Santa Catarina Palopo

Clinic Day 1

Best part of the day was giving children their goody bags

While in Belize we cared for people that had the bare minimum for healthcare insurance; regardless, they still had the privilege to see the doctor when they needed to if they did not feel well. In these small villages of Guatemala, these people have nothing. After my first day in the clinic, I discovered that the people in Guatemala rarely go to the doctor and they often have no insight into their own medical problems. Even pregnant mothers rarely go to the hospital to have their babies, instead they have “comodromas,” a Midwife, who delivers the children. Medications such as Tylenol or Ibuprofen are too expensive to buy and the patient has to suffer in pain for many days. It is not that the people do not care about their health, it’s that they don’t have access or the funds necessary to maintain all areas of health.

Walking towards the first clinic

The clinic we set up was up the stairs on the right
The building is a medical office for the locals to go to if they have a problem; however when we arrived it seemed like no one had used it in a very long time

The town we visited today was a first-time clinic for the program; never before had we been in this town to provide medical care. Not only did we not have a previous relationships built with this town, but also the locals had no idea who we were and there was no established foundation of trust. The best we could do for that day was advertise that we were there and hope people showed up.

The town of Santa Catarina

This is a "taxi" where people climb into the back of the truck, hold onto the rails, and stand until they reach their destination 

Another obstacle for being a first time town was that we did not know common specific problems in that area, so we only brought a few supplies and medications to hand out. We were supplied with Ibuprofen, Tylenol, acid reflux medication, Benadryl, hydrocortisone cream, anti-dandruff shampoo, cough drops, and a goodie bag for everyone that included a month supply of vitamins, soap, toothpaste, and a toothbrush. Unfortunately, we had no antibiotics, blood pressure medication, or diabetic medications. 

I was assigned the role of pharmacy, where I had to hand out medications based on the physical exam findings. I found myself saying “sorry” too many times because we did not have antibiotics for a baby's respiratory infection or Metformin for a patient’s high blood sugar. It was devastating seeing a patient's face drop after you explain that we don't have what they need. Eventually a few people ran to a local pharmacy to buy some antibiotics, blood pressure medications, and metformin pills but we had to hand them out sparingly because our stock was limited. I was happy that 95% of the patients only needed some Tylenol and hydrocortisone cream, supplies we had an abundance of, but I wish I never had to deny a patient medication for a problem they had. 

Pharmacist for the day! 

Sometimes patients had a new problem right before they were about to leave.
No problem, we got it covered! 

We also faced one more challenge for the day… no translators and only 2 people knowing enough Spanish to speak a full sentence. I know very little Spanish, and the phrases I do know have nothing to do with medicine. And while I know very little Spanish, the citizens of Guatemala know very little English. I was forced to jump right in, make a lot of mistakes, but eventually figure out enough to say  to describe how much and how often they should be taking medications. I spent the majority of the day describing how to take medications in details; however, it made realize that too often as clinicians we assume that all patients know exactly how many and how often they should be taking their medications. No matter who the patient is, one you see every month or someone who speaks a different language than you, time needs to be taken to explain exactly what to do. I like that different experiences in Belize and Guatemala have reinforced statements I had heard during the didactic year of PA school to make them more realistic and reinforce their importance.

Explaining how to dose the medication 

Writing down instructions for this mom so she knows how many vitamins to give her children

Overall, the first day at the clinics was incredibly humbling. I saw so many people, over 60, and situations that I will never forget. One patient came in who was 15 years old and she had a son who was 6 months old. She was accompanied by her 17-year-old sister, who also had a baby of 9 months old. The 6-month old baby had a bad infection and while a person was out at the pharmacy grabbing some antibiotics, the baby would not stop crying and screaming, no matter what the mother seemed to do. Eventually, I watched the sisters switch babies and the older sister began breast feeding her nephew. I do not know all the specifics of the situation because the language barrier prevented me from asking, but I found the situation sad, yet moving at the same time. It saddened me that a 15-year-old child has a kid of her own and she is struggling to keep her son in good health. Regardless, the sister stepped in without a second thought to feed her nephew. It shows that family bonds and blood are the way that people live in this country. Family will do anything for each other and friends will always keep an eye out and lend a hand. I was really moved by this experience and the significance of always being there for family.

We ended our time in the Santa Catarina village by visiting local women who make woven bags, tapestries, and other hand made items. They demonstrated the amount of precision and work that goes into creating intricate designs on shirts and quilts. Just a small table runner takes up to 6 months to complete; that is so much time for such a small item! Every woman was so proud of the work that she had done and when you bought something you knew it was more than something from a factory, it was a piece of art made with love and passion. It was a great stop to end our first day in the villages of Guatemala; we got to experience local culture as well as serve a community in need.

The women will sit on the floor to make their art 

Look at all of the tiny detail

Everyone picking out their favorite item to buy!