Sharing my story:
Another year has gone by, but it has definitely not been a normal one. Getting certified to work as a medical doctor in Guatemala is a difficult task, just as it is almost anywhere in the world. The legal requirements are defined by San Carlos University, an entity with 300 years of experience training doctors. Trying to be fair to their students, International physicians seeking to be certified have the last selection for location and are often placed where no other graduating doctor wants to go. But God, who is in control, sends us to the right place at the right time, to meet the right people for the right purpose.
The journey starts asking you to be willing and ready for any thing, at any place and at anytime. The university announces your location two or three days before your start date, giving you virtually no time to prepare, pack, or plan your stay. There is no such a thing as planning ahead. Once you arrive, you get settled in what will be your home for the next six months. I had the blessing of finding a great hotel one block away from the health center. I had in my room every thing I needed for the time I was going to be there, and I saw God’s hand taking care of me with little caring details for my safety and my comfort.
The rural work experience allowed me to see how the community is organized, how the health system interacts with community leaders to solve problems, and how government programs are implemented and carried out by the health providers. These community programs focus on mothers & children and preventable communicable diseases. The clinic’s health personnel go to homes looking for patients that meet the age criteria and need vaccines or weight and height follow up. Unfortunately, there are never enough resources to fill all the needs. Even if a child continues to be malnourished, they are kicked out of the program after they reach age 5. It takes a tremendous effort to encourage people to keep coming to the health center once they are no longer pregnant, have children over the age of 5, or don’t expect to get any pills or food. Men usually come only for emergencies, and the elderly have a very low consultation rate. They still consult the traditional doctors first and die at home surrounded by family. Which does not sound bad to me, only that the expectancy of life is only 73! The government is doing a great effort to implement programs that include all ages and provides free service for anyone that comes to request it, with the resources that are available.
Even though the child mortality rate has decreased since the World Health Organization instituted the target of eradicating extreme poverty as part of its Millennium Development Goals, Guatemala’s rate continues to be higher than most other countries. Government programs and international aid continue to help Guatemala in its effort to further decrease the nation’s mortality rate. It is true to say that it is hard to evaluate the effect of the programs due to a very precarious form of recording the information and the statistics are not reliable since there is a lot of misinformation and illiteracy. Education becomes the number one need at all levels and it is a never ending goal.
After having my final exam of public health I moved to Escuintla, the area where the tragedy of the volcano took place. I had been praying for God to send me to the place where I could serve the best and here I am, now completed two months of the second semester, working full time at the state hospital. While the public health clinic presented its own set of challenges, the long 30-hour hospital shifts every four days with no rest in between, with one hour free to take a shower and eat are taking a toll on my strength. Wait! Don’t forget the classes that need to be prepared and the exams every two weeks. The hospital in Escuintla allows any student to have a great practice due to the volume of patients and the variety of illnesses that come on a daily basis. For me, it has been a very nice experience to start all over as an intern student after 30 years of graduation. For sure, things are different now, specially in a foreign country with different circumstances and with a different health system. My gratitude goes to God who strengthens me to pursue the hardships of the road.
One of the challenges is to adjust to the way things get done here. There is no prior orientation about the processes of the hospital or the job you are expected to do. You just learn it on the go and you do certain things because “that is the way we do things here”. All communication is word to mouth or by WhatsApp at the moment that needs to happen: for classes, changes of schedules, regarding homework’s or any other important information. It is hard to get used to not knowing how your day would be because it can change with a WhatsApp message. It is hard for an old lady like me to get use to this kind of improvisation, I might not even read it on time!!!!
One observation that saddens me is the poor attention and caring towards the patients as culturally accepted. The overload of work has made the practice impersonal and cold. No personal relationships are developed, and compassion is rarely seen. This hospital is an example of a reality happening in every state: any given night there could be 15 C-sections and 15 deliveries in the OBGYN department, 7 appendectomies or emergency surgeries, or even 3 babies sharing the same un-clean stretcher because the hospital runs out of water very frequently, therefore, hygiene is not enforced and there is always an excuse for the mess around. There are not enough ventilators for the critical patients, and students sometimes need to manually ventilate patients for days. I was pleasantly surprised when I had to be in the intensive care unit for the newborns. It looks like a different country. There are 17 incubators full equipped with everything you need to assist a baby in distress. The personnel working here has also a different attitude and anyone would envy the free bill at the end of the stay!
The families of the patients sleep in a room on the floor, or on cement benches, and they are grateful for the roof to stay under. Some of them get to sneak in and sleep in the hallways of the hospital on the floor. A lot of families are coming from very far since it is the only hospital in the state, and spend days in this room where they can get some good friends sharing the same situation. Visiting hours are Tuesday, Thursday and Sundays only from 1 to 2 pm. Please, don’t get sick Thursday afternoon. You won’t see your family until Sunday!!
People know the rules and they are followed with submission. Sooooo much to learn from them!
Escuintla is one of the most dangerous cities in Guatemala, and every night there is at least one wounded person, or a seriously injured patient from a motorcycle or car accident due to reckless driving and alcoholism. A patient with craneo encephalic trauma needs to get his CT scan outside the hospital in the only imaging center in town that works regular hours, and only week days. So imagine you being injured on Friday night, you have to wait until Monday to get your CT if your family can get the Q900. People’s faith is the only thing left. 🏼. I am a witness of that the more hopeless the situation is, the presence of God is more evident to provide the needs.
This is the cruel reality of our beloved Guatemala. I am very thankful for this experience that has opened my eyes to a reality that is not seen as much in San Pedro where there is more private practices. There is a huge need in the public sector of places where the patients will be treated with dignity and seen as a person in distress, where they can find the love of Christ in the service received, and where hope can be shared as brothers and sisters in the faith.
I want to thank all of you for supporting Proyecto Fe and allowing me to get my legal license so we, together, can continue in our mission of serving the people in their illness and sharing with them the hope that makes us one in Jesus.
Please continue to support our growing ministry and join us in prayers or service with the upcoming medical teams.
Strengthened by The Lord,