Sunday, October 23, 2011

87. OverseasProject #10: Monterrico


Monterrico

About three hours away from Guatamala City on the Pacific coast, Monterrico (aka Monte Rico) is the largest (and therefore the commercial  trading center) of a cluster of villages that also includes Agua Dulce (a system of esturaries—reminding me of Louisianan bayous) in which each family has its own small island, Curvina, and Hawaii.  Catchment population about 20,000, I’ve been told, certainly an overestimate.  The closest local doctor is about a 90 minute drive away, with no guarantee of being seen on the same day, a real deal-breaker.

Sharing the black sand beach are weekend homes for the wealthy of Guatamala City, a couple of  2 or  3 star hotels, and the two buildings of the CCCG retreat. One building holds the kitchen and store room; the other has two stories of dormitories, each with 30 or so bunk beds.










The palm-leaf covered but otherwise open-air areas above each building  were converted into a clinic for the week, with folding tables for registration, lab, pharmacy, and 3 clinician stations in the larger room.  Draped sheets provided some exam room privacy.  The smaller room was divided into two areas for me and the midwife.  Altogether, 16 volunteers:  3 docs (two family practice and me), one midwife, two nurse practitioners, one NP student, one FP resident, one med student, one lab tech, two nurses, two med admin students, and two non-medical volunteers.


Knowing that there were no facilities or an OR team for surgery, I expected just outpatient care.
Over three days I saw 24 patients, equally divided among:
cervical cancer screening
pelvic pain,
bladder problems,
abnormal vaginal discharge, and
reproductive issues.

A long ways to travel for 24 patients, but I was also scouting the potential for future surgical trips.
I'll have to think more, but I don't think I'll ever being doing much major surgery in Monterrico.
Tubal ligations maybe, repairing vaginal prolapse and superficial skin tumors, but not much more.
Which is okay; I think I'll go back.



Wednesday, October 5, 2011

86: Hurricane Mitch


David, Samuel, and Roberto Alvarez are evangelists, community activists, and entrepreneurs. In 1982 David started his ministry (Centro Cristiano Cultural de Guatemala:  cccguatemala.com) in his garage as a young man and hasn’t looked back.   He has worked a number of jobs to support CCCG, most recently an advertising business, but along the way he worked as a bombadero (firefighter).  He built a church in the middle of a gang-ridden neighborhood and feeds children breakfast if they agree to go to school that day.  He developed an Oceanside retreat near Monterrico so these same kids could escape the city for a few weeks every summer. Photo: Roberto (right) working with his David's son Eric inside the clinic.
 
Enter a Puyallup firefighter who came to Guatemala to teach bomberos paramedic skills.  When his translator didn’t show he asked if anyone knew English;  David raised his hand and said he spoke a little. They've been friends since. Photo: Front entrance to the clinic. Under construction on right will be open air waiting area.

Enter Donald Van Nimwegen, a Seattle anesthesiologist who has a long history of overseas volunteer work that did not end with retirement--many of his days now spent in a large basement room donated by Group Health where he collects, sorts, and packs donated medical supplies for various volunteer groups including Healing The Children and Amigos de Salud. Firefighter introduced Don to David during a paramedic training mission that turned into a Hurricane Mitch rescue mission.  Don then introduced David to Jennifer Hooch during an ENT trip.  Jennifer is a family practice doctor with an interest in public health and lots of energy.
Photo: Work progressing on the clinic's outdoor waiting area.  I suspect it will also be a thatched roof.


Add about $40,000 from Rotary groups in the Puget Sound and the result is a new clinic in Monterrico, the site of my overseas project #10.

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