Saving a Thumb

August 18, 2014

Sergio uses stick and decapitated plastic liter-size Coke bottle to tease the ripe duraznos off the tree in his museo courtyard. 

The last time I was here we had a patient show up asking Don Sergio for help after a lasso accident. The cow (or horse) he had roped, pulled away and the rope tightened around his left thumb and pulled the skin almost completely off the bone. This happened 2 weeks prior and he had gone to the local hospital. The patient, we'll call him Caballero, is about 63 years old, excellent health, and has a pleasant and calm demeanor.

Caballero's thumb 2 weeks after injury.

At the local hospital, the skin was sewn back on to the base of where it had separated. The photos tell the story. Upon his return visit to the hospital for suture removal, his thumb was black and necrotic (tissue not viable). He was told they need to cut off the thumb. Caballero declined and showed up at Don Sergio's museo clinic.  How he heard of Don Sergio I don't know but word gets around.

Upon first sight of this tragedy, my first thought was the same, 'oh no, the thumb needs to come off'. However, Don Sergio with his 40 plus years of experience of treating some grotesque back-country wounds thought there was a chance to save it. The thumb did have a small amount of viable tissue remaining on the dorsal side and this is what he focused on.

Side of thumb with small patch of viable skin.

The few days following Caballero's first visit to Sergio's I returned to the US. Prior to my leaving I had asked him to please return in August so I can see what his thumb looked like.  He did return and and proudly showed me the results. Don Sergio's poco a poco daily and every other day cleaning and debriding allowed the viable skin and adequate tissue underneath to regenerate and cover the thumb. He had mobility and use although the skin was scarred and sensitive and the tip of the thumb had nail remnants with still a little healing to go. Caballero was happy and grateful to Don Sergio and was glad to show me his thumb.

~12 weeks later, remnants of nail base at top.

When one donates to Don Sergio, they are giving him resources to help people like Caballero. Working folk that eek out a living to support themselves and their families and being a part of a community. They are hard working and humble. It is stories like these that make Don Sergio a legend.

Caballero gave verbal permission to share his story.
Posted by Patricia Ferrer

Working Gems

August 16, 2014

We have several patients in Teopisca and one family gave us Chiapanecan free-range eggs.

Yesterday I spent the morning with a local named Sebastian who works for DIF (Desarrollo Integral de la Familia). This is a foundation in which wives of the Mexican politicians help support charity organizations in various ways.

Sebastian took me to a local non-profit healthcare facility called Esquipulas. This clinic is supported (almost single-handedly) by a family out of Monterrey, Mexico and physicians that are trained there. Part of their training is working at Esquipulas for their social service. They provide primary care to those that speak a Mayan language.  In addition, they work with various non-profit global healthcare campaigns. Like Clínica Amistad  (a free clinic that provides primary care to Tucson, AZ's low-income uninsured), they provide free services and patients have to pay for their medication. The difference is Esquipulas is much better and consistently funded, has a better building, better rooms and nice equipment and they are highly culturally sensitive to their patrons (as we are at Clínica Amistad). They are also open daily M-F compared to Clínica Amistad being open two nights per week. It was quite impressive and seems a paradox since the US appears monetarily wealthier than Mexico.

Entrance to Clínica Amistad, Tucson, AZ.

Entrance to Esquipulas, San Cristóbal de las Casas, Chiapas, Mexico.

Exam room Esquipulas. To my companeros de Clínica Amistad: eat your heart out.

They have a strong connection with select physicians from Monterrey to work there and it is a very organized operation. They have good reasons for doing it this way, which from my perception include keeping it small and collective. This maintains focus of their mission, prevents dilution of quality of care, maintains continuity of care, supports cultural awareness, and builds a family-like environment center for those that work there. Many of the employees speak a Mayan language and are born into the respective culture.

Other side of the exam room, a desk and chairs.

Esquipulas is a nice resource for Don Sergio to have to refer the Mayan patients that consult him for conditions he cannot care for.

After seeing all this it made me realize why Don Sergio has kept things small for himself; he likes medical professionals to come help, but he also likes that he can control how people are treated (cultural sensitivity), the care given (he oversees that the optimum care is given within his means), chooses his own projects (in which he receives donations from various sources), and learns from those with more expertise. This is all part of his 'healing' process and is why when one comes to work with him, their experience is so rich.

Sergio and Iker visit with Teopisca family on the patio porch after wound care is given to a abuelita.

Finding the 'working-gems' in the world like Don Sergio, Esquipulas, Clínica Amistad is inspiring. We all see the deficiencies in larger systems and instead of complaining, protesting, expending energy trying to move a mountain, there are some (gracias Adios) that provide solutions to the immediate needs and take care of those in our respective communities.

Juevos revueltos de Teopisca.
These REAL free range chicken eggs are a vibrant yellow and more flavorful than any store-bought eggs I've tasted in the US.

Posted by Patricia Ferrer.

Unstoppable

August 9, 2014

Real de Guadalupe August 6, 2014 - Culebra.

The hot Tucson summer has driven me back to the cool climate of San Cristóbal.  I arrived on the day of a tornado that was captured by several locals on film.  This was the third tornado this summer and when the clouds gather overhead you see people anticipating another tornado.  Growing up in US tornado alley, it seems weird to have a tornado in the mountains of southern Mexico.  Wednesday over 200 homes were damage and fortunately no major injuries reported.

Friend of Bela, Ricardo from the Belil Restaurant took this foto of the tornado.

The patient volume for Don Sergio at this time is high and many of the patients I saw three months ago have healed and are no longer coming to the museo clinic.  There is a new batch though: same type of wounds just different people. Don Sergio told me the young man who lost his left leg due to an assault burn injury and severely damaged his right leg is now using crutches and is somewhat mobile. Our 5 year old boy's chest wound and the 3 y/o with a hot water burn have healed well.

On Thursday we traveled to Teopisca and spent most of our time seeing 5 or 6 patients, then back to San Cris to see several patients. The evening clinic was jam packed and thankfully we had Cesar, Iker and Amethyst (who I met last year from Cozumel on vacation) come to help.

Previous class room for elementary school, now a supply storage as Don Sergio finishes the school.

 Friday we went to work on a school in the 'burbs' that Don Sergio has constructed. It seems these are the last two buildings for this school area. Our driver Juanito and friend Alfonso pitched in and Iker called upon his 'posada' friends to help.  

Before painting.

After painting. I learned that adding salt to the paint will prevent it from washing away from the rain when the paint is still wet.

Afterwards Don Sergio and I saw a few patients in the city and I went back to Bela's in the afternoon for a siesta. The museo/clinic gets rolling at 4pm and started slow as it appeared it would rain but then numerous patients showed up. Cesar, Alfsonso, Carolina, Iker and Amethyst were all there so everyone pitched in. There is never a need to talk to each other while working as we all know our places and positions. Its like an orchestra playing a well-known piece of music.

One room before cleaning.

After cleaning.

Las chicas from Argentina just traveling and enjoying life, riding on the wind and sharing memories and friendships and hey, why not help paint a school.  A free life they live and thank goodness they have good health, great attitudes and open minds. They may not have a lot of money, but they seem very rich to me.

Don Sergio hires expert to coat the walls with cement. On Tuesday it will be ready for painting. We will call upon la posada amigos to help us.

At 6pm we were so busy and then Don Sergio had about 15 tourist waiting for a tour.  He ended up giving 2 tours while we saw patients and waited for everyone to leave.  I was exhausted! I don't know how Don Sergio does it, the man is unstoppable and does what's needed to get the job done.

Don Sergio works harder than any 73 year old I know.

Posted by Patricia Ferrer.