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.

San Cristóbal con Don Sergio - Day Three

March 19, 2011



The weather has been spectacular since we arrived. The day starts with cloud cover which burns off by the time we leave to meet Sergio's at 9:00 am at his museo. It is a pleasant walk through el centro.



Today's field trip includes going back to Teopisca to see the baby girl with the leg burn and other patients that may be waiting at the church.

Kieu shows this atopic dermatitis patient how to apply the hydrocortisone and the vaseline to her rashes. Our options for treatment are limited.

We saw seven more patients with a variety of health complaints. Most of the 50-year-old plus group complain of back, knee, shoulder and neck pain. We see them carrying 50 kg bags of charcoal or wood on their backs and it takes its toll. People look older than their stated age due to the hard labor and sun damage. We bought 100 capsules of ibuprofen as that is all we can offer.

Back in San Cristóbal we see a few more patients and we are done by 1:15 pm. Walking in the door to Bela's place we are greeted by her and her happy dogs.


Bela's cook takes the weekend off so we're on our own for lunch. She has three women guests from Mexico City (DF), two came with us, Eva and Ana and who shows up but the third guest, Christine from Germany, via DF. We had a leisurely lunch at Napoli...the food was delicioso!

The women here have to be some of the best cooks in the world!


Left to right: Bela, Kieu, Eva and Ana, the chef is in the background.


Just before the food arrived we were joined by Christine, also from DF (originally Germany). Left to right: Patricia, Kieu, Christine, Eva and Ana.

After lunch Kieu, Bela, Ana and Eva go walk around el centro. Christine and I went back to our rooms, and I gathered our things for our evening clinic. Bela and Kieu met us at the museo.

Sergio changes the dressing on another child with a burn. The older sister holds her little sister while Don Sergio gets the job done.

The mother of this child is young and may be mentally delayed. She speaks her native language and Sergio translates. The child had otitis media (ear infection) but since you cannot buy antibiotics over the counter anymore in Mexico, Sergio had to ask a Mexican physician friend for the prescription. Kieu shows the mother how to give the patient medication with a syringe.


Kieu changes bandage for gentleman with a chronic ulcer. He was hit by a car many years ago and has used crutches since as he cannot walk on this leg. He comes to Sergio's museo two to three times a week.


Sergio gives a tour to a group and Kieu, Eva, Ana and Christine join the group. Afterward, Eva and Ana invite us for dinner then back home we stay up chatting with Bela. Tea and homemade banana bread before bed.

San Cristóbal con Don Sergio - Day Two

March 18, 2011



Per Sergio the plan is to see the baby from Teopisca at the museo at 9:00 am and then he has a group of students to take on a tour at the museum at 10:00 am. Kieu and I would organize the supplies while he gave the tour. Afterward we would go see the patients in San Cristóbal.

The baby girl has her burn dressing changed without pain medication.

Kieu and I organized the supplies for easy access for Don Sergio.


Sergio gives tour and educates students on the artifacts in his costume museum. He is big advocate for education and health.

We change the dressing on the patient with the vasculitic ulcer.

The patient needed some debridement so we applied lidocaine ointment 30 minutes prior. Kieu debrided the wound and we dressed the wound gently with a foam wrap and coban.

I don't think Sergio minds that we do some of the work.

By helping out we get to visit some unique homes, this is one of many.

This patient has neurocysticercosis, which is the leading cause of seizures and epilepsy in the developing world and is caused by ingestion of eggs from a tape worm in contaminated food (mostly undercooked pork and fish). He had a seizure while cooking and fell in the fire.

Kieu and I made it back for a wonderful lunch at Bela's B&B, I took a nap while Kieu checked her email. Back to the museo at 4:00 pm.

This patient with chronic venous stasis dermatitis and ulcer that has been coming to Sergio for care.

Sergio is taking a break while Kieu is working away at this patient with ulcerated leg from falling onto a piece a metal.

Sergio is also a janitor at his museo.

San Cristóbal con Don Sergio Castro - Day One

Kieu and I flagged down a taxi cab and the driver loaded our supplies in his trunk. We met with Sergio at his museo as he was waiting for us. We grabbed a few supplies from the suitcases and off we went. Sergio quickly gives us the plan: first to Teopisca by way of a taxi, then we'll get another taxi, see a little girl with a leg burn then back to San Cristóbal to see more patients.



No problema, we're ready. We arrived at a central church in Teopisca and the mother and little girl were waiting. To our surprise afterward there were seven other patients wanting to be seen for various medical ailments: dysmenorrhea, back pain, arthritis, atopic dermatitis, colitis and reflux. Sergio explained that we specialized in dermatology, but we are glad to use our basic family med skills to help out.



Returning back to San Cristóbal we see several patients in their homes. Don Sergio takes care of anyone who needs the care. There are no wound care centers here and Don Sergio is a one man show.... rich, poor, Indigenous, Ladino and foreigners that may show up at his museo asking for wound care.

This patient had an ulcer Don Sergio has worked on over the last month and the patient was practically in tears as he told Kieu and me of his gratitude. Incidentally, we found he had a couple of basal cell skin cancers on his face and numerous precancers on his hands. He stated he goes to Tuxtla for his dermatological care.... maybe he hasn't been recently so they didn't notice this nodular BCC on his left cheek.


It appears this patient had an episode of possibly cutaneous mixed small and medium vessel vasculitis. This condition can be caused from a variety of reasons and it is difficult to pin it down due to her many health problems. Fortunately, the vasculitis appears to be resolved but the aftermath is a large, suppurative, deep stage II ulcer that is very painful. She really needs a vascular/arterial work up, etc.... resources not easily accessible.


Beet soup lunch. We made it back to Bela's B&B for lunch around 2:45 and Manuela and her daughters made us an incredible meal. The food they eat is mostly locally grown and so flavorful. This is the way we are supposed to eat!! MUY SABOROSO! Napolitas, tortillas y queso, ensalada y pico de gallo.... incredible!


Back to the museo at 5:00 pm.... patients are waiting.

I have refrained from putting in clinical photos but will put them in a Powerpoint file at a later time for those health care providers that are interested in what type of patients we see here. This one I had to post because she has healed from a severe burn injure a few years ago. Her arm is weak and she uses this modified brace to support her arm.

She had a seizure and fell in a fire and severely burned her right upper arm. This is what it looks like five years later.

Sergio, like a superhero to the rescue, provided the wound care this profound 3rdº burn and she was able to keep her arm, and, although it is significantly compromised, she has remarkable use of her right hand.

Don Sergio let us go early for the evening so our tasks were to buy meds, have dinner, go home and get some rest. At dinner Kieu and I succumbed to the children street vendors and bought several of their handmade clay figures.


This was a great way to end the day. A hug and a smile from this 10 year-old pounding the pavement to make a few pesos for his family.



So much for rest, we ended staying up until midnight chatting with Bela.... good times!

Arrived safely in San Cristóbal de Las Casas

March 17, 2011

Kieu and I arrived around 9:30 last night to Bela's B&B. Bela sent her favorite trusted driver, Don Gerardo, to pick us up at the airport and got us to San Cristóbal efficiently.

Arriving at her place is like walking into a small Mexican paradise. Bela has four dogs that give such life to the place you immediately feel welcomed and at home. In the morning, the birdsong and activity in the open central garden just out our room door add to the quality of the experience.... along with the church bells in the background.

Bela has known and helped Sergio for many years. Sergio's museum is high on her recommended places to visit while here in San Cristóbal, thus sending her guests to meet this humanitarian legend and be enriched with his knowledge of the indigenous culture. We will leave El Andalon videos here to sell and give all proceeds to Sergio. Thank you for hosting us Bela!