Thursday, October 2, 2014

Christian's Pop Wuj Medical Program Experience, Part 1 of 4

Christian Ngo was a 4th year medical student at the State University of New York, Downstate Medical Center when he participated in the Pop Wuj Medical Spanish Program in the spring of 2014. He is now a first year internal medicine resident in Dallas at UT Southwestern.  Thank you Christian for sharing your insights with the Pop Wuj blog!

Contextualizing the Pop Wuj Clinic
I traveled to Quetzaltenango, Guatemala and participated in the medical program of Pop Wuj clinic for six weeks. Guatemala has a population of approximately 15 million people. The population of Guatemala is extremely diverse with 25 different ethnic subgroups typically recognized as comprising the native Guatemalan population. Twenty-two of these ethnic subgroups are considered to be culturally Mayan. The other ethnic subgroups are the Garifuna, a population along the Caribbean coast of Guatemala descended from West African and Central African groups, the Xinka, a non-Mayan indigenous Guatemalan group, and the mestizo, descendants of the Spanish and Mayan people. Quetzaltenango is the second largest city in Guatemala with a population of approximately 225,000. The population is largely indigenous with the most common linguistic minorities being Mam and K’iche’. The city is situated in the highlands of Guatemala with an elevation of greater than 7,000 feet above sea level. This high elevation significantly affects the kinds of vectors that are able to survive in the area and, as such, certain diseases which are traditionally thought to be endemic to Central America -- dengue fever and malaria being two prime examples -- are quite rare in Quetzaltenango.

Pop Wuj was founded as a teachers cooperative which taught Spanish as a second language. The proceeds from the school are reinvested into several community projects focused on improving the social situations of the local communities around the school. The development projects associated with the school include a safe stove project, a scholarship program, a family support center which provides child care and educational support for children of single, working mothers in Llanos del Pinal, and the clinic in which I worked. The Pop Wuj clinic permanent staff consists of two local Guatemalan physicians and a nurse. The main physical location of the clinic is in Xela. The clinic here has three examination rooms and sees approximately 25 patients three mornings per week. In addition, the clinic is stocked with medications provided by Timmy Global Health. The clinic occurs at this location two days per week. Once weekly, the staff holds a mobile clinic. These mobile clinics are located in more rural areas of Guatemala between half an hour and two hours from the main clinic site. The mobile clinics are typically run out of a family’s home and the resources available at these mobile clinic sites vary greatly, in particular private spaces in which to perform physical exams. Medications and supplies for the mobile clinic are brought with the clinic staff.

In addition to these three clinic days, the medical staff also have one day of the week devoted to a nutrition program. As a part of this program, the staff visits three different sites each month and measures the heights and weights of children between the ages of 6 and 24 months. Children who fall into moderate malnutrition category are provided with Nutributter nutritional supplementation and children in the severe malnutrition category are given Plumpy Nut nutritional supplementation. During these nutrition and development screenings, the clinic also offers educational sessions to the mothers in attendance. The topics of these sessions range from family planning and approaching spouses regarding birth spacing, to hygiene, to incorporating discipline into child rearing.

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