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Monday, March 21, 2011

Do medical brigades work? Why are they worried about malpractice?

There are countless medical brigades and countless attempts to help the poor here. I have participated in several, while basically only in one for much time. The most wide spread handicap is partial blindness due to glasses being very expensive. Basically, the medical brigades come for many reasons, yet I helped a dental and eye doctor’s lion club mission. The eyes of many were only slightly bad. Usually, kids dropped out of school, or lost jobs, due to their not being able to perform the tasks needed. We had a fun case with a metal scrap coming from a lady working in one of the coke bottling distributors in la Esperanza. Most patients merely came for the sun glasses, while I was shocked to see the wealthy getting the same treatment of $2 for 2 glasses and sunglasses, as the poor. I guess the wealthy just know how to enjoy a better life than the poor. Regardless, it was fun to see how happy people were afterwards and the doctors in experiencing relative poverty along with the fun of traveling and enjoying a different walk home and clientèle.

The sad thing about teeth here is that no amount of brushing can really save their teeth. This is of course, if you trust their “I brush my teeth 3 times a day” claim. Basically, they have on average 3 bad cavities and 10-15 ones developing. This means that nearly half their teeth have problems, which is mostly due to their diet, consumption of pop/soft drinks, and love of everything with 2 large helpings of sugar. They also eat very few vegetables, as beans keep their fiber up, yet do not have any cleaning effect on their teeth (this could just be an assumption on vegetables cleaning teeth). The only problem with the dentists was that many found the hygiene lacking and were not professionals. Otherwise, the dentists had trained a local staff, donated equipment, much better than at the public hospital, and had it running weekly. This allowed many people to realize that the lions club was also a dentist’s office and often had medical brigades coming through.

I have since met others building homes for the poor. The local middle class are very opposed to donations, as they find it gives the wrong message and often undervalues their hard work to pull themselves out of poverty. I was surprised to see that many of those building houses were doctors and other professionals retired and working for the poor. The doctors explained to me that it would be malpractice for him to work in Honduras without a professional translator and a license. The sad thing is that the local doctors are so bad, that he would have probably done much better. Most people coming in for work had had work done at public hospitals in the capital from which they came away with nothing but scars in their eyes. This leads me to believe that many doctors are experimenting on patients here or are grossly under qualified.

Regardless, the malpractice cases here are largely unheard of, while the cases of really surgeries gone wrong happen all the time. The morning news usually opens with a mother complaining that the public office destroyed, maimed, disfigured her kid, yet any record of her child happened to go missing. Thus, as in 98% of police cases go unsolved, even malpractice easily goes the way of murders, where every a couple of dollars will take the next justice. Honduras is the 3 most corrupt country after Venezuela and Haiti. It is interesting to see a doctor morally unwilling to provide services to someone, who needs them solely due to his moral, albeit some legal fear, of being prosecuted for malpractice. He was retired and not fluent in Spanish, which all put him off from administering basic medicine.

This leads me to ask, which system is worse that someone capable finds it morally wrong to practice, while those practicing get away with gross malpractice?

How can we get the individual to help without feeling wrong for not doing it “to expert professional standards”, while hindering experimenting with poor patients by under qualified doctors?

How can one help the poor without merely helping those relatively richer dominate the poor?

Can one actually help the poor or are the destined to be just that poor with or without your attempt to help?

I admit that information and knowledge is a weapon. Yet how can one give out information to improve people’s lives without having that free information being used to maintain inequality without helping the poor get out of the poverty trap?

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