Clinic Day 1

Our group reached Ocote Paulino yesterday evening, by bus. It was an amazing view of sandy landscapes mixed with pines and precipitous drops down either side of the road.  To top off the dangerous journey, there was a beautiful sunset all around us, erasing everyone's fears when the bus whipped around each subsequent corner, narrowly avoiding plummeting to certain death to the valley down below.

Day one in clinic was truly a full day! Since in our group only Erin (family med resident) and I were the only ones who spoke Spanish (besides the translators), we split up our duties amongst clinic and pharmacy.  I started in the pharmacy during the morning. Angi (pharmacy student) and I sorted all of the medicine and discovered that we don't have certain critical things.

There was nothing for blood pressure, no aspirin, no scabicidal!  It's an important lesson learned (imho), that when accepting medicine donations from companies, it's important to submit to them a "suggested donations list" in order to make sure that at least some of the necessary meds make it to the patients.  Our attending, Tom, headed down the valley on a truck to get some of the meds we would need.

We saw 84 patients this day with a variety of health problems. When I switched to clinic in the afternoon, I saw a 12 year old boy with large pinqueculae (ingrowths of white scar tissue over the white part of the eye, most commonly caused by UV light and dust/dirt). A 49 year old gentleman had an endstage finding of pingueculum, what's called a pterygium (a 'wing-shaped' continuation of growth over the clear part of the eye that causes blindness).

  It was frustrating that I couldn't do anything for them.  The young man needed to wear sunglasses to prevent his pingueculum from growing into a pterygium and an the older gentleman needed a surgical excision to restore vision in his right eye).

A lot of little kids had come to clinic on their own, but we asked them to bring their older siblings or better yet, parents in order to get proper treatment.  During the afternoon, we each saw about 15 patients.  I was kicking myself for not bringing some of the glasses that I brought to Honduras (the glasses went with the other group to San Jose and were awaiting when I would return from Ocote Paulino to prescribe them to patients there).

So far, I saw a few people who were presbyopic (meaning were unable to read up close due to aging of the lens fibers in their eyes).

It seemed that everyone could see 20/70 or worse on the near chart and would benefit tremendously from +1.50 or +2.50 glasses.  The sun is very strong here up in the mountains, and sunglasses would definitely do a lot of good... but I wonder if people would wear them?

After clinic, our tired group took a walk up the hill and watched a game of futbol that the men were playing wearing rubber boots.  I envisioned the calluses and ulcers that we might see if the men actually came into our clinic.  Our group brought many pairs of socks to prevent these injuries, but we simply weren't seeing men come to our clinic.