‘Stop being poor’...(posting from the road)

Today was a very frustrating day. It was day one of our clinics. For those unfamiliar with the clinics I speak of...a team of about 35 people ascend up a mountain to a remote mountain village, take-over a school or church and in 30 short minutes set up a full clinic that will see 400 patients a day. Traditionally I am part of the pharmacy team...and I still am a little on this trip. My preplanning and clinic day step up is pharmacy but during the day, due to an unexpected shortage of physicians, I am serving in the role of a clinician.

Pharmacy is a role that is more hands off I now realize, we see patients and talk to patients and hear their stories but in a different way than the clinicians do. Now I have to see patients -

listen to their problems and then order them something from our limited pharmacy. They sit across from me and look for an answer to their ailments and sadly the only thing I can think of is to say “stop being poor”.

It’s awful, listening to their issues and realizing that so many of them would never exist if they were simply born somewhere else. There was a family that all had colds because they don’t have blankets for night. One man had been experiencing urinary retention and hydronephrosis for 8 years after an accident – it was too expensive for the surgery but he is saving up...1,000 Quetzales or $125 USD. (Imagine having a painfully full bladder for 8 years) I had the chance to diagnosis congestive heart failure on my own using entirely archaic measures (fingers crossed that I am correct). Many people had GERD/heartburn after a diet exclusively of tortillas and coffee but some people’s abdominal pain actually resolved with food – it wasn’t a stomach-ache they had – it was hunger.

There were the usual aches and pains from carrying firewood and water hundreds of miles a month – what do you tell them? Or the family who must be living in some horrible conditions as several of the children had infected insect bites where some type of fly laid eggs. Then there is the telltale ‘pregnant’ bellies of the children that are full or parasites who are in so much pain the simply don’t eat. People come with such hope – it is hard to crush that...I had to tell a man that there was nothing we could do to fix his failing hearing or vision, he was simply getting old. This was especially frustrating for him as he was responsible for carrying all the wood for his family – he’s 80.

I don’t ever tend to get emotional about patients at home...in fact is has been a point of criticism from previous coworkers in the past. I rarely remember a patients name after I step away from their bed and rarely ever recall the reason that brought them to the hospital in the first place.

Well today I didn’t make it through the first patient before tearing up. Jessica is 3 yrs old

– she ranks in the severely malnourished category for 2 reasons. First her little body is parasite ridden and thus not interested in eating. And secondly, the family simple cannot afford food. On average Jessica will eat a tortilla a day and drink a little coffee. Mom said, occasionally they find eggs from some of the wild chickens so she gets a bit of protein a month. We are attempting to get Jessica enrolled in a special program (Embrace – more on that later) that allows people to sponsor Jessica to get her out of the severely malnourished category. At first her mother declines the offer but when we press for a reason and she self consciously replies that it is simply because they cannot get to the enrolment meeting in Camotan (where we are staying). It is at least an hour drive by truck and there is simply no way Jessica can walk that far. Realizing that this is the only hurdle we simply give them the fare to and from their village ($3.20 USD). That’s right – 1 latte was the only difference between this girl getting food and potentially dying. See why I started to tear up? If she shows is anyone’s guess.

On my 60 min bone crushing, organ squishing drive straight down the mountain from Hierba Buena, I reflected back upon my day, frustrated that I really seemed to do little to help but more thankful than ever to be Canadian.