Santos Viernes

Day 9/ April 5: Today we had a pretty leisurely morning. There was not much to do until it was time to go to Asilo for our regular outing. I spent the morning reading on the top deck of the boat and then we took the panga into town for batidos (Spanish for milkshake). We boated to a nearby beach where we had the entire beach to ourselves. In the afternoon we took the panga to Asilo and Hanily and Jordan took some of the residents on a walk while Natasha and I took care of Rafael's wounds. I debrided a lot of necrotic tissue and am hopeful it will look a tiny bit better tomorrow. Next we headed to clinic at the warehouse.
Today was not very busy at clinic, and I saw only about 5 patients. I saw a 40 year old woman who was worried she was pregnant because her period was 10 days late. She had taken a home pregnancy test that was negative but was still worried because her periods are always regular. I decided to do a quick ultrasound and to our relief, her uterus did not contain a pregnancy. I will see her next week if she has still not started her period. I'm not sure how much investigation I would be able to do because most of the labs I would need to order cannot be done here at the Bocas hospital.

Another interesting patient was an 11 year old boy from la Solucion who fell and cut his foot open on a bottle. Most kids here do not wear shoes and the ground (in La Solucion especially) is risky for all kinds of infection. I cleaned the laceration and used steri strips to close it before bandaging and wrapping the foot with an ace bandage (my best attempt to keep dirt off it) I asked him where his shoes are and he told me he doesn't own any. We didn't have any spare shoes in the warehouse, so we put his foot in a ziplock bag and sent him on his way. I asked him to come back tomorrow with his mom so I could check his foot and talk to his mom about buying some shoes.

After clinic at 6pm we held our weekly English class. A lot of kids showed up! We taught them the verbs, "to want" and "to have." It was the cutest thing watching them all enthusiastically yell, "I wan a mango!" and, "she needs ice cream!" After English class we headed back to the boat and are now about to go for una cerveza. Buenas noches!

Lindsay






Day 10/ April 6: Today is "Viernes Santos," which literally means saint Friday, but it is their equivalent of Good Friday. There is no school and there are a lot of backpackers and "tourists" from Panama City in town. We were supposed to be having a mobile clinic in Bastimentos, but we are not working because most prospective patients are not around to come to a clinic, and kids are not in school so we could not do the well-child checks like we did in Solarte. We are celebrating Passover at one of Lori's friend's dock, so we have been cooking and for most of the afternoon.
This morning Hanily and I went to the warehouse to see our patient with the axillary abscess and the boy with the foot laceration. Neither showed up. I went looking for the 11 year old boy in La Solucion, and finally found a little boy who knew him. The boy showed me to his house and a woman was standing in the door. I asked her if Valencio, the little boy who cut his foot was home and she said yes and pointed behind her. Then I heard another adult say something behind her, and she suddenly said "no, no esta aqui." Confused, I asked if she knew where he was, and she said no she did not. Defeated, I went back to the warehouse. I learned later that the government pays families based on how many children are in the house.  Apparently many mothers take extra children into their homes even though they cannot afford to care for them, just so they can get the extra money. Jenny thinks that the family did not want me to come to their house because they were afraid I would report the unsanitary living conditions and get their kids taken away. I will likely see the boy on Tuesday because all the kids from La Solucion come to our warehouse to play when we are there. If not I may go look for him again, but preface it with letting her know I have no bad intentions.
After the warehouse we went to Asilo to see Rafael. To my great disappointment, his wounds look worse. The part I debrided yesterday looks good, but now on the other hip he has a lot of pus draining from deep inside the leg. We did our best cleaning, debriding and dressing, and will go back again tomorrow. I honestly don't think he is going to make it, but we will not stop trying to palliate his wounds.
It's almost time for Passover dinner, so it is time to finish cooking and head across the water.

Adios,
Lindsay