Final Day Clinic
Porvenir
Our final clinic for the week took place in Porvenir. Porvenir and the two communities across the street, Tierra Santa and Totolya, were rebuilt in their current locations after they were destroyed by a mudslide back in the early 2000s. Father John told the group that the mudslide was incredibly deadly because it came at night while people were sleeping so there were some entire families that perished. The salon where we held clinic had a memorial on the outside wall for those families. After the mudslide all three towns were relocated from the base of the volcano where they previously existed to their current location on the road down from San Lucas.
Clinic moved at a good pace. I worked with my mom again and one of our first group of patients was a family of a mother and her four children. We started with the youngest girl, who is 2 years old, and the mother told us that she had been having multiple episodes of diarrhea a day for the last week. In addition, she has a rash which is extremely itchy for 6 months. It turns out all of the kids have the same rash complaint and the littlest one was absolutely covered in scabies. While the mother understood Spanish, Kachikel was her preferred language so we called the health promoter over to explain the diagnoses and the fact that we needed to treat everyone that lived in the house. The mother explained that 10 people live in her house total as she has 4 other children and her spouse. Mom spent a decent chunk of time at the pharmacy ensuring she had the correct dosing of Ivermectin for each individual based on their age. The youngest daughter and the mother were given a scabies cream as the mother is 5 months pregnant. I can only hope that the mother fully understood the directions for treating scabies as it involves both a medication and cleaning and washing all clothes and bedding. We continued to use the health promoter as a Kachikel interpreter but sometimes when I am looking at the patient across from me I feel as if they are simply nodding yes because they think we expect them to understand and are hesitant to ask clarifying questions. We used our Kachikel interpreters more today than any other clinic day and I was so grateful to have Ana, who can interpret Kachikel straight to English, and that both of the health promoters spoke Kachikel so we could use them to interpret Kachikel to Spanish if Ana was with a patient.
While I always think of our clinics as places of healing there are difficult moments as well. Rod and Carmen had a adorable elderly man as a patient who came in on crutches nearly non-weight-baring on one of his feet. He had a motor vehicle crash which left him with a traumatic injury to that ankle that he had an operation for in Solola over a year ago. The ankle started draining fluid 2 weeks post-op and has continued to since. When Dr. Rod spoke about the importance of starting the patient on preventative antibiotics, the patient interjected he was already receiving them. He had both a pill and an injection made of the same pills which he sent a family member to buy for him. When he pulled out the pill package, Carmen could see that the pills were simple multivitamins, not antibiotics as this man had been told. While corruption is present everywhere, to see it so blatantly displayed in the health care system is disheartening. Rod and Carmen had to tell this man that he had been duped and for this entire year he has not been taking preventative antibiotics but rather vitamins. While they were able to prescribe antibiotics here in the clinic we are all aware this is not a long term solution for this patient. Given that his wound has been draining all year it is likely he already has a chronic infection in his bones.
Overall it was a very successful clinic. The vast majority of patients yesterday were mothers with children. Most of them had only brought the children they could as others were going to school or busy working. I don’t have a definitive count but I believe we served around 50 patients in Porvenir. After clinic ended the nurses and I were able to pack up and inventory the nursing suitcase which will remain in storage here at the hospital in San Lucas. Mom and I ended up having enough time to also inventory the pharmacy suitcase so that the next team coming down will know what we left here. We dropped those suitcases at the hospital and donated our extra medications once we arrived back from clinic. We were back early enough that I was able to make it down to the soccer field where mission employees and friends play in a chamusca, or pick up soccer game, every week. It was fun to run around with and see some of my friends who I have not been able to work with this trip as they are construction workers for the mission. After dinner the team had a reflective meeting to share our “stretches and treasures,” things that we will bring back with us and what challenged us during this trip. I believe I can speak for the group when I say we will all miss San Lucas when we leave later this morning, though Antigua is always a fun city to explore. Once in Antigua, our thoughts often turn towards home and the families we have been without for over a week. ¡Nos vemos pronto en los Estados¡
-Sarah
