Thursday, March 22, 2018
A patient came in with complaints of headache, eye pain. My heart sank. Another angle closure. However, this patient has had the symptoms for almost a month and was dilated by a local ophthalmologist. Part of the completion of the karmic circle. We closed two angles and then treated somebody else’s. We gave her diamox, pilocarpine, combigan and lumigan and explained that because she had been suffering for a month, that she would have to go to the hospital in Santa Cruz. She would need surgery to permit fluid outflow and then most likely need cataract surgery.
The kids are the most fun to treat. We did not see many the first two days but were fortunate to see a lot of them, especially the last day. Many of the children do not need glasses. Those children are typically given toys and they are so grateful for a plastic toy car and a neon glow bracelet or a couple of chains of plastic beads that cost 15 cents.
We also saw a lot more rural people in the last couple of days. They were much more direct in their concerns. They did not just simply answer yes to every question of do you have blurry vision, do your eyes hurt etc. They very simply stated what their concern was and they were super grateful to be treated.
In the end, we had to leave about 30 people who had wanted treatment without being seen. That is always one of the hardest parts of these trips. But you have to stop somewhere. If we didn’t, we could work 24/7 and there would still be people showing up wanting to be seen. It is a sad but necessary situation.
As we were walking back to the hotel, a woman stopped me in the street to ask us when we were coming back. I truthfully answered that I had no idea. It all has to do with when CRE can coordinate with us, when we are available, when we can get government approval, and where we are most needed. We get this question often. The answer is usually to thank us for our work and to hope that we can come back soon. This woman decided to chastise me for leaving people unattended. Again, my heart sank. The exhaustion didn’t help. I explained as best I could, and said goodbye.
The Chief Justice of Bolivia honored us with a visit. This pleasant woman in quechua dress came all the way from La Paz to tour the clinic and to personally thank us. Natalie asked me to give a short description of what the ODs do and how.
CRE gave a presentation at dinner and discussed how they were accomplishing their goals. They thanked us and generously presented each of us with CRE swag bags; cap, polo, apron, music CDs and assorted other gifts. Natalie was acknowledged with a photo plaque with a picture on either side from the last trip to Bolivia in Samaipata. A photo of her then-teenaged daughter giving a patient stickers in on one side and a photo of Natalie with an adorable boy wearing glasses on the other.
After dinner, we went to a lovely restaurant for drinks and more conversation. CRE announced that they were covering our hotel costs (in addition to everything else mentioned above) for Sunday through Friday. This unheard of generosity meant we paid for no meals or hotel stays, except for the last night back in Santa Cruz.
Approximately 1350 patients were respectfully cared for in four days. They were examined and medications and glasses dispensed as necessary.
I was extremely impressed with my fellow ODs. Jack triaged patients, determining if they needed to be refracted or just needed a medical eye check. Rachel and Emily cared for their fair share of patients as well as taking pressures and instilling drops whenever needed with a smile. Sandy and Jane stayed on the main floor and saw all of the patients who could not make the three steps up to the “stage” area where the other ODs were. Their care was sincere, compassionate and thorough. I examined patients but spent a lot of time translating for others and floating into other areas as needed.
Both students, worked where needed with no complaints. Their examination skills were amazing and rarely needed guidance.
Volunteers are put into the fire and asked to perform important tasks with minimal preparation. Managing patient flow is one of the most critical tasks we have.
Registration is fun at first but can become mind-numbing asking the same questions 350 times a day. Mel gladly spends the entire day providing the first patient contact and giving us the most vital concerns of the patient so we know where to concentrate the exams.
Tracy and her daughter only took minimal lunch breaks each day and performed almost all of the autorefractions for the entire clinic. They were proficient, efficient and warm.
Friday, March 23, 2018
Loaded back onto the bus for a trip to Amboro.
We said goodbye to Rachel and Scott because they are leaving the group to travel to Manchu Pichu.
Encountered a parade blocking the road on the way, acknowledging the day in 1904 that Bolivia lost access to the ocean and became landlocked. Between wars and a president that had a habit of getting drunk and giving away territory, Bolivia lost a considerable amount of territory.
The resort where we stayed was discovered, or rediscovered, in the 1960s when some people stopped to camp nearby. In the morning, their horses and mules had wandered off in search of water and they found them at this pond. We were told that a group of scientists determined that it resulted from a volcanic crater and is about 35 feet deep. The water at the bottom is very warm and at the top is much cooler. After a thunderstorm, the lake rumbles with the change in water temperature. Swimming has been prohibited in the recent past.
We had a couple of hours to explore, sit by the pool or nap before our award dinner. Paul generously bought the beer and wine for the dinner. One of my favorite parts of a trip is when Natalie presents awards. Randall got a multi-colored neon wig to acknowledge his sense of style even under difficult clinic conditions.I was given gold Pom poms for raising people’s spirits while floating through the various clinic stations.
I went to bed earlier than most, wanting to avoid a hangover the next morning.
Saturday, March 24, 2018
Some of us left with a guide at 9:00 for a 2 and a half hour guided tour of Amboro National Park. Vincente showed us grasses that would close up when snapped, roots that the monkeys eat, a flower similar to chamomile that could be made into a tea to soothe a cough and an upset stomach. He pulled the purple flower off of a Santa Lucía plant and showed us how it released drops that would relieve irritation and redness when put in the eyes. Vincente, in addition to being a wealth of information, was a complete goofball and kept us entertained. The sights were amazing.