Sunday, May 10, 2015

May 10th: Day 2 of Clinic


As part of the Medical Brigade, GMB@RiceU partners with in-country Global Brigades Staff and Nicaraguan community volunteers to run a temporary, mobile medical clinic.  For my morning shift in the clinic, I got to work the triage station.  This entailed me taking patients’ vitals like blood pressure, weight, pulse etc. while my fantastic partner Olivia handled the Spanish speaking components of collecting patients’ medical histories, allergies, principal symptoms, etc.

 Last year, I did not have a very positive experience with triage.  Not that many patients came through my station, the blood pressure cuffs were difficult to work with due to some mechanical issues, and I didn’t know any Spanish at the time.  This year, my experience was much different and very meaningful.  After warming up my limited Spanish acquired from one semester of the class at Rice, I got the handle of many basic Spanish phrases and could understand a decent amount of what Olivia was discussing with the patients.  I was even able to ask basic questions when I needed to take patients’ vitals, suggest ways to reduce health issues, and casually converse with the patients in Spanish.

Unlike during last year’s triage, I got extremely comfortable with the blood pressure cuff this time around—I manually took the blood pressure of elderly people, skinny people, fat people, etc.  I learned to accurately take blood pressure in one or two tries, even when the station was very loud, which felt very rewarding given my previous struggles.  We saw some pretty weird vitals, with blood pressures with systolic values of over 180 and diastolic pressures of over 120.  Things like this happen more frequently in communities with limited access to medical care or resources needed to treat chronic conditions like high blood pressure, which goes to show why the Medical Brigade is so important on a short-term scale before the community can become sustainable.

On brigade, you have to work with what you have.  And sometimes what you have isn’t as technologically advanced as what you’ll find in an American clinic, but is still enough to get by.  For example, Olivia and I even got clever about weighing an infant using adult scales.  We took the weight of the mom + baby, and then subtracted the weight of just the mom.  Which meant I got to hold a two-month old!  She was adorable J

Speaking of babies, the most meaningful part of triage for me was when my work went directly towards treating a very sick baby.  She was maybe 6 months old, and was brought to the clinic to be treated for recurrent fever.  I took her temperature via armpit, and watched as her temperature reading shot up incredibly quickly from 99 degrees to over 104 degrees in less than a minute.  From there I called the GB staff and let them know the baby needed to see the doctor immediately.  Babies do have higher resting temperatures than adults, but it was still important for the baby to get immediate medical attention. 

They sent her off to do the doctor, and the diagnosis didn’t look too good.  In fact, it took three doctors to come up with an appropriate course of action. They discovered that she had been treated for pneumonia 3 days before, but it seemed as though the medicine wasn’t working (or was even making her sicker!).  It was clear that she was under mild respiratory distress—the doctors observed that the muscles around her ribs were being recruited to assist with breathing, which happens in extreme situations comparable to during a workout that brings a body to the brink of total exhaustion.  In the end, the American and Nicaraguan doctors decided the baby needed to go to the hospital immediately.  Normally, the combination of mountainous terrain, inadequate transportation and/or cost prevents families from receiving adequate medical care in hospital settings.  But Global Brigades ended up using one of their personal trucks usually designated for transporting medical supplies to rush the mom and the baby to the hospital. 

I would much rather have days where there aren’t “exciting” cases like this.  In fact, I would rather there not be a need for GB in a hypothetical world where every community across the globe became sustainable.  But given that these situations exist, it was really rewarding to have played even a small a role in the front line of that baby’s treatment.  If GMB hadn’t been there, that baby would not have gotten the medical attention she needed.  One of the doctors told me that cases of pneumonia in young children can progress from severe to fatal in as few as three hours, and that we were lucky to have caught it at our clinic.


Again, all of this brings me back to GB’s strive for sustainability.  Respiratory illnesses can be aggravated by a lack of proper ventilation in houses with wood-burning stoves.  Taking the steps to implement an eco-stove can help prevent cases like that of the baby that I just described. With that in mind, I look forward to the Public Health Brigade in the days to come.  We will be implementing a set of 3 public health installments in each of the homes of three families within a rural community to help make a sustainable difference.  Thanks for reading, and stay healthy J

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