Tuesday, February 13, 2018

Day 5: Dentist, Audiologists & Pediatricians

Guatemala Day 5  (second day in the town named for the avocado) 

Dr. David works on Sujeryly as translator Sharon
attempts to comfort
Sujeyly is a three year old with four abscessed teeth and the first patient to enter the dental clinic this morning. Checking her, Dr. David, a pediatric oral surgeon from Boston, says he sees similar things in his practice at home.  He lifts up the girl from the chair and asks her mother to take a seat.  She appears nervous, pointing to her daughter, but when she sits down, Dr. David places the girl on her lap and has her hold her daughter.  Sharon, a translator with a puppet, tries to assure the toddler that it’ll be soon over and her teeth won’t hurt. She gives a shy smile.  Dr. David turns to prepare the novocaine, telling me that at home, he’d use anesthesia and the procedure would go quickly.  “Here,” he says, “there’s going to be a lot of blood and crying but by tomorrow she’ll be fine.”  He takes the syringe and numbs the area around the teeth. The girl begins to wail as the medicine is given.  He has the translator tell the girl and her mother that they will wait a few minutes for the numbing to take place.  He then turns to his next patient, a seven year old girl named Brenda. 

Dr. Robert with Rosa and her family
In another station, Dr. Robert, also an oral surgeon from Boston, is working between two older children.  Rosa is 11 years old who needs two extractions.  Saul is nine and needs one. They are both brave as he gives them the shot to numb their teeth and neither cry as the teeth are extracted.  At the third station, Dr. Carlos, a dentist from Guatemala is seeing Amanda, age 12, and Celeste, age 2.  All six chairs are filled within minutes of the clinic opening.  He prepares a syringe and gives numbs the area around the teeth, having them to wait before the teeth are pulled.  

Dr. David and Robert both examine Sujeryly

Once Sujeyly’s mouth is numb, Dr. David begins pulling her infected teeth.  As he grabs a tooth and begins to pull, she screams. He drops the tooth into a cup as blood fills her mouth. There is no suction. Using gauze to wipe up the blood, he pulls another tooth. The girl continues to scream as her mother holds her tightly.  In a few minutes it’s over.  The doctor tells her that she felt no pain with her mouth numb. Her mother is given instructions and antibiotics as the girl’s crying wanes.  Blood drools down her mouth.  The translator grabs a gauze and wipes it off her shirt.  It’s been less than thirty minutes. The first patients have all been treated as others are taking their place in the chairs.  

Dr. Jill cleans Venango's ears
Leaving the dental clinic, I head over to the audiology, where it is much quieter.  Dr. Jill, from Buffalo, New York, is cleaning Venango’s ears.  He’s 75 and can’t hear.  Once his ears are cleansed of wax, she has him sit in front of a hearing machine and learns that he is totally deaf in his left ear and has severe loss in the right. The doctor places a hearing aid in his right ear and he smiles and can hear.  She then takes the aid out and adjusts it to better fit his ear.

On the other side of the room, Courtney, an audiologist from Thunder Bay, Ontario, is speaking to the granddaughter of Maria, a 67 year old woman with a hearing aid.  But her aid doesn’t appear to be working.  Both Courtney and Dr. Jill are impressed with the quality of the aid and assume it must have been a used hearing aid donated in the States.  The quality of her aid is much higher than the ones that Faith in Practice can provide.  Courtney tests the aid. It’s working, but needs cleaning. Courtney cleans it and through a translator describes the limitation of such devices as she was wondering why she can’t hear when someone is talking from behind her. The cleaned hearing aid works better and the woman is sent home with a year supply of batteries.  

Interpreter Sharon explains to Venango and
his wife the operation of a hearing aid
Once Venango has been fitted with the hearing aid, he is sent to find his wife.  Dr. Jill wants to assure that someone else can help him maintain the aid. She joins him and to too listen to Sharon, a translator, go through the talking points that Dr. Jill has supplied. They are shown how to install the aid in the ear, how to clean it and replace the battery. They are also reminded of the dangers the batteries pose to small children and animals.  

Audiologist Courtney examines Juan
As Sharon describes the handling of the hearing aid, she is constantly asked to translate for Courtney’s new patient, Juan, a 13 year old boy. He’s there with his father. He has no hearing in his left ear in which he has a malformed ear lobe.  She tests both ears, starting with the right. His hearing is normal. In his left, he is unable to hear but she determines that the nerves which transmits the hearing to the brain are working. This makes Juan a good candidate for surgery, for simple procedure of opening the ear canal will provide Juan with full hearing.  Courtney writes up her notes and sends Juan and his father over to the referral clinic where they will arrange a visit for Juan to one of the partner hospitals where a Faith in Practice volunteer surgeon will reconstruct his ear.

Dr. Ava examines Hian

In the pediatric clinic, Dr. Ava from Syracuse New York is examine Hian, an 18 month old boy.  He has a hernia and it hurts when he coughs or cries.  The child has already had two hernia surgeries and Dr. Ava recommends a third, suggestions they look at a mesh to repair the tear. After Hian and his mother leave for the referral clinic, where volunteers will work to arrange the surgery, Ava comments on how many cases of scabies she’s seen today.
Todd taking roll to make sure everyone is accounted for
before heading back to Jalapa

One of two trucks to haul our equipment 

This is our second and last day in Aquacate. Around 2 PM, most of the clinics are completed and we begin to pack up.  Everything is hauled out to the gate of the school yard by 3 PM, except for the dental clinic which is still seeing patients.  As soon as they finish, they pack up and we haul the gear out.  We’re on the road back to our hotel in Jalapa before 4 PM.

Your humble blogger in the brightest scrubs he could find

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