and the hike, so many of them took a short nap on the principal’s couch while his kids poked and prod at them.

Over lunch the teacher from the Ministry of Education that came in to do the testing, was recalling stories of the last time he came in to do the testing, which turned out to be the wrong time of the year to attempt getting into one of these villages. It was the rainy season and he had rented a horse to bring him in, but while crossing one of the make-shift wooden bridges, his horse managed to get his hind foot stuck between the logs of the bridge. He thus was there up to his knees in mud trying to pull the foot of this not so happy horse out from between the logs. When he finally made it into the village, he was told that school was actually closed that day. After the ordeal with the horse, he was not taking “no” for an answer and decided to travel door to door to each house to administer the test. Luckily, we had it much easier.

 

After lunch, we went back and repeated the same DAP training, dental education, and fluoride treatment with the older kids. Some of the older girls had questions surrounding how they would be able to get glasses if they could not see so well. For most of us, that does not seem like such a hard task. However, considering that the closest eye exam location was at the BCVI (Belize Council for the Visually Impaired) in Punta Gorda, which would mean for the average individual from Machakil Ha a 2 hour hike to Dolores, then another 2 hour hike to Corazon if the bus is not running (as it has not been the majority of the year), then another 2 hour bus ride to PG. Keeping in mind the bus leaves from Corazon likely around 4-5am, it would mean departing their village close to midnight. Not the easiest feat for the average teenager.

We seem to have gotten into the swing of things here in Belize to the point that it seems that at one moment I look at the calendar and it is January and now the next moment and it is May.   The last time I was able to sit down and write a blog entry it was about my trip to San Ignacio to check out the ATM caves.  Therefore I will try to give a quick run down of what we have been up to the last couple of months.

January

In January we had two students for the first student rotation of 2019   Fortunately, we also had a short-term-volunteer-physiotherapist, Carol Beckel, who was here for the first two weeks of the rotation.   She precepted the students during the two weeks that she was here so that Gail and I could focus on administrating the rehab department.   She is also on the board of Hillside and the rehab committee so it was great to get to know in person whom we had been speaking with by email and Skype for the last year and a half, ever since we expressed interest in volunteering at Hillside.

Outside of work, we were blessed to be able to visit one of our co-workers from Creston Valley Hospital, Terri-Lynn Barrett, who was on vacation with her brother in Hopkins.   We spent the weekend with her and enjoyed the beach in Hopkins as there are no sand beaches to speak of in Punta Gorda.   We had a wonderful time catching up with her and meeting her brother.

February

We had no PT students during February.   This was the first time since we arrived in July that we were without any PT students.  This meant that we got to do all the patient care ourselves, which has its pros and cons.  On one hand, it was nice for a change to do the assessing and treating ourselves instead of having to be teaching and supervising, however, it also meant that we had to see all the patients ourselves.   Ironically enough during the previous rotations with 2 – 3 students/rotation we often had mornings of outpatient clinic with only 1 or 2 patients the entire morning.  Then in February, when we had no PT students to assist, we sometimes had up to 8 patients in a single morning.

Starting in January we began presenting the disability awareness program (a.k.a DAP) to children in every school in the Toledo District.   Normally during the other times of the year we travel with the medical team to do mobile clinics to 14 of the villages in the Toledo district.   To present the disability awareness program we have to travel to all the villages in Toledo, covering approximately 50 schools, between January and June.   This means that instead of driving out to one or two villages a week we now had to drive out to three or four villages a week.  One or two villages to do mobile clinic and one or two villages to do DAP.   We would try to combine the villages when we could.    The DAP presentation consists of presenting on different types of disabilities (visual, auditory, physical, learning).  We read a story about being “different,” how we are all “special” despite our differences,  and the importance of showing kindness and respect to all children and people.    We play games with the kids to give them an idea of what it is like to live and play with a disability.  Lastly, we do a fun quiz and teach the children the diversity song.   I especially enjoyed presenting the DAP in Barranco where one of the children provided some really amazing accompaniment for the diversity song.

The DAP diversity song, Garifuna style!

Glover’s Atoll

Since we were without a student for most of February we decided to take some of our vacation time (we were allowed 4 weeks off in total for the year) to explore a little more of Belize.   We decided to spend a week at Glover’s Atoll which is part of the Belizean barrier reef system that is considered a UNESCO world heritage site.   To get there you have to take a 3-hour-boat ride from Sittee River which is just down the road from Hopkins, about a 2.5 hour drive from where we are living in Punta Gorda.    The scenery around Glover’s is spectacular and you can snorkel right off the island and find schools of beautiful fish, nurse sharks, and manta rays.  The accommodations are reasonably priced, provided you do not mind “roughing” it.   We had booked to stay in the dorm on the island but were “upgraded” to a private beach cabin.  By cabin I mean a slab board tree house with a fenced area underneath that served as a kitchen.

We stayed on Glover’s Atoll from a Sunday until a Saturday since you do not have to pay for the boat ride if you stay the week.   There is no real source of fresh water so we brought a 5 gallon container of filtered water from our apartment in Forest home.  There is drinking water for sale on Glover’s Atoll, but since it cost about $2.50 US per gallon we became good at finding and cracking opening coconuts in order to keep hydrated. This helped us ration our precious 5 gallons for the duration of our stay. They did actually have one small well of brackish water which we would use for dishwashing. However, this water smelled extremely strong of sulphur despite putting a good capful of bleach with every bucketful of water. We attempted washing some of our clothes in this water once, but somehow the “washed” clothes smelled worse off than when they were not washed.

March

After we got back from our trip to Glover’s Atoll we started a new rotation at the clinic where we had one PT student.    We were also blessed to have a short term volunteer who was a previous PT student at Hillside and thus already had a good idea of how things operated.

Halfway through the rotation in March, Gail’s sister Amy and her family come to visit us in Belize for 3 weeks.   Stephen and Aidan had been “counting the sleeps” for this moment since we arrived Belize in July.  We hung close to Punta Gorda their first 2 weeks here, since we still had a student at the clinic to supervise. This turned out to be a good thing, since during these first 2 weeks, six of the eight of us came down with the flu.  Only Amy and myself seemed to escape without getting any infections. Thees 2 weeks were also a good opportunity for them to experience the “real” Belize…between constant power/water outages, scorpions, car breakdowns, chigger bites, home ant invasions, and many sleepless itchy/hot nights.

Prior to the wave of illnesses began (or actually right as they were beginning), we took one weekend trip to Lime Caye for some sand, sun, and snorkelling.  We were joined by Gail’s physiotherapy classmate who was down to observe the clinic since she had a Global health student doing a placement here for the first time.

March seemed to be the month that we were to be inundated with visitors. In addition to Amy’s family, and Gail’s classmate, I got the news that my university chaplain, Father David Shulist, was in Belize for a week with a high school group as well.   He was up in Cayo district with no time to get down south and since I was more familiar with traveling around Belize I made the 7 hour-bus-trip up to catch up with a good friend.

The last week that Amy and her family were here was the first week of a new rotation in which we again had no PT students.  We had been waiting for this week to explore parts of Belize we had never yet been to (having spent the majority of our time in the Toledo District). We took the week to slowly make our way up the country prior to dropping them off at the Belize City airport.

The first place that we went to was Tobacco Caye off the coast of Belize close to the town of Dangriga where we had a cabin on the water where it was common sight to see stingrays swim by.   We spent two days there before heading back inland.

From there we headed towards San Ignacio in Cayo district taking a short detour along the way to check out the Belize zoo.

We spent three days up in San Ignacio close to the border of Guatemala where we went to visit Tikal, one of the most extensive Mayan ruins in Central America.    It was very impressive.   I also found out from a tourist I was chatting with that it was also a place where they did some filming for the first Star Wars film.

On one of our other days, Gail, Amy, Taupas and Stephen and Tiang explored the ATM caves where I had gone myself in January.   I stayed back with Aidan and Lani since they were not quite old enough to do the ATM tour.   We had fun exploring San Ignacio and visiting a butterfly farm.

April

On the 1st day of April after a great 3-week visit we had to say goodbye to Amy and family at the airport.   With four people less at our place in Forest Home it felt much too quiet. The next day we were busily working back at the clinic as we were still without a PT student for the next 3 weeks.    Murphy’s law never fails to deliver and so, again, we had more patients per day while we were on our own than when we previously had one or two more sets of hands to assess and treat.

Antigua

Since this was the last rotation that we were “student-less” we took the opportunity to use up the remainder for our vacation time to visit Antigua, Guatemala during Easter.   Antigua is an old cobble-stoned city not far from Guatemala City which is surrounded by several volcanos.   It’s claim to fame is that during Semana Santa (Holy Week) the whole town decorates the streets with Alfombras (floor carpets) which are made out of dyed saw dust, wood chips, flowers, and sometimes vegetables.   The majority of the carpets are made out of just saw dust which have been dyed in wide spectrum of bright beautiful colours.

To get to Antigua we became pros at taking various forms of transportation. We first trudged from our home to the local bus stop, took the local “chicken” bus to the immigration building in Punta Gorda, caught a 45 minute ferry from Punta Gorda to Livingston, Guatemala, took 2 other public water taxis up the Rio Dulce River, grabbed a 6.5 hour bus to Guatemala City, another 2 hour shuttle to Antingua, then needed to trudge another 30 minutes across town to catch our final shuttle (since the city was closed down to most traffic because of the Easter processions). As expected, none of the transitions between each form of transportation went smoothly, but all added to part of the adventure and to a lot of patience. Good thing the boys are troopers.

Livingstone is a cute little town with a lot more life and activity than Punta Gorda. Though I guess that is to be expected since Guatemala has a population of 17 million people while Belize on the other hand has a population of 400 thousand.

After reaching Antigua, we spent our first  two days at a place called EarthLodge which was high in the hills above the town of Antigua. There were miles of “hiking” trails (mostly trails used by locals to transport items between their farms on the mountain side and their villages), a playground for kids, and a Mayan sauna. The boys had fun making new friends with the on-site dogs and with kids from some of the other visiting families.

After departing Earth Lodge we spent one morning doing a hike up Pacaya, which is one of the active volcanoes close to Antigua and Guatemala City.  Getting to Pacaya involved a very cramped and hot shuttle ride followed by a 2-3 hour hike with donkeys breathing down our backs the majority of the way up the mountain. The locals were insistent that we needed a “horse” for the kids to get up to the top as the hike was apparently very “steep.”  Thus they stayed a close distance behind us the entire way, hoping we would “give in.” We were almost half convinced that we needed a horse by the sheer number of people with horses following us, only to discover that we were already “there.” We did not go right to the top but were close enough to see some flowing lava and the occasional molten rock slide off in the distance. The big “touristy” thing to do at the end of the hike was to purchase some lava souvenirs from the lava shop at the top and to roast marshmallows over the hot rocks.

We stayed in Antigua until Easter Sunday where we admired the Alfombras (floor carpets) that people make throughout the town to celebrate Holy Week and Easter.   The guest house that we were staying at made a floor carpet on the street outside their entrance on Holy Thursday.   We spent the morning helping them dye some of the sawdust and then late that night we helped create the floor carpet with them before going on a midnight tour of the carpets throughout town.

The carpets are absolutely beautiful, looking almost like fancy woven rugs.

The sad thing is that they are all very short lived,    The Alfombras are meant to decorate the way for the religious processions that come through, which reduce the floor carpets to a pile of rubble as they pass.

It was quite the sight to see the processions.    Each one begins at a church somewhere in town and makes its way along a predetermined route through the streets of Antigua and finally ends back where they began, taking sometimes 7 to 8 hours or more.   The main part of the procession consists of large wooden platform with several religious statues of either Jesus, Mary, the Saints which in total weigh up to 7 thousand pounds.  These platforms are carried on the shoulders of about 50 to 100 people.   The platforms are followed by an orchestra, then by people pushing spot lights (if the procession is happening at night), and then finally by several people with brooms and shovels cleaning up the Alfombras that are wrecked by the passing procession.

Returning to Work

After we got back from our trip to Antigua over Easter we started another rotation at the clinic where we met our next PT student who is with us at Hillside for eight weeks instead of the typical four.   This rotation began a little differently as we had an offer from a PT in Canada to come down and teach a K-taping course at Hillside.   The course took place during the first two days of the rotation.  Eleven people attended the course including three Belizean staff from Hillside, 6 people from the ministry of education and local high schools, our PT student as well as Gail and myself.  It was a jam-packed two days but we learned a lot that we were able to apply immediately with some of our patients.

The following week we did the DAP presentation in a place called Punta Negra which is one of the three harder to reach villages that we are supposed to do DAP in. There is no road to Punta Negra.  In order to get to that village we had to take a 45- minute-boat ride from Punta Gorda.

Preparing to return to Canada

It may be hard to believe but our year of volunteer work is quickly approaching.    In some ways it seems like we just arrived a few months ago but on the other hand we have stayed so busy that our departure from Calgary back in Canada seems but a distant memory.  We have been fortunate to find a well qualified PT from Switzerland who will be taking on the reins as the new volunteer Rehab Director starting in August.

One of the joys of living in a tropical country and at the edge of a jungle is all the “wildlife” or maybe more “critters” we get to encounter. We still are in awe with all the different types of bugs we discover each day. Each with varying colours, shapes, and movement patterns.

Rubber boots are usually a necessity around here, whether it is for crossing the front yard during rainy season or for avoiding chigger bites when doing chores in the grass. A few weeks ago, Stephen was trying to put on his rubber boot and started to complain that he could not quite get his foot in. He wiggled it this way and that way, and finally decided he had left his sock inside of the boot. We turned the boot upside down to shake on the “sock” and out plopped a big fat toad that was somewhat stunned from having someone stepping on him/her. Stephen had quite the shock from seeing a toad and not a sock drop out. Unfortunately, this is quite a regular occurrence here, as all of us except for Aidan has had toads in our boots unexpectedly. We know the regular protocol before putting on boots is to shake out the boot before putting them on, but sometimes a bit of laziness gets in the way. Aidan must of being sharing his story of the toad in the boot with his preschool mom, as he came home telling us that they had told him a very simple solution to the problem. Store your boots one tucked inside the other. Not sure why we never thought of this. Thank goodness for local knowledge!

Power outages and disruption of water services are a regular occurrence around here…usually a minimum of once a week. We all know that when the power goes out, that the water likely will stop within a few minutes. We are now all well trained to jump up and start filling pots and buckets with water as soon as the power goes out, as one never knows how long we will be without power or water for. One evening a few weeks back, we had one of these regular power outages. Ron ran to the bathroom to fill up a bucket, while I ran around in the dark trying to grab a pot out of the cupboard to fill up in the sink. As it was pretty dark without power it was hard to see what one was doing, but as the pot filled up I saw a shadow of something swimming around in the water in the pot I was filling. I called Ron over, who had a headlamp on, to shine into the pot, fully expecting a gecko in the pot. Lo and behold, it was not a gecko, but rather a large scorpion swimming laps in his new-found pool. The next dilemma was how to kill the swimming scorpion. We debated between throwing it outside with the water into the grass (though then we would have a live scorpion running around in the yard), or to throw the scorpion down the toilet (though we somehow imagined in swimming back up and out of the toilet). We finally decided to squish the scorpion in the pot with a glass bottle, which did the trick, though we were not in the mood to use the water after the fact.

One night back in February, Aidan asked me what my least favorite thing about Belize was. I really had not given it much thought so asked him back what his least favorite thing was. He quickly replied, “going to Immigration.” After a rough week of having to deal with immigration, I had to agree with him.

 

Back in July 2018 when we first arrived Belize, one of the first things we did was to start the process of applying for our work visa. Our clinic which has yearly long-term medical, nursing, pharmacy, and rehab volunteers, is quite familiar with the process and brought us to the office to get the paperwork completed. The office indicated that the work visa should take 1-2 months to get approved.

 

In the meantime, while awaiting our work visas to get approved, we would be expected to go to the immigration office each month to apply and pay for a one month visa extension. Some other local expats had indicated to us that if our boys went to a local school we could apply for a student visa for them, which would save on us paying for their monthly visa extension fees. Thus when our visas were due around October we asked if this was a possibility for the kids. The lady at the front desk indicated that we could apply for Stephen, since he was in Standard 1 (Grade 2), but not for Aidan, since he was in preschool (which did not count). We were happy enough with this, since it would mean that we could at least cut down on paying one of the fees. The lady gave us a list of items that we needed to get to apply for Stephen’s student visa and told us to come back in the next day to process both Stephen’s student visa as well as the rest of our visa extensions (as they were all out of visa extensions for that day anyways). Most stores were going to be closing soon, so we rushed around that afternoon getting the necessary passport photos, making the necessary photocopies of documents, getting forms signed by the justice of peace, etc… The next morning I drive in, park the car across the road from the Immigration office, as we had done several times before, and go in to get the visa extensions. The same lady asks me to wait as she brings Stephen’s paperwork to her manager. As I am there waiting, a maintenance man comes around and nicely asks if my car is parked across the street. I nod “yes” and he proceeds to tell me that I should consider moving the car. I walk out of the building to see what the matter is, and a man in uniform comes up to me and yells at me for parking where one is not supposed to park. I quietly tell him, that I did not know that. He proceeds to gruffly tell me that there is a huge sign that says “no parking” and that he could fine me for this. I get out on the street looking for the sign that says “no parking,” but the only one I can see is a sign on the same side of the street as the Immigration office, which is why I did not park on that side of the road. The security guard at the Immigration office had never said anything to me when I had initially parked there in full view of him, so I could not figure out what the problem was. However, not wanting to get fined, I politely drove my car to a different parking location. When I get back into the office with kids in tow, the manager comes out and tells me that they can’t/won’t approve Stephen’s student visa until our work visas our approved.

 

Each month our clinic director would call up to Belmopan office to ask about the status of our work visa, and each month, they would say that it should be done the next month. Finally, in January 2019 we get word that our work visas are finally approved. We get the letter indicating that our work visas are approved and bring them into Immigration. Our clinic staff had reminded Ron that the fee for the work visa should be $100 and that if they indicated otherwise, to let them know that Belmopan had told us it was $100 for the work visas. Ron gets into the office to process the work visas, the manager tells him that the fee is $1000 per person. Ron clarifies that he was told it was $100. This did not go over so well. After being spoken down to for proceeding next few minutes, Ron slowly “crawls” out of Immigration, gives me a call, and says “no luck.” They basically felt we were “lying” about being volunteers, questioned how we could support ourselves if we were volunteers, and insisted the fee was $1000 because we could not actually be volunteering here. At times your blood wants to boil, but you learn to control your tongue and know that getting angry and upset gets you nowhere. Unfortunately after Ron’s encounter, the Immigration office then demanded that each long-term volunteer at the clinic needed to pay $1000 for work visas. For a non-for-profit clinic that is already running on little income and a very tight budget, a $1000 fee for each long-term volunteer staff, was going to be extraordinary.

 

Luckily having an excellent local Belizean clinic director who is persistent and works hard for the best of the clinic, after another month of back and forth phone calls and emails, it was finally clarified that the fee was indeed $100.

 

We head back in February to again get our work visas approved and also the kid’s dependant and student visas. We had brought in all the paper work we had originally organized for Stephen’s student visa with us. The man at the front desk tells us that we need to get a similar list of documents for Aidan for his dependent visa to be approved, and to come back tomorrow (Tuesday), to get all of our visas processed. That afternoon Ron needed to do a few home visits in town, so I decide to walk around town with the boys to get the paperwork required. I first walk to the one store that I know of that does passport photos, but after walking 15 minutes in the hot sun, realize that the store is closed. I walk across the street to ask to see if they know when the store might be open. They indicate that they think the owner closed the shop for the afternoon, but that there might be a store on the other side of town called Mahung’s that does passport photos. I start trudging the boys down towards Mahungs and happen across one of the lotto shops whose owner is Chinese and good friends with the only other Taiwanese person in PG. The lady recognizes me and calls out to ask me where I am headed. I tell her I need a passport photo done for Aidan and was headed to see if they might do it at some store called Mahungs. The Chinese lady tells me that the only store that does passport photos is the one that I was just at. I tell her it was closed and she says, she knows the owner well, and he is probably just taking a nap. She offered to walk me back over and to wake the owner up for me. She pulls out two umbrellas to give some much-appreciated shade as we backtrack to the original store. The Chinese lady calls through all the windows, knocks at all the doors, and concludes that the owner must actually be gone. She offers to try to call him, but can’t find the number, so calls another Chinese friend to find the number. The other lady walks over to meet us at the store and calls the owner, only to find out the owner is indeed at a meeting. Luckily the second Chinese lady indicated that she thought there was a second store that did passport photos (not Mahungs). So once again, we trudge back to the other end of town and finally get the passport photos done, now with 2 very hot and tired boys. We proceed to compile the remainder of the required documents for the next day. One form needed to be signed by the justice of peace, who luckily lives almost next door to us, but unfortunately that evening he had an emergency in town. Lukily at 6:30am the next morning, Ron manages to get the form signed by him.

 

Of course the week that we need to deal with our work visas, happens to be the week our car is again undergoing major repairs (this time the bottom of the car was getting welded since it was rusted out). Buses in and out of town are very limited on non-market days (Tuesdays, Thursdays, Sundays). Luckily Tuesday morning the boys and I manage to catch an early bus into town. We get into the office with all the paper work requested. The same man as the day before, looks it all over and says that the manager is at a meeting that morning and tells me to come back the next day (Wednesday). I ask when the meeting might be over hoping that I might be able to process the paperwork later that afternoon, but am told that they don’t know when the meeting is done. Disappointed I head the boys to the bus stop expecting to possibly have to wait a few hours for the next bus, but luckily after waiting 10-15 minutes get offered a ride home by one of Aidan’s preschool classmate’s mom (and also wife of our car mechanic).

 

Wednesday, as I am working, Ron heads in first thing in the morning with the 2 boys. This time, they agree to approve Ron’s, Stephen’s, and my visa but not Aidan’s. One of the papers they needed for Aidan’s dependant visa was a copy of our bank statement. The manager asked how we could support Aidan if the bank statement was showing no income. Ron reminds her we had no income because we were volunteering, but that the statement showed that we had enough savings to support Aidan for the duration of our time here. Apparently this was not good enough. The manager demanded we get a letter from the clinic for us to get Aidan’s visa approved. No use arguing with her that the list simply said a copy of bank statement and not a bank statement with income. The remainder of our 3 visas ended up taking the remainder of the day to be approved, so that was yet again another full day in town awaiting for 3 stickers to be put on our passports.

 

Thursday, once again, not a great day to get in and out of town by bus, so I figured since we had all the paperwork this time around, that I would just bike in with Aidan, so that I did not have to wait around for the bus. I first bike 15 minutes west towards the clinic to get the “required” letter, and then bike 45 minutes east with Aidan on the back seat, to get to the Immigration office. They had already looked through the rest of Aidan’s document’s every other day this week, and had said the only thing we were lacking was the letter from the clinic, so I thought for sure it would be a “go” this time around. I get there, and it a different man at the front desk this time around. He looks through all the documents and points out that the birth certificate is not original. I mention that the list only said for a “copy” of the birth certificate. I also point out that all the same information is on Aidan’s passport. I explain to him that I had just biked in with Aidan and that to get the original notarized copy of his birth certificate meant biking back to Forest Home (40 minutes away). Once again, it was no use arguing. I cringe at the thought of having to bike back home, and walk around the block trying to figure out what to do. I find a familiar face to borrow a phone to call Ron at the clinic to see if by chance things might be slow enough for him to maybe slip out, borrow someone’s vehicle, and bring me the required document. Of course, no luck, the clinic was hopping busy and Ron would not be able to slip out. I take a deep breath and figured the only option was to bike back and get the notarized copy of Aidan’s birth certificate. Biking back to town the second time, I am half way there when I hear a scraping noise and Aidan screaming. At first, I thought I had got another flat tire, but after finally stopping, realize that Aidan’s foot had drifted into the back bike tire and was now firmly stuck in with the spokes. I pull the bike over to the side of the road and proceed to try to unravel his little foot from the back wheel. Luckily, he somehow managed to come out with just a large bruise and scrape on his lower leg. I bike the rest of the way in and hand over the paperwork just before noon. Once again the man looks through all the paper work and this time says, “your marriage certificate is not original.” I had to admit to him, that I did not have my original marriage certificate with me in Belize, nor did I have a notarized copy of it. He finally indicated it would be alright. After bringing the paperwork to the manager, he comes back out and says that since processing the dependant visa involved a lot of paperwork, that it would not be ready till the next day (Friday). I had thought for sure if I brought in all the papers before noon, the one visa could be completed before the end of the day, but apparently not.

 

Friday, I head in again, this time expecting no trouble. I pick up the documents only to find that they had spelled my last name wrong on every single one of Aidan’s dependant visa and supporting document. Not knowing whether or not to try to point it out to the lady, I decided I best let them know in case I get in trouble with Immigration because of having inconsistent names in our passports. The lady looks it over, thinks about it for a while, and tells me not to worry about it. Keeping fingers crossed, this won’t be an issue later on.

 

On the back and forth bike rides from town, it was easy to start feeling frustrated about the situation, but looking around, I am reminded that this is the reality for the majority of people here. Most people have no cars and are reliant on walking, biking, or inconsistent buses. While dealing with bureaucracy has been a true lesson in patience and has been a frustrating side of living in Belize, we are constantly reminded of true generosity by the people we rub shoulders with on a day to day basis.

 

 

 

After we got back to work at the clinic from Christmas holidays on January 2, I unexpectedly ended up going on a road trip the very next weekend to San Ignacio with the students at the clinic during January’s rotation.    At Abby’s house, the student residence, is a binder of suggestions of things to see and do on the weekends while they are doing their rotation at Hillside.   A popular destination that many of the student groups chose is to go to San Ignacio in Cayo district from where they can visit the popular Mayan ruin, Tikal, as well as the thrilling hike / swim through the Actun Tunichil Muknal (ATM) caves.  The family and I had not yet toured this area and were waiting until the middle of March when my sister-in-law and her family are coming to visit in order to tour it together.   However the ATM caves can be require some physical adeptness to tour so we decided that I would go along with the one of the student groups before March so that we could better judge it would be appropriate for our kids.   As it happened the very first weekend was the one that students from January’s rotation chose to go to San Ignacio and so three days after getting back to PG and work at hillside clinic I was off again.

After I finished work on Friday, for the day, around 3:30 to 4:00 I hoped into the 12 seater van with the students and Armondo and we headed off into the night to San Ignacio.   San Ignacio is in Cayo district which is North of here.  If you head north-east along the highway from the clinic it will take you through Stan Creek district where Placentia and Hopkins are located.   Heading north from Stan Creek district are the districts of Belize, where Belize City is located, to the East and Cayo district where San Ignacio is located, to the West.   After leaving PG around 4:00 we made it to San Ignacio by about 7:30 to 8:00

The first day that the students were in San Ignacio they had decided to go visit Tikal which is an all day trip.  I decided not to join them for that one since from what we had read, Tikal is a family friendly trip and so there was no need for me to check it out before hand.    Therefore they left around 7:15 and I stayed back and did some sight seeing around San Ignacio for the day.

San Ignacio Market

In the morning before the students went to Tikal I went for a run around San Ignacio which was quite the wake-up call since, unlike Punta Gorda,  San Ignacio has hills.   Well, actually one big one just outside our door which took me along the main highway through Santa Elena and then back to the San Ignacio where I ended up at the San Ignacio.  At the market place where I was pleased to find a vendor selling my personal favourite thing to drink after a run, fresh coconut water!  Much better than gatorade!

Octavia Waight Centre

After my run, one of the first places that I went to was the Octavia Waight Centre.   The Octavia Waight centre is one of the few other places in Belize that offers physiotherapy.  It is actually a nursing home for 34 residents in San Ignacio.  Here, a retired nurse, who is a friend of a family who previously lived in Belize and now lives in Creston, provides physiotherapy services to the residents there.   This was our first opportunity to make it up to Cayo so I had tried to connect with the retired nurse / physical therapy provider to meet up with her and find out about the work she does here.    However with such  short notice she was not going to be in town.  She did arrange for me to meet up with one of the administrators of the facility to take a look around.

Cahal Peche

After spending about 2 hours looking around the Octavia Waight centre and learning about the service provided there by speaking with the administrator, Susan, I walked just up the road to a Mayan ruin called Cahal Peche.   Cahal Peche may not be as extensive as Tikal is reported to be but it was very impressive with many restored structures.   It also has a very informative museum detailing the history and giving and idea of the society that existed there over two thousand years ago.  It is very humbling to walk amongst the ruins and think on the people who existed there along time ago.

Actun Tunichil Muknal (ATM) caves

The second day in San Ignacio I joined the hillside students to go through the ATM caves. The ATM caves was discovered by a Canadian, in 1986.   It is a hike along an underground river leading to beautiful caverns containing impressive stalactites, stalagmites and mayan relics including, pottery and the remains of human sacrifices.    I do not have any pictures of the inside of the caverns because cameras are not permitted.   This is because there have been a couple of incidents of tourists who dropped a camera and broke some of the artifacts while visiting the caves.

It was about a 25-minute-walk to the cave.   In order to get to the cave we had to cross a river 3 times.   The river crossings were not very deep so you could almost walk across but you could also swim across or pull you self along the ropes that were laid in the water from bank to bank.

Once we made it to the opening of the cave there was a 20-foot-swim in some deeper water before we could start walking / wading our way along the river which goes in about 5 km underground.  The hike along the underground river was not for the faint of heart since it involved a lot of tight squeezes.   I remember one particular spot where my helmet would not fit between two rocks but my neck did which required me to get up on my tiptoes to get my helmet and head up higher where the passage way was a little wider allowing my helmet to pass through, while at the same time cautiously squeezing my neck though the narrower portion of the passage below.

On the tour, though we actually only hiked in about 1/2 km where we reached a couple of rocks that we scaled up in order to gain entrance into what are called Cathedral Caverns where the artifacts and human remains are.   Once up inside the caverns we were required to remove our shoes and walk in sock-feet so as to avoid damaging the rock formations.   There was reflective tape on the floor marking out the path to follow.

It was very impressive inside Cathedral caverns.  I think we all were at risk of getting sore necks from craning our heads up to peer at the blue stalactites about 50 feet above us.   They contained copper which appeared blue since they were not exposed to sunlight which would normally cause the copper to turn green.   There were also many holes in the ceiling where bats were sleeping which were created by the rock being dissolved by the urea in the bath urine.  Along the path there were many clay pots.  Some were intact while others were broken either by tourists who were not walking where they were supposed or from the Mayan ceremonies performed here thousands of years ago which involved the breaking of pots to release incense.

There were also about 3 – 4 remains of human sacrifice either by decapitation or be having the heart removed.  One of the victims of human sacrifice had a flattened skull and jade implanted in the teeth.   According to our guide the flattened skull was the result of cranial modifications accomplished by tying boards to the infant’s skull and keeping them there while the child grew.   The cranial modifications and jade implanted into the teeth indicated that this particular person was part of the ruling or priestly caste who considered it a great honour to be sacrificed since their soul would be set free.   An honour I can safely say I would pass on.

The entire journey in and out of the ATM caves took about 4 hours.   When we got back to the vans at the trail head we were greeted by a delicious lunch of Belizean food.

 

 

 

Having been here 7 months, the work we do can seem quite normal to us, but once in a while, we still see things that reminds us that we are doing health care in a much different place and way. Being with limited resources is always a good challenge towards being creative with the care that we give and also a reminder to get back to the “basics” of care.

 

We had driven to Dolores in February and there was a small elderly lady that had significantly decreased oxygen saturation. The volunteer nurse practitioner and student physician assistants were recommending a nebulizer. What does one do for a nebulizer where there is no electric supply to hook the nebulizer machine up to? This is where Mr. Rudy, the medical team driver and community liaison comes into hand. He pops up the hood of the clinic van and starts fiddling with the connectors on the jeep battery. He hooks up an adaptor to the vehicle battery, to which then, the nebulizer machine is plugged into. The little lady crawls up into the back seat of the jeep, and with the engine turned on, she completes her nebulizer treatment after a few minutes. The mobile post in Dolores is adjacent to the school, and as the kids were on their lunch break, of course there were a good 20 kids staring into the back of the jeep as treatment was taking place.

 

How about spacers for puffers? Some kids have a difficult time figuring out how to appropriately use a puffer. In North America it is common to have access some form of a paper or plastic spacer to assist with this. Resources being limited, our pharmacists have cleverly figured out how to make a spacer out of a recycled pop bottle with a bit of cutting and taping, it seems to work just as easily.

 

While in Dolores, I looked through our previous assessments and noted that there was a kid that was previously assessed for delayed walking. I thought that even if the kid did not show up to clinic that it would be good to follow up to make sure things were going alright. After asking a few of the patients waiting in line, we got some vague instructions as to how to get to this child’s house. We drove down the road, asked a few other people, and finally found the house. Good news was that this now 2-year-old boy had just started to walk a few months prior (still would have been considered delayed from a gross motor development perspective, but at least walking). Bad news for me, was that the kid was terrified of an outsider trying to assess him. As soon as this 2-year-old got any glance of me, he would scream out in terror. Initially it was just the mom and the boy in the house, but the grandmother heard the kid crying and came over to help out. We decided that if I was going to have any luck trying to assess this boy’s walking, it would have to be without him seeing me watch him. The grandmother took the boy outside of the house and walked him up and down the uneven terrain outside. Meanwhile I tried by best to peak through the spaces between the boards of the house to gather what information I could about this boy’s gait. Unfortunately, the only real room to walk outside was along the side of the house, so while I really needed to get an anterior and posterior (forwards/backwards) view of his walk, all I could really see was a lateral (side) view. And unfortunately, the cracks between the boards were quite large, so any time the little boy got a glance of me, he would start whaling again and needed to be recomforted and re-encouraged to start walking. After doing what I could do to assess the gait through the gaps in the wall, I really wanted to try to check for lower extremity tone and range of motion. I knew I likely would have not much luck, but tried pulling out the little toy car from our home-health bag to distract him, of course with little success. His mom tried to brace him down while I tried to passively move his leg.  Trying to assess range of motion and tone in a screaming kid is less than ideal or accurate. It sounded like the main current concern was speech delays, as the 2-year-old boy only had one word in his vocabulary. There are no speech language services in the area at all, and my knowledge of assisting with providing speech therapy recommendations is very limited to none. Finally, based on the limited assessment we could do, I provided what recommendations I had and prepared to get ready to leave. I look around and noticed that we had attracted a small crowd with our assessment. What started out as 1 adult and 1 kid in the house had now evolved to about 5 women and 10 kids all trying to see what we were doing to this poor kid. I waved to say good bye to the little boy not expecting any response, but he looked up and gave the biggest smile (as if though he had never been crying and screaming for the last 30 minutes) and gave us a big wave good-bye.

 

Just prior to Christmas we had done a mobile to Otoxha. We had a PT student from the US who was travelling out of US for the first time. Otoxha is about a 2.5-hour drive from our clinic. We had had a referral for a man in his 40s for knee pain that had been sitting in our referral pile for a while, as the man had not showed up to the mobile post when rehab was there yet. We touched base with the local Peace Corp Volunteer who was able to bring us in person to the man’s house. Sure enough, the man had slipped while working on his farm 4 months prior and had been “hammock” bound since then. He struggled immensely to even get out of his hammock, and since being in the hammock for the majority of the past 4 months, was pretty much fixed with his hips in a severe hip flexion contraction and also very bent over at his spine. Our student, being in his first week of rotation, and still being unfamiliar with the resources, strongly recommended diagnostic imaging. We explained to our student that diagnostic imaging options were very limited. An x-ray could be done in Punta Gorda (a 2.5 hour drive away), but any CTs or MRIs would likely be out of the picture. As well, as a PT, always good to consider if and how the imaging will actually change treatment. Billy, the Peace Corp Volunteer, then explained that the only bus that was previously coming into Otoxha had apparently stopped services a few months prior, because of the poor road condition, so the only option to get this man to Punta Gorda was to either have him walk the 2 hours to the adjacent village that still had bus service (which would be out of the picture for a man that cannot even hardly get out of his hammock) or to “charter” a ride into PG (sort of like taking a private taxi with somebody that might own a vehicle). Unfortunately, as the man explained to us, he could not afford to charter a car ride into PG, as he was unable to work on his farm because of his back/hip pain and of course he could not walk out of his village because he was in too much pain. Conservative treatment that included passive back/hip stretches, provision of a walker to encourage more upright mobility, and patient education to try to get moving, seemed to be the most rationale route of treatment. Roll forwards to February when we do our next visit to Otoxha. I head over to do a follow up with this gentleman. This time I seem to be greeted by a completely different man. He has a big smile on his face and tells me that he had cleared the brush with his machete on the trail I had just walked up to get to his home. He shows me that he can now easily get in and out of his hammock and as well is back working on his farm half the day. Still not completely perfect, but at least 75% better than the last time we saw him, and the big thing, at least able to be functionally back at work. On the walk back to the clinic, I am busy thinking about how sometimes just basic therapy can make the difference, not really paying attention to where I was going, ran into a large pig in the middle of the path that was busy rooting for something underground. Both the pig and I had a good startle and both jumped back a good distance with the pig giving off a good loud grunt at me. One never knows what one will run into in the villages.

 

 

 

One of our “projects” with community based rehabilitation is looking into obtaining sustainable solutions for rehabilitation equipment such as wheelchairs, walkers, commodes, canes, etc…The original “plan” regarding wheelchairs that was passed over to us from the previous rehab director was to ideally find or build relationships with a local source which could ideally provide wheelchairs in a long standing way for our region or possibly country for years to come. Unfortunately, the Disability Services Division of the Ministry of Health in Belize was dismantled in 2000, which subsequently meant that services for individuals with disabilities was largely transferred over to private companies and NGOs. Meaning that there is little to no money for services or equipment required to service those with disabilities in the country. After making numerous phone calls, emailing multiple individuals, it quickly became clear that the majority of the country obtains wheelchairs through donations. There is no “pot” of governmental money that would magically cover the costs of wheelchairs for those in our area. Through some research it became clear that while there are great organizations out there (e.g.,  Free Wheelchair Mission, CLASP) that strive to provide low cost solutions for wheelchairs designed for places with limited resources and rough terrains, there still fundamentally needed to be some funding in place. Whether it is to cover the basic cost of the wheelchair or even just the taxes on the shipment of wheelchairs, money always seemed to be a limiting factor. It seemed like we had come to a disappointing conclusion, when one of our emails to the Inspiration Center (one of the very few other NGO clinic in Belize that offer therapy to kids in Belize City) had a response back that indicated that they had just secured funding for a large number of new wheelchairs for Belize through the American Wheelchair Mission, founded by Chris Lewis (son of Jerry Lewis). As there are a very limited number of Physical Therapists in Belize, the Inspiration Center wanted to partner with Hillside to see if we could complete the applications forms for individuals that might require wheelchairs in the Toledo area of Belize. While measuring and completing wheelchair applications in Canada might seem pretty straight forwards, somehow things are just always a bit more complex here. We had obtained the application forms in November with a deadline for all applications to be delivered by the end of January. We quickly realized that we would not have the opportunity to make it out to all of the remote villages in Toledo before the January deadline. We checked the calendar and saw that the next day would likely be the last day the Community Health Workers (CHWs) from the villages would have their training in town (Punta Gorda) before the deadline. CHWs generally have training on the last Friday of each month (though they were having Dec off). The CHWs are representatives from each village that come into town and receive basic medical training from the Ministry of Health representative for things such as weighing babies, vaccinating babies, taking temperatures, blood pressures, blood glucose, blood smear samples for malaria, etc. This assists with meeting health needs in very remote and difficult to access villages. Many of the CHWs are catching buses at 3-4am to make it into town for the monthly 8am meetings. We quickly made a phone call to the CHW trainer with the Ministry of Health who agreed to squeeze us in for a quick 5 minute presentation the next day. Along with 3 other PT students we quickly described to all the CHWs how to measure hip width, floor to knee heights, thigh lengths, back heights, etc.. One of the requirements for the wheelchair application was that a full body photo were taken of the individual needing the wheelchairs, with them holding a piece of paper with their name written on it, as to help ensure that the wheelchairs were not being sold to the black market. Unfortunately, a large number of the CHWs had no method to take photos of individuals in their communities and the other challenge was how they would get the photos to us since emailing would not really be an option. Another limiting factor was the lack of basic measuring tapes. There were 3 different versions of chairs being donated. Some with increased support for those with increased tone, another was a basic folding wheelchair, and another sportier model with mountain bike tires. Seeing how wheelchairs last in Belize, we knew the tires on the basic folding wheelchair would not be ideal for most villages, as the rubber on the tires seem to just completely rot out with the weather or torn up with the road conditions. However the sturdier model, which would probably last longer on the rocky roads, were not foldable, which would be tricky in the common village home with only approximately a few hundred square feet in floor space.  Trying to determine which model best to pick for each individual was another tricky thing. Despite the challenges we fumbled our way through and via many different creative measures managed to complete 37 applications for those in Toledo.

Last week we were trying to organize our applications in alphabetical order and soon realized we had 3 applications of people with the same name. Now it is not that uncommon to come across individuals with the same names in a number of the villages we work in. We thought we could easily determine if there was a repeat in application by looking at the picture, only to be surprised to find that all 3 applicants with the same names were about the same age and wore exactly the same outfit (Mopan Mayan) in all 3 pictures. 1 applicant we quickly determined was a different person as they were from a different village, however the other 2 applicants had us all a bit stumped. One picture was taken of a lady in our clinic where she looked very solemn. The other picture of a lady with the same name was taken in her home where she had a large smile on her face. We checked the rings on the fingers and determined that the rings were worn on the same fingers in both pictures. Long green dresses were identical with a white lace trim. White blouses appeared almost identical with a black trim with birds on it. The application also requested for date of birth, hip width measurements, and person of contact. Date of birth was identical on the two applications…same name, same date of birth, must be the same person…but not so quick.  Hip width measurement was 5” difference…did we really do such poor job of training the CHWs? Person to contact was a different name all together. We went around Hillside asking all the locals for their opinions. Our conclusion after much debate was that they were indeed 2 different applicants. Why the same date of birth? Well, apparently a large number of the older Mayan generation here don’t always know their date of birth and thus were assigned date of births when they went to get registered. Resulting in a number of people looking similar in age having identical date of births. With some close attention it looked like also perhaps one of the birds on the black trim was perhaps different. We might have been wrong, but it was our best educated guess after much discussion.

 

So it is about time that we write another blog post.   The last time we wrote was to share about our adventure doing the “End of the World” half marathon about 2 weeks before Christmas.   Now as hard as it is to believe, it is actually February.   I had better get down to business and write about our tropical Christmas or before I know it we will be into our next non-tropical Christmas.

Our Christmas break began on December 14, 2018.   Hillside clinic was officially closed on for the week of December 24 -28, however we were informed by management that there would be no patients seen during the week from the 17th to the the 21st.  That week was reserved for staff to tidy up their departments and complete inventories before taking off for the Christmas break.    Therefore if we managed to get those tasks completed before that time then staff could also take the prior to the week of the 24th off from their vacation.   As you can guess all departments made a special effort to have their areas organized and inventories completed prior to the 14th so that we could have a full two weeks off for Christmas.

I scrambled to finish work by the end of the 14th.   Our department had been tided and inventory completed but there was still the rehab schedule to be planned out for the entire year of 2019.  I had starting working on this back in November but because the rehab schedule is dependant on the medical mobiles and the ministry of education,  the process was held up for a couple of weeks.  However, by divine intervention, it seemed, I had the schedule done by 4 p.m on the last day of work.

That night we had the staff Christmas party.   Our co-worker Allie, the pharmacy director hosted it at her place.   It was a lovely evening with great food, drink, and Carribean Christmas Carols.   As I found out that night as well as on the buses that the Christmas Carols here have quite the “bing bop” as our colleague Kristine put it.

Instead of Turkey we feasted on a Punta Gorda favourite:  BBQ chicken.  Our grill masters Jamie, Rudy and Alva cooked up quite the storm

After recovering from the staff Christmas party we hung around Punta Gorda for the weekend preparing for our first trip away over the Christmas break.   On the Sunday morning we celebrated the 4th Sunday of Advent at a Mopan Mayan mass in San Antonia.  Traditionally the Mayan people like the sap from the Copal tree to make incense that they like to use at mass.  It did smell nice but at one point during the mass I could not help but think to myself that a little oxygen might go nicely with the lung fulls of fragrant smoke I was breathing in.

Cotton Tree Lodge

On the 17th of December we left for Cotton tree lodge which is a resort not far from where we live between the villages of San Felipe and Santa Ana.   When we were down in March, scoping out the place, we bought a couple of chocolate bars from the Cotton Tree Chocolate Factory in Punta Gorda Town.   On the wrapper was a code to enter a draw for a 7-night stay at Cotton Tree Lodge.    Without thinking much about it Gail and I both entered in the contest.    Much to our surprise, Gail received an Email in June saying that she won the 7-night stay at the lodge.   If this was not shocking enough about a day later I also received the same Email informing me that I had also won a 7 night stay at Cotton Tree Lodge.   Then when we got to Punta Gorda in the summer and met our new counterpart in the Pharmacy department, Allie,  and got to talking we found that she also won the same prize.    At this point we were pretty suspicious and thought this must be a scam.  However since we were here we thought we might look into it.    We called them up and they confirmed that we indeed were entitled to the seven night stay but that it did not include meals or transportation from town to the lodge.  It did however include two tours one of a chocolate farm and the other of the Punta Gorda market place.    Since we both had won the trip and each stay was for two people we negotiated with them to use both prizes so that we could bring the boys and all of us stay together.   Since 7 days seemed kind of long we decided that we would only stay for 3 or 4 days.

On the 17th of December we caught the bus from Forest home that would take us to the junction between San Felipe and Santa Ana.   Along the way were again reminded that despite the warm temperatures we were having every day that it was indeed Christmas here by the quickly becoming familiar sound of Christmas music with a “bing bop”.

Bopping along to Christmas Carols on the bus.

After 30 minutes of bopping to Christmas Carols we had to get off the bus and walk a mile from the road into the lodge.   Since we were staying about 4 days we had a fair amount of luggage including our clothes and food for our stay.

Even though we were just 8 days from Christmas it was quite a warm walk but it was well worth it.   Cotton tree lodge is a jungle paradise of comfortable cabanas along the Moho River.

Once we made it to the lodge we were met by the staff and shown the main lodge and then our Cabana where we would be spending the next 3 days.

It was quite a treat to stay a cotton tree lodge.   Our Cabana over looked a portion of the Moho River.   About 20 paces from it there was a dock into the river and a rope swing that I had way too much fun jumping off into the river.

What was really a treat while staying at Cotton tree was hot water.   Except for the night we stayed in Placentia to participate in the half-marathon we have been taking cold showers.    Mind you that when we first arrived it was so hot that the last thing we wanted was warm water however after 5 months of cold showers to be able to turn on a facet and be covered in warm water was quite a treat indeed.

Our first afternoon there we spent the day just exploring the grounds, laying in the hammocks and going for the occasional swim off the dock followed by a brief but thoroughly enjoyed hot shower.  On our favourite things was to watch the iguanas fall into the water a crawl around on the grass just below our Cabana.

Cotton Tree Lodge: Elidio’s Chocolate Farm

On our first full day at Cotton tree lodge we went out on a tour of a chocolate factory in the nearby village of San Pedro Columbia.   We all piled into the Cotton Tree jeep and we were on our way.

When we arrived at Elido’s chocolate farm he took us on a 2 hour tour where he explained how he grows not only chocolate but many different crops such as plantain, ginger, sugar cane and many others.

After the farm tour with Elidio we went back with him to us factory and home where we had a delicious lunch followed by a demonstration of how to make chocolate from the beans.

During the chocolate making demonstration we learned that traditionally the mayan people would use Cacao beans as a form of currency as well as making into a Cacao drink (i.e hot chocolate).  When they would make the Cacao drink they would just wash the beans, dry them, roast them, grind them and then mix with hot water and serve.    Presently chocolate companies also ferment the beans before drying, roasting them and grinding them to give them a more chocolatey flavour that we are all familiar with.   In order to ferment the beans they would harvest the beans from the pods with they white jelly still surrounding them and place them in boxes with banana leaves.   They would need to stay in the boxes for about 7 days and  be turned every two days.   Then the beans would be removed from the boxes and laid out to dry for 10 days.   Following that they would be roasted for 30 minutes and then they are ready to made into chocolate by removing the shells and grinding what is inside to produce a chocolate paste since Cacao beans are composed of 40% fat naturally.

Cotton Tree Lodge: Jungle Survival Tour

On our second day at Cotton tree lodge we went on a jungle survival tour with one of the Gardener’s who works at the lodge, Armondo.   Originally the second tour that came with our prize was a tour of Punta Gorda market place.   However since we have a had a habit of frequenting since July in search of our weekly groceries we requested that if its different tour could be subsisted in its place, to which management agreed.

Our guide for the jungle survival tour, Armondo, is from a village just up the road, Santa Ana and spent time serving in the Belize Defense Force popularly know as BDF where along with just growing up in Belize learned many tricks of finding water, food and shelter in jungle which he shared with us.

One of the first things that we taught showed us was one means of obtaining food by cooking the heart of palm trees such as the wari palm or the give and take palm.

After we had the opportunity to taste some of the heart of palm trees that could be used as a source of food,  Armondo showed us another source of food that I never would expected to find in the jungle, Crayfish.   Apparently crayfish live in the ground throughout the jungle leaving telltale plies of dirt on the jungle floor above their residences.  Unfortunately we did not have time to taste these guys.

Not far from where we discovered the cray fish we had a good view of some howler monkeys which had been “serenading” us every night since we arrived at Cotton tree lodge but had never been able to get a glimpse of.  The first time I heard their calls I thought it was a jaguar in distress.

After we spent some time gazing at the Howler monkey’s high up in the trees, Armondo taught us some ways to obtain water in the jungle.  The first two methods involved using leaves along with branches, bamboo and vines to create cradles to collect either rain water or just condensation of the highly humid jungle air.   He had come in earlier in the morning a constructed a couple of these and within an hour there was already a half a litre of water even though there was not a cloud in the sky.

The last method which he showed us which we thought was the coolest was to chop a section a water vine.   There are particular vines in the Belizen jungle, identified by a cracked surface that will drop water if you chop a section and then hold it vertical.   He chopped us each a section and we got to try drinking water straight from the vine.

The water vine: A quick way to find water in the jungle

After showing us how to find water in the jungle, the last thing that Armondo showed was how to build a lean-to using branches, vines and cahoone leaves for shelter.

Days Leading up to and following Christmas Day

After we got back from a relaxing and fun time at Cotton tree lodge we spent the days around Christmas Day in our neighbourhood.   We were invited to a couple of Christmas parties at some of the churches that we attended we had to dance to those catchy Carribean Christmas Carols that we had become accustomed to hearing such as “Good Morning Miss Lady” and “Drink a Rum”.

We also got to meet Saint Nicholas with a tan.

It was not very practical to have a Christmas tree here as that would involve having a thousand miniature guests with little feelers join us for Christmas dinner which we very much wanted to avoid.   Therefore, instead of finding a few gifts under the Christmas tree good old Saint Nick had a Christmas gift scavenger hunt Stephen instead.

Our Boxing Day was a new experience as we made a trip to the ocean to swim and play in the sea.   I cannot remember too many boxing days like that growing up in Newfoundland!

Maya Mountain Research Farm

For the last couple of days of our vacation before New Years and heading back to the clinic to start another rotation we spent three days up at a permaculture farm in San Pedro Columbia, a Mayan village about 30 minutes drive from our house.   The farm is not accessible by road so once you get to San Pedro / Columbia, which you can drive to or take the bus (we took the bus), you either have to hike about an hour along foot path or hire a local man, Jorge who will take you up the river in a dory.   Since the path was very muddy and rough this time of year we chose to take the dory.   The route to the farm goes along the Columbia River which is not very deep so instead of paddling the boat, Jorge used` a pole to push the canoe along and transport passengers up the river.

Maya mountain research farm is owned by Chris Nesbitt, originally from New York City, and his lovely Belizean wife Celini who live off grid.  We had met Chris at one of the local festivals and he had invited us to come stay with them at some point during our year in Belize to see what they do. The place looks more like a jungle then a farm but everything except for a few mango trees was planted by Chris and has one or several specific purposes, whether it be to trap soil from eroding, fixing nitrogen in the soil, providing feed for chickens, or long term cash crop (hard wood trees).    Chris and Ceini host interns on their farm who want to gain practical experience with permaculture who can stay for a minimum of week up to a month.   Since we were volunteering in the area, they graciously allowed us to stay just a couple of days since we don’t get a lot of time off.   For more information you can check out their website:

Maya Mountain Research Farm

Staying at MMRF was not the luxurious accommodation of Cotton Tree Lodge but we throughly enjoyed it.   Chris and Celini are very knowledgeable, interesting and kind.   Chris has lots of great stories that one could listen to for hours.   While we were staying there, Chris and Celini had their had their granddaughter Mia as well as Rego, the 7-year old-brother of one their farm staff.   Stephen and Aidan took little time to make friends with them and had a blast the three days running around the farm together and playing school in the dining room.

The first night there we had the tastiest vegetarian pizza we have ever eaten which was cooked in an earthen-made, wood-fired-oven.  It was delicious

Since the farm is off the grid our only option for laundry and bathing was done all at the same time down at the river just as we would often see the Mayan women and children do in the rivers that we would pass along our way to do mobile clinics

All in all it was fun and interesting Christmas.  One quite unlike we are used to but one we will definitely remember.  It was nice to have a break from the clinic and we were able to have some interesting experiences right in our own backyard.

The Hillside Running Team!  

Hillside clinic, where Gail and I are volunteering at the past year, has taken part in the End of the World Marathon as a way to raise funds for the clinic. As if we were not already sweating enough we thought why not do a 13 mile race along a sandy peninsula in the Caribbean!  The Marathon takes place in Placentia which is about a 2 hours-drive north east of Punta Gorda. Even though it is not that far away from us this is the first time we have visited Placentia since we arrived here in July for the year.

We drove up on Saturday morning with the rest of the runners from the clinic. We left the clinic at 11:30 and made it to Placentia at 1:30.   Although Placentia, distance-wise, is not that far away from Punta Gorda, it is a whole different world from Punta Gorda.   PG, although we have come to love it is mishmash of nice homes, with dilapidated shacks and thatch houses place randomly along the ocean side and extending into the jungle of Southern Belize.   Placentia on the other hand is on a narrow peninsula filled with high class resorts and sprawling mansion like condos.   It is definitely not “real-Belize” but much the touristy side of Belize you would see in advertisements for all-inclusive vacations.   Interestingly, there is a Garifuna village about halfway along the Peninsula called Seine Bight which was given its name by French fishermen deported from NEWFOUNDLAND after Britain gained control.   There is one main road going down the centre of the peninsula which as you drive by you can see beaches on either side of the road since the peninsula at its widest is less than a kilometre wide.

The beach along Placentia

In order to do the Half-Marathon, since it started at 5:30 a.m, we had to stay one night in Placentia.    Most of the Hillside team stayed at a house owned by one of the doctors on the Stateside board.   However for our sake and to ensure that the rest of the team got the full night sleep they needed for the race the next morning Gail, the boys and I found a place close by where we stayed with one of our colleagues who agreed to stay with our boys while we left super-early to start the race   It was a nice little Cabana which was not to expensive but very neat and it had warm showers which is the first time we have had warm showers (not that we needed them) since we arrived!  The things you take for granted!

Our Cabana in Placentia

After we got settled we had to make our way to down-town Placentia to register for the race and pick up our numbers and T-shirts.   We quickly had supper so that we could be to bed as early as possible considering that we were going to be running 21.5 km the next morning and had to be at the road side at 4:00 a.m. to catch the bus to the starting line.

Thankfully, (I guess should say that) we heard our alarm go off at 3:40 a.m the next morning so we did not miss our 4:10 a.m. bus to the starting line.   Actually 2 buses passed us that were already filled with runners.   There were over 200 people registered to run the half marathon / marathon.    The third bus to arrive was only 1/4 full so we were able to get a seat.   About 5 minutes up the road we stopped in Seine Bight to pick up runners from a local running club.   The bus went from being 1/4 full to over capacity in a manner of minutes.   A little further down the road we picked up a couple who sat next to us who turned up to be from Calgary and are friends of the Foy’s, the couple who used to own physioworks in Creston when first moved to Creston over 11 years ago.   The wife is also a physiotherapist who teaches K-taping and lymphatic drainage techniques and might consider putting off a course for us when she comes back in April.   Along the way we saw people on the road side twirling flaming batons.   The husband of the couple in Calgary informed us that there is a competition for the best decorated water station along the route so we should expect to see some interesting sights as we ran.

At the starting line there was a tent where we had to register again but had lots of snacks and water to fuel up on.   It was also our last chance to use the facilities before the run.   Even with 8 port-a-potties, there was quite a long line-up.   From the tent area we walked to the actual starting line which seemed like far distance in the dark with no street lights.      Once we made it to the starting line we took the group picture above and then I, being the physical therapist, was drafted to lead the warm-up for our team.

With no more of a warning besides, ‘Ready! Now go” we were off.  It was quite a mess of arms, legs and bodies with little sense of direction since we were all equally blinded by the barrage of flashes from smartphones and cameras followed by return to the darkness that we would be running in for the first 20 minutes of the race.  Once our night vision returned it was quite beautiful running along the road with the stars above and just being able to make out the beach on the East side as the sun was starting to come up.   If I had a camera with me I would have had some amazing pictures to show but alas you will have to depend on your imagination for those.

 Louis our night-time and weekend security guard.

The route is probably the flattest I have ever run for such a distance.   There were no hills to speak of and only one major curve around the airport so I was able to go at pretty good pace the whole way.   There was one foreign girl running in front of me and she stayed about 20 meters ahead of me for most of the race so I used her to gage my pace for most of it.

Mr. Randy our daytime security-guard who hardly ran before and was the least stiff of us all!

Victor, the pharmacist from Hillside looking strong!

Our rehab tech.  Go Amira go!

Every mile or so along the route there were water stations set up and as promised they were creatively decorated.  One water station had a “home on the range” theme, with cowboys and salon girls giving out water.   Another station was playing the song, “Under The Sea” and had a little mermaid giving out water.  It also had a tunnel which you could run through which had pipes that poured water down as you passed by, making it one of my favourite stations.   Although the station that won first prize, and rightfully so, was staffed by a bunch zombies who every now and then would break into a coordinated dance to ‘Thriller”.  Pretty cool to see but a little scary run through.

 

The Zombie Water Station.  Do I really want to drink that water?

Around the 11 mile mark the foreign girl I had been following to pace myself started to pick up the pace.  I thought about trying to speed up as well but I could feel my calves on the verge of cramping so in stead I just kept up the same pace I ran for the rest of the race and made it into the finish line with a time of 1:52:53 which I was quite pleased with.

Made it!

Gail came in with a time of 2:22:44 and won third place in her age category.

Gail makes it across the line.   “You are not going to pass me that easily!”

Our physiotherapy student, Kyle, who was with us during this rotation also ran and won third place in his age category.  Kinsey, a pharmacy student at hillside place won second place in her age category bringing, so it was a good showing for the Hillside team.

Hillside’s trophy winners:  Gail, Kinsey and Kyle. Great job!

Ah it feels good to be finished!

 

Dolores is one of the furthest villages we service. We expected the drive to take a long time, but with the combination of rain and very poor road conditions, the one-way trip took a good three hours. The road was very questionable in a number of spots and involved much holding of breath that the land cruiser was going to make it through the mucky, muddy, hills with deep grooves cut out by previous vehicles. When we finally made it to Dolores, Mr. Rudy came over to congratulate me on making it through some of the worst road conditions he had seen coming this direction. The health post at Dolores is attached to the local school and we quickly unpack the vehicle to set up “shop” knowing that we did not have a whole amount of time to spend in clinic considering the required travel time on the way back. After holding our bladders for a good three hours, the majority of us urgently needed to use the bathroom. The health post had 2 bathrooms, but unfortunately, neither had running water and thus were not flushable. However, considering how desperately we all needed to go, we took turns using one of the students cellphone flashlight and crammed ourselves into the small cramped bathroom to relieve ourselves. In situations like this, one cannot choose to be picky.

 

 

View from outback from the PT treatment room in Dolores

The PT student assessed one elderly mad with an injured knee who actually had been waiting 3 months to see us. We provided him with some exercise and education that hopefully was helpful.

Nursing students had been put to task to do fluoride treatment for all the kids in the school. However, considering we were only going to be physically in Dolores for a few hours, and the fact that one cannot apply fluoride right before a meal, meant that the task had to be done quickly before the kids had lunch. Not normally considered a PT role, but being that we were slow with patients, we kicked in to help out the nurses. We tackled one class at a time, gave a brief presentation on how to brush your teeth, provided each kid with a free toothbrush, and had each kid brush their teeth and spit off the front cement deck of the school. For many of the kids this was the first time for them to ever use a toothbrush. Hussling the kids back into their classroom, we broke up and systematically went down each row and brushed each kids with the fluoride paste. It was amazing to see the large number of cavities present. Some kids had severe caries on almost all of their teeth, and I asked the nurse if we should be referring those kids to the local dentist in PG. The nurse said, we could consider, but it was a near impossibility that these kids would actually make it out to get followed up regarding their teeth, especially considering that buses no longer run to Dolores and that the closest bus stop would be a good few hour walk away.

Teaching kids how to brush their teeth

The kids were very cooperative and cute and let us strangers brush this strange, bad tasting solution on their teeth with little fuss. The teachers in the villages were very helpful and seemed to be excellent teachers considering the limited resources they had. While we were treating the older classes we could hear the Kindergarten teacher having the entire class sing various songs for washing hands, cleaning up, learning the ABC, etc…which the kids all joined in with much gusto.

Got caught in action by one of the co-workers

The Standard V class (grade 7) was located in a traditional thatched roof building. The teacher apologized to us about the “lighting,” as there was actually no electricity or light to this particular classroom, which perhaps was doable when the sun was out, but did make things quite dim when there was cloud cover, as it was that particular day. I was wondering how it impacted learning when visibility could be quite poor depending on the level of sunlight.

Stray dog looking into the PT treatment room. Thatched building in the back is the Grade 7 classroom.

Stray pig decides to join in, in the picture

We were running low on time, so luckily the physician assistant students pitched in to help out with the last few classrooms, so that we could finish off all the classes with the fluoride treatment prior to departure.

As we packed up to go, the rain started to come down. By the time we hit to road to head back, it was raining torrentially. If the road was bad on the way in, it was that much worse on the way back out. Sometimes I question what we signed ourselves up for, especially not being adventurous types. Mr. Rudy had me drive ahead of him. We came to some hills, which I thought there was no way I could make up with the mud pouring down the hills. Luckily I had a good bunch of “back seat drivers” that cheered me on and yelled at me to push the gas harder and somehow we managed to swerve our way up the hills. I wonder if there was any carry over from driving up Wynndel Road in the winter time. After another grueling 3+ hour drive back, we finally make it back to the clinic in one piece, much to my relief. We get out of the vehicle and Mr. Rudy comes over to pat me on the back to say, “you passed.” I guess in some ways in his eyes, being able to make it to and from Dolores with the roads in that condition were admirable. I was just glad to hear that that was considered to be as hard as it got.

I bike back home and hear that Ron had a typical Belizean day trying to figure out our cooking gas situation. Our cooking gas had been getting low about 4 days previous and we had called the local gas company to indicate that we needed more gas. After 2 days of not hearing back from them, we called and left another message. By Sunday night, right in the middle of trying to bake some bread, the gas completely ran out (the neighbours kindly offered to let us try to finish baking off our bread in their oven, but it never really did save the half cooked bread). Monday, Ron decided to personally bike over to the gas company to request for gas. He gets there to find out that the gas company is actually all out of gas, and not expecting gas any time soon. They recommend 2 other places in town that sell gas, neither of which deliver gas. Luckily we had just managed to get our vehicle fixed a few days prior, and Ron was able to load the gas tank into the back of the car and head into town to get a newly filled gas tank. When he gets back he notices that the washer is missing and searches all over for it, and determines he must of left it at the gas company, so drives back over the very bumpy road to town. When he finally makes it to town the owner manages to find that the washer had fallen under the seat in the car. Ron makes it back home, borrows some tools from 2 different neighbours and tries to reattach the tank to the wall. This time the washer breaks and the tank can no longer be attached. He bikes over to a local acquaintance that works at the gas company who indicates that he would recommend getting a different type of attachment since the washers tend to break. Ron had just made it back from the acquaintance when I get home from my very long day, with still no gas for the stove!

Maybe this was a good excuse of a day to go out for a meal. We decide to try out a place that one of the previous rehab directors had indicated was his favorite place to eat (i.e., the Mangrove Inn). Turns out the husband of the couple that runs it is Canadian as well. Not sure if it was because we were all famished and exhausted, but somehow the food tasted so very good. The conch fritters were excellent, and Stephen loved the pasta. Somehow good food always makes the day seem that much better.

Addendum to “passing” the driving. The following day, I am at clinic and one of the maintenance men pulls the rehab tech aside to say that I ran into one of the clinic trucks when I was backing out. The rehab tech said that she never noticed and called me over. I also never noticed running into anything on the way out and remembered noting that the truck was very close, but had made sure that I checked the rear view mirror to make sure that I cleared it when backing out. We checked with a few other people that were sitting in the jeep with us and nobody recalled us running into anything on the way out. The maintenance guy points out a slight stripe of black paint on the back bumper of the truck and shows me a small dent on soft bumper on the very front left corner of the jeep. He demonstrates how much further you need to clear the jeep after it has cleared the rear view mirror. Sure enough, it looks like another car length to clear. He explains that none of us likely felt anything since the car is so large. Rightly so. Mr. Rudy comes around and says that the “passing” from the day before was maybe just brought down a bit of a notch. Good to stay humble.