Carlos Luis Burneo

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You know how I said this work was hot, tiring and frustrating? Add thankless to the list.

We were awoken at 6am this morning to an explosion of fireworks and the songs of a brass band in the courtyard of the hotel. Thankfully I was already awake and showered otherwise I’m sure my heart would have been pounding, my ears throbbing and I wouldn’t have been able to enjoy the pleasant start to the day. Part of me secretly thinks that the hotel did this on purpose as payback for the group of us who stayed up playing drinking games last night until all hours of the night. I admit that I quietly snicker to myself as they drag themselves out of bed grumbling about how ridiculous this early morning wake-up call is. Not that I wasn’t partly involved in last nights revelries, but I do know my limits (and that I wake up at 6am without an alarm regardless of when I go to bed) and called it a night sooner than later.

This morning our team is stationed at the new health clinic in Carlos Luis Burneo, a poorer barrio outside of Santo Domingo. Although the clinic officially opened nearly three weeks ago (now permanently staffed with an Ecuadorian physician, a nurse, part-time dentist and health-promoter) there has apparently been little knowledge of the clinic outside of the immediate area. Indeed one of the reasons this particular medical brigade attracted my attention was that although I, personally, will be down here short term providing remedies to acute problems and short-term solutions to long-term problems, the clinic itself will be here to provide follow-up care. Shoulder-to-Shoulder, in conjunction with the multitude of various partner organizations in Kentucky and Ecuador, advertised through local community leaders, radio and print media. The amount of coverage this brigade received was overwhelming (and will have to be subsequently altered in the future lest we all go mad) and we arrived to over 100 people lined up around the perimeter of the compound wall anxious to receive medical attention. By “lined up” I mean more or less an unorganized mass of individuals pushing ahead, jockeying to be first and entering rooms as soon as the doors were opened. I am immediately assaulted by a string of questions in Spanish - most of which I probably wouldn’t have known the answer to even if I could have understood them. Where do we go? Are you a doctor? I have this paper, are you a doctor? Vitamins? We had a plan in place, a semi-structured idea of how the flow of individuals and stations would occur, most of which went out of the window as soon as we saw what we were dealing with. Improvisation. That’s the word of the day.

The sheer number of people begging for attention made any sort of set-up difficult, not to mention that many of the supplies had gotten shuffled and misplaced during the relocation from Tsachila to here. The room used for blood-work was small and through an outside door on the side of the building. Plastic deck chairs and cardboard boxes substituted as our workspace. Before we had even located our equipment people began to enter and request the ‘examen de sangre’. I had already broken out into a sweat. The hot and claustrophobic clinic space was made worse by the dozens of screaming children afraid of the lancet or the drop of blood used for the test. It’s curious (in the way that children are) that they would have no qualms shoving their hand into the sharps container, or playing with the lancets up on the “table” while we focused our attention on another patient—but try to use the lancet on them and all hell would break loose. At one point I distinctly remember one little boy hysterical on his mother’s lap, one girl shrieking at the top of her lungs, another child being drug by his foot into the room while he desperately tried to crawl out the door, and three children outside the door crying presumably because the others were. This display, naturally, drew quite crowd and soon everyone in ear-shot tried to peer through the doorway and window to see just what we were doing that was causing such a ruckus (the answer: looking up the words for ‘please calm down’ in a Spanish-English dictionary and trying not to go hypertensive). It’s not that I don’t have patience, or that I do not understand what it’s like to have blood drawn (I too get that squeamish feeling when pricked even though I know what to expect) but on more than one occasion I found myself having to step outside to remind myself of why I am here—that this type of service is not for bragging rights or vacation on my part, but to provide a service on the part of the local community. I am not here for me. I am here for them. Still, I eat my lunch on the bus slower than usual and dawdle on my way back inside the clinic gate. Better care can be given if I’m not irritated and annoyed right? That’s how I justify it.

Things began to slow down towards the end of the day and I was able to enjoy the company of my two little helpers. Like yesterday, we had a bag of small toys and stickers to give to the children after we bandaged their fingers to calm them down and give them something to play with while they waited in line for the physicians. Today we had an assortment of mini plastic cameras and Alex (who had been here for what seemed like hours now—initially just hanging around and now with his mother) was exuberantly taking “photos” of everything in the room. When Karima reminded me that I should take a picture of that, I pulled my camera out from under my chair to see if he wanted a real picture taken. Absolutely! Although he didn’t want me to take it, he wanted to take them himself. Onto my lap goes his little sister (who he was responsible for holding), out goes his hands for the camera, he asks which button to push and away he snaps. Indeed, some of the best photos of today aren’t even mine, but his. After this, Alex and his friend decided to be my helper for the rest of the day. Having watched me do the same thing over and over now, they knew the order I needed everything and were happy to get it for me.

“Good afternoon, senora. Please sit down. Finger please…”

I reach for an alcohol swap but there’s Alex holding one out for me. Thank you…

“Quick little pinch. Let me find a…”

His friend has found me a new curvette. I’ll run it through and get a ….. Alex holds up a band-aid.

We made quite the team. Saved me the trouble and having to bend-down and look for what I needed, plus it helped me earn the trust of the children. After all, if Alex and his friend are in here having a good time, surely I couldn’t be that scary! But I am no favorite by far. One boy (maybe 10?) apprehensively sits down in the chair with brave face. He’s ready for the worst; we can rip off his fingernails, refuses to show any fear! Still, when we inform him that, “This isn’t necessary for you, only boys under five” his poker-face drops and he slumps down into the chair with a smile. “Oh thank god!” and exaggeratedly wipes his brow in relief. We all get a good laugh.

The rest of the day went smoother but towards the end I am still extremely exhausted. It’s only 5 o’clock but I could have fallen asleep standing up had I the opportunity to do so. We are thoroughly beat. I’ll have to synthesize thoughts on the matter later when I have more energy. For now—that’s the play-by-play.

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Photos

Through a Child's Eye
Alex photographs his friend

Exhausted
Body language speaks louder than words

Child with Dogs
It’s an unfortunate truth that there are more feral dogs than healthy children in Ecuador

Dental Clinic
That says it all

Arrival to the Clinic
Lots of lines to nowhere

Examen de sangre
A sanitary place to blood work if there ever was one