medical mission: Labo Medical Mission Day 3

Day 3.
Today we were greeted by a front lawn filled with patients waiting for us to arrive. I can guarantee that most of these people have come from afar and have already waited in line since dawn to ensure a visit with us. Our team now functions like a well-oiled wheel. Everyone moves into their department and begins working. I am amazed at how well we all adapted to our meager surroundings and have just made it work. "Make do." That's the motto here.
It's sunny today. I think this drew out more people. I know it made our little Outpatient Clinic room stifling hot and humid.

I wish everyone back home could see how different this world is here. The hospital has no running water. Now I realize this sounds ridiculous for a hospital. When the water does run, it's important to keep the buckets full. This way you know there is always a reserve of water somewhere. The basic needs such as running water and electricity are not always met. One of our team members bought a battery for a generator that was not functional and hadn't been functional for quite some time, but he couldn't let our plastic surgeon operate on anyone without that. There are 'brown-outs' during the day and any interruption of electricity when a patient is under general anesthesia would obviously be a disaster. In one room, another one of the team members bought an air-conditioner for the OR so the surgeons didn't have to operate with sweat dripping off their brows onto a sterile field. There's not really a way for us to improve the water system without digging up the entire city. As of now, the only source of water entering the hospital is through one pipe the size of a water hose.

HOSPITAL water source!!!!!!

Lots of interesting patients came through the clinic today. A 54 yo. man came in today with large deformities on his joints. He reported that he had gout, but no medications for treatment. These were the largest tophi I have seen in person. It's what I have only seen in textbooks.

Gout tophi

We also had 2 kids and 1 adult with chicken pox, and at least 2 kids with measles. Immunizations are not routine here, nor are they required for school. I'm glad I am updated on my shots. These kids were ill. There's not much we could do for them other than educate them on preventing spread of infection to the rest of their family as well as their entire community. The secondary infections following these illnesses usually cause more problems more than the initial illness- dehydration from diarrhea, malnutrition...

I saw a 6yo boy who had wrecked his bike YESTERDAY and had a deep gaping wound on his lower leg. He walked into the clinic with his mother, removed the dirty scarf tied around his leg, let us evaluate him, then tied it back on. He went to OR for wound debridement and closure. They would not have seen a doctor for treatment had we not been there. They travelled from quite a distance. He did not cry a single tear.

Needs to learn to ride a bike better!

A man was rushed into the hospital mid-afternoon. He was unconscious. The local hospital staff nurses performed chest compressions for a few minutes, then stopped. He died right there in front of dozens of patients watching. No code was called. No epinephrine. No heart monitor. No mad dashing... I heard he had a stroke while at work in the fields. Several of us from our team gave his family some pesos to help with funeral expenses. Personally, Joel and I gave P500 which is equivalent to $12 and that was a significant amount for the family. His body lay on that gurney in the hall uncovered for 2-3 hours with his widow standing over him before being moved into the family's home.

God bless this man and his family

I saw quite a number of children with extensive scabies head to toe, with secondary bacterial infection; one infant had cellulitis and fever of over 104F for 5 days before coming in! Mom cried. Normally this child would've gone into the pediatric ICU, Infectious Disease consult, IV antibiotics, etc... all i could do is one injection and oral antibiotics plus educate the family.

Scabies

The surgeons removed a number of very large tumors today- I wonder how such small malnourished people can grow such large tumors. One older man had a growth on his neck that was almost as large as his head. Another patient had a growth on her back the size of a grapefruit. The reason for this I suspect is that there is no money to get evaluated, much the less, have surgery.

Wow!

The last of our team arrived back to the hotel at almost 10pm- that's a 15 hour day! We all just work until the work is done. There are so many people to serve.

Grand totals: Inguinal hernia repairs-3; emergency cesarean delivery for surprise twins- 1; major gyne surgeries- 3; tumor/cysts/lumps excised- 40; pairs of reading glasses provided- 150; patients seen in outpatient department- over 400; Rx written/OTC meds dispensed- hundreds; Largest tumor 'delivered' 7.5 lb ovarian cyst.

I'd say that's another productive day.