SECOND QUARTER REPORT 2o09 COLLECTION PARAGUAY REPORT - SECOND QUARTER
APRIL - MAY - JUNE 2009
KARAIMI COMPANY - DISTRICT Ybycuí - DEPARTMENT Paraguarí
I-) COMPARATIVE AMOUNT OF PATIENTS / FIRST AND SECOND QUARTER. COOMPAÑIAS receiving medical care and medicines free of charge
We have provided medical care to a total of 771 patients during the second quarter of this year, this represents an increase of 22% for a total of 1,265 patients treated since the beginning of the year. This increase is due to the 10 new companies have joined the others to get medical attention. Bringing the total to date of 17 companies. These companies are divided again into three districts: The Hive - Ybucui - Mboyapey. They all belong to the Department of Paraguari. The Department of Paraguari capital bears the same name and is the only place where the District Hospital. Still, many patients must be sent to Asuncion, according to the complexity of the disease.
This does not include patients who have been referred to health centers for minor and major surgeries, consultations with specialists, mainly orthopedic neurology, allergy and immunology. The treatment of nodular goiter either diffuse or growth is very strong in this area, both children and adults. In many cases, children require and endocrinological address to determine the degree of hyper-or hypothyroidism. The main complications presented by these children are cretinism and heart disease.
patients also have led to several clinical studies, ultrasound, x-rays et al.
II-) forms of medical care.
THE REALITY OF THE RURAL HEALTH CARE.
• The rural reality is not very different from the reality of health care that occurs in children in the streets. Poverty is extreme in both cases. Field Children also work hard and most families are fragmented. On the other hand, a large majority of rural children traveling to Asuncion and its environs, with the hope of a better life expectancy, but are transformed into children on the streets quickly. 72% of children on the streets from the field. This is the main why the Truth and Justice Association, Inter Institutional
in coordination with the National Secretariat for Children and Adolescents, decide, from early 2008 to implement the project slowly MOTHER EARTH, rehabilitation of street children in Home Farm Rural School and Medical Clinic on one side and on the other hand, prophylaxis to prevent new children from the countryside to migrate to the capital, obviously in our area of \u200b\u200bwork in the Department of Paraguari.
• Given the distance from different companies, health care begins at 9:00 pm., So that patients can get to the medical clinic that is in Karaimi. Medical care ends at 17:00, because as the whole area is located between hills and mountains, the roads we are prepared to walk again late afternoon. Companies are more distant from Cerro Cajon Ñuai Ñuai I and II, a distance of three hours' drive to the rural medical clinic and three hours to return. In general, most distant of these companies, 5 to 6 families gather to attend the consultations. On these occasions, we talk to these families as their competition due to the distance, is just one or two times a month, depending on the severity of cases.
• Children make up 79% of consultations medical, with a main age group of 2 to 7 years. The priority is medical care for them. Then pregnant women, mothers and finally seniors.
• The role of elders in the whole area is very important because most children are cared for them and their mothers work as domestic workers in Asuncion. They are usually single mothers or mothers who have children from different partners. This is also why we prioritize the attention in the elderly, especially those in charge of several children.
• Mothers are usually multiparous, the number of births varies from 7 children as a kitten and up to 14 children recorded in two families. Many mothers attend an initial consultation with four or five children and then bring the others in the next query is why the birth control and pap smear are essential. But amazingly these only take place in Paraguari District Hospital, located about 200 km
III-) PREGNANCY. BIRTHS. GYNECOLOGY.
• Most of the parts are home, mothers have no access to the respective doses of tetanus vaccines, much less control scans.
• There is a high rate of maternal and infant mortality. Indeed
Paraguay has the second highest rate in
maternal and child mortality after Haiti.
• We have achieved in six months and five years in working with mothers on the street, that women attending a health center, at the time of delivery. Also, at this time the Government has arranged for free normal deliveries and caesarean sections. However, this is true only in Asuncion and with great difficulty. Health centers in rural areas does not exist, can hardly cope with a normal delivery, when delivery is often complicated by the mother and child die. And if they were taken to the Hospital District in Paraguari, labor cost is incapable of being taken by these families in extreme poverty.
• Both doses of tetanus vaccines applied them in the rural medical clinic of the Association for Justice and Truth, for free. We try to do blood pressure checks every two weeks and deliver iron and folic acid in all cases. On the other hand, calcium is essential, given the fact the child multparidad.
• A high rate of teenage mothers is found in the area, and induced abortions, performed in a home.
• The incestuous relationships between siblings or in the field are still the result of a cultural factor. This leads to pregnancy, chronic urinary infections and obviously increases the rate of sexually transmitted diseases.
We recorded renal colic and urinary infections in girls as young as 8 years. In addition, secretions or fungal type flow primarily by Candida albicans, in addition, trichomonas, gonorrhea, HPV - Human Papilloma Virus and Genital Herpes.
• We are currently conducting a statistical control of syphilis and HIV, through VDRL test and ELISA respectively. The Association is responsible for the payment of these tests, since this same statistic had done in adults on the street and was really positive and unfortunately the statistics did not match the records of the Ministry of Health of the country.
IV-) Main pathologies IN CHILDREN
• The main pathologies of the second quarter, matching the onset of seasonal change. The mountain areas are much colder, the streets of Asuncion. Therefore colds, bronchopulmonary complications, pneumonia, asthma, sinusitis and other are the main registered. Does not exist in the Department of Paraguari to date no cases of H1 N1 virus, according to the Ministry of Health of the Country.
bronchopulmonary pathologies, respond quickly to treatment and
that many of the children, because they are virtually isolated in different
cities have not consumed any kind of antibiotic or bronchodilator. Anyway, in two cases, we have derived
children to the nearest health center.
• Internal and external parasites. Severe anemia as a result of poor diet, based only fats and carbohydrates and parasitic diseases. • Like
skin diseases, mainly psoriasis, fungal skin and hair, etc. Also congenital heart disease, strokes and amputations, by fall of horse or animal husbandry own field.
cures of all kinds, burns, cuts, etc.
cysts and inguinal hernias.
V-) complex pathologies
AREA
• We have registered a case, made up of three siblings suffering from congenital Deformans rheumatoid arthritis, in a family of 12 children. Have not received any treatment in either childhood or adolescence. These young people belong to a more distant company, called Cerro Cajon. Association members have taken the drugs indicated only for combating the symptoms, such as pain mainly because, as it is a degenerative disease, expectations are not very encouraging.
• Another clinical case corresponds to a young man with schizophrenia Evefrenica. The young man is tied with a string, not to escape, has not received any treatment. Currently, the Clinical Psychologist of the Association, is pursuing the case.
• There have been cases of leprosy and tuberculosis. Thyroid tumors.
children suffering from meningitis or mental retardation of unknown etiology and three cases of Sx. Down. Epilepsy
three children and a teenager.
• Bites by spiders, snakes and other insects. There will be a visit to the Institute of Tropical Medicine in order to obtain polyvalent and monovalent sera. If victims do not die, the most common is to observe the consequences, such as necrotic lesions, nerve damage, blindness and others.
VI-)
DRUGS The particularity of a rural medical clinic, because it is not available any other nearby center requires the calculation of stock of medicines, which in this case has been treated differently to medical clinic for children on the street.
We are guided always agree, to the basic drugs for the Association which was amended in quantities including also special medicines to diseases mentioned above and a good team full of first aid.
In severe cases the patient can be taken to the Regional Hospital Paraguari or to a specialized center in Asuncion.
VI-) and deworming HYGIENE
• Works exactly the same job Protocol established for children in the streets.
Children are bathed and wormed. They change clothes, in case of scabies or multiple boils on the body. Also for burns and dressings.
• The main parasites found are: tunga penetrans, fungus, psoriasis, worms on hand, foot and scalp. Chafing infected limbs and genitals. In general the variety of parasites own field and the absolute lack of hygiene
VII-) DENTAL
Again the concept of extreme poverty and poor sanitation causes 83% children of the 17 companies, suffering from dental problems. Many also express dental malformations.
In most cases, withdrawals can only be made due to deep infection. We
Dentistry Dr. Marlene Gonzalez who runs the Dental Area. The main requirements are
anesthesia, antibiotics and anti-inflammatory. And disposable equipment, syringes, cotton, gauze, swabs, gloves and cover mouths.
The area will be completely separate dental Area Medical Clinic. At this time we are taking a census of major dental problems and children and youth in order to determine a priority list of patients. It is also essential to realize health talks for prophylaxis in this situation.
VII-) AREA CLINICAL PSYCHOLOGY
This area is being implemented in two months.
Gabriel Chaparro clinical psychologist, works primarily in two areas. Stimulation and teaching in the cognitive area, along with Argentina Soledad Lugones psychologist for the School Department.
Secondly, stimulation for rural children in a state of extreme poverty. And rehabilitation of street children who come home.
in principle also this new stage area is in recognition of the area. From a psychological approach - social. Extreme poverty is the breeding ground for many diseases in the area, typical of the reality that these families. However
already have in treatment:
1. A 3 year old girl with Down Sx
2. A 11 year old boy with mental retardation as a result of meningitis sequelae.
3. A 10-year-old girl with emotional trauma caused by an armed assault on his family.
4. As adolescents, 11 young people more in treatment.
Our deepest gratitude to all organizations and individuals goodwill, which allow this intense task in which we are committed full time, health professionals and other areas. Being benefited homeless children and rural children, both in a state of extreme poverty and extreme vulnerability.
team on behalf of the Association for Justice and Truth and all the children receiving free and dignified care.
Thank You! Dr. Chantal Hulin
Truth and Justice Association President
Karaimi, July 13, 2009 Company Ybycui
Paraguari Department
Paraguay