One day our team worked in a local government health clinic in an outlying village called Sisle. When we arrived, there were hundreds of women and children lined up to see us, far more than we could every see in one day. The run down, dirty, poorly maintained clinic has no running water in any of the rooms. There is plumbing and a toilet. Water is kept in a open concrete tub/tank that gets filled when the water to the town is flowing. Buckets are used to bring water from the tank to flush the toilet. There is no electricity. The nurse that runs the clinic is responsible for every aspect of providing primary health care to a huge area of isolated villages. She is responsible for everything including maintenance and cleaning. She does all the vaccinations, pregnancy checkups and child health monitoring as well as any emergencies like stitching up machete wounds. Weekly she visits various villages on foot to check on TB patients and to vaccinate children.

On this particular day the nurse Isabel was seeing women for their prenatal checkups while we took care of the hundreds of children waiting to be seen by a doctor. Shortly after getting started for the day a young man came running in to the clinic trailing blood on the sidewalk leading inside. He’d walked three hours from his coffee fields with a machete wound to the hand. He had been cultivating his coffee plants, lost his balance and somehow leaning on the machete he managed to slide his hand down the muddy blade. Rafael had cut three fingers of the right hand rather badly, near the palm. He then wrapped them in a dirty t-shirt and high-tailed it to the clinic, where he had the tremendous fortune to land on a day when the visiting gringo doctors could take care of him. Tim Miller, a fourth year medical student and aspiring neurosurgeon, stitched him up supervised by Dr. Orzie Henderson, who also happens to be a retired emergency room doctor. Meanwhile I fed him fruit salad and tried to distract him while we waited for the rehydration effects of an IV to work their magic. In between bites of watermelon and papaya, he told me about himself. Every day he leaves his home around 3 AM to arrive before dawn and walks two hours to his little parcel of land, works all day, then walks two hours back. Now THAT’S a commute.

Before the week was over our team arranged for Isabel to receive a fully equipped mountain bike so she could more easily and rapidly make her rounds of the villages she serves. Needless to say she was in tears when we presented her with the bike.