We returned to the Jurisdiccion Sanitaria in the morning to assist with the day’s brigadas. We set out to the 21 de Marzo community, where we canvassed door-to-door assessing prevention methods and looking for possible Dengue patients.
In theory the preventive methods are simple: ensure that there are no sources of clean water for mosquitoes larvae. But in practice, it takes considerable effort. Tanques where clean water is stored for washing dishes must have insecticide in them. And with the daily tropical down-pour, anything can become a receptacle if left uncovered outside. The largest problem, however, is that it takes complete community support. If you do all of the outlined steps, but your neighbor doesn’t, chances are the resulting mosquitoes aren’t going to respect your efforts.
With that in mind, ensuring everyone in the community understands the importance of prevention was our goal of the day. We split into teams and walked house-to-house interviewing residents about recent symptoms that correspond to Dengue, assessing their preventive techniques, and addressing any concerns. Working in these communities is a slow game—many families weren’t at home and others weren’t eager to open their homes for inspection. The majority of homes we visited were following the public health guidelines, but it’s not stopping the spread of Dengue—we found a case of probable Dengue in an 8-month-old girl. Taking a sample (no easy feat in the field) and encouraging the family to take her to the nearest hospital were all we could offer.
After finishing up in the community, we flagged down a truck for a ride back to the city and headed over to Hospital General de Tapachula. Faced with an ever-increasing list of Dengue patients, Dr. Romero provided a crash course on the disease. After familiarizing us with Mexico’s classification of Dengue No Grave, Dengue con Signos de Alarma, and Dengue Grave, she gave us an overview of the symptoms that land patients on her registry. These signs and symptoms include a high fever, hepatomegaly, fluid accumulation, persistent vomiting, abdominal pain, myalgias, and retro-ocular pain.
With this background, we’re ready to see patients!
Global Health Mexico 