Resumencito

Three and a half weeks of clinic and I am still amazed that it went by so quickly. With six medical students and either 1 or 2 doctors (depending on what week)-- we managed to serve around eighty patients a day on a slow day and over a hundred and fifty on our last and busiest day. It is barely a raindrop in the ocean in comparison to all of the need for medical care in Ecuador, let alone in the world-- but I guess all oceans started off as raindrops...right?
I can't say that every day was easy peasy and that we solved every problem, cured every person. What I can say is that we gave every person our best care and utilized every available resource we had. Suffice it to say there were times when we had to put our hands up and surrender and say-- "I'm sorry there is nothing more we can do." It ripped my heart out to see people accept it when I myself couldn't. You want them to yell at you-- to tell you you are a failure-- and they don't-- they thank you instead for doing everything that you could.

For example, we made a housecall on a family who had asked us to stop in. We'd been told that the father of the house had some sort of leg wound and couldn't make the twenty minute walk up to the clinic which involved many rocky pathways and lots of uphill hiking. When we got to the tipsy house, leaning out over the road, the entire family came down to greet us-- in all about seven children, four dogs, and three women. The children called down to the father who was apparently working in the backyard. About five minutes later, a man hobbled up the precariously steep earth stairs to the road where we waited and then we all climbed up some plywood stairs to the house. He carried his leg like one carries a sack of potatoes-- sort of dragging it up. We all crowded into the one visible bedroom in the house and he sat on the bed with his leg on a small stool. He unwrapped his leg and the smell was like a knife cutting through the room. It was double the size of the other leg and was a mottled grey and yellow. Two large open sores were visible from one side and a third wet sore was on the other side.
Dr. Serlin asked, pointing at the leg, "Cuanto tiempo?" (how long)
"Un año" (one year)
Dr. Serlin looked at Darren and me after examining it further-- "That's gangrene. It's going to have to come off."
I tried to explain it to the family in a way that would drive the importance home-- that the infection could spread and eventually affect his heart, his brain, all of the important organs along the way. They understood-- but kept telling me that he needed his leg-- he worked with the cows and the crops-- he'd already had a surgery on his hip after being assaulted-- he already had enough trouble walking. They thanked us for our trouble and told us they would stop by the clinic again.
Several days later, they returned saying they would not go through with the surgery-- even with financial help-- but "thank you so much for everything you've done, may God pay you for your service."

However, there was also the patient suffering from chronic arthritis who finally was able to move her fingers after years of having them clenched and throbbing who couldn't stop thanking us for giving her her hands back.

It's both rewarding and frustrating to have this opportunity to serve the community of San Martin-- however, is it good enough to just fix the symptoms of another underlying problem? Once the naprosyn, the ranitidine, the lotrel that we gave our patients runs out-- what then? If someone had been able to monitor our patient with diabetes, he wouldn't have ended up with an infected foot ulcer that turned gangrenous and needed amputation.

The Quito Project is designed to address some of those underlying problems-- addressing information on nutrition, social work, tutors-- but we are only there for three months out of a very long year. I wish there were a way that we could help all year long. We are working toward that end-- and who knows? Anything can happen when you have enough gumption, enough idealism, and a creative executive board.