Our clinic duties had been completed and we had just set out for our return to Manaus when our boat captain asked a favor of our wound care specialist, Dr. Mohamed. Our captain’s aunt had a wound on her leg that was slow to heal and he asked if Dr. Mohamed would make a house call. Our doctor of course agreed enthusiastically. I asked if I could go, both because as a first year medical resident, I am still trying to learn as much as possible, and also because an extra pair of hands is always helpful when procedure may be required.
We embarked by speed boat, Dr. Mohamed, team leader Suzie, translator Marcos, our boat captain, and myself. We docked at a home on the river’s edge. There was a series of wooden walkways that led to her home. Everything was on stilts to accommodate the water level as it rises. We were greeted on the front porch by our patient, and Dr. Mohamed began his work there. Her right leg was already wrapped with a bandage, and the patient indicated she was seeing a doctor in Manaus on a weekly basis for this wound. He began asking questions to gather her medical history and any relevant information as he unwrapped her leg to examine the wound. She had been told the wound was a “veinous stasis ulcer.” She had broken that leg some years ago, and either the injury itself or the surgery had disrupted the veins in the leg, predisposing her to this condition.
I assisted Dr. Mohamed as he carefully debrided the wound and cleaned it to help it further heal, as he explained what he was doing step by step to the patient via translator Marcos. After completing, we re-dressed the wound and gave her additional supplies that will aide in its healing, along with instructions on how to change the dressing. Dr Mohamed asked the boat captain for her doctor’s number so that after we return to America, he could pass on helpful advise to continue to help the patient. We then cleaned up our supplies, wished the patient well and headed back to our boat. I don’t think I will be going on any other house calls that will be as unique as that one with Dr. Mohamed on the Amazon. — Dr. Mario, resident physician, Team Brazil Volunteer