Autumn Update

Paul Jacquay - Paraguay

As we enter the third week of spring the purple flowers of the Lapacho trees have given way to the yellow Lapachos. They are much less common but make up for it with their vibrant yellow grow a shade brighter than the Aspen groves that are probably putting on a show of their own right about now in the states.

Paul Jacquay - Paraguay

As we enter the third week of spring the purple flowers of the Lapacho trees have given way to the yellow Lapachos. They are much less common but make up for it with their vibrant yellow grow a shade brighter than the Aspen groves that are probably putting on a show of their own right about now in the states.

My work continues to grow. We added 2 new clinics to the schedule last week. One of them is at Santa Lucia School for the blind. I will be doing this clinic by myself with back-up support from the medical director of Friendship Mission, just as I do at Don Bosco Rogas School for street children. I saw 10 children for the first clinic. They all appear to have some form of mental retardation of varying levels to compound their blind disability. The other clinic is at another government health clinic called "24 de Juneo". With this addition we also add another doctor to our staff. Her name is Zulma Ramos. She is in her 3rd year of Family Practice Residency and would like to pick up more work when she completes her residency next March. This is perfect for us because one of our other doctors will be leaving in March to start her residency in pediatrics. So now I am doing 7 clinics a week. As a team we are averaging about 60 patients per week. We expect/hope that these numbers will grow with time as we prove ourselves to be a stable provider of quality health care.

I have learned that this word "stable" is a big factor in this culture. When we were doing clinics in Arroyos y Esteros our numbers suddenly dropped from 15 to 20 per week to 2 to 5 per week. The local nurse who helped us at times explained that it was because of the politicians. When they start campaigning one of the things they do is to provide free clinics, including medications. They pay doctors and nurses to go to various locations and set up a clinic for a month or two and then move on. In Arroyos y Esteros they set up their clinic in the same building as the police station, albeit from a different entrance.

This brings us to DIBEN, the organization that I wrote about before whose director promised us all of the medications that we need. Our director took our list of needed medications to them. She spent an entire day being sent from one office to another but never received the promised goods. She talked to the director again and received the same promise again. Her secretary called every day for nearly 3 weeks asking if the order was ready. Right about the time that they gave up there appeared in the press stories about the politicians giving out free medications. They showed pictures of medications with political posters pasted onto the sides of the bottles or boxes. Thus explains where the promised meds had gone. If they would do this on a regular basis it would be wonderful. But as soon as the elections are over they will be gone and the patients left to buy their own medications.

While I'm on the political bandwagon I would like to relate another situation with the public health clinics. There are 86 clinics in the Asuncion district and many more throughout Paraguay. Nearly all of the clinics are staffed by a full time nurse, and some of them also have an aid in charge of the pharmacy. It is a remarkable system, with a local community board involved in running and maintaining the facilities. They provide free vaccinations, and some of the nurses are trained to due PAP smears. In May of this year the government stopped paying these nurses. They do not know why they are not being paid. They are told that the checks will be coming eventually, and so they keep working and speculating about the cause of the problem. One explanation is that the president wants to shut down all of the clinics. But this would be an unpopular move. So they stop paying the nurses and wait for them all to quit so they can blame it on some one else. Apparently this type of haphazard payment for government workers is a normal and accepted custom and it occurs in all areas of the government.

As our time here passes we continue to grow, improve communication, meet new people and are opened to new opportunities. More frying pans are being placed on the fire. A new project is that of building a nursing home. This will take quite a lot of planning and study. I have no idea what the chances are for it to come to fruition. But I am looking forward to working alongside the people here to try to help them realize this goal.

Marianne and I are doing well. We are looking forward to another year in Paraguay, which is an extension of our original two year commitment.

Shalom y bendiciones,
Paul Jacquay
Paul Jacquay serves as a long term volunteer at Mision de Amistad (Friendship Mission) in Paraguay.  Paul works as health consultant for the medical department and is a nurse trainer at the Mision de Amistad School of Nursing.