Touching Ground

Yesterday was insane. Landing in GUA was so much different than I ever could have imagined. Every five minutes I would look out of the plane in amazement. The terrain is so beautiful. Life seems so simple here. I watched children play on the street with a bottle on a string; while their parents pedal trinkets. The people are so welcoming here. Everywhere we go we are welcomed with open arms and smiles. This morning (Sunday morning) we went to the holocaust museum. It’s important to GUA Because history repeated itself in countries across the world. We also went to the square. It a was nice to see all the families feeding pigeons and the kids running around having fun. Next we went to the cemetery, which was really interesting. Many of the tombs were broken into. In fact we saw a femur on the side of path. José said it was likely the result of gang activity. It was really interesting to see the intentional separation between the rich and the poor in the cemetery. However since the contrary had become so over crowded over the years he rich and the poor lived together.

During this tour José taught us 4 very important lessons.

1. We are always trying to separate our self from the other but we have to live with the other. 
2. Don’t be greatful for what you have but for what they are. 
3. Don’t work for the other work with the other. 
4. Call the other by their name not the other.

Lauryn Watson

Moving Beyond the "Other"

"Be grateful for not what we have, but for what they are" - Jose Roland

We're standing in a cemetery looking out into the valley referred to as "the dump", where workers sift through the trash from the city to sell. As we look out, we are taken back by the immense growth of the trash in a mere 4 years, starting as a valley and quickly filling up to be even with the top where we stand. We are also distracted by the sun burning our skin and causing us to sweat. It is initially easy to feel pity on the garbage scavengers, living a life amongst the heat and garbage just to make it another day. One may also think, "Wow, I'm so glad I have been blessed with air conditioning and security in nutrition and finances". But, as we reflected, Jose Roland challenged this type of thinking. Rather than looking at these garbage scavengers as the "garbage scavengers", or the "poor" or the "others" that have lesser, resulting in us appreciating what we've been blessed with- what if we approached it a different way. What if, as we watched them work, we think about their past life that lead them to this lifestyle, and their present, of working day after day under the sun's burning rays amongst the people's unwanted leftovers. How amazing are they. Trekking on in the worst of conditions while being suppressed by the social and economic structure that prevents them from change their lifestyle, resulting in a seeming lack of hope. Yet, they wake up day after day, doing what they need to do to feed themselves and families. So much will and strength and dedication and love.

These reflections we had as a team lead me to my own reflections that challenge the motive for this trip. We didn't just come here to help the "others" who have less resources than we do. In fact, as we also discussed, the word "others" is problematic in itself, encouraging a further distance between ourself and those we serve. Rather, we came here to learn how to be incredible. We came here to learn how to grow and love and be thankful and have an incredible spirit for life, all without the materialistic things and resources that we've grown up with. We came here to learn how to be grateful for who they are. And let me tell you, they have so much to offer and we have so much to learn.

I feel excited and grateful and humbled to be in this beautiful country with its loving people. As we begin clinic tomorrow, I pray that with the short time I have with each patient, I can make even a portion of difference in the patient's life, of what this country and their people have already made on mine. Thank you to Jose Roland, the staff, and my team for keeping me centered and my motives in check as I begin the week in clinic.

Madelyn Hayes

An Opportunity to Grow

"Just because you don't know doesn't mean you aren't good enough, it means you have an opportunity to grow," said Stephanie Ibemere as we ended our first medical debrief. We have spent about 5 months preparing for this trip. We practiced medical skills, Spanish skills, learned about the Guatemalan culture, and developed as a team. As a team we have gotten so much closer and our friendships will last a lifetime. Today was the first day of clinic and I was ready.

I learned so much today. I began my morning in glasses with Rabbi Abie. really feeling like I still have my spanish skills because I got to use them because rabbi can’t really speak Spanish. My favorite patient was a woman who I did all by myself. Her eyes lit up and I don’t even know how to describe her thankfulness. I had no idea what I was getting into with glasses. I have never had glasses or contacts so I learned the different prescriptions.

In the afternoon, I was in triage. I loved it. As a nursing major, we are able to do these skills in clinicals in the US but here it is so different. Our patients are so thankful. One of our patients passed out as Maddie took his blood sugar. His eyes rolled in the back of the head and passed out. They had a pulse but he was having PVCs and so they think he had a heart attack. Kristen and Stephanie were amazing. Anyway, no one had aspirin until Osie ran down hill to get some. He got some aspirin and the ambulance was called. 

Kristen and Stephanie were able to critically think and I am striving to be that. I have the best teachers in the world. I have learned so much in clinic and it has only been one day. I just want to thank the medical team for all they do. I am ready to grow emotionally, spiritually, and in knowledge.

Margaret Sullivan

Muchísimas Gracias Guatemala

Be thankful not for what we have but for what they are. These wise words along with many others came from our incredible Jose Roland, the one who knows the people of Guatemala better than anyone. On Sunday we looked over a massive trash dump a few yards from a cemetery in Guatemala City and saw some of the most extreme poverty of the country. The scene looked like something from a sci-fi movie - dozens of vultures circling around in the air, smoke drifting upwards and an abyss of trash that extended deep into the valley. People were scavenging for hours under the intense sun through the depths of garbage hoping to find some treasures that they could eventually sell and earn some money from. This was their means of income. I had never seen anything like it and my instant reaction- like many others was to feel pity for them and be thankful for what I had- that I would never have to search through a dump in order to put food on the table. But Jose made me think differently.

He called me to appreciate and find the beauty in these hardworking and hopeful people who were doing what it took to support themselves. They had dignity and they had strength. Throughout my time in Guatemala I’ve looked for the beauty in what others may find ugly. Though the roads here may not be as well kept as in the United States and people live more simply- there is so much beauty in the spirit of the people of Guatemala. I have been blown away time and time again by the way they live their lives- with positivity, patience and generosity. During our days in the clinic I had the incredible opportunity to get a sense of the community that lives in the mountains of San Lucas. Each and every person I encountered, no matter how sick they were, greeted me with a warm hello and a smile. Their love of life was infectious beyond compare. Some patients would wait in the clinic all day to be seen by the doctor if it was busy. I’d lead them to the waiting area and even if they were there for hours, they would be so calm and content with waiting for their turn- they never complained and they never got upset with us. They were happy just to be there and it didn’t matter how long it took. Some would even hangout after they had been seen because the clinic like a watering hole for the community. Finally, the amount of generosity was overwhelming. It was so powerful to see people who have little give so much; they gave small gifts but beyond that they gave their time and their prayers. They were gracious and excited to help in anyway they could.

Our patients may have learned from our medical team; but they taught me so much more about the type of person I want to be. I hope upon returning to the US I am able to emanate this unparalleled, beautiful spirit of the people of Guatemala. Muchísimas gracias Guatemala, ojalá que nos veamos pronto.

Prasun Shah

Agua es Vida

As I am riding a bus along the base of Volcano Agua outside of Antigua I finally have some time to reflect on this year’s trip. Agua, water, water, water. It is easy to take for granted in our comfortable lives back in the United States how easy it is to get clean water. You can drink water safely out of the tap almost anywhere in the USA. Unfortunately the same is not true in places like Guatemala, and much of the rest of the world.

I met a little baby named Levi here a year ago. He was 6-months-old and had failure to thrive. With the help of my amazing interpreter, Diana, we talked mom through why his growth curve was worrisome and discussed practical ways she could get him to grow better. The family drank water out of the tap and all the kids suffered from chronic diarrhea. We talked about how they could get a water filter from Ecofiltro at a subsidized price and cautioned against Levi being given unclean water with his at-risk growth. I put Levi on my list of kids that I knew needed close follow-up. This year I had the pleasure of seeing him again. He is now a beautiful toddler and is thankfully back on the curve on the lower percentiles.

At least he is growing marginally better. But he wasn’t well. Mom brought two of her other 6 kids with her this year to see me. They all have chronic diarrhea, distended abdomens; the older ones often complain of headaches and dizziness. The family never got the filter, they still drink water out of the tap. Diana and I careful explained that all of her children are suffering from not drinking clean water. You can treat them all for parasites, amebas, the GI pathogens ubiquitous in unclean water, but as soon as they drink from the tap again they will once again get sick. I think she understood this year. It helped so much to have the few plots on the growth curve (a birth weight, last year’s weight, this year’s weight). I think when families see that plotted out and explained it helps to put it in context for them. I was not surprised she didn’t get a filter after last year’s visit. These families have lived off of unclean water for generations, they don’t change overnight.

Today we just took the Xavier team to tour Ecofiltro, the factory where the filters are made. I have been here once before. A year ago in January Rabbi, Abie, Eric, our pharmacist and I came down to Guatemala for a scout trip. We were looking to plug into a new community to try to help them become more self sustaining with their own health over a period of years. When we toured the clinic in the town where Levi lives I asked the community health worker if the families drank clean, filtered water. She told me no and I knew at that point we had our work cut out for us. I told our Guatemalan host, Jose Roland that we can do very little good in a place like this without providing a way for them to get clean water. The next thing we knew we were touring a factory outside Antigua called Ecofiltro. They make water filters using clay, sawdust and silver - all materials harvested in Guatemala and manufactured in an environmentally sustainable way, organically using the sun and wind. The employees are not even allowed to bring junk food or soda to work. I love Ecofiltro. It gives me hope, hope for the lives of people in places like Guatemala. The technology Ecofiltro developed is used in 38 countries around the world.

The company agreed last year to help us in our work here. They come to our clinic and families can purchase a filter at a subsidized price - basically for the equivalent of buying bottled water over three months they will pay for the filter. The filter will last for two years. Needless to say, Diana and I asked every family last year and this if they drank filtered water. Last year none did, this year 5 families had filters. We made a dent. This year Diana and her super saleswoman skills was able to convince all of the families that we saw who didn’t have a filter to let her put their names on a list of families interested in getting a filter. Now Ecofiltro will meet with those families for further education about the filters and hopefully will sell some. We can change the trajectory of a community little by little (poco y poco). It is work, a lot of work, but it is worth it. It is life.

Here is the website link to Ecofiltro for more information:
http://ecofiltro.com/en

Lauri Pramuk, MD