CRMF Mission

For ten days I volunteered with the Caring Response Madagascar Foundation (CRMF) as a translator. CRMF is a nonprofit organization that started literacy and sanitation projects in the Tamatave area in 2004. Six years ago they began a program where doctors from the U.S. come for ten days and hold free healthcare clinics in five different areas, including one in the countryside. Ten PCVs volunteered to translate for the doctors, run triage, and help distribute medications prescribed by the doctors. 

I worked in one area per day but experienced each station throughout the week and a half. When I helped in triage I asked patients, 'Inona tena marary indrindra?' or essentially 'what is the most pressing problem?' Most often the patients said they had a headache, back pain, upset stomach, or shortness of breath. I would then fill the intake form and decide if the patient should go to pulmonary, infectious disease, internal medicine/general, pediatrics, or OB/GYN. They would consult with the doctor and then go to pharmacy to receive prescribed medications, deworming pill, vitamins, and iron. In pharmacy I explained the medication schedule and asked the patient to repeat it back to me to make sure they understood which pill to take when. The day I worked triage, I would jump back to pharmacy when they were backed up. It was interesting to see the initial intake form and then the diagnosis. Somebody that came in with a headache turned out to have very high blood pressure for example.

In pulmonary, the doctor asked me questions with vocabulary I had never used in Malagasy such as 'wheeze' or 'hold your breath.' I quickly learned these terms well and asked other volunteers when needed so that the doctor could accurately diagnose. We sent several people to the hospital to get a chest x-ray, and guessed that several others had COPD, tuberculosis, or lung cancer by asking about their symptoms, listening to their lungs, or looking at their fingernails. In internal/general medicine, we saw many people with high blood pressure or difficulty seeing. One woman couldn't see out of her left eye and I had to break the news that we couldn't treat that. Another woman was diagnosed with ovarian cancer and no funds to seek treatment. The internal medicine doctor was also a deacon of the Catholic church and so I translated a prayer and blessing for the woman. In infectious disease, I saw a man with end stage liver disease whom we sent to the hospital. One women had a tooth infection that had spread to the outside of her cheek. We were able to treat her with several months of antibiotics.

There were a lot of very difficult cases in which people did not or weren't able to seek treatment sooner resulting in such extreme cases that even the doctors had not seen before. Some questions were difficult to translate in a way that the patient understand and could give the answer we were looking for. For example, when I asked 'when did symptoms begin,' many people answered, 'efa elaela' ('already a long time ago') when it was very important to find out exactly how many months/years ago a rash or growth started. On the flipside, we were able to provide healthcare to over 800 people that may not have sought or been able to afford medications otherwise, especially in the countryside. We covered several x-rays and hospital stays in order to help the person in every way we could. 

Translating was more difficult than I thought. It was harder to speak English after translating Gasy for several hours. I found myself even translating English to English.
 
Dr: I need to find gloves
Me: We need some gloves!
Dr: and a privacy curtain
Me: Can we get a lamba! Wait you're asking other English speakers.

However, one year ago I never would have thought my language skills could progress to a level where I could participate in a mission like this. All of the PCVs worked great together in that no one was too prideful to ask what a word meant. Everyone understood that the patient's care was the most important. The CRMF mission was exhausting but so rewarding. Each member of the team was invaluable to making the clinics possible, and we helped hundreds of people and their families that may not have sought treatment otherwise. The CRMF mission helped me personally in that I'm now considering a career path I hadn't thought about before. The founder of the organization gave me wonderful advice on non-profit program coordinator positions and the logic model for grant writing. This was another very memorable part of Peace Corps service, and one of the best programs I have been a part of.

You know you're a PCV when:
-You never need to use an alarm. 7Am is sleeping in.
-You rarely feel the need to look in a mirror

This woman was 100 years old!