Ready set, super stress mode

So with two weeks left in the program the race is on. I've got a ton of work left to do and am constantly at the brink of exhaustion. I work hours in the clinic, get home spend time with the family, work on homework and then conk out.

I've got a twenty page paper to write and stories galore in addition. Here goes crunch time!

Antigua, NO this does not mean the island

Not only is this my first time in Guatemala, but it is also my first time out of the country. With that comes awe at nearly every city I visit, be it in a good way or a bad way. It was no different with Antigua. Antigua was unlike any city I have visited so far in Guatemala. Guatemala City is fast paced, dirty and feels terribly dangerous. Panajachel reeks of tourism and has little personality of its own. Chichicastenango is busy, touristy, and expensive and even has a bit of its own history with some colossal and gorgeous churches. Santa Cruz and Tzununá are hamlets off to themselves, as self-sufficient and as private as they can be with the resources available to them.

Antigua is an entirely different beast. It is quiet and busy at the same time; it is a tourist town, but also a hometown. There, tourists pack the market, but locals also go to buy their necessities. It is one of the more modern cities in Guatemala, yet its history is vibrant in its churches, parks and ruins. Despite its reputation as one of the most dangerous towns in Guatemala, Antigua gives a sense of security and comfort, which may be part of the reason for its danger. The city almost gave a sense of being back in the States (apart from the shotgun guard) with many restaurants and stores I hadn’t seen since leaving Miami. For this reason I liked and disliked the city at the same time. It threw me off to see so many ‘Western’ influences in Antigua, yet despite that, the city was able to maintain its own personality and vividness as a part of a Central American country.

The colonial and indigenous influence is seen in the contrast of everything that is Antigua. Its colonial influence can be seen in every church and monastery that stands in Antigua and even those that have collapsed. Colonialism has a hand in everything that is in Antigua, especially the shops and restaurants around town (McDonald’s). Even the markets geared towards tourists have that colonial touch, where women wear the traje to give tourists the ‘authentic’ touch, but the woman typically wear more modern clothes when not working. The people walking around town have a much more westernized style of dress and living. There are still the chicken buses of Guatemala in and out of town, but I almost get the sense that what was once indigenous is now hidden from view, leaving only to display a modernized city.

Antigua is practically as much in contrast with Santa Cruz as Columbia, South Carolina. The abundance and plenty in Antigua is unequalled. There is actually nightlife after 9 pm besides a few drunks meandering through the streets. Cars are parked everywhere, lining every street, advertising Antigua’s ever ironic modernity.

I found it impossible to get a sense of Antigua in just three days, every time I thought I knew about the city it would surprise me with what was around the corner. I found one thing for sure though; you can never be bored in Antigua.

Rain Rain Go AWAY

After I finished working on Spanish in the clinic I was running back and forth trying to stay underneath the awning of the wash basin for as long as possible. In aonly five or so seconds between the awnings I became fairly soaked. There were drops of water permeating almost every inch of my clothes. There was only an inch of my clothes. There was only an inch separating every dark blotches that vary between the size of a quarter to a dime. There there seems to be no small raindrops. When I watched the rain begin out on the basketball court, it seemed that there were even larger raindrops practically the size of a baseball. It took me only two minutes to cause every inch of the court to be darker gray with the color of wet cement. On the walk back to the clinic I stopped onto the road of squarish cement blocks. The water was rushing down the sides of the road where gullies cause deeper water. I splashed into water practically two inches deep and immediately felt the rush of water soaking my shoe. On the next step I felt the slosh of a soaked sock in my shoe. I had a flashback to the days of soccer pratice and tryouts with the drenched fields, avoiding the puddles, but not always being so lucky as to avoid them. I remember my blue, red and black socks being soaked as I sloshed off the field. Getting in the car as I peeled off the layers of socks almost wanting to leave them on to keep the warmth but knowing if I did, they would gradually get colder until I couldn’t get warm without the steaing water of a shower. Back in the street in Santa Cruz all I could hope for was the warmth of hot air blasting on my frozen toes.

There was nobody in the street to see my sloshing expedition through the streets/. It was silent apart from the drips of rain on the surrounding tin roofs. The store that is usually sitting open with its bags of processed food was closed down with wooden boards across the front. The children were all in the school, no PE for the kids the rest of the day. The library is silent as usually. The dogs, absent from the streets hiding out underneath the awnings throughout town. This is not the vivid Santa Cruz I usually know. It is a different type of tranquil, transformed by the rain.

June 6

Tonight I made the mistake of dipping a tea packet in lemonade because I thought it was hot water as I was talking to my family. The family laughed at me and Marta said I was probably thinking about my boyfriend. When I told them I didn’t have one she said she would look for one for me. I had heard a comment earlier involving me and a boyfriend, but this was the first time I had been told up front that they were interested in finding me one. I wouldn’t be surprised if they tried to get me to date Andres, but they probably think he is too young for me. And so it begins…

June 11
Today Andres was a bit distracted and was staring off into space most of the day. Marta kept joking to me that he was thinking about his novia all day. He kept looking away and blushing, so we kept picking at him since he didn’t deny anything. Later in the day after the political rally he joked that it was a girl from Tzununa. It has become a fun joke among the family to say one is distracted by their novio whenever they make a simple mistake. 

 

Clinic Day 1

So, I haven't had any access to internet for about a week, sorry I haven't been able to keep you updated. In the sake of saving time, I am going to simply posted an amended version of the notes I take during the day from class. I don't know how well posting pictures will go since the internet here is rather Jurassic.
This is about the first day in the clinic, my thoughts on ideas for my project and some medicine that I learned in a few hours.

Day one of the clinic

 When we arrived in San Marcos, we had to drive to San Pablo because it was too expensive to continue all the way by boat. Some men were working in the road and took their jolly sweet time to get out of the way of the middle of the road with their truck. Once at the clinic the ‘Salud’ doctors were in the room we should have been using. It seems that in San Pablo it’s not of huge importance to have a clinic to everyone who is not sitting and waiting. It’s possible that the people simply don’t know the clinic workers. Because of the meeting all of the pregnant women have

The following is simply a progression of my thoughts as I worked in the clinic today.

In the clinic the local women doing reception had papers strewn everywhere on a foldout table we brought from the clinic in Santa Cruz. There is another list besides what these women fill out for histories that includes the medicines that have been passed out to the visitors of the clinic. Men and women constantly surrounded the check-in table during the busy hours. People are constantly filling up the room to be seen until around 2:30 or 3 when things started to quiet down.

During one visit, a little girl was sick with diarrhea. The mother gave her daughter Gatorade which she was supposed to wait to do until the medicine had taken effect. I am unsure whether this was a miscommunication or the woman did not understand because she did not speak Spanish. The daughter proceeded to throw up the drink immediately. I later learned that she has a history of not keeping down liquids when she is medicated. She received a shot simply sitting on her mother’s lap. Later in the day older patients laid down on an exam table and went through the long process of removing their skirts to receive shots.

The pediatrician at one point early in the visits was asked ‘Do you have gloves?’ her response ‘I don’t have anything!’ Gloves were brought to her from the stash, but the process of examination is incredibly different in this country and region. The clinic was held in the public health center and was by no means sterile. The pediatrician is much the same as a doctor from the States, even though she is from Guatemala and received her medical degree in Guate City. She is incredibly intelligent and dedicated to her people. Children here also receive small ‘premios’ to distract them from the examination and calm them down a bit. Mothers in Guate are much the same as well. They both want drugs to cure their children of crying , however with the lack of education in Guate it is more understandable for the women to mistake it as magic.

The woman here in San Pablo wear much more colorful clothing, especially faldas, than the women in Santa Cruz. Maria, the new Suhtihil translator, explained to me that it is la vestido de la pueblo. In Santa Cruz the traditional garments include a black skirt usually with a red and blue striped shirt. Maria said the color of Santa Cruz was verde. I think it is incredibly beneficial to the community to hire locals to work as translators and transcribers in the clinic. I feel that it is so much more effective when they are taking histories because they can be much more in depth with their questions and they are receiving an education at the same time. This method is highly beneficial for the community.

Doctors in this clinic do an extremely good job of consulting each other and solving problems together. They are not afraid to ask each other for help when they need it. In the check-in process, by now most of the workers know exactly what the doctors want and can ask more specific questions so that if the doctor is busy histories can be taken. This speeds up the entire process a great deal.

To consult for information the doctor uses an almost antiquated or at least well broken in book by the looks of its pages. She said it would be wonderful to have a desk reference, preferably in Spanish for the doctors on the iPad. It may be best to have both languages if at all possible.

There are many prevalent problems in Guatemala. Many children are stricken with scabies and cause their entire family to be afflicted. Rhotovirus is also common. It is incredibly common to be afflicted with diarrhea. Supplementation with zinc has shown an improved survival of children with a diarrheal virus. The pediatrician believes that scabies is epidemic in Guatemala.

Sometimes it can be difficult for the visiting doctors because their Spanish is limited or the patient speaks a predominantly Mayan language. Suhtihil is the Mayan language of San Pablo. Here diabetics can only be checked once a week. If their sugar is out of control, they can only get it controlled if/when they go to the clinics once a week.

Compliance varies among patients. It is difficult to tell whether patients are compliant in general because it is so difficult to follow up with most patients. Addresses are not very explicit in Guatemala and doctors cannot help patients that do not come to the clinic because they usually can’t find them. The pediatrician is under the impression that compliance is good from what she has seen. There are, however, many reasons why a patient would not be compliant. The parent may think the medicine doesn’t work, sometimes kids vomit the medicine and it doesn’t get into their system or the medication has to be taken daily and they find that too annoying to deal with. Dr. Sinkinson was under the opposite opinion, especially with one respiratory patient who only takes medicines when acute problems present.

One ninety-year old Suhtihil woman who distrusted the clinic put purple ant poison in her wound to heal it.

When the pregnant women returned they were everywhere! The youngest I saw was only 14 years old, and her grandmother had just been in with another pregnant granddaughter. Nursing is not a private thing in Guatemala. Mothers probably see it as a necessity and it is not at all taboo to do in public with company you do not know. It is likely seen as a beautiful and necessary bond between mother and child.

Questions that arose about the project during the clinic visit:

Since prescriptions and information are all written on a sheet and calculations are generally done on a small calculator, will it be better to use during visits or to check patients in, or to compile information afterwards?

Is it possible to get a reference in both languages for the doctors who are rusty on their Spanish and one in Spanish so that they can still explain to the patients about what the medicine does?

Would it be beneficial to have a picture associated with a patient’s file to more easily identify them?

En la casa:

I think my family really wants me to learn Kaqchikel. They keep asking me, but I always respond I don’t know enough Spanish yet! They have taught me a couple words and I want to continue to learn.

I noticed that there are toothbrushes for everyone in the family by the sink. I thought that maybe because Marta is a dental assistant, she had encouraged them all to do so. I asked Cecilia if everyone in town did the same and she said yes. This is probably one of a number of good influences the clinic has had on the community. A doctor and dentist available in the same place have allowed the people of Santa Cruz to become more educated about health and sanitation. I would be interested to see if there is any data that indicates whether there really has been such an increase of health and sanitation in the community.

Day 1

Today I started my journey to Guatemala with Hannah's school day. We dropped Hannah off...and after a long hug (my buddy wouldn't let go) we got on the road towards Charlotte. I won't lie, I was nervous just before I went back to my flights. I don't think I've ever traveled alone and this was a HUGE first step, never having left the country before. We got to the airport incredibly early because technically my flight was international so it was around 9:20 when I checked in. Of course Mom was there to the last moment to say goodbye. (Don't trust her if she tells you she didn't cry in the car on the way to see Hannah's award ceremony... shoutout for winning 5 awards boo!)
After having my gate changed and an hour long delay because of the weather:

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I was finally on the plane to Miami. I happened to sit next to a guy on his way to Aruba because he decided to go last week! Besides the lady who had the same seat assignment (I think she looked at the wrong ticket) and pitched a fit, the flight went fairly well. In Miami I scarfed a piece of pizza and got ready to board the next plane to Guatemala City. All, of course, while furiously reading the book assignments that I couldn't finish because I only got them last week. On the plane to Guate an off duty flight attendant was next to me...I'm telling you that's the way to fly, first drinks and snacks, he knew where everything was! I got to practice my Spanish a bit on the flight as well.

When I landed in Guate, I had already filled out my customs forms and everything was a breeze. My luggage was exactly where it should be woohoo! I walked outside and there was Dr. Wallace waiting with a sign. He offered to take a bag, and yes Mom he said the black one was incredibly heavy.

We drove back to our hotel and I was thrust into a meeting to start off the program. 

It feels like nothing has changed weather-wise, humid just like Cola!

Here are some pictures from the street on the way to hotel, I thought SC's drivers were bad...

There are beautiful parks everywhere.

Coppers..most of them carry shotguns, yeah....

It's kind of hard to see, but this lady was carrying a Wal-Mart bag on her head. Yes this consumerist market has perforated this seemingly native society.

Our hotel room was pretty cool, but I still couldn't figure out how to get the hot-water working in the shower:

I am off to bed for now and to Panajachel on the morrow.