May 5, 2015 3:13 pm

Meet the Patient: Maura's Tragic Accident

Written by  Molly Trerotola
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360-1In her dark, unlit kitchen filled with swarming flies and dust billowing up from the dirt floor, Maura lifts up her skirt to reveal her left leg—mangled.

Her flesh is contorted in unnatural ways, sunken in due to an absence of muscle, patterned with criss-crossed and jagged scars slithering up and down her leg. Deep maroon marks – a constant reminder of her physically traumatic accident – converge at a robust protrusion just left of her kneecap, which oozes liquid from a persistent internal infection. Nothing has healed since the day her life took a turn.

She tells us her story:

One day in November of 2011, Maura Quiñones Morales, a mother in her mid-30s, was driving her 10-year-old son to school in Villa María del Triunfo in Lima, Peru, going about their day as usual. Maura would take breaks from her workday as a driver of a mototaxi, a three-wheeled motorized scooter, to ensure her son (and sometimes his friends) arrived to school safely. On this particular day, Maura offered a ride to one of her son's teachers, and the three continued down the dusty road. Everything was fine, until a stray dog jutted out into their path, causing Maura to swerve violently out of control. She remembers the events vividly:

“When I stopped short, the taxi's roof flew off and I went flying through the windshield. After we crashed I didn't know what was going on, but I thought the worst. I thought my son had died. Sincerely, I fell trying to get myself up to see my son. When I saw him walk out of the moto[taxi], my reaction was… I was relieved. He walked over to me and said ‘mom your leg is broken', but I hadn't even felt anything at all, until I looked down. When I looked down I saw the top of my leg going in one direction, from above the knee down going in another direction, and my leg opened up with the muscle hanging out. It was ugly. I told my son not to worry, that I was fine. ‘I'm fine', I said, but I wasn't fine. And I tried to walk away. A woman came over to help and wanted to attend to me. I told her ‘please, I'm fine, but please give water to my son'. I didn't care about myself, only about my son.”

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Maura's son and the teacher were both fine; her son sustained a small cut on his head requiring only two stitches. Maura, however, was not fine. After examining her own physical condition, Maura realized the severity of her injury, and she understood she would need emergency medical care.

The accident occurred at 1:30 in the afternoon, and Maura did not receive any medical attention until 6:00 p.m. at the Maria Auxiliadora Hospital in Villa María del Triunfo. By the time Maura was seen, she had passed out from the pain, only to rouse from her unconscious state in an ambulance that was rushing her to another hospital. The first hospital not only failed to attend to her, but also lacked the facilities and medical professionals to treat her injuries.

Maura was transported to Virgen Guadalupe Hospital in Chorrillos, Lima, about a thirty-minute drive from the first hospital. While in pain she thought, “Why didn't they see me earlier? Why didn't they clean my wound?” She says these questions still haunt her today.

At Virgen Guadalupe, Maura was immediately admitted to surgery, which lasted four to five days. Although she suffered from pain and trauma, Maura found peace in knowing her husband was by her side taking care of her son; she was in the hands of experienced medical professionals, and her health insurance earned from her job as a mototaxista covered her medical expenses.

All at once, Maura's securities fell apart, she tells us.

The recovery was rough, Maura says, more difficult than expected, but she trusted in her surgeon who assured her everything was normal. For several months following the accident, Maura would have routine post-surgery check-ups every fifteen days. During these visits she voiced her concerns that her leg was healing slower than she had hoped for. Her intuition pointed to an error with the plates, screws, stitches, and bone reconstruction, but her doctor's confidence in her result did not waver. The doctor also sliced open Maura's arm from wrist to elbow to mend a broken bone, which she suspected was unnecessary.

360-3Maura continues her story by explaining how, after months of virtually no improvement, she consulted with another doctor whose second opinion revealed the first doctor's horrific surgical mistakes. The first surgery left her with a loose bolt protruding out of one bone, unattached to the other bone it should have been attached to, and one leg resulted four centimeters shorter than the other. Maura's leg was in the same state as the day of her accident, nothing had healed, and she needed another surgery.

“I didn't know what to do. I started to cry... It was all very traumatic,” Maura confesses. She felt immediate panic because her first surgeries and bi-monthly doctor check-ups had already drained the limit of 21,000 soles ($7,000) that her health insurance allowed her. She had no remaining financial resources to pay for additional surgeries.

“How was I supposed to pay for another surgery when I had a first surgery and it didn't fix my problem? What could I do?” Maura asks.

To further complicate the situation, Maura explains, she became pregnant just months after the accident. Her husband could not handle the stress of Maura's injury and a child on the way, so he left her to fend for herself. Left alone with no support system or income in Lima, Maura retreated to her city of origin in Trujillo, Peru, where family could care for her.

“It was a difficult pregnancy, but I endured it. And now look what I have,” Maura tells us, pointing to her bubbly two-year-old son Angel, who lovingly pulls at her skirt during the interview.

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Maura continues to tell us that, just days after Angel was born, she was rushed to the hospital with pain and an infection in her leg. “After that, I visited about six different surgeons in Trujillo,” none of whom knew how to treat her injuries after the botched surgery job.

She returned to Lima where she fortunately obtained minimal health coverage through an insurance system called SIS, a plan for Peruvians with low economic resources. Since then, she has been living a strained life as a disabled single mother.

Her unsolved injuries render her incapable of walking without crutches, so she seldom leaves her small, two-room casita house perched at the very top of a hill. Even with the MEDLIFE staircase, Maura explains, she walks down only twice a week, usually for medical appointments.

“Thank god MEDLIFE built the staircase near my house, otherwise I don't know what I would do,” Maura admits.

Her family of three is sustained by her oldest son who is now 13 years old. He purchases food, helps clean the house, and takes care of his two-year-old brother. “He is practically an adult,” Maura says regrettably. Money for food comes from the boys' father, who drops of a weekly allowance for the family at the bottom of the hill, then drives off. “He doesn't even come up to see us,” Maura says.

Maura admits that she misses her freedom as an agile and independent woman who could provide for her family. Her eyes fill with tears.

The injuries sustained from the accident are persistent and a constant reminder of the day Maura's life took a traumatic turn. The infection she developed during her time in Trujillo after Angel was born still remains; the doctor tells her it's a virus and slowly chewing away at the tissue inside her leg. She shows us the wound and shamefully re-bandages it. She's embarrassed.

“If I don't have surgery soon, if the infection does not heal, I will lose my leg. This is my biggest fear.”

Maura's good news is that, finally, after three and a half years since the day of her accident, she will soon receive the reconstructive surgery needed for a full recovery. The surgery will be intensive, she explains, with weeks in the hospital ahead of her. She knows her leg will never be the same, as she's lost a significant amount of muscle and bone, but at least she will have the ability to work again and provide for her family.

Her experience with the new health insurance, which covers almost all expenses, is infinitely better than before, she says. She still deals with frustrating issues to get the coverage she needs, as errors are continually made with her case—that is where MEDLIFE comes in.

Isolated in her house on the hill, Maura struggles to access medical care without external support. Her neighbor Herminia, a former MEDLIFE follow-up patient, suggested Maura contact the organization for help. Maura was reluctant to do so. “I had lost all hope that anyone would help me. I didn't want to get my hopes up.”

Since being introduced through Herminia to MEDLIFE, Maura has been immediately enrolled in the follow-up patient program and has received support from MEDLIFE in the form of medication, transportation to her doctor visits, and moral support throughout the entire process.

Although Maura is rational and accepts the reality of her situation, she is still angry with first surgeon who caused her years of pain and suffering.

“I would tell him how bad it's been, and that I trusted him to heal me, and he did the opposite. I would ask him why he operated on me if he wasn't sure how to do it. He should have sent me to a better doctor! I've had to undo all of the work this doctor did on my arm and legs, and lost years of my life. If you go to a doctor, you put your confidence in them. They have a license, so you put your life in their hands. I've always wanted to tell him how upset I am.”

Her anger subsides when she talks about her wishes for the future. “My children are the best thing I have in my life, and my hope is to have the ability to care for them.” Although this period of her life has been dark, Maura looks forward to the next step with optimism and hope that everything will get better.

“I would tell others in my position to never lose hope. If you have strength and determination to continue forward, help will come,” Maura concludes with a smile.

Last modified on June 24, 2015 2:17 pm