Our friend Regina (mother to three of our cleft palate kids - and who you'll see in the first picture below) has been pretty good about bringing us some patients that we really need to see. About once a month or so, we get a call from her at home asking if we can give some numbers at ASELSI. Because of where Regina lives, she can't get to ASELSI early enough to get a number (they start turning people away by about 5am every week!) Nearly every time Regina has brought us a patient, it's been someone who truly needs medical attention - not just a headache or a stomach that burns when they eat chili.
This time was no exception. She asked for three numbers and two of the three were in pretty bad shape (a father and son). Naturally, the mother had to come along and we treated her with Tums and Tylenol. The son had been working at the bus terminal in Guatemala City about 8 months ago when he got shot in the leg with a 9mm. Since then, he hasn't been able to walk (or work) and has been quite worried about feeding his family. He's on crutches and can't even put any weight on his leg. So we sent him to Buen Samaritano to get an X-ray. He came back with evidence of two bullet fragments still in his leg and an apparent spiral facture that hasn't completely healed. We referred him to Dr. Edgar, our orthopedic surgeon friend.
The dad presented with diarrhea and really swollen feet. We asked to make sure he wasn't pregnant (with the swollen feet and all) and got a pretty good laugh out of that. The part that's not funny is that his liver is huge. He used to drink - about 20 years ago, before he joined the church - but it looks like the damage is done. So we sent him to Dr. Hoak at Buen Samaritano, who at press time hadn't called us to let us know what's going on with his liver.
Later, we had one of the workers at ASELSI who has been married for 8 years and still doesn't have any kids. That's pretty unusual here. She's been to several doctors and if they actually told her what she says they told her, we shudder to think what the thought process is! Her husband came in, too, and will be a participant in the process to try to figure out what's not working right. Both will need to go get some labs and we'll pray a lot for them.
We got to see three or four babies whose mothers we've provided prenatal care for. Those are always fun! And we saw a dozen or so prenatal patients, too, including our friend who is on her 11th or 12th pregnancy, is diabetic, and had a c-section on her first baby but has delivered each subsequent child at home. As always, we're encouraging her to go to the hospital to have this baby and to at least consider some type of family planning, but history tells us that she'll probably ignore our advice.
One mother came in with her baby to check her weight. She's been in twice - asking for free milk each time. Apparently she's breast feeding about eight times a day and giving a bottle a few times a day, too. The problem is that she only breast feeds for about two minutes on each side. So we had a teaching moment. The problem is that moms around here think that because it comes in a can it must be better than what you get for free if you'll only breast feed. So we get a ton of moms who come in and want free milk. The milk programs we work with only give milk to malnourished kids, and only about half of what the baby needs. If Mom is not going to breast feed, she at least needs to participate and buy SOME of what the baby needs. ASELSI and the Fickers both spend insane amounts of money on milk and we can't afford to give it to everyone who asks - nor should we. Getting babies started on bottles can be downright dangerous. Hygiene isn't always the greatest and we're reasonably sure that not all moms clean the bottles well with soap, water, and bleach. If a baby is already a little malnourished, diarrhea could easily do them in.
Using that as a segue, our last patient of the day was a mom asking for milk for her baby since she didn't have any breast milk. 99% of moms who say that have plenty. Heidi always makes them show her and usually gets squirted with milk for her trouble. This woman had nothing. Plus, she's about 45 years old (or more). In Heidi's opinion, she didn't look anything like a woman who had just given birth. Yet, she insisted that this was her baby. Through our translators, we explained that we're not going to call the police or anything, but we need to know, for medical reasons, whether this is her baby or not.
Finally, she and her husband admitted that this is not their baby. They don't have any kids and are worried about who is going to take care of them when they get old, so they're "adopting", which basically consists of them going to the local health office and claming that this is their baby. Then they'll get papers for her. Mom has quite a large belly, though, and we wanted to take a look on ultrasound just to be sure. It looked like her bladder was completely full, so we asked her to go pee and come back. When she came back, she was still completely full, so Heidi catherized her and got nothing out. Clearly, the ton of fluid we're seeing inside her abdomen is not urine. So Heidi tried to get her to come to Buen Samaritano tomorrow where she has a lot more resources. But the patient is scared of hospitals and is not going to go. We've put them in the milk program at ASELSI, as the only thing they've been feeding the baby is warm water - milk is too expensive. We're not sure how they're going to care for this baby so it lives long enough to take care of them, but...
Anyway, here are some pics from the day. The first is Regina with her daughter Carolina (one of our cleft kids) on her back and Isaac on her front. The second, third, and fifth pictures are of the new babies we mentioned earlier. And the fourth pic is a woman who is completely riddled with rheumatoid arthritis and had an appointment with the orthopedic surgeon last week, but can't read and came in on the wrong week. We pulled her chart and continued her on the same meds he gave her last time and gave her another appointment to come see him when he comes back.
Tomorrow is Heidi's clinic at Buen Samaritano. Next week is Thanksgiving, when we'll be headed up into the jungles of Zona Reina for two or three days. Please keep praying for all of that to go smoothly. We're expecting about 1,000 patients. No kidding.
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