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!
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