A War They Don’t Talk About

Not having been in the Fajardo Hospital since its repairs, I was told that the Emergency Room was the most significant of the improvements. The Latin American students cared for Rafael Tuesday night, he’d had a fever since the previous day. They ordered urgent blood and urine tests. It didn’t occur to any of them to acknowledge him. The supervisor of the three students was a young as they were so I suppose he’s doing his social service or perhaps he’s a student too, who knows.

Waiting for the results of the tests allowed me to observe the national apathy that has really set in in that place. The lack of lights, the trail of dirt on the enamel painted wall, so easy to maintain with a damp cloth, cigarette butts on the floor under a sign that says No Smoking.

The waiting area seems to be a place for drunks to sleep it off, or the homeless, whose grimy aspect contributes to the bad impression. Inevitably, I wondered if the Hospital Director would pass through after the re-opening.

As the results of the tests were inconclusive, and as my son didn’t show any signs of improvement, the doctors said he would be kept under observation for any changes.

The next day two medical students went from house to house, thermometer in hand, checking for fevers. I let them in and they took Rafa’s temperature which was 102F. In the afternoon a new doctor came to the house from the clinic in my neighborhood and scolded me for not properly using the steps of the health care system (did you know? the family doctor is the primary caregiver and the hospital is the third step). He repeated the urgent order for tests, including a platelet count in the polyclinic (second step of the health care system), and made an appointment for the first clinic hour the following day.

I also accompanied Rafa on that occasion and saw what they did. The doctor took his blood pressure, pulse, listened to his lungs, looked in his eyes, opened his mouth, pulled up his shirt and looked carefully at his skin. That gave me confidence, what I would had expected the night at the Fajardo emergency room.

“We have to wait for the tests to come back but this is dengue. Home care, rest, liquids, no aspirin, and repeat the tests in two days. These platelets are very low and the skin color is irregular.”

Dengue. This is a war that is not spoken of. The School of Medicine has begun classes but the students and doctors who would normally be seeing patients are in the different steps of which I already spoke, handling cases about which the statistics are kept confidential, but they don’t appear to be diminishing.

The media carries on about the life cycle of the aedes aegypti mosquito, and thus the responsibility of citizens in its proliferation. Flowerbeds and vacant areas overgrown with weeds, water leaks, potholes, insufficient garbage collection, and abundant rains are a losing combination. There are no public ads about the inability to respond to this accumulation of problems, not even one article. What can’t be fixed won’t be talked about, seems to be the orientation.

As an aside: I hope Dr. Naybí will have long stay in our clinic.

September 24 2012

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