Through Kathy's Eyes...

Tuesday, July 26, 2005

“Clinic, Day Three: Observations and Reflections”

At 8:30 , the bus pulls away from the home of Missionaries Michael and Denise Mills, and the mission team once more focuses on the day before us. Gary Isaacson leads the group in a devotion and challenges us to think about what the disciples of Jesus did between the time He ascended into heaven and the coming of the Holy Spirit.

We drive into the village of San Francisco , hugging the high hills of a volcano. The village has been developed over a former landfill, and there is a large population of rats. The team members expect no danger to themselves, but are sensitized to the daily living conditions of the village people. As we endure the difficulties each site presents (inadequate plumbing, sporadic electricity—or none, constant dust in the air, unhygienic conditions, a parasite-infected water supply, a decaying infrastructure, and buildings that will surely never withstand an earthquake or volcano eruption), we are reminded that our discomfort is only temporary. We can climb back onto the bus and drive away from this site. Our privilege, our wealth—comparative to most of the world's citizens', our mobility, the protection we bear as citizens of a world power, all insulate us from the kind of poverty and suffering we see around us.

Even while we breathe a prayer of gratitude for what God has given us, we are simultaneously aware that perhaps our privilege is more of a curse than a blessing. The distractions of materialism in an image-rich society, the addictions of consumerism, and the blatant neglect and abuse of our environment are the fruits of our irresponsible stewardship of what God has given us. What we have been given, we have handled carelessly.

And still, God gives us the privilege of coming to these beautiful people of Ecuador to share our medical and spiritual resources. It is a daily humbling to realize that with all of our gluttonous behaviors, God still entrusts us to be faithful to Him. My prayer is that we do not hold our own experiences in America as normative, that we don't judge these people and their lifestyles by the privilege we experience.

If we strip away our material wealth, these people are, in many ways, far richer than we. They have a warm and receptive spirit; they have supportive family relationships; they are governed not by a spirit of independence and individuality that leads to selfishness and an attitude of entitlement, but by a sense of community and sharing.

Once the bus is parked, the team leaders disembark and determine the configuration of the clinic's set-up. Each day's clinic site presents different challenges, but today's site is the best we've had yet. We are in an auditorium with an entrance way consisting of a central foyer, flanked on the right by restrooms and on the left by a closed area that will serve as the pharmacy. Windows with bars open to the outside and into the foyer area. The pharmacist, Kim, and her technician, Ben, are thrilled that the area has only one point of entrance. Keeping the medicines secure, many of which are commonly available, but expensive, is a major concern for the medical team.

Beyond the entrance area is a large open space with a raised stage at the end. The doctors' clinic is set up on the stage, and privacy screens are rigged with parts of a tent. The ob-gyn observation cot is tucked into an alcove at the far edge of the stage. There the doctors receive patients after they have made their way through triage.

One of the visitors to today's clinic was a 7 year old boy with a swollen lymph node and a swollen cheek on the other side of his face. Dr. Julia Richards believes that the boy may have Burkitt's Lymphoma, a disease usually seen in African children, and rarely seen in America . Without a blood test and a biopsy, the diagnosis is not certain, but Dr. Julia suggested to the mother that she take her son to a doctor for a biopsy. If the boy indeed has cancer, chemotherapy would be the prescribed treatment. But for today, the medical team can only pray that the boy gets the necessary care that exceeds their abilities at this make-shift clinic.

Another visitor to the clinic was a small girl with the third and fourth toes on her right foot webbed from the second joint down. Had her great toe been so affected, her balance would have been compromised, but she doesn't suffer from any balance problems. In the U.S. , one might seek cosmetic surgery for the condition, but here it is probably not worth the risk and expense of surgery.

Part of the mission of the medical team is education. Because of the proximity of the sun, the dust and the wind, many of the villagers suffer from irritated eyes and scarred faces. Often the eyes will become encrusted with mucus, and in the worst cases of sun effect, the lenses can be scarred, and even young people can begin developing cataracts. Dr. Stephen Kerley's desire is to inform the villagers of the need for sunscreen, sunglasses, and hats. As he dismisses a woman from the clinic, he says to the translator, “Tell her that when I see her next year, I want to see her wearing sunglasses!”

Early in the clinic today, Dr. Stephen saw a pregnant woman who will probably deliver within a week. She has been receiving regular prenatal care, but came to the clinic today to see a picture of her baby on ultrasound. She was excited to learn that she will soon have a baby boy. Dr. Stephen says that most of the women in this area are not as fortunate as the woman he just examined. He estimates that only 30% get any kind of prenatal care, and of that percentage, only a small number see a doctor. Mid-wives provide the predominant prenatal care available to women. He notes the deficit of prenatal vitamins in the area. While the most common medicines are available here, the cost makes them prohibitive for most people. After examining a young mother and her seven children, Dr. Stephen says, “Contraception is badly needed in this area. IUDs and the pill would help a lot.” Again, the cost of contraceptives perhaps discourages their use as does the influence of the Catholic Church in the area.

Dr. Julia examines a 27-year-old woman, the mother of three, who fell when she was a child and suffered a cerebral hemorrhage. As a result, her left side is greatly weakened, her muscles are atrophied, and she suffers from seizures. Had she received appropriate medical treatment when the accident happened, her health today might be radically differently. The medical team once more understands the urgency of their mission and the need to provide health care for those who might have no other opportunity.

When ICMO began establishing relationship with the missionary station in Quito , the missionaries met with the local government and talked with the community leaders about the possibility of providing health care for the village poor. Because of the quality of medical training in the United States , Ecuador recognizes the licensing of the doctors, nurses, and pharmacists who come with the medical team. Dr. Jonathan Kerley reports that in his contacts with members of the local medical community, they have been completely supportive of the work of ICMO. Because the medical team dispenses a huge quantity of medicine over the course of the week's clinics, I asked Dr. Jonathan if it created any impact on the local pharmaceutical community. “No,” he replied. “The patients we see would simply go without medication. They cannot afford it.” He added that it is not unusual to see patients at the clinic who have been to see their own doctor, and who bring a prescription that they may have carried for months, having been unable to afford to fill it.

At 4:00 PM , the medical team starts packing up equipment after having seen 320 patients. As the medical equipment is wheeled out, members of the mission church starts wheeling in sound equipment in preparation for a service in the auditorium. Many of the villagers who came for medical attention are now seated, waiting for the music and preaching which will follow. And we are jubilant, we are humbled, we are quiet in our spirits, we are gloriously exhausted.