Saturday, March 4, 2017

Packing Party

Each year, the Xavier University Interfaith Guatemala Medical Service Trip brings hundreds of pounds of supplies to stock the clinic. This year, the team packed 37 50-pound bags (that's 1,850 lbs, nearly 1 ton of supplies!). That doesn't include all of the additional supplies that were sent via mail ahead to time, and coming from LA with Dr. Richard.

Check out this time-lapse video and watch 2 hours of hard work flash before your eyes:

Friday, March 3, 2017

Shaking the Tree Women in Guatemala

A tribute to two beautiful young women for International Women’s Day, March 2017

Seven years ago in a dusty grade school gymnasium on the side of a mountain in the western highlands of Guatemala I met two young sisters, Diana and Mishel.  At the time they were bridging the gap between adolescence and adulthood.  One was 20, the other 19 years of age.  They were hired as medical interpreters for Dr. Richard Walter, an internist from LA, and myself, a pediatrician from Cincinnati.  Richard and I were embarking on our first trip to help improve the healthcare and lives of the people in this small village in Guatemala.  This was Richard’s first time practicing medicine outside of his office and practice in LA.  I had a bit more experience, having studied pediatric malnutrition for a month in medical school in rural Honduras.

The little community we were matched with had never had a physician in their village before that day.  We were there with Xavier University’s Center for Interfaith Community Engagement’s Guatemala Medical Service trip.  The trip was organized by the center’s director, Rabbi Abie Ingber.  We brought with us two triage nurses – also both from LA, and 12 Xavier University pre-med and nursing students, along with Rabbi Abie’s assistant.  Somehow we had to transform this dusty gymnasium into a clinic for a week.  With the help of some sheets and tarps we strung up with ropes, we made two exam rooms and started seeing patient after patient.  I knew some medical Spanish, but Richard, really knew none.  Randomly Diana was assigned to me in the peds room, and Mishel to Richard for the adult patients.  We dove in, not really knowing what we were doing.

After a long, hot and exhausting day of seeing patients and teaching students we all piled into the vans to go back to our hotel.  I ended up sitting next to Richard in the van.  We had only met each other the day before, but now seven years later I count him as one of my closest friends.  Richard looked at me on that van drive home, overwhelmed by all of what we had seen that day, but the first thing he asked me was, “Your sister, your interpreter, Diana, is she really smart?  Because the one I have, Mishel, is amazing.”  This launched a conversation that is still ongoing between Richard and me about the myriad gifts these two girls possess.  Within a half of a day of working with us, Mishel and Diana knew how to take a full medical history.  Each new chief complaint was memorized and categorized into some intricate filing system into their brains.  If Richard was seeing a patient with headaches, Mishel knew the next ten questions he was going to ask about headaches. They intently listen to everything we say, translate it into Spanish or Kachiquel and communicate it all so seamlessly.  They are fluent in several languages.  Having worked with students in training our whole careers Richard and I can honestly say we have never worked with more accomplished students.  They are quicker learners than any medical student I have encountered in my career.

They also understand that doing medicine well takes time.  Sometimes you have to ask that next question.  They have been in rooms with us as patients have revealed very private and personal information.  They have helped us learn about rapes, immigration horror stories, domestic abuse issues and many more.  And they do all of this with compassion and grace.

Several days into our first week, we were out in the evening looking for a good place to get some guacamole and Gallo beer to unwind and decompress after our long day.  We walked by a colorful restaurant on the main strip of Panajachel playing the most wonderful marimba music.  To our surprise the musicians were none other than our Diana and Mishel.  Their father, Miguel, who I could write chapters more about, owns the restaurant and his daughters play the music along with a cousin.  Their lovely mother is the cook!  We have since enjoyed hours of entertainment listening to them play the marimba.  They are now famous around Guatemala for their marimba skills.  If you are ever in Panajachel stop at El Pinguinos to say hello to them – it will be well worth it!

A few years ago we added a pharmacist to our annual trip.  His name is Eric Bertelsen and he travels with us from Cincinnati.  When he first met Diana in the van that year he asked her what she was studying in college.  She replied, “Psychology, so I can help my people be happy.”  Eric can’t recall this memory without tearing up.  She was so genuine, so honest and so committed to changing the world around her.

One of the days toward the end of our trip each year we try to do home visits for patients who are too ill to come to clinic.  Because I am the younger of our two physicians, I go up the mountain to see home bound patients (both adult and children), while Richard goes down the mountain.  It is a nerve-wracking day for us, since we both feel like fish out of water taking care of patients not in our typical age group.  As an infant, Diana had hip dysplasia that was not diagnosed in time, so she lives with chronic hip pain.  Because of this we decided it was best for Diana to go with Richard on the less-steep terrain.  So we switched interpreters.  Little did we know how brilliant this switch was until Richard found himself taking care of a child with respiratory issues and I had an elderly woman with diabetes.  We both were in unchartered water.  But the girls had been with us so much they knew what we would do and what questions we would ask.  Mishel knew the adult medicine from working with Richard and Diana knew the pediatric from working with me.

Even more impressive than their sponge-like brains, is their zest for life.  They are ALWAYS smiling.  They are joyful to be around and always lift us up.  Needless to say, our trip to Guatemala each year would not be the same without them.  They have been with us now each week for six years straight.  This year we are starting a new clinic in a different community and Mishel and Diana have agreed to travel with us for the week, giving up the other responsibilities of their lives to come and help us.   When I think about women who should be known to the whole world on a day like International Women’s Day, I think about Diana and Mishel!

Lauri Pramuk, MD