Doble K'aj y Doble Talleres

We arrived early this morning at Santa Eulalia after climbing past 10,000 feet in the altiplano in the 4 hour journey from Huehuetenango. Orlando is our featured bloggist today and will describe the joys of a corn and wheat based gruel that we are been fortunate to be treated to today. Here goes:

Orlando, the most interesting man in the world:
"I don't always take public transportation, but when I do, I usually take a Tuk Tuk"

An impossible hotel, gaudy, yet dilapidated hotel, with views over the hills and fog,  whose vintage appears to be the 1940s, but the locals swear that this hotel has only been here 5, maybe 10 years at most.   How can this be? Santa Eulalia was a saint from Barcelona.  The Romans placed her in a barrel and rolled her down the street.  If this had occurred in Guatemala, she would have rolled 700 miles to the ocean, picking up some plastic bags and tortillas on the way.   Even the elevation of Santa Eulalia is in question.  Our headaches and giddiness imply at least 10k feet, though wikipedia experts say it is less. People here share a positive attitude, friendly even in the face of a difficult political and economic reality.   A few days ago I had to explain, once again what the hell a family physician is, much less one that might be interested in providing care to pregnant people.

Elena teaching about breastfeeding

Honorary Comadronas Bob, Orlando and Suzy with our new tribe. Note the Providence Bags with the Midwife kits.

Mali and PCI Member Rudy passing out the midwife kits

We spent a wonderful morning working with comadronas (midwives), via an interpreter translating from our lousy Spanish to K'anjoBal. Beautiful women in their outfits and ideas completely at odds to our own scientific biases.  An afternoon with nurses and nurses aids who work in outposts was easier and both were really fun.  These people take care of major emergencies, births, revolutions with zero governmental support, no gauze, no stitches, NO SHIT, I am not kidding.  Really inspiring.  

Anyways, mis companeros have come to not only tolerate but appreciate my unique personality, which I can say most do not.  On to another day tomorrow.  This is really fun.

The K'aj del dia

Orlando, El Chompipe.

Quincenera de Casa Materna y Lago Atitlan

Susy and the CMO and CNO in Huehuetenango
accepting the Misoprostil donated by our Providence Pharmacy.

Attentive Nursing Students listening to Elena's
Presentation on the breast pump.

Quinceañera De Casa Materna and visit to Lake Atitlan - Sorry that we have not written much in the past few days. We have finally been joined by our 7th member, El Tejon (the Badger) from Wisconsin, Mike Waddick who arrived safely even though one of his bags with some important supplies somehow bypassed Guatemala. Rumors are that penguins in Antartica have been selling the metronidazole on the "white" market. We spent most of Thursday seeing patients and doing ultrasounds at Casa Materna. Friday, however was a very special and beautiful day for Casa Materna, as we celebrated its 15th birthday, complete with speeches from dignitaries (like our own cigueña Suzy), music, singing, pastel and of course - a Piñata.

Santa Susana speaking at the "birthday party"

The Hood River Contingent outside the PCI office.

We spent the weekend bonding and relaxing at Lake Atilan, were we took in the amazing sites, failed miserably at haggling for the better prices and ate mountains of churrasco and great comida tipica. The nature conservatory was a highlight, with live coati's, spider monkeys, waterfalls and frightening suspension bridges. But the best thrill rides were the Tuk-Tuk that whizzed us in the narrow and bumpy streets of Panajachel.

Desayuno Tipico

Our "Guide" Pedro and the first poor bargaining
"deal" of the day

Tomorrow we will be in the mountains and the altiplano's at 7000- 10000 feet and will be working with midwives, physicians and nurses in the two smaller communities of Santa Eulalia and Soloma. Both still have a high maternal mortality rate and we will hope to learn from the midwives and health care workers what barriers they encounter and see if we can help them in their very difficult work.

Lago Atitlan at Sunset with the volcanos in the distance.

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