Today was a good day with challenges to make it interesting. It's Tuesday today, which means it's a full medical day. I spend the morning helping at the Canossian clinic at school and in the afternoon I volunteer at the Assert Rehabilitation Center.
There were three really interesting situations today. First an older woman, "grandmother," came to the clinic today to get a fungal infection on her feet treated. She is from a farm family that lives near the school and Brendan and I see her often on our walks. After we treated a relative of hers at the clinic, yesterday she asked me if she could come too. I said of course and encouraged her to go the following morning. The clinic is for the 2,000 students at the school, the teachers and employees, and the community, but many do not know about the clinic if they have never been on the school grounds. On my daily walks I try to refer people who are visibly sick to the clinic so they can spread the word.
She was there this morning and, while Sister Aquelina assessed her and got her appropriate medicine, I looked in. She put her hands together like she was praying and nodded her head toward me in a 'thank you' gesture, but I shook my head and pointed up to God. She smiled, pointed up to God too, and nodded slowly. She is a beautiful woman who works very, very hard and lives a tough life. Today was the first time I had ever seen her with any type of shoes on (probably one reason her feet have suffered). But despite her tough life I always see her smiling as she works and she is very appreciative of the smallest things. And she knows the One who helps her make it through the day : )
(Since this day when I pass her on the walk to school when she sees me coming she will point up to God and smile and nod and I do the same. It's the unspoken communication that means the most).
Secondly, later that morning Sister Aquelina let me off early because there was a long lull in patients. So I went to talk with Sister Ervi at the High School. We talked about getting the students ready for the Canossian Global Youth Conference in Hong Kong in July. The three students Brendan and I helped with their applications were accepted (yay!), but now they must do a lot of research and write a position paper in English about social issues in the country they are assigned. A few weeks before the conference they will download their papers on the internet and the participants will read the papers to be able to discuss them at the conference. The students are excited, but very nervous. None of the three have ever flown in an airplane or have ever been out of East Timor! This trip will be quite an experience for them.
After we talked, I went back to the clinic to pick up my backpack, but as I got to the door Maliana (a student we sometimes play basketball with) limped out. I asked what happened, but she could barely talk she was in so much pain. What I eventually heard was that a wild dog had been coming towards her barking and she got nervous and jumped away, but when she jumped she got a deep cut from a piece of metal that was sticking out of the ground.
Her leg was already bandaged heavily when I got there and Sister Aquelina wanted her to go to the hospital to see if she needed stitches. Her friend waited with her by the road to try to find a quick way home and then to the Hospital Nacional. They hadn't moved in a couple of minutes so I asked if they needed money for a taxi. Maliana slowly nodded her head yes. Between Sister Aque and I we found enough money. Then I explained the situation to Victor, the gatekeeper, who flagged down a taxi quick and Maliana was off! We will find out soon how it all went.
The third exciting event today was at physical rehabilitation clinic, Assert, this afternoon. After helping Yenni, the Indonesian physical therapist, clean all the toys used for the therapy, she asked me to help her set a cast for a baby with club foot. Club foot is one of the top conditions treated at Assert. They work with the midwives throughout East Timor to get early diagnoses so that the children with club foot can be treated as early as possible. I learned just today from an Australian orthopedic surgeon that the surgery is very simple on young children - in most it requires only a local anesthetic and the tenotomy of the Achilles tendon can be finished in literally 1 minute! As in most cases though, later diagnosis decreased treatment options and their effectiveness.
At the Canossian Sisters' convent in Balide, the gatekeeper Fernando has severe club foot that was never corrected. His feet are turned completely inward - 90 degrees farther than they should be. This limits his movement outside of the convent. When I started volunteering at Assert I asked if anything could be done for him, but they said that because he is in his forties the only viable option was that they could fit him for a wheelchair so he could go farther into Dili.
It's difficult to hear that - that it's too late.
So lately I've had the opportunity to learn about club foot and all of the work that they are doing to improve early detection and minimize the disabilities caused by this condition. On this particular day I was able to help Yenni as she wrapped a 9-month old's legs and smoothe the plaster to make the cast. While she wrapped, I held the child's knees and feet at the appropriate angles (which was harder than it sounds because this baby was a shockingly big boy for a 9-month old and he could kick hard when he didn't like the angle you were putting his foot in). After the casts were on both legs and dried we all took a picture that will go on the wall so that the family of the child can see the progress and other families can be more comfortable with the process knowing it has worked for other children.
The technique that they use to treat Club Foot is the Ponsetti Technique, which was developed by a physical therapist in Iowa! When I first started volunteering I was shocked that they had heard of Iowa, and it is because of Ponsetti who developed this club foot treatment which is now the "gold standard for everyone from first world to third world" they told me.
In his method, they have a series of castings where they gradually change the angle of the foot until it is as it should be. There are six castings and for optimal effectiveness surgery should be done after week three. Then another three weeks of castings and, finally, "bars and boots". These special boots must be worn day and night for 3 months and then every night for 3-4 years. You can see what a problem this would cause for any person older than a baby. As they told us, 3-4 years of nights is a small price to pay for a normal foot for a lifetime, but it's still difficult for the Timorese to understand that even when the foot looks normal and healed that they must continue for this long to prevent a relapse.
Everything is in the beginnings here. In Australia or America, almost all babies are born in hospitals where they can be immediately diagnosed with club foot and it is almost never a problem. Here they are still trying to make the public aware that club foot is a treatable problem. We are so blessed in so many ways I never realized!
So that was the rollercoaster of one day in East Timor. Hope all is well with you!
Always,
Rachel and Brendan
No comments:
Post a Comment