Clinical Experiences at a clinic in Ciudad Vieja, Guatemala

Experiences at Puesto de Salud (so far)
Within my first couple days of volunteering at Puesto de Salud [Place of Health], I was taking vitals (blood pressure, weight, height, etc.) and even received permission to administer a few medications. I highly doubt that if I was not able to speak and understand as much Spanish as I do now, the staff would have allowed me to assume as many responsibilities.

When I first arrived it was kind of awkward because I wasn't sure what to do, where to go, or what they wanted or expected of me. But I was told that that's normal. Volunteers should expect a lack of structure because we are thrown into a busy, Spanish speaking environment that isn’t highly funded, so we have to be patient, positive, and cheerful. I ask a couple of the nurses a lot of questions, because I want to understand more about Guatemala's health system and medical conventions, and I would like to deepen my involvement as much as I can.

I try my best to be meticulous and careful in everything I've been asked to do, whether it’s reading as accurately as possible the height of the patients when they stand against the wall or on the office scale, or washing my hands every single time I’m asked to administer some medication in the mouths of the children (latex gloves are not available). But I hadn’t realized that on my first day I’d been measuring the height of the babies incorrectly. Once they were laid down on a measuring table, I instructed the mothers to have their heads placed in the opposite direction of which they should have been. Once one of the nurses saw this, he told me sternly, “Noo, es al revés!” (It’s the other way!) I. was. so. embarrassed. I’d measured the past 10 or so babies the wrong way. I was afraid the nurse was going to kick me out or something because I reported information that was off! (even though it wasn't by much --maybe about 2 cm--but it was still off!) I was about to suggest that we find the other babies in the waiting room for whom I reported incorrect information, but the nurse simply continued with the check up. No one said anything to me after that. No one scolded me. The mother simply turned her baby around the correct way and didn’t seem to mind at all that there was an incompetent American volunteering in the clinic.

In fact, the people respect my presence. On my second day, an elderly Mayan woman, after I’d taken her vitals, took my hand and asked me, “Y por qué está usted aquí?” (And why are you here?) I placed my other hand on her shoulder and said, “Soy voluntaría por unas semanas.” (I’m volunteering for a few weeks). She smiled at me and responded, “Me alegro mucho que esté aquí.” (I’m very happy that you’re here). I can’t explain how amazing it felt to hear such words of appreciation by this woman. My contributions to the community are minor; I’m not doing anything significant. I’m not healing wounds, curing sicknesses, or saving lives. But my just being there is meaningful to some of the people, and I am so happy that my mere presence makes such a difference.

Arriving at the clinic
I usually get to the clinic a little bit before the gates open at 8AM, and I wait alongside the long line of people who arrive early to get a number and wait to pass through triage (pre-consultation/vitals). When I walk to the clinic up a mini hill that leads from the main road where the chicken bus drops me off, I come face to face with a long line of Guatemalans, most of whom just stare at me. It’s kind of an intimidating site, having so many pairs of eyes watching you for a few moments. But I just smile at all of them. They must think of me as a weird foreigner.

Smile
Whenever I see an unfamiliar face, I smile, and often times, it’s returned. It’s inevitable that here in Antigua I get a lot of stares and interested glances because I’m an “extranjera” (foreigner). If you’re not used to seeing, for example, a random black girl roam your town's streets, you’ll start to stare, and you’ll wonder where she’s from and why she’s here. (Perhaps that’s not commonly the thought process now, because there are tons of foreigners roaming the streets of Antigua every day, so I’m sure Guatemalans have grown used to seeing so many of them.) But people still stare, some harder than others. And all I do is smile :) I smile at children who look up at me with curious eyes, at young adults my age, older men and women, and families. 

                                       

Chicken buses and economic challenges in Antigua, Guatemala

"Chicken" bus

I started volunteering at a free health clinic, Puesto de Salud [Place of Health], this past Thursday, December 27. It’s located in Ciudad Vieja (“Old City”), a small town right outside of Antigua, about 10 minutes away by bus. Ciudad Vieja was actually the capital of Guatemala before the volcanic eruption that wiped out much of the city. The capital then became Antigua, but soon became Guatemala City because a severe earthquake hit the colonial town. Guatemala City is still the capital today.

Taking a "chicken" bus
I take what the locals and tourists call a “chicken bus” every weekday to the clinic. I believe they are hand-me-down school buses from the U.S. This name was coined by tourists who've seen many Guatemalans on the buses with chickens and other animals too).

There is nothing to pull or press to signal a stop, and the one aisle for people to pass through in the middle of the bus is very tight. If you want to get off, you better get up fast and move towards the front or you’ll miss the stop. I ended up missing my stop coming back from the clinic on my first day because I didn’t get up quickly enough. There are a lot of people riding these buses everyday, so it gets crowded and cramped.

I always feel like a giant when I board these buses; I have to duck when I sit down in a seat nearby a window or else I’ll hit my head on the overhead storage compartments. That happened to me once last summer. I hadn’t realized that my head was so close to the compartments, so when I carelessly moved through the aisle to sit down in a seat by the window, I was just met by a painful, clobbering sensation in my forehead.

The Plaza Central Park, Antigua, Guatemala

Employment and a brief look at the economy in Guatemala

Guatemala is the most populous nation in Central America, and about 75% of the population lives below the poverty line.

I take a bus from Antigua to Ciudad Vieja, which costs 3 quetzals (less than a dollar: about $0.40). 7.70 quetzales is equivalent to 1 U.S. dollar. My teacher at the school, who is a native Guatemalan, told me that many workers in Antigua (especially those who come from neighboring towns) make only about 50Q a day (~$7). In the town’s park, there are many Indigenous women with their beautiful, traditional garbs who walk around and ask people to buy scarves, jewelry, or other pieces of clothing that they put together with their own hands. You also see young boys walking around with shoe polishing equipment asking passerbys if they’d like to be serviced. There are also people who sell ice cream and popsicles from a mini-ice cream bar with wheels. Some sell newspapers and magazines. Others hand out fliers for a travel agency they’re trying to promote. A few men try to sell flutes that are decorated with Mayan designs. I bought one of those last summer. There are many ways that people here try to make money to support their families and I am humbled by both their creativity and perseverance in doing so.

Arrival in Guatemala

La Aurora International Airport

Guatemala City, Guatemala

Trapped at the airport

Well, I thought I would be. When I arrived in Guatemala City, I was tired, anxious, cold, and excited all at the same time. I stepped outside of the airport and stood face to face with streams of people waiting for family and friends. A few random men came up to me and asked loudly, “Taxi? Taxi?” or “Señorita, quiere hacer una llamada?” (Miss, do you want to make a call?) I said, “No, gracias” to all of them and searched anxiously for a representative from the school (Maximo Nivel) holding a sign with my name. 10 minutes passed, then 20, then 40. Soon it was 9:30PM local time, and I started to worry. I couldn’t get in contact with anyone from the school because it was closed, and I didn’t know yet who my homestay family was. Just when I was about to exit the airport to ask that a taxi drive me to a hotel in Antigua, a guy called out, “Hey, excuse me, are you Deborah?” He was also traveling with the school and had been waiting for about as long as I was for the same representative. Apparently, there was a ton of traffic because of the holiday, so that delayed the rep’s arrival.

Guatemala City, Guatemala

My ride from the city to Antigua and meeting my homestay family canceled out all of the negative events from earlier that day. On the way, I saw fireworks in a park that were being set off to celebrate Christmas (la Navidad), smelled the wonderful familiar smells of the country (not exactly sure how to describe the smells; they were a mix of pollution, food from the street vendors, and other things), saw the familiar sights of people walking about exchanging loud chats in Spanish, and spotting a motorbike every other car. I also forgot about the cobblestone streets of Antigua and how bumpy car rides had been. I arrived at my homestay around 10:30PM where I was warmly welcomed by Cecilia (Ceci for short), the helper of the house, and another volunteer from San Francisco, CA. My host mother, Olga, was visiting her family in the capital (Guatemala City) for the holiday.

Christmas in Guatemala
At 12AM it sounded as though the skies opened in anger; fireworks thundered throughout the small town. I was invited to go out to a fiesta to celebrate the holiday but I had no energy. I was very jetlagged. I plan to celebrate the New Year though (el año nuevo).

Christmas in Antigua, Guatemala

Christmas in Guatemala is celebrated the day before. It doesn’t mirror the US tradition of waking up early the next morning to open presents under the tree. Instead, here they exchange gifts and throw festivities on the 24th. The 25th is a day of rest. No shop, library, school, or anywhere else is open.

Gratitude
One very important thing I have realized upon entering my humble home for the next month (and that we all have realized at some point but should ruminate more on it) is that we take a lot of things for granted. I remember it was just a few days ago that I was complaining at home and mindlessly chattering about how I wished my family had a more privileged background, lived in a better house, came from a nicer neighborhood, etc… But even though we don’t live in the best of the best conditions, we’re still better off than many others, including millions of those from developing nations. So we need to be grateful for everything that we have – our education, our iPhones and preppy technological gadgets, our fashionable, comfortable clothes, and the thousands of opportunities available to us as citizens of the United States – because there are millions who don’t have even half of the things that we do.

Pre-departure to Guatemala - Stressful Events

Antigua, Guatemala

I made it to Guatemala! I’m so excited I’m trembling (that could actually just be shivers from the cold. It's freezing at night!) I had two lay overs in Miami and Panama; I boarded three planes from Newark to Miami to Panama to Guatemala. It was an exhausting trip.

Stressful things that happened before my flight

I was originally going to fly out on Sunday, December 16th and stay for five weeks until January 18th. I went back home to NJ from Ithaca on the Thursday before the 16th and realized later that evening that I’d left my passport in my dorm room. I was four hours away by car from Cornell. I froze in the middle of a conversation I was having with my brother when I’d suddenly realized in horror that I didn’t have my passport with me. If it weren’t for my roommate I wouldn’t be able to leave the country, so I thank her so much for mailing me my passport. I call this one of the stupidest mistakes I’ve made because it cost me a lot of money: to cancel the flight and to rebook.

Here's another stressful event I encountered before boarding my flight: I thought I was going to have a heart attack at the Newark International airport. My first flight was at 9:12AM to Miami, and I’d just gotten on the long line to have my bag checked at 8. (Tip to everyone: NEVER arrive only an hour before your flight! Always two!) It was already about 8:25 by the time I got to the front. Once I had everything checked, my boarding passes printed, my carry-on backpack on my back, and ready to look for the gate to board the plane after the next checking point, the agent suddenly stopped me and said, “Excuse me, ma’am, your bag is 6 pounds overweight. We’re going to have to charge you $200.” I screamed internally, glancing at the time on my phone. It glared 8:35, 2 minutes from boarding time. “I don’t have that money,” I said outright. The agent shrugged his shoulders, “I’m sorry, ma’am, but you can’t board the flight unless you pay the fee or take out the 6 pounds.”

I had no choice but to drop to the floor in the middle of the airport and remove some clothes, my flat iron, a few shoes, and anything else I thought might’ve weighed a lot. I stuffed these things into my carry-on bag. If I hadn’t been so flustered and worried that I was going to miss my flight I would’ve been embarrassed. I didn’t take out a full 6 pounds but they accepted it at 52. I then sprinted for my flight, managing to make it before they shut the doors.

Pictures of Miami and Panama City
I’d taken a couple of pictures of Miami upon flying out, and Panama City upon arriving. I believe we flew over Cuba as well. It would’ve been awesome to spend at least a day in each city. Notice the blatant differences in infrastructure. Even the skies look different. That could just be a slight difference in weather and time of day.

Miami, FL

Panama City, Panama

End of semester bliss and blues

Doubts about pursuing a medical career
This Monday I took my last final for Organic Chemistry. My concentration was broken a few times by the girl sitting next to me who constantly sighed in exasperation and discouragement throughout the exam. Last year during the General Chemistry final, another girl had burst out in tears and was anxiously told to calm down by one of the TAs.

I've considered reevaluating my life. It’s easy to give up on a medical career. It’s so easy to kiss those future years of education goodbye and aim for something that’s 'easier' to attain. I can already feel how much more stress-free, happy and liberated I’ll be if I shut out medical school from my future plans.

I often complain about how difficult this process is - particularly my coursework - mostly to myself, but sometimes to friends. One of my close friends keeps me in check, reprimanding me every time another complaint leaves my mouth. She reminds me that there are people who are in way worse situations and experiencing deeper troubles, so I need to hush up and push forward. She tells me that lovingly, of course. I appreciate her candor.

 

Many have encouraged me to persevere, including my family, my advising dean, my mentors, friends, and my professors.

Pressing forward

I was in a fit of blues at the end of this semester because I felt beaten by Organic Chemistry. I worried that I was aiming too high by choosing to pursue a medical career. But my bliss comes from the encouragement of my family and friends, and my mindset and optimism that it’s not the end of the world and I will make it through.

I want to encourage every single student to FOLLOW HER DREAM until she achieves it. If you really want what you’re working towards, do NOT give up. Keep going. You are capable of attaining your goals if you truly put your mind to it. Maybe you won’t achieve it in the same way as others, and perhaps you'll have to change the course of your journey, wait longer, or encounter different barriers along the way, but you WILL get there if you keep pushing through.

"A dream doesn't become reality through magic; it takes sweat, determination and hard work." -Colin Powell

Most importantly, “I Can Do All Things Through Christ Who Strengthens Me". Philippians 4:13. I would not have made it as far as I have in my life if it weren't for the strength God has given me to achieve what I had achieved.