Shortly before Christmas, Dr. Julia Kuen returned to Tyrol from her first assignment in the Philippines. She spent six weeks in a hospital for the poor in Valencia. Afterwards, together with the local medical team, she provided care for the neglected population in the remote mountain villages with a clinic on wheels.
Here she tells us…
The last two weeks of my assignment as an Austrian Doctor were really tough: we were out in the field with the Unimog, our mobile hospital vehicle. Every day, our team drove to a different village in the Arakan area of Mindanao and treated patients. Around 60-70 patients per day. Most of the time there were also 1-2 home visits. The patients then slept in a room provided by the residents in one of the bamboo huts. Often without electricity and usually without running water. “Elephant shower” was the name of the game every morning – which translates as pouring a bucket of cold water over your head…
Over hill and dale
The six of us set off each day for about two hours to our next location, which sometimes led through very rough terrain. It was thanks to the Unimog and not least the skills of our driver that we always reached the desired location, even if some of the situations seemed hopeless at first. Most of the villages provided so-called health workers, who were trained by the German Doctors to carry out medical support activities such as measuring blood pressure, MUAC (= mean arm circumference in children to check their nutritional status), weight and temperature (no one else had ever seen a clinical thermometer there). The patients were usually eagerly awaiting our arrival. There were a particularly large number of patients at this Rolling Clinic as there was also a dentist, which was only the second time this year, so the rush was correspondingly high for him.
A wide variety of clinical pictures determine everyday working life
Otherwise, everything was represented, from young to old, injuries, infectious diseases, chronic conditions and skin diseases to neurological issues – which was very challenging and sometimes unfortunately also showed its limits. Many examinations, including most ultrasounds, had to be carried out on the floor. However, with a blanket and a cushion brought by the villagers, this was no problem. Work often continued into the dark because there were simply too many patients. However, as there was often no electricity available, we had to help ourselves with flashlights and solar lights. You quickly learn that everything always works out somehow. All in all, children make up the majority of the patients. The children with severe malnutrition have to be picked out. The Sonosite ultrasound device, which our Unimog is fortunately equipped with, was very useful in many cases. In this case, an ascites (=water belly) and an enlarged liver and spleen could be ruled out in a severely malnourished child.
A touching encounter
I was particularly touched by the fate of one patient: A woman (about 60 years old – very few people here know her exact age, see photo on the right) with left hemiplegia, presumably due to a stroke three years ago. Now her blood pressure and sugar need to be optimally adjusted to prevent a further event. This woman is looked after by her son, who is blind in both eyes due to a childhood case of measles. Together, however, they manage to provide themselves with the bare essentials. Impressive.
Occasionally there are also injuries. Most of them are a few days old or older. Either while working in the fields or banana plantations with a bush knife or burns from the exhaust of motorcycles (often the only means of transportation besides horses that some inhabitants share to get out of their village) or from the open fire on which cooking takes place in all the bamboo huts.
Last but not least, my thanks go first and foremost to the numerous Barangay Health Workers and the team who accompanied me throughout the Rolling Clinic. Without them, the process would not have run so smoothly and efficiently and their positive and cheerful manner made many a difficult situation easier and they always took good care of you so that you never felt alone.
Great people who support this meaningful work of the Austrian / German Doctors on the ground. It was a pleasure to be able to work with them in the Philippines.
