Today we stayed closed to home and visited Arco
Iris, a school in Urubamba for children with disabilities. It's always
been particularly fun and memorable to work with kids while here in Peru.
Although some come to clinic quite sick, many are funny, engaging, and very
loving, despite a significant language barrier. My Spanish is very
beginner and my Quechua limited to a few words, but in the past fews days,
I've received hugs and kisses from my little patients, or have been lead
around the clinic by someone half my size. As we set up our clinical
stations today, many of the students kept their distance, but one boy came over
very eager to play catch with his soccer ball. A little later,
a 3 year old girl was very curious about my suitcase full of
supplies, and as soon as I emptied its contents, she climbed in and looked like
she never intended on leaving. She was very interested with playing with
my hair and took great care combing it with her hands.
Although most of our patients today were children,
we were very busy on the adult med team. Many of our patients had the same
complaints we've seen over the past few weeks - back pain, cough, and vision problems.
I've spent a lot of time in the vision clinic over the past week testing vision
and fitting glasses, so it was interesting seeing the cases from the
medical perspective and hearing the patient's vision history. With help from
the senior medical students and attending physicians, I've become more
comfortable testing for strabismus, red reflex, and cataracts, and identifying
pterigium. Today in the adult med clinic, I successfully identified early stage
bilateral cataracts in an older man presenting with vision loss. The patient
was a bit disappointed to learn that he had cataracts, but I was
excited to inform him that another medical team arriving in a few weeks
could perform cataract surgery that would improve his vision. Making these
referrals has been particularly rewarding because there is a good chance that
our clinical visit will drastically help improve a patient's physical
well-being.
Working in the vision clinic can be particularly
rewarding, because with the right pair of glasses, we can help someone see
clearly, often for the first time in many years. My first day working in
the vision clinic last week, four Quechua women came up to kiss me,
thanking me for their glasses. Unfortunately, we are not always able to fit
everyone with the right pair of glasses. Over the past few weeks, we have
given out hundreds of glasses, but recently we've run out of the lowest
power distance vision glasses. Many patients complain of blurry distance vision
and are able to read the majority of the eye chart, but we have no glasses
left to give them. It's particularly hard to send these patients away
empty-handed, after they have waited patiently in line for several hours.
Sunglasses and eye drops (gottitas)
are extremely popular everywhere we go. Pterygium is very common, and many
patients complain of itchy, watery eyes. Due to the hard work
and diligence of our glasses committee, we have many pairs of sunglasses to
give out to help manage this problem. I try to make it very clear to
each patient the importance of wearing sunglasses to protect their eyes
from further damage. I like to give each patient a choice between a
few pairs of sunglasses and often hear "mas chico,
doctorita?" Many different types of sunglasses have been donated, and it's
very amusing to see which pair the patient with pick. Many patients often get
input from others waiting in line, or laugh when I offer them a pair that they
think is particularly silly or unusual.
Working with the vision clinic has been extremely
fun and very rewarding. It's given me an amazing opportunity to work
individually with patients and to improve my Spanish. While sometimes I feel
that our assistance is limited to multivitamins and ibuprofen, helping an
individual see provides a very immediate sense of relief and satisfaction. I am
very thankful to all who donated and collected all the glasses and sunglasses -
they have been very gratefully received!
Julia Liebner
MS2, Case Western Reserve University
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