April 2014 Trip Report

A Different Emphasis

I hope this month’s report will highlight positive impacts beyond those that occur during the time patients spend with our providers.  There is also some back story on the dynamics of putting this clinic together.    

First the clinics - Unfortunately we did not have a dentist or a chiropractor for Lopez Mateos on this trip and unlike some months, no local dentists were available.  Without the numbers that these specialties contribute, we had a relatively low total patient count.   Putting aside raw numbers, a more important question is: “Did we have positive impact and did our medical providers end the clinic day with a sense they had improved the lives of those they treated?”  My end of day conversations tell me that the answer to both was definitely yes!  It is also amazing how sometimes simple ideas can have such a positive impact.  Our reading glasses program continues to be a big success, all based on reading glasses that are donated by the Lions or purchase wholesale at 60 cents a pair and can be fitted by anyone with basic Spanish language skills.   For additional info please see Alicia’s blog at http://samaritansmovil.blogspot.com/

We also held clinic at LSI.  Gail report follows. 

LSI is as remote as it comes yet so many lovely people who are just making a living at the lagoon. Loved the school library held in an old school bus, very creative

A great clinic at LSI in a beautiful building that our Tucson Chapter built, and I loved my gyn room! Thank you Tucson!

Three planes and two providers plus lots of help. Big thanks to Dr Greg Hatch,our dentist and pilot, and his assistants Carrie Rowlands and Trang Hua. Pilot/physician/pharmacist Chuck Schroll, i nterpreters Joey Flynn and Chris Nelson Bingham, and pilot Pat McClure with co-pilot  Don Downey(plumbers, electricians, "make it work please"!). 

We came very close to having additional providers for our clinics.  I was contacted by a dentist/pilot member of the Aeromedicos , a volunteer group from Santa Barbara, CA that operates a clinic in Cadeje.  He told me that they could not hold there clinic because the runway at Cadeje was temporarily closed and offered to help staff our clinic.  We had planned to have a dentist and perhaps other providers from them, but I got some bad news the Tuesday before clinic.  The dentist/pilot developed a bad sore throat/cold and would not be able to support us.  His was the only plane available, so no help this time.  They may, however, be able to support our June clinic and that could allow us to have another month of clinics at both Lopez and LSI

Now the story beyond the clinic proper - A few months ago a mother brought her three year old to the Lopez clinic concerned with his foot deformity and an umbilical hernia. Our medical provider detected a heart mummer and told the mother she needed to have the murmur evaluated and that the foot deformity and the umbilical hernia are surgical repairs and surgeons will not consider him a candidate until the murmur was addressed. 

The mother sought further treatment and learned the murmur was caused by Patent Ductus Arteriosus (frequently abbreviated PDA).  It is a congenital heart problem that is the result of an improper bypass between the aorta and the pulmonary artery. This bypass is appropriate while the baby is in the womb, but should close after birth.  When it does not, part of the blood supply to the lungs bypasses and oxygenation is not as efficient as it should be.  The ‘fix’ is to use a catheter to insert a small metal coils or plug type implant to seal the improper bypass

The mother was resourceful and got state sponsored support for the procedure and a commitment from the manufacturer of the “plug” to donate the device.  They took the child to the hospital in La Paz and waited four days for the device to arrive, but it never did.  It appears the manufacturer may have backed out of the commitment.  

Our plan is to pay for the device so the surgery can proceed.  The cost is about $3,300 USD, but may be less to us if we get other support.  This will proceed as soon as we can get confirmation that all the other pieces are in place.

But wait! There’s more!  Beyond the clinic visits, the medication and the occasional special financial support, we offer help in other ways.  One of our pilot/interpreters had the insight to detect that the mother of this three year old was extremely agitated about her child’s condition, perhaps beyond what was appropriate given the situation.  He was involved in the medical discussions, so he had an understanding of the condition and detected that the mother’s description that ‘two blood vessels had grown together and needed to be surgically separated’ was not quite on target.  He sought out the mother, got a better understanding of her anxieties and explained that this condition was more mainstream and probably not as challenging to repair as she believed.  He reported that the mother was much less anxious after their discussions.  

This certainly highlights the importance of our interpreters and may indicate another value we bring.  I believe (and I should be corrected if I’m wrong) that in our culture there is a lower cultural barrier between medical provider and patient than is true down south.  Our willingness to communicate more openly may be valuable to the well being and comfort of our patients even though it may appear, at times, that we are just offering a second opinion that supports the locally obtained diagnosis.

Our next clinic is June 20-22.  I look forward to being sufficiently staff to run two strong clinics at Lopez Mateos and LSI.  The final clinic of this season is scheduled for July 18-20.  Please help us finish this highly successful clinic season on a positive note.

¡ Viva las clínicas !

Dennis