Over the last several months I have focused on better understanding the government paperwork and reporting requirements Hombro a Hombro is subject to as a manager of a decentralized network of health centers. This entails reviewing a suite of confusing, repetitive, and tedious forms where names are written and re-written multiple times and where different counts are taken multiple times, summed by hand, and copied to other "consolidation" forms. Moreover, while all the forms must be complete, we are only required to report a small subset back to the government; the amount of time wasted writing and re-writing information that can never be summarized or searched in any useful way is astronomical. Parallel to this record-keeping, we have been working to develop an individual encounter-based medical information management system and database that in the long-term would enable us to produce the reports required by the ministry of health.
Recently, I returned from a very nice trip to Antigua, Guatemala. We went by bus and crossed the border at El Florido. There, we all exited the bus, went to a window to register our entry to Guatemala, and then to a second window a few feet down in the same building to register our exit from Honduras. I approached the Guatemalan window, the clerk took and scanned my passport, made a few clicks on his computer, and then sent me over to the Honduran window. There, the clerk took my passport and proceeded to unfold a 18 in. x 12 in. paper form (essentially identical to the form used by the doctors in our government health centers to record patient encounters and diagnoses) and copy by hand the identifying information from my passport. After a minute or two of scribbling he handed me my passport and sent me on my way.
Two countries, two systems, two levels of development, one border. While this may seem trivial, I have to admit it was quite surreal to see such a stark difference in the exact same building on the border between these two countries.
