Why Do They Matter?
By Gloria Obialisi, USC Medical Student
I don’t know how to swim. Well, if I had to freestyle across a pool, I can maybe do it for 25-50m, but honestly, I’m not even sure if I can do that anymore. I’ve taken three swimming classes and have never been able to let go of the wall in the deep end. It’s just too scary. Of course, I’ve known for months that I would have to commute via boat to not only get to the Floating Doctors’ base, but also between islands for clinic. However, I just didn’t pay it much attention. Prior to leaving, I did not give myself a pep talk, because I had confidence in the captains hired by FD and certainly didn’t want to entertain the thought of anything going wrong while I was on a boat. I was either in denial of my fears, not in tune with them because of all the hype and energy from the other members of my group, or I simply was unaware that the fear no longer existed.
It wasn’t until the middle our first boat ride from Bocas del Toro to Isla San Cristobal, that as I looked from left to right and saw nothing but miles of seawater that I thought, “Oh crap, what am I doing here?” Had I let my mind run wild, I probably would have started hyperventilating, but I tapped into my deeper feelings and realized that I actually loved it. I loved the cool gentle splashes of water hitting my sweaty face, I loved knowing that we were free from 405 traffic, and I loved sitting atop that beautiful water with not a care in the world. After several boat rides -some a little bumpier than I would have liked, I started to envision myself surfing the waves. This newfound love grew day by day and to this moment I am still eager to become a better swimmer, so I can finally explore the world of surfing.
When I signed up to volunteer, I thought at most I would be able to further delineate my niche under the umbrella of public health, but thanks to Floating Doctors, I’ve now discovered a love for the seas and a hungry desire to learn how to surf. Sure, it’s great having become aware of this, but it was but a single jewel compared to the heaps of treasures unearthed during the entirety of this trip.
The Asilo is a government-funded nursing home for individuals who are without family or friends to offer care for them in somewhat their later stages of life. Several students and I had the opportunity to visit this place while other members were at the first multi-day clinic for the week. We split into pairs to check the resident’s blood pressures, play games, color pictures, chat about life before the Asilo, and so forth. While all residents were quite impactful, two stood out to me the most, a woman and a man who I’ll refer to as Emilia and Arturo.
Arturo was the first male patient I interacted with there. He was sitting in the corner of the male quarters in worn-out clothing facing a wall, and fidgeting. I walked to him with a fellow Global Medicine student and asked if I could sit on the bed across from him. As my partner turned the pages of her book to locate his file to record his BP, I commenced to make small talk, asking him what he did today. He made eye contact very rarely and spoke slightly incoherently. Perhaps I would have caught more had I practiced Spanish more frequently. In the middle of his ramble, he turned 90 degrees to me, looked square into my eyes and said, “I am very sad. Do you know what it means to be sad?” As I tried to comfort him and ensure him that I understood, he simply turned his head back to the original position, facing the wall, and continued mumbling.
As bleak as this experience was, I found gratitude in the Asilo. People here have no one to look after them. I spoke with colleagues later, and they shared that he cheered up after receiving some cookies. I cannot imagine what his life would consist of would it not be for the Asilo. There he had caregivers, other men to keep him company, regular meals, and visitors like us who understand the importance of caring for these populations.
Emilia was the opposite of Arturo, but again, gave me an overwhelming sense of gratitude for the Asilo. It was almost as if she was running to meet us when we arrived. Her joy and eagerness to mingle with each of us enveloped the whole room. She was extremely excited and bubbled all about the room. Emilia like her sister has a cognitive disability and if I am remembering correctly, was brought to the Asilo because her mother could no longer care for them. Well into her 30’s, Emilia was the only future I could think of when I later met a boy on a different Island, who was12 years old and also with a cognitive impairment. Was this the life he would end up living? He too was characteristically full of life and quite bubbly, but his community lacked the resources to give him the attention and specialized care he needed. Even if he didn’t end up in the Asilo, I am incredibly grateful that it exist for people like Emilia and Arturo. There they have a new family and support during their vulnerable years of life.
On Day 2 of the multi-day clinic at Playa Verde, I was invited to go on a house call with Dr. Ben, a fellow USC student, and several medical students from Dublin. As we walked from our clinic area into the community, we briefed ourselves on the case and reviewed the patient’s file which was only gathered from her visits to previous FD clinics (talk about building your own health system, huh). We were prepared for what we would potentially face once at her home, but we did not anticipate such a long, steep trek there. At the top of a hill, we gazed out from behind the luscious trees at the beautiful beach. It was a metaphor to me of the incredible outcomes of doing such mission work. We push ourselves and give our best to serve these people, and in the end, with sweat pouring down our faces and oozing from all crevices, we reap beautiful results.
Something particularly funny to me after having seen the patient with Dr. Ben and later discussing a possible case of metastatic uterine or abdominal cancer, was my encounter with some of the local children. I climbed over the ledge of her house and jumped down only to meet a little girl that was utterly fascinated by my skin complexion.
“Where are you from?” she asked
“The United States, but before that, Nigeria in Africa.”
“Yes” (She looked at me with both confusion and skepticism.)
“Where is that?”
“Far, far away from here.”
“How many countries do you have to pass to get there?”
“A lot, maybe 10” (of course I didn’t know)
“Are the people good or bad there”
I tried to hold in my laughter as I replied, “Both. Same as you have here and everywhere else in the world.”
After we talked a bit more, I learned that I was the first black person she had ever met. How interesting that she was first curious about the character of our people. I’m grateful to be the first “Chomba” she met, thanks to FD, and hope I left a good impression for others. How I’d love to re- visit and teach her a lot more.
Aside from gaining exposure to many health issues and recognizing common chief complaints, one of the benefits of being assigned to the intake station during clinic is that you have a chance to meet many families and entertain their children while other team members try to take mom, dad, or grandma’s pulse. As a pre-school Sunday school teacher, I appreciated this opportunity to express my heart for children. Sometimes I had to play games to try to vitals from toddlers, and once I had to carry a very heavy, sleeping 1-year old while quietly altering my voice to feign excitement at nail clipping supplies to console his hysterically crying cousin.
These kinds of situations though somewhat difficult, are valuable because they highlight some of the difficulties in these communities like the lack of enough children supervision. The child’s mother would not have been free to provide a urine sample if I were not watching after her kids, and my partners could not perform the test if they were also holding a baby or trying to quiet another. I believe this patient had the confidence to travel to clinic with her children because Floating Doctors had already established a reputation that we will do all in our power to advance the delivery of care.
“Why do these people even matter? Why did Dr. Ben start this and why has Floating Doctors grown to the extent that it has? What do the few staff and revolving volunteers see in continually coming and putting themselves through this?” These are the questions that surfaced one morning as we traversed soaked and huddled, head down, through the pounding, blinding rain. It literally felt like it was blinding because our eyes were burning. One girl was moved to the point of tears, others found it exhilarating, some felt numb, but all I could do was try to find the answer to those questions. We weren’t traveling with a camera crew, there was no Noble Prize waiting for us at home, we weren’t getting paid exorbitant salaries, and we certainly weren’t getting guaranteed acceptance letters to the doctoral programs of our choice.
So, why then? It was a rough start to the trip and probably one of the most difficult second to having to use the possibly toxic latrines outside of clinic. I am grateful for that incredibly uncomfortable and trying time on that boat because it was at that moment that everything became real to me.
Certainly, as an aspiring physician and one who is especially interested in helping under- served communities, I knew this type of work was important to the development of my career and these were at minimum, valuable steps we could make to aid the physicians and bring healthcare to neglected communities. Here we were literally sailing to a remote island with people who would probably find a way to keep happily surviving even without our service, and all I could think of for that brief moment in time was that jarring question “Why do they matter?”
It was as if the sun emerged from the behind clouds and the rain vanished when I finally began to answer those questions. Health is a human right. So long as you are living and a human being, you deserve medical attention. In a world where technology abounds and people have been flying to the moon, surgeons are transplant faces, and we’re able to eradicate monsters like small pox, these people deserve to receive even the most basic form of healthcare. Whole communities shouldn’t be afraid to name their children until age 3 due to the unacceptably high infant mortality rates. Loving fathers and husbands deserve get treated for chronic pain or injuries sustained by the difficult lifestyles they live in order to provide for their families. Health is a human right.
This is why that short moment of salt water burning my eyes and having my wet scrubs clinging to my entire back was so important. Because health is a human right, and they matter. Neglected communities are also our responsibility. We seek not fame or recognition, just satisfaction in knowing we helped another person and we are strengthened by the beautiful, grateful smiles.