Last Days by Rich Lopez

Friday blends into Saturday.  It went like this.  Clinic-inventory-packing-swimming-eating-dancing-snoozing-busing-flying-arriving in 30 hours.  Sound tiring?  It was.

The morning started the final day of the clinic. Patients had their last chance to see the “gringo doctors.”  While the docs were seeing patients, I worked with a team of nursing students, counting, grouping, boxing and labeling supplies in the storeroom.

As the clinic started to shut down, more supplies arrived at our doorstep.  The trickle became a flow, then the flow became a rush and soon we enlisted other students to pack up the mobile clinic.  Everyone helped, students, interpreters, doctors, nurses and volunteers. Andres’ daughter and several of her middle school girlfriends drop by and soon they were part of our team. Continue reading “Last Days by Rich Lopez”

THE FULL MANTE Vol 11, No 8- All the News To Print That Fits – February 7, 2009

By Jean Bedell
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The days may be long, but the week is so short. We are writing this on Friday…clean up, pack up, and move out. Anne has us organized procedurally with an eye to efficiency for next year. It is a given that we focus on quality more than quantity, but at the Clinic, over 4000 patients have been seen and screened. Although two docs short, the Eye Team completed over 250 procedures. (OR stats later when we get them) Continue reading “THE FULL MANTE Vol 11, No 8- All the News To Print That Fits – February 7, 2009”

Last Days on the Campaign by Rich Lopez

Friday blends into Saturday.  It went like this.  Clinic-inventory-packing-swimming-eating-dancing-snoozing-busing-flying-arriving in 30 hours.  Sound tiring?  It was.
The morning started the final day of the clinic. Patients had their last chance to see the “gringo doctors.”  While the docs were seeing patients, I worked with a team of nursing students, counting, grouping, boxing and labeling supplies in the storeroom.

As the clinic started to shut down, more supplies arrived at our doorstep.  The trickle became a flow, then the flow became a rush and soon we enlisted other students to pack up the mobile clinic.  Everyone helped, students, interpreters, doctors, nurses and volunteers. Andres’ daughter and several of her middle school girlfriends drop by and soon they were part of our team. Continue reading “Last Days on the Campaign by Rich Lopez”

THE FULL MANTE Vol 11, No 7- All the News To Print That Fits – February 6, 2009

By Jean Bedell
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THOUGHT TO PONDER UPON:  There are two ways to get enough.  One is to continue to accumulate more and more.  The other is to desire less and less.

What are the chances?  Pablo is 13yo with Downs Syndrome.  His brother, Pedro is 5yo with Downs Syndrome.  Both had bilateral strabismus repairs.  Both have cardiac problems.  What a challenge this mother has to care for them.  Is it imagination, or have we seen more Downs children this year?  They are such friendly and affectionate folk.  One girl is 23yo, born when her mother was past 50yo. Continue reading “THE FULL MANTE Vol 11, No 7- All the News To Print That Fits – February 6, 2009”

Tortas, Tacos, Cakes, and Supply Room Inventory by Rich Lopez

dscn1704Where ever there is a crowd of people there are resourceful people.  The BCH Medical Mission attracts thousands of people and it is not surprises that food vendors circulate through the crowds, selling cokes, and other items to eat while they pass the hours long waits for their opportunity to see a “gringo doctor.”    I’ve noticed a “two-legged toy store” selling balloons and cute “mice on a string.”  No stimulus plan needed here. Continue reading “Tortas, Tacos, Cakes, and Supply Room Inventory by Rich Lopez”

Hump Day by Rich Lopez

dscn1696Wednesday, “Hump Day” means we’re half way through the 19th BCH Medical Mission.  After the morning meeting, Anne asked me to work in the pharmacy to fill in for Marjorie Hutchings.  Marjorie is a member of the BCH Auxiliary and wanted to see her friend, Charlie Jones, in surgery.  My job was to assist our pharmacist, Laurel Blissett.  My qualifications for this job were an ability to count to ten in multiples of five (counting pills).  “I can do that!”  Tucked away in the corner of the four-stall exam room is a six feet by six foot pharmacy with a small table bookcase and three chairs.  Our interpreter is Vanessa, a fifteen-year-old student who lived in Florida for seven years. She attended a dual immersion bilingual school there is perfectly bilingual and very mature for her age.  I learned that Laurel had just finished giving the Wednesday morning lecture to the nursing students. Continue reading “Hump Day by Rich Lopez”

THE FULL MANTE Vol 11, No 6 – All the News To Print That Fits – February 5, 2009

By Jean Bedell
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jean1There are not only objective criteria involved in whom we treat.  There are also subjective and ethical considerations.  As of this morning, eyes had only 10 slots open for Friday.  Within a short time, there were only 6 slots left.  Yesterday, 297 patients were screened in the one day.  Considerations when triaging patients include 1)  bilateral cataracts, 2) age, with a focus on mothers caring for young children or young men working to support a family and 3) diabetic complications.  For example, 50yo Hector is a tractor driver and is blind.  Will cataract surgery allow him to return to work, or is there retinal damage which, because of diabetes, will not provide vision even with surgery?  Andres, 43yo was given one of the last slots so he can return to work selling papers and sweeping streets. Continue reading “THE FULL MANTE Vol 11, No 6 – All the News To Print That Fits – February 5, 2009”

THE FULL MANTE Vol 11, No 5 – All the News To Print That Fits – February 4, 2009

By Jean Bedell
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It was a life-saving event. A first time event never seen before, Samanatha went from the lab at the clinic to a locked storeroom looking for a table. She heard a rustling noise coming from a black trash bag. Upon examination, she found a little blue-green parakeet. Mouth to beak resuscitation was not needed. A cardboard home was designed with architectural perfection. Water and seed arrived. Now we just need a good foster home or adoptive family for Bruise Cotorra.

Pregnancy tests can bring either joyful or sad news. One woman who wanted to become pregnant had a negative test. A 15 yo girl tested positive and is fearful of the stigma and ridicule attached to her. Continue reading “THE FULL MANTE Vol 11, No 5 – All the News To Print That Fits – February 4, 2009”

A Day In the Camaign by Rich Lopez

Each morning the clinic team leader Anne conducts a staff meeting. This follows an earlier education session for the student nurses.  The team realizes that their impact will be greater if they can provide more information on common medical issues and do so each morning.

Anne conducts the morning staff meeting
Anne conducts the morning staff meeting

Each morning the clinic team leader Anne conducts a staff meeting. This follows an earlier education session for the student nurses.  The team realizes that their impact will be greater if they can provide more information on common medical issues and do so each morning.

At the 8:30 staff meeting, Anne outlines the anticipated activities and provides additional information.  There are a few openings for surgery at the hospital over the next 3 days.  This is important because some clinic visits result in needed surgery.  Anne mentions that patients who might request birth control pills can get them for free at the DIF (public health department).

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Dr. David Rodriguez, with his son Andres interpreting

The next part of the staff meeting is another educational piece on the history of medical care in Mexico.  Dr. David Rodriguez, with his son Andres interpreting, explain that Mexico has a population that speaks 52 indigenous languages.  Most of the people relied on traditional medicine until the Spanish arrived.  Medical care has evolved into four basic types; charity, private, institutional and popular.  However, 50 percent of the population do not have access to medical care.  48 million Mexicans have no health insurance.  Even those that do have coverage must pay for the actual supplies used by the doctors.  Imagine having to go buy an implant for your knee.  “Mr. Lopez, it looks like you need a 33 regular, would you like to see a titanium model or are you going to go with a more inexpensive steel knee?”  Most of the population (85 percent) live on minimum incomes and pay no taxes.  The middle class makes up 12 percent of the population and pay some taxes.  The upper three percent are “ricos’ or rich and pay no taxes.

These facts underscore the importance of this medical mission.  Our patients would have virtually no opportunity to receive the quality medical care provided by the BCH Medical Mission.

Tuesday finds me back doing intake for the GYN clinic.  Dr. Laurie Coryell is my doc and I’m assisted by Johanny and Peral, both second year student nurses.  Dr. Carson is seeing children today in the pediatrics section.  I think he was glad to rotate when he saw me passing out business cards as his patients left.  Just kidding.

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Rich helps with intake for the GYN clinic assisted by Johanny and Peral

dscn16731dscn1675Dr. Coryell suggests a way to improve patient flow by stringing a sheet up in the corner of the room to create a changing room for the patients.  A few minutes later a rope and sheet arrive and presto, a changing room.  The women that we see have a variety of concerns,  bleeding, menstruation irregularity, inability to conceive, weight loss and breast lumps.  They sit quietly on a row of chairs in the courtyard, shifting chairs as the next patient goes into the converted office to see Dr. Coryell.

I sit outside with them, Peral asks them their name, age, address, medications, special diet and then asks them to “what are your problems.”  Together we fill out the forms and hand them back to the patients.  Some patients bring lab reports and ultra sound images.

About mid morning a large mobile examination van arrives.  This van had been sent by the State government but had a mechanical breakdown before it arrived.  Anne asks me to help move the GYN supplies to the van during the lunch break.  There are two examination rooms and tables so two of the doctors can work together.  I ask one of the nursing students to write the doctors names on a piece of paper to place on each of the two entry doors.  Why not custom tailor the van a bit.  Unfortunately, the small exam rooms are air conditioned and feel like a meat locker.  Dr. Coryell opted to remain in the much larger and warmer converted office, complete with changing room.  The involvement of the State government is both helpful and sometimes a hindrance.  The State expects us to use the van.  Perhaps today, we will find a way to fit all the supplies into the van and turn down the AC.

The medical mission provides an opportunity for the team to see patients with conditions that they may only read about back home.  Cleft palates in young children are regularly seen.  Some children have been using a plug to seal off their mouth from their nasal cavity.  With surgery they will live a better life.  As I was filling out an intake form I noticed a 3 foot tall man walk by.  Not a dwarf or midget, a normally proportioned man who looked to be in his 50’s.   Anne thought he might be Mayan.  Later over dinner, some of the doctors explained that there a some genetic anomalies that result in tiny people.

Several children come in with “crossed eyes” and others with different eye problems.  Fortunately we have an Eye Surgeon on the team and this afternoon he drops in at the clinic after a morning of surgeries at the hospital.  One 12year old boy has what called “jittery eyes.”  His eyes would move left and right rapidly.  It’s hard to imagine how he could focus, let alone walk.  The Eye Surgeon, Dr. Ticho, is from California and his Anaesthesiologist, Dr. Ticho, is from Chicago.  That’s right, Simon and Ben are brothers and for the very first time since become doctors, they worked together here in Mante.  The medical mission provides opportunities for family reunions.  Charlie Jones has been assisted in surgery by his daughter in past campaigns.  Anne Donovan and her daughter Abigale Stangl, an landscape designer, are here from Boulder

Then there is the husband and wife team of Dr. Carolyn Sanders and Dr. Eric Boyen.

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Police van ride back to the hotel

At the end of the day I accompany Dr. Sanders to the hospital for a tour.  When we arrive we walk through the surgery wing, past a woman being prepared for skin grafts.  She was horribly burned a year ago and the repairs to her body are slow and hopefully not too painful.

The work day ends in a Police Van.  The nurses, docs and I pile into the back of a van to be delivered to our hotels, we hope.  The chatter reflects on the day’s work and we talk about a dinner party being given by Juan Villareal, the bother of the former mayor, Javier.  He throws a party for the medical team in his back yard each year. Why?  Just one of the friendships that have developed over the many years of the campaign.  A time to renew friendships and enjoy some delicious food and drink.  Tomorrow is another work day.

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THE FULL MANTE Vol 11, No 4 – All the News To Print That Fits – February 3, 2009

Today’s message read “the grand essentials of happiness are: something to do, something to love, something to hope for.”  Howard, PACU’s team builder- nurse extraordinaire, posts daily missions on the scheduling board.  Today at the Hospital General the surgical teams, PACU, the bio-medical technicians, triage nurses and assistants, and the sterile processing department (SPD) assistants started their days early and began patient care before 8:00 am.    With sixteen beds open for patient recovery, PACU was ready to take a full load of patients.

In the OR, the life of a tiny three month old Pablo was changed by an hour long surgery that corrected his cleft lip.  As he was brought into recovery, his mother and subsequently all of the nurses burst into tears of joy.  Next year he will have his cleft palate repaired.  This IS life changing because it affects nutrition, speech and language development, peer and social acceptance for him.

There are words of appreciation that bring tears, even without the drama of surgery.  At the end of work yesterday, Laurel and Margie welcomed 43 yo Maria.  They filled seven prescriptions for her… medicines she would not have been able to afford.  She burst into tears of joy, “because of you, my whole day is beautiful.”  “It’s why we are here,” was the response.

Of course, there are moments of humor.  Erick looked at the wooden, worn-down, too-long, crutch with no rubber tip 67 yo Magda was using.  “It’s too long…wouldn’t you like a new one?”  “No, I like it.”  “Well, maybe you will grow some more.”

Victoria, a 17 year old girl, came to the hospital with a 2.5 kilo (5.5 pound!) noncancerous growth under her arm.  All she wished for was to be able to wear a dress like all of the other girls in her village.  Yesterday she travelled an hour in the back of a pick-up truck and then a six hour bus ride to Mante.  Tomorrow she will return home with her wish granted.

Here’s some more interesting and useful info about DIF.  Every morning DIF provides a free hot meal for every school child.  Sometimes it is their only meal for the day. We learned it is illegal to not allow kids to attend school if they cant speak.  On a different focus, DIF provides free birth control pills.

Some situations we cannot help.  Some congenital anomalies are not ‘fixable.’  It may be enough to provide reassurance for the parents that they are doing the best possible.  And, occasionally there is an angry response.  Yolanda, 52yo, came demanding a prostheses.  We no longer have any to give.  She stated that all of her friends had received one, she deserved one, and we should supply them.  Again, thanks go to DIF who will provide these for poor women living in Mante.

Every year “The Perfect Person’ comes for a ‘useless’ piece of equipment.  43yo Pedro lost both legs in an accident.  He supports himself shining shoes at the plaza.  He has been using a broken-down chair.  PT had one wheelchair with no legs, and a Jay-pad, used to prevent pressure sores.  Pedro has no use for a chair with legs, and the Jay-pad was a perfect fit for his size and needs.

What does ENT stand for?  Maybe it is ‘Ear, Nose, and Toes.’  Sarg went from a T&A to next remove a baseball-sized dermoid cyst from the foot of 78yo Patricio.  Now he can wear his dancing shoes. Because of some problems, OR didn’t finish till 10:00pm last night.  Hopefully that will not recur. The flexibility of folks here is amazing.  The results of our work bring tears of gratitude.

Adios from your reporters Abby and Jean