I am working with Dr. R this week, who is the clinic pediatrician. He speaks minimal English, therefore I have been forced to use my Spanish as much as possible. We have seen a few interesting cases this week that has made me stop and really think. Most of the patients we see have colds or allergy like symptoms, but a few had developed complications from seriously illnesses. The first was a deaf girl. She was about 6 or 7 years old, and had meningitis a few months prior. She survived, but unfortunately she lost her hearing as a result. Unfortunately there are not a lot of services for the deaf. There are schools for deaf children, but not on the island. They are all on the main land in the capital. The second girl was 8 years old. She has congenital hypothyroidism. Dr. R saw her first when she was 6 months old, and was already showing symptoms of hypothyroidism, such as lethargy and poor muscle tone. He tested her, and started on treatment.
She has since regained her muscle tone, however the neurological damage was already done. Now she has intellectual impairment. In the United States, or at least at Magee, every baby at birth gets tested for a number of diseases, including hypothyroidism. Also for her, there are no schools available on the island for her to attend for special education. These two cases make me so sad, because not only could they have been prevented, but it will be very difficult for them to reach their full potential given the lack of schools and services. They do vaccinate children here, but it is fewer than in the US, and menactra is not one of them.
On a positive note, I heard that Mr. D is improving and was able to go for a walk!