Comadronas and Discapacitados (Midwives and Disabled Kids)

El Mirador with clouds and volcano

Monday began with another trip up north over El Mirador and onto the altiplano. This time we headed through San Juan Ixcoy and Soloma to the community of Santa Eulalia (ay-oo-la-lee-ah). The drive took 3 hours over a very windy road over the Cachumatanes mountain range. Santa Eulalia is a community of 50,000 people in the western region of Guatemala in the departament of Huehuetenango named after Saint Eulalia a 13 year girl from Barcelona who was killed by the Romans for refusing to recant her faith. The predominant language in the area is Q'anjob'al (kahn-ho-bal), then Castellano (Spanish).

Santa Eulalia from a distance

Due to various delays, we arrived for our meeting with the comadronas (midwives) about an hour late. As  we awkwardly entered a small room, we received a round of applause from a group of about 60 comadronas quietly waiting for us. After a speech by a leader of the comadronas in Spanish, Suzy and Doctora Ana made gracious comments from us in Spanish which were interpreted to the comadronas in Q'anjob'al. 

Comadrona leader interpreting in Q'anjob'al

We broke into four groups to have small group workshops on specific topics: bleeding in pregnancy, preeclampsia, postpartum hemorrhage, and prolonged labor, with about 15 women in each group. Each group had its own Q'anjob'al interpreter. They told us they were doing a lot of deliveries, with some women delivering 2-12 women per month and one older woman having done 2,000 deliveries. Many followed their mother or aunt into the role of comadrona. After the small group workshops, we did a small drama about shoulder dystocia, demonstrating the McRoberts and Gaskin maneuvers, the latter maneuver having originated with comadronas in Guatemala. The comadronas expressed their thanks profusely, saying "Yuj wal dios" (thank you in Q'anjob'al) many times. They also asked about getting some resources such as backpack kits to include scissors (to cut the cord), thread (to tie it off), suction bulb, clamps, and gloves.

Bob and Dominga, who had a missing arm from birth

After our session with the comadronas, we met with an organization called "Pixan Konob" (Heart of the People). Pixan Konob (see link) was founded one year ago by community leaders to advocate for disabled children and adults. What we found is that although all Guatemalans have access to free emergent care in the municipal health center or the departmental hospital (in Huehue), children with special needs often receive no special care or therapy and instead are mostly kept out of sight. As a result, their development is often stunted. During the afternoon, we saw thirty children and created a database with their diagnoses and recommended treatment. Their were several children with limb deformities (club foot, missing legs/arms) as well as many children with severe developmental delay and cerebral palsy. There was one 15 yo girl with obvious features of Down Syndrome that the mother had never sought or received any medical care and was unaware of her diagnosis. This was by far the most emotionally challenging times during our trip, seeing the disabilities and lack of access to appropriate care. We are hoping to do some resource connecting for some of the patients as well.

Pixan Konob leaders with our team

We ended the day sharing dinner with the directors of Pixan Konob, one of which who won the national "Mayan Princess" award for 2011. This was a recognition of her outfit, native language speech, and comportment. We spent the night at Fran Pab, a small but comfortable hotel in Santa Eulalia which ran a whopping $10 (80 Quetzales) per person for a shared room.

Vicente, who had a foot deformity and a penchant for charming Suzy