The Orphanage
09 October 2011 | Rio Dulce, Guatemala
Casa Guatemala is an orphanage located along the river in the jungle. They are very poor and funded only by donations and volunteers. 100 full time children live there and another 100-150 come to school there from the 3 outlying villages, ages 2-16. There is no electricity during the day, I'm not sure at night, and generally all they can afford to feed the children and volunteers is rice and beans, occasionally vegetables or fruit, sometimes they have meat donated to them on Fridays. There is a medical clinic on site but rarely does it have any trained staff, occasionally an MD will volunteer for a few weeks but that is rare. Last month we started working the clinic 2 days a week, we are all they have, and the villagers also come in. They have no other access to health care, most have little or no income and live at barely a subsistence level, it is very sad.
The clinic has some very basic equipment and a large variety of drugs donated to them, very little of what we use the most of, topical antibiotics, steroid creams, and anti itch medicines. We have an assortment of oral antibiotics but we are only nurses not trained to diagnose and prescribe and hesitant to do so. On the other hand we are all they have and they are very grateful for what ever we may be able to do for them.
Everything they have has been donated but unfortunately almost every medication name is in Spanish. All the brand names are in Spanish as well as the generic names, so I've been spending a lot of time on the computer translating their names to English and making a chart for us and who ever follows after us. The most common things we see are cuts, scrapes, skin infections, lacerations, and lots of head lice. They even asked us if we knew how to set broken bones. We may be in way over our heads. We won't give anybody injections without a doctors order, which we won't be able to get in any case. Nearest doctor is 6 miles away by boat.
Our second day at the orphanage we did see one boy Michelle thought had possible strep throat, and had been running a 102 fever on and off for days. We checked our reference books and what was recommended for an anti biotic was not in the clinic. It is something that needs refrigeration so there is no way they could keep in anyway. The disease can lead to scarlet fever if untreated so we took the child, along with one of the instructors, to the free clinic in town when we were finished for the day. I went with them hoping to speak with an English speaking doctor to see if something we had at the clinic would have been appropriate. Of course no doctor was on duty that day, but the nurse that saw him ended up giving him an injection of Penicillin, which is what our book said, then he got another injection of a different medication. I also went because I wanted to make sure he got an anti-biotic. Apparently one of the volunteers went to the free clinic for a possible eye infection and all they gave him was Visine. A few days later he went to a hospital in another town and was diagnosed with conjunctivitis and give anti-biotic eye drops. So the orphanage people aren't too confident in the care available at the free clinic.
While we were at the orphanage one of the older boys carried in a large trash bag full of various medications, mostly anti-biotics or anti-parasitics. They have tons of that kind of stuff but very short of topical medications, which we seem to be using the most. Creams and ointments like Benadryl (Benadryl pills too), triple anti-biotics creams, hydrocortisone, anti fungal creams and powders/sprays for athletes foot. If it gets to be too frustrating for me I can always make use of the large supply of codeine, valium, tranxene, and assortment of other benzodiazepines I am still translating. Why they even have these medications there I cannot guess. We are not very comfortable playing doctor but at least we know when to call for one.
Last week a True North medical mission team arrived at our marina, the director had heard of our work at the orphanage and came to our boat for introductions. His organization has been coming to the area for a decade and his first visit this trip was to be the orphanage. He brought a team of 5 doctors, 2 pediatricians, 2 anesthesiologists, and 1 ER doctor. They saw 185+ children and each child received medicine to de-worm them. Alan, the mission director, told us that every child they see gets the medication because intestinal parasites are very common among these people. The mission spent the next 4 days visiting remote villages before they sailed to Belize to give the volunteer docs some well earned R&R.
We were relieved to learn that we had been doing an effective job treating the few things that we thought did require antibiotics. We only have a few days left to work at the clinic and we have not heard of anyone taking our place anytime in the near future.
I have added a link to the Casa Guatemala web site but much of the information is out of date.
I'm not sure what happened to the farming, fish farm, or chicken ranch but they no longer exist. They still raise pigs which are sold in their shop in town to help support the orphanage.