Isla Popa Dos

Natasha and I on the way to Isla Popa Dos

Day 13/ April 9th: Today, after a long weekend we were back to work! Dr. Benjamin Labrot is finally back on the boat after a few weeks trip home to Cali. It's great to have him back and to finally meet him! He is the person who dreamt up this amazing organization and turned it into a reality. Apparently when he was in medical school he went on a lot of medical mission trips to places like Africa and India. He said the worst feeling was when they would run out of medicine with more people who needed help. The more mission trips he went on, the more his bag became full of medicine and supplies instead of clothes and personal necessities. He sees his ship, the Southern Wind as a large backpack that he can pack full of medicine and supplies and take almost anywhere. It was great to finally meet him. Natasha and I have been here for over two weeks and the whole time Natasha has been joking that he's like Jesus; we never see him but we know he's there :)

Today we conducted a mobile clinic at an island called Isla Popa Dos. It is about a 45 minute boat ride away from Bocas, and is a GORGEOUS ride. There is no civilization, the water is clear, and the mountains stand tall behind the mangroves. We saw dolphins beside the boat both going and returning. You have to know where you are going, because when you get there you may see indigenous people paddling in piraguas, but if not you'd never know there was a village nearby. We boated through the mangrove forests and after turning a corner, suddenly the a few brightly colored shacks appeared at the water's edge. We carried our supplies up the hill as school children ran away from us and back to their classrooms.
To our disappointment, many Panamanians are still on vacation for Easter weekend. School was back in session though, so we started the day with well-child checks for the kids in school. We each saw individual children as they piled out of their classrooms forming a line to be checked. I saw about 15 students, and most were very healthy besides bug bites and not having shoes (Jenny is planning on writing to TOMS to hopefully get a donation for these kids) One boy I saw was about 7 years old and had a fungating mass the size of a pencil eraser on his top lip. It is likely a wart and so we are planning to take it off at a later date.
After the well-child checks, we went tow pavilion up the hill and set up out clinic. Only about 25 patients showed up. I saw 11 and most were pretty standard back pain in women and rashes, worms, and URI's in children. An interesting patient was a 38 year old woman with arthritic pain in most of her body, but specifically her left ring and 5th fingers could not make a fist. She had pain with passive fist formation and pain and tenderness on the medial side of her forearm. She denied any injury and is right handed. After much questioning, we discovered that she washes clothes by hand, with her right hand rubbing against her left forearm. We are still not sure what the exact problem is, but I believe it has to do with her ulnar nerve (it almost seems like an "Ulnar Claw," but it is painful and the lumbricals are not wasted. I gave her a pain reliever called Diclofenac and showed her some exercises to do to stretch out her forearm and fingers. The frustrating thing once again is that I feel the medical care I gave her is inadequate, because if we were in the states I could order an X-ray, MRI or electromyelogram. Someone from Floating Doctors will see her again in the near future though, and hopefully she will be doing better. We will be going back to Popa Dos on Wednesday to follow up on some of the patients we saw today.

View from Isla Popa Dos

After boating back to Bocas, we went to town to see Rafael at Asilo. Today he is doing, much worse. His wounds are about the same size, but he is febrile and pretty out of it. He did not speak but I finally got him to lift his head and slowly sip some water. We think he has aspiration pneumonia, as he doesn't swallow well and now has some rales and wheezing in his right lower lung lobe. We dressed his wounds and changed his bedding. He is now only getting oral antibiotics and IM Tramadol for pain. Dr. Ben told the workers that if he has any difficulty breathing tonight, they should call him and he will walk over with an oxygen tank and mask. We will see how he is doing tomorrow.
Tonight Jenny is making spaghetti for all of us and then I'm probably going to go to bed early! Tomorrow we will be heading to Asilo to do well checks on all the residents, and then we will have our regular Tuesday clinic at the warehouse. I am hoping my 11 year old patient with the foot laceration is running around so I can check his foot.

Buenas noches,
Lindsay