Medical Outreach: A Day in the Life

This medical outreach team consisted of Dr. Michael (ASOSAP Medical Director, internist, and emergency room physician), Dr. Beth (Pediatrician), and Dr. Eric (Doctor specializing in Facial-Maxillary surgery, and Dentist). Dr. Beth’s son and Dr. Eric’s daughter were also part of the team. They left their lives and generously gave of their time, expertise, and resources. We are so grateful for their dedication. We all worked well together as if no time had passed since our last outreach three years ago.

The days started early, at 6:30am or 7am, and the journey took one to two hours, depending on which health post we were going to. Let’s have a look at how a typical medical outreach day went.

Starting from the Shekinah Center, we all piled into the rented minibus, ready to see what the day would hold. Through San Cristobal the ride was relatively smooth, but soon the bus was slowly bumping along a muddy dirt road filled with potholes. Along the way, the team admired the misty mountains, corn fields, pine trees, tropical plants, and small bursts of brightly colored flowers. They also engaged in people-watching and questions popped up upon seeing how people live and work here. Another blessing of these long rides was that we got to know more about each other and to catch up on the family news of the doctors. Spanish and Pokomchi words were practiced along the way interspersed with periods of silent reflection on the sights, and thoughts about what awaited us.

Upon arrival at the health post, everyone sprang into action – unloading the bus, setting up the clinics, and outlining plans for the day. We knew that, in spite of well-laid plans, the unexpected could happen. Each doctor had their own room, Dr. Michael for chronic patients and Dr. Beth for pediatric patients. General patients were shared between them. Also, an area for pharmacy and a large entry area for the dental clinic. Each doctor had an ASOSAP nurse and a staff person to complete their team. With everyone in place, it was time for the action to start.  

Large numbers of patients anxiously waited outside for their number to be called. Soon the flow of people began. Discussion started with each patient to gain information about their symptoms, health history, and lifestyle. Stethoscopes and other tools for examination were at the ready. With this, the pieces came together and the nurses made diagnoses and decided what medications and lifestyle changes were needed. The doctors were close by, watching and listening. If the nurses needed assistance with a new or rare condition, the doctors were there to guide and share their medical knowledge and experience with the nurses.

Patients came with common concerns such as colds, intestinal infections, allergies, scabies, acid reflux/ gastritis, dehydration, and muscle pain. Other patients presented with more unique and challenging conditions. Some of these were complications after an accident, a rare and complicated wound needing treatment, a facial tumor that had to be removed, and symptoms of diabetes or high blood pressure, which had gone undetected. These patients were started on appropriate medication and enrolled in our chronic patient program.  Each person seen and treated was launched on a path of recovery and restoration of health that they so urgently needed.  

In the dental clinic, children and adults were called in three at a time. Each nervously sat on a wooden chair. Most had serious dental decay and even infections. Dental hygiene is poor to non-existent in rural areas. It was disheartening to see the abysmal state of their dental health. The extractions would certainly bring some relief, but prevention through much education was the real solution. Dr. Eric taught along the way and the nurses did some uncomplicated teeth extractions and dental suturing as needed. Patients then went to a post-treatment area where they were briefly observed and given instructions for follow-up care at home. During this whole time, tools used for one patient were cleaned and then sterilized to be used again safely. There were lots of moving pieces to this clinic!

Around mid-day, we all took a much-needed lunch break to rest and replenish our energy. Huddled all together, we ate and shared snacks. Laughter and conversation flowed as each of us shared how our day was going.

Dr. Michael shared about his joy of seeing a chronic patient whom he has a special connection with. He was one of Dr. Michael’s first patients in Guatemala, a boy struggling with seizures so frequent that he couldn’t go to school. Dr. Michael diagnosed him with epilepsy, started him on appropriate medication, and admitted him to the chronic patient program. As he stabilized, he was able to finish his school and live a normal life.  Now, ten years later, he is a married young man with a wife and child, has a steady job and provides for his family. He is at the point now where he hasn’t had seizures for years and with Dr. Michael’s permission, he has been  gradually tapering down the meds and soon will no longer need them. Seeing him and others succeed like this is a joy and the ultimate goal.

After lunch, the clinics continued. Some patients were identified with a condition needing surgery, such as a benign facial tumor. One man in particular arrived who had been in a motorcycle accident and had some facial reconstruction. Post-op complications occurred. His lower eye lid area was open and stretched. Also, metal that was placed could be seen pushing through the skin near this area. He was in extreme pain and had gone to several hospitals for help, but no one would help him. He hardly left his home because of embarrassment of how he looked. At the end of the busy day, Dr. Eric, with Dr. Michael assisting, performed surgery to remove the metal and close the lower eye lid area. The patient has a long road ahead to recovery, but he is starting that journey. This and the other surgeries that occurred are life changing to patients and their families.  

At the end of the day, we packed all the supplies and loaded them on the bus for the trip back to the Shekinah Center. There it was time to rest and organize supplies for the next day. Each day had its joys and challenges. We felt blessed to be able to serve people through medical outreach. 

We’ll leave you with the words of the two first-timers, Julia, Dr. Eric’s daughter, and Josh, Dr. Beth’s son. 

Josh, age 12:

Because this was my first time, I knew nothing about Guatemala coming into this and I never thought it would look as pretty as this. It’s a beautiful place to experience. All the people are very nice. Something I really enjoyed about working in the clinic, is that even though it seems like what I was doing was very boring, it wasn’t, as I spent the entire time talking to people. I knew that my job (cleaning tools) was very important, because without it we might not have had enough tools to take out teeth. Having that done was very important to the people.

Julia, age 18:

This trip has exceeded any expectations that I’ve had. I’ve had such a wonderful time. I loved seeing the people here and getting to talk to them. A favorite moment is driving through Guatemala and seeing how the people live. Also, the beautiful landscape here, it’s stunning. Then also helping my dad in the dental clinic. While it’s not enjoyable seeing them in pain, it’s great seeing the impact that it’ll have on their future. It’s overall been an incredible experience and I’m so happy I’ve had the chance to come here.