San Cristóbal - Day Eight

March 25, 2011

The day begins with juicing three oranges which yields one large glass of orange juice. This is much better than pouring it out of a plastic jug.... I love slow food.

Our regular driver has not shown up the past couple of days. This happens at times; some days he will be there everyday and others he won't. So we take a taxi to the market to find another cheaper taxi to go to Nishnamtic.


The drive through the country-side is beautiful, here we see a family herding their sheep.


Our taxi driver is a young man in his early twenties and I hear him asking Sergio many questions. I enjoyed the conversation and his curiosity about Don Sergio as Sergio explained matter-of-factly what he did.

We saw the two-year-old with the hot liquid burn and he tolerated the dressing changes well.


A group of onlookers were behind us whispering amongst themselves. Several scamper away as I pull out my camera to take a photo.


This is a photo of the part of the family's yard. In a Mexico history book I had read, "The man who farms the land owns the land."


Back to San Cristóbal, we see the three-year-old and quickly do our work. The child tolerates all dressing changes well until we get to her left hand and arm. Bandage changes are always done without pain medication as we have none.


Making our rounds through San Cristóbal we saw four more patients and called it a day. We were both so tired today we kept falling asleep in the taxi ride back from Nishnamtic.

Later, back at the museo a few people trickle in and out and our patient load is light this evening.


This young lady who gladly poses for this photo came in last week while Kieu was here. After a history and physical exam and we recommended lab tests which yielded the cause of her complaints. Today she brings the results in and we put her in the right direction for the medical care she needs.


Our last patient of the evening is a 14 year old with a circumferential burn of his left lower leg that happened the day before yesterday. His parents took him to the Red Cross where they gave him an antibiotic and ibuprofen. At this point his wound looks like a superficial second degree burn caused by boiling hot water from a broken ceramic pot.

Between patients with down time, I browse through the museo and I have the luxury of getting my own private explanation of certain pieces. This old pot was made for a fiesta and held atole, a liquid grain breakfast food. After the festival, corn is stored in these pots. Sergio took care of a burned child and the father saw that Sergio admired the pot and gave it to him.


Sergio said this mask is made out of cartón (cardboard) and found it years ago in place he can't remember.

San Cristóbal - Day Seven

March 24, 2011

Yesterday after the morning rounds there was a man waiting on Don Sergio's museum steps. He explained that his two-year-old son had been burned with boiling coffee eight days ago. This will make three children under the age of four that we will be caring for.

Today, the man met us at the museo at 9:30 this morning to take us to a community called Nichnamtii, which is about a 30- 40 minute drive.

As we were leaving San Cristóbal we were halted by a parade and many children were dressed in costumes.



Nichnamtii is on the road to Tenejapa at a higher elevation. It was a bit cooler, more green, and there are more crops and small villages dotting the landscape. This is a cemetery in the style of the local people. Tall trees around the blue Mayan crosses (that are pre-Hispanic) and signify 'the tree of life'.


This is a drive-by photo of the local school children.

I have photos and a video of this two-year-old but they are a bit graphic so I will put them on a powerpoint or video link at a later date. It turns out most of his right leg from his thigh to ankle were burned to the superficial dermis. It appears that 13% of his body surface area is a first and second degree burn.

These are the women of the house of the two-year-old. They walked us outside and gave us many thanks for helping this child.



As we left their home I saw a man and two women preparing the soil for planting.... was this what it was like in the US before WW2?

Returning to San Cristóbal we saw our usual patients and afterward I met Bela and Sheri for lunch. Sheri is a guest at Bela's and is an expert in Mexican textiles and lives in Oaxaca. Her website explores the traditional textiles of Mexico and she highly recommends going to Don Sergio's museo. Her website is Living Textiles of Mexico.

As usual we had a tasty lunch – we went to a restaurant called La Canela. A close up of Sheri's quesadilla: home-made blue corn tortilla with potatoes and chorizo and a small pasta salad with small chunks of apples (not in photo) . My quesadilla had nopales and mushrooms with a just enough cheese. So yummy!


Back to the museo at 4:000 pm and the psoriasis patient had returned and said he was doing much better, however, he complained of a few annoying problem areas. It is difficult to explain that the medicine can take up to two weeks for best improvement and it had only been three days. Since all we had was weak topical cortisone I used the poorman's treatment of applying the cream to the bothersome and thick areas and occluding it with tegaderm (a cellophane-like tape). He will on return on Monday and I will have to explain again, this is not curable but we can try to control it. The sun is strong here and it would help his psoriasis but he is resistant to that idea.

Shortly afterward the patient with the hugely parasitic infected foot I saw six monthw ago came in. I did a biopsy and took him to the lab for blood work. I'm hoping we can find what ails him. He saw a physician a few years ago and was offered amputation of his leg which he declined. This has been present for 12 years.

I have better clinical photos which are to grotesque but this one gives you the idea of how this infection is deforming his foot.

Two blocks from the museo is a laboratorio. The patient did not speak Spanish but he had an interpreter with him. I explained the need for blood work and that I would pay. The lab tech and I soon discovered his interpreter spoke limited Spanish so we spent 20 minutes explaining what needed to be done. Once he understood he agreed. Notice the tech not using gloves: this is not unusual in Mexico.


With that taking up most of the evening, when I returned the women from the day prior were there. Kieu left her tennis shoes and socks for the girl with scleroderma as her feet get cold and painful. Many of the locals wear cheap plastic sandals and I admire the ability to do that but in this particular case, the girl would benefit from shoes.

It was a long day and I was in bed by 9:30..pooped.

San Cristóbal - Day Six - Observations

March 23, 2011



To follow are observations of women in the indigenous culture and it seems basically they work all the time. Three years ago when Bruce and I drove through Mexico, we commented on how the women did quite a bit of heavy labor. We know men are stronger physically but we saw women (young and old) carrying wood on their backs, a young girl balancing a tree trunk on her head carrying it uphill, women tilling the land, minding the sheep, shearing the sheep, spinning the wool, weaving the wool, then carrying and selling their products with babies strapped to their backs. I'm assuming they do all the cooking as well. We did see some men doing the labor but not as prevalent as the women.

Young girls getting water. There is nothing wrong with working hard but the balance of work between sexes may be off kilter favoring the male sex.

Women doing laundry the hard way.

Sergio showed me photos of building a water filtration system which basically the walls are made of concrete blocks and mortar. Here the women mix the mortar. My father did some masonry work and we, as children, mixed concrete in an electric concrete mixer.


Fortunately, my father did not make us carry concrete blocks on our backs, with no shoes!

At the museo over the last four or five evenings there has been a young lady, sitting to the far left and her friends sitting to the right, bring me gifts of food and a new patient (always a woman) from there village. It is likely these women would not otherwise seek medical consult. The patients are in their indigenous garb and she translates from their native tongue to Spanish. It makes me happy that this young woman is an advocate for the women of her community.

Sergio informs me that the women do most of the work, it is their culture and jokingly says (I think jokingly) the men are "to think".

This 70 year-old-man carries his own bag uphill.


I'm glad to inform all that Kieu made it back home to her family safely and we already miss her!

San Cristobal - Day Five - Kieu's Last Day

March 22, 2011

Our first stop of the morning was a three-year-old girl that was burned a month and a half ago. Evidently, she was playing near a burning trash fire with a friend and fell into the fire. In our minds we may think, "What was she doing near the fire playing?". The trash pick-up infrastructure is not the best here and the family may have limited land on which to burn their trash, which is fairly typical here, as it is in rural USA. This photo depicts the first time she is able to walk after the accident.


True to my word of not displaying more clinical photos, I want to explain the extensiveness of her injuries. The palm of her left hand is a deep 2ndº burn, Sergio is concerned that her hand will heal contracted palm-side and she will lose a significant mobility. Both of her dorsal feet (top side) have second degree burns as does her left inner arm. The areas with 1stº burns are healing well and she will recover well, the other areas will take more time.



While at this home, other relatives knew we were coming so they bring us a baby that is crying, not eating well and appears cranky. Kieu is great with babies! She evaluates lungs, abdomen, eyes, throat and find the baby has otitis media (ear infection).


There were two men talking with Sergio after we saw the babies so we decided to take a mini-break.



We made it home by 12:30 pm – a good hour and a half before lunch. Kieu sat down in the dining area to read and quickly fell asleep. She is learning the way of the Latin American life: the siesta.



Manuela made pollo borracho (drunken chicken) for lunch which was perfect for me as I was not feeling well. Kieu as usual asked for seconds.


Today is Kieu's last full day with us as she departs tomorrow. The quality of this trip is due to many factors, the major factor is Bela. Her B&B is like a home that you feel like you've known forever. She treats her guests and staff as family which gives an ambiance of peace and comfort.


Back at the museo at 4:00 pm we had few patients. Since we had time to kill Sergio showed us some artifacts and items that most people do not see or recognize. He told us he found many things as he searched for water sources to build water treatment systems for various villages. There are many facets to this man and this private tour and explanation was a great treat for me and Kieu.


A group from San Miguel de Allende of mostly US citizens came in for a tour at 6:00 pm. Kieu and I saw a few more patients while he gave the tour and I ran back to Bela's to get more DVDs of "El Andalon" to sell. A friend of the director, Consuelo Alba, had bought and donated several DVDs and the proceeds of the sales go to Sergio. Kieu and I were so excited to speak (in English) to the tour group about Sergio. The wife of one man had to finally break him away from us.... of course I could have gone on and on!

Our day ends around 8:00 pm. I was not feeling well so Kieu heated up some pozole (hominy soup with pork) and toasted bread before going to bed. She and I hugged and cried in celebration of this unique experience we both have had together this past week. Unforgettable!

San Cristóbal - Day Four

March 21, 2011

Our friends from Mexico City (DF) leave this morning and go to Sumidero Canyon for a tour before flying back home. We got to know much about the Mexican culture and about Germany which adds to our educational experience. Staying at Bela's B & B has made meeting these wonderful people a very special trip.
Left to right: Ana, Kieu, Christine and Eva.


Sergio awaits us at his museo with Isabel, a college student who grew up in San Cristóbal. We got to Teopisca to see the little girl with the leg burn and to our surprise there were no other patients waiting making our trip short.


We saw a few patients in San Cristóbal then had to end our morning rounds a little early to meet with a local B & B owner and philanthropist who is part of a group called Amigos de San Cristobal that helps a variety of NGOs in the community. I left a few DVDs with him to share with his B&B patrons who may be interested in purchasing them.


We walked through the neighborhood where I usually stay that has beautiful small markets. Kieu could not resist stopping and buying pineapple, fresh strawberries and mangos. Mango season in Mexico is out of this world!


There is a Holiday Inn in San Cris and it is like no other Holiday Inn I've ever seen. Kieu and I browsed through the area to take a few photos.





Back to Bela's for lunch we had pozole made fresh by Manuela. Her food is so tasty that Kieu has had seconds with every meal!

We get back to the museo at 4:00 pm (mas o menos) and there is a house full of patients waiting. Sergio in his usual chair treating patients looks up at us as if to say, "¡Por fin!" We quickly divide the patients and get to work.


This three-year-old girl has 1st and 2ndº burns to 25% of her body. Her parents brought her in for Sergio to take care after spending 45 days in a local hospital. She was amazingly calm and cooperative.






Here she is after getting her dressing changed. She never cried while being worked on.


Sergio was translating three languages to make sure patients understood our instructions.





An indigenous patient with widespread vitiligo and psoriasis came for care. He was showing us the extensiveness of his skin condition. It is a not cultural norm for a man to be evaluated by a female medical practitioner. This is such an honor to serve this indigenous population that we would normally have no access to. They really trust Sergio and therefore trust us.





We meet Susan, a friend of Bela's who runs an NGO helping the autonomous communities in Chiapas with various projects called Schools for Chiapas. She came and took a tour of Sergio's museo and walked with us back to Bela's after we were done for the evening. We stopped at a chuck wagon to buy a bottle of homemade beer for a friend of hers.

San Cristóbal - Day Four - Our Day Off!

March 20, 2011



Sunday is our day off so we walked the streets of San Cristóbal up to Cerro de San Cristobalito.


We rested in the church then walked to a friend's house to meet him and his girlfriend. They showed us around their place then brought us back to Bela's.

Afterward we went out for lunch around 3:00 pm with the whole B&B gang and had a fabulous meal at a nearby hotel. Their courtyard was so tropical.



We walked off our lunch by going to the market and browsing at all the great gifts from Guatemala and the surrounding areas of San Cristóbal.


The day ends at midnight as we stayed up chatting, eating toast, and drinking tea with our friends from Mexico City and Bela. The warmth and aesthetics of the fire adds to this paradisaical home.