Appendicitis!

Around noon Wednesday was turning out to be a pretty normal day with Matt, Dan and I watching a couple of episodes of how I met your mother under one of the buildings to escape the heat. In the middle of our second episode Jeff walked over and asked if we wanted to help transport a patient with suspected appendicitis to the hospital in Waspam. After about a third of a second we decided, 'yes that would be a good idea and when we're we leaving?' The cooks handed us lunch in a bowl and we ran to the truck for the ride to the clinic. When we got there we found the patient waiting in a room with an IV already started by Maria. Apparently the sense of urgency ended there because we ended up waiting at the clinic for over almost an hour. During this time the Doctor and Maria tried to call an ambulance and then when that wasn't an option a debate ensued about whether to drive the patient out to the main road and wait with him until a vehicle heading to Waspam passed or to drive all the way in the deuce.

Eventually the conclusion was reached that we should drive the deuce all the way to Waspam and we loaded up the patient and rolled out. I can't imagine a ride in any vehicle over these roads would be the best idea for a patient with acute appendicitis, but being in the back of the deuce is especially punishing. We set up a small cot in the back and the driver tried to take it slow but that didn't seem to improve things very much. The shocks on the truck are very stiff for heavy loads and with not much weight in the back it’s a very bumpy ride. I was kind of expecting to have to do some kind of EMT stuff on the ride up but we really didn't have to do much of any thing. We made it to Waspam and the hospital in about 3 hours and went right to the hospital. The hospital is close to the outskirts of town and is apparently staffed by Cuban doctors and nurses.

Once we dropped the patient off the medical portion of the trip was over and we went shopping for the mission. On the way to one of the stores we stopped by the Rio Coco that separates Nicaragua from Honduras. There isn't much on the other side and there is no bridge connecting Waspam to the Honduran side. Apparently the only way to cross is by boat and it didn't look like there was any kind of border security on the other side either. Apparently the Miskito people can cross freely without a passport since they live on both sides of the river. Waspam is smaller than Puerto Cabezas and seems a little cleaner and maybe less busy.

After shopping we went to an internet café by the airport (really a grass runway with a two room terminal) and got a few emails out. After that we loaded up the deuce and got ready to head out of town. On the way out we stopped by the hospital to check on our patient and found out that he had already been to surgery but unfortunately his appendix had already burst by the time they opened him up. With the age of the patient, he was over 60 which is very old for Miskitos, and the rough ride to town I don't think the prognosis is very good. Since then I haven't heard anything but I may try to check when we head back to Waspam this Sunday for our river trip.

It was a unfortunate dichotomy to the day; on the one hand I was excited to get out to civilization, get a cold coke, by some food, and get internet but on the other it was because someone was seriously ill. Its pretty easy to get jaded here by people's medical problems, many of which are a result of their lifestyle, but this patient was sad reminder of the heath reality these people face. It hit me when I got back to Francia that this guy might die and I was excited that I had gotten a cold drink…I felt pretty guilty after I realized that.