“For the Body is not one member, but many. “
Throughout the world each day God uses exceptional people to do exceptional things in His name. At Loma de Luz we see this each day, and we see the truth of Paul’s teaching about the diversity of gifts and the unity of the body. This work could never have gotten here and could not last one single day without the contributions and the sacrifice of many exceptional people through whom He accomplishes His purposes. At the end of each day, one can see that more was accomplished for His purposes than the sum of the visible parts. A synergy transpires from a body with coordinated components and the Creator who makes up the glue and makes up the difference.
This is a theme of Loma de Luz. With the LdL Times, we hope to present the Creator’s work at Loma de Luz as a whole, and do so through the sum of its parts . Many of our excellent missionary members write blogs and newsletters. We propose to coordinate and present the best and the most applicable of these individual writings to the theme at hand, and for better or worse, the theme at hand these days is the elephant in everybody’s living room; Covid-19; the threat of it, our response to it, and how that is effecting our lives.
Anne Hofer is one of our exceptional missionary physicians. Many of you know Anne and her husband Isaac Hotz. Not all of you might know that they write a great individual blog. What follows is most of Anne’s reporting from March 24. As things change so rapidly with Covid-19, the numbers, and the governmental response, we won’t attempt to update numbers and developments each day. But this is a great series of snapshots of where we had gotten to in preparations at the Hospital by the 24th of March, a process we began in January.
On the next installment we plan to present the impact and the changes we’ve made at El Camino Bilingual School.
Preparing for a Pandemic, by Ann Hoefer:
Like the rest of the world, there have been quite a lot of changes down here in the last couple of weeks. Honduras got its first known COVID patient in the country a couple of weeks ago. It was a pregnant Honduran lady who had flown home from Spain. Now, that one known patient has turned into 36. The government, alarmed by the way the disease has overwhelmed the health care systems in China, Iran, and Italy, and knowing that the Honduran health care system is decidedly not up to this challenge, is determined to try to contain the disease. To that end, the borders have been closed, all non-essential businesses have been closed, public transportation has been stopped, all gatherings of 50 people or more are banned, and a nightly curfew at 6pm is in effect. We are unable to drive to the nearest city for grocery shopping anymore and now try to pick stuff up from delivery trucks that come through about once a week (our version of Amazon). Several of the missionaries who were planning to go away on furlough to the states had their flights canceled, so they will be staying here for now. All of our repeat short-term physicians that were supposed to come this spring have also been canceled, including Otolaryngology, Plastic Surgery, general surgery, and internal medicine.
We estimate that if we have a pandemic with the same density as China, then there will be about 2122 people hospitalized in Honduras with COVID with 530 needing a vent. As far as we know, there are 8 ventilators in the public hospital in San Pedro Sula and probably a similar number in Tegucigalpa. Those ventilators are almost always occupied and usually only occupied by previously healthy individuals who are felt to have the best chance of recovery. It is not uncommon for family members to “bag” their loved ones (manually breathe for them with a bag attached to an endotracheal tube) in the emergency room for days while they wait for a ventilator to become available. Needless to say, there is no way the country could provide for the ICU-level patients if COVID becomes rampant here.
Of course, the hospitals are still allowed to remain open, so we have been working hard to prepare for a pandemic that we hope never affects us as many anticipate. (Vaccine, treatment, God’s mercy?) We do not have any fancy isolation rooms in our hospital, nor to we have the capability to test for COVID here (yet….we are working on trying to import tests). There is a lab in Tegucigalpa which can do the test, but for that to happen, the patient would have to go through the public hospital system and have their blood sent to the lab.
In the end, we decided that it would be best to try to keep our potential COVID patients as separated from the rest of the hospital patients as possible. Essentially we are establishing an entire hospital system separate for COVID patients. Lab, x ray, triage, waiting room, vital signs, inpatient, ICU. All separate. We have started to build a new triage/waiting area for them outside the gate where their histories and vitals will be taken. The ones that seem to be mild COVID will be given a mask, medications, and instructions on how to complete a 2 week quarantine at home, all without actually entering the hospital.
The ones who are more moderately affected and might need admission or laboratory work, will be sent up to the COVID evaluation area, where we will have personal protective equipment ready for nurses or lab techs to put on before seeing the patients.
The ones who need to be admitted will go over to the Samaritan’s Housing part of the hospital, or “casitas.” They were originally built a few years ago to house patients who need to be near the hospital but don’t have to be admitted. Now, they will be our COVID inpatient unit. We will be able to keep them separate from the other patients in the hospital as well as separate from each other. (Since we don’t have COVID tests yet, it is feasible that a patient with regular bacterial pneumonia or asthma could be put into the COVID unit, so we don’t want them all to be together and actually spread the disease.) We have constructed fencing so that only authorized hospital employees can enter the area. Several new sinks have been placed throughout the hospital in order to help our patients and staff wash their hands as much as possible.
We have also bought 500 gallons of bleach in order to make our own disinfecting solution for cleaning the rooms and hospital and are trying to get some isopropyl alcohol to make hand sanitizer. Luckily, we are blessed to have a small supply of expired N95 masks which were donated to the hospital by previous visitors. We have put in an order from Blessing International for chloroquine or hydroxychloroquine in the hopes that these meds might help our patients avoid needing intubation. We will likely only have the capability to vent 2 patients in our COVID ward. Hopefully, the meds will be able to be flown into Honduras soon.
Through all of this, we are still seeing our regular patients and waiting for the day when a COVID patient will show up.
A couple nights ago we were having a music night at our house and re-encountered this old song. The words felt appropriate for the day:
Abide with me, fast falls the eventide
The darkness deepens; Lord with me abide
When other helpers fail and comforts flee
Help of the helpless; abide with me
Thou on my head in early youth did smile
And though rebellious and perverse meanwhile
Thou has not left me, though I oft left Thee
Unto the close, Lord, abide with me
I need Thy presence every passing hour
What but Thy grace can foil the tempter’s power?
Who like Thyself my guide and stay can be?
Through cloud and sunshine, abide with me
I fear no foe, with Thee at hand to bless
Ills have no weight, tears lose their bitterness
Where is thy sting, death? Where, grave, thy victory?
I triumph still; abide with me
Hold Thou Thy cross before my closing eyes
Shine through the gloom and point me to the skies
Heaven’s morning breaks and earth’s vain shadows flee
In life, in death, Lord, abide with me.