The long walk

From Mark last night:

Call was uneventful throughout the night. We had one patient come in early in the morning with stomach pain which was concerning given that she had been shipped out 4 days ago for an emergent appendectomy. Concerns for infection, perforated bowel, gallbladder issue that could have previously been misdiagnosed as an appy. After the docs taking the xray themselves, developing the xray in the darkroom, and giving some mild pain meds, the patient recovered over several hours as was able to go home close by.

I did not stay for the xray, but instead, loaded into the back of a pickup, rolled through the cobblestone and paver streets of Santa Lucia out onto rutted dirtroad leading to a school about 40 minutes away but likely only a few miles up into the hills really. We continued our childhood screening and intervention initiative. Thankfully, very few significantly anemic children. Vitamin A, multivitamins with iron, and albendazole deworming was given for all. I went with one child, a resident doctor, and an interpretor to visit the home of one of the children who lived close by and was diagnosed with asthma. We explained the medications and possible contributing factors to the mother, and she agreed to come to the clinic in about 2 weeks. Many homes have a slow burning cooking fire inside the small 1 or 2 room houses, and we have seen a lot of children and adults with respiratory symptoms.

I took along one of the soccer balls and a pump to the school. The boys and a few girls went crazy over it, careening around a school yard that had large rocks, cement blocks, exposed random metal pieces and trash thoughout it. I asked someone to check to see if we had brought along suture material, but amazingly, the boys just dusted off their various falls and kept playing. Whenever I got the ball, they would call¨Marco!Marco!¨ A great time. I left the ball and pump with the school caretaker for judicious use.

This evening, I took my camera and went out to ¨walkaround town¨ I got a Pepsi Light from the tiny cornerstore for 12 limpera, which is about 75 cents, and went walking. My walk took me through the town square about 5 blocks away and then out of the square on aroad Liz Schlaudecker had recommended as heading up to give a good view of the city. My pepsi long gone, I found myself unable to turn around, and an hour later I was about 1000 vertical feet up in the mountains overlooking the city and the valleys beyond, with the volcanoes once again prominent in the background. I passed a wide range of homes, those with a fence and gate, evidence of a pickup in any state of repair, I now find quite elaborate. As I topped the saddle of the ridge, I sat down for a few minutes to soak up the view, the brightly colored birds, and to slow my rate of perspired fluid loss. My return was delayed as a herd of 20 to 30 cattle were driven by me by a man and a young boy who laughed when I took a picture of his cow. Don´t worry, I´ve had an orange soda and 2 liters of water since returning to the clinica.