June 15, 2015 3:36 pm

Meet the Patient: Raul Veliz

Written by  Jake Kincaid
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Raul lives around the corner from a primary school in San Juan de Lurigancho with big murals of lush scenes from children's stories outside it, Little Red Riding Hood and Bambi. Grass, trees, flowers and smiling forest animals flank the entrance to the school and decorate the street leading to Raul's home.

The murals stand in stark contrast to the surrounding barren landscape that encloses the community- rolling hills of dirt and crumbling rock the color of ash. As you get this far into the hills surrounding Lima it takes over everything, swallowing all normal city infrastructure, even a staircase is a blessing here.

Raul opened the door to the communal gravel courtyard adjacent to his small home in San Juan. It takes him some time to wearily limp from the door to a seat in the center of the courtyard, his step quickly passes over his bulging and discolored right foot. A tella novella can be heard conflicting with cartoons in neighboring houses- a lot of people live in close proximity here.   

Raul's young daughter, one of four children, mills about and watches us with wary eyes as Raul sits down heavily and begins to tell us how he is doing.

Raul is a taxi driver. He spends hours seated, pushing on a gas pedal with his now badly infected right foot. A combination of long days sitting in a taxi, genetics, and obesity all contributed to the development of varicose veins. A vein became blocked in one spot, the vein swelled into an ulcer, which left untreated, then burst leaving the open wounds that are now highly infected.

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He only bothers to use one word to describe how his foot feels: “dolor” (pain).            

Raul said this problem began more than a year ago and signifies the beginning of it with the same word, pain. He had pain, so he decided to try and get treatment-he went to a doctor.

Raul's daughter runs off as Janet, the MEDLIFE nurse, gives him an injection.

Raul said the first doctor he visited told him to continue his work normally, bandage the wound and then to release the bandage and elevate it at night. He did this, but it got worse.

Janet slowly pours bottled water on the gauze as she prepares to inspect it. She unravels the gauze partway then gets stuck and sighs when she gets to the open flesh, the centerpoint on his calf where the bulging black and purple flesh begins to radiate outward. The gauze won't budge without taking some of the wound with it.

Since Raul's condition was worsening, he went to another doctor, who told him not to bandage it. This was awful advice, and the infection progressed. He continued working as a taxi driver.

After lots of water and careful tugging both Raul and Janet wince as a section of the gauze finally comes free, pulling only a little bit of flesh with it. Then another section comes free, then another, with each one the sour, damp, astringent smell of infected flesh gets stronger, mixing with the dusty air. The sores have gone untreated for a long time and the infection is clearly very severe.

At his wits end, Raul decided to try another doctor recommended by a friend who was supposed to be a specialist. The doctor gave him 5 injections in the wound at a cost of 85 soles each- a huge cost in this community. They did not help him, it is bad practice to inject an open wound and this was not an effective medicine for the condition.

“Every doctor has a different way to work,” Raul said. “Who am I supposed to listen to?”

At this point, it did not take a doctor to see that the situation was becoming dire. Raul went to a hospital. They told him he could get an appointment in a month, but by then, he would likely have to amputate the leg.

It is not unusual for healthcare to be delivered on these time-scales in Peru, and it is often too slow. Had he received proper and timely treatment an infection could have been avoided. Raul went to a Medlife mobile clinic, and is now finally receiving reliable medical care.

Janet cleans the sores and gives him anti-inflammatories, painkillers and antibiotics to fight the infection. It is uncertain whether or not it is too late to save the foot. Janet schedules another appointment in a few days to check on him. MEDLIFE is committed to finally giving Raul the reliable quality healthcare he deserves.

Last modified on June 23, 2015 3:59 pm