Chojzunil

Over the last trips we have made an effort to reach out to smaller communities outside of larger towns. These smaller towns always have less resources and less access to health care than bigger communities. Today we traveled to Chojzunil (Cho - su - neal). It is 2 1/2 hour drive along a 20 mile road that at minimum requires four-wheel drive and a high clearance. The road winds east from Santa Eulalia through the Cuchumatanes mountains. Chojzunil has no pharmacy, no hotel, no internet access.

Chojzunil sits in the center of the photo atop a narrow ridge extending east.

The goals of today were to do "consultas" (medical visits) and ultrasounds. Most of the patients spoke only Q'anjob'al, although there were a few Spanish speaking patients as well. Sometimes a consulta is a nicely lobbed softball, fairly easy to diagnose and figure out a plan. Other times it feels as though there is no feasible solution. Carly had a young boy who has been having generalized seizures and developmental regression (losing physical and mental abilities he previously had). They had previously been prescribed an antiseizure medication but could not afford it. Getting to the capital for a pediatric neurology consult was beyond their means. We ended up creating a plan with the only anti-seizure medication we had, Phenobarbital.

friendly kids in town

Chris had two patients with a new diagnosis of diabetes. The first was a woman who is 58 and had gone from 105 pounds to 98 (not obese). Her glucose was 440, and we made plans to start insulin, only to realize later that insulin is difficult and expensive to purchase. The second patient had a blood glucose of 580, and probably had Diabetic Ketoacidosis (hyperventilation, tachycardia). We made arrangements to give her IV fluids, and transport her to Huehuetenango (5+ hours). the following day. Even so the patient and her family were very reluctant to go to the capital because of limited money, and a language/cultural barrier.

Ana is happy about getting reading glasses.

Brenda, Jemie, and Susan (doctor at Casa Materna) did ultrasounds while Kristen did consults and Suzy manned the pharmacy/lab with José Andrés. At about 11, Suzy, Kristen, Jemie, and Carlie met with a group of about 15 midwives for some pregnancy emergency training.

Carly and Jemie discussing postpartum hemorrhage with a comadrona

At the end of the day, we met up with several of the nurses from the CAP and played a game of fútbol. As if running wasn't enough by itself, Santa Eulalia sits at about 7500 feet and made it difficult to catch one's breath while playing. Nonetheless Jemie won the golden boot, while Carly played excellent defense while Chris and Kristen survived.

Post-football match