The MAINE Leg
Back to the airport by 4am for the 6am flight to New York. A bit of a delay again - 1 1/2 hours - waiting for a flight attendant. Later she and I learned that she'd been in my adult ed Spanish course about 5-6 years ago. Arrived in the Big Apple with rain coming down. It took about 30 minutes to get our carry on luggage off the puddle jumper, because they had stowed it underneath. At this point the arrangement was for us to take a direct flight from NYC to Lima at 11pm tonight. Wow - it would be a long day, but "just keep moving".
Hector stayed at the airport with the luggage and to await Art to catch up with us. He had to separate due to flights, etc. Marianne, Will, and I headed into the Big Apple for the middle of the day. An adventure on the Sky Train and the Subway took us to NYU. Will is possible interested in attending. We were told to keep away from certain streets due to the Pride Parade. Passed a number of people who were very creatively dressed. We saw Time Square and Rockefeller Plaza with NBC and stuff. We decided to purchase tickets for a show and got to see Chicago on Broadway! It was great.
Tuesday June 27, 2006 - Chulucanas, Peru
Regarding the remainder of the trip to get here - it was a disaster. What should have taken about one day ended up taking three. Delays, cancellations, re-routing. The last leg between Lima and Piura I finally acquired one of the worst migraines I’ve had in years. Nice. By the time we arrived in Chulucanas, about 11pm, and found a horizontal surface on which to crash - that's what I did. And slept until about 8 a.m. the following morning. Mariana got up and went jogging with Hector about 5. I kept sleeping and missed breakfast - wasn’t much hungry anyway.
After some very basic instructions were given to the group, we were off to the clinic, still setting up while numbers of people were waiting, and had been waiting for quite a while to see us. None of us will ever forget this first day. For some of the workers this is NOT the first time here, but for a few of us it IS. And it is something that is changing our lives.
Dr. Hector came in with Marianne and I for the first patient to basically show us the procedure. I was concerned because I couldn’t understand what the man was saying. The nurse volunteer, Geraldine, assisting us was a sweet young lady and was a great help. The girl in the afternoon, Beatrix, was even better – I told her she should go to medical school and become a doctor. Beatriz was amazing. We all improved as the day proceeded and learned what to do and how to work with each other more efficiently.
Patients almost always are accompanied by someone who loves them. Two sisters brought in their father, who, even to my eye, was basically dying. Jaundiced, emaciated, and other signs - it was quite obvious. Marianne and I needed a few minutes after to discuss and recoup. We weren’t sure if we should have said something about the inevitable, or just make them feel better for the moment.
Two sisters came together, the older one bringing her younger, about 17, with a foot so swollen and smelling and rotten. They had been told by some doctor about a year a go that the leg would have to be amputated about up to the knee. The girl didn't want to lose her foot. Her mother hadn't had the money for the operation, so it was not done. She'd had this foot horror for about 10 years. Marianne (Nurse Practitioner, who by this time was "Doctora") checked to be sure it had not progressed to other parts of the body. Then went to get Hector for a back-up check. He confirmed a bad fungal infection which hadn’t been treated. Some antibiotics, foot cleansing, anti-fungal topical cream and continued treatment is expected to clear it up.
A mother with a girl of about 8 or 10 who had a club foot. There had been an operation when the girl was about 9 months, since she’d been born with this foot that was doubled back toward her leg. The mom is now concerned that the foot is not growing and improving like the other. The girl cannot run without falling down. Explaining that the foot will never be like the other exactly, but with a good amount of physical therapy it can improve. And vitamins. Vitamins help everyone and everything. At the very least it will help this girl develop better.
Another girl had been having seizures. They developed during her 3-9 years, then stopped for a while and recommenced when she entered High School. She's 15 now and had had a number recently. The mother had journaled the episodes very carefully, which I told her was very helpful. What had happened is that they had run out of the medication for these seizures - and they had increased daily since then. We put her back on the meds and gave her enough for 2 months and then explained that she can go to her local parish parochial for continuing medication. They were not even aware that this had been a possibility. Something so simple to give this child a more normal life.
Dr. Hector came in with Marianne and I for the first patient to basically show us the procedure. I was concerned because I couldn’t understand what the man was saying. The nurse volunteer, Geraldine, assisting us was a sweet young lady and was a great help. The girl in the afternoon, Beatrix, was even better – I told her she should go to medical school and become a doctor. Beatriz was amazing. We all improved as the day proceeded and learned what to do and how to work with each other more efficiently.
Patients almost always are accompanied by someone who loves them. Two sisters brought in their father, who, even to my eye, was basically dying. Jaundiced, emaciated, and other signs - it was quite obvious. Marianne and I needed a few minutes after to discuss and recoup. We weren’t sure if we should have said something about the inevitable, or just make them feel better for the moment.
Two sisters came together, the older one bringing her younger, about 17, with a foot so swollen and smelling and rotten. They had been told by some doctor about a year a go that the leg would have to be amputated about up to the knee. The girl didn't want to lose her foot. Her mother hadn't had the money for the operation, so it was not done. She'd had this foot horror for about 10 years. Marianne (Nurse Practitioner, who by this time was "Doctora") checked to be sure it had not progressed to other parts of the body. Then went to get Hector for a back-up check. He confirmed a bad fungal infection which hadn’t been treated. Some antibiotics, foot cleansing, anti-fungal topical cream and continued treatment is expected to clear it up.
A mother with a girl of about 8 or 10 who had a club foot. There had been an operation when the girl was about 9 months, since she’d been born with this foot that was doubled back toward her leg. The mom is now concerned that the foot is not growing and improving like the other. The girl cannot run without falling down. Explaining that the foot will never be like the other exactly, but with a good amount of physical therapy it can improve. And vitamins. Vitamins help everyone and everything. At the very least it will help this girl develop better.
Another girl had been having seizures. They developed during her 3-9 years, then stopped for a while and recommenced when she entered High School. She's 15 now and had had a number recently. The mother had journaled the episodes very carefully, which I told her was very helpful. What had happened is that they had run out of the medication for these seizures - and they had increased daily since then. We put her back on the meds and gave her enough for 2 months and then explained that she can go to her local parish parochial for continuing medication. They were not even aware that this had been a possibility. Something so simple to give this child a more normal life.
A young man about 19 with a broken arm - the elbow was totally disjointed. It had happened over a year before and he had not gone to see anyone for it. He wears a bandage over it so no one can see how it's disfigured. He cannot use it at all. He is one of many whose names are added to a list for surgery. This list is passed on to the local parishes and then as money becomes available, they can choose people from their area to have the surgeries.
Hector pulled us into his OBGYN room to help us learn: a young woman had a fibroid tumor in her uterus about the size of a bowling ball. She went on the list. It causes constant pain and she has to walk ‘around” it all the time. She was so pretty and sweet and patient.
So many others. Mariana said tonight: "It’s so hard to believe when we're here that it's the 21st century."
Wednesday, June 28, 2006
Beginning to settle in. The guys had taken dibs on when we'd arrive in Chulucanas when we were still in NYC. They said Wednesday, but we've been here 2 days now working. God always works things out.
This morning, after breakfast and that WONDERFUL Peruvian coffee (which is basically strong espresso type syrup then add hot water or milk) we were back to open the clinic at 9am.
Amazing how many repeated ailments come through the door. Marianne is so careful to note down as much as possible with good details and thorough instructions (my new word: "minusiosa"). A lot fewer people pass through our small sala then others, and often Hector will come and pick up some of those who are waiting outside. Regularly now I present her to the patients as "la doctora". Many still will also look to me (since I'm the one basically communicating with them the information) and call me doctora also. Gratitude is the greatest payment here. They are all so thankful for what we can do for them.
There are a lot of hernias, parasites, and headaches. A number of things that is a bit more unusual like broken bones that were never set and have healed incorrectly, fibrous growths that have been there for ten years and are now the size of a baseball. We've had a few people with fungal infections in their feet - they leave with instructions to wash and dry the feet, then apply the anti-fungal ointment and wear socks and shoes that cover the feet if they can. Many of these people just wear sandals. Then there are the occasional more serious things like an infant with cauliflower ear, a young woman with a malformed foot, a baby with a cleft pallet. Most get medicines, ibuprofen and antibiotics; many get the slips that will put them on the list for surgery - mostly for hernias, but others for things that are more serious. One young mother today had a problem around her left breast so she’s being lined up for an ultrasound - I think that Mariana suspects cancer. The woman has a baby at home who she is still breastfeeding.
One adorable little boy of about 4 years, although tiny for his age, had a malformed jaw. He couldn’t chew, talk, and he had trouble swallowing. He was taking food, but liquefied. His teeth are rotten because his mouth is constantly open and the saliva and oxygen just destroy them. He’d smile and be coy. The back of his throat also was not formed correctly and we couldn’t see to the back. He's on the list for an operation or whatever they can do for him. But his eyes sparkle with a deep black light. He is intelligent and catches everything although he can respond only through grunts and motions. If he were in the States, this would have been corrected when he was an infant, and his life would be so different.
It's amazing to see the emotions flow through these people. It all shows in their eyes. Fear, hope, concern, worry - they are all so transparent. And trusting. They will go behind a curtain, timid as they are, men and women, disrobe whatever we ask and lie there, allowing themselves to be prodded with 3 women standing around asking questions. They are so obedient and will do anything you ask. Then they will get dressed, come sit back down on the front side of the curtain, and look at you with so much hope that you will say something positive or enlightening. I try to have chit-chat or make light banter while Marianne is writing down her information. The open hearts of these people is amazing.
The assistants and I are learning to nearly anticipate what she’s going to say - I can tell a lot by perusing what she’s written on the chart - then we confirm it 2-3 times before they're out the door. Sometimes you can see in their eyes that they do not understand all, or that the amount of information and different medicines they’re getting is confusing. We try so hard to make it clear (me and the volunteers). I love the girls we are working with. Geraldine is quiet and sweet and intelligent. Beatriz is quick and witty and sharp. They are amazing. I need to check again for sure, but I believe that they are just total volunteers. Maybe it's a trade-off for the medical training. Again, I am so impressed by these simple and wonderful people.
Everyone else has gone out after lunch for a walk around town - to the ceramic fairs and such. I decided to rest some more and get some notes down here. I'm also taking more pictures and telling the people that they are to show people "over there" so that they can help us more … since they'd be more inclined to do so if they see "real people" being helped. I also want to organize some entries for the Blog I started.
Saturday, July 1, 2006
The days are going so quickly or we're just so busy that it's hard to remember what day it is. Luckily we have our volunteers to remind us. Actually I had June 31st here without thinking!
My God. I just came from seeing a lady which I had helped to lie down earlier because she was in such pain. When Hector went to examine her I saw him pulling Marianne in and I followed. The woman's arm was so swollen and when he opened her bandages, the puss and mess that was her underarm and breast was obvious. Her daughter said that the doctors before had not even indicated that the possibility of cancer existed. This woman is dying. I had to find this quiet solitary spot to have a quick cry and do something to remove myself a bit from the reality. Hopefully this will help. The daughter just kept saying "help me, help me, help me". They were both just crying and crying. The Clinic is going to try to see what they can do to get her to Lima for help and comfort. But at this point, that’s all that can be done. … all …Our first "casualty" of the group has occurred. Art, the optometrist, acquired a fungal infection in his feet somehow. Some betadine treatment this morning, but by noon he’s down for the count with an IV. I had to run up by metrotaxi to the CEOBatania to inform the nurses and patients waiting there that he wouldn’t be coming this afternoon. Some of these people come for miles, meaning 5-8 hours away. One teen had a horrible infection or something in his eye and it was all whitish around the iris. Hopefully someone can do something to help him now.
Sunday, July 02, 2006
