Sunday, August 7, 2016

Working from Within

 July 6, 2016
Photo taken from Mexican Destinos website.

This is my 8th year of coming to San Cris to work with Don Sergio and I have seen some beautiful changes develop, albeit very slow from US cultural perspective, it is nonetheless in the making and  hopeful. I have learned my place in this process.

When I started working with Don Sergio I saw much that could be done to improve things and I wanted to jump in and help out but I'm not here day-in and day-out. So, by my own means I kept returning, supporting and attended to people along-side Don Sergio and doing what I can by being aware of what they need: NOT what I THINK they need.  When formulating this sentence, it is the epiphany that all of us need to accept when coming from 'our world' into 'their world' wanting to help. 

Don Sergio's day time assistant is a nurse, Anita, that has not been paid for 6 months from her nursing job at a community women's' hospital. She started working with Don Sergio on the morning rounds and he pays her when he can. She is smart, confident, aware, mature and attentive. Anita is a single Mom with 3 children and is aware of the fluctuation of Don Sergio's financial dependency on others, so when he doesn't have money, she continues to work with him, knowing funds will arrive some day.  Pure trust.

In the evening, one medical student, Cesar, and a nursing student, Edith, come in to help Don Sergio. Cesar is in his 2nd year of medical school and when he has free time he is always working with Don Sergio. Even on the weekends.  Edith, is there every evening. She lives far away but takes a collectivo to be at the evening clinic. She is shy, quite, smart and takes in everything.  Don Sergio pays Edith when he can and occasionally he will give Cesar a few pesos. Cesar asks for nothing and has family support.
L>R: Don Sergio, Edith, Cesar.

Cesar wants to come to the US in a year or two during summer break and learn how we, in the US, practice medicine. Edith wants to be able to finish her nursing training. It is very possible both may one day be the successors to Sergio's clinic.  Don Sergio is 75 years old and still has great compassionate energy but he will not live forever.  Cesar and Edith are constants that can step in as healthcare professionals, they are both Coletos (locals born here - which is important), and are building trust of the patients and community with their dedication.

Cesar is in his 2nd yr of med school in San Cris. Ethan has applied to US med school this year.
Our roll is to facilitate their needs; observe, listen, accept, support and follow through. They know what they need and we need to be there for them.

Thank you to everyone who has contributed on all levels and those who, in the future, will.

Posted by Patricia Ferrer, PA-C.

Thursday, July 7, 2016

Sergio Presents to the Local Medical School

L>R: Elsa, Don Sergio, Ethan.

Cesar and his girlfriend Lupe (both 2nd year medical students) invited Don Sergio to talk to their peers at the local medical school UNICH.  Sergio asked me to bring the video, El Andalon, to show the students then afterwards he'd say a few words about caring for wounds and burns.

Display put up by Cesar and Lupe about the care Don Sergio provides.
Sergio was clearly nervous, which was refreshing to see: indicative of the importance of speaking to future local health professionals. After the film, he quickly went into a dialog of how best to assess and treat burns, then onto ulcers. I never seen Don Sergio talk so much. If he knew how to do a powerpoint he may have talked for hours.

Don Sergio talking about burn and wound care.
The university emphasizes cultural awareness of the local indigenous population and opened the medical school 3 years ago.  It will take a total of 6 years for Cesar and Lupe to finish their training, then one year of social service to obtain their medical degree.

Sergio and his wife, Elsa.

Sixteen medical students came to the lecture.
L>R: Don Sergio, Cesar, Lupe.

A special thank you to Veremos Productions, Consuelo Alba and John Speyer for their generosity of creating this well told story of Don Sergio and his work.

Posted by Patricia Ferrer, PA-C.

Wednesday, July 6, 2016

School Construction

Escuela 5th of marzo

The small center room with the sheet metal roof is the nurses exam room, being completed soon.
The situation in this part of Mexico is on shaky ground with the 'bloqueados' (road blocks). From what I'm told, teachers are protesting for the rights to teach children what they need to learn in life to do well for themselves and to know their rights. Some teachers have been paid and some have not; same for healthcare professionals. A nurse I know was only partially paid. I would imagine if this happened in the US, there would be a major revolucion.  Just imagine what it is like for everyone here.  Nonetheless, those suffering at this moment are the minds of children not being educated at all.

The library, currently is also being used as the ground keeper residence.
Another view of the library.
Recent educational math activities remain on the board.
Outside the grounds-keeper's home.
Don Sergio's 5th of marzo school project continues and the community it serves is involved with the school and they remain open with the exception of summer break. So, for now construction continues.  Sergio has completed the latrines and the school library, there is a room for a school nurse and he is completing a home for the school's grounds-keeper.  This school complex has been in the making for 6 years now....typical poco a poco.

Completing the ground keepers home.
Fortunately, for Don Sergio, foreigners have stepped up to help. One couple, R&L, have generously donated a nice sum to help complete the library, nurses room, water pump for the latrines and roof.  Then, out of the blue, Don Sergio was contacted by a newly formed US solar company to see if they can donate solar panels for one of his projects. They worked out a visit to San Cris while on a family vacation, visited with Don Sergio and took a tour of the school and all agreed it is an excellent place to add the solar panels. Everyone is happy about this as there is only one business in San Cris that has solar panels, this will be the second and it is a community school.  All are excited about not being dependent on the city's electricity. For those that may not know, electricity is very expensive here.

Sunday, July 3, 2016

Summer 2016: Indiegogo Generosity Campaign

Ethan presents our mock up five thousand USDs award raised via the Indiegogo Generosity Campaign.

Our 2nd annual fundraising campaign, thanks to everyone who donated, was an absolute success! Our goal of $5000 USDs was reached and we are able to help fund Don Sergio over the next year.  As usual, he is grateful to all his friends that continue to support him and his work.  The never-ending influx of patients with burns and wounds seems endless and all donations help reduce the suffering in this part of the world.

At this time we have a 2 and a half-year-old that was pushed into a tub of hot water by her brother, which burned her back, legs and genitalia.  These are first-degree burns (epidermal blisters) and superficial second-degree burns (the superficial portion of the dermis).  These types of burns are so painful and although the little girl cries when we change her bandages, she lets us do our job. We do it as quickly and smoothly as possible.  The poverty she, her family and neighbors live in astounds us: no clean water, no toilets, they cook with wood, the walls are thin planks, and discarded items are used in any way possible for shelter. There is no waste for the poor; they find utility in everything, just as nature does.

Neighborhood kids wait for us to finish our burn care for the 2 1/2 y/o girl.

30% of her body surface area was burned, 1st and superficial 2nd degree burns.

Anita, a nurse works with Don Sergio M - F for his morning rounds. She has not been paid at her hospital job in 6 months. She has 3 children ages 12, 9, and 4. Sergio pays her what he can, when he can.

Summer 2016: Effects of the road blocks

Flowers at Bela's are in full bloom.

This summer trip finds Sergio with good energy and nice support so that he can complete his local projects.  As usual, on the medicine side, we see the same health problems but different people.  As for the local turmoil, teachers and healthcare professionals are striking and protesting and have control of the flow of traffic in and out of the San Cris.

Ethan and I arrived Tuesday night with a few glitches but we knew everything would work out.  Our taxi driver What'sApp'd us and said he could not pick us up at the airport. So when we arrived in Tuxtla at 630pm it turned out the OCC bus was getting ready to depart to San Cris and unknown to us, we purchased the last 2 seats (the bus was packed). Eleven kilometers outside of San Cris we had to detour via a dirt road to get on the old highway into the city.  Safely we arrived at Bela's around 9pm.

Driving against traffic, these are the lines to get into the gas station, double file.
We had been aware of the recent protesting and violence in Oaxaca and although we did not see any protesting, we definitely experienced the effects. Teachers and health professionals (to my understanding have not been paid) create road blocks which prevent certain items to come in and out of the city. Tourism numbers are low and gasoline is limited. The lines at gas stations are long and they run out quickly. We cannot go out to the communities so we only treat the local patients....keeps us busy enough!

Sunday, January 31, 2016

Progress at a snails pace

January 24, 2016

In some parts of the world progress moves at a snails pace...or as Don Sergio says, 'poco a poco'.

I am back home now after spending 2 weeks with Sergio in San Cristobol.  It was a rewarding visit finding Sergio well and busy.  Below are some thoughts I have about the state of Sergio's mission.

The Supply Line
Don Sergio is always in need of burn and wound care supplies. He can never have enough gauze, gauze wraps, ointment and gloves. Thankfully, there is a Tucson organization where I can request these items and check them as luggage when I visit him. Also, my medical network seems to come through when I request items they no longer need and a friendly physician who ships me boxes of good, unused supplies from Michigan throughout the year (Thank You, Dr. Beckmyer).

Some supplies I repack as tightly as possible and have friends (Thank You, Alejandra) who visit family in Mexico and postal ship them from Sonora. This system has worked well and supplements Sergio's inventory.  He does have friends from France that send him creams and other items as well.

The Help
L>R: friend of the team, Nataly, Esmeralda, Deborah and Edith.
Edith, is now in nursing school and doing well. She continues to help Sergio on a regular basis. I believe her nursing school is 5 years long and this is her first year. She had recruited a few others students to come help as well and they love it. They love the hands-on care and knowing they are making a difference in their community working along side Don Sergio.

Alfonso also continues to help Sergio. His unwavering admiration and respect is palpable. He has decided to pursue an engineering degree in San Cris and help Don Sergio until his compadre Cesar completes his medical training. Alfonso told me he looks to Don Sergio as a wise grandfather and spends most evenings working with him.
L>R: Sergio, Juanito, Alfonso.
Cesar, El General, is in his second year of med school and is doing well. Only when he is on break is he able to come help Sergio. He says his studies are going well and he is learning so much about medicine and loves it. He will be an exceptional physician!

Newbies: Esmeralda, Deborah, and Nataly. Esmeralda has a permanent smile on her face and is in nursing school with Edith. Nataly is a gymnastic teacher and helps in the evenings as well. She took up running a year and a half ago and has run 2 marathons already...she's a natural athlete.  She usually comes in the top 10 of various races...usually 15 to 42 kilometers. She was there most nights these past two weeks. Deborah is 15 years old and loves to hang out and hand out supplies to everyone working. I love the feeling of camaraderie and family that has developed over the years.

Gymnastic teacher and runner by day, volunteer at night.

Iker has been gone for almost a year now. He's ridden his bicycle over 9000 kilometers and is putting on another 3000 more as he heads to Usuiasia in Argentina.  We still hope for his return one day. We all miss him.
Having gloves, good blades to care for wounds is a plus.
Here we use a bucket for a stool.

Indiegogo Fundraiser
Last year's fund raising was a tremendous help for Sergio. This fundraiser helped support him over the last 8 months. His life is easier because of all of your donors. We plan another Indiegogo this spring. 

The Patients
It is a dream to one day, to find a way to integrate a patient education program...alas..for now, just a dream. Sadly, same conditions, different patients. It seems there is no end. We are making a difference but albeit, a bandaid..speaking metaphorically.  Each patient, young and old, are always expressing their gratitude for Sergio's (and his team's) help. The care they would receive if Sergio were not there, may not be adequate or sufficient to heal their wounds. As I've mentioned before, sometimes its more cost effective for the hospital to cut off the limb as oppose to nurse a wound back to health.  Sergio has nursed many limbs back to life.

Stop here, the following is for strong eyes and stomachs only.

His family brought him in 4 days after the injury.

This photo, left, is the young boy who was accidentally burned with polvora (flammable power used for fireworks). See posting Jan 9th. I cannot paint the picture with words of how quietly and calmly this child sat while Sergio applied vaseline and silver sulfasalazine to his open facial wounds.

Day 15 after initial burn and 11 days of burn care.

Sergio believes when one is calm during receiving wound care, their bodies heal quickly.

We hope all who know and/or who've met Sergio continue to provide support in some way, every bit helps. Stay tuned, we will keep updating the blog.

My nephew Ethan, a pre-med student, joined me this trip. He will do great things in his life!

Sunday, January 17, 2016

Buildling schools piece by piece, poco a poco......

One thing we take for granted in the US is primary education, like elementary school. Even the elementary school I went to 43 years ago was adequately supplied, comfortable and we had good teachers. This is not always the case in Chiapas. 

This school room is now being used on a regular basis. The parents of a poor San Cristobal suburb called upon Don Sergio for help to build a school. The government supplies the teachers.

The same room above: before
 During my two week visit with Sergio we stopped by a school he has been working on for a few years. He receives funding from various groups (usually international) and over time he's been able to build one room, then another, then the latrines, etc.  Most recently he has received support from a Swiss group that allowed him to finish a couple more rooms for the school he is showing me today. One, that I have been to several times before. If you look back through this blog you can see the progress of this elementary/primary school.

Outside the room, before: the masonry worker is hand applying the outer concrete/stucco.

Almost completed.

 The schools here in Mexico aren't like ours. They are basic concrete blocks with concrete floors, no AC, no heater, they have windows with bars and a chalkboard. No computers, no projectors, no drop-down screens. The basics at best seems to work. The kids love their schools as do the parents. Costly items are the desks and Sergio seems to drum up the money for that as well.

Completed and in use.
You may ask, why isn't the government building these schools? That question is hard for me to answer. All I can say is what I've been told: the money that is given to build schools is reduced along the way and sometimes, well, very little or nothing gets done. Fortunately, the government does send teachers and pays them if a school is in place. People want action and if there are kids in areas that need a school, the community advocates approach Sergio. Such a different world than ours in the US.

In construction.
Sergio hires workers he's known for years and sometimes pitches in to do the work himself. I enjoy visiting the workers and seeing the progress.
Almost complete. One room will be divided to make room for un biblioteca.

 Posted by Patricia Ferrer, PA-C.

Saturday, January 9, 2016

2016 Some things never change

Advertisements for Sergio's museo. 
After seeing patients all day, if there are enough
tourists, he will give them an unforgettable
cultural and Mayan textile tour. Donations
partly support his ability to do his
humanitarian work.  
Its hard to believe I met Sergio 8 years ago and how little things have changed in his world of wound and burn care. At least as far as patients go: same accidents, different people. Our patients are the young, the old, and everyone in between.

On New Year's Eve a 5 year-old boy, with his 23 year-old uncle from Chamula, were planning to use fireworks and pulvora - literally in English 'gunpowder' -  and somehow it when 'boom'.  Both their hands and faces were burned.  The boy's complete face (excluding his eyelids) has a superficial second degree burn and he looks like a kid from a horror movie. The back of his hands suffered a 1st degree burn in which the superficial aspect of his skin will peel and probably won't leave any scarring. At this point we really don't if he will be left with any facial disfigurement, but his function of blinking, and use of his mouth should be fine. Sergio cleans his face and applies cream and this 5 year-old does not cry. His absolute attention and caring in doing this must have some calming the boy knows Sergio will give him a piece of chocolate afterwards.

The uncle does the whimpering when we change the bandage on his right hand which has a superficial 2nd degree burn. His face suffered a burn equivalent to a chemical peel that many women in the US pay hundreds of dollars to help with wrinkles. His face is recovering very quickly but his hand will take longer.

The older patients have diabetic or venous ulcers we see on a regular basis. The blindness from diabetes continues to amaze me and lack of education for diabetes prevention is sorely lacking (as it is in the US). It also continues to amaze me how people get along with their maladies that interfere with their daily activities of living and their quality of life. They seem to blame no one and accept their fate.

An ornate decoration from one of Mexico's oldest churches in San Cristóbal.

Posted by Patricia Ferrer, PA-C

Tuesday, January 5, 2016

My First Day With Sergio - by Ethan Hartman

After breakfast, Patti runs to call a taxi as I wait with the medical supplies that we have gathered for Don Sergio. The taxi takes us to Sergio’s museum, which doubles as his clinic. We unpack the supplies that we need for this morning’s house calls, and we leave almost as soon as we arrive. The taxi driver, a very good friend of Sergio’s, greets us at the door. “You’re late,” Sergio bellows. The two of them laugh and embrace. I receive a handshake, and notice that he has no thumb on his right hand—an amputation? “Me llamo Juanito, mucho gusto” he says with much gusto. “Soy Ethan, es buen conocerte,” I reply with a smile.
The four of us jump in Juanito’s taxi and begin an unexpectedly long journey.
It is possible to tell the generosity of a person by many measures. As we drove through the mountains, I begin to realize the true generosity of Don Sergio, a man willing to pay for a taxi to travel an hour and a half just to change the bandages and clean the burn wounds of a man he barely knew. The roads twist, rise, and fall, as we go deeper towards our destination; the town of Chanal. Patti feels nauseous and I hand her a plastic bag just in case.
I enjoy the long periods of silence between small talk when I just sit and think. I imagine myself living in Chiapas, writing medical blogs or working at Bela’s to pay for my rent. Above all I imagine helping Sergio with his work. I think about Brazil, and how much I long to visit the friends I made last summer. There is something about travel that I find so romantic, it truly is the greatest teacher. Learning a language introduces a new way of thinking, and a knowledge of 3rd world medicine is difficult to get in the 1st world. Maybe I can do all this in my year off between graduation and medical school…
No sei.
Plans are difficult to make in such an uncertain future.
When we arrive in Chanal, Sergio leads me into the home of burn victim, and I see what real 3rd world looks like. An entire family of 8 lives in 2 rooms, with no shoes, no clean water, and few sources of light or heat. One light bulb illuminates the room where a 41 year old man lies, cachectic and moaning. After greeting us with a weak smile, he uncovers himself to reveal his naked lower body. His legs, thinner than arms, are wrapped in bandages, oozing with green pus. My job for today is to hold the LED light, retrieve supplies, and take pictures. As Patti and Sergio take off the bandages, we can see that most of his right leg and half of his left is covered in 2nd and 3rd degree burns. This man had gotten drunk and fell into the fire at the center of his home. This story is all too common in Chiapas, and Sergio knows from experience that these wounds take a long time to heal without surgery. As we packed up to leave, I notice Sergio leave 100 pesos for the man on his dresser without saying a word.
The rest of the day is very busy. Juanito delivers us to people with various problems including diabetic ulcers, venous/arterial ulcers, and burns. I am thankful for my strong stomach, because many things we come across would destroy most of my friends’ desire to eat for days. 
After about 8 patients, Patti and I return to Bela’s for lunch; beet soup with salad and pepper empanadas…tan delicioso! After a quick nap, we are off to Sergio’s museum again. Only this time, patients are coming to him. Sergio also has other helpers, an 18 year old man who wants to go to medical school, and two 20 year old girls that are studying to become nurses. I struggle to get into the flow of where everything is, and I quickly become overwhelmed by all of the supplies, and how to get organized. I learn the ropes, however, as Patti scolds me a few times, and I observe how the other volunteers work with the patients and Sergio.
A child with terrible burns to his face from a firecracker accident is brought in by his parents. His face is inflamed and covered in pus. He sniffles slightly as Sergio cleans, debrides, and wraps his wounds, but he does not cry. What a champion. Another kid, who had cut his thumb open and received stitches several days ago, cries and thrashes as if we are torturing him when we take out his stitches. Not quite the same level of champ in that kid. I can’t blame him, I was the same way as a child.
Throughout the night we see infections, fistulas, eczema, ulcers, burns, and scabies. It’s amazing that Sergio can send these people home with some sort of treatment, from a limited amount of antibiotics, to various topical medications and wrappings. It’s great to know that people believe in his work and send things from all over the world. The end of the shift working with Sergio and his team brings a warm feeling to my heart, and I can’t wait to play a larger part in it.
Patti and I leave just before 7pm. I buy us some sandwiches and we walk home. After a quick workout, I head to the kitchen to eat my sandwich and Meli stops me, asking me to help her translate what a man named Jose is asking her. Why she asks me, I haven’t the slightest clue. I probably know less Spanish than she. By the end of our conversation, however, Jose asks for my email, and wishes to stay in touch with me. As I write my email down for him, he expresses interest in my pen, which has a flashlight at the end. I tell him that it’s his, and his face lights up with delight. How wonderful to make someone so happy with such a simple thing. Whether it’s treating a burn, or giving a gift, we can all make a difference.
Patti and I meditate on this before we chow down our sandwiches and discuss the clinical presentation and treatment of ulcers. You know that you are medically inclined when you can eat and look at disgusting photos…

Friday, January 1, 2016

Vistors from Kenosis Spirit Keepers

Earlier in 2015

Spiritual leader Carla Woody, founder of Kenosis Spirit Keepers ( has been traveling to Central and South America over the years leading tours in efforts to educate others of Indigenous traditions that may be on the verge of extinction. Somewhere along the way she met Don Sergio Castro and during her trips to Chiapas, she makes his museo/clinic one of her stops. She has noticed and appreciates Don Sergio's ability to heal wounds by the compassion and care he provides and does not miss an opportunity to share the experience with others.

Ms. Woody gives a portion of her proceeds from her tours to help Don Sergio carry on in his work. Below is a photo of her latest trip to Chiapas in 2015.