Sunday, September 1, 2013

Conditions of Care: August 2013 Trip Summary

For Don Sergio's make shift wound care clinic the conditions we work in are not the cleanest. He does the best he can with what he has and its all the locals have.

His stocked travel bag is always by his side.

The chairs we use are tiny, Don Sergio always looks up to the patient, never downward.

For house calls he adequately stocks his travel bag with what he needs for the daily rounds.  For the museo/clinic he keeps this bag at his side, on the floor and uses small chairs for a foot rest for dressing changes and the burn patients sit in an larger chair.

The 'dispensary' room.
There is no privacy as those waiting are sitting on one of two benches behind him. HIPPA patient privacy rules don't apply. He does have a dispensary/supply room with poor lighting which is where I usually work. Thanks to Clínica Amistad in Tucson, they donated a wall mount oto/ophthalmoscopy that I use for focused lighting when necessary as well as it's functional purpose.

As for supplies, here's how it works:
 - people from France and the US with access to medical supplies ship them to him. The supplies he receives differ depending on what people have access to.
 - from the US, I ship donated and purchased supplies to San Cristobal from Nogales, Sonora via Correo Mexico. (I drive across the border, have aduana's search through the items and give their stamp of approval.)  If anyone would like to donate supplies to Sergio it would be best to send them to me in Tucson. Contact me by email if you are interested.
 - if patients can afford it, they will bring in their own supplies which Don Sergio will use.
 - visitors who are aware of Don Sergio's work will have collected supplies and bring them down as well.
 - donated money allows Don Sergio to buy medications, creams and supplies locally.

Many people ask "what does Don Sergio need?".  From my observation:
 - Funding: although this is a small operation it is costly and time consuming as Don Sergio sees about 100 patient visits per week.
 - A constant stock of medical supplies (gauze, gauze wraps, wound dressings, medicated ointments, etc - see Yok Chij website Support page).

These conditions are not easy for a US-trained healthcare provider to work in. One has to keep an open mind and adjust to the patient's culture, mindset and expectations. This is challenging and satisfying when results are obtained and a positive difference is made; its disheartening when resources are so limited there is nothing that can be done.

This visit completes my 8th trip working with Don Sergio over the last 5 years and it is so gratifying to assist this septuagenarian provide needed medical services that are otherwise not available.  Don Sergio is unstoppable even after his auto accident in Febuary 2013 that caused him to lose all his upper teeth (his face hit the dashboard). An avid supporter of Don Sergio has given him the money to have him fitted for dentures, I hope he uses this for himself and not others.

Don Sergio lost some mobility in both wrists and hands in his auto accident as well. A physical therapist from Monterrey Mexico had been on his small tour the night before and came by to work on him.  He does accept help from others.

I plan to return January 2014.
Post by P. Ferrer, PA-C