Yucucha’a  is a small Mixteco village about 3 hours from the Roca Blanca Base.  The last hour involves driving on curvy, rutted, at times steep roads for about 12 miles.  Traveling with the regular team from Roca Blance was a team of 8 nursing students and faculty from Oklahoma Baptist University.  As we travel, we learn the life stories of those traveling with us, always interesting and edifying.  This village has been attended medically by Lupe (Laura’s adopted daughter) who has nursing assistant training, but who has learned additional diagnostic and therapeutic skills.  Our visit there is a way to support her and the local church which has been there for 10 years.  We were warmly greeted by the village Pastor and his family and members of the local church who helped us unload and begin to set up clinic in the church with strings and sheets.  Though they had not made a general announcement that we would do consultations that afternoon, we nonetheless saw members of several church families (most being rather large and multi-generational).

Later in the afternoon, we were served a delicious meal by the pastor’s wife and some women in the church.  There were 19 of us as well as about 6-8 Mixteco translators supplied by the village.  Preparing meals for this size group is no mean feat (remember, no modern stoves, sinks, dishwashers, etc), but they did so generously, with joy and a spirit of service in their hearts.    In the evening there was a lively service during which we were introduced.  Following that, there was an even more lively birthday fiesta for one of the parishioners, with food, loud music and dancing, and a cake.

Almuerzo, or 10 am meal

Children at the birthday party

The birthday celebrant and her spouse. She danced a lot!

We slept in a tent set up on the porch of one of the houses, while others slept in rooms graciously vacated by the family. Two puppies managed to find the side wall of our tent-a good place for warmth, comfort, and a sentinel  post from which to bark occasionally.  A pig patrolled the courtyard with his own cadence of grunts. We arose relatively early, there being no dearth of local alarm clocks like roosters, pigs, dogs, etc.  Some arose in time to see clearly the alignment of the moon with several planets.  After devotions, coffee and “Marias” (a kind of cookie), we again set up the clinic, teams of providers and translators, the pharmacy, and the spiritual care area, anticipating a brisk day of seeing patients.

Spiritual care team

Children engrossed in drawing scenes from the Christmas Story

From Sunday 2 pm to Monday 7 pm we saw about  115 patients, 35 of whom  chose to accept Jesus as their Lord and Savior.  Pastor Balthazar will follow up with them.  From our perspective as physicians, there was much pathology.  A cachectic 15 year old girl presented with fever, cough, blood-tinged sputum, weight loss, poor appetite, night sweats – tuberculosis until proven otherwise.  A referral letter to the local hospital was written to facilitate her evaluation and treatment.  A 44 year old woman presented with a blood sugar of 600 (normal <120), on no medicines now, having failed on various regimens of oral diabetic medicines.  Insulin had not been tried, and it is problematic in this area because of a lack of refrigeration in many homes.  We wrote another referral letter to the local hospital, suggesting a trial of insulin to get her diabetes under control.  A 24 year old woman presented with a complaint of headache; additional history revealed symptoms suggestive of early pregnancy: prenatal vitamins and general advice was given.  We saw a 68 year old man, still working in the fields, with marked evidence of emphysema (had smoked for many years, though had stopped some time ago).  He had the most abnormal lung exam (wheezes, ronchi, and rales in all lung fields.  It was a good teaching moment for the students.  We visited his home the next morning, and as suspected, there was smoke from the cooking fire and dust.  We had chosen to give him an evening dose of furosemide (a water pill), as his sleep was troubled by coughing.  That next morning he reported less cough and better sleep, so we gave him more furosemide.  We made the house call to see his wife who is bed and chair bound due to a long affliction with rheumatoid arthritis.  His love and compassion for her was evident in his eyes and in the way he carried her from chair to bed.  For what the family said was the first time, she accepted medicine to ease the pain.  And also, there were no bed sores!

One memorable patient was a young woman, very slight, looking more like a child, and obviously anxious and easily distractible.  Her chief complaint was “mareo”, or dizziness.  Now this is an extremely common complaint, especially among women, and is often secondary to low blood pressure because of inadequate fluid intake (maybe 8 oz. a day).  So it is tempting, especially towards the end of a long day, to do a perfunctory history and exam, recommend increased fluids and be done with it.  However, in her case, we learned that she would often “fall down” when she became dizzy.  More than once this has been the presenting description of seizures, so we continued.  These spells had begun at the age of 1 ½ years of age.  Eventually, they took her to a doctor and she was diagnosed with “spells”.  They do not call them “seizures” because those are attributed to Satanic influence.  She was seeing a specialist in Oaxaca City (8 hours away), who had her on a very reasonable,” American-style” regimen of medications.  She reported that if she did not forget any doses of pills, she did not have spells.  She was visibly distressed and sad when we said the regimen was a good one and she should stay on it. Further history revealed evidence that she was treated differently in her family, and denied opportunities such as attending high school.  We tried to encourage her that she could live a perfectly normal life, with a career if she wished it, marriage, family etc.  By now, she was on the verge of tears.  We finally asked her directly, “When you came here today, were you expecting and hoping that we would have a cure for you and you would not have to take medicine again?”- a tearful nod of the head.  Such an amazing, innocent expression of hope!  She then went to spiritual care, where she eventually broke down crying and was embraced by Marisol (our pastor’s wife) and accepted Jesus as her Lord and Savior.  Perhaps out of that will grow acceptance of her condition and mature care of herself.  Who knows? Perhaps more.

Family team that was so hospitable to us.

Mother, infant daughter, grandmother, great grandmother

God bless you!  Que Dios te bendiga! Dio nasoka chu’u! (Mixteco).

Dave and Mary Kay Ness