AHOME, Mexico — Trinidad Monson Payan arose before dawn and hitched a ride to the small white adobe clinic where he knew the gringos from California would be. A wide straw hat shading his wizened face, the 77-year-old man patiently awaited his turn.
By the time the hot sun had climbed high in the sky, a couple of hundred people crowded with Monson Payan outside the clinic, located off a dirt path in this distant Mexican village. Drawn by announcements on the radio and word of mouth, the townspeople lined up under a tree, sat on benches, leaned against pickup trucks. Babies cried, gray-haired women napped, vendors with carts sold fruit and horchata , a kind of drink.
Inside the clinic, the gringos--a group of American doctors, nurses and volunteers--worked with relentless assembly-line speed: quick, efficient, hectic. Patient after patient filed in. A dentist extracted teeth in between emergency surgeries; three nurses diagnosed aches, gave shots and counseled on diabetes care; a nurse-practitioner gave dozens of women what would be their first-ever gynecological exams.
And in one of the clinic's five makeshift examination rooms, Dr. Jule Lamm, a Santa Monica optometrist, worked steadily.
As a ceiling fan whirled overhead, Lamm used a tattered eye chart, donated plastic test glasses and a hand-held retinascope to detect everything from cataracts and retina diabetes to simple farsightedness. It is a rudimentary system, Lamm admitted, but it does some good.
"We do the best we can with what we have," Lamm said, wiping sweat from his brow as he sat on a cracked metal folding chair. "I wouldn't work like this in the United States for anything, . . . (but) I feel lucky here to be able to do something that someone really needs.
"There are few things in life that if you don't do it, it doesn't get done," he said. "This is one of them."
Lamm, 65, and the others are part of a cadre of doctors and nurses from California who for years have taken time out of their often lucrative private practices to go to Mexico, where they offer free or inexpensive medical care to impoverished Mexican peasants and townsfolk.
Under the auspices of a handful of organizations, the medics fly down in small private airplanes, hauling their own equipment and boxes of medicines, vitamins, blankets and other supplies. Several of the doctors, such as Lamm, pilot their own planes.
They say the work gives them a rewarding sense of independence and gratification that they don't always get in their regular practices. Here, patients dress in their Sunday best, wait hours without complaint, and give hugs of thanks to the nurse or doctor who attends them. Here, free of bureaucracy and hospital hierarchy, nurses can diagnose; pharmacists can prescribe.
The care offered is simple, back-to-the-basics, grass-roots medicine. Immediate, quick. You see a problem, you fix it. No insurance forms, no liability, no threats of malpractice lawsuits. And it's tax-deductible.
So for one long Saturday each month, eight or nine months a year, Lamm and the others staff the Red Cross clinic in Ahome, an agricultural town of about 20,000 people roughly 850 miles south of Los Angeles.
On a recent Saturday, the day that Monson Payan visited the clinic, the American group saw about 300 people in 11 hours.
When Lamm saw Monson Payan, he shook his head. The old man was one of 23 cataract cases Lamm diagnosed that day. Most were rescheduled for operations that will be performed later this year, when the weather is cooler, by an ophthalmologist who, like Lamm, will fly down.
"I want them to operate on my eyes so I can see better," Monson Payan said in Spanish.
As the day wore on, the volunteers took blood pressure readings, inspected skin rashes, dispensed medicine for stomach ailments, and remedied vitamin deficiencies. Dozens of people with arthritis, diabetes and infections passed through.
Nurse Teresa Plomgren, a Pasadena native who works at the San Bernardino Community Hospital, compared the day's pace to that of an inner-city emergency room. Yet the solutions are sometimes as simple as over-the-counter pain relievers, eye drops or an antibiotic.
"Something that is so easy in the States is like a miracle here," she said.
"It's like the Peace Corps," said Chuck Olver, a pharmacist who doled out medicines from metal shelves set up in a side room.
Lunch on Gurney
The Americans, who work with interpreters since few speak Spanish, paused only for a lunch of refried beans, tortillas and spaghetti, served up on a gurney that also doubled as the operating table.
Behind one door with a hand-lettered sign saying Quirofano (surgery), Dr. Eric Munson, a dentist, spent most of his day pulling teeth. No suction is available, and fillings are not performed because they are too complicated. Munson said he can relieve a lot of pain by the relatively simple procedure of extracting rotten teeth.