Sunday morning and it was time to meet the newest brigade. Usually Tabby and I meet a little earlier to make sure everything is ready and in place. This time when I got to Cornerhouse, where we do our welcome to the island accompanied by great coffee and breakfast, Tabby was already there with a group of students. It took me a few moments to realize that I was not late, which was my first thought as when the power goes out my clock sets itself to a whole new time zone, but that some students had gotten in early as they were already on the island. Shortly after I sat down, the rest of the group came in. The majority of the students were from Tabby’s Alma Mater, NCNM in Portland. Along with the NCNM group, there was one student from CCNM and two practicing ND’s, one of whom had been here many times and had been in my position a few years ago and so for her it was more like a homecoming. The group was smaller than the other brigades and with four doctors working in the clinic there would be a lot of one on one time with students.
The first day of the brigade was the usual welcome to the island, introductions to the team and their homestay families, followed by tours of the hospital and the clinic and then clinic set up. As the Fiesta Patronale was still going on in Los Angeles and as most were tired from a long day of travel, it was decided class would be done another day so that the brigade could rest or stop by the fiesta to see the bulls or go dancing. Angela and I went to the fiesta later to see if the brigaders were still there but as the torro’s never got started they had all had left, which was for the best as a good nights sleep is just what the doctor ordered for a fresh start in the clinic.
This brigade had a really interesting energy. We started out with three doctor stations inside and the physical exam station outside. The fourth doctor bounced between the other stations for the first couple of days before setting up on her own. Having four stations really speeded things up and we were able to see a lot of patients while not having to be rushed. It was also interesting to work more one on one or with two students at a station and I felt I got to know more about their own style and which modalities they were interested in better. As with all brigades, this group brought down a lot of knowledge, new ideas and much needed medical donations to the clinic. Another thing that made this brigade really special were the patients. Almost all of the patients came from the other side of the island. Although this is a small island relatively speaking, it can be quite a challenge to move about between the different volcanoes due to road conditions and minimal bus service to the various towns and communities. There were people coming to the clinic from towns that even Tabby had not heard of, and she has lived here for over 6 years now. It still surprises me how many people are finding out about NDI and making a very long trek to come and be seen by us.
My favorite day was our third day in clinic. I had a patient come from Alta Gracia, the town on the other side of the volcano, whom I have seen several times. She is a very charismatic and interesting patient, who always makes me laugh and this time she brought her family as well. The relationship she had with one of her children was what really brightened my day. They spent most of the consult teasing each other back and forth and making myself and the brigader working with me laugh the entire time. As is typical during brigades we had several challenging cases come through the clinic. One involved a young child with a fairly severe burn that just as it was getting better got infected as the family thought it was too painful to clean and dress the wound daily. Another was an extended family from the other side of the island that were a challenge to treat due to communication challenges and who were all very malnourished. It is cases like those that really create lasting memories in terms of how basic access to food and education affect health. I still take it for granted that people here don’t eat vegetables, as all I see are fields and fields of farms. I figure that they might not get a variety of vegetables but at least a few basics such as onions, tomatoes, peppers and plantains. However most patients when asked what they eat just laugh and say food, and when pressed further say rice and beans. That is it. It is not a wonder that so many children are undernourished, many look several years younger than they really are, and that everyone who comes into the clinic asks for a vitamin for themselves and their family members.