Wednesday, March 16, 2011

Santa Cruz

Wednesday, 3-16-11

It’s been another day of learning with the medical delegation. We left around 7:30 for the Canton of Santa Cruz which is about an hour away. The set up crew got to work right away preparing all the different rooms and stations. I chatted with a couple people and took pictures of some adorable babies. At 9:30 the big truck full of the rest of the group arrived. More people from the community came to the school where we were stationed and then one of the translators explained the process of how things would be going.

Today I spent the morning with Tom who does eye exams and fits people with glasses. He gave me an explanation of the system before any people came to our area. When doing exams the doctor always starts with the right eye. Thus, the way the eyeglasses are arranged is according to the right eye. From there you look at the strength of the prescription for the left eye. The numbers for the right and left eye may be positive or negative depending on the person’s vision; are they far-sighted or near-sighted. He also explained that sometimes people have astigmatism or they need bifocals. I don’t have glasses so this was all very new to me. I understood most of what he said until we got to the part about astigmatism and bifocals. Then he was explaining the geometry of the lenses and I got totally lost. Anything involving math is not my strong point.

Then some people began to arrive at our area. Most people start with an eye screening to determine the likelihood of whether they’ll need glasses. Do they have 20/20 vision, 20/40 vision, etc. From there they wait in line until Tom is free. Then he has them hold up a little gadget up to their eyes. There are two little windows where your eyes are. You close the little window on one eye so you’re just looking with the other eye. The person looks at a chart up on the wall. Many people use the chart with all the “E”s instead of letters because a lot of people are illiterate. Then you turn a little dial to determine what strength of lense you need in that eye. Then you switch sides and check the other eye. You should end up with a number for each eye.

From there you go over to the area where the eye glasses are and try to find a pair. The glasses are organized according to the number of the right eye. After you’ve found the section for the right eye you look within that section for the number of the left eye. You grab out one or two pairs (however many you can find of that exact prescription) so the person can try on different styles. They pick one they like and voila! They have a new pair of glasses.

Of course it’s not always that easy. There are some people who have astigmatism or need bifocals so it’s harder to find glasses that will work for them because those prescription lenses are tailored to a person’s specific vision. Throughout this process you’re not only dealing with a language barrier but you also have to take into consideration that most people in the cantons have never had an eye test. Many have never seen a doctor. They would have no concept of what the little device was that you hold up to your eyes. Explaining the process of how we check people’s eyes may be confusing, especially for the older generations.

Thus, it takes a lot of patience on the part of the person doing the eye exams and your explanations have to be comprehensible. There was one older lady today who really didn’t seem to understand what was going on. We tried explaining it to her a couple different ways but she still didn’t understand. Tom made a guess about what kind of glasses she needed and picked out some pairs for her to try on. That was easier than making her go through the process again and again. Other times, like when people need bifocals, there’s not much you can do. You can write down the different strengths they need for bifocals and search but there’s no guarantee that you’ll find an exact match. If nothing else you can always give someone a pair of reading glasses that will help magnify things for them. And with all the cooking and sewing these people do being able to see up close is important.

I had a break for lunch a little after 12:00. We walked up to Oscar’s house where the ladies had made pupusas and vegetables. I was pretty hungry though not a hungry as I was yesterday at lunchtime. We sat inside and chatted with his family. Then something really beautiful happened. Oscar’s wife began breastfeeding her baby. As she was breastfeeding a tiny kitten who was sitting on the ground went over to its mother and began to breastfeed as well. It was an amazing sight! The beauty of two mothers of different species nursing their young together is incredible. For obvious reasons I did not take a picture, but I will remember the wonder of the moment.

After lunch we headed back to the school. I spent some of my time in the afternoon in the lab area asking questions and watching how things were done. They can do some blood and urine testing. The blood work they do is to determine hemoglobin levels and blood sugar levels. The nurse at the lab uses a small, disposable needle to prick the finger and get a small amount of blood. She puts that onto a tab and into a machine that reports what the hemoglobin levels are.

If the levels are low then the person may be feeling weak, tired, and not have much energy. In that case they often give the person vitamins with extra iron. Other than that there’s not much they can do. The person may not be able to afford to eat foods with lots of iron; a lot of people in the cantons are malnourished. One woman who went to the clinic yesterday had a hemoglobin level of 4. That’s scary! Just for the experience I decided to have my levels checked. I was told that 12-16 was good for an adult woman and that 14-18 was good for an adult man. My levels were at 12.9 so I was normal. Good, good.

The nurse also explained the kind of testing they do with urine. The person who gets a test is usually referred by one of the doctors they’d just seen. The urine goes into a plastic baggie and the nurse tests it using special strips of paper. This test can help determine if the person has a UTI, possible kidney problems, or if they’re diabetic. They also do pregnancy testing. I remember one of the women yesterday who had a test was pregnant. She has four kids and the youngest was only a few months old. That’s not uncommon in the cantons. It seems like a lot of women spend their lives pregnant and taking care of babies.

Most of the people had arrived by 3:00pm and we were ready to take the first group of people back by 3:45pm. The ride back was pleasant and almost as soon as we’d arrived I went out to get some more plátanos tostados (toasted plantains). They’re hard to describe. They are kind of dried and toasted, thin like a chip and very delicious. I “took orders” of what the ladies wanted and bought some for everyone. We munched away until a group of students from the University of Iowa arrived with Bob Cook for a visit. We talked to them for a while and they looked through the store at the Pastoral House. We’ll be seeing them tomorrow because they’ll be observing the medical delegation. It’s an early morning so I need to get some sleep!!

8:30am and I'm already eating cookies

The clinic was set up at the school

Before everything was ready

Not sure why she was wheeling around this boy in a wheelbarrow

Kathy getting her baby fix

Too cute!

She really loves babies!

What a sweet face!

A beautiful family

Waiting for the clinic to be open

People start arriving

The big truck arrives

This was a big boy!

Look at all that hair!

An example of the bags the eyeglasses come in

A kit full of different prescription lenses

Tom explaining everything to me

Explaining the device that tests your vision

Another vision testing device

Oscar's house is next to the soccer field

Taking a nap by the corn

Grinding corn is not as easy as it looks

Crank that thing!

Bathroom break

Mommy and baby

Taking a break

Delicious charramusca (like popsicles)

Carrying around the cooler

Sitting with mom

A neat map of the municipality of Berlin

A lovely young lady waiting at the pharmacy

A test strip used in urinalysis

What the different colors mean

The lab area

The waiting area

I think that bike is a little small for you, Doug

He thought Doug was hilarious

Jump, jump, jump, Tom!!


Matt said...

See what you miss out on by not having glasses. It was really interesting to learn about the different exams and tests that the medical delegation does. It's great that they can help the community like that.

Mom said...

I enjoyed learning the procedure for eye exams and getting glasses. How wonderful for the people to be able to see better.