When we met with the Stove Team back in January, Nancy Hughes, the director, mentioned to us that she got involved in the stoves as a preventive health measure. She explained that she used to work, along with her husband who was a doctor, with a group called the Cascade Medical Team through HELPS International. They would come to Guatemala for one week every year to offer their professional skills, but even in those short visits she met numerous plastic surgery patients who were having things like their hands reconstructed after suffering from burns as children. Their mothers cooked over open fires, and children playing in the house were prone to accidents. Fletch strated talking to her about all the services HELPS offers. He remembered a man from our village telling us in November about losing sight in one eye. He’s a truck driver who drives loads of recyclables into Xela, 7 hours away. With sight in only one eye he can no longer drive in the city where the traffic is intense. He thought his site was going in the other eye now, too. Nancy knew the team was coming the first week in March, and she gave us the contact information to see if we could get our villager to the team’s optometrist. Thus, we were hooked up with the Cascade Medical Team.

Fletch contacted the team to confirm the eye doctor was coming, and relayed the man’s problems. We then went to his house up the road where we sat down with him and his daughters, two of whom have very proficient Spanish and could clarify anything the man needed. They were thrilled with the prospect of someone being able to fix their father’s sight. We kept telling Juan Francisco that this was far from a guarantee they would be able to operate and fix his vision. However, the doctors in Guatemala City had told him the operation would cost 22,000 quetzales (he makes about 30q a day when he has work), so a potentially free operation was definitely cause for excitement. We didn’t want them to get overly excited or to accidentally foster false hopes, so we tried to make it as clear as possible that they would have to pay for the trip there and back, but the medical costs would be completely covered. They said they were in.

Once we confirmed with the organizers, they asked us if we might be able to translate some, as they were short in that department. Both of us jumped at the chance, to the extent that we called our boss and begged out of the first day of In Service Training (they were just doing stuff we know how to do anyway). And we were off early Saturday morning to travel about 10 hours to Panajachel, one of Guatemala’s best known tourist destinations. We decided to stay the night there to enjoy sleeping-in at least one of our weekend days and we could also get a tasty breakfast at one of the many tourist restaurants before heading up the hill to Solola where the temporary hospital was set up.

We stayed just off the Cathedral square in Pana, so here’s what we came across walking home from dinner Saturday night.   This town is at the edge of the volcanic lake where we stayed for my birthday in August. We actually had a big debate about whether or not we wanted to stay in Pana on Sunday night also, or stay with the medical team. Fletch had forgotten to mention that was option until after we arrived. We kept going back and forth on the issue, as not staying with them meant eating where ever and what ever we wanted as well as some privacy, which we get precious little of here. Staying with them meant a free bed, free food, and a chance to socialize with new people. The latter won out.

On Sunday morning as we were sitting on the bus to Solala I spotted a women who looked like Maria, Juan Francisco’s daughter, and sure enough it was her. We’d planned to meet just outside the medical area, but things worked out perfectly, so we rode together and entered the medical compound together, which made our friends the first Guatemalan patients to enter. They totally got to jump the line that started at 3 am Sunday morning. They sat in the sun relaxing and waiting in the infinitely patient way that only Guatmalans can, as we ran around trying to figure out what’s was going on.

It was totally insanity. We were told to go claim our beds in the respective dorms, men and women separated, of course. There were only cots left, so I had to jam what would have been a rather comfortable 3 person room with a fourth bed and my hiking pack, but the ladies who invited me in were very kind about it. I assured them I was only going to be there one night, if they were overjoyed with that news they did a good job not showing it. The general atmosphere was one excitement and eagerness. All these people have come to Guatemala to help, and I think they were excited about doing it.

After finding our beds we went to find food before we started to work, as instructed by the coordinator. We found and unbelievable amount of food. It was like walking into the camp kitchen at the beginning of a ten day session, endless possibilities of food…And it was all such American fare it was really kind of exciting. However, none of the food was prepared, it was all being organized for the kitchen staff’s ease and convenience, so we helped unpack, and then left to find the translators without having eaten.

The line at the gates was pretty intense, but we had to set up the entry process before we could let anyone in, then stall as the medical staff finished setting up. But soon enough all was ready, and we started admitting people. We being a loose term. Somehow Fletch figured out where to jump in, and he had work, but I spent a while waiting around for an opportunity. In that time I had to marvel at the sheer scale of this project, and all the different people–type A aggressive medical professionals who want to get stuff done and all have their own way of doing things–as they had to work around what they thought/wanted and come up with fast solutions to ease the process of checking patients and getting them to the correct doctor at the clinic. I saw quite a few people begin to speak and bite their tongues before moving on to something they deemed more productive. And I had to admire their get-it-done way of working together without stepping on people’s toes.

Finally a doctor with no Spanish skills showed up, looking lost. His name was McGuiver, so he should have been able to find his way out of any situation with confidence if he was true to the name, but I jumped at the chance to help someone. All this did was get me from the entrance to the clinic where the doctor promptly disappeared, so I waited around some more until I saw someone in need. I jumped in to explain the line system, to usher patients, and finally to go with the next doctor who raised his voice with urgency, “Translator?!” then I ran. I spent all afternoon in the clinic going from one doctor to the next, checking out hernias (there are A LOT of those here in Guatemala), doing gyno exams, ultrasounds, explaining when and where and how procedures would take place.

The matter of translation is pretty interesting, in my opinion. You need to be aware of who your audience is, what’s important to them, how well they speak the language you’re translating to. I felt like I had a distinct advantage over the spanish speakers who came from the states with the team to translate. I was translating for an aneasthesiologist who seemed like the kind of doctor I would trust in the US. She was thoroughly explaining the different options for preparing this mute guy with severe scoliosis for his hernia procedure the next day. The dramatic curvuture of his spine was tricky for them. But she was explaining, “This is what I could do, and how it works, but won’t I won’t do because it doesn’t sound like the best option. Here’s what I think I will do, because I think it will work better. I’ve done a similar thing on a similar patient in Africa.” Her approach was just what I would want under normal circumstances. However, she was translating for a family that speaks K’iche as their maternal language. The patient is mute and the rest of the family has shakey spanish. All I would do in translating everything she said was confuse the hell out of them. But I felt self conscious letting her talk forever and then giving them a two sentence translation. So I said, “I don’t mean any disrespect, but they hardly speak Spanish, and I think the best thing is probably to tell them exactly what you’re going to do, and what time they need to be here and be done.” She looked kind of aghast and stuttered, “Yeah, but… I mean, ok. Whatever.” I then felt bad for having said anything. Like I said, she’s exactly the kind of doctor I would trust in the states because I want to know that information. Here they play a very different ball game.

The consultations were really interesting, and all the medical staff was working so hard. The worst case was this woman whose family had driven from the Peten to Solala, which on Guatemalan roads in this landscape of mountains was a nearly 20 hour journey. The woman had a huge growth of some sort on her knee, but was checked out for the massive abdominal tumor that disformed her belly. The doctors wanted to help her and get the tumor out asap. She was scheduled as the first surgery on Monday morning. However, they took a vial of blood to check out some preliminary stuff and found she had terribley low iron. Anemia is an endemic problem in Guatemala as the diet here doesn’t include enough green vegetables and meat is so expensive for the poor campesinos. It’s such a problem the government regulates that regular white sugar be fortified with iron, as Guatemalans consume ridiculous quantities of that. The team didn’t have a blood bank, so they couldn’t give her a transfusion. The tumor was so huge she was going to lose too much blood and be left dangerously weak. Much to everyone’s chagrin they had to cancel her surgery. They sent her away with iron pills and a referral to the next jornada in San Marcos in April. I was translating all the bad news to her and a man I assume was her adult son. I asked the doctors, “Can I tell her she needs to eat iron rich foods too, would that help?” A nurse jumped in and said, “Don’t bother; they don’t have them here.” But they do, too! There are 3 well known varieties of edible leafy plants growing in the campo that the indigenous populations are aware of and eat from time to time; they just don’t eat enough. So I told her she should try to eat as much of those as she could. The woman said they bother her stomach. The doctor said the pills might also upset her stomach. I told her that, but I explained if she didn’t take the pills and eat more greens she had no chance of having the surgery next month because the problem wasn’t going to fix itself. Everyone sighed. Her son said, “Well, she’s really just worried she has cancer. Can you just tell her she doesn’t have cancer?” No, I couldn’t, and I had I feeling I knew what the doctor’s response would be. I told the doctor; he said it was quite likely it was cancer since she had two enormous tumors, but they would have to do a biopsy to know for sure. This jornada lasts 10 days and results for a biopsy here take close to a month. So I passed on the bad news, the pills, the referral sheet to the next chance at an operation, and we sent the family on their way. I feel like everyone involved felt a little bummed, but their limitations here are so many. I heard over and over, “This would be so easy in the states.”

When the clinic finally stopped seeing people I realized I was starving. About that time Fletch showed up–I hadn’t seen him since the front gate–and we hung around talking to the doctors and lab techs for a while. By the time I got to dinner I was dying to eat, and then eating just about killed me. I started having really bad abdominal cramps and apparently scared the nurses at my table as I turned white as a sheet. “Well, if you’re going to faint, here’s the place to do it. We’ve got all kinds of people who can take care of you,” one said. I was just waiting for it to pass. I have this any time I don’t eat; I get really suddenly ill when I start to again later. It passed, like it always does, but not before I got to have my own little interview with a doctor regarding this issue. I assured him it’s just when I don’t bring a snack with me (which Fletch and I had planned on doing that morning and then decided against doing-bad move). The doctor didn’t hassle me too much, but told me if this becomes a frequent thing I should have my blood sugar level tested. 😛 I think I just need to eat like a normal person and I will be fine…So once that was over I met up with Fletch again (he’d stayed in the lab so we didn’t eat together), and we hung out with the organizers who’d invited us. They were so much fun, we were the last people to leave the dining hall.

I spent Monday morning translating for the dentist and dental assistant (the latter doubled as one of my roomies the night before). The team was pretty awesome, as they whipped through extractions like nobody’s business. The doctor kept commenting on how this numbing shot or that would, without fail, elicit some sort pained moan from all patients in the states, but here everyone just sat through the shots. She just kept repeating, “I can’t believe how stoic people are here.” At one point she had to do a molar extraction on this man, the tooth with the deepest roots up into the cheek bone, and the roots broke off, half of them staying in the gum. The dentist was twisting, yanking, cutting, with so much force, and the man said nothing. His eyes looked like those of a trapped animal, but he didn’t make a sound. Another woman was a rather chatty drama queen, but it was kind of cute, and in the end she was pretty excited to take her tooth home. And one boy came in just because he wanted the doctor to pull out a tooth of his that was slightly crooked because it was feo, ugly. I told him it was a healthy tooth, God made it crooked, and there was no reason to pull it out. He brought his father in to re-explain the situation, and I re-explained my explanation to the father. While Fletch tried all morning to help the eye doctor finish her first procedure, the dentist and her assistants ran through 13 patients before lunch.

I was sad when lunch came, as it meant we had to eat and leave so we could get to Antigua for our meetings the next day. I think we would have both been content to stay all week with the medical team. One of the most satisfying aspects of helping them is feeling like we actually accomplished something in a day. They get results, rather than dealing with our long term frustrations here. In a way I think the idea of the medical jornada goes against sustainable development, but it’s redemption is the fact that it’s covering health services the Ministry of Health can’t provide. Ideally health care here is free; the trick is a lot of the services are frequently unavailable, and private practices make money offering what the public system can’t, but they also do not donate their time and services to the countries poorest. It was so much fun talking to and working with team members. I have a lot of respect for them. They’re donating services that most of us can’t provide. In fact, working with them gave me a twinge of regret for not pursuing medecine, but then I remember that I’d still be in school slaving over labs and tests and the gruelling interview process with years to go still until I could practice on my own. That’s when I’m glad I’m here doing this work now. On our way out the door to jump on the next passing chicken bus, Tamara Orlando, one of the organizers stopped and gave us a bag full of thank-you tokens: a box of…THIN MINT GIRL SCOUT COOKIES! as they found our how-we-met story pretty hilarious, a jar of homemade Oregon blackberry jam, and antibacterial wipes. We will totally translate for them next year if they want us too. : )

The really great thing was, on our nearly 4 hour trip to Antigua, for once in a very long time, we actually had things to talk about since we hadn’t seen each other for almost a day of non-stop action. And that, as Mastercard would say, was priceless.