Short entry today as there is not too much to share. I went back to San Nicolás this morning to continue my service there. Another morning of check-ups for children and adults followed by another afternoon of health presentations.
The morning was chaotic, though not as much as the day before. I did see a few more interesting and sad situations however. At one point, as I was checking a woman's blood pressure, another lady came up to me, anxious and in tears. I had met this woman yesterday and had heard her sad story of her eleven year old son who suffers from progeria. I had never heard of progeria but a quick internet search revealed that it is a very rare genetic disorder which affects 1 in 8 million live births. It is a disease of premature aging of the body, and most children with progeria die by age 13, usually of atherosclerotic effects such as a heart attack or stroke. Incredibly sad. Today, the boy's mother was crying because her son was having terrible pain in his legs. She had called the doctor and he had told her to purchase an ampule of some kind of medication (I later learned it was a mix of antispasmotics and Vitamin B12). On her way over to the church with her son, the syringe had come loose and some of the medication had leaked into the bag. The woman pleaded with me to give the remainder of the medication so that her son could have some relief. I consulted with Adaia who backed up the woman's story and advised me to go ahead and give the intramuscular injection into the boy's buttocks as this was the preferred site for the injection. Not too many lawsuits around San Nicolás, Colombia, so I went ahead and gave the medication to the best of my ability (I don't give too many IM injections as a NP, but I verified my technique again this evening). This story sounds pretty crazy as I'm typing it up, but así es la vida in a “work with what you have” non-medical setting.
Story number two involved a couple who patiently waited their turn for a consult with me. Their hygiene was not great and their clothes disheveled. The woman's lip was pierced and her abdomen clearly revealed her pregnancy. Somehow they didn't quite fit in with the rest of the people in the room. I asked the woman if she knew when her last menstrual period was, and she reported she wasn't sure. She had had no prenatal care at all due to a lack of any kind of insurance. A consult and ultrasound would cost around 35,000 pesos or $17.00. I measured her uterus to the best of my ability, and she measured somewhere around 27 weeks pregnant. As we talked some more, she and her husband confessed that they were living on the streets and had been using “perico” or cocaine as recently as two days ago. We discussed the effects of drug use on their bodies and the fetus, and both expressed an interest in going to rehabilitation, but were unaware of any free programs. I pulled Adaia aside after speaking with this couple. She stated she was aware of a program that could help and when I offered her the 35,000 pesos to ensure the couple had at least one consult and an ultrasound, she reassured me that she would have someone from the church accompany the couple personally to the consult to make sure the money was spent there. Another sad story…
The afternoon talks today consisted of nutrition, diabetes, hypertension, discussing important topics with children/adolescents, and depression. It was a pretty intense afternoon, and when we approached the subject of depression, the silence in the room spoke louder than words. Apparently there will soon be a program addressing psychosocial needs in San Nicolas, but I don't think it could get there soon enough.
At the end of the afternoon, children and adults alike lined up to give me a hug. We gathered in a circle, held hands, and one of the women in the group prayed for ME! It was an incredibly powerful and humbling experience that brought tears to my eyes and reminded me again of the presence of God among the poor.
On a more humorous note, tonight I decided to prepare one of my grandmother's pasta dishes for Maria Inez and family. Turns out when all of the 5 ingredients needed are not quite the same as what I would use in the States, the pasta dish didn't come out quite the same. It was good, none-the-less, with a slightly Colombian flavor.
I guess I had more to write than I thought…