Facing an Array of Problems

WARNING: Some photographs are quite graphic. Viewer discretion is advised.

When the staff arrive at the clinic in the morning, they don’t know what types of patient cases they will be called upon to treat on any given day. Each day presents its own unique challenges with which they must deal. The cases may range from separating a frightened, feverish, crying child from his or her mother for a few minutes to take vital signs, monitor weights, check on the condition or progress of diabetic patients or to treat serious wounds and infections. And sometimes patients are even too dehydrated or too weak to sit upright.

As soon as patients arrive on the campus, they are shown respect, treated with kindness and their concerns are addressed without regard to whether they can pay for the services rendered or not. Medications are provided as necessary. This is not the norm for patients seeking treatment at public clinics or hospitals. Since the Manos Amigas clinic is not sponsored or run by the government, it is designated as a private clinic, primarily for the poorest of the poor—but open to all who seek its services.  

In the photos that follow, we have captured a few of the more remarkable cases encountered at the clinic during the preceding month that we would like to share with you, simply to show the scope of the patient presentations encountered there.

Malnourished 18-month-old child from an impoverished family weighing in at 11 lbs. New pajamas and nutritional supplements were provided.


Frequently the clinic encounters patients with multiple maladies, especially in older patients. This patient has psoriasis, a bacterial super-infection and conjunctivitis.


Diabetic patients are frequently encountered. Many of them are prone to infection and foot problems, sometimes because of improper fitting of shoes, abrasions, irritation, and even cuts and bruises from a lack of footwear or suitable garment covering while walking barefooted along trails, through brush and tall vegetation or traversing unpaved roads and fording rocky rivers and streams.


Many families still cook outdoors over an open flame, so burns are common, especially among children or older family members who sometimes accidentally stumble onto the ashes or fall into the fire. Here is a patient who had been scalded by a hot liquid.


This patient sought attention at the clinic from a gun shot wound. Earlier in the day he was turned away without treatment from a regional hospital. The physician cleaned the wound, removed the bullet, applied antibiotic, and sutured the wound. Firearms are prevalent throughout the country, especially in rural areas.


This patient has an outbreak of Herpes zoster, a painful, blistering skin rash. It is more commonly know as shingles.