Desperation: a missing post

Trying to catch up, I discovered the following draft that I didn’t complete while we were in Nicaragua.  It’s out of sequence and I can no longer recall the date for the entry, but it seems worth reporting.

100 patients were seen and treated at the outpost clinic today.  Drs. Roger Martinez, Fran Uriarte Wallas, and Dr. John Showalter kept up the pace and tried hard to meet the diverse and sometimes complicated needs, but sometimes the problems simply are beyond our capabilities.  We left the clinic — and the field — feeling good about our efforts and our accomplishments.  (Never mind that we nearly always feel inadequate to the needs and worried about the long-term consequences of our presence.)  We arrived at the Totagalpa clinic for the daily de-briefing and to check in with our partners there.

A young family was waiting for medical attention for their three-year old child.  The clinic doctors were away treating other patients, so Dr. John met with the family (through our translators) and examined the child.  He was severely malnourished and unable to sit, stand, or crawl.  The examination suggested a severe neurological disorder that made even the most basic developmental tasks — and eating — problematic.  The feeling of helplessness was written painfully on John’s face as he turned to the parents and translators.  He could offer nutritional supplements and encourage contact with a specialist, but the outlook for the short and longer term is not promising.

Can we try harder to build connections to regional health resources — to specialists in Esteli or elsewhere?  Should we spend more time building towards resource networks beyond Cuje at the risk of reducing our efforts and energy on the ground, in the community?  We’ll take up these and other questions when we return — no consolation for this small family and little relief from the searing doubts.