Musings of a Confused Grasshopper

Day who knows...

My first blog entry. What happened? Where are we? What is happing next? I still don't know.

We finished an exhausting day working at Casa Materna. Today we had a clinic or "consulta" for both the women at Casa Materna as well as folks from greater Huehuetenango. This was an eye opener at best. Women and children lined up, many just for the novelty of having an ultrasound done by the American doctors, but just as many with incredibly grave illnesses. Mali and Orlando provided cover for the front lines, triaging the women, men and children that came for the clinic. In back Bob and I worked as ultrasound monkeys. Everyone had incredible stories at the end. Orlando saw many sick children, but also a homeless woman with end stage heart failure who was turned away from hospital because she couldn't afford any treatment. Elena was the madre de agujas, administering innumerable acupuncture treatments for employees of Casa Materna, the National Hospital and the Health Department. Employees and patients alike have been through more stress and trauma than I can imagine; all were grateful for the Elena's healing touch.

Beyond the cultural differences, the vast differences in medical care, probably the most difficult thing for most of us was navigating a completely different medical system. Although Orlando reveled in being able to chart on paper, only writing three sentences instead of wrangling with Epic, all was not peaches and gravy. Trying to figure out how to order basic lab tests, how to arrange for follow up, all this was nearly impossible.

Now exhausted, we're waiting before heading off to dinner with La Licenciada, Bal Maria! The mood is mellow, people gathered throughout the casa de la familia Lopez Guevara. Everyone is low energy after the training workshop yesterday and the frantic clinic today. Tomorrow we do it all over again. One has to wonder at the effect we're having. I know it's expected for visiting American doctors to hold a clinic like this, but think about the numerical difference. At the training yesterday we worked with 50 doctors and nurses, each of whom will see hundreds or thousands of patients in their careers. It pales in contrast with the 100 patients we saw in clinic today.

Just my confused and hungry musings. Disregard as desired. - Matt Sperry

Happy Patient and Doctora

Matt instructing La Medica Cubana Dagmar on Ultrasound

El Chapulin es un Wizard

Can you guess who is throwing who under the bus for the lock job

Chapulin" Sperry.

Thanks Matt - a few other amusing stories, Mali placed our first Jadelle (see above) - somewhat of a frightening yet awesome procedure if you like shoving blunt instruments the size of a Javelin into someone's arm, we were locked into our procedure room with 3 nursing students (right), eating Cardon Blue de Reis for almuerza in three large chews, the power outages while 14 women were waiting for their scans and getting to teaching a wonderful Cubana medico named Dagmar ultrasound. Not too mention we nailed two other members of our teams with their Guate Motes (Nicknames): Orlando es "El Campepe Malcreado" y Mali "La Paloma Blanca! Felicedades.

Mas adelante! Beto "Loro".

Ataques y Charlas y Pepian

Today was our first full day in Huehue. We started off the morning right with a delicious breakfast of meat sandwiches made by Abesaida. We got a ride over to the hotel where we were holding the ALSO course-- and it was raining hard on the way over.  We arrived with an hour to set up, and there were already 5 nurses there! By the time we got started, we had about 40 participants, from community health workers to nurses to OB residents from the national hospital. It was an interesting conference-- Dr Gobbo got all participants engaged and even had a few folks filming the charlas, or group talks.

While in small groups, we learned about various birth practices common here as well as heard some stories.  Matt put on a dress and performed a skit for us, in which he was a pregnant mother with preeclampsia, which progressed to eclampsia. His seizures (or "ataques") were quite impressive, and later one participant said that was the favorite moment of the conference!
Overall it seemed to be great success.

After the conference we returned to Abesaida's house and we went for our second group run. This time there was still light left so we ventured out into the campo for a muddy run. 15 minutes later, we returned... and we were out for 5 minutes longer than the night before!
Dinner was another delicious homemade meal by Abesaida-- pollo pepian, a chicken stew with roasted ground pumpkin seed, sesame oil and red sauce, rice, and a tasty beet salad.  After dinner we had in-house entertainment by our very own comedian Beto Loco... my sides still hurt from laughing so hard.

Tomorrow we have our first day of clinic at Casa Materna.  I'm feeling a bit nervous about what we might encounter there, but also excited.  The system is so different here, and it is both inspiring and frightening to realize what an impact we make here, and what daily life is like for health care workers here.
-Mali

Thanks Mali for writing our blog today. It was an amazing day as described. Although teaching in Spanish was a challenge for this crew from Oregon, the audience was gracious, good natured, appreciative and enthusiastic! While we were teaching, Elena treated 20 patients with acupuncture at Casa Materna! We are so fortunate to be together and to be in this beautiful country. Hasta manana!
El Loro Beto Gobbo

 El Condon Bakri Balloon Taller ^



Matt and Mali teaching about Post Partum Hemorrhage presentation-------------------->>

< El Cubano Orlando Acosta teaching Neonatal Resuscitation while Matt Sperry does the - Breath 2-3 Waltz.

Matt Sperry's performance of "Eclampsia"









Taller Naciemiento Podalico












Post Conference Run Group Selfie!

We Made it Back to Guatemala!

Hemos llegado bien en Guatemala, pero estamos muy cansado ! Dear Friends - We arrived safely in Guatemala, had a lovely stay in Antigua and arrived in Huehuetenago this afternoon. We have been busy preparing for our conference tomorrow with medical students and residents at the National Hospital. However here are a few pictures of proof that we made it and are having a great time as well and enjoying Abesida's amazing cooking! We are definitely not in Portlandia anymore....but we found Pollolandia! Below are a pic of the our team above Lake Atilan and Matt Sperry getting in "caracter" for the medico-socio drama tomorrow.

Hasta Manana! Loro Verde Beto Gobbo

Here we go again!!!



Packing Birth Kits at SE Clinic--Many Hands Make Light Work!

 Two weeks left to go. Getting Ready.

In about 2 weeks' time, another group from the Providence Oregon Family Medicine Residency program will head back to Huehuetenango, Guatemala to work alongside staff at the Project Concern International sponsored Casa Materna. This year's group is a little bigger than both previous years. It consists of 3 faculty doctors--Bob Gobbo, (Loro Verde from 2013 trip), Hood River Family Medicine Residency Director, Mike Waddick from SE Clinic, and Orlando Acosta from Hood River's One Community Health, 2 residents, Mali Nakhai from SE Clinic and Matt Sperry from the Hood River program, as well as FNP/Acupuncturist/Lactation Consultant Elena Mejia, and Suzy Happ, home visiting nurse with Providence Beginnings, and this program coordinator.

These are interesting times in Guatemala, with the former president and vice president currently incarcerated for corruption, allegedly skimming millions of government dollars accepting bribes for businesses to avoid paying import taxes. The people stood up for themselves and took to the streets protesting this type of corruption in the face of some of the abysmal conditions that exist in their country--lack of adequate health care and education, malnutrition, and rampant poverty. The country is in the process of electing a new president, and we sincerely hope for that person to better represent the needs of the people!

Staff at both the Providence Oregon Family Medicine Residency Southeast and Milwaukie Clinics are helping us to prepare for our trip. We are having two "birth kit assembly parties" to put together clean birth kits for the indigenous midwives. The kits consist of: 1. a plastic sheet to go under mom at delivery 2. a bar of soap for the midwife to wash her hands 3 a pair of gloves 4. clean twine to clamp cord, 5. a clean razor blade to cut cord, and 6. gauze pads to wipe babies' eyes and to clean mom after delivery. Oh, yes and a nice index card with a handwritten note to the mom congratulating her on her new baby! All these items fit in a nifty little ziploc sandwich bag.  For all their hard work, we got some real Guatemalan tamales for lunch.  We are really excited for the coming trip, and look forward to reconnecting with the Casa Materna staff, the local health care providers who will attend our workshops to hear what we have to say, as well as share their knowledge with us, especially the comadronas or village midwives, and the patients we will have the opportunity to meet.  Keep us in your thoughts as we get ready, and stay tuned for future posts when we get on the ground in a couple of weeks.



Veronica on left, Dr. Tom Schwartz and Mali Nakhai