Sometimes You Wish You Could Do More

While the majority of the class decided to hike a volcano for the day, I hung back and had plans of resting and lounging by the pool for our final day in Guatemala. While I had planned to just relax for the day, I found myself reflecting on this past week and weighing the pros and cons of our trip.

With each village that you enter you find yourself being able to help patients really well in some areas and not being able to do anything for them in other aspects. The number of children we saw who had scabies was initially surprising, but towards the end of the week something normal. The pharmacy had enough cream for each family to put on the children to control the itching, but that is not enough. The patients need education on washing their clothing and bedding and giving it enough time to kill the bugs. Some of the patients didn't even understand that the rash on their body was from a bug and they thought it just occurred from some type of internal infection. We tried our best to explain how to fix the situation, but between the language barrier, lack of available time to thoroughly explain, and inability for the families to have the necessary resources, we often found ourselves at a standstill. It is frustrating to know that you can treat the problem for a few days, but it is going to keep happening and there is nothing you can do about it.

Another similar situation we found almost everyone to have is a chronic cough and sore throat. Through observation and talking with my professors and locals I learned that all of the homes in the outer villages in Guatemala use wood burning stoves to cook without proper ventilation to rid the house of the excess smoke. Additionally, to get rid of all trash, families create a pile in their yard and set the trash on fire to get rid of it. People are being exposed to thick smoke all day long, some of which may contain harmful chemicals from the trash, so it is no wonder they all have sore throats and coughs. When you look at the problem, yes, we can help with the symptoms and give some cough drops, but we cannot fix the root of the underlying cause. There is no way we can go to everyones home and install a gas stove or go to the government officials to enforce trash pickup and ban burning of trash. These matters are completely out of our hands and level of practice.

The majority of the problems we saw stemmed from lack of financial wealth. To put it simply, we served the poorest of the poor and people who had very little. Children presented with loss of appetite and distended bellies because they have a parasite, which come from unclean drinking water and contaminated food. This is the food they have access to and there is nothing else. Other patients presented with a laundry list of complaints and it is not because they had all of them at that time. It is because they have experienced each of these symptoms at some other time and want to know if there is something available to help should they ever experience that type of pain again. They cannot afford to go to the doctor for a checkup, let alone go to the pharmacy to pickup some ibuprofen for their headache.

Some of the most difficult moments I had during this trip, in regards to lack of access, were moments focused on female and maternal health. In the United States most women (definitely not all) get a PAP smear at some point in their lives to screen for cervical cancer and have access to services specific for women should they have a GYN or breast complaint. In the US, women who are pregnant go to see an Obstetrician and take prenatal vitamins enriched with folic acid and iron. If a woman does not wish to become pregnant, there are a variety of different birth control options available to choose from. In Guatemala, women do not have access to any of these options.

If a woman came in with vaginal discharge she often has had it for a very long time and no one has ever examined the issue. We tried our best to figure out the problem, but we as well did not have the appropriate space to privately examine the patient or equipment to do make a proper diagnosis and treatment plan. Moms we saw who were pregnant were not taking prenatal vitamins or any type of multivitamin; vitamins are too expensive. Additionally, we saw so many children because there are no family planning options or education available to teach women about pregnancy and spacing pregnancies. We saw women at the age of 18 with already 3 children. It was heartbreaking to find out how women's health is treated in Guatemala. The women in the village are responsible for maintaining the household while the men go out to work. They have to care for their children, cook the food over wood stoves, find clean water, and walk miles with their children strapped onto their back to surrounding villages to sell goods or food, which they carry on their head. These women are so brave, bold, and hardworking yet they have no access to medical care. It is devastating to see the women who care for everyone else not have access to the care they needed most.

I can think about all the things I wish we could do more of: more vitamins, more medications, longer hours to see more people, more time to sit and educate patients, etc, etc, etc. I keep reminding myself that we DID make an impact on these villages. We went to 6 different towns serving over 800 people in only 4 days. We gave out every last item we had to everyone we saw. We provided medications to people, told people they would be okay, and even told people they were going to be a new mother. There was so much joy and reward during the four days of being in the village that I have to tell myself that we did make a difference and our weaknesses should only be a driving point to make the next visit even better.

I hope to be a graduate leader for the group next year who goes to Guatemala. I have a lot of small ideas and suggestions to make the trip an even better success. Things like an education stop before the patient receives their goody bag, bringing a large set of teeth and giant toothbrush to teach kids how to brush their teeth, bringing a privacy screen with a table and equipment to do a vaginal exam or have a patient lie down to check a fetal heart rate would be a few small improvements to an already extremely successful operation.

I thank everyone I had the opportunity to work with and the Wagner PA program for this unforgettable experience. I am so thankful for all of the people I have met and will never forget. I cannot wait until the next time I am back in Guatemala.

Feeling more blessed than ever for experiences such as this one