Wednesday, February 14, 2018

Day 6, Monjas Guatemala

While numbers is not the main measurement of Faith in Practice’s work in Guatemala, our Jalapa Mission Team lead by John Tysse and Scott Kincaid have racked up some incredible numbers. With two days of clinics in El Aguacate, we saw over 1100 patients.  This include 190 pediatric cases, 136 Gynecology cases, 67 visual inspection of cervix to check for cancer, 186 dental patients, and fitted 29 wheel chairs. The team referred 183 patients, many of whom will be having surgical procedures in “Faith in Practice” partnering hospitals. Part of the purpose of these village teams is to find candidates in the countryside that may benefit from surgery. As cervical cancer is a major cause of death among women in Guatemala, the exams found 4 women who need to have lesions removed. These four women will be given a new lease on life.  

School in Monjas
Our third village day begins at 5:30 AM with devotions and, because it is Ash Wednesday, a brief service of the imposition of ashes on those interested in participating. After breakfast, we headed south to the town of Monjas, a city built on a wide plateau with rich agricultural fields that are irrigated with an impressive infrastructure.  Again, we set up in a school which appears to be a better equipped than the school we worked out of in El Aguacate.  Here there are regular bathrooms and not just privies behind the buildings. 
In the Lab:
From Left: Louise, Marti, teacher (in red) and Joy

As we arrive, there was a long line of those seeking treatment along with vendors preparing lunch to sell. In the back of the school, several women set up a small tortilla operation and make rice and salsa. Unlike in Aguacate, in which we set the clinics up on Sunday afternoon before the first day, here we had to set up the clinic. There were boxes and crates to be distributed to the right rooms, partitions to be installed for patient privacy, tables, chairs and beds to be set up.  While we are working several of the teachers come into their rooms and thank us for volunteering.  We arrive before 8 AM, but are unable able to see the first patients until around 9 AM.   
Dr. Cam with Interpreter Lucy
with Baby Daniella and her mother

The second patient Dr. Cam, a pediatrician from Houston, Texas, sees is Daniela, an 18 month old girl who only weighs 13 pounds.  As her 18 year old mother takes off her top for an exam, we all can tell she’s struggling to breath. Her mother says she is always congested and that she eats very little and has a hard time swallowing and often chokes when eating.  Examining her, it becomes obvious that she has a double ear infection, but are  other issues concerning Dr. Cam. The child is extremely underweight.  He wonders if perhaps she had a airway obstruction in the nose and calls for a consult with an oral surgeon.  While waiting for the consult, her mother breast feeds Daniela and another patient was examined. 
Interpreter Lucy with Britney and her mother

Britney is a seven month old girl who weighs two more pounds that Daniela, and is over a year older.  Britany’s the first child for her 24 year old mother.  The mother is concerned that Britany seems not interested in standing. Checking her out, Dr. Cam finds her to be developmentally fine.  She was using her hands.  After asking her mother for permission to photograph, I take her photo on my iPad and show it to the mother. Britany laughs and tries to grab the iPad. She is obviously aware of her surroundings. Dr. Cam reassures her mother and shows her how to help her gain leg strength by holding her arms so she is in an upright position while she attempts to walk.  Britney’s visit was a welcome reprieve as she is an obviously healthy infant.

When Dr. David arrives for the consult, he takes a look at Daniela and asks that I bring her and her mother to his clinic where he can have a better look. In the dental clinic, we have the mother lay down in a dental chair holding Daniela. Dr. David checks her out.  Although he doesn’t think she has an obstruction in the nasal passage, he finds her tonsils and adenoids  enlarged.  With the infection and congestion in her head causing her inability to breath through her nose, Daniela also has problems breathing through her mouth. Her condition causes her difficulty eating and sleep apnea.  After consulting with Dr. Cam, they decide to recommend she be urgently seen by an Ear-Nose and Throat specialist. The mother is also given antibiotics for her ear infection.  
Dr. Cam with Oliver David

An older mother with her seven year old son is Dr. Cam’s next patient.  She has seven children and has lost another, a young girl who died when she was a year and a half.  Her son, Oliver David, is 7 years old and complains of pain in his legs.  He only walks a little and because of this, she keeps him from attending school.  Examining his feet, Dr. Cam discovers that his Achilles tendon in his left leg is short and does not extend to where he can put his heel to the ground.  Dr. Cam tells his mother that this shouldn’t keep him from school, but that he will be referred to a orthopedic surgeon who could determine if they can lengthen his tendon and allow him to place his feet flat on the ground.  

Oscar discussing how to take medicine
After a filling lunch prepared by Hector and his crew (beef stew with rice and tortillas), I visit the Farmacia (Pharmacy).  There, six pharmacists work hard, not only filling prescriptions but consulting with physicians as to what medicines they have for certain treatments.  As the week continues, they have run out of certain medicines and must come up with substitutes. As the drugs are being dispensed, Oscar, one of our bus drivers who’s obviously Spanish speaking, help sthe pharmacists explain to the patient (or the patient’s parents) how to administrator the drugs. Most of the drugs were prepackaged in the fall by a team overseen by one of our team leaders, Pharmacist Scott Kincaid.  

The Pharmacy Team (from left): Kyle, Kylie, Nathan, Kirsten,
Heather and the local volunteer 

Denillo informs patients what to expect
to the left, Jessica is at computer making referrals

Next to the Farmacia is the office for referrals.  There, Denillo, a member of the Faith in Practice team from Guatemala, explain what will happen as they are referred to one of two hospitals that partner with Faith in Practice.  While he orients the patients, Jessica, another in-country Faith in Practice worker (she’s from the Netherlands) is busy at her computer arranging schedules and follow-up schedules.

By early in the afternoon, things are slowing down.  As we swap stories, Wilma, an interpreter from Michigan, tells about five people (two couples and a single woman) who travelled from the town of Escuintla, which is over three hours away. They had a series of medical needs,  especially in the gynecology area.  Having heard about the reputation of Faith in Practice, they took the long trip that involved walking and taking buses. 

As we load the buses for the trip back to the hotel in Jalapa, the smeared ash crosses on foreheads on many of the volunteers are still visible. 

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