Mis Nuevos Horizontes

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Dias 16, 17, 18
Week 3 is already flying by! This week marked a big change in our schedules- now we have volunteering in the morning (somewhere between 8 am and 12 noon, then we have a quick lunch with our families, and hten have classes 2 PM – 6PM, and a usually we have an activity, documentary ,or conference after dinner.. basically things went into hyperspeed! I already miss my lazy afternoons doing nothing, but the volunteering experience is gonna be really cool so I’m excited.
Monday was my first day of volunteering- I walked with Stephen to Nuevos Horizontes, a clinic for women that helps deal with everything from family planning to support for victims of sexual violence. The clinic itself sees very few patients in house, but they frequently travel out to poorer areas in Xela and hold clinics. Right now it looks like Stephen and I will be working at the clinic Mondays and Wednesdays. It took a little time in the beginning to get organized and figure out where we were supposed to go, and around 9:30 a medical student named Raquel met us at the clinic and walked with us towards the community they work in on Mondays, Choqui. We had to walk about ¾ mile and then take a chicken bus for another ten minutes or so. Though we were technically still in Xela, the community was extremely rural and the poverty was very apparent by the buildings and clothing we saw. In what appeared to be a church building, there were already about a dozen women in trajes (traditional Mayan clothing) waiting to be seen by the one doctor working the clinic, Dr. Teresa Gramajo. She was extremely friendly and made it clear she was going to work to keep us included in the clinic visits and try to create learning opportunities for us. The room she conduced clinic visits in was extremely small, so only one of us could shadow her at a time. Stephen shadowed for the first few hours, and I headed back out into the waiting room with Raquel, who works to perform immunizations. The clinics are funded partly by the government through a program called SIAS, and partly by Nuevos Horizontes. Every child that is born receives a card to keep track of their vaccinations, and the program is responsible for administering those vaccinations in these neighborhoods. They have tons of paperwork to fill out, and if motehr’s fail to brign their children in for vaccinations, the nurses of this program are responsible for going door to door to deliver the vaccinations. We didn’t have a chance to do this on Monday, so unfortunately my time spent with Raquel was basically spent just filling out paperwork in advance in anticipation of future visist. Once we switched, however, I really enjoyed my time with Doctra Tere. Many of the women come in with children or pregnant, and it is essentially a primary care clinic. We saw a few babies with the flu, a few children with ear infections, and a pregnant woman with parasites. Dr. Tere was great about keeping me included, offering me a chance to look into the ears during the visits, etc. We worked a few hours at the clinic before returning to our homes for lunch, where I had a huge, delicious lunch with my family. Julia really is a great cook- we had a delicious vegetable soup made with a puree of carrots, potatoes, and a few other green veggies that I think only exist here.
Class started at 2, and we switched teachers this week. I was paired with an older woman named Leti (short for Leticia). For about 5 minutes I was convinced I didn’t like her and was going to dread Spanish classes for the next 2 weeks. Everytime I would say something, she would interrupt me immediately to correct EVERY SINGLE MISTAKE I made… it was frustrating. Carmen corrected my mistakes but would let me finish talking first, and would let some mistakes go. But, with time, Leti grew on me. I can tell she is going to push me- and although that’s going to make my classes more difficult, it’s going to be good. She’s actually very funny and is a wonderful teacher- she has been teaching for over 25 years and I can tell my time with her will be well spent.
After class, I quickly went to the gym with Matt and ran 2 miles (without walking this time, straight through!) and then showered, ate a quick dinner with my family (a fried egg sunny side up and beans) and then ahd to meet the group at La Luna for a documentary at 8. We watched a documentary called Salud. It was a little on the longer side, but was very interesting. It dealt with healthcare access on a worldwide scale, but focused in on Cuba’s system. Despite being an extremely poor country, Cuba has an incredible healthcare system with universal access and great statistics. I was shocked to learn that Cuba has a lower infant mortality rate than the United States, and a higher ratio of physicians to patients. They have a very well integrated system in which primary care is a huge focus, and prevention is the main goal. Primary care physicians actually live in the communities in which they work, and often make house calls. Perhaps the most impressive part, we learned about the decades of humanitarian medical aid Cuba has given to other countries over the years. Cuba has sent hundreds of thousands of physicians abroad to countries desperately lacking in healthcare. Cuban doctors came to the aid of Honduras after Hurricane Mitch, saving thousands of lives. Cuban doctors came to South Africa to help communities with virtually no access to physicians. Cuban doctors worked with Gambia to help establish the countries first-ever public health program. And Cuba founded an enormous medical school called the Latin American School of Medicine, which helps thousands of students from throughout Latin American and the Caribbean by offering full scholarships to students from impoverished, rural areas. Basically, despite being extremely poor, this country has reached out to help its neighbors when they are in need. A political analyst in the film asked the question: is this one of the most enormous humanitarian efforts our modern world has seen, or an incredibly strategic political move to gain the favor of neighboring countries? Probably a combination of both… But, whatever the motivations are, you have to admit- if every country did this, the world would be a better place.
Tuesday morning I got up VERY early to catch a bus to go to Toto to volunteer in the hospital. It is the only hospital in a very large rural area and though it caters to tens of thousands of people, it only has 90 beds. I worked in the gynecological department for the day. The hospital was even more basic than I could have expected. I was directed a small room to change into my scrubs, and it reeked of urine. There was absolutely no toilet paper in ANY of the bathrooms, and many of them weren’t in working order. I was paired with a 5th year medical student (they have 6 years of medical school, incluing 3 years of “university” style classes) named Juan Carlos who was a wonderful host and guide. I watched a few visits in the gynecology clinic, watching basic procedures like Pap smears and speculoscopies (looking at the cervix with the help of a speculum). Most of them women who came in her Mayan, dressed in trajes, but luckily spoke Spanish. One woman was a particularly interesting case- when she came in, her stomach was HUGE- it looked like she was 9 months pregnant and about to pop. But when we talked to her, she was just barely 7 months… I wondered to myself if she was carrying twins, or it if was normal to look this large only 7 months along. She had brought an ultrasound performed at another clinic, but there was no one at the other clinic to interepret it. The medical students looked it over and immediately determined she had wayyy too much amniotic fluid in her uterus. Just like in the US, the attending physician proceeded to drill the students, asking them what could cause this. Some answers were familiar to me, while others weren’t: kidney failure, fetal malformations (like spina bifida or anencephaly), or a failure of the esophagus. They ran a few tests on the woman and decided to admit her for observation. I asked Juan why they couldn’t just run tests to see if it was indeed a malformation, and he said they didn’t have proper equipment. After talking to him, I feel like I understand the problems here a lot more clearly. In a previous blog, I mentioned how everyone has access to healthcare for free. Essentially, this is true.. but it still isn’t working as intended. Juan explained to me how the education level here is the limiting factor. Many people aren’t educated and thus don’t actually utilize the resources when they are needed, allowing preventable illnesses and easily treatable conditions to escalate into larger problems. Also, the resources are extremely limited. Though citizens here are guaranteed free healthcare, the hospitals are extremely under funded and equipment is extremely limited. I watched 3 gynecological visits which were performed on the same sheet, since they can’t afford to have the tear-off paper like we have in the US.
Rachelle shadowed in the same department on Monday and saw 2 live births and a cessarian section.. unfortunately for me, it just happened to be a slower day on Turesday and there weren’t any births… but I still enjoyed my time and got a glimpse of what life is like in a public hospital here (pretty bleak…). After our shift at Toto Matt and I headed back and I had lunch with Margarita, Jaime, and Julia. We met a little before class today to discuss our plans for the upcoming free weekend. We all really want to go to a place called Semuc Champey, a natural formation of gorgeous turquoise pools in the jungle. We have been doing a little research and still ahven’t finalized our plans, but it looks like we’re gonna be able to go this weekend. We will see… Class was good and I feel myself making progress with Leti already. I really enjoy her as a teacher and am glad I didn’t write her off too soon… after class I went to the gym with Matt and I ran 2 ½ miles on the treadmill. After eating dinner witht eh family, I found myself TOTALLY exhausted, so I did my hw quickly and went to bed around 9 PM.
Wednesday morning Stephen and I went back to Nuevos Horizonates and were met with disappointment- as it was the end of the month, both the local clinic and the community clinics wouldn’t being seeing patients today so they could complete the necessary paperwork and reports for the month. I decided to come back home and nap… even though I had a great night sleep last night, my body is still feeling a little fatigued, so I decided to listen to my gut and rest some more. When I woke up I went online and got to tlak ot my mom and Bobby at the same time- how cool is that! Me in Guatemala, Bobby in Spain, and my mom in Los Angeles- talk about an international convo! It seems like Bobby and Oliver and the gang are really enjoying Madrid, and are leaving tomorrow for San Sebastian. Class today was good, still working on some tough grammar points but I feel like I am getting a lot out of my time with Leti. After class we went straight from school to Café Red, a really cool café in Xela that works to help Guatemalans who were deported from America. We had a conference given by Harry, one of the recently graduated medical students I went to a movie with a few weeks ago, and it was really intersitng. He talked a lot about the lack of resources and failure of their healthcare system. The government spends very little on the healthcare system- this section of government spending ony makes up .9% of the total!! He echoed what I heard from Juan Carlos, another medical student I met at Toto hospital, said- though there is “universal access” to healthcare in Guatemala, it is severely underfunded, lacks resources, and suffers from a poorly educated population that doesn’t know how to utilize it correctly. He described how many in rural areas wait and wait before going into the hospital, then finally go when they are gravely ill, and usually die in the hospital. From the perspective of the people in the rural areas, this means the hospital failed to help or even “killed” the person, further reinforcing their fears that only bad things can result from going to the hospital… overall it was extremely interesting, and I can understand why those who have the resources choose to pay out of pocket for care in a private hospital.
The conference ran pretty late, so I just came home afterwards, did a little research, and did some homework.. now I’m off to bed! Buenas Noches!

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