Work begins - Monday - Friday. August 12-16, 2013 - Our Lady of Nazareth Medical Clinic
Following our morning reflections Elizabeth Tancock wrote, “Our work day mornings, thanks to Edna, promise a spiritual awakening replete with prayer and candle lighting signifying the burning love we share for Christ, our Ecuadoran clients and fellow workers. Yesterday, I observed that when the collection basket was passed at Sunday mass families were donating from their need whereas we in the U.S. donate from our excess."
More Reflections
* Edna was touched by the presence of so many children attending mass yesterday. "The smiles and visible openness to us."
* Mary Anne shared a memorable experience that happened during a previous SMA trip to Guatemala. "A woman at the clinic was kissing her baby. It was evident she was in love with the infant." Mary Anne asked if this was her first child. The woman explained, “My daughter was playing outside not long ago and heard a baby crying. She came to get me and I found this newborn in the trash. I already have six children. I asked my husband if we could keep the baby. He said, “Yes, it's God's Will."
* Jerry Smith wrote, “During morning reflections and inspirational comments Mary Anne told of a previous SMA trip and of a mother who was desperately poor. Diamond Lil, an old friend of Joe's, joined us as translator. She will try to get a tour of her husband's chocolate factory, or at least a sample bar of the candy [which she did a few days later.].
* Doris said, "After seeing the dedication of the worker/volunteers at my first SMA clinic in Peru I was inspired to sign up for this clinic."
* Alyce said, “I've always wanted to do something like this and told myself that if I get a chance... and here I am. The group seems to be cohesive after spending the last two days together.”
* Another said, “I have the physical and mental abilities. I have abundance. I want to share.
* Lesley said, “It's been a 50 year journey. Ever since the days of JFK and the Peace Corps, I have been on a quest. This is the right time in my life.
After breakfast (pineapple juice, flaky croissant-style bread and marmalade, hard-boiled egg and instant coffee or herbal tea) suitcases full of medicines that had been sorted and re-packed yesterday were placed on the bus. Benito would be our driver over the next two weeks for the 20 minute drive across the river to the work sites in Duran. (On those afternoons ahead when the clinic ran late it took an hour to return because we got hung up in rush-hour traffic.)
More Reflections
* Edna was touched by the presence of so many children attending mass yesterday. "The smiles and visible openness to us."
* Mary Anne shared a memorable experience that happened during a previous SMA trip to Guatemala. "A woman at the clinic was kissing her baby. It was evident she was in love with the infant." Mary Anne asked if this was her first child. The woman explained, “My daughter was playing outside not long ago and heard a baby crying. She came to get me and I found this newborn in the trash. I already have six children. I asked my husband if we could keep the baby. He said, “Yes, it's God's Will."
* Jerry Smith wrote, “During morning reflections and inspirational comments Mary Anne told of a previous SMA trip and of a mother who was desperately poor. Diamond Lil, an old friend of Joe's, joined us as translator. She will try to get a tour of her husband's chocolate factory, or at least a sample bar of the candy [which she did a few days later.].
* Doris said, "After seeing the dedication of the worker/volunteers at my first SMA clinic in Peru I was inspired to sign up for this clinic."
* Alyce said, “I've always wanted to do something like this and told myself that if I get a chance... and here I am. The group seems to be cohesive after spending the last two days together.”
* Another said, “I have the physical and mental abilities. I have abundance. I want to share.
* Lesley said, “It's been a 50 year journey. Ever since the days of JFK and the Peace Corps, I have been on a quest. This is the right time in my life.
After breakfast (pineapple juice, flaky croissant-style bread and marmalade, hard-boiled egg and instant coffee or herbal tea) suitcases full of medicines that had been sorted and re-packed yesterday were placed on the bus. Benito would be our driver over the next two weeks for the 20 minute drive across the river to the work sites in Duran. (On those afternoons ahead when the clinic ran late it took an hour to return because we got hung up in rush-hour traffic.)
How our patients live. Upon arrival Alyce noted, “Cattle were grazing across the dirt road from the clinic/school. Here at a shack built from sugar cane stalks a little girl came out with two fat, white rabbits. (to the left in photo) Pets? Or dinner perhaps?" Our patients live in typical houses like this built from sugar cane stalks grown in the jungle 50 miles away. These may last for 10 years if cared for. On the last day Maggie and a few others were invited inside the home of a patient, who has four children. "It's one large room," said Maggie. "Cardboard or a sheet partitioned off the parent's bed from the rest of the room. The bed had mosquito netting over it, as did the one bed for the four children. Daylight and the ground could be seen through the floor boards." Even with this gut-wrenching poverty the family managed to have a television and satellite dish.
Who are the patients?
In recent decades, there has been a massive exit from rural areas. Not unlike in the United States rural populations here migrate to main cities, especially Guayaquil and nearby locations such as Duran creating shantytowns, with no services like water or electricity. These are the areas of greatest need and where we worked.
Sixty-five percent of the ethnicity in Ecuador is Mestiso: Amerindian and white. Twenty-five percent is Amerindian. The language is Spanish and some Quechua (primarily in the high country.) During the SMA mission to Peru in 2009 even our Spanish translators needed translations into Quechua - the language of the former Inca civilizations of Peru, Bolivia, Chile, Colombia and Ecuador. However, in this coastal town of Duran our crew only needed translations of Spanish.
Elizabeth said, “Our ranks swelled as we welcomed three new interpreters. Longtime friend of Joe Kelly, 'Diamond' Lil, lives in Guayaquil. Dr. Patricia Hanchi, formerly from Guayaquil, is our beloved pediatrician [whom several met on the 2012 SMA medical mission to Honduras.] Susca is Dr. Patricia's niece . All are invaluable as interpreters for those in the clinic who are linguistically challenged."
In recent decades, there has been a massive exit from rural areas. Not unlike in the United States rural populations here migrate to main cities, especially Guayaquil and nearby locations such as Duran creating shantytowns, with no services like water or electricity. These are the areas of greatest need and where we worked.
Sixty-five percent of the ethnicity in Ecuador is Mestiso: Amerindian and white. Twenty-five percent is Amerindian. The language is Spanish and some Quechua (primarily in the high country.) During the SMA mission to Peru in 2009 even our Spanish translators needed translations into Quechua - the language of the former Inca civilizations of Peru, Bolivia, Chile, Colombia and Ecuador. However, in this coastal town of Duran our crew only needed translations of Spanish.
Elizabeth said, “Our ranks swelled as we welcomed three new interpreters. Longtime friend of Joe Kelly, 'Diamond' Lil, lives in Guayaquil. Dr. Patricia Hanchi, formerly from Guayaquil, is our beloved pediatrician [whom several met on the 2012 SMA medical mission to Honduras.] Susca is Dr. Patricia's niece . All are invaluable as interpreters for those in the clinic who are linguistically challenged."
Yesterday, upon arriving at the clinic to set-up the pharmacy ahead of time the parish priest, Padre Juan Pablo advised us not to leave suitcases full of medical supplies at the clinic. Break-in are not uncommon. Temptations are great with the unemployment rate at 30%. Instead, supplies were re-loaded on the bus yesterday and taken back to the retreat center until this morning when only the bags for the first week clinic were transported since the clinic would move locations the following week. In the meantime, a nightwatchman was hired to guard the building.
Our first-week clinic was located in a free-standing building at the front of Our Lady of Nazareth K-8 Elementary school, a private Catholic school. There is also a public school, in this town of 4,000, where two sessions are held each day from 7 to 12-30 and 1 to 6 for classes kindergarten through 8th.
This is the first time this building has been used as a clinic. Sometime in September Centro Medico Nuestra Senora del Guayco is planning to set up a permanent clinic here. Unused medical supplies remaining after the second week at the other clinic will be collected and delivered to this clinic.
The medical team for the first week was set up in stations:
Registration and Triage: Alyce Grisson, Mary Murphy, Kay Smith and translator, Lillian Marques de la Plata
Treatment Room #1: Dr. Del Endres, Bea Balsamo, and a translator (which later in the week turned out to be Iris borrowed from the construction crew.)
Treatment Room #2: Dr. Patricia Hanchi and Edna Greene,
Treatment Room #3: Joe Balsamo and Susca as translator.
Parasite Treatment: Jerry Smith and Elizabeth Tancock.
Pharmacy: Cheryl Cecil and Lesley Torrey.
Patient Facilitator: Mary Anne Fay
Eye Exam and Eye Glasses: Doris Lippo, Evelyn Jacobs, Maggie Fleming and Jerry Smith.
Monday morning - School children first:
By time the two physicians,two physician assistants, nurses and pharmacy took their first break they had already seen 85 pre-K to 8th grade school children. The children were well-dressed in school uniforms. Alyce said, "They were well-behaved. Even the boys." Six adult patients deemed emergencies were also seen this morning with symptoms of diarrhea and severe cough.
All school children were given worm medicine as it is most likely they have the infection, which typically spreads hand-to-mouth and occurs after someone consumes contaminated food or water. Here the roundworm is common due to poor hygiene practices. Worms are common in warm tropical climates and children are more affected than adults. According to a study 800 million people worldwide are infected with roundworm, which can be treated with an inexpensive one dose pill. Some say closer to one billion people are infected. Over the next few days a total of 220 of 250 students from this school were treated. In the afternoon and following days children from the public school and their families were also seen. Women who were pregnant or breast-feeding were not given the medicine. As a precaution to avoid infection we mission volunteers were advised to eat only cooked foods, avoid salads, as well as fruits and vegetables that cannot be peeled.
Our first-week clinic was located in a free-standing building at the front of Our Lady of Nazareth K-8 Elementary school, a private Catholic school. There is also a public school, in this town of 4,000, where two sessions are held each day from 7 to 12-30 and 1 to 6 for classes kindergarten through 8th.
This is the first time this building has been used as a clinic. Sometime in September Centro Medico Nuestra Senora del Guayco is planning to set up a permanent clinic here. Unused medical supplies remaining after the second week at the other clinic will be collected and delivered to this clinic.
The medical team for the first week was set up in stations:
Registration and Triage: Alyce Grisson, Mary Murphy, Kay Smith and translator, Lillian Marques de la Plata
Treatment Room #1: Dr. Del Endres, Bea Balsamo, and a translator (which later in the week turned out to be Iris borrowed from the construction crew.)
Treatment Room #2: Dr. Patricia Hanchi and Edna Greene,
Treatment Room #3: Joe Balsamo and Susca as translator.
Parasite Treatment: Jerry Smith and Elizabeth Tancock.
Pharmacy: Cheryl Cecil and Lesley Torrey.
Patient Facilitator: Mary Anne Fay
Eye Exam and Eye Glasses: Doris Lippo, Evelyn Jacobs, Maggie Fleming and Jerry Smith.
Monday morning - School children first:
By time the two physicians,two physician assistants, nurses and pharmacy took their first break they had already seen 85 pre-K to 8th grade school children. The children were well-dressed in school uniforms. Alyce said, "They were well-behaved. Even the boys." Six adult patients deemed emergencies were also seen this morning with symptoms of diarrhea and severe cough.
All school children were given worm medicine as it is most likely they have the infection, which typically spreads hand-to-mouth and occurs after someone consumes contaminated food or water. Here the roundworm is common due to poor hygiene practices. Worms are common in warm tropical climates and children are more affected than adults. According to a study 800 million people worldwide are infected with roundworm, which can be treated with an inexpensive one dose pill. Some say closer to one billion people are infected. Over the next few days a total of 220 of 250 students from this school were treated. In the afternoon and following days children from the public school and their families were also seen. Women who were pregnant or breast-feeding were not given the medicine. As a precaution to avoid infection we mission volunteers were advised to eat only cooked foods, avoid salads, as well as fruits and vegetables that cannot be peeled.
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Lunch was a welcome break for both medical and construction and we ate in two shifts because the room could only accommodate half at a time. The handsome, blue-eyed Jose and his wife, Gladys prepared chicken soup with (cooked) carrots, chicken pieces, and a type of a plantain that was sliced like a potato.
Alyce Grissom wrote, "I'm recording weight, height, oxygen stats, pulse rates and greeting all the patients. My co-worker Elizabeth and I have a wonderful system. We meet the mommas. They love their children and usually can get them to stand on the weight scale. The hardest part is getting the children to let us put their little finger into the pulse oximeter. Sometimes they think it's a shot, or it's going to hurt. They fight us but mom usually wins. Occasionally men come to the clinic. They are stoic and it's no fuss. But gosh, they are also friendly and appreciate the care. They just wait with the women and children.
Alyce continued, "In the afternoon came the mommas, both young and old. Gracious grandmas, too. Their ailments were mostly general stuff like colds, sore throat, some issues with parasites and a few had more personal problems. I noticed the difference from our culture where breast feeding was not something to cover up. Momma openly gave baby her breast to suckle without worrying about other people staring at her, except maybe us for a moment or two. I also noticed a lot of the women wore something feminine on her hair, face or clothing. It was very special to them and you could tell they liked wearing these items.
"At the end of the day we were tired from working in the clinic after seeing all these people. The school children had a full medical check up and we [did the paperwork necessary] for the [new and permanent] clinic which will start operating around mid September after we leave. It's a joy to be with the locals. They are loving, happy and enjoy our presence.
"At closing time before we left this clinic, oh the children! Moms and even the men were so appreciative of what we were doing for them. Hugs for everyone who would hug back. Smiles, laughter and a few high-fives. I was a little afraid to begin this new journey of mine, but now after the first week I really feel at home. I enjoy my fellow peers, the work that I do and the joy I think I am giving to these wonderful children of God."
Elizabeth added, “Those with high hopes of a flawless first-day-start at our clinic were predictably chagrined to find otherwise. The high volume morning crush of attendees forced teams to mobilize, assess their situation and quickly resolve problems. Happily the end of the day saw performance improvements in most areas. We returned back at the retreat center tired, and with sore muscles, but filled with our thoughts of the lives we have touched. We have a plan for the morrow and a huge store of love and humor to share."
Alyce Grissom wrote, "I'm recording weight, height, oxygen stats, pulse rates and greeting all the patients. My co-worker Elizabeth and I have a wonderful system. We meet the mommas. They love their children and usually can get them to stand on the weight scale. The hardest part is getting the children to let us put their little finger into the pulse oximeter. Sometimes they think it's a shot, or it's going to hurt. They fight us but mom usually wins. Occasionally men come to the clinic. They are stoic and it's no fuss. But gosh, they are also friendly and appreciate the care. They just wait with the women and children.
Alyce continued, "In the afternoon came the mommas, both young and old. Gracious grandmas, too. Their ailments were mostly general stuff like colds, sore throat, some issues with parasites and a few had more personal problems. I noticed the difference from our culture where breast feeding was not something to cover up. Momma openly gave baby her breast to suckle without worrying about other people staring at her, except maybe us for a moment or two. I also noticed a lot of the women wore something feminine on her hair, face or clothing. It was very special to them and you could tell they liked wearing these items.
"At the end of the day we were tired from working in the clinic after seeing all these people. The school children had a full medical check up and we [did the paperwork necessary] for the [new and permanent] clinic which will start operating around mid September after we leave. It's a joy to be with the locals. They are loving, happy and enjoy our presence.
"At closing time before we left this clinic, oh the children! Moms and even the men were so appreciative of what we were doing for them. Hugs for everyone who would hug back. Smiles, laughter and a few high-fives. I was a little afraid to begin this new journey of mine, but now after the first week I really feel at home. I enjoy my fellow peers, the work that I do and the joy I think I am giving to these wonderful children of God."
Elizabeth added, “Those with high hopes of a flawless first-day-start at our clinic were predictably chagrined to find otherwise. The high volume morning crush of attendees forced teams to mobilize, assess their situation and quickly resolve problems. Happily the end of the day saw performance improvements in most areas. We returned back at the retreat center tired, and with sore muscles, but filled with our thoughts of the lives we have touched. We have a plan for the morrow and a huge store of love and humor to share."
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Tuesday, August 13
An unidentified volunteer wrote, "I've been on many medical brigades, and traveled to Ecuador before, but this was a new experience for me. SMA is a dedicated group of volunteers who are willing to work hard, and have fun too. I always enjoy seeing people connect, and meeting people I otherwise would not have the opportunity to interact with. This has been a privilege. Medicine is only a part of the experience. Hearing people's personal stories - learning how they live, what worries they have, what hopes, what joys - is integral of the experience for me. Sharing my stories and finding common ground is exciting. "
Jerry Smith wrote, "Nourished by lunch of ensalada (chopped eggs, carrots, and beets), hearty vegetable soup, rice, potatoes, and fried fish we were fortified for the afternoon. We were also served the astronaut's favorite drink, Tang. At the end of the day a count was taken - 148 patients were seen plus 125 eye exams. On the bus ride back to our living quarters Joe invited anyone to the microphone for announcements, or otherwise. E.J. won the price for the best joke." (You will have to ask her yourself. What happens in Ecuador stays in Ecuador.)
Wednesday, August 14th
By now several on the crew are "falling like flies." Nurse Edna fell down a step at the Retreat Center this morning. Then Dr. Patricia became ill that afternoon. In the meantime, Alyce felt sick to her stomach and Barbara (construction) felt ill, so the cab back to the Retreat Center was full. Edna and Barbara came down in time for dinner, but Alyce did not. The next morning, on Thursday, Alli (construction) was not feel well and took a cab back to the retreat center.
The medical team moves around as needed with E.J. and Maggie now in eyeglasses. Doris is taking blood pressures, Cheryl and Leslie in pharmacy.
Elizabeth taking height and weight. Kay and Lil in registration.
Thursday, August 15
Doris Lippo said, "If only you could have seen or heard:
-The excitement of the children when we came to do eye exams
-The giggles when they tried to say words in English
-Lin Cross mixing and shoveling cement in construction
-The joy when the adults could see after being fitted with glasses
-Maggie and E.J. teaching the children the chicken dance
-The happy, tired and dusty folks on the return bus ride
-The parrots in the trees around the clinic
-The birds singing to wake us in the morning
-Open mike on the ride back to the retreat center - jokes and singing
-The parents and grandparents who came to help build the concrete court for their children
-Our group bursting into song for birthdays or just because of a catch word - Tomorrow. Sunshine. Amen
-Our SMA workers with wheelbarrows full of cement, mixed by hand on the ground, dodging the children who are playing in the same area
-The bats flying overhead as we were waiting for mass (What time is mass?)
-Happy Hour (wine, cheese, chocolate, yuca chips, beer and stories)
-Morning devotions and quiet time as we start each new day of service
-The groups of people in Duran waiting to see us as we arrive at the clinic
-Waving hello, hugs and kisses with thanks for helping them
-The thin young mothers nursing their babies as other children clung to their skirts."
Doris Lippo added, "Today we saw a woman (perhaps in her 40s) who needed glasses. I asked her about the scars on her arms. She said her children scratched her. These were not scars from scratching. When I asked again she said she used to cut herself when she was drinking, but said she is getting treatment now and is not doing that anymore. She showed us her treatment card. She is HIV positive, which is still considered here as if touching her would make others contract the illness. She had tears in her eyes when I reached out to hold her hand as she talked. We were able to find the proper glasses for her and the tears changed to gracias and a smile."
E.J. Jacobs said, "Feast of the Assumption. For me this morning's most impressive prayer line was, 'Energizing, organizing, God drawing us together in global solidarity.' As I reflect on this, the images of the previous days work reminded me of how colonies of ants go about their business. I thought there were many groups going about the world of being God's servants. Then I wondered if this would be enough to save the world? Or at least help humanity?
"When we arrived at the clinic, the children were out and doing a special project for the feast of Our Lady. They had worked hard and it was impressive to see them speaking words in English. It was another grueling day of almost non-stop work. My teammate Maggie is a delight to work with and we have learned to dance together now that we have the music.
"Boys will be boys and trying to keep them off the cement was a challenge to watch. We were hidden in a breezeway, trying to be out of the way but also trying to provide a less distracting situation for the children. We were charmed by the 2nd and 3rd grade students, but also impressed with the readiness, obedience and quickness of the 3rd grade girls.
"In the afternoon, we tended to the community's eyeglass needs. It's truly teamwork and made it easier for one sort, another to gate-keep, to assist. It was organized and I was energized.
E. J. ended by saying, "I was emotionally struck, and deeply touched, by an elderly gentleman with deteriorating eyesight. We found glasses so he could at least see close up for Bible-reading. He even got a pair of sunglasses. His tearful and emotional words of gratefulness said volumes to me that the work we do does make a difference. It's through God's organization that energizes me even when I'm the most tired all through the 5th “last person,” who was a child needing bifocals. The best we could do was give him readers and distance glasses. That made all the difference for him, and his mother. Both were extremely grateful. It was truly a day of 'yes', as our Mother Mary gracefully accepted her challenge."
Dr. Del saw a patient with a EKC viral infection, which feels like there is sand in the eyes. The retina grows around the obstacle. When asked if he wears eye protection or sunglasses he said he works security patrol and not allowed to wear sunglasses on the job. They must be able to see his eyes. It was determined he had two different problems and may have to go into town to be treated for this infection.
One patient had been hospitalized for bladder infection eight months ago.
Another received medication via IV.
Another is an operator of heavy equipment. Before he used to be able to see far away. Now he can't see cars coming at dusk. About 3-4 months ago he was seen by an eye doctor and was given eyeglasses, but he still can't see.
A pregnant woman wanted something to alleviate morning sickness. Suggested she eat crackers, and advised to see the regular clinic but she said it's too hard to get there.
Another woman six months pregnant complained of sore breasts.
Friday, August 16
Dr. Del said, "My patients were mostly retired or the elderly. Today we saw a variety of maladies: a deaf-mute adult; pyelonephritis (kidney infection) in a child and adult; multiple families with 3-4 children all wanting to be checked. We were so popular that some returned later [and lied] giving a different name or same name and insisting they had not been seen before. All for a few pills of Motrin, Tylenol or vitamins. Most were very grateful and appreciative. Even after many hours of waiting.
"It was hot in the small rooms with the high humidity and no air circulation. An oscillating fan purchased after work one evening was greatly appreciated. Physician Assistant, Bea, shared an exam room with me, along with 1-2 interpreters, the patient, a parent and oftentimes siblings were in the room running and playing, adding to the chaos and making it a challenge to give each patient quality care.
"Like anywhere, adult obesity was common, along with associated diabetes and hypertension. Some are able to get medication free at dispensarias, but only on certain days of the month and if the dispensarias were still stocked with their needed medicines.
"Blood sugar of more then 400 was not uncommon. Very little to no insulin being used for disabetes. When we tried to discuss weight loss, exercise and diet (life style changes) this met with mixed reviews. Like in the U.S. these are the hardest things to change. Some accepted suggestions while others gave us the impression they heard that before. The only type 2 diabetes medicine we obtained at the end of the week was metformin, which most patients took at one time or another. Diabetic education, and very common experiences, was professionally conducted by our staff.
"Many female patients have had C-sections. One needed gallbladder surgery. Another had a Ruptured appendicitis. One child had open-heart surgery. By end of the week we had seen 220 schoolchildren routine physical exams and all were given parasitic medicine and eye check-ups.
"Children from the public school also came, as well as their parents and grand-parents were seen.
"It was a successful first week clinic.
"Of all the [20 or so] medical missions I've been on here at this community is where the least amount of English was spoken. Although the school teaches English to school children and was used during the program yesterday, presented for us and the parents."
An unidentified volunteer wrote, "I've been on many medical brigades, and traveled to Ecuador before, but this was a new experience for me. SMA is a dedicated group of volunteers who are willing to work hard, and have fun too. I always enjoy seeing people connect, and meeting people I otherwise would not have the opportunity to interact with. This has been a privilege. Medicine is only a part of the experience. Hearing people's personal stories - learning how they live, what worries they have, what hopes, what joys - is integral of the experience for me. Sharing my stories and finding common ground is exciting. "
Jerry Smith wrote, "Nourished by lunch of ensalada (chopped eggs, carrots, and beets), hearty vegetable soup, rice, potatoes, and fried fish we were fortified for the afternoon. We were also served the astronaut's favorite drink, Tang. At the end of the day a count was taken - 148 patients were seen plus 125 eye exams. On the bus ride back to our living quarters Joe invited anyone to the microphone for announcements, or otherwise. E.J. won the price for the best joke." (You will have to ask her yourself. What happens in Ecuador stays in Ecuador.)
Wednesday, August 14th
By now several on the crew are "falling like flies." Nurse Edna fell down a step at the Retreat Center this morning. Then Dr. Patricia became ill that afternoon. In the meantime, Alyce felt sick to her stomach and Barbara (construction) felt ill, so the cab back to the Retreat Center was full. Edna and Barbara came down in time for dinner, but Alyce did not. The next morning, on Thursday, Alli (construction) was not feel well and took a cab back to the retreat center.
The medical team moves around as needed with E.J. and Maggie now in eyeglasses. Doris is taking blood pressures, Cheryl and Leslie in pharmacy.
Elizabeth taking height and weight. Kay and Lil in registration.
Thursday, August 15
Doris Lippo said, "If only you could have seen or heard:
-The excitement of the children when we came to do eye exams
-The giggles when they tried to say words in English
-Lin Cross mixing and shoveling cement in construction
-The joy when the adults could see after being fitted with glasses
-Maggie and E.J. teaching the children the chicken dance
-The happy, tired and dusty folks on the return bus ride
-The parrots in the trees around the clinic
-The birds singing to wake us in the morning
-Open mike on the ride back to the retreat center - jokes and singing
-The parents and grandparents who came to help build the concrete court for their children
-Our group bursting into song for birthdays or just because of a catch word - Tomorrow. Sunshine. Amen
-Our SMA workers with wheelbarrows full of cement, mixed by hand on the ground, dodging the children who are playing in the same area
-The bats flying overhead as we were waiting for mass (What time is mass?)
-Happy Hour (wine, cheese, chocolate, yuca chips, beer and stories)
-Morning devotions and quiet time as we start each new day of service
-The groups of people in Duran waiting to see us as we arrive at the clinic
-Waving hello, hugs and kisses with thanks for helping them
-The thin young mothers nursing their babies as other children clung to their skirts."
Doris Lippo added, "Today we saw a woman (perhaps in her 40s) who needed glasses. I asked her about the scars on her arms. She said her children scratched her. These were not scars from scratching. When I asked again she said she used to cut herself when she was drinking, but said she is getting treatment now and is not doing that anymore. She showed us her treatment card. She is HIV positive, which is still considered here as if touching her would make others contract the illness. She had tears in her eyes when I reached out to hold her hand as she talked. We were able to find the proper glasses for her and the tears changed to gracias and a smile."
E.J. Jacobs said, "Feast of the Assumption. For me this morning's most impressive prayer line was, 'Energizing, organizing, God drawing us together in global solidarity.' As I reflect on this, the images of the previous days work reminded me of how colonies of ants go about their business. I thought there were many groups going about the world of being God's servants. Then I wondered if this would be enough to save the world? Or at least help humanity?
"When we arrived at the clinic, the children were out and doing a special project for the feast of Our Lady. They had worked hard and it was impressive to see them speaking words in English. It was another grueling day of almost non-stop work. My teammate Maggie is a delight to work with and we have learned to dance together now that we have the music.
"Boys will be boys and trying to keep them off the cement was a challenge to watch. We were hidden in a breezeway, trying to be out of the way but also trying to provide a less distracting situation for the children. We were charmed by the 2nd and 3rd grade students, but also impressed with the readiness, obedience and quickness of the 3rd grade girls.
"In the afternoon, we tended to the community's eyeglass needs. It's truly teamwork and made it easier for one sort, another to gate-keep, to assist. It was organized and I was energized.
E. J. ended by saying, "I was emotionally struck, and deeply touched, by an elderly gentleman with deteriorating eyesight. We found glasses so he could at least see close up for Bible-reading. He even got a pair of sunglasses. His tearful and emotional words of gratefulness said volumes to me that the work we do does make a difference. It's through God's organization that energizes me even when I'm the most tired all through the 5th “last person,” who was a child needing bifocals. The best we could do was give him readers and distance glasses. That made all the difference for him, and his mother. Both were extremely grateful. It was truly a day of 'yes', as our Mother Mary gracefully accepted her challenge."
Dr. Del saw a patient with a EKC viral infection, which feels like there is sand in the eyes. The retina grows around the obstacle. When asked if he wears eye protection or sunglasses he said he works security patrol and not allowed to wear sunglasses on the job. They must be able to see his eyes. It was determined he had two different problems and may have to go into town to be treated for this infection.
One patient had been hospitalized for bladder infection eight months ago.
Another received medication via IV.
Another is an operator of heavy equipment. Before he used to be able to see far away. Now he can't see cars coming at dusk. About 3-4 months ago he was seen by an eye doctor and was given eyeglasses, but he still can't see.
A pregnant woman wanted something to alleviate morning sickness. Suggested she eat crackers, and advised to see the regular clinic but she said it's too hard to get there.
Another woman six months pregnant complained of sore breasts.
Friday, August 16
Dr. Del said, "My patients were mostly retired or the elderly. Today we saw a variety of maladies: a deaf-mute adult; pyelonephritis (kidney infection) in a child and adult; multiple families with 3-4 children all wanting to be checked. We were so popular that some returned later [and lied] giving a different name or same name and insisting they had not been seen before. All for a few pills of Motrin, Tylenol or vitamins. Most were very grateful and appreciative. Even after many hours of waiting.
"It was hot in the small rooms with the high humidity and no air circulation. An oscillating fan purchased after work one evening was greatly appreciated. Physician Assistant, Bea, shared an exam room with me, along with 1-2 interpreters, the patient, a parent and oftentimes siblings were in the room running and playing, adding to the chaos and making it a challenge to give each patient quality care.
"Like anywhere, adult obesity was common, along with associated diabetes and hypertension. Some are able to get medication free at dispensarias, but only on certain days of the month and if the dispensarias were still stocked with their needed medicines.
"Blood sugar of more then 400 was not uncommon. Very little to no insulin being used for disabetes. When we tried to discuss weight loss, exercise and diet (life style changes) this met with mixed reviews. Like in the U.S. these are the hardest things to change. Some accepted suggestions while others gave us the impression they heard that before. The only type 2 diabetes medicine we obtained at the end of the week was metformin, which most patients took at one time or another. Diabetic education, and very common experiences, was professionally conducted by our staff.
"Many female patients have had C-sections. One needed gallbladder surgery. Another had a Ruptured appendicitis. One child had open-heart surgery. By end of the week we had seen 220 schoolchildren routine physical exams and all were given parasitic medicine and eye check-ups.
"Children from the public school also came, as well as their parents and grand-parents were seen.
"It was a successful first week clinic.
"Of all the [20 or so] medical missions I've been on here at this community is where the least amount of English was spoken. Although the school teaches English to school children and was used during the program yesterday, presented for us and the parents."