Sunday, August 10, 2014

Stories from a medical mission

This is my column today, August 10, 2014.


She sat in the back row and quietly waited for her turn, aided by a badly sunburned young man in tattered shorts and tank tops.  We had actually already stopped taking in new patients because those that were already in line to see a doctor was already more than enough for the remaining hour.  But there was something in her eyes that struck me—she looked like a deeply wounded animal valiantly struggling to get up and live. 
The young man was a tricycle driver who had just learned about the medical mission, ran home, bundled her ailing mother to come to the medical mission.  She had been having pain in her belly for almost a year already and since six months ago, she noticed that her lower abdomen was swelling.  She was steadily losing weight and was unable to do certain body functions properly.  The first and only doctor she went to pressed a stethoscope to her chest and abdomen and pronounced that she was retaining water in her system; she was prescribed medicines and was told to undergo advanced medical procedures in Tacloban City, a good 20 kilometers away from the town.  She didn’t buy the prescription; her son barely made enough to buy food for the family.  She said the pain was already intense.  Fortunately, we had an ob-gyne expert in the medical mission team we had a portable ultrasound machine.  As I had feared, hers was an emergency case.  She had what the doctors suspected to be ovarian cancer.  Her condition was already critical.  We made arrangements for her to be seen by another team of doctors, this time French doctors who were scheduled to do a surgical mission in a few days in Tacloban.  She and her son wanted to know if it was possible for the doctors to just prescribe medicines instead, which she promised she would take regularly.  The complications of cancer were beyond their comprehension.  I had to make arrangements even for transportation money as well as provisions for the trip to Tacloban. 
In another town, I sat down with a man who was in his mid-forties, but looked like he was pushing 60.  He had been working non-stop for most of his life.  He had been having leg cramps, dizziness and had difficulty seeing, plus a host of other symptoms.  The nurses in our medical mission team took his blood pressure and random blood sugar.  I was stumped.  His blood pressure was 210/140, his random blood sugar almost 300.  He said it was the first time he was tested for blood sugar but he had known he was already hypertensive as early as ten years ago.  When asked if he was taking maintenance medication for his hypertension, he said yes, he took medicines every time he felt that his blood pressure was high which happened about twice a month.  I had to explain yet again what maintenance medication meant.  In the end we had to give him at least six months’ worth of medication.
There was this mother with four children, all of which had various ailments.  The children were showing the obvious signs of essential vitamins and nutrients deficiencies.  After we treated the children, she confessed that she also came to seek consultation for certain ailments.  She turned out to be hypertensive and the doctors in the team suspected tuberculosis.
In the four towns that we visited in four days, we saw far too many children with a host of illnesses associated with very weak immune systems and lack of proper nutrition.  We attended to scores of women—mothers mainly—who were either anemic or had various infections.
And then there were the many elderly people who were hypertensive, diabetic, asthmatic, or had gout, arthritis, and a host of other problems that were not being addressed by regular medication.  In a poor country such as ours, children, women and the elderly are poorer.  When asked why they were not taking maintenance medications or taking the full dosage of antibiotics, they responded with amusement.  Where were they supposed to get the resources to buy medications given that their livelihoods were destroyed by the supertyphoon? 
In one of the towns, we were granted permission to hold the medical mission in the parish social hall.  The parish priest graciously offered to help us with medication – he said there were a number of medicines in the parish office left behind by previous medical missions immediately after the supertyphoon.  We checked out the stash and found boxes upon boxes of high-end and branded medicines including boxes of antibiotic in vials.  Most were already expired.  The parish hall was like a mini-pharmacy and they dispensed medications to parishioners that had prescriptions issued by local doctors but couldn’t do counseling.  This is yet another example of how lack of organization from the top (in this case regional and provincial leaders) results in wastage and how civil and religious leaders often end up taking over and making do with what they can, even on matters they are not qualified on. 
The doctors in our team, mostly Americans, couldn’t understand how people could be so nonchalant and fatalistic about health issues.  After talking to the patients and really listening to their concerns, I understood why.  What options do poor people have but to ignore their pains and ailments and to just rely on faith?

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