My day at the clinic!

This past week, I had the opportunity to spend a day at the clinic in Guiamaca with a pediatric nurse practitioner. She is a volunteer living there for three months who is actually from Massachusetts also, so it was a nice little connection we were able to have about many things. She was really knowledgeable about nursing and working with kids, and although she herself was still learning the language and the culture, she was great in the clinical setting.
I think there were several thing there that certainly impacted me a lot. One of the kiddos we saw was a little girl that was malnourished. It was hard to see, a four year old weighing 19 pounds, but she was in relatively good spirits. They came down from "the mountains" early that morning, and it took them about 4 hours to make the trek to the clinic. The mother that brought her in was very thin also, and I'm sure was malnourished herself. There was no father in the picture, and not a huge amount of familial support it seemed (which is odd in this culture, but who knows what situation the family was in after having seen this girl and her mother). She happened to be sick also, parasites, amoebas, who knows what else. Of course, the family had no electricity, so to think of giving them something you could refrigerate was out of the question. The child couldn't swallow pills, so this left the NP in a bit of a tough spot. There were other alternatives, but you try and save those for last resort. Well, with her, this was the last resort. We gave them some elixirs and medications, tons of vitamins for mom, child, and the three other children that were still at home waiting for their return, some clothes they had in the clinic, toothbrushes and paste, soap and shampoo, rice, nutritive powder, and lots of prayers.
The clinic, I found was really good about trying to cover everything. In a place like this you may not see the family for two or three months, meaning, give them everything you can while they are there. Every patient we saw got toothbrushes and vitamins and a few got soap and shampoo. Imagine a doctors office in the states doing this!
There were also these great packet of nutritive powder that the clinic made themselves. The farm that is part of their project grows all sorts of soy and nuts and other things high in protein, vitamins and minerals. They grind it all up, add it to purified water, and its an instant meal packed with the good stuff. Its really done wonders for many children and families (the NP said).
A lot of the other kids that came to the clinic that had some interesting stuff going on (well interesting to a nurse anyways), and I certainly will spare you the details, but I would like to discuss the common theme. Everything we saw, to some extend, was preventable.
The biggest issues here are respiratory issues, mostly asthma, gi issues with parasites and amoebas, and some of the tropical diseases, like malaria and dengue. (HIV is huge here also, but that's a whole other topic in itself). The respiratory issues come down to parents smoking, and families weekly burning trash (plastic is the worst offender to kids lungs). If parents recycled or put things into dumpsters, there wouldn't be half of the issues that we see in the kiddos. The gi issues are commonly caused because of kids that drink water that isn't clean. People in the mountains do not have great access to clean water, but any water boiled for three minutes will at least kill whatever is in it. People don't take the time to boil it, or kids just drink whatever is easiest when they are thirsty, and kids get sick. Malaria and dengue are pretty preventable as well. Its the things like wearing long sleeves and pants, especially at night, and having a net over their beds, that could save a lot of trouble. For the amount they will spend on medicines they could have bought the nets. Its a bit troubling.
I think the biggest issue here is simply education. People rarely learn to read and write beyond a fourth grade level here, never mind to understand how parasites, respiratory diseases and other health related issues work. The education system is lacking so badly that this just isn't a part of the curriculum, especially in those mountain towns where they need the health information the most.
I guess its food for thought for me for me. Hopefully I can work in some type of program but I still will continue to go to the clinic, and hopefully a few other clinics in our town, and learn, so I can see what I can do about all of this. Its a bit daunting, but certianly a jumping off point.

Take care! Thanks again for all the love and support!