Clinic life

A little about the clinic.

Hours are 8am-12n, and 1p-4p. No appointments so it is first come, first serve.
This explains why some folks show up before 6:30am.

Currently we are seeing between 10 and 30 patients a day. Some days have been slow because the clinic has been without a consistent doctor for several months and so people are not aware that someone is there full-time. The slow days have been nice to get adjusted to life here - but we are here to work, so I would like to see it get busier.

Our lab is limited to spun hematocrits (to check for anemia), urinalysis, pregnancy tests and a finger-prick blood test for H. pylori. Patients are sent to the local hospital if any other labs are desired. This includes the third positive dengue test we ordered earlier this week.

We do have an ultrasound machine. The image is a little hazy but I have looked for gallbladder and aorta disease, dated a couple of pregnancies and located a foreign body.

We do have an ECG machine. I use it to determine if someone needs to be on aspirin or not :)

In a town called Orange Walk, about a 45 minute drive, there are a couple of surgeons and a variety of other specialists. Some people, when they really want to get something done, travel north about 30 minutes to Mexico – how weird is that to say good quality medical care can be had in Mexico?

We have a pharmacy that is fairly well stocked.

So far lots of diabetes and hypertension management. Many older patients are fixated on their cholesterol – we think there was some sort of government education program sometime back. We wish they would be more fixated on their diabetes! Lots of arthritis - most people work hard labor, either around their home or on the sugarcane fields. Most everyone has congestion – either from the dust or their open-air fires in their huts/homes. Some parents want vitamins and/or worm medicine for their kids – I say OK.

I have had three ER cases so far. First, removed a bead from one kids ear- three people to hold him down. Second, took an inch long piece of metal out of the base of one guys foot – it had been there for 5 months. He had had frequent infections but didn’t know why. They forgot to X-ray despite his repeated problems!! He said only sometimes he could barely feel something in there. Walking barefoot your whole life takes a lot of the sensation out of your sole. Finally, patient had a vagal event in our waiting room - though this was only determined after am intense, quick evaluation. Things like heart arrhythmia's, stroke and low blood sugar were at the top of my list initially. Maybe he just wanted out of the waiting room and back to a bed :)

Our patient population is primarily Mayan – most speak Spanish, a few speak only a dialect. Some of our patients are a mix of Creole. Some are Americans or Canadians down to visit or live. And we also have a few Mennonites - they make up around 1/7th of the total population, but mostly keep to themselves.

Click here for a link to the clinic's website. It has some interesting information, including how the clinic got started.