Guatemala Al Finale

The Finale!

We have finally arrived to the last day of driving an hour each day through windy roads dodging people, dogs, and other cars to arrive safely each time to Sibilia. The doctor picked us all up at the same location in front of the great smelling panaderia.

Today was market day in Sibilia filled with all of the animals for sale. People were walking their little piglets by ropes swatting their bottoms if they fell behind. Others had cows crowded on the back of their truck with turkeys tied to a basket on top. It was amazing to see.

Usually there is an exam where we test each individual. If they pass they get antibiotics, and if they don´t then they spend more time practicing with the doctor in the clinic. But, people became so nervous in the past that not many would pass. So we opted on doing more practice exams.

But the clinic was filled with kids. So we had each one act as though they were in their own communities and had to see each kid one on one. I would sit behind them and tell them to pretend I was not there, but that only meant them looking at me after each answer they provided to see if they were doing ok or not. They would even ask if they were doing ok or not...and I would look out the window ¨with a smile saying no estoy aqui!

I ended up with at 50% pass rate...3 people did perfect, 3 people failed miserably. I thought, well this probably isn´t good, until I heard that the other groups had only a 25% pass rate (1 out of 4 people) which made me feel slightly better.

We ended the day with a graduation ceremony and provided all certificates. They were all so grateful. One lady decided to hand out prayer cards and then do an overextended prayer inviting the evangelists to stand up and pray. Another lady stood up to say that she was catholic but felt it was ok for all of her religion to stand up as well. We went on for 10 minutes praying and I couldn´t tell who was winning in prayer since each seemed to be doing their own saying out loud. Augustine and I laughed quietly and I was sure one lady was going to fall over like they do in the tv.

At the end, everyone wanted photos of everyone. My group couldn´t stop giving the hugs asking me to come back. One lady cried which of course made me have to look another direction for a small bit.

I had Gloria, my 18 year old star student talk with the doctor about medical school. I was so excited for her and proud hoping that she could achieve what she wanted until Doctor Tomedi brought down the mood with...¨that´s not what we are trying to achieve- you send her to medical school and then there is no prometora in that village- we want the best to stay in their village and help out their communities.¨I found that a very odd way of looking at things. I always want to better people and help them to do what they want. And for this girl to go to medical school would be an amazing thing. The hope is that she could help her community out even more by doing that. But to keep her in her village because she has talent...it just seems odd.

She ended the day by giving me a homemade card very beautifully designed with roses and sayings. I definitely could not help the tears and couldn´t stop hugging her. I don´t care what anyone else says, I want her to fulfill all her dreams and not be held back by who or where she is! Hopefully we will stay in touch and I can hear how she is doing!

I am now back in Xela for one last bang. The stomach has held through the many foods even though others have been infected by the ¨worm¨ otherwise known as Jorge. We have finally diagnosed it as Ascaris Lumbricodes since it has appeared in forms such as linguine...and have quickly gotten them on medicines. Others have had the enjoyment of fleas, but I am still holding strong. But who knows what tonight and tomorrow will bring!

Now I am on the search for a guatemalan bike jersey and a beer!
Until tomorrow!

Guatemala Nutrition

I have all these degrees and today was my hardest day...Nutrition of all things.

The goal was to have a discussion about the malnutrition and how to prevent disease. Then, easy enough, we talk about what to give kids from the ages of 0 to 2 years! Right up my alley right? Dietitian, Pediatritian...what could go wrong?

Oh yah, the small thing called spanish. Today it was the deer in headlights effect. I would ask something and they would stare at me. Then they would get excited and start rambling away, and I would give them the blank lost look.

After lunch, the idea was that we could bring all the small groups back together and present the topics discussed earlier. After lunch my heart started to beat. I realized I had no idea what, if anything, they got out of the morning. And, my fear started to build as I had no idea what they would present. I decided to pick the smartest girl of the bunch which is, of course, the 18 year old female interested in Medical school someday.

The first group presented and they blew me away. Then our group was up. The dentist decided to do his own presentation of the group which i was quite fine with. Then the presentation. It was unbelievable! I was taken back by how much information she provided and how exquisite she presented. I could go as far to say that I was very proud of my group much less my student! However, I am not sure if that was my doing or her knowledge already. Whatever it was, she made me look like I had all those titles and taught something...whew!

We are almost done with our project. Tomorrow will be the last day with some exams for them and certificates to end the show! They have learned alot and although some I would not trust giving antibiotics to as they would give it to a child with one day of cough...the others have, I guess what you call, grown from this experience.

My new project is to communicate with the doctor tomorrow and see how I can get this girl in my group to medical school. Their medical school costs $5/ month roughly....and I am sure that can be provided if she really wanted to go. She is a family of 8 children living in no town and has finished her high school education. She is unbelievably intelligent, and it would be my dream to make her go from health care worker to doctor if I can!!! That would be an accomplishment!

Until tomorrow

Guatemala-Return of the Chicken Bus

Day 3
Wednesday hump day

The return of the chicken bus. At 5:30 am the only thing available to get us to the chicken bus was a taxi that all 6 of us piled into. The poor guy kept scraping every bump we hit and at the end got a flat maybe from us or maybe from the car not having its tires changed since it was bought in the 80s.

Aaahhh but the chicken bus. I miss the bus. The man nearly had all of us in the front of the bus when he slammed the breaks to miss the sheep in the middle of the road. Only the gringas screamed which made all the others around us laugh. The women in their traditional wear holding on to the middle trying to fit 4 people on one seat on those old school buses with smelly farmers sitting practically on my lap. Why wouldt you take this kind of transportation. And of course you cant miss the blaring music with the occasional american 80s song making a hit or the bus hugging the edges of the mountain side to make it to Sebililla. that was the start of our morning.

We decided since the real docs went to the city to pick up supplies that Augustine and I would run the clinic while they were gone. After all, we are doctors.
So again we found kids, and had the promatoras practice while we treated the kids afterwards. I had to make sure they didnt try to give kids antibiotics with every runny nose as that seems to be their favorite thing to do.

Then, it was back home by 3pm the early day to walk the Parque and watch the little children run around like it was the best thing that ever happened to them today. They seem to find joy in just being outside and the rock under their mothers shoes is the most fascinating thing to play with. I have realized that you dont need fancy toys to satisfy kids. You can just find a dirt patch and they will be happy for hours.

I had my ice cream and shower, and am now relaxing with the sun shining nice and bright today. It is great to finally calm into guatemalan time and shake the daily grind of american life. We work too much. We dont find the dirt patch and see the excitement in just sitting and watching life in its fullest. There is so much in just what is right here. And when I am in America, there is this constant push to work...work to be healthy, work to make money, work to make dinner, work to study....lots o work. It takes effort to break that American mold and balance the life we all live. I have found ways, but that also takes work.

So please, everyone, grab a glass of wine and take off your shoes and let your feet feel the grass tonight. Afterall, we are living the great life right now as you read this

Love Amy

Guatemala- Doctoring

My group of 6th grade educated health care workers faced another day of experiencing what the danger signs are of a child about ready to die. At least that is how I have to teach it so that they will get the idea of a sick kid and not so sick kid. My one man who apparently has been a dentist for 35 years (although his teeth would not show it) commented on his extensive knowledge of giving injections for nerve blocks. But as soon as I taught them how to give injections of Ceftriaxone, he was the first to start out wrong. Again, I would highly NOT recommend him for dental car unless you are stuck in the mountains of Guatemala with a root canal and no transportation...then maybe. (plus he is a farmer so his hands don´t look like our friendly neighborhood dentist with pristine nails).

Today we had ¨real´¨ children from the clinic that we could all have them practice how to assess. The first, of course, was a kid who decided to cry through the whole exam which meant having them try to count respirations with a crying child. They did a great job ( try counting for a whole minute...especially with a screaming child...ain´t fun) and of course it was faster than normal so they all wanted to give antibiotics. They were right, if the kid weren´t crying and they soon learned that you have to calm a child down before getting a good reading.

We then had to give injections to each other to practice. To my amazement, they got it save the dentist. All of them could mix it, draw it up, and inject it (water for practice of course) by the end of the session.

One of the ladies brought her baby doll and I used it for my practice cases for them to ask questions. They would laugh when trying to count the respirations as I made the doll bounce up and down with respiratory rates or cry throughout the questions. I named my kids ¨Rico Suave¨and Gringa Rubia, and they laughed so hard. I am not quite sure how much they got, but I do know that they seemed to have a good time.

One lady lived across from the Centro and invited me to her house with cats on the counters and a dog trying to get my attention by petting itself on my leg. It was apparent this family had connections with the united states as their pets were already ¨pets¨. She opened her back gate to a whole field of corn. One as big as Brett´s apple orchard...and when I asked if they sold it, they said...no we eat it all! Can you believe it? That´s alot of corn!

Anyway, another day!
I´m heading over to the doctor´s house with the others for dinner so will have to write more later!

Hasta pronto
De Guatemala

Guatemala Again

Day 1
The Return to Guatemala

Ah, the smells of guatemala return with the sweet petrol creeping through my 6 dollar per night room as well as the bumping comforting noise of the regeton music from a few streets down. I turned off the lights last night and felt the comfort creep back in of being back in Xela. Amazing what a little noise and smell will do for you. The walls, although they make for a private quarter, don´t do justice for the creeping noises of other folks crawling back to bed or opening their doors at 3am for a potty break. But every time I awoke, I smiled and returned to my nesting position realizing that there are people close by.

This morning I walked towards the smell of the panaderia to find breakfast for all of 50 cents. We then piled 7 people until a four person car and traveled safely up the winding roads to the mountainous village of Simbala. If corn was worth something this whole community would be rich with row upon rows of corn intermixing with villages and horses. Dogs ran past the cars with one unfortunately getting hit before our eyes. And when a team of medical people still have to turn their eyes it shows that we still get emotional to watch something die.

The Centro de Salud was nothing more than a huge concrete building with 30 chairs. All of the prometores came from different communities, and we split them into groups. My group of 6 ended up being a mix of people who have been health care workers (meaning no education required to be the liasion between their understanding and when to send them to a doctor) for 20 years to a new one only 18 years old. But the amount of knowledge they carried surprised me! We discussed danger signs in kids, diarrhea, dehydration, respiratory distress....all in one day. I had a baby come in from the clinic that they could practice counting respiratory rates...but by the end I think the little chitlin could handle no more and was breathing way past the normal. At least they could tell me that. One lady was trying to count with her watch held upside down, and after I realized that she was only counting whatever she wanted (not the baby), I turned the watch around and told her just to watch the baby. I think she got it. Maybe.

The wife of the doctor made cafecito and lunch which consisted of pollo de pepein (traditional chicken with mole like sauce but not...apparently I was told that) rice, tamalitos and some gelatin dessert I would highly recommend not eating again. The melted M and M´s on the top gave it away.

It was really interesting being the ¨trainer¨for the day. They really looked to me for advice but the idea was that they come up with all of the information and then practice different scenarios. They were more excited to learn about my new engagement and how to come back with me to the United States the the guide. Many times, they would start talking about the food they wanted to make me and stories of their family in the US. We had fun, but I would try to bring them back to the reason they were there without forgetting to have some laughs in between.

We ended with me telling them to go home and practice counting respirations on other people which quickly turned into trying to count respirations on the opposite sex. One guy said that would definitley make the respiratory count go higher than normal (at least they got the concept) and became the talk of all the other groups as they came out laughing about their homework.

As I sit in the infamous internet cafe with computers no farther than two feet from each other, I realize what I miss about Latin America. When you have mix of blaring stereos and mixed scents of burning wood with petrol that is one moment to bring you back. But the smiles and affection felt by mere strangers that continually welcome you into their life, their homes, and their food...now that is the latin america I miss.

Time to go look for dinner!
Hasta Manana