A Whirlwind Week

Hello! After some time away from the internet, I’m back and vowing to post more regularly.

I’ve just moved back to San Pedro and am finally moved in and into full swing in the HIV unit and with the community health team. Before the move, I was working in the rural town of Santana Bani (about two and a half hours away) preparing for and then translating for a visiting short-term medical team from western North Carolina. No amount of words can describe the experience, but I’ll give it my best shot and throw in some pictures for flavor.

Part I of my work, preparing for the team, proved a bigger job than I’d anticipated. I started simply by making nametags in Spanish for the Americans: Jim became Jaime, Ray à Raymundo, Joan à Joana, etc. In the days that followed I worked with two others to plan the clinic flow through the church and school building available to us: waiting room to intake to waiting room to exam room to pharmacy to parasite station to exit. We trained community volunteers, picked up meds, strung up sheets for examination areas, made signs, scrubbed bathrooms, and had countless conversations with willing and wonderful locals on how to ensure water, electricity, and working fans and toilets. Lesson learned: Always make friends with security guards and maintenance people.

Part II began when the team arrived to provide four days of free medical care. We had an ophthalmologist, three doctors doing general medicine, one physician’s assistant, one nurse practitioner, one paramedic, two nurses, a med student, a marketing analyst, a priest, a dance teacher, and an organist. Phew. Only two or three of those spoke Spanish, so I spent most of each day jumping from room to room translating. (I snuck some picture-taking in too.)

We saw about 180 patients each day and there still wasn’t time to see everyone. Our “waiting room” in the church sanctuary was full most of the time, as families gave their medical history to a volunteer or waited to be weighed.

These three kids waited patiently all morning - when I took this picture – but by the time I was translating for them and Mom at 11:30 they could no longer curb their curiosity over tongue depressors and stethoscopes. My pictures of them then all turned out blurry with movement, though I had a great time during that session.

We did exam after exam, until some things became so common the providers turned over explanation to me. Kate, please find out what they’re eating and do The Diet Spiel… Could you please do the Diabetic Foot Care Explanation? …. I need a Scabies Cream Tutorial over here! etc. OK, so maybe they didn’t use those exact words, but pretty close! In truth, I was lucky to be with a team of experienced providers who were excited to teach me new skills and talk through their diagnostic approach with me. For every patient I helped, I was helped in return, since everyone was willing to let me take a second listen to the lungs, watch an exam, or re-palpate a lymph node. A big thanks to all our providers and patients!

On February 27th, in the middle of our clinic week, the country celebrated Independence Day, so we spent the day watching parades and hanging out with the neighborhood folks.

I inadvertently ended up part of the parade, marching and waving a flag, and got a good view of family onlookers:


Now that the hubbub is over, reflections are starting to percolate through my brain. I can’t get over the huge amount of preventable or easily treatable illness, left un-checked, that we encountered every day. I saw adult after adult with hypertension and/or diabetes, and all the heart/foot/eye/body problems that go with them. I saw child after child with iron-deficient anemia and skin/digestive tract parasites. And then facing our own limitations to help as a short-term group: It’s hard to provide the necessary follow-up care for these chronic conditions. And what does it mean to give every child anti-parasite treatment when they’ll be back playing in the contaminated dirt and water next week?

When your advice is to drink less Coke, but drinkable water costs as much or more…. When you recommend monthly doctor check-ups but the nearest free clinic is often un-manned or out of meds…. When your instructions are to stay out of the dirt, but there’s nowhere else to play…. How can you help?

Sometimes I am overwhelmed by the incredible need in this country. The short-term clinic and my work here in San Pedro provide wonderful ways to concretely help people in these communities, even when it is the service of simply being with the people. Every time a child gets an iron supplement, a parent physical therapy, or an infant a vaccine, it is an important contribution. But I can’t help but feel the pull for infrastructural change, for running water, clean streets, health education, sewage systems, etc. These are big issues in a big picture, and I don’t have the background or skills to fairly address them, but I think it´s worth thinking about.

But for now I´ll close with a lighter anecdote: On Independence Day, after a morning of watching and marching in parades, two of us settled down under a tree with books. Suddenly I heard the clanging of spoons on pots and pans and turned to see about fifteen kids in all type of dress – though most with their underwear on their heads – yelling and marching our way. They swarmed around us jumping and laughing and yelling something about chicken, celebrating Independence and a day off school in their own unique way. Pretty soon, as spoons were dropped and participants´ underwear-hats became askew, we were all in hysterics. And then just as quickly, the kids waved and went back the way they came. Interactions like that, where language isn´t necessary and everyone is having a good time, are simply some of the most enjoyable. I still smile to think of Santana Bani´s Impromptu Parade.

That´s it for now, though there´s more on the way! Happy March, and have a great weekend!