Daniela traveled over an hour by bus, through the Andean highlands of Ecuador. Taking time away from family, children, and grandchildren, and even the $2 round trip bus fare was a strain, yet she felt she should not wait any longer to see a doctor.
She made her way to the Hospital del Dia Virgen de Guadalupe and the examining room of Mission Doctor, Albert Exner. She had become more and more concerned about a dark painless spot on her cheek that had been growing larger and larger.
“In the United States, this would be a skin cancer until proven otherwise, and warrant a referral to Dermatology for microsurgery”, noted Dr. Exner. He explained that while the government provides health care at no cost she would first need to visit the dispensary near her home for a referral to primary care 30 km away. She might then be referred to dermatology another three hours away, and if all went well she would be seen in three months, and perhaps the next month has the excision.
Knowing she was unlikely to seek this course of treatment due to the expense of travel and concerned about leaving this untreated for another three-four months, Dr. Exner offered to remove it with the understanding that no biopsy would be able to be done from Guadalupe. Daniella gratefully accepted. Dr. Exner said, “I removed a modestly generous border, and thankfully everything looked clean.” He added, “You do the best that you can, often weighing the risks and benefits, and in the end put everything in God’s hands.”
Dr. Albert “Rusty” Exner is the Medical Director at Hospital del Dia Virgen de Guadalupe in rural Ecuador. You are a partner in the lifesaving care Dr. Exner and all Mission Doctors provide around the world. Thank you for your support, we could not do it without you!