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.