San Juan Ixcoy

Thursday was a challenging day in many respects. We were scheduled to do consultas and ultrasounds in San Juan Ixcoy (pronounced eesh-coy). First off, we all got up at 5 and met our drivers, Henry and Josue to make the 2 hour trip. Heading north from Huehuetenango you hit a very windy road with lots of switchbacks that takes you to the top of the altiplano (highlands), about 10,000 feet. We lost track of the potholes after the first thousand. After a brief stop for coffee, we got to San Juan Ixcoy around 9am.

We arrived at the "capacitación" which is the local clinic/mini hospital to find about 200 people waiting, and 50 or so hoping to have ultrasounds. There was a little disappointment when we said that 20-25 ultrasounds was probably all we could do but we got down to business fairly quickly and divided into teams. Melissa and Josh did consultas, while Chris, Rosalicia, and Mariah did a combination of consultas and ultrasounds. 

The patients themselves were lovely as usual. Most spoke Spanish, but some spoke Mam (pronounced "mom") and others Q'anjob'al (con-ho-ball). Of course our consultas were fairly limited without xray or labs (we could do urinalysis and pregnancy tests), but we had brought out own pharmacy thanks to the Providence pharmacy team and Debi Farr who supplied us with antibiotics and an assortment of other medicines. I suppose since we are doing shoutouts, we should say a huge THANK YOU to Sonosite for loaning us a very nice portable ultrasound machine that we brought with us.

We finished up around 4 but as our luck would have it, one of our pickups began to have some clutch problems on the road winding up and over the altiplano which slowed us down so we didn't get back until 7:30 or so to our host family. The night was spent preparing for a teaching session on Friday with medical students on obstetrical emergencies.

Feria de la Salud

In case you thought our trip to Guatemala was all fun and games, there is actually a reason we did not  post yesterday. For the past two days we worked at the Casa Materna in a Feria de la Salud (Health Fair). As you can see in the poster (of Melissa) we were seeing pregnant patients for prenatal consults, obstetrical ultrasounds, consults for pediatrics and general women's health. A "consulta" basically translates as a doctor visit to ask medical questions. Luckily our kind and competent colleague Dagmar "la Cubana" helped us with PAP tests, so la Flaminga Negra happily passed her PAP queen crown on to Dagmar.  Every one we meet wants to know "Donde esta El Loro, Dr. Gobbo?"  Pues Donde Beto??



Tuesday, we all worked in the Feria de Salud. On Wednesday, while Chris, Josh, and Melissa saw patients at Casa Materna, Rosalicia and Mariah were trailblazer residents, stepping Providence feet into the National Hospital. They were paired up with a nice resident, and got to see how birth is managed in a hospital with few resources, with as many as 16 vaginal births and 12 cesareans in a 4 hour period.







As is generally the case, the first day of the Feria was a cluster $#%$. In the morning as patients filled the front entry hall and spilled out the door. Gracias a Dios for the help of everyone at Casa Materna and the Rafael Landivar nursing students.







Last night we met with the Minister of Health of Huehuetenango, as well as Pascale and Bal Maria, the respective heads of PCI Guatemala and PCI Huehuetenango.  He approved placing misoprostol in remote rural health outposts, which is a step forward toward reducing the maternal death rate.  Tomorrow we head to San Juan Ixcoy for the first of our rural health clinics.

Manifestación destino (Destiny of protest)

Estela in front

Manifest Destiny is the belief that the westward bound trail naturally belongs to those with the will to take it. Today was a bitch slap to our plans for a quick and speedy journey to Huehuetenango.

We packed our bags and said our goodbyes to our gracious host Estela in the bonita city of Antigua to make our way to Huehuetenano.  She sent us off with hearty breakfast of frijoles and pan.  Our two amigos Henry and Josue David from PCI came with two trucks for what we thought would be a 3-4 hr journey.  Winding roads with beautiful views greeted us on the drive into the cool mountains.  We stopped to stretch our legs and caught the stunning view of lago Atitlán.  An hour or so into the journey we came to a stop, only to learn a manifestación (protest/demonstration) was happening up ahead. Ironically the cause being protested was for better rural roads.  

The manifestación

Josh and Melissa, who are allergic to sitting, gathered the group to explore and journey to the barricade.  Unsure of what was ahead we walked with friendly greetings from our stuck comrades.  Unsure of how far the barricade was or for how long it would occur we chatted with various people along the way.  Our impatient and questioning behavior was juxtaposed with the tranquila nature of the Guatemalans who laughed and calmly responded with maybe 2 hrs maybe 6.  There is a lovely idiom in Guatemala, “saber” which means “who knows?” The nearly 2 mile journey uphill to the manifestación was breezy with pockets of sun.  It was a peaceful protest with groups of people huddled at the barricade.  Along our walk we ran into no other gringos. We found a nice little restaurant (conveniently placed at the barricade) to enjoy some comida típica, and then we headed back down to our appreciative PCI amigos trailed by Chula, Rosalicia’s adopted dog.

Once we arrived back to the trucks, we still had plenty of time to chill out, sitting on the curb, in the truck, or lying in the median. All of the inconvenience of the unplanned travel time was made up for when we finally arrived, 12 hours after departure, to our host’s home. Abesaida and Arnoldo along with their family, greeted us with steaming bowls of cocido, a traditional Guatemalan vegetable and ground beef stew, and warmed our hearts with their welcome.  

Our welcoming sign. David (on couch) has other concerns

Sunday is a day for rest

Traveling can require bouts of endurance and sometimes offer lovely moments of calm. We had a bit of an endurance test last night when the neighbor’s rooster (“gallo inglese” according to Estela our host) began to crow throughout the night. Needless to say we slept in after our late arrival. Estela made a feast of fresh fruit (papaya, pineapple, banana, watermelon), eggs, freshly made tortillas, and coffee.

















Today was a day of rest and relaxation in Antigua. We got a chance to roam the city and have a paseo along with many locals and visitors. Some of us opted for the pampered version of relaxation. Suzy had a very nice masseuse while Mariah had the sadist version who had a special technique of applying pressure to the kneecap.

Three of us hiked up to a hill with a lookout over the city accompanied by Crista. Crista is a young girl whom Estela has more or less adopted and is finishing 2nd grade. She managed to make Josh her personal mule for a ride up the hill as well as a human step ladder to reach some avocados in the tree.

We met up in the afternoon and took a vanbus up to a cute restaurant with a nice view of the valley and surrounding volcanoes along with Andean muzak for ambience.

Travel Day

Portland to Houston to Guatemala city. Suzy our fearless leader booked us on a plane that took off at 12:30, much better than a 6am flight. She brilliantly managed it so our layover in Houston was less than an hour. Once we deplaned in Guatemala city, we had to go through customs and immigration. Each of us had to go through a "sorting hat" ritual in which we pushed a button and ?randomly got a red light or a green light. The light color determined your fate of needing your luggage opened and searched or not. The sorting light gave reds to Suzy and Mariah. Fortunately they got a very nice customs lady who read a letter Suzy brought from PCI that perhaps resulted in less of s search.



We were met at the airport by Estela, a timeless Chapina (Guatemalan woman) who stands about 4'10".  She had arranged a van transport from the airport to Antigua where she has a small hostel. Despite getting into Antigua around 10:30 our time, 11:30 local time, we all wanted to walk around and get some energy out before going to sleep. Antigua is the cutest town in Guatemala, but we managed to find lot of jóvenes roaming the street and helped us locate a place to have a beer. Monoloco (Funky Monkey) also doubles as a political forum with interesting political statements on the wall. Google Translate gives a few colorful options for the word "pendejo" but perhaps "stupid" is the simplest.