Health and healing in Guatemala: 2017 Doreen Morales

Day 1: Welcome to Guatemala, don't drink the water!

We arrive to Central America after traveling for over 12 hours. Stepping out of the airport I couldn't help but notice so many amputees and paralyzed people around. Maybe it was a location locals could gain money from outside travelers? Having a limb lost seemed to be something of the norm when encountering a medical condition like diabetes perhaps. I realize my healthcare experience in this country will be an eye opener. We learn that Guatemala City, the capital of the country is where the majority of the entire country's wealth resides. Because of this, the population is flooded with people for the financial opportunities. On the 4 hour ride to Panajachel, Lupe shares some sad news with us about a relative of hers. Her cousin was in a horrible car crash the week before, and died due to injuries too serious for the healthcare providers to repair in time. The healthcare setting is very different from that of the US. Hospitals do not have supplies available for doctors and nurses to use to care for sick patients. When a patient is admitted, the family of the patient must be responsible for the purchase of supplies, after finding out what is needed in order for care to be properly provided. This causes many issues in delaying patient care. It is said that many supplies are reused, where as in the US, sterility is vital for the safety from infection for the patient. A question I wonder about is why people seem to be desensitized to lost limbs?

Day 2: Organic Coffee excellence
weaver in action/ coffee berries
Best cup of Jose!

Day 2 we traveled across Lake Atitlan to visit the coffee plantation. I was bothered to discover that Panajachel's sewage flows into these waters, and there isn't a better sewage system established for this beautiful city. I wondered what reasons could be preventing the city from resolving this problem. The country overall is rich in many things including food and minerals. The plantation was a perfect example of this. At the coffee site, over 150 acres of organic coffee plants along with other fruits are grown here. I was surprised to find out that the coffee plant was not originated in Guatemala, but rather Ethiopia. The horticulture is very similar to the US, however, the people of the coffee plantation along with other Guatemalans choose to be in power of their resources. The process is very labor intensive- hand picked berries, sifting the ripe (red) from the bad (yellow or green), extracting the bean, raking the beans every hour for 10 days until thoroughly dried, then roasting to perfection. This process made me have more of an appreciation when drinking this delicious coffee. I ended up buying 3 pounds of it! As we walked back to the boat to return to Panajachel, there were several shops, some with weavers working diligently on their next pieces. Such gorgeous work! Aside from tourists visiting the town, how are these businesses surviving?

Day 3: Holding in for dear life
The best crew/ Indiana Jones bridge
Excitement!
picture with the artist
busy marketplace

Day 3 we have our last delicious breakfast at the hotel in Panajachel and depart for X-tremos to go zip lining! The drive was really crazy and I was holding on for dear life the entire time. Cars continually passed each other at speeding rates, and the driving was borderline reckless. Looking back to the first day, I wondered what the percentage of injuries were caused from car accidents. When we arrived to X-tremos there was a beautiful butterfly sanctuary at the location. Such a calming touch to an otherwise intense experience to some. The trek to zip line was amazing! We ended up hiking the equivalency of over 60 flights of stairs. This was my first time zip lining, and I'm so happy to have had the opportunity to do it in such a scenic and tropical location, the views were breathtaking. After zip lining, we headed to Chichicastenango to go shopping in the marketplace. The vendors were very aggressive sellers, following potential buyers until a sale was made, but everyone seemed to walk away with some really great deals. The persistence of the vendors could be uncomfortable to some, very different than shopping in the US. After the marketplace we headed to the AMA house where dinner was held and a presentation of the organization was given by Lupe's sister. The mission of AMA was to empower the most isolated and marginalized women from the highlands through organizations, training, resources, and partnerships so that they can achieve a life of dignity and initiate processes of sustainable development in their communities. Something so surprising to me was Lupe mentioned nonchalantly that she got Malaria in helping the widowed and fatherless women after the civil war in Guatemala in the 1990s. Truly inspiring the impact she has tried to make to preserve and strengthen her heritage. I was ready to give my contribution to the community in the days to come.

Day 4: Stoves for salvation
Families of Marroquines

Day 4 was our first day in the village of Los Marroquines in Quetzaltenango. On our way to the village I saw a woman trying to change the diaper of her child while on the side of the busy road. Why couldn't the diaper change wait until a more appropriate and safer time I wondered. It took us about an hour to get to the village from the hotel with a good portion of the commute on unpaved roads. The women of Los Marroquines were waiting in the center of the village upon our arrival. The group received bouquets of flowers from the women as a welcoming gift, which was so thoughtful! I was extremely emotional over the living conditions and how poor the community was. The sanitation issue was an immediate detection- there were flies everywhere and their latrines were located right above food crops. The group did a warm up exercise and watched a demonstration by the masons on building the stoves. The task looked so much easier than what it really was! Michael, Alexa, and I were determined to get the job done. Carolina was the mother of the family we would be working with. She had 2 sons and 2 daughters- Rudy, Elvis, and Alfonza were the older children. The youngest daughter never left Carolina's back. The technique on carrying the children was similar to that of carrying a backpack. The endurance and strength of the mothers surprised me, having to carry their children up and down the steep hills throughout the day and doing so with ease. Many people choose to hike outside for fun, but these people have to do so in order to get from place to place and in order to feed their children and survive. I had a newfound appreciation for many things that I feel like Americans including myself take for granted. I was looking forward to completing the stove to improve the quality of life for Carolina and her beautiful family.

day 5: The fire in our hearts
The finished product!
Prayers to heal

Day 5 we returned to the village with the intention to finish the stoves. The weather was cold and rainy, and on our drive to the village I saw a woman walking in the rain with a baby on her back. I worried for the baby's well being because the mother had a plastic tarp over-top of them. The baby's breathing could potentially be compromised, but I understood the mother was trying to protect them and keep them dry- just not the safest option. When we got to the village, the groups tried to finish as much as possible with the stoves. Michael, Alexa, and I were sad we couldn't complete the job to its entirety, but the masons were coming with us the following day to ensure the stoves were ready to go. That evening we returned to the AMA house where a presentation on Mayan culture and a fire ceremony were held. According to Mayan culture healing the sick involved an imbalance. This imbalance could be corrected by the use of herbs and plants, massage, acupuncture and pressure, hydrotherapy, and most importantly, prayer. The group got to experience how strongly the religious aspect played a role in their healing. The fire ceremony was something I had never experienced before. It was truly touching- a form of rejuvenation covering any possible area in need of healing and prayer. I feel like the ceremony might have had an impact on everyone regardless of what religious affiliation they came from. I wondered though: how far could these religious acts take the place of diagnoses that require true medical intervention?

Day 6: Health screening harmony
Focused
Sugar Shock

Day 6 was Part one of the health fair and it was a huge success! This clinic provided blood pressure, blood sugar, and eye screenings for all the attendees, and offered an opportunity for the nursing students in our group to reiterate their skills by providing services and education to not only the villagers, but the midwives in training. I was a little nervous when I found out I would be partially responsible for registering every villager attending, because the line was extremely long! Annelise and I were in one of two groups with Mayan translators conducting health histories for the villagers. Some of the villagers understood Spanish, but I wondered how much they really comprehended what was being said to them. In the US, hospitals require healthcare providers to have a qualified interpreter to properly provide translation as closely as possible to the physician's instruction. If a person from Mayan descent who only understood Mayan went to a hospital in Guatemala, are these kinds of accommodations made for them as well?

Day 7: midwives education and saying goodbye
We're godparents now!
Walter with the hot box sipping on some delicious tea/ the beautiful volcanic spring
majestic scenery

Day 7 was our last day in the village. The clinical group prepared the night before on presenting an education to the midwives on STIs and contraception. I was surprised to see how eager the midwives were ready to learn about the topics we covered, and shocked to know that they learn very little about this in their schooling- curious to know the extent of their education. Anne guided us through- she was truly a wealth of knowledge, and it was great to see the midwives interaction with all of the excellent questions they asked us. After the education, the women of the group were dressed in the most gorgeous clothes provided by the villagers, and bouquets were given to all of us. Truly an emotional day for me, I was so sad to leave. In such a short time, we were able to establish such wonderful and loving relationships with many of the villagers. They have so little, yet they seem to have such happy and purposeful lives. Contribution to the strengthening of the indigenous women of the Mayan community is something I am so proud to be a part of, and will forever remember. I hope that after our trip the women would continue to want to learn more to better their lives and improve their quality of life.

Day 8: Guatever you wanna Do
Youngest Mayan Ruin 1000 BC

Our last days were in Antiqua, but on our way we stopped at Iximche, the youngest Mayan ruin in existence. It was something to cross off on my bucket list! After learning so much this past week about the culture and history of Guatemala, I felt a personal connection in the ruins. So much history, so sacred, it was unbelievable to be able to walk around in something that existed several thousand years ago. Many people in the group learned about their Mayan symbol from a vendor outside of the ruins. The characteristics of their symbols to many were spot on, including my own. My symbol was the fish- someone that is capable, supportive, a tireless fighter with the gift of healing! What a wonderful end on history. The hotel we stayed at was another amazing end to the trip. I feel like I appreciated the stay more than I usually would have after experiencing what we saw during the week. Walking away from this trip, I had such an appreciation for so many things. The fact that we have safe tap water to drink, temperature regulation in our homes for comfort, healthy and affordable foods to eat, a solid roof over our heads, transportation to make travel more convenient, cell phones to contact whomever we wanted. The fact that the US uses state of the art medical advancements for treatment, aseptic technique, and supplies readily available to save lives. The list goes on and on, but there are so many things society takes for granted. We should be so privileged to have all of these things easily accessible. When the woman from Marroquines said she was grateful for our help because she would no longer suffer, that affected me in such a way that I'll never be the same. I am so grateful to have had the opportunity to experience such a life changing trip, and with such amazing people. I believe we all walked away with a better perspective and understanding on what gratitude truly is.

Began as strangers, ended as friends!

Based on observation, healthcare services are few and far between in the country of Guatemala, and nonexistent in its more rural areas. I don't think I saw a hospital during the entire trip, even in the busier more established cities, which is the complete opposite from the US. This makes treatment for diseases and conditions almost impossible. Whats worse is that it doesn't seem like the government is doing anything to help change that. From learning about the history of Guatemala, this country has been devastated by oppression and violence, and even to this day cannot be recognized as a democracy because of the inequalities that exist. There has been much political action to defending rights for basic survival needs, like clean water, something that is vital for anyone's life. The fact that this country had a civil war in the 1990s because the government was intentionally trying to prohibit the communities from converting to communism says alot about the struggle that exists in Guatemala.

There are many factors that contribute to the social and health injustice that exists in Guatemala, especially within the indigenous communities. As stated earlier, I learned that hospitals in the country do not provide medical supplies necessary for treatment- it is the responsibility of the families to retrieve these items. What if the family is poor and cannot afford to purchase these supplies? Then the family member is left to die? As in many countries, healthcare services are available to those financially able to afford it. This is unfortunate for Guatemala because more than half the country lives in extreme poverty. There is also a prejudice that exists between the indigenous communities and the rest of the country, which is surprising due to the fact that Guatemala has one of the largest indigenous populations in Latin America. These communities are stuck in poverty, in rural areas too far from health clinics or hospitals. I learned that when they do have the opportunity to seek medical intervention, they are rejected because they are Mayan. This is mind boggling to me that a prejudice like this exists in such a culture rich country. Poverty does exist in the US, but there are a number of state and government programs available to provide assistance to those in need of care. Many of our hospitals cannot turn patients away and offer charity care and payment programs to those without insurance. Not receiving medical care in the US is solely a voluntary decision by the patient, and not because of who they are, how much money they have, or where they come from. Witnessing this in Guatemala was an eye opener for me.

There were many similarities and differences seen when comparing Guatemalan culture to my country of birth. The US is a melting pot of many cultures- I believe many people are able to live freely and practice what they believe in (to a certain degree) because that is the beauty of living in a free country. I was born here but I am of Hispanic descent, so throughout my life I experienced many things similar to Guatemala. Similar to Guatemalan culture, my family practiced holistic therapies when we were ill, and only utilized a doctors visit when it was a serious issue. Prayer was also a big thing in my family and was frequently used for healing and giving thanks. Family was also the most important thing, but I believe that is something that could be seen in any culture world wide. A difference I appreciated was the clothing- a good portion of all the women we saw on the trip wore traditional dresses, whereas in the US women are able to wear whatever they choose. Alot of the women in the village were stay at home mothers where they worked from home making clothes and caring for the children. In the US, women work just as much as the men do, and in some cases are the main sources of income for the household.

The language barrier was definitely the biggest issue the group encountered. There was a four way translation most of the time- from English educator to Spanish translator, Spanish translator to Mayan translator, and then Mayan translator to villager. This severely delayed communication. I speak and understand Spanish fairly but I don't really think it benefited me as much as I thought it would. I tried to help others as much as I could, but the bulk of the help definitely came from the AMA group and Lupe.

Before going on this trip, I always had the desire to travel and use my knowledge to help those less fortunate, especially in other countries. My inspiration to pursue humanitarian nursing has grown even more after experiencing what came with my contribution on this trip. The villagers were so happy and grateful for everything that we provided, it really made me feel like I had purpose. I hope after gaining enough clinical experience I can give back and give my contribution to those in need.

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