Today Fr. Chris and I go to the mobility clinic. Efficiency has improved this year over last, as the Obras is beginning to transition to electronic medical records. The wheelchairs we give out are donated by another organization, Free Wheelchair Mission, which designs and manufactures durable wheelchairs for patients in developing countries. These wheelchairs are sturdy but very basic. They don’t have padded arms, so for patients who need the padding, Jill Crary (PT/OT) cuts sections of foam pool noodles to wrap around the metal armrests.
Patients find their way to the mobility clinic because they’re having trouble getting around, but there can be any number of reasons why they have a hard time walking. Drs. Michael Bubis and Adam Schindler evaluate them as comprehensively as possible in order to attempt to address the underlying causes. These vary widely, but all the patients have urgent needs. Some conditions would be impossible to cure in the U.S. as well, such as that of the first patient we see, a young man with Down Syndrome. Even more difficult is the situation of the 26 year-old with both cerebral palsy and autism, who experiences seizures on a weekly basis. We fit him with a wheelchair, but that’s all we can do for him.
Other patients are suffering from disease processes that would require sophisticated treatments that are simply not possible here, such as that of the man with amyloidosis, that is, abnormal protein deposits all through his body. We can give him a wheelchair, but we can’t offer the sort of interventions that might be available in the U.S.
Many of the patients have underlying conditions such as high blood pressure that could be managed cheaply by U.S. standards, if only we could continue to supply the necessary medication long term. The doctors have two chests of donated drugs to rummage through, and they make do with this smorgasbord as best they can, but one baggy of pills is not sufficient to keep high blood pressure under control going forward.
Other patients have chronic mobility issues but also other problems that we might be able to solve. There’s an 85 year-old woman who needs a wheelchair, but what is bothering her the most today is wrist pain. She gets the wheelchair, but Dr. Schindler also orders an X-ray to see if we can figure out what is wrong with her wrist. Another lady says that she was hit by a car five years ago and has been evaluated elsewhere, but no one has been able to resolve her chronic leg pain. So she gets a wheelchair and an order for an X-ray of her thigh. Then there’s a man who has trouble getting around because his vision is impaired by cataracts. He doesn’t actually have mobility problems at all: what he needs is cataract surgery, so he can see where he’s going. The challenge in his case is to track down a referral to someone outside Faith In Practice who can provide that treatment.
Some situations, although difficult, are actually a testament to the success of previous medical interventions. We see an 80 year-old woman who has been living most of her life with nerve damage from the meningitis she got when she was two years old, which caused her left leg to remain permanently contracted. Back in 1947, she got a spinal tap and antibiotics, which for rural Guatemala in the mid-20th century really was a triumph of medical care: she survived and went on to have a family. She now lives with her grandson and, in her ninth decade of life, is asking for a wheelchair to assist with mobility, after having always walked with a crutch.
Another 91 year-old Kaqchikel lady who does not speak Spanish is here with her relatives, who are hoping to get her a wheelchair, fifteen years after a stroke that crippled one side of her body. And the most sprightly patient of all is an indomitable 89 year-old Kaqchikel lady who announces that she needs a wheelchair, but what she really wants is to see a Gringo for the first time in her life. This is no doubt the easiest request of the week, and everyone gets a good laugh out of it.
Courtney Kim, Team Blogger
