Feb. 1 – ‘Matilda’

Today’s most interesting cases were Matilda and the boy with the snake bite.

The morning started with doctors’ rounds and the cleft palate babies are doing fine. Victor, the man with the amputated finger, went home. Apparently, he opted to let his finger rot off as it was when he came in. I guess it’s a cultural matter and 4 fingers (for now) are better than 3?

The day of the screening, while there is chaos everywhere, there is indeed a method to the madness — which is, babies first and adults last. Although for some reason, the nurses felt it was necessary to push a grown woman to the front of the line. No one was really sure why …. was it something about her eyes or her stoic manner? Everyone did agreed that she need not go back to the end of the line. Today we learned that her name is Matilda and she lives in a village of about 70 people with her husband and 4 kids.

They are farmers and she has feet tough as nails. Two years ago, she was cooking (over an open fire, of course), when she caught on fire herself. Nothing was done until today. Someone from the village heard a radio ad and offered to drive her to Coca. Her burn is very similar to Christian’s, a story that will be told in Latucunga. Today, Dr. Pap and Dr. Chris released her neck. The anesthesiologist had 3 plans to keep her airway open because all the muscles in her neck have keloids (thick scars resulting from excessive growth of fibrous tissue that occurs especially after burns or radiation injury) and they even had trouble locating her vocal cords. Everything here reminds me of the 80s television show “MacGyver,” where impromptu resourcefulness matters because the technology simply does not exist. The last option was to cut her throat so she could breathe.  She’s resting now with a splitting headache which is no surprise.

Friday is supposed to be a half day for everyone, and our host Alexandria had planned a boat ride on the Amazon. But the doctors can’t seem to turn away any potential patients as they normally do not have access to any surgeons. It’s after 10 p.m. now and we started at 7 a.m. . . . and the doctors are still working!

And, although the river trip sounds wonderful, I am okay with passing on the event – after seeing what a snake’s venom did to a young boy’s leg.  He had a skin graph when it happened but the foot started to turn from the damage done and whomever the surgeon was – it was a very primitive job.  I’m including a photo.

We had a beautiful girl come in today with a burn on her face. We learned that she had been bitten by a spider and that the treatment was to burn off the bite with candle wax. There was nothing we could do!

We spent the majority of the first day in the screening process but stopped by the hospital to see the operating rooms get set up.  They started another operating room today because they needed to add more surgeries. So now there are 4 operating rooms. On set up day, the power went out. Today, the power went out again while three patients were on anesthesia. The doctors were prepared to “bag ’em” as they say in the hospital business, but this hospital is old.  I now find myself assisting the doctors. Today, my job was to keep pumping on the hydraulics of a stretcher because it was broken. If I stopped, the patient would drop from the table to the

stretcher.  A door broke today and may never get fixed, a 2×4 is a foot rest on the one and only wheelchair, and yet, somewhat ironically, they are determined to make everyone wear booties . . . we call it “bootie control.”   No one is allowed in the sterile area without booties on. The booties sit in a box, near a line on the floor and when you have to leave, you throw your booties in a box before your cross that line. When you return, you grab booties from the same box which are not necessarily yours. They are quite dirty, it is disgusting, but they think it’s sterile.

Perhaps tomorrow my crew and I will meet the mayor who will give us a tour of the area. Alexandria, the social worker, has her support, and she was here on our first day, so maybe it will happen. We never thought the military would fly us out here but they did.  Tonight the police escorted us while we shot out of the back of a truck through the town of Coca – so you can imagine what the nightlife must be like on the streets (police escort!).

More to come from these amazing people who are here for physic income.

I need to get a rest now. Buenos noches.