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.