Baltimore Village Aug 7th

Today we took a long boat ride past Livingston to get to the Baltimore Village. We were not sure that we were going to be able to make it to this village today because there was a huge storm the night before that was possibly going to prevent us from boating.  I worked in triage translating this day. This village had many Spanish speakers with little need for translators. I noted that this people in this village were much more over weight and even the children had cookie wrappers and such they were clinging onto. The adults complained about pain in their hearts which I was not sure the cause of. I thought maybe it was heart burn from so much junk food. They also had rather poorly controlled diabetes. As we were leaving the clinic, we walked past rows of drying fish. We learned that the town sold these salted dried fish at the markets nearby for a profit. As we were leaving we watched little children in the water playing with a small boat. It was truly humbling and beautiful to watch these people who had so little be so happy and content with their lives. On a side note, the hotel “finka tatine” is AMAZING. Wonderful owners, food, animals, and it right off the river essentially in the tropical swamp grounds.

Reflection after the return home

I feel that I gained a mountain of perspective from this study abroad trip. I was able to see how people in another country of a different economical background survive. The political climate and the overall culture of Guatemala were hard for me to digest. I think that on our day with the promoters, I had true sadness brought to my attention. I was talking with one of the promoters who said he did his best to teach about safe partnerships, the importance of family planning, the need for contraception, and healthy relationships. This man recognized all of those problems and was doing his best to educate the youth. I asked him what he thought was going to actually change the way things were, he said he didn’t know if it could change because of the machismo culture. It made me so sad to hear this man who was pouring his heart and soul into educating the youth say he didn’t know anything would make a difference. These problems are on a country level and are not going to be able to change unless huge endeavors are made. I do not know how you can change a deep-rooted culture or a country that is strong on its religions beliefs even if it seems it is pressing the people deeper and deeper into poverty.

Baltimore Clinic

Our travel to the Baltimore clinic was by boat from the Finca Tatin hotel. At first, we weren’t sure we were going to be able to make the clinic day as it had rained so hard the night before. However, word was that the ocean had calmed down and there were no safety concerns about travel to the village after all. This village was off the Caribbean coast, and one of the more resource wealthy villages that we visited. I was surprised that this remote feeling village still existed as it does being so much closer to “city”life in Livingston and Barrio in comparison the more rural villages we had already visited in the mountains. There was a group of men and children waiting for us on the shore. Kids were laughing, playing in the water. We walked past a tarp covered in sardines as we trudged through the sand and grass to arrive at the clinic. This clinic was also larger and more spread out, which made patient flow a little easier. I was excited that this day was our windshield survey as I wanted to get a better view of the village and how its people lived. I was surprised to learn that school had been cancelled today because the teacher decided not to show up from Livingston. What a bummer for those kids, having a teacher that didn’t seem invested in her job. I wondered what kind of motivator might work to keep teachers coming back? I also was pleasantly surprised at the village tienda, which sold snacks as well as many common personal products. There was even a refrigerator/freezer in the tienda! (although it was not plugged in). The homes even had fences, some had gardens, a water source, and the animals that co-habitated (dogs, chickens, pigs, turkeys) all seemed a little more plump compared to the mountain villages. Our leader that took us on the tour, Manuel, was obviously a known community leader as several groups of kids came over throughout our walk into town to give Manuel a hug. Overall, the patients we saw on this day were more overwheigt and seemed to have more problems with diabetes and hypertension compared to our other clinics. I am certain that being less than a 20 minute boat ride to a larger city with resources (Livingston) made a difference in both patient activity level and proximity to processed food and other non-healthy resources. I was sad when we drove away in our boat, as we watched the children giggling and waving at us in their canoes close to the shore. This was our last clinic day for the trip. What a beautiful spot to call it a wrap.

To the Eastern Guatemalan Mountains

We only stayed in Guatemala city for a day before we left to head East in our giant old school bus to reach villages in the jungles of Izabal.  The 8 hour ride was intense. It was hot, sweaty, and literally kept me on the edge of my seat. The gravel roads and steep cliffs mixed with sporadic drivers had me clenching the seat in front of me. As we traveled deeper into the country, the attire of people began to change. Instead of generic t-shirts and pants, I noticed the women dressed in colorful skirts and lacey tops layered over satin tank tops. We stopped at a diner and I got a hamburger. As I took my first bite, I thought about seeing the ribs on the cows as we passed them on the side of the road.

When the animals are not being fed enough, it is clear the people are also struggling to get enough food. The burger tasted dry and gamey. I could only tolerate one bite before I passed it on to the others at my table. I felt guilty not finishing my food. Moving forward, I decided to eliminate beef from my diet for the trip.

Then we went to a special place full of Mayan ruins, where we were in awe of the beautiful stelea –the natural rocks that were upgraded to carve the inscription of hieroglyphic texts and images of rulers. These were dated as far back as the 200 A.D. years. While we were taking pictures of the plaza juego de pelota, we saw clouds congregating above us and a roar of thunder in the distance. Before we knew it, we were welcoming the giant, warm drops of rain as we ran squealing with excitement and delight under the large palm leaves above us. The moisture from the sky was so refreshing after sitting on the sticky and hot bus all day. By the time we arrived to our final destination –Palaiso –we all happily went to our cabins with fans and cool a/c for our first sleep in the rainforest of Guatemala. Our adventure to the other side of the country had been a success.

Esperanza Village

August 2018, Blog by Lauren Smith.

On this day, we had our first taste of the rural village Esperanza in Guatemala. The bus ride was hot and sweaty, with some staggering and beautiful views of the rainforest. There were huts dispersed throughout the area that were the homes to people of this village. As the bus jolted up and down over large rocks and bumps, I looked out the window and was taken aback by the green, luscious leaves and stocks of corn that engrossed the hillsides. What a beautiful, rugged place to call home. When our bus pulled up to the area we used as our clinic, there were Guatemalan women and children swarmed around the cement building, waiting for our arrival. Our first clinic day, I was assigned to be a runner. I helped make flags for the different stations to help us have some sort of organization within the chaos of the pop-up clinic. However, the disorder that occurred as a result of being in a single, hot room seemed inevitable. I ended up helping out in triage and the pharmacy the most. I enjoyed having multiple job roles since I am used to be a float nurse at work. I love variety in my job. The majority of the people we saw were women who were either pregnant, breast feeding, or almost pregnant. Many of the women and most of the children had a skin rash that they complained to be itchy and painful. I have never seen so many cases of scabies! I was relieved to learn that premetherine, which I had treated all of my clothes with, is also the treatment for scabies, as I was in such close contact with so many of the infected patients. This is also the first time I saw the way women carry their babies in a sheet over their shoulder and on their backs. I can’t imagine the dirty looks a woman would get in the United States if she carried her child this way. The other thing I noticed was all the gold caps and gold fillings that some of the native Guatemalans had, and the decayed and rotted appearing teeth that most of the others had. It was sad to see so many kids with decaying baby teeth. Overall, the day was exhausting but rewarding. This was one of the first times I have seen how happy people can be living such a simple life in poverty –and it seems they are so happy because they don’t seem to have been exposed to other ways of living. I felt a twinge of guilt and shame knowing how privileged I was and how terrible we are to each other and to people with less in the US. On the other hand, I was in awe of how a simple life of having less can lead to such genuine happiness. Another successful learning day in the books for me.

Landscape

Wednesday, August 1st, Blog by Heidi Stecher.

We had an amazing third clinic, seeing about 100 patients. The team worked cohesively and efficiently. We had reset the stations as they were the day before. We saw another village but in the same spot. I was impressed with Lesbia, the health care worker who does all the charlas.  The charlas are different talks such as on gastritis, headache/back pain, colds, and GI viruses. Lesbia saw many people at a time teaching patients about these subjects and how to care for themselves. It is the presence and work of the local trainers, promodores, that make a huge difference in the education and understanding that allow for lifestyle changes to be made. They already have a rapport and built in trust since they are from the villages.  This work is priceless and incredibly meaningful to the people they serve. It is my belief that this is where the focus ought to be when outside organizations come in to serve. It is very brief and has a “band aid” effect when people come and go, but when there is a villager who is the health care worker who can help maintain and continue the education, this is where change can happen.

There were seven of us that decided to walk an hour from the village to where our bus had broken down. We were so impressed with the beautiful landscape and wanted to spend more time in it. Along the side of the road we found a mama pig with her seven piglets, plants with leaves that curl in when touched, and smiling children playing. The time went fast talking with my colleagues learning about where people worked and plans for their future. I think times like this with smaller groups within the large group lends itself to better communication and understanding. It was a walk to remember.

 

 

 

Village

 Tuesday July 31, Blog by Heidi Stecher. 

We took our bus carrying at least 25 people and supplies to Chinachabilchoch.  This is a very remote village straight up a mountain with precarious turns and drop-offs.  But the view from the bus was spectacular, emerald green hills and mountains softened the landscape with its curves. Such tremendous beauty with luscious over growing plants and trees. This came to an abrupt stop after the bus we were traveling in could not move its back tires up a hill. We all plopped out of the bus with half of us taking the truck to start triaging patients while the rest had to hike up the mountain an hour and a half trek.  Thankfully, I was in the truck group, but once we arrived we scurried to put our stations together and formatted lab, vitals, triage, provider, pharmacy and charla (teaching) stations. We saw about 40 people that day.

     The villagers stayed around us, watching inquisitively, smiling.  Some children would burst out laughing, but when catching their eye they would look serious. I noticed the beauty of the people, to intricate fabricates women wore for their skirts with lace-like tops.  Many had babies or children hanging on them.

      That night we played scattergories and had a delicious meal of tamales, beans and rice outdoors in the village’s center. Ron and I debriefed with everyone and reflected on how it has been going so far, what they had learned, what they have been processing on the trip. I think this was a point that brought us closer sharing our thoughts and feelings about our experiences.

    We spent the night up in the village in our sleep sacks under mosquito nets in the school. This was an adventure, from a reclined position we had a hilarious time, spending the first hour in our sleep sacks laughing at and with each other. During the night so many sounds affected our sleep from snoring, to the sound of large pig being slaughtered, to gentle, creeping children’s footsteps on the grass outside the open air window to numerous crickets chirping their song.

First Clinic Day

Monday, July 30th, Blog by Heidi Stecher.

Our first official clinic day was spent in the town of Esperanza Tunico.  We saw about 60 patients. We, unfortunately, had a sick colleague that needed immediate help in the clinic. This threw many for a loop as some left their stations to assist her and getting her IV fluids and nausea medication.  It was stressful for those taking care of her, and the rest of us plugged along in the sweltering heat and humidity. I can’t remember the last time I had been drenched from head to toe and continued that way all day. I realized that this is what it will be like for the next week before heading back to Guatemala City.  So, I told myself not to expect the moon, and I can only do my best according to what the environment provides, as the weather itself is debilitating to the mind and body. The weather affected my ability to think quickly and I was slow in my movements. This reminded me to drink more and include electrolytes.

The clinic itself was busy, we were exhausted.  There was confusion with who was next after vital signs.  So, I knew we needed to get that ironed out before the next clinic.  I worked in triage and we saw many with complaints of body aches, gastritis, cough, skin issues like scabies, some wounds and also pregnant mothers and children.  One woman had to give a urine sample, so I offered to hold her baby. The babies are swaddled with a large blanket triangled and twisted at the top. They hold babies from the twisted top and swing them. Elma, our lab tech, said she doesn’t hold the babies because she is not used to holding them that way.  I tried and swung the baby, but I felt uncomfortable, so brought the baby up to my arms and held him.

 

Exploring

Sunday, July 29th, Blog by Heidi Stecher.

Today we traveled east about 8 hours from Guatemala City to Lake Izabal in an old yellow school bus. From what I heard is that the yellow buses found in Guatemala are from the United States, ones that didn’t work very well.  Oh geez! But I am sure the Guatemalans are resourceful when they break down or maybe most people are more mechanically inclined than most Westerners who bring their vehicles to get serviced instead of fixing it themselves.

We made about an hour stop at Quirigua Mayan ruins.  We are staying at La Finca Paraiso outside of the town, El Estor.  This was very cool to see, I enjoy going to Mayan ruins, I have been to Tikal which is outstanding.  Quirigua of what has been uncovered was minor compared to Tikal but nonetheless impressive. It is situated amongst large beautiful trees entangled in immense vines.  I tried to imagine life there as before when it was a booming commercial center. What are the Mayans wearing, what did they look like, the colors? In my mind, I saw brightness, blue, yellows, and reds, shiny jewelry with many beautiful colored stones.  What was the condition of the stelaes? The natural rocks that were both an art form but also a way to communicate the history of the leaders and wars. I also imagined if similar trees existed there if the climate was the same or different if we were smelling the same air.  Was it thick and humid? I wanted to jump back in time to the 800 A.D. because it felt unreal and I wanted it to become real. As I was thinking all of this, we received a downpour that lasted minutes but seemed to wake me up from my imagination. Now I saw my colleagues ahead of me that looked like drowning cats. Another thought that came to mind did they have cats?  Ha-ha, oh yeah panthers…

 

Guatemala Reflection

Saturday, July 28th, Blog By Heidi Stecher, Guatemala: Health Services Delivery in Resource- Poor Settings Program.

 

Today we are in Guatemala City, our first full day here.  We traveled to Dr. Jennifer Hoock’s home, in Santiago, about an hour bus ride from our hotel, Barcelo in Guatemala City.  (Barcelo is a higher end hotel, which I was pleasantly surprised to experience). Dr. Jennifer’s home is the main outpost for Guatemala Village Health.  This is where she has trainings for local Guatemalans and volunteers from the United States. Aldeas Sanas is the partner organization of GVH. Samwel, our driver and English-Spanish interpreter is the director of Aldeas Sanas. He is the man on the ground in Guatemala for GVH.  Surrounding the training center outside are stations where GVH teaches and trains people on better living practices. The stations include a permaculture garden, a carpentry studio, a safer housing structure for villagers and a latrine utilizing sawdust for cleaner sanitation.

After being introduced to the center, we began unpacking our medical supplies and then repacking our medications into various categories. Some students worked on their projects, while others organized for our first mock clinic at the training center. We divided into the following sections for our clinic: registration, vitals, lab, triage, provider, and pharmacy.  The Guatemalans oversaw registration, and the rest of us were at the other stations. Our provider is Sukhi, a physician from Illinois, who also brought her son to volunteer, Suryabir, who is studying genetics in college. We also have Sam, a high school student with us translating Spanish to English for Sukhi. The leaders of GVH who are with us are Dr. Jennifer Hoock and Carolyn.  Carolyn speaks English and Spanish and is one of our primary interpreters.

I have to say the mock clinic was insightful to how our team will work.  Having at least 30-40 Guatemalans show up and move through the clinic was a big task, but I felt we did very well and communication between the team members was smoother than I anticipated. However, it ran a long time, but as to be expected since this was our first time. We were able to “tryout” our Sexually Transmitted Infections survey and realized that it was too sensitive of information to bring forth by someone outside the culture. It seemed to work well if Juanita, the Guatemalan nurse or Lesbia, the health promoter asked the questions in a secluded area. So, we hope to give this a try with our subsequent clinics.