Dra. Kim and I spent the first three days of Pediatric clinic at Casa Matena in El Chal and the final two at our clinic in Santa Ana. The number of patients seen was lower which allowed us more time to talk (and listen). This helped us better understand the community needs and how we can better serve them. Between patients we had time to discuss various ways in which we could better communicate with our patients. We are in the process of developing handouts for the most common complaints and later we plan to make audiovisual materials for use at the clinic. We will probably use both material already available on the web as well as making some of our own.
We talked with Katalina about needs for the Casa Materna. She does not have antibiotic ophthalmic ointment for eye prophylaxis, she she may need that. Her newborns also do not receive Vitamin K injection. Oral Vitamin K is available, but is less effective and requires three doses, and I don't know the cost. We may need to do more research to see if we should provide this. She delivered the third baby in Casa Materna this week - a boy. Katalina may also be interested in checking blood pressure or glucose to see if the should deliver in a hospital. I don't know if this is appropriate, but it is something to consider. The clinic is beautiful and the patients really enjoyed it, so hopefully our clinic helped get the word out and her business will increase.
We stopped by the construction site for the new clinic. I was struck by how much larger it looks vs on paper. The men were hard at work under the hot sun and are making rapid progress. I think that it will be a beautiful site when completed. Hansel is doing a great job with planting trees and vegetables. I can't wait to see the finished product.
The "old " clinic still functions well. Kim successfully fitted the shoes that Dr John Lane had made for the two diabetic women. We also were able to do some staff education. Kim demonstrated measuring blood pressures, nebulizer use (for emergencies), and use of bag valve mask for newborns (in El Chal). We discussed some common problems, but have much more staff education to do in the future. Kim also gave a career talk to the students in the clinic. All of the girls want to be pediatricians, but none of the boys do.
We had a pleasant dinner withe Martinez family at La Luna. We discussed potential use of the therapeutic food described in the Herperian book for malnourished children. I also asked Ismael about the current direction of Sewhope - if there are things we are not doing that we should start or things we should stop doing. He feels that we have made good decisions and are moving in the right direction.
At the end of the day Friday, we stopped to visit the Santos family. The boys look good and the new house is wonderful. They are growing tomatoes and raising chicken and have a little pig. They were very happy to see us.
Having Kim on this trip has been a special blessing to me. I am truly amazed at how she has grown since her trips as a med student then resident and now an attending physician. Her expertise in evidence based medicine, patient safety and a patient centered focus have helped shape a vision of how we can better serve the children of the Peten.