Kathy Braico, MD: Glens Falls Medical Mission
Guatemala: April 2015

As always, our mission saw many patients whom we know well, as well as many new ones.

In pediatrics, we saw Wilson, a teenager with an unrepaired VSD and Eisenmenger's complex for management of his chronic heart failure. He was doing amazingly well considering the severity of his disease.

Another young lady, Elvira has dystrophic epidermolysis bullosa with extensive destruction of her skin and fusing of her fingers to "mitten hands". We treated her local infections and give her mother 3 suitcases worth of dressing materials to take home. When she runs out of that, she uses newspaper to dress the lesions. Elvira is so disabled that in order to get her to the bus to get to the clinic, her mother has to carry her on her back. We donated money to find a local man with a truck to drive them back to their mountain home with the suitcases (and some of her 9 sisters and brothers!)

A new patient was a mother with an 8 month old child who weighed only 5 kg. The mother was tiny, and undoubtedly comes from a malnourished mother herself. The infant had motor skills consistent with a newborn. Mother could not read, so was mixing "Incaparina" (a powdered weaning beverage) with water just until it looked milky, and not adding the sugar it called for. She just fed him this weak solution 4 oz 3 times a day, with no complimentary foods. After careful nutritional teaching, we connected her with her local public health clinic, but we are afraid this child will have limited learning ability himself after experiencing such malnutrition at such an important developmental stage.

Other children had diagnoses such as scabies, chronic diarrhea, pneumonia, congenital abnormalities, asthma and epilepsy. Malnutrition and especially stunting was rampant, on some days we didn't see any children at all who hit the "normal" range of the WHO growth charts. We sent many children to our dentists to have permanent teeth extracted due to abscesses or caries that had totally destroyed the tooth. One volunteer was dedicated to just applying fluoride varnish to children's teeth and teaching them how to brush in hopes that future missions will see less of these severe caries.

As always, our mission to Guatemala was rewarding, humbling, and ultimately even fun! I plan to go again next year and for as long as I can contribute something to the beautiful people of Guatemala.

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The Benjamin H. Josephson, MD Fund
Overlook Medical Center / Atlantic Health System
Summit, New Jersey
908-522-2853