Day 10 Guate and then to Monterrico

Today Mike left really early to catch his flight with the dentistas. We had a fun night the night before, having some drinks and dinner at the hotel and swimming.

Today at the church, Zora, Anne and I did see and treat for four women. They were all sophisticated- they all had had paps before, and knew a lot about planificacion and cervical cancer- one of them had actually taken a class on see and treat!

See and treat is where you look at the cervix with acetic acid, and if you see a lesion, you can freeze it (cryotherapy).

After lunch we headed to Monterrico in two large vans. It rained the whole way there, including on our ferry ride (when the whole van is put on a floating raft thing with a motor). Our van was in pretty good spirits- listening to Shakira and the rain.

Day 9 Drive back to Guate

So yesterday there were tropical storm warnings- tropical storm Matthew was pretty much headed right to our area in Guatemala- and everyone was worried about mudslides, road conditions, and if we went to Nacimiento, that we might get stuck there. Instead, we ended up booking it back to the capital after breakfast. I was a little nervous, but the weather and roads ended up being okay.

Day 8: Clinic at Las Flores

Las Flores (former plan was to go to Las Brisas)- got there by vehicle- we all packed into a truck- I think we fit 14 people in the flat bed of the truck (with bunches), and 7 people in the front cab part, with a pretty rough road, and a minor water crossing.

Emily’s day in the pharmacy! Had a lot of fun working with the girls in the pharmacy- I think we ran a pretty tidy ship. There were a few pretty sick kids seen today- two needed albuterol nebs, another we felt should go on to the nearest actual clinic and maybe hospital. There was a woman who did know she was pregnant until our test, and she had 7 children already.

We had a nice set-up in a part of the school; we also had very good crowd control. It was kind of nice to take it easy in the pharmacy today.

On the way back, Jennifer, Carol, Miriam, and I went to a meeting with Dr. Marta to discuss me working at the clinic week after next, and to discuss our clinics so far, and VIA. Should be interesting! My Spanish is coming back/improving daily- hopefully I will understand what is going on when I get there a week from Monday (8am sharp!).

This evening was eventful- lovely swim. Turns out that Mike had a frustrating day where he and Tim were waiting on Edgar to go get materials and get to work, but E was with us in the town all day (this actually really sucked). The evening proceeded with one of our party cutting her finger with a scalpel, and another breaking her tooth at dinner, oh and there was a needle-stick earlier in the day.

Needless to say, we were sort of a sorry bunch!

Day 7: Nuevo Nacimiento de Calles

Nuevo Nacimiento de Calles- got there by a boat- first the lake, then a tributary/ narrow passageway, then 2 people took horses, and the rest went by foot on this very open, very hot trail (supposed to be about a 30-45minute walk). The tractor truck was going to meet us, but was still on its way back to the river from the town when we arrived. The going was hard- a lot of mud and water on the trail, and the sun beating down on us (prob about 830am or so). Thankfully, the tractor did end up picking us up for the last 1/3 or so of the way- we actually had to tend to our own for a while before setting up clinic- she almost had heat stroke, requiring needing to lie down, drink fluids, we put cold water and ice on her, and tried to fan her.

I think all of us dumped cold water on our heads.

Once we had recovered, clinic was open for business. We some interesting things, including two abscesses on kids. Carol and I removed a piece of wood from a girl’s foot!

I stepped out of clinic for a minute to attend the community meeting (all men)- they were very excited about smokeless stove ideas.

Day 6: Snorkeling in Belize

Free day! In the past, the group has gone to Tikal or taken a trip on a river. Shira read in her book about an excursion to snorkel in Belize, and made it happen. We got up at 5am, took the bus for 45 minutes to Rio Dulce, then hopped on a boat that took us to Livingston- this boat ride was beautiful- after the lake, the waterway narrowed, and there was lush jungle sloping in, and overhanging the river, with lots of birds flying from shore to shore. During the bus and the boat ride there was a spectacular sunrise. At Livingston, we found our tour group/restaurant, got sized for snorkel fins, and had breakfast. After having out passports stamped at the immigration office in Livingston (and paying $10 dollars), we headed to our boat! Not much different than your standard lancha, I was simply glad it was covered. We headed straight out into the Caribbean Sea.

It was a gorgeous day- clear blue sky, sunshine, and shimmery blue water. The boatride out was maybe 1.5 hours? Straight out into open water. Seemingly in the middle of nowhere, we started to see shallow water and reefs below us, and a few tiny tropical islands, each with 1-2 palm trees. We got out on two of the larger islands- that had primitive bathrooms and bunkhouses. There were some really cool iguanas- up to maybe 4 feet long, and orange!

The snorkeling was really fun- the boat stopped at two different places- the 2^nd place had more varieties of fish- fun to get so close to them. Others in the group saw barracuda and a sting ray!

Day 5: Clinic at Agua Caliente

The morning went more smoothly today- the clinic was already set up, and I felt more used to the temperature. We took more frequent short breaks with snacks, and much more easily worked through the day, with lunch again around 3pm.

We were torn- we needed to go to a community meeting, but we also wanted to swim in the famous hot water springs waterfall (which we meant to do yesterday, but it was dark by the time the meeting ended). We decided to swim first while it was light, and then head to the community meeting. This worked out great!

Finca del Paraiso waterfall is gorgeous- it is a large waterfall of warm water, falling into a cool stream, and perfect for swimming. The rocks that come down to the river also had hallowed out areas, with caves you could get to by bobbing your head under water and under the rock (I put my hand into the cave- and it was super-hot, like a sauna.

Matt and Mike jumped off the top of the waterfall- I just hiked up to the top and then walked back down- there were cool caves off the trail- full of bats and toads! Mike got some great pictures. The swimming was definitely a highlight, and the waterfall was a MUCH warmer shower than those at the hotel! (which were just cold water). The cool river made it all refreshing.

Some of us then headed to a community meeting at Boquaron- the women had a great meeting about cervical cancer and things. Usually we like to think that it is best if folks from the community learn to do health checks and procedures, but at this meeting a few women said they strongly preferred to have strangers do these exams- the community is so small, and they find it embarrassing.

I was at the other meeting- a mix of men and women- and I talked about stoves. They were concerned with respiratory problems, and the fact that black ashes from their ceiling would fall on their food. I passed around my camera with pictures of the stove from Common Hope, and people were very positive about it. It got dark partway through the meeting, and we could see a lot of lightening in the distance. Our meeting ended abruptly when the storm picked up and there was pouring rain and wind (it was good timing actually, the meeting felt complete)- I got to briefly see a stove, and then we headed on our way, back to the hotel.

Crazy storm at dinner- so things were pretty stormy as dinner got started, and we were all enjoying watching the lightening over the lake- but then it got much stronger, with rain coming in at a slant and soaking the dinner table, and a lot of wind; and the power went out. It was a rather cozy, shared experience, and the storm continued with force through the night.

A note on cozy group dinners: one of my favorite meals was when we were at small tables, and Mike and I got to know Luis Alberto and Luis Cristobal, Xijira, and Ingrid a bit better with the help of Samuel (who has a great sense of humor). Both of the Luises seem interested in engineering, and loved chatting with Mike about building racecars.

Day 4: Clinic in Agua Caliente and meeting in Tablitas

There were a lot of folks waiting at the church when we pulled up in the bus, and it was super-hot right from the get-go. We had one building- with triage and lab in the front; then a sheet wall, and then two exam room areas. There were also two rooms (with doors) in the back- one for the dentists, and one for the OB/Gyn exams. The pharmacy and check-in were in two tents in the yard. My exam area was in the back right, and the sun really beat in through the window.

It was a little rough getting organized and starting, but we did eventually get in a groove, seeing patients from around 830am and working right through lunch- I remember taking a break around 2pm, and then feeling so tired, it was all I could do to help out in the pharmacy for awhile. We ended up having lunch at a restaurant nearby around 3pm- everyone seemed so exhausted/tired/hot/hungry, there was barely any conversation at all. We definitely needed some recovery time.

Some notes about the patients: a lot of them spoke Q'eqchi' (sometimes spelled Kekchi), so we would pull an interpreter to help from Spanish- mainly the local pastor. There were a lot of skin infections (scabies, fungal infections), lots of abdominal pain (gastritis, reflux), colds and coughs, and one really red eye x4months where the woman had lost vision in the eye (we provided referral for that one). A few people with new diagnosis of HTN, and we put them on a list to have their BP rechecked in 2 weeks after initiating captopril.

Per the dental team- almost all of the dental patients would bleed a lot- as if they were on coumadin (due to malnutrition? Weird supplements? Genetic issues?).

Right from our quick lunch, we headed to Tablitas for a community meeting. This was a really neat town on a hillside. The meeting was well-attended by about 5 men and 2 women; one of the men was a young pastor. Many other women chose to go to the meeting discussing cervical cancer- led by Carol and Anne.

Issues brought up in the community meeting that I attended included nutrient-poor soil, and having their corn fields flooded this year, so there is a real concern about having enough food; they also wanted to have more classrooms in the school. Mike and I talked about a possible stove project in the future, and the villagers were positive about it, but wanted to ensure that each home would have the opportunity to get one. At the meeting 6 months ago, they had set a goal to work on gardening. After the meeting, we looked at the school, the community garden they set up (growing a lot of different vegetables), and I got to see a stove (open fire over rocks; blackened walls and ceiling from smoke).

Back at the hotel, dinner was fun, with the sisters teaching me and Mike and a whole group of the dice game called Frunkle (?).

Day 3 Drive to Rio Dulce

Saw a few patients and families with Zora at the church Sunday morning during church services. It was fun- a lot of the patients gave us hugs at the end!

Then as a group, we were introduced on stage to the whole congregation- Mike was introduced as mi “esposa”, which made me turn red (goodness).

After lunch we headed out in a school bus. The drive to Rio Dulce is supposed to take 6-8 hours- we left around 2pm.

The drive actually wasn’t that bad- pretty scenery, roads were okay, though there was some rain. We were all in a school bus, so it was easy to socialize. Dinner at hotel- the hotel is a series of cabanas; the restaurant is a great rotunda-like shape without real walls, looking at the lake. This is in Finca de Paraiso, on the edge of Lago Izbal.

There was a really friendly (tail-wagging) cute dog on the beach by the lake that I pet (it rolled on its back to have its tummy rubbed)- I KNOW you are not supposed to pet dogs in foreign countries, but it was so cute, and looked fairly well cared for. I was feeling fine about it, until I turned back to go to dinner, and the dog grabbed my leg with its front paws, and then sort of jumped up and down with excitement, nipping. Yeah. Well, I promise I won’t pet any more dogs here!

Arrival in Guate and the first few days

I meant to have a picture of me and Mike with the 4 enormous blue duffel bags (provided by CCCG) that we brought with us, but it was a bit hectic getting packed and making it on to the airplane.

Day 1:

After a quick flight to L.A., and then a red-eye, we arrived in Guatemala City around 530am. We were met by Samuel, and brought to the church, where we had breakfast with the school children, and then took naps upstairs (much needed naps!).

The church is in a dramatic and beautiful location, on the edge of a steep ravine (see photo); certainly a nice place to spend time.

Half- asleep still, it was then time to head to Antigua for our two meetings; we were joined by two others in our group, Shira and Tim.

The first meeting was in Antigua, with the group A.L.A.S., where we learned a lot about their family planning services and cervical cancer screening and treatment. This is a very impressive organization- very well thought-out, and makes efforts to be culturally appropriate. I learned a lot from this meeting. I'm happy to share any notes or contacts; what seemed helpful to me is that ALAS would be willing to train community promotores in the communities we are going to- it seems like a great connection to make.

The second meeting was with Mario at Familias de Esperanza, just outside of Antigua. This was a meeting to learn more about their stove-building projects, and see in-person how they are put together. Mario was very helpful and kind- there are several good stove designs out there; one of my goals for this trip is to get a sense of whether this type of project would be helpful and well-received in the aldeas we are visiting. It seems like we could have a simple stove design that the youths at the church could make in their metal-working shop.

It seemed like a productive day! I wished that some folks from the church could have come to the meetings (especially the stove-building one), but there will be more meetings and opportunities to further establish the connection.

Mike and I settled in at Hotel Barcelo- it has a great outside pool (heated) and hot tub- which felt great at the end of a long day.

Day 2

Many more people from the group arrived overnight or in the morning. We headed to the church after breakfast and spent the day meeting in groups, preparing for seeing patients, and sorting through all the stuff people brought. In Mike's case, he fixed a lot of things. I worked on organizing the pharmacy. We worked pretty hard all day, wrapping up with a late dinner as a group.

Oh dear, I almost forgot the most exciting part of the day when I burned my eyeball! I have this contact solution called Clear Care, and its main ingredient is hydrogen peroxide. It comes with a special case, and has a process where the solution neutralizes over the course of 6 hours (so, while you sleep), and it works really well in cleaning off the debris on the contact. Unfortunately, I forgot one of my bags at the church that had the case in it, so I put the contacts in regular cups- low and behold, overnight the liquid did not neutralize, and when I put in my right contact, I basically put hydrogen peroxide in my eye, and it burned and stung immediately, with my contact stuck to my eye! it was awful. FYI for you readers out there, hydrogen peroxide can cause an abrasion on the cornea; redness, irritaiton, and pain, but usually no lasting damage. You are supposed to just flush the eye with a lot of water. Needless to say, I will be wearing my glasses for much of this trip.