Alright, so here is probably more information than anyone ever wanted to know about the medical clinic that we had here in March, but these are the notes that I wrote up to give to the other volunteers I work with and to have to help plan future medical clinics. We host medical teams of doctors, dentists, nurses and such who come down from the states or other countries to spend a week providing medical care for the people in the villages where we work. Eventually the clinic we are building will be a place where we host a medical-dental team once every month or every other month. The advantages of having an actual clinic will be that we have a place to keep records, we plan to have a nurse who works full time at the clinic who can help with meds or with follow-up care from the clinics, the doctors and dentsists will have more tools and instruments they need to provide a higher quality of care, and we will have a pharmacy where we can store medicines securely. Also we want this building to be used a lot!… a community building. I am currently working on a health needs assessment to see how we can provide the best services. Hopefully the clinic will also be used as a place where we can provide classes and such on preventative health care, hygiene, nutrition, water, natural medicines…ect. So that we can get to the cause of the illnesses and maybe prevent them instead of having to treat them. People from the community have also expressed interest in holding meetings such as AA meetings and a women´s weaving group would like to use it to meet in. So we have lots of hopes for this building to really be a community building!
Here are the notes from the clinic we had in March… there are lots of extra details…
The team arrived in Panajachel on Monday March 10th, spent the night and met up with JoAn on Tuesday morning. JoAn and the team took a private launch over to Casa Rosada, the Launchero—Andres charged 300Q for the trip, and JoAn was very pleased that he helped load and unload bags for the team. After the team arrived at Casa Rosada, they settled in claiming their bunk beds and arranging the food they brought in the kitchen. After a brief intro to Casa Rosada and a lovely demonstration of the Pila by Mary, the group had a bit of free time and then headed to San Juan for a day of fun! We took a little tour of the town such as the new market and new library and such. Then some of us went to visit Ana and Francisco and to see Ana’s weaving groups’ weavings. Though it was difficult to actually get the group to go to Ana’s house, some finally did agree to go, and they seemed to be just so happy they went. They even got samples of the different kind of natural die thread in addition to some weavings. Some people in the group went to see Juan Carlos and some had a refresco at the nice hotel and checked out the art galleries. Then we waited around for Santiago and spent much time trying to find him to place their order for coffee. I am thinking that this must be the very best coffee in the whole world… they were seriously so very worried they would not be able to find Santiago with the coffee. Well as it was nearing dark, and Mary kept telling the group we probably should catch a ride back cause it is not fun to walk on the path at dark. So finally most of us decided to go find a ride back. But not our heroes Marilee, Evie, and Riley… no they were on a mission to find that coffee for the team, even if they had to brave that curvy, robber filled dirt path in the pitch dark. Now as for the rest of the group, they are mostly all some kind of medical professionals from the states; however the 3 extra Q to take a tuk tuk back to Casa Rosada instead of searching high and low for a picop (pick-up truck) was too much of an expense. So we waited and waited for a picop to get ready to leave. They kept messing with the engine and pouring water over something, which is probably not a great sign… as the yellowy pink sunset faded into an increasingly greyer and greyer color. And then who shows up but the coffee hunters! They came running with their bags of happy all exclaiming how Santiago had come riding down the road on his bicycle with a great big smile on his face… how very happy was to see them all. Or perhaps happy to sell hundreds of pounds of coffee??? But with our group reunited and the engine cooled down from the recently added water, we were ready to head back to Casa Rosada; the picop made it and we climbed the stone steps up to the house just in the nick of time! What an adventure!
Of course upon returning home the group was “starving” not sure if they could even wait for dinner? Why are we eating so late they would ask? Hmmm ask your leaders… But luckily in walk Rosa, Nicolas, and Loida with dinner—hooray! And what a spread there was. Rosa prepared a delicious caldo de pollo (chicken soup) with carrots, potatoes, and quiskil along side, Tere brought her amazing pasta salad on the boat from Pana, and Juan brought some tortillas and cheese spread… it was quite a feast! And it was a wonderful time of fellowship and a chance to meet new friends.
After dinner we circled up for the cultural orientation. Medoh gave quite an introduction on ODIM, our programs, and how she became involved with ODIM. After this presentation, Juan Toj presented some information on culture and how to work with the indigenous people in the villages and to be culturally sensitive. Unfortunately Juan did not have that much time to present this information, so it mostly consisted of people asking questions. JoAn and I noticed many things during the clinics which we did not go over, but which were in the cultural sensitivity piece. On some of the feedback forms, there were comments that the team members would have preferred more cultural information and discussion especially from Juan, and less information about ODIM and our background. I agree that we could just hand out the brochures, give a very brief intro to what we are about and then I am sure people would have questions they could ask us at other times. Or it might be a good idea to read the group while we are presenting, if they seem interested then we could go into more depth. After the orientation we kind of divided up roles and who was going to work where and we were off to bed.
The next morning bright and early we woke up and started getting ready for the day. The group did kind of a make your own breakfast thing with granola, yogurt, fruit, mosh, juice, coffee, tea, etc. Which seemed to work well for everyone and was pretty easy. For lunches the team packed tostadas, cans of refried beans, packets of tomato sauce and chopped up onions and cucumbers and tomatoes and avocados and such. The lunch people each day spread the beans on the tostadas and set them out for people to top with what they wanted. They also brought fruit, bread, cookies, and leftover salads from dinner. These lunches were a big hit and they went over great! Some days though there was not quite enough food, so it would be a good idea to bring more than we think we need. And on the comment forms it was unanimous praise for Rosa’s dinners, they loved them! They did suggest perhaps having a fish dish for dinner one night.
The first clinic at San Pablo, was well, a little crazy! We ended up seeing 92 patients! We got started later this day, like 9:30, at the teams request… they actually wanted to start even later. And the doctors got off to kind of a slow start with some pretty sick patients. I think that perhaps we should have brought Marilee to see Gaspar at a later time after the clinic to open up some time—she spent an hour with him. It was kind of chaotic inside the clinic with people waiting and such, and Mac was not a lot of help in trying to organize this. The pharmacy was great, and there was never really any backup. And it was really great to have Jill a nurse who worked with the patients on nutrition and medication education. The team especially Marilee was really pretty mad at the end of the day on Wednesday, because they felt that their requests to have 60 patients had not been heard. We ended up leaving the clinic around 6:00 and they said that was not ok. JoAn and I both thought it was great and there were so many very sick people who got seen, but the team seemed to have a different view. They also wanted things to be very orderly, but San Pablo is just not really orderly. Timoteo at one point tried closing the door to keep the other people out especially the kids who kept running in. But Mac made him open the door back up saying that they needed to keep it open, and thus more people came in, and we had more patients! But we made lots of referrals, including many referrals which we have not had before… such as to the Hospital in Solola and the centro de salud in SP. We even ended sending one lady with a blood sugar of 481 to the clinic in San Pedro as an emergency.
The next morning we were off on the hour trip to Pasaquim. The mini bus picked us up at the public doc and we rode the twisty, curvy path through San Pablo, up to Santa Clara, and over behind Nariz and back down a bit to Pasaquim. This was a great place to have a medical jornada, as they have never had one in this aldea before! One thing we might need to think about though is that during the rainy season this road might be kind of dicey since much of it is dirt road and down a hill and such. But we had the clinic at a guy named Oscar’s house… we used a couple rooms inside the house for the two doctors and their exam rooms and the outside big front porch we used for registration, intake, vitals, pharmacy, and waiting. It seemed to me that doctors saw a lot of cases of scabies here! We ended up having 72 patients at this clinic and the team seemed to think this was a much more manageable number. The team also did a little skit/ song for the kids as they were waiting. Two of the members of the team have some clowning and acting background and they made up a cute little song about brushing your teeth, washing your hands, not drinking sodas, and such. The team also handed out lots of toothbrushes which seemed to get kind of out of hand. The kids kept coming back to ask for more toothbrushes. Perhaps in the future we should encourage the doctors to hand out the toothbrushes in the exam room, or the pharmacy with the medicine. Also, JoAn suggested unwrapping the toothbrushes first so they couldn’t go and sell them. But the clinic in Pasaquim seemed to go very smoothly, and the translators were overall very good. Francisco changed out one for the second day because he thought she wasn’t doing a very good job?
For the clinic in Pasaquim we had a shorter drive, only about half an hour—this aldea is the one closest to Santa Clara. When we arrived in Palestina, the translators had already set up the clinic with sheets and all exactly the way we had it set up the day before in Pasaquim. However, once the group arrived, they began moving everything around and completely changed the set up that our translators had worked hard all morning and the night before to set up. This is perhaps something else to add to our cultural sensitivity document, or at least something to talk with the teams about. The clinic at Palestina was quite calm and very manageable, even though Karen, the adult physician, was sick and unable to examine patients most of the day. Jill and Evie ended up examining the patients and consulting Karen when they had a problem. JoAn worked on education of patients to fill in for Jill, and Mary worked in the lab with urine and blood samples. But everything flowed smoothly despite this little problem. We had fewer patients at Palestina and actually even ended up leaving a little early. There was a small problem with the mini-bus driver and JoAn and I were a bit worried he wasn’t going to show up to pick us back up… but he came! Some of the group though had decided to begin walking back though… not quite sure where they were walking too… they did not want to wait for the mini-bus though, and they were cold because it was pretty cold this day up in Palestina. Many of the patients in Palestina wanted glasses or needed cataract surgery, and it was hard not having any place to refer them for glasses or cataract surgery. Some patients were very insistent, so we did end up referring them to the eye clinic at the Solola hospital, but we found out later that the glasses are a crazy amount of money that these people could never afford. Later we found out that there was a huge eye clinic which included free glasses and surgeries in Pana in April, and we were able to call the community contacts and let them know about this clinic. But it would be great to have this info ahead of time.
But over all the clinic was a great success, despite some of the personality conflicts and trouble with people on the team trying to be in control of everything. Marilee is going to send out all the statistics of the clinic, so we will add that info to this document.
