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March 15, 2015
Santa Rosa de Copan, Honduras

This is the update on Edin Ayuri. It's longer than most, but worth reading to the end.

I arrived in Honduras on Monday and made it up to Santa Rosa on Tuesday. This was the 2nd time I had seen Ayuri since he first became sick. If you don't know who Ayuri (Eddy) is, then please click here to read his story before proceeding. The picture to the left is of Ayuri with his fiancée. To be a better fund-raiser, I should have taken pictures that showed him when I left him on Friday... but I have too much respect for him to do it.

Last time I saw him in November, he was supposedly recovering from Hepatitis. Wrong. I thought he was a ghost last time I saw him. This time I saw a young man who has gone on a liquid diet because eating normal food tends to cut his gums which then bleed all night - making it impossible to sleep without choking on his own blood. But ask him how he's doing and he answers "tranquilo" with a smile (tranquil or fine). I informed him that I was going to take him to Tegucigalpa the next day as we had an appointment at the cancer center early Wednesday morning and the appointment was about 6.5 hours away by car. It used to be more, but since the current president is from our region, they've improved a back road through the mountains that cuts the trip.

We went out to the Moses Project for the night and he came back into Santa Rosa early in the morning with Daisy to get an injection of Vitamin K (whatever that is) to reduce the bleeding. They had arranged a donor to transfer a pint of blood in the morning but I asked them not to so that the tests in Teguc would reflect his blood and condition as-is and not as reflecting somebody else's blood. We made our way to Comayagua in the afternoon and met up with a doctor there (my wife's brother) who had arranged the appointment in the cancer center. We arranged to leave for Teguc at 6am on Thursday and true to his word we set off early to join the traffic nightmare that is Teguc.

At the Cancer Center Emma Romero de Callejas I heard Ayuri recount his story to the first doctor that established his case file before the specialist was to see him:

They did various tests at the Cancer Center and asked us to return in the morning to do a third bone marrow biopsy (but this time they scooped a sample of the bone itself). Before finally letting us go at noon, the blood specialist there asked us in to review the preliminary results and said because his blood levels were so low, she had arranged with a doctor in the Hospital Escuela (University Hospital) to give him a transfusion of 3 pints of blood. So we took a taxi to the hospital and entered a war zone. We finally made it through two layers of guards to get into emergency and then with no indication of where to go, we were directed by a student catching his breath that we should enter a side waiting room.

Upon our entry to that room, we were accosted by a young doctor demanding to know why we were there. We said we were there for a blood transfusion arranged between the Cancer Center and a Dr. Chavez. This young doctor kept insisting on asking for our proof of blood donation (which we obviously didn't have) or a relative from whom they could steal the blood. Had it been just Ayurin, they would have turned him out, but I was mad and quite willing to fight the young gods in white uniforms. They kept asking me to leave and wait outside and I kept answering that I'd leave when they started putting blood into him. Three hours we waited for them to "find" 2 pints of blood. Three was presented as an atrocity that we would even ask. Then they decided that his condition was so critical that they wanted to keep him overnight.

Given the instructions from the cancer center and Ayuri's experience in the public hospital in San Pedro, he was having none of that and asked me to sign a release that I was taking him into my custody (the only way we could get him out of there). Six and a half hours after arriving, we finally left. I came to realize that these student doctors were really trying to do their job in war zone conditions - but the way they treat the humble people who stream through their doors is what I would expect of a vet in a cattle operation.

We had arrived in Teguc on Thursday expecting to leave at 4pm. We finally left Saturday afternoon and then our ride arrived so late that we had to stay overnight 1.5 hours away to avoid driving through the night to get back to Santa Rosa, a no-no on the highways for personal security (extreme levels of carjacking) and potholes that can eat your car if you stay on the highway.

The next day, Monday, we met in the local university with Dr. Ricky from a neighbouring city, Gracias, who coordinates the Cuban medical brigades. It was encouraging to have the director of the agricultural engineering programs help us physically locate the doctor on the university grounds and then stay with us until we finished. He sincerely demonstrated full support for any kind of assistance that could be given to Ayuri and while looking for the doctor, mentioned that the students were doing a campaign on Tuesday to raise funds to help Ayuri.

The hope with this doctor is that he helped arrange for another Honduran to go to Cuba for a bone marrow transplant and we're hoping he'll repeat the feat with Ayuri. He told us that we needed to take Ayuri to Gracias that very afternoon for more blood and further tests. He's basically having to recreate all the test results in the public health system that we have already obtained in the private for political reasons in Cuba. It makes sense that they wouldn't want to select someone perceived to be rich to be a recipient of their public assistance.

I took Ayuri to the hospital in Gracias and they did another X-Ray and took another blood sample (this guy needs a plumbing valve that he can simply open to provide samples). The nurse in the lab informed me that they couldn't do half the blood tests because they ran out of reactant and didn't know when more would come (days, weeks or months). Then before starting the blood transfusion, the doctor informed me that Ayuri's defences were so low that he had to stay for the night. This time we relented as we count on a doctor who is genuinely interested in helping Ayuri and who promised to check in with him late that night and then again first thing in the morning.

Tuesday I texted Ayuri at noon that I was on my way and he responded that they were fine with him leaving - just waiting for a doctor to fill out his exit report. We waited until 2:45pm for that report and finally left for Teguc. His arms look like a bad heroin addict with all the scars from injections that didn't quite work too well (the one nurse was almost blind and had some difficulty finding a vein...). But they treated him well. Ayuri mentioned that his room-mates (5) told him it was weird that they all looked sick and he looked fine, but that they understood that he was in far worse condition than them. One asked for his personal information to pass along to his church's prayer chain and others asked for his number to keep in contact (which they have). It's cool to see God in the middle of horrible situations.

I asked one of the young guys there what happened to his arm (all wrapped up). He said it was cut. Then he tilted his head to show the stiches in his neck and the back of his head. He had been wacked 7 times by a machete. Judging by the fact that his head was still on top of his shoulders, I'm guessing the machete wasn't very sharp. Ayuri tells me that during the night another guy was brought in with 3 bullets in him... I could never work in emergency medicine in Honduras!

After waiting 3 hours for a doctor to sign his exit papers, I was able to take Ayuri out the next day and return to the Cancer Center in Teguc to review results.  The doctor confirmed severe aplastic anemia and said the medicines he was on were all they could do for him in Honduras.  Dr. Duarte mentioned that they used to have an agreement with the Bethesda Hospital in Maryland for cases like Ayuri’s, but that it had come to an end.  She mentioned that apart from the US, the other option was a clinic in Navarro, Spain, which would be about 10% of the cost of the required transplant in the US.

On Thursday, a friend helped me obtain a copy of Ayuri’s file in the Hospital Catarino by taking pictures of the documents in the file - a file that has no record of the biopsy from December 29.  A medical student who was one of my students 10 years ago took me to a hematologist who told me that Honduras does not have the capacity to perform compatibility tests for a stem cell transplant.  Ayuri has 4 full brothers & sisters (mother and father) and I hadn’t understood before that they wouldn’t be automatically compatible for a transplant.

On Friday, March 20th, Ayuri woke up back at our project (we made it home Thursday night) with fever and vomiting and in extreme pain.  I was called to his room at 6am and it was a mess.  I took him to the emergency in Gracias where they gave another blood transfusion along with medicines by IV (that they had sent me out to pharmacies to find as they didn’t have any) and oxygen trying to stabilize him.  I then had to leave for Santa Rosa de Copan for a much delayed appointment that was the original purpose of my trip back to Honduras and the next morning I returned to Canada.

On Saturday morning at 7am they transferred Ayuri by ambulance back to the Hospital Catarino where he has been shuttling between emergency and the men’s ward.  This morning, they were trying to locate another 2 pints of blood and indicated that he was still in serious condition. Two ex-students from Hector Emilio Medina Bilingual School in Santa Rosa are our personal angels in that hospital - keeping an eye on Ayuri and notifying us if there is anything he needs that they don't have and his dad can't get. I thought they were afraid of Triny when I spent one year working for her at that school, but it turns out they realized how much they meant to her and they're paying her back by helping us. God bless them!!

We are pursuing options in Spain, Cuba and Mexico - trying to find a place that can help Ayuri with a stem cell transplant, both with action and financial support. More to the point, Ayuri needs a touch from the Master Doctor to cure him outright or keep him alive until He uses a bright doctor here to cure him.

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