Let me tell you a story.
A Costa Rican man wakes before dawn. His family, wife and five children, sleep soundly though the house—open to the outside as there is no door—is warm, the air sticky and filled with the buzz of insects. He pulls a long sleeve shirt on, patched pants and thick boots. Though the day is going to be hot he needs the protection from sun, insects, and foliage. He notices briefly that his legs are swollen and his stomach aches but he brushes it off as just another symptom of work. He leaves for the fields before the coming sun has a chance to even dimly light the horizon.
Work is hard and intensive. He has a single bottle of water to last the day, filled from an unknown source, and the sun by ten beats down relentless. By noon there are still no clouds in the sky and the temperature climbs steadily toward its peak in the mid 90’s. The man feels each degree and movements become painful—the human body not designed to withstand such physical labor in such painful conditions. But he continues. His sons are too young to begin working, the oldest only five, and his wife cannot work as the baby needs constant attention. His lone income must support them.
By the end of the eleven-hour day he is stiff, sore, and irritable. His back aches from the stress of constantly leaning over, pulling weeds and debris from the plants destined for shipment to the United States and Europe. A headache pulses at his temple from dehydration and sun exposure. When he arrives home he says a brief greeting to his family before reaching for the pain killers, cheap and over the counter. He swallows three in quick succession with the aid of a beer.
Alcohol is cheap here and it helps him relax. The weight of the stress—feeding and clothing a family on such limited income—melts away with each drink. He eventually sleeps soundly enough.
The next day is not the same. He is nauseous and can barely pull himself from bed. His limbs are thickly swollen and he is exhausted but unable to sleep due to the sharp pain in his abdomen. He takes a ride with his friend—the only one of whom who own a car in his neighborhood of patchwork houses—to the regional Hospital. The doctor comes out looking tired but unsurprised, diagnosing the man with kidney disease. He will need to begin dialysis immediately.
He can no longer work. As they begin the surgery to implant the catheter into his abdomen he wonders vaguely…how will his family eat now?
This has become a sadly common story for those working in the fields of Costa Rica and specifically Guanacaste. For the Liberia Regional Hospital the average age seen beginning dialysis is only 40. Within the last few weeks, two 18 year olds (having already been working for a number of years) were diagnostic with kidney disease. Most of these people have families they are supporting and have only a very limited income. Some, those immigrants from Nicaragua, without papers or government support, will not even be able to withdraw from the Costa Rican health care system.
I traveled to the Liberia Hospital this past week to see what could be done for these patients. Many do not have the means at home to perform the dialysis procedure and must make the often lengthy and costly journey to the hospital regularly. It is in this that we, both my team in GMI and Rice University as a whole, can make perhaps the most immediate and greatest difference. The design and construct of a cheap, adjustable tool for the aid in dialysis delivery can help those who cannot currently complete this task on their own.
I’d like to think this is why the Global Medical Innovation program exists. We are students but we are also engineers, designers, builders, creators, and dreamers. With the aid of Rice, and this program, we can begin to fill the gaps in the world’s healthcare system: going to the places, meeting the people, and repairing the systems that have been ignored, forgotten, or over-looked. There are so many needs in the world of medicine and medical technology, some small and some large. We students only have a year to try and meet some of these needs but even if we bridge only a small gap in a small corner then we have moved the whole world forward just a little.
This is why I’m here. This is what moves me and why I strive to grow as a medical engineer. I don’t know if I’ll ever see any difference in the world, but if I can make a difference to one struggling family then it was worth it. That’s all.
Jeannette Nelson
I would like to thank a few people for my experience in Liberia this past week, it truly was an inspiration trip. First to Emmanuel and Bernal for helping me experience what is truly faced by the patients. Without them I would not have understood the hardship and real needs of the community. Secondly Rice University, the GMI program, Eric Richardson, and Sheretta Edwards for coordinating and financing the extra trip. Thank you for helping me understand why I’m here.