Jesse and Basketball Team
February 02, 2012
A Day at the Emergency Room –
Today the Emergency Room was filled to capacity. We had a forty-five year old male patient that arrived suffering from a grandmal seizure. His muscles contracted violently, his fists were clenched and he was unresponsive to communication. After interviewing his girlfriend we learned he had been up late the night before, drinking a large amount of beer. We took his blood sugar and discovered it was low. We also learned he had a stroke three years ago but that he was not currently taking his stroke medication. The doctor suspected the patient was suffering from hypoglycemia. He was given a glucose drip and was monitored closely. His seizures eventually subsided and he became responsive to verbal and physical communication. One diabetic patient was having their wound dressings changed on their infected foot while another diabetic patient waited to have his dressing changed. There were a number of children and adults receiving IV drips in order to rehydrate from a stomach illness. The nurses are amazing at finding the blood vessels of children especially under the disruptive conditions. The children are never cooperative with the process and usually kick and scream when the nurse is trying to insert the IV. I help hold the babies' legs from kicking the nurse as she inserts the needle.
As more patients arrived I asked them what is ailing them and direct them to an open bed or a place to sit while they wait to be processed by the senior doctor. While they wait I take their vitals and learn more about the illness. A 65 year old woman arrived today complaining of a terrible headache. Her eyes and back hurt as well. I took her blood pressure and immediately discover she has dangerously high blood pressure. She has a history of high blood pressure and took her BP medication today. After telling the doctor her BP the doctor instructs me to give her half a pill of BP medication to lower her BP.
Los Paramedicos: Jonny and Santos are the paramedics in the ER. They are like the special teams guys on a football squad. They handle everything, transporting patients, delivering IV drips, and suturing big open lacerations. Both of them grew up on the bateys and still live there now. It is amazing how far they have come considering the adversity they have faced living on the bateys all their lives. Every day they welcome me to the ER with a big smile and a fist pump.
Life & Death in the ER – It was a sad day. A 48 year old male patient arrived suffering from a heart attack. I felt no pulse and immediately began chest compressions while the hospital staff rushed to give him medication. Another nurse began to bag air into his lungs as I took turns with another doctor with the chest compressions. Once the EKG machine showed no signs of a heart rate he was declared deceased. His family had arrived at the hospital at this time and they were all obviously distressed by the terrible news. I hope one day the hospital will have a room for grieving because they were upset and there was nowhere for them to go to process this sudden death in their family in private.
February 1, 2012
Batey Landscaping and Playground construction -
Today we went out with the water filtration team to deliver and install a basketball net and flowers to a remote batey far north of La Romana. The batey has a lot of children who will really appreciate having a basketball net to keep them entertained. When we arrive I take a pick ax and swing it into the ground to make the holes needed to plant the flowers outside of the batey homes. The flowers hopefully will make the batey residents feel better about their homes. Others in our group begin to break up the hard clay earth to prepare the ground for planting the sod we have brought.
After the flowers are planted we begin digging a deep hole to support the basketball net securely. The children gather and watch us at work. Some of them have built toy cars from plastic bottles. We finished erecting the net around three today. The sun was hot even for February . Fortunately, there was a winter breeze that kept us from burning up too much. Someone in our party observed how hot it must be for them in the summer.
January 22, 2012
Hospital Construction –
The Maine-Iowa team has arrived. The team has both a first rate medical squad with them that will be delivering medicine to the bateys and a superb construction crew. This week I will primarily assist the Maine – Iowa construction crew complete the outside walls of the third floor of the hospital. We meet every morning on the third floor of the hospital and choose what our primary job will be. The jobs include: moving construction materials like cement blocks, sand, or cement to the wall builders, pulling materials up to the third floor using our archaic pulley system, cutting rebar or mixing cement. The Maine-Iowa crew have brought with them a great attitude and a sense of humor. The day goes by much quicker when your teammates can maintain some levity even in challenging environments. The construction crew has a number of very capable individuals and in two weeks we nearly complete all that is needed to finish the third floor outside walls. It is likely the hospital will have a lot more beds next year.
January 10, 2012
Basketball Practice -
Today is Monday and every Monday, Wednesday and Friday afternoon from two till four I coach basketball with Pedro Maldonado aka Gato. Gato is the patron of basketball here in La Romana. The other day a giant of a man came into the ER to have a cut on his hand sutured. I asked if he played basketball and he responded that he was playing in Europe. I asked if he knew Gato and he said Gato coached him throughout his youth.
I am coaching the 6 to 10 year-olds how to play basketball. Working in the ER is simple compared to coaching these children. It has been a crash course in Spanish and child development. Keeping the attention of 8 year-olds is by far the greatest challenge I have encountered since arriving here in LaRomana. Gato wants me to develop their dribbling skills. Throughout practice we try various dribbling drills with varying success. In Spanish, I instruct the boys to dribble between the cones using only their left hands. I am confident that only three of the ten players have understood or listened to my instructions so I tell them to watch me demonstrate the drill. Again, the majority of players have their eyes gazing anywhere but where I am demonstrating but I am beginning to understand they learn best through failure. Gato’s son has been listening though. Christian dribbles with his left hand but the rest have trouble and I explain to them individually what they should do. It is an exhaustive process that requires patience but I hope I will see them improve. I have learned a lot watching Gato coach. I have learned that sometimes engaging them by asking questions at eye level gets better results than yelling to get their attention. It takes longer but often times it does engage them more.
October 10, 2011
Water Filtration Project -
Since arriving here in La Romana, I have been working in the ER of El Buen Samaritano Hospital. Today, instead of my normal rotation in the ER, I headed out to the Bateys with the water filtration team. The water filtration team regularly visits the Bateys to inspect, fix and install water filters provided by the Rotary Club. According to UNESCO-IHE AndrásSzöllösi-Nagy, 80% of diseases in the developing world are unsanitary conditions and the lack of sanitary water. A recent survey discovered that 50 out of the 53 wells in the bateys were contaminated. Today we interviewed the homeowners about their water filters to confirm they were working properly in addition to monitoring whether they were being utilized properly. A rotation of nurses from the hospital accompanied us on the trip to discuss the importance of drinking from clean water sources and the health hazards of cholera and other waterborne diseases. The batey was very remote. There were lots of children. One six year old boy had a hernia pushing out of his stomach. I have been told this is very common on the bateys. We were all sweating from the hot October day. The batey shanty homes provide very little relief for the people living under the sun every day. It gave me a small appreciation of the daily challenges folks face here on the bateys. To learn more about the water filtration project through El Buen Samaritano, go to their website: http://www.drmissionteam.org/waterfilters/
October 1, 2011
Babies Delivered – One of the surgical technicians, named Junior appeared in the ER and invited me to watch a cesarean in the afternoon. Junior is anything but junior. He is agiant who with his size could play linebacker for a Nebraska football. He would much rather be in the operating room doing what he does best though. He is the hardest working person I know at the hospital and that is saying a lot because everyone works hard here. I enthusiastically accepted the invitation while simultaneously thinking to myself what the heck have I gotten myself into. This would be my first time witnessing a cesarean surgery and I wasn’t sure how I would handle all the blood. I have to say I was happy to know the experience was fascinating to watch and not one but two healthy babies were born. El BuenSamaritano had delivered two babies from different mothers simultaneously in adjoining operating rooms. It was really impressive to see how well orchestrated the surgeons and nurses handled the two cesareans.
September 22, 2011
Another day in the ER - anything but typical.
Today I saw a premature baby in the ER that had been born 12 days ago. She was delivered at the public hospital but brought to Buen Samaritano because resources are limited at the Public Hospital. The mother had abandoned her baby and El Buen Samaritano was doing everything it could do to keep her alive. I’ve never seen anything so small and emaciated. It was obvious that the baby's life was hanging by a thread but she was a fighter. She had lived twelve days as a premature baby and looked like she was defying the odds despite her weakened state. Sadly, a day later she expired.