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Sometimes the Family Doctor – Margarita – El Carmen

As we travel to the heights of Modelo Mountain, we pass through the village of El Carmen. At that altitude we see the first stands of coffee bushes. Locals say the best coffee is grown still higher where the climate is cooler and the rain more abundant.

On this day in October 2014 we set up a medical clinic in the village school of El Carmen. Even though we do not go to the same villages each year we do expect to see repeat patients. Many travel hours to see our doctors if they know we are not scheduled to visit their particular village. It is not unusual to see patients who have come more than four hours on foot or horseback. For many it may be the only opportunity they will have to see a healthcare professional in a year’s time. Even if their ailments are minor they know that they will be heard and will be treated with dignity and caring. If their problems are more serious, medications we have are provided at no cost. At the very least they will receive a caring exam and consultation, some vitamins, soap, and medicine for the parasites which plague them all young and old. For the aging we might also have a pair of dollar store reading glasses or a cane which could help get them through their sunset years. A popular bonus is when the pharmacy puts all their goodies in one of those colorful cloth tote bags made by those caring women back in Texas. It makes the walk home so much easier. For those whose needs are beyond our capability or resources we provide prescriptions or referrals to existing medical facilities with which we have networked and supported. Sometimes this includes arranging for transportation to get there.

When we spotted a familiar face in the registration line, we were not surprised. Margarita is a grandmother we first met about five years ago when people arriving at the clinic reported that a woman had collapsed on her way to our location. We found her about a half a mile down the road. Margarita proved to be a severe asthmatic that lived in a house where like most, cooking was done indoors on an unventilated wood burning fireplace. Over the period we have known her, the treatment has included not only medication for her symptoms but intercession to have her cooking comal (cooking surface) ventilated to remove the smoke from the indoor living space used by her extended family. While the respiratory heath of her family improved, eventually we had to provide Margarita a donated nebulizer for her use. In accepting the nebulizer, she readily agreed to function as a part of our network of village first responders. This loosely knit network is useful because of the wide spread practice of cooking on unventilated indoor wood fires. Those with nebulizers make themselves available to provide breathing treatments to neighbors who we have identified as highly likely to need them on an urgent basis. This unofficial network includes a man who has installed an AC/DC converter in his work truck with which he can provide a breathing treatment on the side of the road.

Margarita was at the clinic with her daughter and four of her grandchildren. After all had been seen renewed attention fell on her daughter, Novey, who was walking with the help of two homemade crutches. Further assessment indicated that Novey’s need for the crutches was probably the result of the snake bite she had suffered. A neurotoxin type venom could produce her symptoms. Fortunately we had a PET (an all terrain alternative to a wheelchair) (SAT-646) stored in San Nicolas and were able to retrieve it, assemble it and train her before night fell on the mountain. Time will tell if she will need it on a permanent basis. CRS, 11-17-14

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