Checking the water and going to school

This week I am at a clinic in Barra de Colotepec, which is basically a suburb of Puerto Escondido. The Clinic is staffed once again by two doctors, a nurse and her helper. At Barra they are all women. And then there is an psychologist/counselor who is fresh out of college and has his offices there as well. More on all that in my next post; I want to tell about my adventures in the village of Barra de Colotepec rather than in the clinic.

Today, I went with Rudolfo, a health promotion specialist (promotor de salud) for the Dept. of Public Health. His job is educate families about the various public health initiatives. Right now, he is going to houses and evaluating the water systems and the orderliness of their patios and yards to be certain there are no standing water sources which would foster mosquito growth and therefore help to spread Dengue Fever and Malaria. July begins a time of year in which it rains daily, and so now is the time for each household to be certain they are not harboring any sources of mosquito production. In addition to talking with people and checking for worrisome sources of standing water; he collects data which he reports to the health dept. I imagine they will collate this data and then determine where the need is greatest and then focus on those areas.

Rudolfo would go to a house and greet the residents (usually women and usually already outside doing chores outside.) He would explain his purpose and check the tanks of water that are common in the yard to see if the are cleaned regularly. Several he tested for the presence of chlorine, a good sign that the water is safer. It is each household´s reponsibilty to chlorinate the water they receive from the municiple wells. He would check the yards and patios for sources of standing water: trash, opened coconuts, tires and the like. He would politely ask the residents to make the corrections and educate them on the reasons behind the request - reducing the risk of mosquitoes and there fore the risk of spread of disease.

Most who had problems, were in agreement with and able to do the changes he requested. Nothing expensive or laborious, simple and standard cleaning. I think the majority were already doing fine. We saw one take which the family had placed fresh water shrimp (perhaps really small crawfish.) These animals eat the moss and mosquito larvae and so is one way to take care of this problem. Another family had an electric device that was collecting mosquitoes (and they would eventually die.) This was a trial of this invention and depending on the number and type of mosquitoes collected the manufacturer may decide to start marketing it´s product in the area.
In one morning, we visited or observed (for the vacant houses) a total of 23 houses. All on foot. A lot of the walking was on paths rather than roads, and some households could only access their property by crossing through someone else´s yard. The ´laundryroom´, ´kitchen´ and ´living area´were all located outside. This seems really reasonable, given the heat. Some were cooking with gas but most were cooking over open wood fires. One woman had a home business of creating pinatas. She was making about 8 Winnie the Poohs when we visited this morning. They were assembled and awaiting decoration to see that they were bears, right now just newpaper papier mache. Another woman had a business of making tortillas and neighbors were droping by to buy them. She had the dough (masa) mixed up, used a metal device to flatten them and had a large flat round ceramic built over her open fire to cook them on. That´s hot work. We met one man, Patrick, who is from the United States and married to a local woman. At 9:30 am he was most of the way through a 40 ounce bottle of beer and seemed drunk and ill. He was probably the sickest looking person I saw.

I saw the grandmother of an 8 year old boy who the doctor sent to the hospital yesterday with suspected apendicitis. The boy had had surgery, the apendicitis was confirmed, and he is now doing better. He should come home tomorrow. It was fun to run into someone who I had met Yesterday, the mother was quite distressed that this son apparently had appendicitis as his older brother had appendicitis less than one year ago and had some complications. More on that in my next post.

After returning to the clinic, I went to the neighborhood primary school and helped the doctors distribute anti parasite medicine. One dose for each child. That was fun, which a few ethical twinges: each child took the dose whether he wanted it or not and the parents were not informed that their children would be receiving this medicine today. Neither the teachers nor the doctors had any second thoughts about making this choice for the parents and it was done. Apparently, one needs to take a de-worming type medicine every so often if living in Mexico. I was a little surpised to see doctors doing this work, as it is a taks which did not require the skill of a doctor. One dcotor keep a running tab of the number and age of those receiving a dose.

This is the second of three annual weeks of vaccinations. Normally, this week falls in May and it was postponed until now as school was cancelled in May due to the whole Swine Flu issue. This health clinic doesn´t have extra vaccine to distribute and the vaccination system in place works without the need of campaigns and blanket vaccination of a certain age group. I recall when I was a school nurse in California (late 1980´s), I was told by parents whose children had received their vaccines in Mexico that health professionals would come to a village and give vaccine to all who were a certain age. So, we gave the kids oral anti parasite medicine instead of vaccinations.