San Andrés Huista

Poco a poco (in English: step by step) was the general theme for me today. On this trip we have had the opportunity to be trained on the use of ultrasounds by Chris and Brenda (two experienced family practitioners). For those who haven't used an ultrasound before, it can be quite difficult to figure out the gentle movements and nuances to the machine. Jemie and I, along with local practitioners, have been lucky to get one-on-one training over these last several days. It takes a lot of patience and guidance to get through each ultrasound as we discover discrete structures to bring into focus and measure. Ever so slowly, each of us have been gaining comfort with their instruction. This is of great benefit to us in our future practice, and for the local physicians to provide improved care to their patients.

Jemie doing ultrasound on a patient in San Andrés Huista

Today we traveled to San Andrés Huista, a beautiful town that seemed to appear out of nowhere amongst the forested mountainside. Upon our arrival, we were greeted by many pregnant women dressed in colorful traditional clothing, with toddlers hanging from their backs, while others ran and played. Most of the women spoke only Popti (see our language map below) and little Spanish. We were very dependent on our Spanish-Popti interpreters, although we did manage to learn a couple of words (girl = Ix 'eesh', boy = Winak 'wee-nahk'. Poco a poco we saw each woman; they were in various stages of pregnancy and for the majority of them it was the first/only ultrasound they would likely receive prior to delivery. Through these efforts, we diagnosed a missed spontaneous abortion, placenta previa, and helped confirm/change appropriate dates for delivery.

Our full team at the Puesto de Salud, including Dr. Dorian

While working in the capacity of a physician, you have the unique opportunity to get a glance into someone's life that you may not otherwise have. One such experience was when we offered contraception to a young woman who already had 2 children, that came in concerned she was pregnant again. She responded with, "I'll have to ask my husband," and quickly left. We later learned from the local physician and nurses that San Andrés Huista is an insular and patriarchal society, in which the husbands can choose if/when a women can receive medical care. Contraception is not permitted. Apparently one woman from the community died about a year ago from a postpartum hemorrhage after delivering her 14th child as she wasn't able to access appropriate medical care in time.

Women at the Puesto de Salud wearing their local traje (traditional outfit)

Poco a poco we make changes in our lives and the world around us.

Visiting Rio Azúl

On the way back to Jacaltenango, we crossed the Rio Azúl (Blue River), so called due to the calcium content from dissolved limestone upstream. It was amazing.