One week off with Dad and then in Antigua, Guatemala

My schedule here allows me to work for 21 days in the community and then take a week off to explore. For this reason, I was able to spend 4 days with my father who visited from New York to see a small piece of Chiapas, and then I spent the latter 4 days in Antigua, Guatemala visiting Lorraine, the Ob/Gyn doctor with whom I worked in Hospital Altamirano, and her husband Miguel. Dad and I explored San Cristobal and the Chiflon waterfalls near Comitan. With him, he brought enough cookies and brownies to throw a grand party, as well as several books I’d been lacking. Despite his altitude sickness and frustration with the omnipresent evidence of poverty, we had a good visit and I hope he went home more worldly for it. From San Cris, I took a 12 hour van across the Guatemalan border to Antigua. On the road, Guatemala’s differences with Chiapas are well pronounced beginning with the famous Chicken buses and continuing with their more sophisticated farming methods. Unfortunately, the border road is very dangerous, although much safer since the police increased their presence a couple years back. The Chicken buses, our old American yellow school buses, are the primary method of public transportation in Guatemala. Completely absent from Chiapas, they are painted in vivid colors and when parked, have a artistic beauty that can only be contrasted by their bat-out-of-hell approach to driving and their exhaust which in itself is reminiscent of the 19th century British Industrial Era.

Antigua, like San Cristobal, is a colonial town with colorful houses lining the cobblestone streets. It stands alone, however, in its architectural achievements and ubiquitous church ruins. From the 16th Century, Antigua had been the center of Latin America, and as such, every church group flocked into to establish their cornerstone. The earthquake of 1773 destroyed nearly all of them and left beautiful ruins on nearly every other block of the city to explore just as the people, unable to move the stone blocks of their city undone, moved the capital from Antigua to Guatemala City. Miguel is heavily involved in preserving Antigua’s cultural heritage and casting a spotlight on Guatemala’s artistic traditions. He and Lorraine have a gorgeous house with a fountain they had designed and a rooftop garden view of the ever prominent Volcanoes.

During my stay, I hiked up Volcano Pacaya (my first volcano – and part of the way with a 2 ½ year old Australian boy named Jessie on my back) a semi-active volcano that smokes sulfurous fumes daily and occasionally spits fiery rocks. The view from the top was incredible but more fun was skiing down the volcanic ash. Also, I went to the market in Chichicastenango (Chichi, (CHEE-CHEE) for short) where colorful Guatemalan textiles collide with colorful Americans from the cruise ships who are bussed in and bussed out without ever having to learn a word of Spanish. That cultural shock aside, it was a very good visit and I left to return to my clinic in Belesario yesterday with a deep appreciation for Antigua and a lasting friendship with Lorraine and Miguel.

into the communities

I spent one of my last weeks in February in a series of small communities on the edge of the Sierra mountains and over an hour off the paved road ways. To get there the health promoters I had gone to support and I hung on to the back of pick-up trucks as we spun around the curves and through the dust of yet another part of Chiapas that has only had electricity for three years. As there is a deprivation of medical attention, we set up shop in three small towns and worked for about 6 days. At my insistence, the health promoters set up consult rooms in their homes or in mud-brick houses with an examination bed and a desk. They stayed with me to take blood pressures and I talked to them about the patients’ medical conditions.

It was really a pleasure to support the health promoters by showing the communities that they are working with a doctor and to see them taking such good notes on my questions and on the differential diagnoses I had discussed with them. In all of the communities, families cooked for us and gave us a place to sleep. The real adventures of the day revolved around the 1-2 hour long hikes, hitchhikes, and walks to the nearest city’s phone to call Ines.

Also, there were a few house calls we made into the mountains. Often, to my surprise, patients would come in with ultrasound results and medicines from other doctors. The people of those communities have a lot of faith in the Guatemalan doctors. One theory on why that is is that the Guatemalan doctors prescribe more medicines and injections than even the Chiapan doctors. Many patients want injections and vitamins. They trust injections more than pills in fact and it is very hard to get them to change. I saw many people with chronic back problems, unsolved colitis symptoms, and rashes that come and go since the hurricane. The rashes I hypothesized were due to the dirty water they are filling their buckets to bathe with. The colitis had already been treated with a buffet of medicines for everything parasites to bacteria so the best I could do was to tell them to avoid the troubling foods. The back pains and aching feet are a more difficult problem. These people do more physical labor than most of us with poorer conditions and the only real solution is a package of painkillers and a long cruise vacation, neither of which I could sufficiently offer.

The whole trip was very educational and I will most likely go back to support the health promoters in march.