800+ Patients

Today was the final day of setting up clinics. We loaded onto the vans early in the morning to travel 2.5 hours to our destination. Again, we went higher and higher into the villages in the mountains and took bumpy dirt trails to reach the village of San Juan. This village was very similar to the ones we had been to the previous day. The homes were composed of concrete slabs with cracked walls and tin roofs. The children were found wondering the street hand-in-hand with younger bothers and sisters or friends. Stray dogs stood on the side of the road waiting patiently for the buses to pass by.

Once we reached the gymnasium where we would be setting up for the day, we were met with the familiar faces of women and children waiting to be seen.

Waiting patiently as we set up our stations and begin registration 

I was stationed at finger stick and was responsible for testing everyones blood sugar age 15 and older. It doesn't seem to matter where you live in the world, NO ONE likes getting their sugar checked. I don't blame them, it hurts! We all did our best to convince each patient that it is very important to get their sugar checked for good health. Thankfully I only had one person cry from the pain, but she quickly recovered and thanked me for my help. It was incredible to know that despite feeling pain and discomfort, the citizens of this village were still so thankful for our help.

What I liked best about the finger stick station is that it was a great "floater" station. If registration is backed up and cannot get information fast enough, we can help out. If physical exam has too many patients and not enough people to examine them, we go find a stethoscope and jump in to see this patient through receiving their medications. If we couldn't find a stethoscope we took everyones history so that the physical exam people would only have to do the exam and write a plan. It was inspirational to see everyone that I was volunteering with jump in and be flexible all day long. I rarely heard someone complain or ask to sit down for a break. Everyone worked so well together to give each other time to quickly run to the bathroom or go outside to get a breath of fresh air. I'll admit that I was worried that our group would not mesh well and we would keep to our friend groups, but I was more than happy to be wrong. The teamwork I saw this week, and especially this last day, inspired me to obtain this level of trust and comfort with my future co-workers and everyone I work with while on rotation.

Jumping in to help vitals with weights 

Helping out with physical exam

One of the patients I jumped in to help do a physical exam on was a mother accompanied by her 4 sons. I always started with the children (especially since they quickly lost attention and would start running away before you finished) and was happy to find that they were all healthy and only in need of some vitamins! When I got to mom, I asked her why she was here and she started describing her symptoms with words I had not heard perviously during the week. I quickly grabbed a translator and discovered that the mom wanted to know if she was pregnant. We ran over to the pharmacy and grabbed the last pregnancy test available. She took the test and it revealed she was pregnant! I asked her when her last menstrual period was and told her that her baby was going to be born around July 20th of this year. The mother had the largest smile on her face and a few tears in her eyes as I told her the exciting news. The majority of my day was spent wishing I could do more for everyone I saw, but having one of my last patients be someone who is extremely satisfied with just the words "you're pregnant, congratulations!" and wanting nothing more was very rewarding. Regardless, I made sure she got a few extra months of vitamins for her pregnancy.

The girl on the right (5 years) brought in her younger sister (3 years) to be seen because she was worried about her sister's cough for the past 2 days. This older girl was so protective over her sister, comforting her and holding her hand to make sure she was okay. It was a heartbreaking moment.  

Then woman on the right is the one we told is pregnant.
These are some of her adorable children running around while we explain the good news

We had the opportunity to see over 250 patients in one day. Towards the end of the day we didn't even have enough registration forms for everyone and had to start using the backs of the translation sheets we were provided for each station. Running out of registration papers also meant that we started running out of supplies at the pharmacy. Early in the morning we were out of Albendazole (an anti-parasitic) that we gave to all children with loss of appetite and distended bellies. Children vitamins became sparse in the afternoon and we had to make the decision to only give out vitamins to children who were accompanied by a sibling 12 years and older or a parent. Thankfully we had just enough backpacks full of goodies for every child and no one had to leave without one!

Busy final rush at the end of the day! 

Everyone walked out happy with a backpack 

Once all the final patients had been seen, we started handing out anything we had left. Some of my classmates handed out the extra shirts they had and others gave away their sneakers. All of the extra food we had from lunch, mostly boiled eggs and bananas, were given away to the children. We gave all of our extra medications and antibiotics to the doctor who volunteers and oversees our clinics. Nothing was brought home with us, because what would it do for us? We knew that the citizens of Guatemala needed it more than we did.

We left the village quite tired after seeing so many patients, but with our hearts full of pride and unforgettable memories. Knowing we had the opportunity to help so many people, even in the simplest ways, is life changing. This was my first experience participating in this type of trip and already I am ready to go back and do another. I have a strong feeling that after graduation I will be volunteering and giving my time to many trips similar to this. This was a life changing experience and one I will never forget.

Children lined up on the side of the street and waved goodbye to us as we left on the buses.
They didn't want us to forget them, but in reality they will never leave my memories 

You Think You've Seen it All

Today was my absolute favorite day during the course of the trip. We had the opportunity to help two extremely underserved and poor villages in the high parts of the mountains. We began our trip early in the morning with a 2 hour drive to the town of Santa Clara. The roads were full of twists and turns as we made our way from the bottom of the mountain (Lake Atitlan) all the way to the top. During our trip up, we stopped and saw the most beautiful view!

Breathtaking! 

The view overlooked both mountains and volcanos; one of the volcanos was even active and you could see smoke coming from the top! After our stop, we continued on and eventually came to a dirt road, which was the path to our final destination. I knew the villages were going to be very poor because the distance between towns and stores were miles apart. When we arrived, my suspicions were correct.

Dirt road leading to the village

Horses on the side of the road carrying wood 

Immediately upon our arrival, there was a cue of women and children. I was amazed how many children there were compared to the number of mothers. Compared to other villages, most groups of people consisted of 2-3 children brought in by their mother. In this village, there seemed to be 8-10 children brought in by one mother. I eventually learned later in the day that the children in this village are abandoned during the day and 1-2 females in the village volunteers one day a week to look after all of the children who don't have parents around. Some of the children are looked after in a "day care" center, which consists of 1 cook to provide lunch and 2 females who have assumed the role of a teacher and are responsible for entertaining and educating the kids. It was heartbreaking to know that the majority of the children in this town are left alone during the day with no one to watch, care for, or cook a meal for them. I was left wondering all day where the parents could possibly be.

Entering the gym where we would be stationed for the morning 

Soon after the doors were open, people started to enter in large groups 

Setting up the pharmacy, a very important station for this particular village

Helping set up the physical exam station, which is where I was at for the day

I was stationed at the physical exam table, a large task for the day. I teamed up with my fellow student, Vin, and we worked together to tackle groups of patients together. While one of us was examining the patient the other was writing down all of the history and physical exam findings. Together we came and conquered and were able to help so many kids.

Writing down all of Vin's exam findings 

There we so many kids that we had no chairs and this was our position for the day

We saw a lot of children with conditions that are common in those who are poor. A lot of kids had scabies and with each child we saw I knew this would be a chronic problem. These children and families do not have access to hot water to wash all of their clothes and bedding or large plastic bags to place their stuff in to kill the bugs. Additionally, most of the children came in because of a loss of appetite and distended bellies. After seeing the first few children present with these symptoms, we gave everyone Albendazol, an anti-parasitic medication.

Even though it was difficult to see so many poor and undernourished children, there was nothing better than seeing the smiles on their face when we gave them their bag full of crayons and goodies or tickled their bellies during the exam. Just take a look at how adorable all of the kids were:

I even had one young girl who brought in her 4 sisters and was very interested in what I was doing when I was examining each of them. She would get close to me and look over my shoulder as I looked into the mouth or into the ears. At the end of examining everyone and writing up their plans, I placed my stethoscope into her ears and had her listen to my heart. The look on her face when she could hear my heart beat was priceless. I will never forget this moment as I left a piece of heart in this village with this young girl.

We wrapped up our time in this village after helping over 160 patients. But before we left, we blew up some soccer balls and played with the kids. It was such a fun moment after a crazy morning.

Already late for the next clinic, we left and drove to the next. Like the first, it was filled with people underserved and in need of medical supplies. In this particular village I was on the vitals station. All of the mothers who have young children carry them by tying them onto their backs. When I had to weight the mom and baby, I had to first weight the mom + baby, and then the mom by herself. I was amazed how easily the mothers took their babies off their backs and handed them to me to hold and carry to the next station. I had seen this level of confidence with parents handing their children to strangers while in Belize, but it never fails to shock me how much they trust us. I also loved holding the little babies and having them snuggle up to me while their mom was busy.

All the citizens of the town lined up before we could even finish setting up!

The second village was equally as busy as the first as we helped over 150 patients in a short three hours. We saw similar cases to the first village: scabies, distended bellies, and coughs & colds from the wood burning ovens. All the children and adults got vitamins and the necessary medications and everyone left with a huge smile on their face and a backpack somewhere on their body. It was another great day in the villages full of memories and helping those less fortunate.

Final stop, the pharmacy! 

Some of the final patients of the day getting their vitamins 

We had an incredibly rewarding third day at the two villages, helping over 300 people. It was truly amazing to sit down on the bus at the end of the day knowing how happy you made so many people in only a few short hours.

Heading home after a successful day! 

Twice the Amount of Fun

Today was the first day that we traveled to two towns to provide medical care. 

We loaded up on a boat at 7:30 AM and made our way across Lake Atitlan to a popular town visited by many tourists, San Pedro. As we loaded off the boat and began walking into town to meet the van, we saw lots of locals selling fruits, juices, and hand made goods on the street. Everyone watched and turned their heads as they witnessed 25 people all dressed in green scrubs and sweatshirts carrying duffle bags up a hill. You could tell they looked at us with equal amounts of admiration and confusion; they were aware we were medical persons coming to provide care, but it must have been comical to see everyone looking exactly the same. Regardless, everyone greeted us with a warm “buenos dias” and children waved and followed us up to our van.

Heading to the boat 

Loading on

Pulling up to the town

Heading to the vans
Check out the guys on the left staring at us and wondering what we are doing

Beautiful quits for sale 

Look at all the fresh fruits on the right for sale 

The first town we drove to, Santa Clara, was approximately 10 minutes outside of the main city center of San Pedro. This was the first village where we had translators, which I was extremely thankful for because I was placed on registration! Myself and two other students, along with a translator, helped to register 100 patients for the morning session. We were responsible for getting the basics: name, age, address, social history, surgical history, family history, and the reason that brought them to the clinic. While this sounds simple, I found the process to be very difficult. I stumbled on words necessary to take a history leaving a lot of silence and me floundering for the right Spanish word. When I finally asked the right question, the patient would often go into a lengthy description of their concerns and I had no idea what was being said. I could pick out key words, such as “cough,” “headache,” or “pain” but anything beyond that was lost in translation. I was very dependent on the translator during the first couple of registrations, but eventually I developed a better script that allowed me to get through the process in about 4 minutes rather than 10 (especially since if the interview were in English the process would take about two minutes).

We were in a school building in the center of town. All day we heard children go out for gym class

When I first started to take the histories, I was surprised how embarrassed all the patients were when I asked if they smoked cigarettes or drank alcohol. While in Belize, whenever we asked this to patients the majority of them were very honest and would openly admit to drinking a lot of beer or smoking marijuana for pleasure. Each patient in Guatemala, regardless of their age, giggled a little, hid their head, and shook it very quickly to say “no.” Eventually, I found out from the translator that the community we were in was very religious and drinking/smoking cigarettes is frowned upon. These people were raised to never even imagine partaking in those activities, so they found it very humorous when the Americans decided to ask them about their social habits.  

A beautiful church right next to the building we were in

Compared to other villages we visited during the week, I was surprised by the vast differences in the patients we saw that day. Since this village is more centrally located and not in the mountains, there were more patients, especially female patients, who had jobs. I had quite a few female traffic officers and other women in professional dress come in with a cold or to get a wellness check and acquire vitamins. In no other village did the women seem to have job other than maintaining the children and taking care of the home (and “taking care of the home” means something completely different than what you’re thinking & I'll explain later). Even the way that the women dressed, shirts with glitter and sparkles on them and skirts in bright fresh colors, contrasted from the villages in the mountains where women wore duller colors with no extra frills. I did not notice it in the moment, but upon reflection after visiting all of the villages I realized this was the most affluent village we had the opportunity to volunteer at.

It was also rare to see men at any of the clinics, especially those who wore a uniform

The second village we went to was approximately 20 minutes up the mountain from the city center of San Pedro. As we drove up the mountain into the more remote villages you could see the difference in how people lived. Houses were in poorer conditions with more cracks and less privacy, the children were running around in the middle of the day instead of being in school, and more people were walking on foot than taking tuk tuks (the local taxis) or cars. Regardless, we arrived at a gym and immediately upon entering the building we saw at least 30 people sitting in chairs lining up to be seen. I knew we were going to have a busy afternoon at this village.

Looking down on San Pedro as we head up the mountain

You start to notice more people on the street  

Living conditions start to become more basic the higher you get in the mountains

I was placed on physical exam with five other students. Thankfully after having registration in the morning I was more in tune with my inner Spanish phrases and it was a little bit easier to understand and communicate with the patient to discuss their problem.

One of the first patients I had was an older lady who came in for a headache. She said she has had this headache for many years now and some days it causes her a lot of pain and discomfort. I did the physical exam and everything was normal, which is to be expected. I told her that I would be giving her some ibuprofen to take when the pain is very bad, as well as some vitamins. As soon as I mentioned we would be able to give her medications she looked down, began praying, and continued to tell me “gracias, gracias, gracias” over and over. We I went to walk her over to the pharmacy, she grabbed my arm and we walked hand in hand all the way through receiving her medication until she left, which is when she gave me a big hug and a final thank you. I was so touched by this moment. All I did for this lady was give her a few doses of Ibuprofen and a month’s worth of vitamins, but she made me feel like I cured her cancer. We take things like NSAIDs, which we pop like candy here in America, for granted and forget that they are too much money for the average Guatemalan to afford. I was incredibly rewarding to know that this lady was so thankful for our visit and would be feeling some relief for her headache soon.

So happy someone took this photo of this moment. 

Another patient that I had the opportunity to help was a 7 month pregnant female who came in complaining of blurry vision. I did a physical exam, checked her vision, and concluded that the patient probably needed glasses to solve her problem. Out of habit from pervious patients I saw who were pregnant, I asked her how the baby was doing and if he was moving. She suddenly had a look of worry wash over her face and started to describe to me and the translator that three days ago she felt a sharp pain in her side and she has not felt the baby move since then. A look of worry probably fell across my face as well and I started to think the worse. I excused myself for a moment and went to ask if we had a fetal Doppler so that I could try to find the fetal heart rate. Unfortunately, we did not have one so instead I tried to find the heart beat with my stethoscope but I could not hear anything. I educated the patient that if anything were to change or she still didn’t feel the baby move, she needs to seek help at the hospital.

I found it difficult to be in a situation that I had absolutely no control over. There was nothing I wanted more than to reassure the patient that the baby was okay and the pain was probably a result of the weight from her belly pulling on her back; I couldn’t let those words out of my mouth because I honestly did not know. We can come prepared with as many medications and equipment as possible, but there will always be something we don’t have. I still think about that patient and I hope that as soon as she left the clinic she felt the baby’s foot sweep across her belly and she is doing fine.

It was very busy day filled with over 200 patients across 2 villages. I am so proud of myself and my classmates for being able to keep up the energy and positivity all day long. Everyday has made me more and more excited for the villages to come.

Leaving San Pedro after an incredible day