Monday, September 29, 2014

Reflections on Healthcare, Guatemala, and Pop Wuj

By John Hann, MD

John was a Pop Wuj Medical Spanish student in May, 2014.  At the time he was finishing his Family Medicine Residency at Ventura County Medical Center in Ventura, CA. Thanks for being a fantastic Pop Wuj student and volunteer -- and for sharing your story and pictures! 

Women walk on the streets while carefully placing their feet in the areas not yet soiled by the stray dogs who rummage through plastic garbage bags that line the streets. Unable to afford niceties of street sweepers, clean engines, or even trash cans, the city instead relies on bright colors, flowers, bustling markets, and the inevitable afternoon downpour to shine through. Even through the thick soup of exhaust belching out from passing buses, the flowing colors of women's clothing can be seen. 

Like many others, Guatemala is a land of contrasts: beauty enveloped by pollution, tranquil people inhabiting cities filled with chaos, and a culture of stamina that belies the chronic disease and pain suffered by many.

Forty-two hospitals cover the 18 million people that live in Guatemala, a country whose economic sector is said to be dominated by money sent by family members living in the U.S. Twenty-two official native languages are recognized that have all descended from the Mayan empire.  Family members are accustomed to systems that are slow, inefficient, and racist. 

The clinic created at Pop Wuj by Guatemalans with the support from the U.S. is, for some, the only healthcare they receive. The projects started with scholarships and building safe stoves before expanding to provide child care for women living in the impoverished countryside and later healthcare.
Stove building material delivery day

Delivering bricks and other materials for the stove construction
Though established by Guatemalans, the organization (like much of the country) relies on foreign donations and volunteers. In the last decades, U.S./European volunteers’ interest in international development waned as interest in medical volunteering rose. Reading the writing on the walls, Pop Wuj teamed with local doctors and organized a volunteer clinic that eventually grew to what it is today.

Pop Wuj's clinic is not entirely dissimilar to clinics in the States. Spanish-speaking patients, diabetes, hypertension, poverty and, of course, "one last question" as you are leaving the room. As is the trend in the states, medical records are stored electronically on old Linux machines.  Teams of volunteers with varying Spanish skills work with local doctors, one of whom is even the daughter of the founders of the school. 

Lining up for clinic

Getting things done, in some ways, is even easier than in the states: very little regulation exists for medications and labs can be ordered just by paying for them (no doctor's Rx is needed). Not having to worry about insurance companies or copay, billing is non-existent, and deciding which medication to give is as simple as determining which medication is in the stockpile that month. 

Parasites and worn out joints dominate chief complaints, but with joint replacements being the equivalent of 15 years wage, most walk away with Tylenol.  Low administrative overhead from all donations keeps things slim on the organization front, but, as it does in every country in the world, perseverance and flexibility are the "recipe for success."
My experience was not limited to the clinic. Building stoves with chimneys for women living in one room, one bed, tin-metal walled, multi-children, smoke-filled homes was especially rewarding. As was being a first responder to the inevitable motorcycle accidents that happen in the anarchic streets...twice. Even my teachers sought assistance with us for their skin infections and wives with hypertension.

Building a safe stove
On the eve of graduation from residency, it is nice to reflect on my training and the blood, sweat and tears I have put into the last three years. Being able to slip from a busy, Spanish-speaking clinic and ER in the states into a busy Spanish-speaking clinic in Guatemala makes me appreciate what the long nights and countless charts have yielded. I look forward to the next adventure and am grateful to those organizations, Family Medicine Education Fund and Pop Wuj, who helped make it happen.

Tuesday, September 23, 2014

Independence Day: Celebrating Everything But Independence

September 15 is a very important day for not only Guatemalans but all of Central America. On this day last week, it marked 193 years of Guatemala’s and Central America’s independence from the Spanish crown. It is celebrated with parades, high school marching bands, fireworks (more than usual that is), food and much festivity.

In the Family Support Centre it was no different.  Thursday last week leading up to the almost week long celebrations, the Family Support Centre once again turned chaotic with the arrival of this year’s Mini-Feria. And the fact the rain forced everyone inside, only heightened the craziness and fun.

As always there were decorations, food, games, prizes, smiles and laughter. The mothers had all laboured hard over the previous days to supply the kids and each other with a smorgasbord of treats and snacks.

The day started off with the formal national flag ceremony and anthem, which was followed by a very important speech regarding the true independence of Guatemala.

Ilcy, Yesica and Wilson bearing the national and department flags for the National Anthem.

Despite being called Independence Day, it is hard to say that the people of Guatemala and much of Central America, for that matter, were every really made independent: rather that its control and profits was transferred from a small elite in Spain to a smaller elite of Spaniards living in Guatemala. With an economy controlled by corrupt bureaucrats, manipulated and tainted by the west; a vast majority of people without the freedom of self-agency; inaccessibility  to education, health and social services; and an inability to do be who or what they want to, due to a lack of resources: can Guatemalan’s really be called ‘Independent’?  

Thus what was celebrated last week at the Family Support Centre was not Independence, but the love for a home land, and the initial steps being undertaken towards the nation’s freedom; achieved through, what the Family Support Centre does best: educating the youth of the Nation.

After this somber reminder of reality, the fun got underway. With their tickets in hand, the kids and moms devoured the delicacies on offer. There was crazy corn, cotton candy, enchiladas, hot dogs, nachos, popcorn and of course the obligatory fresh fruit just to name a few.

Jonathan getting his fill of crazy corn.

With still half swallowed food in their mouths, the kids charged full speed into the games. There was the traditional coin toss; ten pin bowling; the pyramid skittle; the lottery/bingo; bean bag toss; and as with every year the crowd favourite was foosball. Prizes went flying out the door and the festivities continued on until dusk began to set in, calling an end to another fun filled Feria at the Family Support Centre.

Amy and Evelyn sharing secrets.

Tia Leti selling her hot dogs.

Yadira winning prizes in ten pin bowling.

Friday, September 5, 2014

Life as a Pop Wuj Intern

Working as the Projects Coordinator intern at Pop Wuj was an incredible experience. I left Xela about three weeks ago and I am now integrating back into my life in the United States. The job that was my day to day responsibility and preoccupation has already become a memory I will never forget.

"Public" transportation in Llanos

When I first arrived at Pop Wuj I was primarily interested in the Safe Stoves Project for its prevention of respiratory illnesses within rural families that used open fires their homes. It was also the project with which I got started with right away by training during my first weekend there. 

As my work on the job progressed I really gained an appreciation for the physical labor and team ethic that goes into stove building. I took the role of leading stove building groups, gaining not only leadership skills but also the ability to adapt quickly to a leadership position in field of work that was unfamiliar to me.

A finished safe stove

Soon after I became involved in the Family Support Center (FSC) as well. Going into it, I did not know what to think of or expect from my work in the FSC. This is not to say I had any doubts about the project itself—it successfully offers academic help and loving support to 41 Guatemalan children. That’s a given. However, I was nervous about working with so many different children of all ages when I had very little background experience working with children. That fear went away as my time in the project quickly turned into some of my favorite memories made while working with Pop Wuj. 

We did everything from painting tables, playing soccer, and constructing puzzles to working on homework and reading books to just goofing around with newspaper hats and paper planes. Upon arriving I immediately felt welcomed by all of them, and upon leaving I received a flooding of hugs, well wishes, and voiced hopes for my future return to the project.

Sharon with some of the Family Support Center participants

Another facet of my job included assisting with the scholarship meetings in towns near Xela. Carmencita, Amy, Chloe, and I spoke with mothers of Pop Wuj scholarship recipients about how their children were doing in school.  Additionally we talked about the very relevant topic: the illegal immigration of Guatemalan children to the United States. In the meetings we gave presentations about the dangers and consequences of making the journey mojado, (illegally) always opening the room up to discussions about the topic: "What do you like about your hometown?" and "Why do people choose to go North?"  We also spoke with the children and youth of the FSC, this time including colored pencils and crayons for the option of drawing their responses. 

These presentations proved to be some of the most challenging work I did as many mothers and kids alike had misconceptions of what the journey was like--some even believing that the border had been opened for free passage. Our work was to discuss the realities of the dangers that children are exposed during the journey and at the destination in hopes of discouraging them from risking their lives in the attempt.

Other projects I helped coordinate and participate in included the Reforestation Project and the Recycling Project, and I occasionally helped out in the Health Projects such as Nutrition. I helped translate some lectures at Pop Wuj and always attended the Thursday night dinner. Though I was sick during my final dinner at Pop Wuj and had no chance to give a speech, I hope it suffices to leave this blog post here as a final appreciation for the great experiences had, memories made, and friendships forged by this opportunity.

Hasta pronto,
Sharon Broadway

Sharon found Pop Wuj via our partnership with Entremundos.  Pop Wuj offers five distinct internships/long-term volunteer options.  Visit Entremundos to learn more and apply.