Mercer On Mission

2015 Blog

Friday-Week 1: Nicole

Today we were at a two classroom school, with one room used for pharmacy and the other used for patient visits. This is a set-up for clinic we have grown accustomed to over this last week, However, there was one difference between today’s clinic and other 2 classroom clinics. Today’s classroom where we saw patients had sheets hanging from the ceiling to the floor, separating the room into 5 separate sections. Even though the “walls” were merely thin bed sheets that were far from soundproof, it created a semblance of privacy, which had been lacking from previous clinics set up in classrooms.

Today’s settings made me consider how different our Honduran patients’ expectations of healthcare delivery are from our American patients. In the US, patients expect privacy in every aspect of medical care. There are laws in place like HIPAA and MISPA, not to mention the ongoing discussions on how to protect patient data in the age of electronic medical records. There are groups and organizations who fight to ensure patient privacy rights. In Honduras, attitudes towards and expectations of privacy cannot be more different. In other clinics set up in classrooms, we usually have one large room with 4-5 providers and teams seeing their patients at the same time, without any partitions in the room. In this open setting, patient’s visits, histories, and physical exams are overheard and seen by family members accompanying them, other patients being seen in the clinic, and people waiting outside of the classroom who poke their heads through the bars on the classroom to get a peek at what is happening inside. Our patients in Honduras are more exposed and have very little privacy compared to patients in the US.

I feel as though patients deserve to have the information they share with healthcare providers stay private and not be overheard or shared with other people. I get nervous that some patients may feel they cannot discuss certain things (which might be important to diagnose or treat them) because their personal information would be overhead in a crowded, public room. In a culture that places such great importance and relies heavily on family, friends, and community members, patient privacy is essential; I believe providing privacy for patients to discuss matters related to health lends itself to more informative conversations that can improve our ability to diagnose and treat the patients. With today’s clinic set-up, I was really pleased that the patients I saw could have a sense of privacy. I feel as though I was able to better serve them and connect with them even more.

Even though there is not much privacy given to them, I want to note that these patients in Honduras are still so grateful and appreciative of everything; they do not complain about the lack of privacy or the crowded, public clinics. They are some of the happiest people I have had to opportunity to meet. Though most on the trip would agree that they have been dealt a tough hand in life, this thought never seems to cross their minds. The Honduran people we have had the pleasure to interact with have shown us love, happiness, and perseverance, in addition to the fantastic bear hugs they have given us. I  will never forget their wonderful outlook on life and I hope it rubs off on me as I continue with my career in medicine.

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