Our third clinic day was in the state of the art high school in Chapala, where the students are headed to College and University.  We were set up in the library lecture room for all of the assessments, the eye team were set up on library tables, the Gynaecology team set up in the women’s washroom with a portable bed.  Physio set up in the foyer where it was pretty busy with people coming and going, so they moved their treatment table into the men’s washroom.  The men’s washroom was also the staff and the patient washroom, but we managed it all.  
We saw 115 people, of whom 38 were adults and 3 or 4 children, the rest being teenagers who wanted ‘physical check up’ meaning they wanted to talk about birth control.  The nurses did see a few skin infections, some warts on hands, and lots of discussion on sexual activity.  One girl had inflammation of the vagina because her mom had her douching with soap and water every day.  OUCH!
We did find out that there is sex ed coming into the school every two weeks and we were giving the same information.  So, why were we there?  The guys wanted condoms and if we had had 1000 we would have been the most popular team ever.  The girls wanted PAP tests and tested for Sexually transmitted diseases, which we did.  We had a woman with B/P of 140/102 and she only took her medication when she felt like it, so lots of health teaching.
Physio saw some back pain patients, injured kneed from sports, a 14 year old girl with a fractured coccyx, a girl with a jammed wrist, a ballerina with a jammed talus or ankle bone and some soccer injuries.
The eye glass team gave 60 pairs of glasses.  They had 7 teenage fakers who wanted glasses and we did not have any that had window glass in them.  Some came to get out of English class.  They did have a 12 year old that needed a significant distance vision correction.  One of our translators knew a friend who would give prescription glasses at a discount, so we sent them off to get tested.  The test is free but the glasses, all prescription glasses seem to be 350 Pesos, C$25.00.  Because he had a significant disability, and they had no money we did cover the cost and it will make a great improvement to his education.  
Probably the biggest benefit we gave the population of this privileged school was that Dr Doug Thompson and our Mexican born esteemed Dentist, Dr Ramon from London Rotary,  went from class to class giving sex education, Doug, talking and Ramon translating, (or giving his own information) and making them aware of potential problems.  
At lunch time, the team were unanimous in the opinion that this kind of health care was not what they came to do and that what we were doing here was readily available here within their own community.  We are booked here tomorrow to do the same thing and the team said we must not come back.  We called a contact here with the Lakeside Association, Doug Scrimgeour, a Shriner and Karl Dyer a Mason and they said we could go tomorrow to an indigenous community, San Pedro, that gets very little service, and they would make all the contacts and arrangements, and the plan was on.
Our Rotary contact came, and we told her the reasons we did not need to return here. She said that in fact we could not get there from here as it was too remote. The other reason is that what could we do in one day, what difference could we make?  She stated they were planning to take a few physicians out to San Pedro in the future and they would do an assessment.  I said we would return all of the charts so they could peruse them and look at what the problems the patients had. I just know the team can be more effective in a remote village where we were told they have lots of health problems. 
Supper was catered in for the first time and it worked very well.  We informed the team about the plans to go to the remote village tomorrow and there was both joy and trepidation.  Was it safe?  Would the food be safe?  If it was as rough as the Rotarian leaders said, should we leave all personal belongings at home?  I said we promised an adventure... Here we go!  I had done a lot of praying before I said that!   
The team had found a local singer on the weekend and invited her to come and perform for us.  She joined us for supper and sang like a bird.  She was delightful.  We passed the hat for some remuneration and she asked to come with us to San Pedro to help translate, play and perform for the children and we welcomed her.
We left at 8 am in order to go the extra miles to San Pedro for the Thursday clinic.  We met Karl at the Bomberos station (Fire and EMS) and saw the guys wearing fire suits from Owen Sound, sent here by Firefighters Without Borders and Karl led the way.  We went to Mezcala where we will be for the next 2 days and found out that no, we could not work at the school as we had been told, but in the community Centre.  OK?  The road on to San Pedro was indeed a one track road.  BUT the wheel tracks were paved and the rest was  cobblestone, just like all of the roads here.  We met some buses and trucks and we just pulled to the side.  The scenery was spectacular, just like Big Sur in California, south of Monterey, but without the surf, just a calm lake, but high cliffs on the side of the road. It was almost a 2 hour trip.  The main crop that we saw was a vine growing on wires similar to grape vines in Niagara.  The vegetables, Chayotes (chai-oat-tays) a smallish green squash like item, then hang down and can easily be picked.  They do not have a lot of taste but easily take on spices and herbs.  Oddly, we did not have any here in Mexico, but I have eaten lots in Guatemala.  
We set up the clinic in a covered area beside the Catholic Church.  It may be their property but no priest or person from the church came to make themselves known.  There were already tables and chairs there for us and we asked for more and the people went home and brought them from their houses.  Dr Doug and Gord strung rope and we hug sheets to make a private area for examinations and PAP tests.  Physio and Reading glasses were on the stage area and Linda used the lecture for glasses.  And there had to be 200 people there already when we arrived!!  We are told they gave out 200 tickets for people but found out that was 200 families!!  We were all set up about 10:00 and ready to work.  The registration folks are extremely well organized to get folks ready for examinations as soon as possible.  We registered families (or who we thought was family) as 13A, 13B, 13C , etc.
Officials from the local and regional government came and thanked us for coming to give service.  The EMS Bomberos came and acted as crowd control.  A little boy fell on a rock outside and they treated him, cleaning and bandaging his finger.  The officials said they would send lunch about 1 pm.  We had taken extra water as we were told there is a huge water problem here in San Pedro.  Many children have kidney problems and 13 are on Dialysis, having to somehow find the money to go all the way to Guadalajara for the treatment, not once but 3 times per week, a trip of more than 2 hours.  
We saw 225 patients, from 95 families.  About 2 pm, we had made a dent in the waiting crowd, but there were so many still to be seen, that I triaged the waiting families to find out what the problems were, and having them decide which one or two were most in need of care, writing on their little paper that they were approved, (definitely not my favourite activity).  All day, the toothbrushes, toothpaste and soap was prepared for the families at the triage station by the Volunteer Bomberos.  Anita, the woman who looks after the community is also a VOLUNTEER Bombero and she is truly dedicated.  
I have NEVER seen so many children!  They were like all children, restless and inquisitive, and many were there before we even arrived.  Josy and her sister had brought colouring pages and crayons, and a soccer ball.  There was no place to play soccer, not even outside because all the streets were hills and the ball would have ended up rolling down the narrow cobblestone roads into the lake.  Which makes me wonder, do they have a flat spot to play soccer? So, in a corner, they played dodge ball and anything else to keep kids amused.  Good job, Josy 
One of the problems the Nurses had, was sorting out who belonged to whom.  We treated everyone for intestinal worms and this was very much appreciated.  Some of the more severe cases can be diagnosed with a stethoscope held over the abdomen.  You hear what we call crackles, a sound produced in the lungs when moisture is present, but this is the movement of worms in the intestines.  In prolonged cases, the worms crawl up the esophagus and then into the lungs to be coughed up.  I know, disgusting!
We had hoards of children that came with a piece of paper saying their urine test from school was positive.  Positive for what?  We did urine dips on many and most were normal exams on our test.  We found out they were positive for protein heavy metals.  We had been told that many people here had kidney problems and the probable source was the water.  The next day, we were visited by government officials from the Municipality and the Region, who told us they have sent numerous water samples to numerous labs and the water is fine, no heavy metals.  They visited homes of the children with high metal count and found lead and other contaminates on the walls and the floors of their houses.  They burn plastics, tires and other products in the fires in their houses to cook with, and there is no ventilation for the smoke.  Another source may be contamination of E-coli (think Walkerton) from poor sanitation causing kidney disease.  There needs to be a lot of work done, BUT it needs to be coordinated with government, and local NGO’s, Rotary included.
Jaimie had a 3 day old baby brought by the grandmother because the baby cried all the time.  It could be colic, but it seemed impossible to get the whole story without seeing the first time mom who was recovering at home from the birth.  She did come and we got Linda Reid who does our eye glass clinic to consult as she is a veteran Maternal Child RN.  Mom’s right breast was hard as a rock and only expressed blood and pus.  She had mastitis and this babe was starving.  She was also dehydrated and had no wet diaper for 24 hours.  The mom had kidney pain and was given antibiotics for both conditions.  Linda and Jaimie sorted out the whole situation, with advice on producing breast milk now and for the long term and gave some of our infant formula and bottles that had made it through customs.  Most had been confiscated because it was ‘nutrition like Ensure’…definitely not allowed into Mexico!  The team being here probably saved this baby’s life.
We saw mostly women and children, here, probably because the men were working. The Lindas gave out 25 reading glasses and the same for sunglasses.  We saw some Ptergiums here, a meat like substance that grows over the middle of the eye globe, from the inside  and outside toward the iris and the pupil.  When it covers the pupil, they cannot see any longer.  It is caused from dust, wind, and smoke in the air irritating the covering of the eye.  Not much can be done except protect the eyes from the irritants.  
The Physio clinic was kept busy trying to treat shoulders, arms, and backs from the hard work the people do.  And as they were on the stage, they were a show to all the people.  
The Municipal officials said they were happy to give us lunch.  They said it would arrive at 1, a perfect hour as we had breakfast at 7.  It did not arrive at 1 or 2 or even 3!  We were fading fast.  We found some nutrient bars to give out.  Lunch arrived at 3:30, but we were so busy trying to finish up seeing the patients as we were only here for this one day.  I grabbed a bite and took the rest to a child on the street.


We needed to be on the way home by 3:30 but that did not happen until past 4:30.  But the team was ecstatic that we had changed the venue and we actually gave care to people who really need it.  We arrived home at 10 to 6 and needed to be at the Montecarlo hotel at 6, so, a quick wash, dress in our best and off to one of the best hotels in town. 
Thursday night we were at a fundraiser for the lakeside Foundation.  They were trying to raise 100,000 Pesos so they could give out 4 twenty five thousand dollars worth of community grants for projects.  This was billed as a Starlight Paella dinner.  It was very enjoyable and the team enjoyed dancing, but at 8 pm after a long and very busy day, we needed our bed.  
I thank all of you for your interest in the medical team.  Please forward to whomever you think might enjoy the stories.  
In Rotarian service, Jean