By Melanie Schuman Rattigan
If you're under the weather or facing a more serious illness, you go to your local doctor or perhaps an urgent care clinic. Maybe even an emergency room. Insurance might be an issue. Frankly, sometimes even getting an appointment can be a challenge. Now imagine you don't have any of these options. That's what most Guatemalans face.
The highlights of my five trips to Guatemala often come from our general medical clinics. You see how people live in mud-and-stick fabricated homes to how they pass the time without television, Internet, school or even unfortunately a job. Sometimes it's a 3-hour road trip through mudslide-ravaged villages. Other times, it's 25 minutes off the main transcontinental road. There are clinics where we see 75-100 patients and then those that easily reach in to the hundreds. Parasites are a common problem, as is malnutrition. For many, this is their one chance to be seen by a health care professional even if they might not have an ear infection or exhibit symptoms of disease. Vitamins, a little ibuprofen for an aching back or antacid for recurring heartburn often does the trick. Sometimes parents of children born with cleft palates come seeking assistance and we arrange for them to be evaluated by our plastic surgery team that visits each March.
While the providers -- pediatricians, registered nurses, general practitioners and even emergency medicine professionals -- are the stars, there are plenty of jobs for the non-medically trained such as myself. We handle head count, people flow -- getting families to the next available provider; we're runners for refills from those dispensing the meds and most fun of all -- we hand out toys or clothes when the patients are finished. I even learned how to make balloon animals, which was just as entertaining for the kids as it was for me.
This February, I translated for a pediatrician who himself has adopted four children from Guatemala and wanted to "give back" to the country that has given him so much. A man in his 40s recovering from a stroke came in with his family. (It's not often we see men at these clinics except on Sundays.) After a brief examination, we referred him to a local neurologist in addition to regular physical therapy at the clinic Hearts In Motion built in the nearby city of Zacapa.
The surprise of the trip was a 9-year old boy with hydrocephalus who came with his grandmother. His head was enlarged and his eyes shifted constantly left-to-right, up-and-down from the pressure of accumulated fluid on his brain. At birth, doctors told the family he wouldn't live long. With a physical disability like this (he is also blind in his right eye) he does not go to school, but has already lived longer than anyone imagined. His family was told he needed surgery to live beyond age 12, but it is cost-prohibitive and not an option. The doctors recommended a shunt to relieve the pressure -- an operation which would have done by a local doctor -- and then began examining his ailing grandmother. It was then that I gave him a toy from my backpack -- a blue truck that was 74 cents on clearance at my local drugstore. His face lit up and, for the next 15 minutes, he laughed as we played. He was better at getting that truck to cruise across the room than I was and when he left, I was in tears. What did his future hold? We have volunteers that live in-country year-round who can monitor the situation and provide assistance when possible.
On average, clinics see about 200 general medical patients each day. There are also clinics specifically for dental care (extractions, cleanings), eye care and ob/gyn care (more on that next week.) And while it's not a clinic, the most-eye opening experience for many volunteers is visiting the local garbage dump where many people live. We make sandwiches of bean puree and cheese and fill plastic bags with horchata -- a rice milk drink. The residents come running when our yellow school bus makes it way in and line up waiting for a meal and the clothes and shoes we bring. It's probably the one hour of the trip that most reminds you -- even on a bad day, life is good.