The Scars of Odessa

I got the idea for the title of this post from my dad.  Yesterday was our first day volunteering together and it was an eye opening experience.  Odessa has many wounds inflicted by the wars and rise and fall of the Soviet Union.  The city is slowly healing though; worn out buildings and dilapidated roads are slowly being remodeled, but I am here to treat the scars of the local people.

Dasha met me at the center to donate clothes and books

Yesterday we started our volunteer adventure by heading to The Way Home's community clinic outside of town.  There I met some old friends of mine who used to work at the center downtown.  We had a joyous reunion and enjoyed catching each other up on the last few years.  They were excited to hear about my plans for PA school, and getting married, of course.  Our first patient was a 21 year old woman who's parents died many years ago, leaving her and her siblings homeless.  Her family quickly fell apart after that, and she reported that she no longer speaks to any of other family members anymore.    It is easy to understand why then she is a self mutilation victim.  She had more self mutilation scars than I have ever seen, and I worked in a psychiatric clinic where attempting suicide is often the only way to escape the relentless voices and hallucinations.  

Outside the clinic - known area where alcoholics and drug users hang out

My friend from 3 years ago

My first clinic patient

She allowed us to examine and treat some of her fresh cuts.  This cut was deep and should have been treated with stitches, but at this point it was too late - all that could now be done was allow the wound to heal by secondary intent.  Apparently the cut she had was much larger days earlier, since she had gone swimming in the sea and it had gotten irritated.  We cleaned off the site with alcohol, then applied Neosporen to the site.  Apparently Neosporen is the biggest thing since sliced bread here.  I had no idea that it was not available for purchase here.  Neosporen, a cheap and simple ointment found in almost every home in America, is a desirable luxury in Ukraine.  I will have to bring a suitcase full of it next time I come.  After cleaning the area and treating it, I applied a simple bandaid.  We told her to remove it tomorrow to let her wound breath - this would keep the bacteria out and would help it heal faster.  The most meaningful part of this experience was not the treatment of her injury, but the conversation I was able to have with her in Russian.  She came into the office after we had treated her, and asked my friend if she could chat with me.  It was a simply enough conversation - Where are you from? Where were you born? etc.  Just the fact that she took the time to sit us me and talk made me feel like she trusted me and appreciated my help.  I also got to learn more about her past life on the street.

Next up, street patrol.

Our van

We got into the Way Home's street patrol van and hit the streets.  We weren't sure what to expect, but the man who came with us did his best to explain what was going on and where we were to me.  The language barrier was there, since most of the vocabulary used is definitely not something you would learn in a generic Russian language course, but we did our best to communicate throughout the day.

Dr. B reporting for duty!

Our first stop was in the middle of a large round-about away from downtown Odessa.  We carried food to the middle of the area where we found a group of 4 teenagers hanging out drinking vodka.  They all seemed to have some neurological defects, similar to the signs I had seen last time I was in Ukraine.  I suspect the defects are due to a life of drug abuse on the streets.  We gave them some food then proceded to ask if any of them had any medical issues we could assist them with.  We cleaned up some cuts with alcohol, then applied the magic Neosporen.  The young woman approached us to show us how the sides of her lips were infected.  She likely had a fungal infection, but unfortunately we did not have much to treat her with.  It is so hard to see problems that would be easy to remedy in the states, but impossible to treat here due to lack of access to medical supplies and equiptment.  Some of the guys were asking about antibiotics, but apparently they are too expensive to even consider buying.  Even if we did buy the medicine, it is unlikely they would be taken correctly.  The street patrol leader told us that even buying toothbrushes for this population is ill-advised.  Seems like encouraging basic hygiene is a losing battle.  

Walking through the round-about

Checking out a minor abrasion on  his forehead

Next one of the guys started telling us he was having abdominal issues.  My dad asked if he could take a look, and what we saw was terrifying. It looked like this kid had been attacked by a shark.  He had the meanest looking scar I have ever seen.  My dad said it looked like a nephrectomy, kidney removal, scar, but that they were highly unusual in children.  The kid sitting next to him, as if to get in on the attention, slowly started lifting up his shirt as well.  To our surprise, he had a nearly identical and equally disturbing scar.  It looks like organ harvesting is an epidemic in Ukraine.  One woman I had met in a bus earlier in the week had told me about how children were being stolen from the streets for their organs, and I could not believe this to be true until I saw those two scars.  I am still trying to find out the full story.  Were they victims of organ harvesting?  Did they willingly sell their kidney?  How much money was given to them if they were sold?  I hope to have my questions answered tomorrow when we attend the street patrol again.

The boy with the unusual scar

Our next stop was through a mini forest behind a few buildings.  It looked like a camp site, but no one was home to greet us.  I was shocked to see people lived here, out in the open, without even a roof over their heads.

No one was home

Our last stop was underground.  We had to wait for a minute before being invited inside.  It was dark, since there were no windows, but the myriad of families that shared this basement level made life comfortable by laying carpets down over the dirt and rocks, making privacy walls out of curtains, and using Christmas lights as decorations.  They were nice enough to let us into their home.  We returned the favor by patching up some minor injuries and treating some guttate psoriasis.  The young man who met us had it on his arm, elbows, and knuckles.  Luckily I had a homeopathic remedy with me - the one I had bought with my future mother-in-law when I needed alternative treatments for my bout with poison ivy/oak (Thanks, Jenny!).  I cleaned the area with alcohol and then applied the ointment using a Q-tip and gloves.  

Life underground

After seeing me treat her son, the old woman who was standing in the back made her way to me and sat down where her son was sitting.  She also wanted to be treated!  The fact that she also had guttate psoriasis confirmed my dad's diagnosis that it was a non-contagious genetic disorder.  After treating her, we left a supply of ointment and Q-tips for them.  I believe tomorrow we will be going back to visit this family, so I bought more Q-tips and intend on leaving the rest of my ointment with them.

All in all, it was a very successful day.  We may not have made the biggest difference, but maybe we helped heal at least a few of the scars of Odessa.