“The thing about rights is that in the end you can't prove what should be considered a right. So I can't show you how, exactly, healthcare is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.”
-Paul Farmer
Yet, they do. Worldwide, millions die from entirely preventable causes ranging from malnutrition to diarrhea. Some victims simply cannot afford medical care; even routine procedures or basic antibiotics can be prohibitively expensive. Others lack access to medical professionals, as is often the case in Ecuador. Although health care is free and universal in Ecuador, many remote communities lack medical facilities and trips to the nearest hospitals and health centers can be quite costly.
As a means of addressing the disparity, teams of doctors, such as the crew I accompanied to Palanda and Zumba in March, often travel to these villages and provide very low-cost health care. While these brigades are certainly needed, there short duration often severely compromises the quality of the care provided. As the doctors only visit once per year, they cannot adequately address chronic health issues plaguing their patients as there is no continuity of medical services. Yet, the doctors generally cannot visit more frequently; job and familial obligations in the United States and other countries obviously reduce their availability.
Given such limitations, the Timmy Foundation has devised a new formula for organizing medical brigades in Guatemala, Ecuador, and the Dominican Republic. In each country, they have adopted about 10 sites without access to adequate medical care. The non-profit organization, based in Indianapolis, then coordinates teams of doctors who visit the community ever two months to provide continuous care. If a physician determines that a patient needs more advanced care than can be provided in the community, the Timmy Foundation then subsidizes a trip to an advanced medical facility in a city.
Although an innovative system, it is not a panacea. As the doctors only commit to one annual visit, the attending physicians change each time. Thus, they are often unaware of the patient's history and the reasoning behind certain treatment regimens. Moreover, some treatment plans are simply too dangerous to administer with little oversight due to serious side effects. It is, therefore, too risky to prescribe psychotropic drugs even to patients in desperate need of such medication such as a twelve-year-old boy suffering from post-traumatic stress disorder after being kidnapped (and later rescued) several years ago. Doctors can only prescribe fish oil and other placebos in these situations.
Regardless, the Timmy Foundation does much good in Ecuador and around the globe. I recently joined a team of five doctors, numerous medical students, and Timmy Foundation staff to provide medical care in numerous villages buried deep in the jungle...provided that we could arrive.
And arriving was never as easy as it sounds. Some villages are only accessible via boat. Others required that we ford raging rivers in our pick-up trucks. Occasionally, we just abandoned our vehicles in the muck and trudged along on foot carrying gigantic bins of medicine and multi-vitamins in our arms.
Yet, however challenging the journey, the reception always made it clear how needed the medical brigades are in many of these communities. As we appropriated outdoor classrooms and turned them into makeshift hospitals, residents began lining up to register and receive care. Prior to the consult, all patients receive a supply of multivitamins—which is especially important considering many eat rice for three meals per day and eat few fruits and vegetables—and a new toothbrush to protect their teeth. Children also receive a free fluoride treatment, and thanks to the support of the provincial government, a free haircut.
Once in the consult, most patients report problems relatively easily treated by the doctors. Oftentimes, the greatest complications result from the language gap between doctors and patients. While many staff members are bilingual—speaking Spanish and English—patients often only speak indigenous languages such as Kichwa and Huoarani thus necessitating multiple translations. Not only is it quite time-consuming, but much is lost in translation throughout this lengthy process.
Translation problems are not, however, the saddest complications. These arise when families' have already received qustionable medical advice from others that has imperiled their health. In one particularly tragic case, an emaciated woman arrived in our clinic. She was extremely skinny but her entire left side was covered with large tumors—although they cannot be sure without more testing, doctors believe that she is in the final stages of metastatic breast cancer. When asked why she had not sought help from an earlier medical brigade, she deliriously explained that she was seeing a local shaman. He had recently recommended that she stop eating and drinking for two months to cleanse her body of all the bad causing the growths. Although only a few days into the regimen, she was already hallucinating and so desperate for nourishment that she downed two liters of pediasure in a few minutes.
While her outlook isn't particularly bright in spite of the Timmy Foundation doctors' intervention, many other severe cases should have happier endings. Children suffering from severe infections received antibiotics; a baby girl with a heart deformity will go to Quito for surgery; a man with osteomyelitis will receive medication. And, barring complications, all will be well at least medically.
Even for the endless stream of children with easily-treatable ailments such as ameobas and parasites, the outlook is better. If they aren't crouching in the outhouse with debilitating diarrhea, they can go to school and get an education. And, perhaps I'm being a bit naïve, but maybe the schooling will enable them to break the cycle of poverty and create a better world for themselves and their children. After all, according to the Arabic proverb, “He who has health has hope, and he who has hope has everything.”
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