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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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