Medical Mission Day

Leo ready to pass out the medicines

Sure we have Amoxicillin - would you like pineapple flavor?  Personally, I think the Philippines, like so many other countries, has a problem with overuse of antibiotics.

Weigh station followed by the que to see the doctor.

Still time for snacks.  Filipinos must eat every two hours to survive.  ;-)

Pick an instrument and pick a tooth.  Note the irony of the "gentle care" cotton next to the extraction tools.  Most people can't afford dental care so extraction is the only option.

After a few minutes of local anesthesia and a good yank ...

out it comes.

We went to one of the local neighborhoods to provide both medical and dental care for those unable to travel to the RHU for care.  It was an interesting approach and I think over 100 medical patients were seen and 30 dental extractions in about 4 hours. 

Stupid travel tricks

#1.  The insects are bad at night and I use a 99% deet spray to help with the bites.  I'm in the bathroom and figure I don't need the light on - mistake number one.  Spray one leg and rub it in.  Grab the spray for the other leg and apparently had it pointed the wrong direction and got a full spray in both eyes.  Stumble to the shower and rinse followed by two bottles of water to the eyes. Swollen, red, and blurry I figure it's the best I can do and go to bed.  Wake with red and swollen eyes but still can see.

#2. Next day: Snacks are sold in larger bags containing about 10 smaller individual sized portions.  After spraying my eyes, I treat myself to a couple snacks.  The next day after returning from work I'm hungry so I grab a bag and open it and dump half the contents in my mouth.  Something feels funny... I look in the mirror and see a bunch of small ants in my mouth.  A quick look in the bag reveals thousands of tiny ants have penetrated the remaining bags.  Quickly my mouth feels numb like a root canal and my lips look like a bad collagen implant.  Shit, I encountered a number of life threatening adventures along the way but I'm going to die from crackers and ants - this sucks.  Searching for options I find 50mg of benadryl that I take immediately.  Ahhhhh, I have 2% lidocaine with epinephrine for local anesthesia.  A quick calculation reveals that I'd expire from a complete heart block from the 1 gm of lidocaine in order to get an adequate dose of epi. 

I'm now headed to a party with swollen lips and tongue, along with tearing and red eyes.  I'm sure the girls will find it attractive.  I'm not sure how I survive these adventures.

Baby #2

I again was able to assist with a delivery and see the differences in practice.  This was a mother who had a prolonged labor with her first child and it appeared this was to be the same but with some assistance, the baby finally delivered.  A couple of differences were that there was a fair amount of manual external pressure applied and second, baby oil was applied vaginally.  I thought the oil was a bit unusual as the deliveries I've been involved with I've been more worried about dropping the slippery baby then anything else.  I was sure this one was going to shoot right out into the bucket.

External pressure

Note the baby oil - seemed to work!

Cord wrapped around neck but easily slipped over.

Seemed a bit blue to me but everyone was calm and she eventually pinked up with some stimulation.

Pig heaven for $125.00

The lechon party on Saturday went well with lots of good food, laughs, and videoke.  Most of the photos were deleted to protect the guilty.

Arrival of pig by trike

Here's looking at you!

4 hours of slow turning by hand

Party girls

It took about 5 minutes to finish off.

Kids

Old chicken saying

Diarrhea lasts only a few days but memories are for a lifetime.  :-)

Chicken head, intestines, blood, and feet

Baby day

Suction after delivery of the head

Drying the infant.

Baby stays on mom's chest for first 30 minutes and then vitals are checked.

On Wednesday mornings in all the health centers in the Philippines immunizations are offered to all the children.  It seems they have a pretty effective program and coverage.  Lots of babies being seen and speaking of babies, I was able to assist in the delivery of one at the infirmary.  Baby was a premie and came in a 2.2kg and was later sent to the regional hospital.

The midwifes are very good at providing both prenatal and delivery care.  I've been very impressed with the quality of health care - especially at the under 5 years old group. 

Clinic and hospital photos

Hospital at Iba

Dra. Abadilla (RHU director) on the right.  She's a fireball full of energy and laughs.

30 minutes old.  5 midwives take care of the 22 Baranquay (neighborhood) which has a total population of ~23,000.  This is at the infirmary in Cabangan where the mother and baby will spend 12-24 hours before discharge.

Lunch time at the clinic

ER at the regional hospital in Iba.  Man in wheelchair was the hacking patient we transported.

EKG - note the suction cups for the electrodes

ER staff

OR suite

New 8 slice CT scan.  Services are usually free but this type of imaging has a cost share by the patient.