Tuesday, March 28, 2017

Tom's Visit, Part 1: A Guatemalan Thanksgiving

Text by Tom Kemple

Tom Kemple is a sociology professor at the University of British Columbia and a long-term friend of Pop Wuj. With his colleague Sylvia Berryman in Philosophy, he has been bringing groups of students to study in Guatemala since the summer of 2010. This past November and December he spent 5 weeks studying Spanish, building stoves, helping out in the Pop Wuj Clinic and Nutrition Program, and having fun at the Family Support Center. What follows are some writings from his trip created in the course of his research project on university fieldshools and study abroad programs, titled “Global Citizenship at Home and Abroad.”  We hope you enjoy Tom's stories and insights as much as we enjoyed having him back at Pop Wuj.

Dr. Herman, Nurse Luby, and I arrived around 8:30 a.m. on Thursday (American Thanksgiving) by microbus in Llano del Pinal, the indigenous village near Xela that I’ve been visiting a few times a week to build safe stoves or to play with the kids in the Family Support Centre. I had been talking about my experiences in this village with my teachers in Spanish classes, and reading about its fascinating history in Greg Grandin’s The Blood of Guatemala: A History of Race and Nation. Some of the fist massacres in the early years of the conquest took place here; communal land was commodified and divided up into plots among families during the liberal reforms of the late 19th century; and it was a centre of resistance in the early 1950s when a leader from this community, an illiterate peasant named Valentin Coyoy Cruz, was murdered, probably by the indigenous elites from the city who were against the radical agrarian reforms of the socialist-leaning government.

To an outsider like me the village seems quiet, poor, and friendly, and yet it also holds answers to many of the questions I brought with me to Guatemala. I have been learning about how the problems which are most evident here – extreme poverty, precarious health, ignorance, adolescent pregnancy, and chronic malnutrition – have their roots in both the recent and the distant past.

I had volunteered to help out with Pop Wuj’s Nutrition Program for children under 3 years of age. When Luby asked me whether I was a doctor or a medical student, as are most gringos at the school these days, I told her ‘Doctor de Sociologia.’ When I later made the same joke to Carmen, who oversees all the social projects, she also laughed: “Then give me a pill for a good society, please!"

It seemed incredible that all the boxes we were unloading were just for our day’s work, and I was ever more surprised when we started pulling computers and wires out of them. Dr. Herman led me to a room filled with women and children (the mother and little girl whose stove we were building yesterday smiled shyly at me as we passed) and then explained our first task: help the mothers place their babies in the white sheet under the scale while he checked their weight, and then hold their heads still on the table while he measured their height and called out the numbers to Victoria behind the laptop at the end of the table. This part of the morning was the most overwhelming: kids are adorable at any age (and often annoying!), but passing these 24 little lives through our hands was heartwrenching. Most were under 2, and several just a few months old; some peered sweetly and trustingly at us as we lowered them gently into the sheet or stretched them out onto the table; others put up a fight, cried out in fear, gave us a suspicious look, or stared at us angrily.

A participant and his mother in La Victoria in February.
(Photo by Emily Rempel)

For each child under 2 we also took a cranium measurement (perimetro cefálico), which reminded me of the anthropometric practice of western ethnologists among so-called ‘savages’ in the late 19th century. Even the most resistant babies calmed down for this part, and yet it still seemed cruel to fit these tiny human beings in their first years of life into a numerical grid of weights and measures — ‘estatura’/‘edad’/‘peso’/‘genero’ (height/age/weight/gender). Dr. Herman lightened the mood with the occasional laugh at a struggling child, a few kind instructions to the mother, or a casual remark to me about a child who was especially tiny or large. As they looked up at us as if to pose a question or issue a command, I could hardly concentrate on the numbers being recorded in the computer (ranging from around 13.99pds and 63cm to 22.51plds and 81cm, as I later noted). When I described these experiences over email to my colleague Sylvia, she pointed out to me that this commitment to record keeping is not just a bureaucratic protocol done for its own sake, but also a way of showing care, not cutting corners, and respectfully enacting a basic right.

As we moved to the computers in the room across the corridor, I mused to myself that in a sense our next task would involve flattening out each of these vulnerable bodies onto a two-dimensional graph. Dr. Herman patiently instructed me on how to navigate between the plastic charts plotting standard deviations and the data just entered into the computer (translated into English according the program that the Timmy Global Health shares with Pop Wuj, and using a mix of both metric and standard measures). Meanwhile, the mothers and their children played together on a finger-painting project and listened to Carmen speak about the importance of nutrition, all to the tune of a Brahms waltz blasting from a pair of speakers behind us.

Our final task was to note any changes in height and weight from last month’s visit, which Dr. Herman used for his diagnoses and prescriptions, and which I dutifully entered into the computer. As the babies in front of us laughed, cried, and played with their mothers in Quiché and Spanish, I conjured up a picture of them being ‘institutionally captured’ (in my sociological jargon) by a medical system projecting out from our computer screens and communicating to us in English. But I could also see that the Nutrition Program included an important educational component, a ritual element of play and socialization, and even a kind of musical therapy.

Medical Spanish Program students do a check-up with Jesler Juanito and his mother Doña Victoria in La Victoria in February.  Jesler Juanito suffered a serious health setback last year with an outbreak of rotavirus and has made excellent proress since then. (Photo by Emily Rempel)

The diagnoses were alarming and sad, nearly all falling into the ‘Stunting’ classification (‘chronic’ or ‘severe’); most suffering from ‘Malnutrition’ (many ‘chronic’, several ‘severe'); and a few ‘Underweight’ (‘chronic’) as well. At Dr Herman’s seminar a couple weeks later, I found out that 100% of the families in Llanos who benefit from the Nutrition Program live in ‘extreme poverty’, officially defined as living under a dollar per person per day. (50% of Guatemalan children are malnourished, and 1.2 to 3.6% of these are acutely malnourished).

Nearly every prescription followed a similar pattern, varying according to severity and age: NutriButter™ supplement 3 packs everyday for 21 days (I later learned that the other supplements, Plumpy Nut and Maní, were out of stock that day); 23 mg pills of Zinc Oxide once a day for 21 days; Incaparina everyday (a thick drink that tastes like corn, served warm to everyone that morning with a banana as a snack). This data then made its way to Nurse Luby’s laptop at the table next to us, where several girls from the community filled the packages for the mothers to take home. With still more work to do, Dr. Herman went on to call out the numbers of patients (written on the back of their hands) for additional consultations, beginning with the twin boys who had arrived late with their beautiful mother, one large and lively the other thin and lethargic, followed by several children with colds, stomach aches, and other intestinal ailments (7 in all). In Dr. Herman’s seminar a few weeks later, I was cheered to learn how the Nutrition Program improves the weight and height of most of the children who participate in it, and prevents acute malnutrition in all of them.

As I rode back with Carmen to the school for my 2 p.m. Spanish class, I thought about the irony that today was American Thanksgiving, which I remember from my childhood as a day spent among family, overeating to my heart’s content. A morning of weighing and measuring malnourished babies and prescribing Nutri Butter™ and Incaparina to indigenous families seemed worlds away from stories of Pilgrims and Indians eating turkey. That evening I went as usual to the weekly dinner at the school, a potluck featuring a huge variety of delicious dishes, with dessert. Sharing a sumptuous meal with teachers, students, and friends of the school made me feel especially thankful to be here.

No comments:

Post a Comment