Dr. Iserson is an Emergency Medicine physician and Professor Emeritis at the University of Arizona, author of several medical related books and numerous medical publications. He accompanied me, Ethan, Dr. Vivan Shi and her husband Khiem on this trip to work with Don Sergio. Ken treated and counseled numerous patients during the past two weeks in San Cristobal and he gave invaluable insight about how we can continue assist in this wound care clinic project.
Where in the world is Ken? Chiapas,
Mexico
Mayans speaking their indigenous
languages and wearing their colorful traditional dress, Zapatistas
intermittently blocking roads and occupying the zocalo (central city square) [Fig 1], abandoned 8th
century cities and pyramids, awesome mist-covered mountains [Fig 2], great food
and a cool climate (during Tucson’s heat extremes). That does not sound much
like my typical developing world experience—but it was.
As part of a 5-person team,
including two wound-care experts, I recently spent two weeks caring for severe
wounds and burns, as well as other medical problems, under the auspices of Don
Sergio Castro [Fig 3], in the indigent indigenous community in Chiapas, Mexico.
The team, organized by Pat Ferrer, a dermatology/wound care PA who helps
support the Chiapas operation [Fig 4], was mostly drawn from the volunteer
clinicians working at Tucson’s Clínica Amistad, a facility for primarily
Spanish-speaking medically indigent patients. It included Vivian Shi, a U of AZ
dermatologist and wound care expert [Fig 5], her husband, Kheim Tran, Ph.D., a
second-year U of AZ medical student [Fig 6], Pat’s nephew who will enter
medical school this Fall, and me.
As Pat noted, each day felt like two
full workdays. Starting early, we first did home calls in the city and outlying
Mayan communities. Working in both Spanish and one of the two regional Mayan
languages, Tzeltal and Tzotzil (Don Sergio speaks both), we cared for patients
in subsistence communities who were too ill or injured to get into the clinic.
Typical patients included those paralyzed from accidents or medical disasters
and those suffering from extensive diabetic- or vascular-induced wounds [Fig 7].
Our wound care supplies were those we could carry on our backs, sometimes
hiking to get to the patient’s home.
In the afternoon and evening, we
helped staff the makeshift clinic outside the small museum used to help support
the operation [Fig 8]. Patients, who were seen in the order that they arrived, ranged
in age from infants (usually suffering burns from hot water boiled over open
fires) to the very elderly [Fig 9]. Some injuries were minor; others required
weeks of daily care. The medical supplies were an amalgam of donated materials
from multiple sources and those we improvised [Fig 10]; there usually seemed to
be barely enough supplies to care for our patients [Fig 11].
Don Sergio Castro [Fig 12], a
remarkable man who has been doing this work for 50 years, first came to Chiapas
as an agronomist. With some veterinary training, he quickly abandoned his
government job to help build schools and sanitation systems, and to care for
wounds in the Mayan communities. While he came from a wealthy background, he
lives frugally, having spent most of his funds on his work. A blog describing
his work can be found at: http://sergiocastrosc.blogspot.mx/. A fascinating 2013 New York Times
video about Don Sertio and his work is at: http://www.nytimes.com/2013/08/14/world/americas/in-mexico-a-healer-who-asks-for-nothing-in-return.html?pagewanted=all&_r=0.
Over the years, many clinicians and
groups have assisted him. Pat Ferrer has helped him financially and on-site for
many years. On this trip, I had the opportunity to assist in an ongoing,
sustainable effort for an indigent population. As a side benefit, I was able to
learn a great deal about wound care from experts—and, of course, the weather
was great!
Fig 1. Zapatistas
occupying the San Cristobal zocalo
Fig 2. Mountains
surrounding San Cristobal, Chiapas
Fig 3. Don Sergio
Castro caring for burned child in clinic
Fig 4. Pat Ferrer, PA,
caring for ulcers in paralyzed patient in his home
Fig 5. Dr. Vivian Shi
examining woman with gout in clinic
Fig 6. Kheim Tran, U
of AZ MS II, blocking large leg wound in clinic
Fig 7. Dr. Ken
Iserson examining girl during home visit
Fig 8. Dr. Ken
Iserson working in Don Sergio’s clinic
Fig 9. Typical
open-flame kitchen—the cause of many burns
Fig 10. Anita, RN,
making medication powder with hammer
Fig 11. Vivian, Ken
& Edit (nursing student volunteer) treating man’s extensive burn in clinic
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Fig 12. Don Sergio
Castro and Pat Ferrer, PA, treating elderly woman’s infected foot at home
Post written by Dr. Ken Iserson, posted by Patricia Ferrer.
