Learning from Each Other = Making Progress

June 25, 2017

As our time comes to a close, our connection with Anita and Edith continues to bond.  They are receptive to our ideas that make sense and are interested in us showing them how to make wound care solutions from locally available inexpensive products.  Most importantly, we are receptive to listening to their needs.

Anita, Edith and Ethan.

A former visitor and wound care physician Scott Bolhack has been a constant resource for this project over the years and sent me the recipes for these homemade wound care solutions. Bela had most of the ingredients, I simplified the recipe, and Ethan translated the recipe for Anita and Edith.  We gathered in Bela's kitchen and went to work.  There were a few experimental mishaps but we managed to do what we wanted.  Vivian's and Ken's idea of making iodine gel was also helpful and with adjusting the recipe we were able to make homemade iodine gel.

Anita, Edith, and Ken.

 Anita had told us that she has used the vinegar solution before helps considerably with many wounds. However patients complain of pain as the vinegar solution burns.  Ken talked with Anita and Edith for a while showing them how to apply hypnosis to help people through the pain. As I watched him I immediately recognized that Don Sergio performs the same method but without telling the patients what he's going to do; he just slides into and it works.

Posted by Patricia Ferrer.

Schools, Solar, and Wounds

June 21, 2017

Our day started late as Don Sergio checks on a school project prior to our house rounds. Today he took us to another school where teachers are requesting his help to build a protective wall to keep the thieves from stealing from the school, create a garden, build a porto coche to protect the kids from the rain and prevent the ground from becoming saturated and a fall hazard. They would like to have their own electricity because now they piggy-back electricity from a nearby house.

Kindergartners happily in school.

Someone cut through the wire and stole kindergartner school property.

This wall extends about 40 yards and they want to replace the fencing wire with blocks.

Here they want to prep the land for a garden to grow fruit trees and have a natural place for children to play.

The black gate is the entrance. When it rains the ground becomes loose and muddy, they would like it covered and paved.

They have latrines, which is not always the case for all schools.

Our second stop was another school Sergio has been working on for 8 years. It is complete thanks to many foreign donors over the years. The latest addition is solar power so they don't have to plug in to the city electricity.

           This is the first solar installation in San Cristobal, thank you TOGETHER SOLAR.

Part of the school complex, you can see the blue solar panels on the middle building.

The kids have light for those dark days (lights on only for show, it is light enough outside at this time of year).

A special room was created to lock up the solar storage batteries.

Young school girls chat with Vivian.

The kids crowd around Ken as he passes out stickers and chats with them. The kids loved this!

                                           A SPECIAL THANK YOU TO TOGETHER SOLAR

Project Summary:  Together Solar, in collaboration with Yok Chij and IF, are proud to have developed a charitable solar micro-grid in Cinco de Marzo Elementary School in the state of Chiapas, Mexico.  Chiapas is Mexico’s poorest state, with significant unmet needs for life’s necessities, including energy.   Cinco de Marzo Elementary School serves over 300 students who are mostly indigenous and speak a Mayan dialect as their primary language.  Our solar micro-grid provided the school with electricity to power their lighting, school equipment like projectors, and a water pump that brings fresh drinking water to the school.   Batteries ensure that the school has electricity at night or when the solar system is not producing.

About Together Solar:  Together Solar is a mission-based company, dedicated to alleviating global energy poverty, and to expanding solar energy access.  We are focused on leading the urban community solar space, where we build large solar installations on commercial rooftops within our target cities, and sell the energy output to nearby residential customers who have not traditionally had access to solar since they often live in rented apartments, condominiums, or co-ops without adequate rooftop space.  For every kilowatt of solar that we develop, we donate at least $10 of critical infrastructure to communities in need.

Morning house rounds include an elderly diabetic woman whom Don Sergio amputated 2 toes and now a 3rd is becoming necrotic.  The hospital wanted to amputate her foot but she declined, now, even with wound care it is obvious she needs a below the knee amputation otherwise the infected foot and toes will progress.  People are very resistant (anywhere in the world) to have an amputation. However, her long term, poorly controlled diabetes, most likely caused from lack of awareness, inadequate healthcare and patient education, and inability to afford medication all play a role.

Patient number two was an anxious woman with a solitary ulcer caused from an injury a few weeks ago. Basic wound care will help this lesion to heal. Don Sergio had one more pt to see but he usually goes on his own.

Evening clinic a young boy suffered a 1st degree hot water burn on his left arm.

The afternoon clinic was busy. A 63 year old Zinacanteca woman has a 10% body surface area burn with 1st and 2nd degree burns. She was carrying a pot of hot coffee and fell and the pot contents fell on her; older skin burns easily and it penetrated her clothing. We then had the typical venous stasis ulcer patients and other wounds and patients seeking consult with Dr. Iserson.

This lady has a large tophus secondary to high uric acid levels (aka gout).

The evening's most challenging case was a man that had fallen backward into a fire and severely burned his back several weeks ago. Debridement is very painful and understandably we US medical providers want to use lidocaine and aggressively debride (scrape away dead tissue). However, if we were to do this, we do not have the resources for post pain management and we do not want to leave Don Sergio dealing with a patient in severe pain.  This case, and the older woman, would definitely be cared for at a burn hospital in the US.

Today, the area needing debridement on the man's back revealed nature doing wound care: maggots.  The dead debris on the patient's back was infested with maggots which is not necessarily a bad thing.  Maggots eat the dead skin debris leaving normal skin alone and suppress the immune system (in turn reducing inflammation) and naturally help the wound to heal. However, continued manual debridement is also a good idea and Don Sergio had Anita gently remove what she could today. The patient will return tomorrow.

This poor man has a deep 2nd degree burn on 30% of his back.

Posted by Patricia Ferrer, PA-C

Generosity 2017

 June 19, 2017

Thanks to the Friends of Don Sergio, our Generosity Campaign exceeded our expectations.  So many of you gave generously to our humanitarian of Chiapas. I presented him with the mock check and as always, he is grateful.  These funds will help keep him afloat over the next year.

Our day home visits include two young people who have endured severe accidents. One 25 year old who was injured in a motorcycle accident and is now a paraplegic. He has a bed ulcer that is healing nicely and his family takes very good care of him. The other young patient is a 12 year old girl who had an appendectomy. When she went into the surgery she was normal, but she never woke up afterwards. Her body is tiny and bony, legs and arms contracted, eyes roll to one side and she has a feeding tube; she has been like this for 2 years now. The family feels she was given to much anesthesia, but Dr. Iserson believes that someone must of intubated her incorrectly, causing her to go with out air for an extended period.

In the evening, Drs. Shi, Iserson and I gave lectures to the medical students which are Cesar's compadres.  Cesar has volunteered with Don Sergio for years and is now in his 3rd year of medical school. Due to his busy schedule he is unable to work with him as much, but he is in close contact and works with him when he can.

Third year medical students of San Cristobal Medical School.

Dr. Iserson's lecture was on ER procedures in limited resource environments.

Dr. Shi's lecture was on dermatologic emergencies.

My lecture was on recognition of skin cancers.

 

 

 

 

 

Progress at a snails pace

January 24, 2016

In some parts of the world progress moves at a snails pace...or as Don Sergio says, 'poco a poco'.

I am back home now after spending 2 weeks with Sergio in San Cristobol.  It was a rewarding visit finding Sergio well and busy.  Below are some thoughts I have about the state of Sergio's mission.

The Supply Line
Don Sergio is always in need of burn and wound care supplies. He can never have enough gauze, gauze wraps, ointment and gloves. Thankfully, there is a Tucson organization where I can request these items and check them as luggage when I visit him. Also, my medical network seems to come through when I request items they no longer need and a friendly physician who ships me boxes of good, unused supplies from Michigan throughout the year (Thank You, Dr. Beckmyer).

Some supplies I repack as tightly as possible and have friends (Thank You, Alejandra) who visit family in Mexico and postal ship them from Sonora. This system has worked well and supplements Sergio's inventory.  He does have friends from France that send him creams and other items as well.

The Help

L>R: friend of the team, Nataly, Esmeralda, Deborah and Edith.

Edith, is now in nursing school and doing well. She continues to help Sergio on a regular basis. I believe her nursing school is 5 years long and this is her first year. She had recruited a few others students to come help as well and they love it. They love the hands-on care and knowing they are making a difference in their community working along side Don Sergio.

Alfonso also continues to help Sergio. His unwavering admiration and respect is palpable. He has decided to pursue an engineering degree in San Cris and help Don Sergio until his compadre Cesar completes his medical training. Alfonso told me he looks to Don Sergio as a wise grandfather and spends most evenings working with him.

L>R: Sergio, Juanito, Alfonso.

Cesar, El General, is in his second year of med school and is doing well. Only when he is on break is he able to come help Sergio. He says his studies are going well and he is learning so much about medicine and loves it. He will be an exceptional physician!

Newbies: Esmeralda, Deborah, and Nataly. Esmeralda has a permanent smile on her face and is in nursing school with Edith. Nataly is a gymnastic teacher and helps in the evenings as well. She took up running a year and a half ago and has run 2 marathons already...she's a natural athlete.  She usually comes in the top 10 of various races...usually 15 to 42 kilometers. She was there most nights these past two weeks. Deborah is 15 years old and loves to hang out and hand out supplies to everyone working. I love the feeling of camaraderie and family that has developed over the years.

Gymnastic teacher and runner by day, volunteer at night.

Iker has been gone for almost a year now. He's ridden his bicycle over 9000 kilometers and is putting on another 3000 more as he heads to Usuiasia in Argentina.  We still hope for his return one day. We all miss him.

Having gloves, good blades to care for wounds is a plus.

Here we use a bucket for a stool.

Indiegogo Fundraiser
Last year's fund raising was a tremendous help for Sergio. This fundraiser helped support him over the last 8 months. His life is easier because of all of your donors. We plan another Indiegogo this spring. 

The Patients
It is a dream to one day, to find a way to integrate a patient education program...alas..for now, just a dream. Sadly, same conditions, different patients. It seems there is no end. We are making a difference but albeit, a bandaid..speaking metaphorically.  Each patient, young and old, are always expressing their gratitude for Sergio's (and his team's) help. The care they would receive if Sergio were not there, may not be adequate or sufficient to heal their wounds. As I've mentioned before, sometimes its more cost effective for the hospital to cut off the limb as oppose to nurse a wound back to health.  Sergio has nursed many limbs back to life.

Stop here, the following is for strong eyes and stomachs only.

His family brought him in 4 days after the injury.

This photo, left, is the young boy who was accidentally burned with polvora (flammable power used for fireworks). See posting Jan 9th. I cannot paint the picture with words of how quietly and calmly this child sat while Sergio applied vaseline and silver sulfasalazine to his open facial wounds.

Day 15 after initial burn and 11 days of burn care.

Sergio believes when one is calm during receiving wound care, their bodies heal quickly.


We hope all who know and/or who've met Sergio continue to provide support in some way, every bit helps. Stay tuned, we will keep updating the blog.

My nephew Ethan, a pre-med student, joined me this trip. He will do great things in his life!

My First Day With Sergio - by Ethan Hartman

After breakfast, Patti runs to call a taxi as I wait with the medical supplies that we have gathered for Don Sergio. The taxi takes us to Sergio’s museum, which doubles as his clinic. We unpack the supplies that we need for this morning’s house calls, and we leave almost as soon as we arrive. The taxi driver, a very good friend of Sergio’s, greets us at the door. “You’re late,” Sergio bellows. The two of them laugh and embrace. I receive a handshake, and notice that he has no thumb on his right hand—an amputation? “Me llamo Juanito, mucho gusto” he says with much gusto. “Soy Ethan, es buen conocerte,” I reply with a smile.
The four of us jump in Juanito’s taxi and begin an unexpectedly long journey.
It is possible to tell the generosity of a person by many measures. As we drove through the mountains, I begin to realize the true generosity of Don Sergio, a man willing to pay for a taxi to travel an hour and a half just to change the bandages and clean the burn wounds of a man he barely knew. The roads twist, rise, and fall, as we go deeper towards our destination; the town of Chanal. Patti feels nauseous and I hand her a plastic bag just in case.
I enjoy the long periods of silence between small talk when I just sit and think. I imagine myself living in Chiapas, writing medical blogs or working at Bela’s to pay for my rent. Above all I imagine helping Sergio with his work. I think about Brazil, and how much I long to visit the friends I made last summer. There is something about travel that I find so romantic, it truly is the greatest teacher. Learning a language introduces a new way of thinking, and a knowledge of 3rd world medicine is difficult to get in the 1st world. Maybe I can do all this in my year off between graduation and medical school…
No sei.
Plans are difficult to make in such an uncertain future.
When we arrive in Chanal, Sergio leads me into the home of burn victim, and I see what real 3rd world looks like. An entire family of 8 lives in 2 rooms, with no shoes, no clean water, and few sources of light or heat. One light bulb illuminates the room where a 41 year old man lies, cachectic and moaning. After greeting us with a weak smile, he uncovers himself to reveal his naked lower body. His legs, thinner than arms, are wrapped in bandages, oozing with green pus. My job for today is to hold the LED light, retrieve supplies, and take pictures. As Patti and Sergio take off the bandages, we can see that most of his right leg and half of his left is covered in 2nd and 3rd degree burns. This man had gotten drunk and fell into the fire at the center of his home. This story is all too common in Chiapas, and Sergio knows from experience that these wounds take a long time to heal without surgery. As we packed up to leave, I notice Sergio leave 100 pesos for the man on his dresser without saying a word.
The rest of the day is very busy. Juanito delivers us to people with various problems including diabetic ulcers, venous/arterial ulcers, and burns. I am thankful for my strong stomach, because many things we come across would destroy most of my friends’ desire to eat for days. 

After about 8 patients, Patti and I return to Bela’s for lunch; beet soup with salad and pepper empanadas…tan delicioso! After a quick nap, we are off to Sergio’s museum again. Only this time, patients are coming to him. Sergio also has other helpers, an 18 year old man who wants to go to medical school, and two 20 year old girls that are studying to become nurses. I struggle to get into the flow of where everything is, and I quickly become overwhelmed by all of the supplies, and how to get organized. I learn the ropes, however, as Patti scolds me a few times, and I observe how the other volunteers work with the patients and Sergio.
A child with terrible burns to his face from a firecracker accident is brought in by his parents. His face is inflamed and covered in pus. He sniffles slightly as Sergio cleans, debrides, and wraps his wounds, but he does not cry. What a champion. Another kid, who had cut his thumb open and received stitches several days ago, cries and thrashes as if we are torturing him when we take out his stitches. Not quite the same level of champ in that kid. I can’t blame him, I was the same way as a child.
Throughout the night we see infections, fistulas, eczema, ulcers, burns, and scabies. It’s amazing that Sergio can send these people home with some sort of treatment, from a limited amount of antibiotics, to various topical medications and wrappings. It’s great to know that people believe in his work and send things from all over the world. The end of the shift working with Sergio and his team brings a warm feeling to my heart, and I can’t wait to play a larger part in it.
Patti and I leave just before 7pm. I buy us some sandwiches and we walk home. After a quick workout, I head to the kitchen to eat my sandwich and Meli stops me, asking me to help her translate what a man named Jose is asking her. Why she asks me, I haven’t the slightest clue. I probably know less Spanish than she. By the end of our conversation, however, Jose asks for my email, and wishes to stay in touch with me. As I write my email down for him, he expresses interest in my pen, which has a flashlight at the end. I tell him that it’s his, and his face lights up with delight. How wonderful to make someone so happy with such a simple thing. Whether it’s treating a burn, or giving a gift, we can all make a difference.
Patti and I meditate on this before we chow down our sandwiches and discuss the clinical presentation and treatment of ulcers. You know that you are medically inclined when you can eat and look at disgusting photos…

Tour to Chamula by Adriana Manago

July 15, 2015

I had the honor of accompanying Physician Assistant Patricia Ferrer and Nurse Practitioner Jennifer Eldred on a tour to San Juan Chamula with Don Sergio Castro one beautiful sunny day in July 2015. Patricia had told me Sergio's story and how he came to be known as "St. Sergio of Chiapas" through his selfless dedication to poor communities in the region. But words fail to transmit all that St. Sergio means to the people he has served. 

Sergio's life work and his way of being in this world is best understood in the presence of the emotions he elicits from people in communities such as Chamula. As we walked through the streets on our way to the spiritual centerpiece of the town, the church of San Juan Bautista, Don Sergio brought smiles, laughter, and reverence from all the men and boys in the church square. 

It seemed all felt a special connection to Don Sergio in his unassuming blue handkerchief and cowboy hat. I felt I was walking alongside a ray of hope in the world, a reminder that although good seems to disappear for some time, it will always return. But it was the embrace in the main streets with an elderly woman that moved me to tears. This woman could not speak and I do not know sign language, but her gestures, the look in her eyes, and the way she nestled so closely into Don Sergio’s arms told me everything I needed to know. Her hands up to the sky, then to her heart and mouth, and then melting into Don Sergio’s arms, she told me how Don Sergio saved her life with his medicine and that he was pure love. A love that heals you because it tells you that you are not alone in the world and that we are all here to care for each other.

Inside the church, the floor covered with fragrant pine needles and lit candles, Don Sergio explained in his soft and gentle manner what St. John the Baptist represents to the people of Chamula, the history of the church, and the native view of healing through “curanderos,” elder men and women healers who are thought to have a heightened ability to communicate with the saints. 

With nothing but reverence for this indigenous way of life so different from how he was raised, Sergio explained how the curanderos come to the church with their patients, light candles, offer sacred pox (a liquor made from corn) and now coca-cola, pray, and wait for the message from the saints about the best course of action. They use the fizzy drinks to expel gas, and thus metaphorically, expel the spiritual disharmony that ails them. The message from Don Sergio was simple and profound: This is their cosmovision and their reality is as legitimate as any other. In this way Don Sergio walks among the curanderos of the indigenous peoples of southern Mexico, utilizing resources he has from Western Medicine, but always humbly recognizing that there is something greater than all our scientific knowledge, and that the sometimes the best we can do is just simply care for others.

Adriana M Manago is an assistant professor of psychology at Western Washington University, specializing in cultural developmental psychology. She conducts research in the Maya community of Zinacantán, studying how sociocultural changes associated with modernization and the proliferation of communication technologies are connected to patterns of change in social development during adolescence and the transition to adulthood.

Indiegogo Fundraiser for Don Sergio

Photo taken by Justin McManus of Australia. For more photos go to: Justin McManus Photography.

The January trip working with Don Sergio was a whirlwind. He and I spent very little time together with all that occurred around that time with his family. From my home in Tucson he and I speak once every 2-3 weeks.

An avid support, Carla Woody who is founder of Kenosis, has donated kindly from her special guided trips through Chiapas. She always makes a special trip with her group to stop and visit with Don Sergio. Through numerous phone calls and help from another friend in San Cris, Don Sergio received the donation at such a crucial time of need...which for him, is almost always!

Meanwhile, those close to me recommended an Indiegogo fundraiser for Don Sergio.
So, here it is: Indiegogo Mexican Healer Who Asks for Nothing in Return

My partner, Bruce, and I once again scoured the internet for any new postings or blog reports from those who have recently met or reported about his work. We found both old and new.

John Scherber, a US citizen traveling all through out Mexico, came across Don Sergio and of course could not resist, like many, to not say anything.  Don Sergio humanitarian work is so compelling one just can't keep it to oneself.  Here is his report from April 2015 visit: http://www.blogster.com/johnscherber/the-chiapas-report-vi-sergio-castro

In the blogging archives we also found a professional photographer's visit with Don Sergio but are uncertain of the year. His story was written before I met Don Sergio; pre-2008 and I found that his experiences then are now mine. Justin McManus knows how to tell a story and take photos that are more descriptive than can be verbalized. Some great shots of Don Sergio, some heart-wrenching photos of Don Sergio's patients. His story, with photos, was published in The InSight Press.

As a follow-up to the patient, Petrona, that Justin reports on, here is a video I took several years later (unaware of Justin's reporting). If you have the time, please see the photos from Justin and read his blog, then click on the video below. You will see that Don Sergio uses all gifts bestowed to him by nature and Petrona is living proof that miracles can happen.

For those who have met Don Sergio or anyone interested, we encourage you to consider an Indiegogo donation to help this tireless humanitarian and share this with friends.  It is our hope that I can present Don Sergio with the fully funded amount when I see him in July this summer.

Posted by Patricia Ferrer, PA-C.

More Supplies Arrive

January 13, 2015 Tuesday

A well constructed home-made child seat for the bike.
 I love the innovation of necessity, this is probably
someone's main transportation.

My cousin Roy happened to be visiting at this time and he always brings an extra suitcase of medical supplies from NGO MedShare  for Don Sergio.  Always one for adventure he had stayed one night in San Cristóbal and was off to Palenque. He texted saying he left the suitcase at his hotel.  What he brought will last 2 – 4 weeks.

Roy brought a suitcase of medical supplies, then off to Palenque
with Mexica Tours. He will return in a few days.

I picked up the suitcase prior to arriving at the museo for morning rounds and Iker was waiting but our taxi driver had not arrived. Again the struggle of finding our two patients' homes was crazy but we found our way to the burn patient’s home where Alfonso, who lived in the area, met us.

They both did the cleaning, debridement and bandage change very efficiently. Fortunately the patient did not have as much pain. Our second patient with both foot ulcers still complained of dizziness but the ulcers were healing well (to our surprise).

We returned to the museo and Alfonso and I took the opportunity to clean and organize this so called ‘clinic’. Don Sergio stopped by and told us la suegra was buried and now the family is getting together. He was on his way to buy 4 kilos of tortillas. He said all was emotional but well and would return the following day for morning rounds.

The evening clinic was busy but there were 4 of us to do the work. Ricci was excused as she had now caught the ‘diarrhea bug’ and was not doing well. ¡Oye, los estomagos las gringas!

Christiane, (in purple sweater) from France, gave a tour to two visitors
 on Tuesday night while Don Sergio was with his family.