Courage

We counseled the mom that her son needed a splint and then, in a couple of days when the swelling went down, he would need a cast on the fractured arm. She wasn't sure about this course of treatment because hueseros (traditional bone "doctors" in Guatemala) often treat fractures and sprains with manual manipulation, distraction, and massage without a cast. It took some convincing, but she allowed us to put on a temporary splint.

We thought that the patient might not come back for the cast, as often patients don't, but the mother did bring her son back 2 days later. The mother told us that many people told her that she should just take him to a huesero, yet against that advice, she brought him back to the hospital and he received his cast.  I was really struck by her courage to make her own decision for her own son, as this is not the norm for people in Guatemala. Family opinion has tremendous influence. We praised the mother for doing what we thought was the right thing for her child.

I saw Christ today.

We had two boys fall out of trees today, both from a height of about 4-5 meters. One had a huge amount of facial swelling, but thankfully no broken bones and the other one had a forearm fracture.

While doing a thorough exam on the second boy, we removed his socks and shoes to make sure we didn't miss any other injuries. He was dirty, his shoes were worn, and his socks were stiff and caked with mud. His family was poor and although he was school age, he was not in school. Public school is free in Guatemala, but the family still needs to provide school supplies, a PE uniform, etc... which is often too much for the family to afford.

A little while later, I saw the nurse with a basin of water washing the boy's feet. He was doing it with such gentleness, compassion, and love. It was Christ washing the feet of one of his followers. It gave me chills and brought tears to my eyes. I hadn't asked the nurse to do this and he had other pressing duties, but he took the time out of his business to touch this boy. He wasn't being judgmental or counseling the boy that he should be cleaner. It was just an act of pure love.

Collage

This collage of pictures come from a local preschool class in Santiago Atitilan.   

It is in the pediatric room in our hospital.  

 
 














I especially like the drawing in the upper right, but I may be a little biased!!  :)

 

Community Outreach

We have started community outreach to two villages near Santiago.   The day starts with a educational talk and then either general medical clinic and/or ultrasound clinic. 

Hospitalito has recently received a portable ultrasound and we have been using this for these outreach clinics. 

Nice Surprise

Had a nice surprise the other day as a medical student was presenting a patient to me,  in the outpatient clinic.  While reviewing the chart, I noted it was a patient we had seen in the emergency room over a year ago after an accident.

Diego Sosof, was riding on the back of a motorcycle and, as is the custom here, without a helmet.   He was going to get medicine for his wife when they were hit by a truck. He arrived at the hospital unresponsive, pupils fixed and dilated and with difficulty breathing.  It did not look good as head trauma in our setting has a very poor prognosis.  We intubated him and transferred him to the capital where patients can be treated for head trauma and where ventilators are available.  After the incident I had heard he had survived but had not seen him and never knew for sure his outcome or functional status.

He informed us that he had spent almost two weeks in the referral hospital with many days on the ventilator.  After he returned home, he had little use of his right arm but after 4 months of physical therapy he now has full use of his arm.  He still feels weak and tires easily but is able to help out around the house and attends church.  His wife works odd jobs to provide for the family. 

Traditional Birth Attendants

In Santiago about 70 percent of all births occur in the house.  Many of these are attended by Traditional Birth Attendants (TBAs).  

Our interaction is mostly when one of their patients is having a difficult labor and come to Hospitalito for help.  We have learned a lot during these interactions and really appreciate all the good work that they do.  

Each month the TBAs participate in monthly trainings where they ask questions and report births. The Centro de Salud, Prodesca and Hospitalito Atitlán take turns hosting the event and a training is provided. The topics range from antepartum care, acute care to   post partum care.  

The last meeting's topic was breast feeding.  These meetings are a lot of fun where there is a role playing and lots of laughter!