Hospitalito and SHANA TOVA!

While it seems I should have begun some notes last week, now I find the pause.

We have come to Antigua, a colonial capital with cobblestone streets and Spanish architecture complete with fountain filled inner courtyards and an endless list of catholic cathedrals in various states of disrepair.

Its nice to explore a little outside of our small lakeside town of Panajachel, although the 3 hour, curvy, nausea inducing van ride past mudslides and ravines was enough to deter jordana and the boys from being excited about doing too much exploration. No one is rushing to take the trip back.

Monday night we hope to go to synagogue in Guatemala City.

My trips across the lake…..

Volunteering in the Hospitalito is rewarding, frustrating, scary, and humbling.

Going across the lake is beautiful. Every day the clouds take on a new pattern and the volcanoes reveal themselves as if it’s the first time I am seeing them. IN the mornings the water is placid and the lanchas (16-20 person covered boats with outboard motors, and few if any life jackets) proceed easily. Although I have my book to read, my gaze inevitably rises to the shorelines. The plastic bottles, bags and other household trash floating on the surface remind me that I am not that excited about swimming in this natural wonder.

I also read in a newspaper opinion column by a wealthy landowner who has a weekend home around the lake, that the water treament facility around lake atitlan was destroyed in Huricane Stan 2006, and despite government promises, still has not been repaired, thus further impacting the lake’s water quality as well as the overall public health of its surrounding towns.

Adding irony, there is a public relations campaign being waged by the regional tourism board to encourage people to go online and vote for Lake Atitlan as one of the new 7 natural wonders of the world. This could mean more plastic bottles and bags I suppose…

I have now done the trip and told my story enough that I can speak with conviction to the capitans and don’t have to haggle over the price of the trip. I pay the locals 15Quetzales (about $2) rather than the 25-30 Q that tourists might pay. Keeping my stethescope visible doesn’t hurt my authenticity.

Unfortuntaely there is not really any schedule to the lanchas as they leave when full, or when the capitan feels they are full enough to justify a trip across. I have waited up to an hour for a morning departure (making me late of course), but there is really no arguing with them.

So much for the ride…

The hospitalito is a well run clinic, emergency room and 3 bed hospital that Jordana says looks like something out of a M*A*S*H episode. It reminds me more of an old summer camp infirmiry in which someone has then thrown a conglomertion of donated, outdated medical equptment. It is mostly staffed by guatemalan docs and support staff as well as a revolving door of volunteers from around the globe. I have already worked with a Phys. Assistant from Oregon, two pediatricians from Madrid, an anethesiologist from Barcelona, and a medical student from London.

The majority of patients are indigenous folks who speak Tzutuhil, the local mayan dialect, which is actually different from Katchiquel which is spoken across the lake n Panajachel. Thus I am using a translator, either one of the lab folks, receptionist, or recently a guatemalan med student who is originally from this town of Santiago. Funny that the translator and I are communicating in Spanish (not the first language for either of us), and I have had to catch myself trying to speak English to them. My brain really flipped when I took care of an Israeli traveler the other day and attempted to broaden my hebrew to include some medical/anatomical terms. The traveler was clearly surprised and relieved to hear me greet him with Shalom, Mah Shlomcha, v mah ha baayah?

None of these helpful folks are actual interpreters and each of them possess some small bit of medical knowledge and cultural bias. Thus it is not uncommon for the “interpreters” to carry on for a few sentences or a few minutes before offering me only a brief account of their conversation. Much as I have tried to do with the Karen interpreters in Carrboro, although treading more carefully here as I am the new kid on the block, just a pinch hitter, and need all the cultural introductions I can get, I urge the interpreters to fill me in with each sentence.

The problems/concerns for which patients present are not dissimilar to what I see in Carrboro with Latino folks. A lot of prenatal care, diabetes, hypertension, anxiety, depression, and various aches,pains and minor traumas. Also owing to the water situation and a high incidence of helicobacter pylori (a bacteria associated with stomach ulcers) there are more abdominal complaints and diarrhea illnesses. There are many homes which utilize wood burning stoves (planchas) and this results in a lot of pulmonary disease (COPD, bronchitis, asthma etc..).

There is a small pharmacy on site (with lots of donated samples, or expired lots of meds, or cheap generics). I have already found that I neeed to switch patients’ regimens based on what the pharmacy might have in stock on any given day. The cost conscious approach is also not unlike what I am used to.

The guatemalan docs seem to use my presence as a relief for their otherwise over worked schedule. They are a combination of experienced practitioners and those just out of training.

They clearly do an excellent job without me and while my presence is noted and appreciated, I am not treated as any sort of savior. (of course I still get the occasional wide eyed stares in guatemala, mostly in the pool when my hair is down, because of some possible resemblance to the other savior who is quite popular around here).

Gone on too long….

Heading to guatemala city…

SHANA TOVA TO ALL OUR DEAR FRIENDS AND FAMILY!!!

MAY THE NEW YEAR BRING YOU MUCH PEACE, HEALTH AND INSPIRATION.

yoni