El Salvador Mission Trip 2012 - Part 3 -- Seeing the doctor and dentist

Once processed, patients take their seats in a waiting area and are seen by a doctor and/or dentist. If referred, they are sent to a station to get their ears flushed, get an injection, get sunglasses or get their teeth varnished (for the kids).

towards the end of the day, there were few patients left to see

Seeing a patient in El Salvador in a medical missions environment is different than seeing them in the office in the States. It is noisy, busy and there is little or no privacy. There is no exam table. Most patients give their history using terms that would mystify most internists. If you ask them "How can I help you?" they look at you confused and say "I don't need any help!" In El Salvador, doctors ask "Que tiene?" -- What d'you have? That magic phrase gets them talking and interestingly, they all begin with "Fijarse doctor, es que tengo..." (Focus on this doctor, it's that I have...). They used expressions like "tengo nervios" (literally, I have nerves or nervousness), "Mis ojos arden" (my eyes burn) or "me duele mis canas". Through the years, we have figured out that there is a lot of dehydration, dry eyes, fatigue, and perhaps parasite-related complaints.

Getting a history -- the key to a diagnosis



Dr. Dave Heegeman seeing a patient

 
 More scary though was that they would use medical terms in their description of symptoms like "cuando tengo cholera..." (when I have cholera...) or "tengo mucho parasitos (I have a lot of parasites...) or "siento mucho malaria" (feel malaria). This can be quite bewildering in the beginning.



Dr. Thao Trinh, a pediatrician seeing a patient



Dr. Princy Ghera checks a thyroid

One learns to adapt and ask different questions until one is satisfied that one has a story that makes sense.

Thinking it through -- the internist's job




What are we going to do next?

 Dr. Boris and myself are talking to Oscar and his mother about what to do for him after I debrided necrotic stage 3 pressure ulcers.


Rick Mueller (our dentist) and Amy Neumann assisting

 Our dentist Rick Mueller has come with us every year. He brings along a portable dentists chair and a pump compressor unit for suction and a whole slew of instruments. Assisting him here is Amy Neumann who is actually a violinist and information technology specialist, but she learned on the job quickly enough.