Tour to Chamula by Adriana Manago

July 15, 2015

I had the honor of accompanying Physician Assistant Patricia Ferrer and Nurse Practitioner Jennifer Eldred on a tour to San Juan Chamula with Don Sergio Castro one beautiful sunny day in July 2015. Patricia had told me Sergio's story and how he came to be known as "St. Sergio of Chiapas" through his selfless dedication to poor communities in the region. But words fail to transmit all that St. Sergio means to the people he has served. 

Sergio's life work and his way of being in this world is best understood in the presence of the emotions he elicits from people in communities such as Chamula. As we walked through the streets on our way to the spiritual centerpiece of the town, the church of San Juan Bautista, Don Sergio brought smiles, laughter, and reverence from all the men and boys in the church square. 

It seemed all felt a special connection to Don Sergio in his unassuming blue handkerchief and cowboy hat. I felt I was walking alongside a ray of hope in the world, a reminder that although good seems to disappear for some time, it will always return. But it was the embrace in the main streets with an elderly woman that moved me to tears. This woman could not speak and I do not know sign language, but her gestures, the look in her eyes, and the way she nestled so closely into Don Sergio’s arms told me everything I needed to know. Her hands up to the sky, then to her heart and mouth, and then melting into Don Sergio’s arms, she told me how Don Sergio saved her life with his medicine and that he was pure love. A love that heals you because it tells you that you are not alone in the world and that we are all here to care for each other.

Inside the church, the floor covered with fragrant pine needles and lit candles, Don Sergio explained in his soft and gentle manner what St. John the Baptist represents to the people of Chamula, the history of the church, and the native view of healing through “curanderos,” elder men and women healers who are thought to have a heightened ability to communicate with the saints. 

With nothing but reverence for this indigenous way of life so different from how he was raised, Sergio explained how the curanderos come to the church with their patients, light candles, offer sacred pox (a liquor made from corn) and now coca-cola, pray, and wait for the message from the saints about the best course of action. They use the fizzy drinks to expel gas, and thus metaphorically, expel the spiritual disharmony that ails them. The message from Don Sergio was simple and profound: This is their cosmovision and their reality is as legitimate as any other. In this way Don Sergio walks among the curanderos of the indigenous peoples of southern Mexico, utilizing resources he has from Western Medicine, but always humbly recognizing that there is something greater than all our scientific knowledge, and that the sometimes the best we can do is just simply care for others.

Adriana M Manago is an assistant professor of psychology at Western Washington University, specializing in cultural developmental psychology. She conducts research in the Maya community of Zinacantán, studying how sociocultural changes associated with modernization and the proliferation of communication technologies are connected to patterns of change in social development during adolescence and the transition to adulthood.

Building Schools and Mini Clinics

The school that Don Sergio has worked on over the last year is
complete however, he is adding another room for kindergarten.
See August 9, 2014 blog post for photos of construction.

Don Sergio has built schools and many water treatment systems for areas in need in addition to his wound care. His most recent project is a 'despensario', kinda like a mini clinic. The government will fund a nurse to provide care for the locals in the area, once it is complete.  At least, that's how I understand it. Why the government does not build it, I'm not sure. But this is the same for the schools: Don Sergio builds schools in areas lacking and once the desks and chalkboards are in, then the government assigns a teacher.

Outside of school.

Don Sergi completed 2 class rooms.

Despensario in one of the small 'burbs' outside the city.

Add caption

Don Sergio and Juan take window and door measurements to
finish this project as Jennifer looks on.

Kindergarten room being added.

Workers making progress.

Teopisca Visit

Monday July 13, 2015
Post by Jennifer Eldred, FNP

After missing a few days from being sick, I was happy to rejoin the team today. Myself, Sergio, Patricia, and a nurse from San Cristobal and our trusty driver Juan, headed out to Teopisca this morning to visit our patients.

Happy to report that our lil Chiquita (2 1/2 year old) with 2nd degree hot water burn is healing well! Here is a photo showing her progress: ...

The people here are so incredibly grateful for our visits that they treat us to a home cooked meal of tortillas, frijoles and huevos, and say adios with a hug, kiss, and a few tears! Makes our hearts swell...Unidos de Corazon!



As we head back to San Cris, we visit a few regulars for dressing changes and are happy to see healing in progress! A homeless man with a severe burn to his leg from falling into a fire is found sleeping on a bench; we awake him to cleanse his wound and will visit again tomorrow.  Another young man with a similar burn, who Pat was treating over 6 months ago, is also starting to heal very well.

After our lunch break we head off to the Museo for evening clinic. There we see several returning patients. One woman with Diabetic ulcers to both feet is making good progress with wounds healing. We continue to encourage her to have better control of her diabetes and educate her on proper footwear.

Unfortunately, we do have several patients that are not making progress. One such man is an uncontrolled diabetic who has already lost one leg and is fighting a serious foot ulcer with necrosis to several toes. His son carries him into the clinic to see Sergio. He is losing his eye sight and recently lost his wife. It is heartbreaking and chances are he will need amputation. We will try to obtain X-rays tomorrow to further evaluate his status.

The team says buenos noches and hasta luego. Time for dinner, sunset, and a restful evening, back at it in the morning!

La vida en Chiapas/Life in Chiapas

July 11, 2015

Life in Chiapas is not easy. The number of patients coming through the clinic and the variety of injuries and ulcers continues to surprise me.

In Teopisca we are caring 2 1/2 year-old girl with a superficial 2nd degree burn on the top of her left foot.
She may whimper a little but does not cry.

One gentleman, 50-something, has both hands severely injured. He told us he was in a fight and someone tied his hands with a rope and dragged him along a road. The rope slipped off his hands taking the full thickness of the skin off his thumbs exposing his bones. The wounds are healing however, his metacarpal phalanges (bones base of thumbs) are clearly visible. With this injury he probably has a bone infection (osteomyelitis) and we hope the skin will grow over it.  His left thumb joint appears to be almost separated and I’m not sure he will ever recover use of it.  He has lost considerable use of both hands right now.

 

Alfonso (premed) and Cesar (2nd yr med student) debride the wound on the right hand of this gentleman.

Then we have the lovely 33 year-old woman who accidently chopped off the end of her right pinky finger in cooking accident. She complains of pain all the way to her neck. She went to the hospital and had to wait and there did not seem to be much they could do. For repeated wound changes she drinks herself into oblivion to deal with the pain.  We had lidocaine so we’d numb the base of the finger (digital block) in order to do the necessary wound care to help the open edge of the finger heal. She claimed to have felt our every move.

Six and a half months after this man's initial burn injury,
Sergio continues to provide wound care until it heals.
See blog posting January 11, 2015.

The young man with the circumferential burn of the right leg (from thigh to ankle) we cared for in January is still a regular patient. He is healing well although slowly. We go to his home for dressing changes as he is unemployed and counts on his brother to help him out.

Then the usual diabetic ulcers caused from poorly controlled diabetes and people wearing inadequate foot wear. One 47 year-old woman had an ulcer on her left foot under the base of her big toe. I pared down the callous and found a deep ulcer. It took me a good 25 minutes, then I asked to see her other foot and she had the same type of ulcer on that foot as well. She brought in what she says are ‘diabetic shoes’ and they are Dr. Scholl’s shoes with a high heel lift that directs more pressure (from body weight) on the areas of the ulcers.

Education about diabetes and all the complications that may arise from inadequate control is sorely lacking. This area needs a system in place to train the locals to become community health workers and reach out to the people regularly. It seems we are in a quagmire of being reactive to problems instead of pro-active.

In the midst of all these difficult situations, I was able to find
 a local restaurant that allowed me to have my "breakfast at Wimbledon".
La Paloma is off the Hildago walking street.  As others suffer daily, I have
the privilege to indulge in my pleasures.....it all boils down to luck and being born
in the US....I won the lottery.

Friends of Sergio Indiegogo Campaign 2015

Thanks to Don Sergio’s Friends, our Indiegogo campaign was a success beyond our goal. I presented Don Sergio with a mock check disclosing the amount raised from the campaign. Several people gave to the campaign outside of the Internet process.

To all we THANK YOU!!

"Thank you all my friends for supporting my work."
Don Sergio Castro.

Don Sergio was surprised and very pleased. This money will tide him over for the next 4 – 6 months, relieving his financial burden of wound and burn care.

For those unaware of medical wound and burn care, it is very costly. The US has many burn hospitals to care for these horrific accident victims, and Mexico opened up their first burn hospital in 2011 (Mexico City). As for wound care clinics, there are many throughout the US: you will not find a major city without one. Here, there are none, at least in Chiapas. Sergio is a one-man wound care clinic, however, as I will post later, this may be changing....at least this is our hope.

Wound care is very costly due to the frequent visits and constant changing of dressings (wound care supplies are not cheap). Diabetes is rampant and once an ulcer starts it is hard to heal when the patient has uncontrolled diabetes and lives in poor conditions. Mexico has one of the highest rates of diabetes.

For those interested in continuous support we have extended the Indiegogo campaign to ‘indemand’, to accept funds indefinitely.

For those of you who’ve never visited Chiapas or San Cristóbal de las Casas, I encourage you to see this magical city and pay a visit to this incredible human being.

Summer Trip 2015

Colleague and friend Jennifer Eldred, FNP has joined me this trip to help Don Sergio. We arrived on Sunday, 3 hours later than planned due to a cancelled flight and bad weather in Mexico City. Thankfully, we arrived safely at Bela’s at 1030pm. As always, she and her staff welcome us as family.

Monday morning we did our patient home visits that extended out to Teopisca, which is a 35-minute drive out of the city. We saw several patients from the area with various conditions: venous stasis ulcer, diabetic foot ulcer, slow healing leg wound on a diabetic, and 3 year old with a hot water burn on the top of the foot and a young man with an impressive lip dermatitis.

After a long day, we started at the museo/clinic at 430 and stayed until 8pm. There was standing room only. The number of foot ulcers continues to increase and, it appears, education about basic diabetes care is continuously lacking.

 

Exhausted from the day, Jennifer and I made it home at 830pm. We showered and crashed.

Thank you to Dr. Henry Beckmeyer at Michigan State University and his resourceful students. Your 4 valuable boxes of medical supplies are much needed and will be put to good use.