Tuesday, January 3, 2012

Lauri Pramuk, MD - Help out of the Moat

Lauri is a pediatrician with Group Health Associates in Cincinnati’s Kenwood location.

Today was another day full of grace in Guatemala. Having spent the week here last March, I had some idea of what to expect, but still found myself filled with awe many times. Today was our first day to travel to Patanatic, the community where we do the clinic, and our main event of the week. Last year the clinic was not even built. Today, just 9 months later, we were overjoyed to find a real clinic - exam rooms, pharmacy, lab, even a dental room! The floors are installed and the walls are up. The building doesn't yet have electricity, so extension cords are run throughout to give light here and there. It also has 2 bathrooms, but unfortunately neither has working plumbing yet. It will be an interesting week of clinic with no toilet, but it could be worse.

We spent the morning organizing our supplies. We brought thousands of dollars of mostly donated medications and some 300 pairs of donated eyeglasses. The students looked like squirrels preparing for winter getting the clinic set for open of business tomorrow.

The afternoon, however, was the real highlight. We divided into four groups, each led by one of the medical professionals. Each group went to a different sector of Patanatic and made house calls - in-home medical visits to community elders and those who had recently been on prescription medications. Prior to this adventure I was intimidated by the fact that, as a pediatrician, I haven't taken care of adult patients since I was in training 14 years ago. Assuming the home-bound patients would be mostly elderly, I brushed up on some adult medicine from colleague Dr. Richard (who is the best and most humble physician I have ever met). My team of Lia, Christian and Annie, led by our guide, Maricella, trekked up the steep mountain of Patanatic to the highest sector. When we arrived at the top of the mountain (completely winded from the steep grade), you can only imagine my delight to find our first home visit patient to be a 17-month-old boy! Right up my power alley! He needed follow-up for a recent throat infection and had developed diarrhea from the antibiotics. He was doing fine, but I discovered he was infested with head lice - probably our first case of many this week. We have plenty of permethrin to treat him, thanks to our phenomenally-stocked pharmacy. Our next visit had me donning the internal medicine hat for a beautiful 79-year-old woman who turned out to be completely healthy. She even out-walked us on our way back down the mountain a few hours later!

The groups returned from the house calls full of energy and amazing stories. They have now been in the families' homes, talked with them, shared stories, and seen how they cook in primitive stoves. The homes are made of cement, cinder block, and tin. The students saw how chickens, dogs, and cats live inside the homes as much as they do outside. In fact, as my team was walking down the mountain, I stepped over a grate in the road and heard a tiny peep. Looking down, I found a tiny chick stuck in the moat of the grate. We lifted off the rebar and I jumped into the moat, chasing the little chick until I caught it. We placed it back on solid ground and continued on our way. That little chick needs to grow up and make eggs to feed one of these families, which she can't do stuck in a moat. Sometimes we all need a little help out of the moat. This week in clinic, we get to help the people of Patanatic find a path to better health - find their way out of the moat.

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