Health Care Public Health

'Til the Cows Come Home

A line of people waiting to be served by the clinical team

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On mission trips, as the week goes on, the work gets harder and harder to do. You start the week energized and by the time Wednesday comes, you hit a wall. Our Wednesday was pretty good. Today, we reached our limit — physically, mentally and emotionally.

We set up the clinic at another school, and some classes were still being held as we set up triage in a large open area in a courtyard. A line of people formed almost immediately, and we were off to seeing patients by 8:30 am. Just over an hour later, we had more than 100 patients triaged and waiting to be seen by a physician.

Some of the patients were from the military and dressed in full military uniform and carrying huge weapons. In the different political jurisdictions, the military walk the streets and protect the community members. We had many of them stop by to see our physicians.

Our military guests provided support as the crowd in triage began losing their tempers – a little fighting/shoving and line cutting was happening, and they put a stop to that before things got out of hand. Some of the moms were afraid we were shutting down for the day, so they sent their kids up to the front of the line with other families so they would be seen.

There were so many children that physicians on our team who normally don't see pediatric patients were treating children. Pretty much everyone on the team held a baby at some point. We also discovered something new – there were many people who had blue thumbs. Someone explained to us that their thumbprint is their signature, since they can't read or write.

Some of our patients needed counseling and we used Lita Simanis, a social worker, as a support to these patients, with Ismael Gama translating. One boy, age 15, explained he has no appetite and doesn't sleep, and feels anxious since a traumatic event three years ago. He was in a boat with his brother when the boat was hit by another boat. He fell into the water and his brother dove in to help him, only to be hit by the boat's motor. His brother survived, but the boy kept playing the event over and over in his mind.

"He was having classic PTSD symptoms," Simanis said. "When he was distracted — at school or at home — he was fine, but when he tried to sleep, he couldn't stop thinking about it. We talked to him about speaking kindly to himself — that he needed to walk through the experience to cope with it. I told him to write it all down, to talk to his brother if he could, and gave him some anxiety management tools. He seemed very intrigued and hopeful. He listened very carefully."

Our OB team, Dr. Papa DelaCruz, Laura Lopez and Karen Moore, were assisted by the local Ministry of Health clinic, who gave visitors flu shots. The team did pap smears and even took care of some men today for various conditions.

The principal of the school came to the clinic. He was helping all day and by the time he was seen by Dr. Gary Lipinski, his shirt was drenched with sweat. We checked his glucose and he said he has diabetes, but with the way he was sweating, we knew something was wrong. He looked seriously ill. Lipinski got him a Kind bar and some fruit and got a glucose tablet from the pharmacy. Soon his color returned to normal. He said he was so busy taking care of things at the school that he forgot to eat lunch!

As we were leaving, we bought ice cream from a street vendor and had to move out of the way as a herd of seven cows came down the street. We saw 448 patients today and dispensed more than 1,000 prescriptions. It was time to get on the bus and head home.

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