temporary gringo

A new doctor is in town, a surgeon from Korea, and after our usual hectic clinic at the Market on Saturday morning, we were asked to take a look at a man who had received 40 stitches in the face after a drunken brawl with a broken bottle.  Apparently the swelling had subsided but his wound was leaking fluid that looked like saliva.  Perhaps the duct from his parotid (salivary) gland to his mouth had been cut.  First the wife took us to the recycling center where the patient was working.  Then we all piled in the taxi truck (me in back) and went back down to the hospital where he could be examined properly.  Kim (the surgeon) removed a few stitches and put in a penrose drain to help relieve the pressure and confirmed what the local doctors had already told the patient; that he had to get to the continent for a specialist to repair the damage. 

For the coming weeks, I will be working with Kim to help translate and hopefully to learn a little medicine (I have been largely unsupervised during my time here, something that has left me feeling unsettled).  My major goal in the few weeks that remain is to develop a plan for our  diabetic/hypertensive clinic to continue identifying uncontrolled/poorly controlled cases and providing care.  To that end, I may have to skip the planned medical brigade trip to the island of Isabela.  Thankfully, however, I’ve already visited and so it won’t be a complete loss!  This way I’ll get an extra week of clinic to coordinate continuity of care with the local healthcare providers. 

Last Thursday night, I was interviewed by the local T.V. station for world health day, to speak about how local people could help to improve their health.  It was a little rough, but I think I got the message across that the most important thing is education and trying to change our habits little by little, to gradually arrive at a more healthy lifestyle.  I also tried to stress the importance of taking care of ourselves so we could take care of our families and teach the little ones good, healthy habits while they are young.  Of course, this all takes time, patience, and consistency to implement, and a brief volunteer position can only hope to build on resources and attitudes already in place.  One thing that has been easy to identify here is the tremendous need for medical skills and public health resources.  

Speaking of the enchanting neighbor island of Isabela, a few of us went over for a quick weekend trip and had a great experience.  We camped at a beautiful little property called Campo Duro in the highlands, with dinner and breakfast provided (from chicken and fruit raised right on the property), and then had an enjoyable (and wet!) tour of the cauldron and the various cinder cones from the recent (the latest within 3 years) lava flows.  Later in the day we had another poor visibility snorkel session, but, we did see turtles, sharks, penguins, sea lions, rays, flamingoes, and marine iguanas.  Our last morning was spent lounging in the hammocks at Campo Duro and later at the beautiful beaches in the main Puerto while we waited for our afternoon boat back to Santa Cruz.  



a close-knit family




Sea-Lion Territory



Sea-Lions know how to relax



...and play



Volcano pix

In a shocking development, we realized we had been booked for a return on the Albany, which had been out of action since last week when she and her crew single-handedly ruined our trip to Floreana after their engine broke down.  Our only other option seemed to be waiting in port until the next morning.  So reluctantly we climbed onboard, stowing our gear within easy reach in case we had to ditch the boat. 

On the way out of the harbor, the captain was zig-zagging around coral banks like a fish fleeing a predator.  I asked him why they hadn’t marked the channel, and he said, “This is a short-cut, I can save 25 minutes this way.”  Two minutes after those words, as we passed the last and gnarliest-looking reef, the boat scraped bottom with a sickening sound (one I know well after my years of trial and error sailing!).  After a concerned silence, the captain fired up the engines, then declared, “Todo bien.” 

And miraculously, everything did work out.  Of course, the boat on which we thought we had been booked passed us mid-channel and was well out of sight (and safely home) an hour before us, but at least we made it.  Well, sort of… when the engines quit outside the harbor just like they had on the previous trip, they restarted without too much trouble and we limped into port.  Part of the reason I am bailing on the planned trip to Isabela is that I don’t want to end up on that damn boat again! 

The rains have been heavy here, and my new apartment has flooded as water comes through the windows and from the unfinished floor above, leaking into the walls.  I caught my neighbor outside and asked her if her apartment was flooding, too.  “Yes,” she replied, with the kind of sarcastic incredulousness that made adding “duh, it’s raining” unnecessary.  Since this incident, I’ve been polling volunteers and locals alike, and it seems like approximately 50% of households do leak when it’s raining.  Other than the foreign volunteers, nobody seems too disturbed about stepping into a lake covering the kitchen or bedroom.  Thankfully, my traveler’s instincts told me to keep my stuff off the floor, and nothing got wet other than furniture. 

Anothering interesting philosophical exchange occurred tonight at the local track, where I was trying to get a little work-out in as the sun set on our exercise group.  Running past a man with a large mongrel off his leash, I was not too surprised when the dog started barking at me and coming toward me aggressively.  Public safety is not high on the priority list for Galapaguenos.

As the dog came closer, growling with teeth bared, I placed a kick just across the hairs on his head that backed him off rather nicely, although I was a little disappointed that I hadn't made contact.  Completely stopped on the track now, facing the owner, I was expecting a bit of remorse from the owner and a perhaps a reprimand for the dog.  Instead, it was I who the owner accosted, "Don't kick my dog!" he fairly shouted at me.  My poor Spanish language skills usually deprive me of a quick comeback, and so I stood there, slack-jawed and awed by the double-barreled attack.  "If you hadn't tried to kick him he wouldn't have tried to bite you" he continued.

"This is a public place!" I finally managed, "that dog tried to bite me!".

"If you hadn't tried to defend yourself he wouldn't have attacked" the man repeated the same perverse logic.  I wanted to explain that this was not an issue of the chicken versus the egg; the sequence was 1) his dog attacked me; 2) I kicked at him to defend myself.  Further, I would have liked to briefly elucidate my belief that his dog should be under control in a public place, that I should be able to run past him without the slightest concern that he might bite me, and finally, I really hoped to explain my urge to kick his *#&%!ing dog the very next chance I got. 

I wanted to say all that, and, given enough time, I might have been able to approximate those sentiments in my gringo Spanish, but before I could even start the dog charged me again.  "Look!" I shouted at the owner, as I moved toward the dog with a rush of adrenaline.  Some protective instinct kicked in and the dog backed off.  "This a public place, that dog is dangerous!" I shouted at the man.  People were stopped on the track, watching.  The man was still shouting at me and not the dog, although he did collar the mutt and put his leash on him.  "you're crazy" I said, and trotted away. 

If a person is attacked by a dog and doesn't defend himself, does he still end up with a gaping wound and a nasty infection?  More in the next installment...