As a member of the 2013 health care team to Panama, I observed and heard from the healthcare providers about a number of patients. I am using actual cases that were treated on this trip and fictionalizing what it is like to be the patient in these cases. Several dental patients were combined into the dental story.
We as urban dwellers, with internet access to health knowledge, may be better prepared to understand a doctor’s visit, but we both share some of the fears.
Dianne Batzkall
The Very Sick Woman with Pneumonia
I don’t want to be a burden, but I feel so sick. I am breathing fast. Fast, so fast. I can never catch my breath. Even when sitting, the top of my chest keeps moving, moving. I feel weak, but I must keep on walking. It is hard. It has been four hours and at last we are at the clinic. My son sits with me as strangers put things on me. They talk in a language I do not understand. I look into their faces. Some others listen to them and then talk to me and my son. They say I am sick, very sick. These people can do little to help me, that I must go to the hospital in David. I have never been there. It is far from my home, many days to walk.
My son wants me to get well, but he is afraid to let me go. What will happen to me in this hospital? He asks many questions. They are afraid I will die if I do not go. I feel weak and tired. I do not know how I will get back home. I don’t think I can walk there. I don’t know how I will get to this hospital, either. And how can I pay for what it may cost? I have no money.
They say I must go to the hospital. I must let my son go home and tell my family. They have given him bus fare, so that they can come to the hospital.
I am too weak to argue. I wait. My son leaves. I get on the bus with the many foreign people. There are about twenty of them crowded on the bus. It is comfortable and cool, but I am scared of what will happen to me. I am alone, without my son. But this man, Rhett, is someone that my people trust. I must trust him, also.
It is a long ride, maybe an hour to the hospital. They pay for some machine to take a picture of my chest. It is still pumping, pumping fast. It has never stopped. I wish it would slow down. I want to breath slowly again. I want to be able to have energy to stand and walk again. They say I must stay in this hospital. My son will come tomorrow and see me.
The Woman with the Head Injury
I have been walking for a long time with my two young twins. I am having trouble remembering since two days ago I hit my head, when I fell. People told me that I did not move for some time after the fall, that I just laid there. My head still hurts badly. It has a lump, where I hit it. It is painful to focus. I am worried that I may not be able to care for my young children. Who would feed them if I can not work? Who would get them water?
I sit half the day waiting for someone to help me feel better. I must because I have to take care of my children.
When they see me they are using strange things to test my other parts of the body. I tell them that my problem is my head. They use other people to ask me questions. I explain and they listen using these other people who speak to them.
I have come here to have my head fixed and they tell me that it will be okay. At first I do not believe them. They need to do more to fix this, it hurts. I am afraid that I can not remember what happened when I fell. I try to explain again.
Another man, who I have seen before, comes and I tell him my concerns and plead for healing from these people. They must help me to get better for the sake of my family. He helps me understand that it will take time to feel better. He convinces me that I will get better and will be able to take care of my family.
The Man with Trench Foot
I live alone and need my feet to walk and to work in the fields. I have saved for many months and have been able to purchase my black plastic boots. They are hot, but they protect me from snakes and the razor sharp leaves of the pineapple plants which I harvest to provide me income. My feet are sore. It is difficult to walk. What will I do if I can not walk? I can’t work, get water, and seek help from others. I must endure the pain and see if these people at the clinic can help me.
They are going to take my boots off. I haven’t taken them off for days, because it hurts too much. There are many sores on the bottoms of my feet and cracks between my toes and my boots protect me from the many rocky paths that I walk each day. The pain is unbelievable as they pull my boot slowly off. I feel my feet are stuck inside and have become part of the boot. A strong smell comes out of the boot with my feet. My feet look bad. I am afraid because I need my feet and they look very sick. These people turn away from my feet as they come out of my boots. I turn away also. They look horrible and the smell. I am afraid. Oh! My poor feet, what have become of you? They clean and soak my feet. They still hurt, but I can see parts of my old feet. But I also can see the damage. The skin is cracked between my toes and is very red. Areas are swollen and of un-natural colors and hurt. They rub something on my feet and wrap them in bandages.
They ask me if I have socks. I can not afford socks. It took so long just to buy my boots. Besides, socks are hot and my boots are already hot, why do I need socks?
They wash my plastic boots. They say I must take them off every night and clean my feet and boots. They say the socks will prevent my feet from getting sick. They give me the medicine to use on my feet. They want me to return in two days. I say I will.
I have done as they asked and my feet are looking and feeling better. I return to the clinic and they inspect my feet. They are soaked, medicated and treated. They give me socks and two pairs of shoes to keep my feet healthy. I will be able to continue working and living well with my healed feet.
The Dental Patient
Most of us don’t smile. What is there to smile about? Our life is difficult, we have joys, but if you see someone smile, you may see their gum and no teeth.
I am about twenty three and have much mouth pain. I have been to the dentist once. He filled a tooth and pulled one. Now I have injured my front teeth and have much pain on both sides of my mouth. I hear there is a dentist at the clinic.
I leave my home at 3 am. It is a long walk to the clinic. It is a bad time to travel as there is only a small crescent moon and there are no lights on the trails. The trails are very rocky, dusty and have the occasional cow or horse droppings, and snakes. But this is a mountainous country and one can easily slide down and be injured.
I must bring my children with me as there is no one at home to watch or feed them. Their father is away at work.
I dress myself and the children in their best clothes. I have carefully ironed these using an iron with the wood fire I build everyday to cook our food.
I carry the baby and the two other children walk beside me on the trail. We stop every so often so that I can breastfeed the little one. The other children and I look forward to a meal and water once we get to the clinic. This is one of the few times I do not have to gather water and cook for the family.
We arrive around 11 am and were in time for the meal. The children have an opportunity to play with others. There are balls and other toys that they have never seen. They even see pictures that move and tell stories. It is good to see them laugh and have fun.
I wait. It is good to just be able to sit with just the baby. Usually, I have many tasks at home. But I am worried that I have walked so long and that there are many people ahead of me to see the dentist. But I will wait my turn.
It is now 4 pm. My children have returned, as the children’s area is closing and everyone is going home. I have not yet seen a dentist.
A foreign woman is pointing at me and my children and then walks away. I just sit and hope that my long journey will not be in vane.
Then the foreign woman returns and walks me and my children to this building and I remember the dental chair.
I am asked about my pain. The dentist asks if I want to keep my front teeth or do I want to have them pulled. He says it will take longer if I want to keep them. I say I have time. I would like to smile and see teeth instead of gum.
It takes more than two hours but I have what the dentist’s calls root canals, a fillings and the removal of a back tooth.
I cannot feel anything and my mouth is numb. Water leaks from the side of my mouth. But the dentist says I will feel better in a few hours.
It is 7pm and dark. The Panamanian lady at the clinic says that I and my children can sleep on the floor, under the roof, of one of the buildings until morning and we can walk home in the light. She has given us food and water while we are here. I am able to smile.
The Orphan
I watch the new foreigners as
they come off the bus with their bundles.
I want to find the good ones, ones who like children. They come every so often and if there are
good ones, I have fun.
I watch what they look at. Some are immediately looking at the
children, others the buildings or busy with themselves. I stand behind the tree and watch.
When I figure out who may like
children I run up to them. “Hi! I’m Estevez.” If they look me in the eyes and smile, it is a good sign. Some will speak to me and I don’t
understand their language, but some I can understand.
Some will ask, “Where is your mother?” I have to explain that I don’t
know. She left two years ago when
I was four. She said she was going
to look for work. She had to,
because my father became ill and died.
We needed money for food.
But she never came back.
She left me with my grandmother, her mother.
My grandmother is a good person,
but she is old and it is hard for her to have enough to take care of herself. Now she has to take care of me. I try to help. I go get water from the river. It is brown. It used to make me sick with diarrhea until someone came and
gave us a special bucket with a tube.
Now the water is not a problem.
I help grandma in the
garden. We grow things, like
Yucca. I dig it up and grandma
cooks some to eat. I also collect
the cashew nuts and fruits.
Sometimes I catch fish at the river.
We have chickens. The strong one looks good. The others look like they are bald on
their neck and other parts of their bodies. The strong one picks on them because they have bugs in their
feathers. We have lots of bugs. Sometimes
the foreign people say I have bugs.
My hair and skin itch, but that is normal. Maybe I’m like the weaker chickens in that I don’t look as
good as the kids with parents. My
hair stands up and isn’t combed. I
have scratches, where I have fallen down.
I have no shoes and my clothes don’t fit.
But grandma lets me go to the
clinic when we hear that the foreign people are coming. She lets me do my chores early so I can
go and have fun.
Sometimes I find a good person
and they give me a hug. They lift
me up in their arm like my mother did and I feel wonderful. Those are the ones who I don’t want to let
go. I grab their legs and they can barely walk. I want them to see only me and not the other orphans.
Some of these good ones bring
toys and play with us.
Sometimes things I have never
seen: things that will leave
pictures on paper in colors, boxes that show moving pictures or make musical
sounds. They even showed me what I
looked like on this flat box.
Now that I have found the good
foreigners, I will stay all day, as long as they are here so that I can have
fun. I will come back every day
until they leave.
The Village Healthcare Worker
I have always been interested in people and why some
are healthy and some are sickly. I
have listened to the wise ones in my village who treat the sick with herbs and
other methods. Some work very
well, but sometimes nothing changes.
I have asked them what to use for this sickness and for that, so that I
could use it with my own family. I
watched and learned when babies were delivered and grew and tried to figure out
what kept them strong.
The foreigners came and started
treating our people with other methods.
They even made some buildings where they would come ever so often, but
not often enough.
Years later they asked if anyone
wanted to learn some of their methods so that we could help our people. I wanted to do this but had to ask my
family if they had time for me to be away from them. There is so much work to do here, just to have enough food,
water, and care for the children.
They agreed and I was
trained. I learned how dirty water
makes people sick, how to identify certain illnesses and how to treat
them.
It is now my job to teach my
people to stay healthy: not to
smoke, not to put coffee on babies teeth as an anesthesia because it will rot
their teeth, to use the water filtration bucket for the drinking water, and to
do many more things.
I love my job and wish I could
do more. I would like to study
more about health and become a nurse or doctor, but this is not taught on the
reservation. I need to go miles
away to school. I do not have the
money for bus fare, let alone tuition.
It is my dream to help keep my people healthy. I will take every opportunity to learn about health.
The American Volunteer
I was bored with my life and tired
of the same old routine. My local
volunteer activities weren’t giving me the satisfaction I craved. In fact, I was becoming jaded by what I
was seeing around me.
I didn’t know if I could handle
the extreme conditions that these people live under, but I knew I would have at
least a “normal” dinner and an air conditioned hotel room to return to in the
evening.
I would be going to an
established medical clinic with a group of people who had been there before and
had helped those in need. It was a
relatively safe bet, even though this trip is through a church organization
that doesn’t endorse gambling!
These devoted medical experts
had it all figured out and I would be a helping hand to them. Where and how weren’t spelled out in
stone and I had no mighty goals or expectations. I had hoped to: Take one day at a time. Try to look on the brighter side. Not get bogged down in the magnitude of
life in extreme conditions. Count
every smile seen as a major accomplishment. Not dwell on one problem or
personality. Be flexible. Be a team player.
These are the lessons of a rooky medical missionary:
Pack a small carryon bag with
all your needs for the trip and then pack a 50 pound bag with medical and other
mission supplies. Make sure you
can tote your two pieces of luggage and be prepared for the wheels on the
luggage to want to go opposite to your direction.
Learn to love beans and white
rice. They are delicious, mildly
spiced and as basic as bread is in the States.
Those multiplication tables you
memorized in grammar school are essential to counting tablets when packing pill
packages for Pharmacy. I was a
slow learner: I started with
binary: 2, 4, 6… 60 for the morning packing. When we switched to needing 90 tablets to a pack, I knew I
needed to up my game and use my advanced math skills: 5, 10, 15…90. Later, I was doing 10 pills at a time!
God help those kids who learned math using a calculator!
Keep drinking water. Keep
hydrated. It’s hot, you’re hot and
you definitely want those beans and rice to keep moving. You can guess at the
complications even if your not medical personnel.
Eye glasses are not a
right. I have been seeing since
the age of nine because my family could afford eye care. We could change a person’s life by
giving them a pair of reading glasses!
The person, who squinted at a chart that they could not read, left with
a broad smile when they could distinguish the characters on that chart. Alleluia, life is GOOD and all is well
with the world.
Though you want to solve all the
person’s problems, you may only be able to solve one and it may be a minor
one. For example, you can give
someone some worm medicine but if their water supply is brown, it is only a
temporary fix that will return.
There is hope for a larger fix in this case, as our local healthcare
workers can give them water filtration materials and teach them how to use
them.
The dentists would have liked to
have given crowns or teeth replacement instead of just pulling the teeth. However, equipment, facilities, and
time did not allow for this.
We were able to give sunglasses to
the adults to prevent the further growth of cataracts but also should be giving
them to the kids to prevent cataract growth. Suggest to the next team to bring kids sunglasses.
Kids are the same throughout the
world. They love to play and have
fun. They may come to us with
stoic faces, but can leave with a smile.
They need hug or at least a smile from us.
Everyone needs to eat and
drink. The clinic staff not only
made us lunch, but they made lunch for every patient and visitor to the
clinic. They probably needed it
more than most of us. Some patient’s
started walking from home at 3 am.
These folks don’t need health club memberships!
Stuff that we throw away is of
value to others. Medicine jars can
store food or act as toys. The
magazines and books we finish can be looked at by others. Our clothes and shoes can be
repurposed.
Remember all the local people
who work with you to support your efforts. You wouldn’t be able to accomplish your goals without their
help. They deeply love this mission.
If you, the volunteer, become
ill, you don’t need a referral.
The whole medical team can advise you and there are free meds for that.
If you thought you were jaded,
before, when looking at life in The States, at least you’ll have lots of research
to back up your theory upon your return.
So if you have the
opportunity to go on a mission trip, follow the Nike saying and “ Just Do It”. Put on you Nikes and then donate them
to the people when you leave.
You will rejoice in your
small but mightily meaningful accomplishments.
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