I was thinking there weren’t enough hours in a day back home but I’m feeling like I need even more time here!
Today was just another ordinary day with lots of patients, scheduled and walk-ins, lots of them, since my second TV interview aired yesterday. (I was dying to see myself but never had a chance! Did they get my better side?!) Since we are staying in a room inside the clinic it didn’t matter the time to end, therefore who ever is here and willing to wait, we’d see them. Yesterday we had some walk-in patients who waited for 4, 5 hours to be seen, some of them came from another community accessible only by boat or canoe. They would canoe to Parintins, then walk to the clinic. I just couldn’t turn them down, therefore we tested all who were here and they left with hearing aids!!! They still needed to get home via Amazon River for 1, 2 hours, hopefully they all arrived safely; come to think of it, they are probably very familiar with the river for this is the only “road” they have.
One not so ordinary event today was that we had a surprise visitor in the clinic. This needs a little explanation. In the previous blogs I’ve mentioned the errors in previous testing performed, these tests were mostly completed in the only other clinic in Parintins with audiometry. It is the Municipal Hospital called SUS (Similar to our General Hospital where people of all income levels can be treated), then sent to the only ENT in town (who comes to Parintins one weekend – 2 days – a month; he sees 80 patients per day from what I was told!). Several patients have told us that the visit was so short that he didn’t even look in their ears! He looks at the audiogram from SUS and writes a referral to the Viva – O-Som Foundation for hearing aids. Since our very first day here with my first patient who came for hearing aid fitting I became suspicious. This lady was carrying on a conversation with me with an audiogram showing severe hearing loss; therefore we retested her and found that her loss was 20 to 30 dB better in average! Wow! That was a sure eye-opening, jaw dropping finding! From then on we retested every patient, even the ones coming for hearing aid checks, and we did not find one audio that was reproducible!
My suspicions were building up as the days go by with the clinic/clinician at SUS, Rildo then called SUS and left a message to their audiologist. This young audiologist named Stephanie appeared at the Foundation this afternoon! Good for her to confront the problems!!! We had a good conversation and found out that she is a newly graduate from the Speech, Language, and Hearing Program in Manaus just the beginning of the year. The degree in Brazil is very different from the USA. In Brazil the Speech, Language and Hearing degree is an undergraduate degree, after completion they are allowed to work in any area of Speech, Language or Hearing they’d prefer. In Stephanie’s case she was hired by SUS to handle ALL!!! Being the only one there, she gives Speech and Language therapies and does hearing tests, one person does it all! (Now, Lord, please forget me and give Stephanie 25 hours a day because she needs the extra hour more than I do!) She explained that she started in March or April of this year but noticed that the microphone of the audiometer was not accurate; therefore she stopped doing the speech audiometry; soon after she noticed that the pure tone audiometry was not accurate either. She continued doing the audiometry and giving the test results for patients to take to the ENT for medical clearance, thinking that they would come back to her after seeing the ENT but these were just forwarded to us. Now her audiometer just completely died (Thank you, Lord! That’s great news!!!) Well, mystery solved! I explained to her that if I am not confident with the accuracy of the test I would not put in paper and sign my name! Because of this inaccuracy the hearing aid fit can cause further harm to patients. She was very agreeable and appreciated my explanation and our help. She even stayed and observed my consult with a patient. Now we know that all previous tests need to be repeated with caution.
Sorry for the long post, and boring for my readers who are not audiologists, I am describing this event is detail with the hope of this message be given to all future volunteers to be cautious and retest all patients referred toViva-O-Som Foundation.
Today was the Cindy and I got to go out for dinner. We ate at a street side vendor for her to try the local “delicacy” called Tacaca, (Cindy did not like the taste, the smell, nor the look!!!) along with BBQ sausage and meat, accompanied by cold rice and bean. I love my food hot (or even just warm would be o.k., not chilled), when I questioned the cold rice and bean I was told that since the Amazons is so hot, people here believe that hot food would give them a stomach ache. Well, I guess my stomach is now “gringo” since I had the worst stomach ache after eating the cold food! It was a lonnnnng night….
Got to go now (it’s 2 a.m. now) to get ready for tomorrow, it’s the clinic’s second anniversary. The open house is eight a.m., guests are invited for breakfast! We need to help tidying up the clinic (or better, our mess in the treatment rooms!)