Something

Who said: “I can't do everything but I can do something.”?* Whoever it was, it’s how we steer our star down here in Santo Domingo, Ecuador.

I met Rene, a little boy 6 years of age, a couple of months ago. He has spina bifida, a birth defect involving the spine, which has left him paralyzed below the waist. He can’t use his legs and can’t control his bowels or his bladder. In addition Rene has hydrocephalus, which occurs frequently with spina bifida. In the US, he would have had an operation for it by now, a “shunt”. Here in Ecuador, the family couldn’t afford it--about one year of dad's salary--so it hasn’t been done and his head is therefore bigger than you’d expect. He’s an engaging, bright-eyed little guy who loves attention.

Spina bifida is certainly a tough go for families, even in the US, and much more so down here. Mom, dad, Rene and his older brother Diego live in a little apartment behind dad’s automobile repair shop in a neighborhood near the clinic. He was getting around in the apartment by rolling around on the floor. While we were talking with his folks about his problem that first time at their place, his mom began to cry quietly and Rene looked confused, not understanding why the fuss.

Jamie Strawser, a friend and physical therapist, brought Rene his first wheelchair last month. She was here as part of a brigade made up mostly of faculty and students from UK. It was quite an event, and a little crowd formed in front of the clinic as Jamie adjusted the chair, passing on instructions and tools to dad, mom crying in the background—she wasn’t the only one—and Rene, he was smiling, happy and excited about his new wheels. It wasn’t everything he needed, but it was something.

*Frederic William Farrar (1831-1903), canon of Westminster and later dean of Canterbury. The complete quote is : “I am only one, but I am one. I cannot do everything, but I can do something. What I can do, I ought to do. And what I ought to do, by the grace of God, I will do.” This quote has also been attributed to the American Everett Hale (1822-1909), religious thinker and writer from Massachusetts, who also said (my favorite): “If you have accomplished all that you have planned for yourself, you have not planned enough.”

Nieve in Ecuador - Rich Letter #2

If you turn right out the front gate of our clinic, right again where the sidewalk ends, and walk carefully four blocks on the muddy road lined by hibiscus bushes up the hill, after a turn or two, you’ll come to Nieve’s house. The first time Mercedes and I visited her, Nieve couldn’t get out of her bed. She could hardly move.

I love doing these house calls with Mercedes, our community nurse. She’s in her element out there and everyone seems to know her and love her. Your patient list has a way of growing when you’re out visiting homes with Mercedes. Recently she recruited me to visit a little girl badly burned on her leg but when we finished with her, 2 or 3 more folks needed a visit. Knowing you are in the neighborhood, people will flag you down and off you go.

Anyway, Nieve is better now, on medication for her severe rheumatoid arthritis, provided through the help of our generous benefactors back home. She now limps on her walker the four blocks to the clinic every week to get her methotrexate shot and have her blood pressure checked. She’s a very positive person, doesn’t complain much about her lot in life. We aren’t able to solve all of her problems, but she’s grateful she can walk again, and so are we. Thanks for making it possible!

Letter from Ecuador #1 (Rich)

June 22, 2008

We got caught in a torrential rain the other day while Cristian, my colleague at the clinic, was driving us home. He’s our young, excellent and hard-working Ecuadorean doctor who sees the adult patients while I see the children. Driving through the rain, he observed good-naturedly that we really weren’t supposed to get rain like this now that summer, theoretically the dry season, had arrived. The passage of the (two) seasons here at the equator, however, is a pretty nebulous concept. Winter and summer are pretty much interchangeable. Winter is warm, humid and rainy, and summer is warm, humid and slightly less rainy. I joked that really the only two seasons in Ecuador were mud and dust and everyone laughed in the usual Ecuadorean way. There is so much here to laugh at, they get pretty good at it; the weather, the water supply, the economy, the crime rate, the corruption and the many unpaved roads being only a few of the possibilities.

Despite it all, or maybe because of it all, Ecuadoreans are hopeful people and our days at the clinic are filled with hope. Rocio, our nurse, and I were talking last week about the unacceptable number of children we are seeing with malnutrition—24 children just in the month of May. We have a supplemental feeding program which keeps most of the kids 6 months to 3 years of age reasonably well-nourished, but still some are falling through the cracks. She thought that organizing group meetings to provide education and support for the families with malnourished children would be a good idea. We’ll also be doing monthly weight and infection checks. Mercedes, our new community outreach nurse, will be visiting the families at home, checking to see whether the family needs food and how the feeding is going. We also have a little money to buy food in emergencies when families are going through rough spots. Hopefully—there’s that hope again—we can start getting these kids back on track nutritionally. Thank you, friends and family back home, for helping to make our hope possible.

Marcelo and Maria

Marcelo, who is four months old and blind, went home on Friday. He and his sixteen-year-old mother Maria came to CRN five weeks ago, following his two week hospitalization to recover from malnutrition. I don't know the cause of his blindness; local doctors are saying he needs an operation within the next few months in order to save his right eye, and that the left eye is a lost cause. Hoping for a miracle if not a possible mis-diagnosis, I have sent pictures to an ophthalmologist friend in Lexington, hoping that she might have a suggestion or lend some insight into why the medical advice has so far been very inconsistent. Marcelo is a real peach -- good natured and pretty straightforward in communicating his needs: a real stroke of luck, since his mom required some major on-the-job training. Thankfully, Maria rose to the task, learning a lot from being with other mothers and the CRN staff. She and her son are a disarming pair, and I'm looking forward to seeing them both at his first check-up (today!)

Laura and Friends

Last Thursday Laura Grabau, a UK student who is studying in Quito for the semester, came to Santo Domingo with three other US college students to volunteer at the clinic and CRN during their spring break. The Hombro clinic was closed for Good Friday, so the six of us gave the reception and waiting area a new coat of paint and some of the girls got started on setting up a better filing system for patient charts. By the time the students leave tomorrow this latter job will be complete - a huge accomplishment which would have taken the staff weeks or months to get done. The picture shows Rich and the workers after the painting was finished, all holding their "good patient" award stickers. Laura is furthest on the left.

We took the group out to the Tsachila festival (previous post) and to the Easter vigil service at the Agnus Dei monastic community, a liturgy beginning with the traditional fire at 3:30 a.m.(!) None of the girls is Catholic, but they will never forget this Easter, I am sure.

Tsachila Indians

The Tsachilas, a community of Colorado Indians (from whom Santo Domingo de los Colorados got its name), had their annual festival this past weekend in Chiguilpe, a pueblo on the outskirts of the city. The Hombro clinic may start sending a medical team out to the community, whose people are among the poorest of the poor here. Rich and I took the bus out with our four house guests and spent a few hours sampling the food (we took a pass on the grilled grubs, though a couple of the college girls tried them), looking at handicrafts made from seeds and wood and cotton, and watching the entertainment - music and dancing and a drama about global warming....a sad irony that this society which has left no footprint at all on the earth should have to be concerned about this travesty. The pictures above are of two Tsachila girls, two American men (Rich and Trent Blair, a Peace Corps volunteer from South Dakota who has been working with the Tsachilas) and a group competing for "best dressed Tsachila". Their red hats are actually their hair, which they coat with a substance made from the red achiote seed.

Follow ups

Here's a new picture of Luis, taken last week, a little more than two weeks after the picture I posted last week. He has made great progress, though he still has a ways to go. This week, due to school matriculation for the older kids and the Holy Week holiday, Lucia is not at the Center.

Rich and Corrinne requested a follow-up on Daisy. I'm sorry to say that I don't have any recent info about her. We went back to the family home several weeks ago to check on her; she had gotten bigger and looked very different, but we didn't have a scale so I don't know what she weighed, and the mother has not brought her back to the clinic to be re-weighed. In spite of the social worker's threatening to remove the child from the home if the mother didn't bring the baby in, the fact is that it's a terrible burden on this mother to come back with any regularity--more than a two-hour bus ride each way at a total cost of $5, which the family can ill afford, plus five other children at home. One of these days the social worker will go back out.

Lucia y Luis

For the last two weeks I have been helping out with Luis, a now three-month-old baby who weighed about four pounds when he was born and hardly gained a thing in his first month at home. So he spent 3 weeks in the hospital and then came to CRN. When I first met his mother she was sitting on the edge of the bed with tears running down her cheeks, despondent over her situation - missing her other children who were at home, the house she shares with a sister and brother-in-law and their children. She said that her sister doesn't love her (Lucia's) children, and the father of the baby "se fue" (is gone, presumably for good); she obviously was feeling hopeless. I took a picture during the first week. You might be able to see Luis's fuzzy forehead. This black fuzz is a common sign of malnutrition. (Sorry about the orientation; I should have posted it vertically but I can't change it.)

Now the fuzz has almost disappeared. Luis is still terribly floppy, but his eyes are bright and he's begun to make baby sounds and follow my keys when I move them across his field of vision. And he's got a smile like a jack-o-lantern!! His mother's spirits have changed completely, so much so that it's obvious she was suffering from severe depression. I'm working on a follow-up picture to post.