***Unfortunately, I don't have any photos from these two days. I really wanted to spend more time experiencing it than trying to record that experience***
On Monday, we visited a Children's Immigration shelter right here in Xela (surprisingly only a few blocks from Parque Central). We're at the end of our 3 week program now and I can confidently say that this is the single most impactful thing I've witnessed here. We got there a little early to get a tour of the facilities. It was small. But cozy. It was bright, warm, welcoming. The kitchen staff had prepared and set hot meals out for the kids. Shortly thereafter, they hustled us outside and asked us to create a barricade of sorts for when the bus came. To prevent kids from running away. The bus came and the kids descended from the bus. And they really were just kids. Right around the age of all my Apple Tree volunteers. Some of them even looked kind of similar or dressed similarly. Immediately I felt myself choking back my feelings because I wanted to participate which would be rendered impossible if I were to become a complete blubbering mess. So yea. I choked back my feelings and watched the kids expressions. Some people started looking around and I could feel the unease rippling through our group as a girl with two black eyes and other visible injuries stepped off the bus. I felt awful that we were gawking at her. I hated that we were put in this position again after everything that had happened at the public hospital. Still I couldn't stop looking at them. It hurt me to see the kids laughing and smiling and joking as they hopped (there really was a spring in their step) off the bus and hurried into the building. Some avoided making eye contact, others stared right back at me. I hate to think that I have any authority to pretend to know what they were thinking or feeling, but I couldn't help but think that this was a kind of defense mechanism because they don't have the emotional tools to deal with this kind of situation.
The first thing they do is eat. Hot food. Good food. Familiar food. Possibly for the first time in months. Once the kids got settled, the staff welcomed them and prayed for them before their meal. Some of them were already nearly halfway done with their plates. They spent a few minutes praying aloud altogether and I was surprised to see that kind of prayer outside of a Korean church. Some of the kids just bowed their heads. Others prayed earnestly and I saw a few wipe tears from their eyes. It was short so they could eat.
We walked outside to have a discussion and talk to some of the staff. They explained that after their meal, they have interviews with a counselor to see whether they can be released to their families (checking for abuse, situation that forced them to leave home, whether the families are actually their families and not smugglers or traffickers, etc.). If they have time (esp. the kids whose families live far away and are still on their way), they meet with a psychiatrist and a doctor. They can shower. They have a nice bed to sleep on. Within 48 hours all these kids will be gone - either back home with their parents or some foster care system that's just as if not more broken than the one in the USA. About 90% of these kids will try to sneak into the USA again.
At this point I had shut down all my feelings. I don't think I said anything during our discussion afterwards. Nancy cried a little bit and she apologized for that. I appreciated that I wasn't the only one to feel this way. I went home. I called my dad. We talked. I cried. I will never forget the look in those kids' eyes or the way they just devoured their meal or the way the boys proudly hid their sadness or disappointment or whatever they were feeling under a mask of silliness and goofiness. I can't help but think that it all just felt so... human.
I've had some time to think about this experience and I think I've had an epiphany. Since I started working at The Apple Tree 10 years ago, I loved working with kids (albeit it may have been a defense mechanism since it was an obligation and I could choose to hate it or to love it and enjoy it). I've been good at working with kids. On another note, I've always been attracted to movies and TV shows and books where children are in search of their parents or in search of their family or they've lost their parents or anything along those lines (think: Lion King when Mufasa dies or CatDog when they go searching for their parents or The Land Before Time when Little Foot's mom dies or Finding Dory where Dory goes in search of her long-lost parents or Homecoming by Cynthia Voigt where 4 siblings are in search for their mother who abandoned them, etc.). Also, one time, I had a dream, a vision, a something idk what it was, that I was in the middle of a field and hundreds of children of all sorts of backgrounds were running towards me. At the time, I felt like God was telling me that it was my job to help these kids. All of these things, together, make me think that I have to work with kids. That I have to help these kids. I have to help these kids.
***
Today, we visited Café Red KAT. It's a restaurant/chill space/yoga house/cooking school/a bunch of other stuff that's meant to 1) revive the idea of the Guatemalan Dream (i.e. screw the American Dream, Guatemala is part of America and a future can be built here) and 2) provide not only encouragement and empowerment but education for the young generation to pursue the Guatemalan Dream. It was founded by a bunch of ex-expats - people who had left Guatemala (some as adults during the worst of the Civil War and others as children following their parents) and had come back (some as a conscious decision, others as a result of deportation).
One of the co-founders, Willy Barreno, insisted that instead of giving our pity, that we just help them grow their network. That we support them and spread the word. So here I am, trying to do my part. Here's the website of the overall organization, DESGUA: https://desgua.org/ There's a shop, internship opportunities, or just information if you want to learn more!
A point that really hit me was the trend in immigration/deportation of Guatemalans throughout the past 30 or so years. In 2001, only 1,000 Guatemalans were deported; in 2007 the number increased in 23,069; in 2008 it was 28,051; in 2009 it was 27,222; in 2013 it was 48,000; and in 2014, it was 52,000! Why these huge increases? It's a change in rhetoric. It's a change in widely held beliefs. For example, in 2001 something big happened in the ol' US of A: 9/11. Immigrants were scapegoated for that (and other) acts of terrorism, which resulted in an increase in deportations. In 2007, the economy crashed. Immigrants were scapegoated for the miserable state of the economy, which resulted in an increase in deportations.
With or without globalization, health, disease, language, culture, economics, government, everything is connected. We are all driven by the same basic things: the search for food, the search for security, the search for a better life for our children. As simple as that sounds, that is my biggest takeaway from this trip. And it's not a lesson that I just know logically or theoretically, but it's something I've become more aware of and something I've witnessed. And whether I'm in Guatemala, in the United States, in Europe, or Asia or wherever life will take me, it's something I'll forever remember. And when I feel so isolated or so different or so confused and feel like I just can't understand someone, I'll remember this lesson and know that, whether you like it or not, we are all just so goddam human and you just gotta deal with that.
Tuesday, June 7, 2016
Sunday, June 5, 2016
Guatemala Day 14-16
This weekend, we visited the beautiful Lake Atitlan. We drove to San Pedro then road a boat to Santiago...
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We took the same truck back to the docks and we started making our way to Panajachel, which would be our base camp for the weekend...
***
Saturday was full of adventures. First we took a tuktuk to the Atitlan Nature Reserve and went ZIPLINING!! It was my first time and it was ABSOLUTELY FANTASTIC. I was a little hesitant about spending so many quetzales, but realized it's actually really cheap compared to other places. So why not. Best 220Q (~$30) I've ever spent. There were 8 ziplines and a surprise obstacle course at the end!
***
tl;dr I got sick with Chikungunya in Guatemala
So something I haven't talked about at all on my blog was my sickness. But I guess now is as good a time as ever, since I found out I probably had Chikungunya o_o Let me explain: on Tuesday of the first week, I woke up with a really swollen eye and I didn't know what it was from. It got worse and worse. Later that day, I got a headache so I took an Advil but didn't think too much of it. On Wednesday, it got really bad so we went to a clinic and it turns out it was an allergic reaction to a certain type of mosquito that likes to bite eyelids (LOL so random). Anyways, they gave me some allergy medication and I went home. The next day, the swelling had already gone down a lot and I was almost back to normal. I still had a slight headache so I took another Advil. On Friday, when we were going to Lake Chicabal, I didn't take very many pictures in the car because I had such a bad headache. I thought it was from carsickness (I used to get really bad headaches in the car) so I just tried to sleep it off. Saturday, my headache hadn't gone away at all and, on the way to Fuentes Georginas, I just took a Dramamine and just knocked out. Same thing on Sunday. I thought my head was going to split open, but I only took half a dose of Dramamine because I didn't want to be completely out of it like I was that Saturday. Towards the end of the day though, I went back to our rendezvous point early because my head was hurting again and I noticed that I had little red dots all over my arms! What the heck! I pointed it out to Ellie and Dr. Quinn, but it wasn't that dark or anything so we didn't think too much of it. I went home and knocked out because of my headache. Within the next two days, though, it was all over my body and it got REALLY bad. I wanted to fight through it and, not wanting to miss any more Spanish class (I had missed 2 hours to go to the allergy specialist), I put on a brave face and trudged to school. As soon as I saw Dr. Quinn, though, I broke down. At that point, I had had a persistent headache for more than 72 hours and I couldn't really hold it in anymore. We made an appointment with a specialist - he wouldn't be able to see me 'til that evening - so I fought through the pain and tried really hard to pay attention... After Dr. Sanchez's lecture, Dr. Quinn, Ellie and I headed to the clinic (again) and waited an hour and a half or so. We were the last patients to be seen. The doctor told me I had vasculitis, which is normally a very dangerous condition, but that I had a rare form of skin vasculitis and that it could be easily treated by steroids. The headaches, he said, were a side effect from the VERY strong allergy medication that I was prescribed. I was worried because he said it was genetic and could develop into a very dangerous condition BUT that I shouldn't worry at all and just take STEROIDS (pretty heavy duty medication). Anyways, I did a lot of research and the steroids didn't seem too harmful since I would only be taking it for a week. I started taking it and the rash started to go away; I stopped the allergy meds and my headaches started to go away too. Also, according to my research, some forms of vasculitis can be caused by strong medication. Everything was explained. Yay. UNTIL a few days later, Ellie came and told me that she thought she was having sympathetic symptoms because she got that same rash and lack of energy and headache! This weekend, she was talking to Tammy, Dr. Quinn's daughter who lives in Mexico, and she said she had Chikungunya last winter and it was the exact same symptoms with an identical rash. SO, like I said in a previous blog post, although there's no test to see if I actually had Chikungunya, she (and I) are fairly certain that the culprit was not vasculitis, but Chikungunya. And that is the story of my firsthand adventures through one facet of the Guatemalan healthcare system (albeit not the public system).
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| I hate walking on stuff like this, but I can proudly say I conquered these docks. Nothing can stop me now! |
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| Some of us were able to ride on top of the boat, so we had a little picnic. I must say, bagels are more delicious when you have a wonderful view atop a boat. |
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| Dr. Quinn was right at home on the water! |
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| People standing on paddle boats |
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| Approaching Santiago! |
Once we arrived in Santiago, we went to go visit Hospitalito, a private hospital.
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| In order to get there, we all piled into the back of this pickup truck! |
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| I can't post the video of our ride right now, so for now, enjoy this picture. (More on tuktuks later) |
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| For some reason, I didn't take any pictures of the outside of the hospital, but here's the pediatric patient rooms. It's basically the same as the adult ones, but the furniture is a little lower... |
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| The hospital room was decorated in artwork from past patients! |
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| They've developed an eye chart that works for people who can't read. Seeing things like this remind me of my privilege. I'm glad that there are people out there who are more aware of things like this than I am and I hope to become more mindful of these things that systematically discriminate against certain people |
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| They gave us an AWESOME lunch (it was SOOOOO GOOOD) but the highlight was definitely dessert: dragonfruit. I had never seen a dragonfruit before and I didn't expect the color to be so beautiful. And, more importantly, it was DELICIOUS |
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| Another obligatory group photo! |
We took the same truck back to the docks and we started making our way to Panajachel, which would be our base camp for the weekend...
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| Some market stalls on our way back down to the docks |
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| These ladies wanted to sell us some fabric. They were pretty persistent and I thought they might jump aboard our boat! They kept yelling and waving at us, even after we had left the dock. As the boats were getting ready to leave, their prices were getting lower and lower, but there was one audacious lady who actually raised her price. HA! They were pretty convincing though because even Dr. Quinn fell victim to their insistence. |
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| Mackenzie. Believe it or not, this picture is 100% candid. She was in the middle of turning her head and I just caught this perfect moment on camera. |
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| Jaeho and Ariel being Jaeho and Ariel. (Not pictured: Jaeho's infamous selfie stick) |
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| Once we arrived in Panajachel, we put all our stuff away in the hotel and we went exploring. The street our hotel was on was the main touristy street in the town so there was just store after store after store selling various trinkets and souvenirs and handmade things. I ended buying 90% of my souvenirs here and I bartered (in Spanish) very successfully! Oh but as for this photo, this bookstore was across the street from our hotel and I loved this idea: Books "a la cart" |
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| I really have no explanation for this photo... |
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We had dinner in a really fancy restaurant with a perfect view of one of the volcanoes (except the clouds...)
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Saturday was full of adventures. First we took a tuktuk to the Atitlan Nature Reserve and went ZIPLINING!! It was my first time and it was ABSOLUTELY FANTASTIC. I was a little hesitant about spending so many quetzales, but realized it's actually really cheap compared to other places. So why not. Best 220Q (~$30) I've ever spent. There were 8 ziplines and a surprise obstacle course at the end!
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| You know what's worse than rickety docks? Rickety swinging bridges OMG But I had to walk across these more than 10x to get to the ziplines. I told you NOTHING CAN STOP ME NOWWWW |
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| While we were there, we fed spider monkeys |
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| I don't have a lot of pictures from ziplining but this is from afterwards when we hiked to the beach (within the nature reserve). What you see here is what we saw while ziplining except more awesome! |
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| Faith the Explorer |
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| Jaeho the Cowboy |
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| After ziplining, a few of us took a boat out to Santa Cruz. That building there is La Iguana Perdida, a hostel with an awesome restaurant and an awesome view. |
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| My go-to Strawberry-Pineapple Yogurt Smoothie!! |
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After a very relaxing lunch, we walked all the way up the mountain and explored Santa Cruz. After being in the tourist center of Panajachel, it was very eye-opening to see a very genuine, local place and observe their daily life. It was also cool to see all these things that I've been researching in person
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| I didn't want to intrude on people's privacy by taking pictures of the stoves inside their house (something we've talked a lot about in a public health perspective), but I took a picture of the roofs. You can see the smoke coming out of their kitchens. Some have chimneys, some don't. |
Instead of going to San Marcos like we had originally planned, we decided to head back to Panajachel and just relax. When we were looking for a boat, they told us 15Q (~$2) per person but we'd have to wait 25ish minutes for the boat to fill up; instead, they offered us the option of taking a private boat (just the 4 of us) for 25Q each (~$3.50). We were okay with waiting and since we were all tight on money, we told them we'd wait. I don't think they were expecting us to say that nor were they expecting the boat to fill up so they just took us all right away for 15Q hahaha We avoided their tourist trap!
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| Luckily, we got back to the hotel just minutes before the downpour started. I was on the 4th floor and this is the view! |
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| I sat down with a good book and listened to the rain. All I needed was a cup of hot chocolate! |
tl;dr I got sick with Chikungunya in Guatemala
So something I haven't talked about at all on my blog was my sickness. But I guess now is as good a time as ever, since I found out I probably had Chikungunya o_o Let me explain: on Tuesday of the first week, I woke up with a really swollen eye and I didn't know what it was from. It got worse and worse. Later that day, I got a headache so I took an Advil but didn't think too much of it. On Wednesday, it got really bad so we went to a clinic and it turns out it was an allergic reaction to a certain type of mosquito that likes to bite eyelids (LOL so random). Anyways, they gave me some allergy medication and I went home. The next day, the swelling had already gone down a lot and I was almost back to normal. I still had a slight headache so I took another Advil. On Friday, when we were going to Lake Chicabal, I didn't take very many pictures in the car because I had such a bad headache. I thought it was from carsickness (I used to get really bad headaches in the car) so I just tried to sleep it off. Saturday, my headache hadn't gone away at all and, on the way to Fuentes Georginas, I just took a Dramamine and just knocked out. Same thing on Sunday. I thought my head was going to split open, but I only took half a dose of Dramamine because I didn't want to be completely out of it like I was that Saturday. Towards the end of the day though, I went back to our rendezvous point early because my head was hurting again and I noticed that I had little red dots all over my arms! What the heck! I pointed it out to Ellie and Dr. Quinn, but it wasn't that dark or anything so we didn't think too much of it. I went home and knocked out because of my headache. Within the next two days, though, it was all over my body and it got REALLY bad. I wanted to fight through it and, not wanting to miss any more Spanish class (I had missed 2 hours to go to the allergy specialist), I put on a brave face and trudged to school. As soon as I saw Dr. Quinn, though, I broke down. At that point, I had had a persistent headache for more than 72 hours and I couldn't really hold it in anymore. We made an appointment with a specialist - he wouldn't be able to see me 'til that evening - so I fought through the pain and tried really hard to pay attention... After Dr. Sanchez's lecture, Dr. Quinn, Ellie and I headed to the clinic (again) and waited an hour and a half or so. We were the last patients to be seen. The doctor told me I had vasculitis, which is normally a very dangerous condition, but that I had a rare form of skin vasculitis and that it could be easily treated by steroids. The headaches, he said, were a side effect from the VERY strong allergy medication that I was prescribed. I was worried because he said it was genetic and could develop into a very dangerous condition BUT that I shouldn't worry at all and just take STEROIDS (pretty heavy duty medication). Anyways, I did a lot of research and the steroids didn't seem too harmful since I would only be taking it for a week. I started taking it and the rash started to go away; I stopped the allergy meds and my headaches started to go away too. Also, according to my research, some forms of vasculitis can be caused by strong medication. Everything was explained. Yay. UNTIL a few days later, Ellie came and told me that she thought she was having sympathetic symptoms because she got that same rash and lack of energy and headache! This weekend, she was talking to Tammy, Dr. Quinn's daughter who lives in Mexico, and she said she had Chikungunya last winter and it was the exact same symptoms with an identical rash. SO, like I said in a previous blog post, although there's no test to see if I actually had Chikungunya, she (and I) are fairly certain that the culprit was not vasculitis, but Chikungunya. And that is the story of my firsthand adventures through one facet of the Guatemalan healthcare system (albeit not the public system).
Thursday, June 2, 2016
Guatemala Day 10-13
On Monday, Dr. Sanchez gave us two talks on Tropical Diseases in Guatemala & Antibiotic Resistance. I will spare you from having to see photos of spaghetti-like intestinal worms that have been pooped out and the various skin rashes and other gross things. I think that Dr. Sanchez's lecture really emphasized how much health, disease, language, culture (and economy) are really intertwined (the name of the class!). I thought it was especially interesting how tourism and emigration/immigration (especially problematic in Guatemala as a result of war and poverty and migrant workers) contributes to the spread of disease. All of these things have socioeconomic consequences. Plus, migrant workers have poor living conditions (unclean, crowded) which leads to the spread of even more communicable diseases.
He also said something interesting about Dengue fever, Chikungunya and the Zika virus. These are all very similar diseases and spread by a type of mosquito called Aedes aegypti. They have the same symptoms, but each one to differing severity. So doctors look at the symptoms and diagnose it based on whether there's more of a fever than joint pain, etc. THEN there's Zika, which is a fairly new disease (been around for 2 years). Again, there are very similar symptoms, but no definitive biomedical test. So it's only diagnosed when you have the right symptoms and the doctors have ruled out Chikunguya and Dengue!
Dr. Sanchez also scared us all away from ever ever EVER eating street food (though half the group didn't need convincing after getting an intestinal bacteria on the first day LOL) and washing our face and brushing our teeth with pure water. Some people were even nervous about taking a shower because what if a drop of contaminated water goes into our mouth and gives us horrible diarrhea haha. But after hearing what the sick people went through, I would be extra wary too.
***
On Tuesday, we had a tour of a local NGO called Primeros Pasos, which works to "improve the quality of life in rural communities [of the Palajunoj Valley] through integrated health education programs and access to medical services." I really loved how they focused so much on sustainability and empowering local residents (esp. by giving them opportunities to become more active in the NGO). While they do provide medical attention, which is an acute need, their main goal is more long-term: to improve health through education <-- sooooooooo important in global health but just in general of making the world a better place.
Anyways, from what I saw, I really liked what they do and how they think and would even considering volunteering there during my gap year. They actively fight against the #whitesaviorcomplex and cultivate cultural humility; it's not about voluntourism or altourism, but real volunteerism and altruism! AAAH idk I just really appreciated everything they had to say there.
After lunch, we had a tour of Public General Hospital San Juan de Dios, the public hospital in Xela. This would be the 3rd tier in the health system (health posts --> health centers --> district hospital --> specialized referral hospitals). There was a HUGE difference between what we saw earlier in the morning at Primeros Pasos and here. And although this is considered one of the large hospitals in Guatemala, I thought it was fairly small and humble. I don't know if anyone else felt this way, but I thought it all looked a little run-down and dilapidated. I really got the sense of what Dr. Sanchez was saying about how the health system is in the worst state in his 35 years of working in the public sector. Maybe I was primed to think that way, but I was really surprised (? that's not the right word) at how much they were lacking. I had read about it in my research and heard about it from teachers, doctors, and the Somos Hermanos staff, but seeing it in person was very... different. Much more poignant.
But there was something else that really made this entire experience kind of awful. We were this large group of foreigners just gawking at people in the hospital (which is already an unpleasant experience for them). We were also a large group so I just felt like we were in the way. I tried my best to smile at people and acknowledge them. I felt really uncomfortable the whole time, but I'm glad we discussed it afterwards and kind of debriefed. I definitely wasn't the only person to feel that way, but I also feel like our visit and our outrage will spur us into action which will make it worth it. I also think there's a large cultural difference when it comes to privacy and we were more outraged because we're not used to that kind of lack of privacy. But anyways, I digress.
***
On Wednesday we watched Estrellas de la Linea, which was about a group of prostitutes from Guatemala City (Guate) who decided to make a soccer team and compete in local tournaments. These prostitutes are all from "La Linea," which is apparently where people who are worth less than trash go. These women prostitute themselves without pimps, so they have some sense of liberty. There was a lot of public backlash, especially from the parents of the teams they played. The first field in which they played, they were kicked out due to the outcry and parents demanded that they change the turf in case there was any blood or sweat that was contaminated with AIDS. Despite the outrage, they also gained a significant amount of fame and international support. Guatemalatravels.net even sponsored their tour and other prostitute soccer teams started appearing worldwide.
In the beginning of the film, one of the women, Valeria, said that this soccer team was a way of getting attention because no one would care if a group of prostitutes marched on the Presidential Palace. But by making this team and getting press, they wanted to advocate for women's rights, especially for protection from gender-based violence and less police harassment of immigrant women. She exclaimed that before prostitutes, we are mothers and women first. Even though they didn't successfully revolutionize gender politics in Guatemala and they weren't respected as athletes and public opinion about prostitutes didn't change, I think it was worth it. They had those little moments of victory and self-confidence and helping each other and being able to visit Tikal and other parts of Guatemala which would have been out of the question otherwise.
It also made me think about why people choose this kind of life. For some people, as we talked about during the discussion, sex work can be empowering, a way of reclaiming sexuality for themselves. But sex work is also dangerous because of its inextricable link to human trafficking and the high incidence of femicide in Guatemala (Guatemala was actually one of the first countries to adopt this as a legal term, presumably because of its prevalence). And at least in this movie, a lot of these women seemed to have to other choice; they had a history of being sexually abused or assaulted; others were kicked out by their family; etc.
Finally, I found it very interesting how religious these women were. It was heartbreaking to hear them talk about how they know they are sinning and how God doesn't like what they're doing, but they have no choice. To know that they are so convicted in their beliefs yet they feel that they have to do this kind of work... I will never fully understand the inner turmoil that must cause. Despite the frustrations and apparent lack of success, I am so glad I watched this movie because it really humanized this group of people that are so often seen as dirty and less than.
***
On Thursday Dr. Fredy came and spoke to us about Design and Function of the Guatemalan Health System and the Role of NGOs in Guatemala & Diabetes in Guatemala. His first lecture basically confirmed 75% of my group's research which was that health in Guatemala shouldn't be this bad, but it does as a direct result of such pervasive inequality and rampant corruption. In theory, the government provides healthcare because it's believed to be a universal right. However, in reality, 75% of the cost is out-of-pocket for patients and 18% of the population have no access at all. That translates to roughly 3 million people in Guatemala alone who have ZERO access to healthcare. We wouldn't know the exact number though because the government is so screwed up that the last census was taken in 2002....
His second lecture was also interesting because he started off by saying that, contrary to popular belief, diabetes is not just a disease of the rich. About 80% of diabetes mellitus incidences occurs in Low and Middle Income Countries (LMIC). In Guatemala, diabetes is, at least in part, caused/exacerbated by remittances from and cultural attitudes towards the USA. Family in Los Estados will send money and say "Hey treat the kids out to some McDonalds" and, because things from "America" are so highly valued, they see it as a good thing. Obviously this is only one example, but that's how remittances contribute to disease. The other problem with diabetes in LMIC is that people either don't know they have diabetes or, if they do know, treatment is either physically or financially inaccessible. As a result, 80% of diabetes-related deaths occur in LIC (that's a lot). In Guatemala, specifically, a big problem is that people who get treated for their diabetes think they can stop taking their medication when the symptoms disappear. This is a result of both lack of education and lack of money (if there are no symptoms, it's not an immediate problem so their limited financial resources can be used elsewhere). Are you guys seeing a theme here? Corruption, inequality, lack of education. That's basically what I've garnered from all the research I've done.
At the end of Dr. Fredy's lecture, Dr. Quinn introduced us to Joe Herrold, one of the co-founders of Somos Hermanos. I talked to him for a while about my what my career path should look like given what I want to do, how the heck I'm going to pay for medical school, etc. He gave me a lot of advice and told me that I shouldn't listen to people who say I have to go into primary care or what have you if I want to work with low-income populations. He also assured me that whatever path I choose, as long as I'm passionate and hard-working, I can make it happen; so if I wanted, I can incorporate medicine, education, public policy, and social innovation into one career. He literally said do whatever the **** I want. LOL But yea. I really appreciated everything he told me and I'm a little bit less unsure about going to medical school now :P
He also said something interesting about Dengue fever, Chikungunya and the Zika virus. These are all very similar diseases and spread by a type of mosquito called Aedes aegypti. They have the same symptoms, but each one to differing severity. So doctors look at the symptoms and diagnose it based on whether there's more of a fever than joint pain, etc. THEN there's Zika, which is a fairly new disease (been around for 2 years). Again, there are very similar symptoms, but no definitive biomedical test. So it's only diagnosed when you have the right symptoms and the doctors have ruled out Chikunguya and Dengue!
Dr. Sanchez also scared us all away from ever ever EVER eating street food (though half the group didn't need convincing after getting an intestinal bacteria on the first day LOL) and washing our face and brushing our teeth with pure water. Some people were even nervous about taking a shower because what if a drop of contaminated water goes into our mouth and gives us horrible diarrhea haha. But after hearing what the sick people went through, I would be extra wary too.
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| Dr. Sanchez giving his lecture on Antibiotic Resistance |
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| This was the last slide of his presentation. It says "Thank you for your attention" LOL What a funny guy |
On Tuesday, we had a tour of a local NGO called Primeros Pasos, which works to "improve the quality of life in rural communities [of the Palajunoj Valley] through integrated health education programs and access to medical services." I really loved how they focused so much on sustainability and empowering local residents (esp. by giving them opportunities to become more active in the NGO). While they do provide medical attention, which is an acute need, their main goal is more long-term: to improve health through education <-- sooooooooo important in global health but just in general of making the world a better place.
Anyways, from what I saw, I really liked what they do and how they think and would even considering volunteering there during my gap year. They actively fight against the #whitesaviorcomplex and cultivate cultural humility; it's not about voluntourism or altourism, but real volunteerism and altruism! AAAH idk I just really appreciated everything they had to say there.
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| The first thing you see when you get to the NGO |
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| Map of the different communities in the Palajunoj Valley. I had to ask my Spanish teacher how to pronounce that... |
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| The dentist's office within the compound |
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| Examination Room |
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| Lab |
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| Cute murals everywhere!! |
But there was something else that really made this entire experience kind of awful. We were this large group of foreigners just gawking at people in the hospital (which is already an unpleasant experience for them). We were also a large group so I just felt like we were in the way. I tried my best to smile at people and acknowledge them. I felt really uncomfortable the whole time, but I'm glad we discussed it afterwards and kind of debriefed. I definitely wasn't the only person to feel that way, but I also feel like our visit and our outrage will spur us into action which will make it worth it. I also think there's a large cultural difference when it comes to privacy and we were more outraged because we're not used to that kind of lack of privacy. But anyways, I digress.
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| The main entrance to the hospital |
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| I don't think this is that important, but I got a kick out of seeing it because in my Business French class, my professor put such a HUGE emphasis on organigrammes. I knew they existed, but I had never really seen anyone who uses organigrammes so I had to take a picture and send it to her :P |
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| They have signs translated into two Mayan dialects that are widely used in this area. Unfortunately, because this is a district hospital, people who come from very far away don't necessarily speak these languages so they are at a disadvantage. At the same time, I don't know how plausible it is to have someone for each of the 22 languages at all times... |
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| Obligatory group picture! |
On Wednesday we watched Estrellas de la Linea, which was about a group of prostitutes from Guatemala City (Guate) who decided to make a soccer team and compete in local tournaments. These prostitutes are all from "La Linea," which is apparently where people who are worth less than trash go. These women prostitute themselves without pimps, so they have some sense of liberty. There was a lot of public backlash, especially from the parents of the teams they played. The first field in which they played, they were kicked out due to the outcry and parents demanded that they change the turf in case there was any blood or sweat that was contaminated with AIDS. Despite the outrage, they also gained a significant amount of fame and international support. Guatemalatravels.net even sponsored their tour and other prostitute soccer teams started appearing worldwide.
In the beginning of the film, one of the women, Valeria, said that this soccer team was a way of getting attention because no one would care if a group of prostitutes marched on the Presidential Palace. But by making this team and getting press, they wanted to advocate for women's rights, especially for protection from gender-based violence and less police harassment of immigrant women. She exclaimed that before prostitutes, we are mothers and women first. Even though they didn't successfully revolutionize gender politics in Guatemala and they weren't respected as athletes and public opinion about prostitutes didn't change, I think it was worth it. They had those little moments of victory and self-confidence and helping each other and being able to visit Tikal and other parts of Guatemala which would have been out of the question otherwise.
It also made me think about why people choose this kind of life. For some people, as we talked about during the discussion, sex work can be empowering, a way of reclaiming sexuality for themselves. But sex work is also dangerous because of its inextricable link to human trafficking and the high incidence of femicide in Guatemala (Guatemala was actually one of the first countries to adopt this as a legal term, presumably because of its prevalence). And at least in this movie, a lot of these women seemed to have to other choice; they had a history of being sexually abused or assaulted; others were kicked out by their family; etc.
Finally, I found it very interesting how religious these women were. It was heartbreaking to hear them talk about how they know they are sinning and how God doesn't like what they're doing, but they have no choice. To know that they are so convicted in their beliefs yet they feel that they have to do this kind of work... I will never fully understand the inner turmoil that must cause. Despite the frustrations and apparent lack of success, I am so glad I watched this movie because it really humanized this group of people that are so often seen as dirty and less than.
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On Thursday Dr. Fredy came and spoke to us about Design and Function of the Guatemalan Health System and the Role of NGOs in Guatemala & Diabetes in Guatemala. His first lecture basically confirmed 75% of my group's research which was that health in Guatemala shouldn't be this bad, but it does as a direct result of such pervasive inequality and rampant corruption. In theory, the government provides healthcare because it's believed to be a universal right. However, in reality, 75% of the cost is out-of-pocket for patients and 18% of the population have no access at all. That translates to roughly 3 million people in Guatemala alone who have ZERO access to healthcare. We wouldn't know the exact number though because the government is so screwed up that the last census was taken in 2002....
His second lecture was also interesting because he started off by saying that, contrary to popular belief, diabetes is not just a disease of the rich. About 80% of diabetes mellitus incidences occurs in Low and Middle Income Countries (LMIC). In Guatemala, diabetes is, at least in part, caused/exacerbated by remittances from and cultural attitudes towards the USA. Family in Los Estados will send money and say "Hey treat the kids out to some McDonalds" and, because things from "America" are so highly valued, they see it as a good thing. Obviously this is only one example, but that's how remittances contribute to disease. The other problem with diabetes in LMIC is that people either don't know they have diabetes or, if they do know, treatment is either physically or financially inaccessible. As a result, 80% of diabetes-related deaths occur in LIC (that's a lot). In Guatemala, specifically, a big problem is that people who get treated for their diabetes think they can stop taking their medication when the symptoms disappear. This is a result of both lack of education and lack of money (if there are no symptoms, it's not an immediate problem so their limited financial resources can be used elsewhere). Are you guys seeing a theme here? Corruption, inequality, lack of education. That's basically what I've garnered from all the research I've done.
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| Dr. Fredy speaks with his eyebrows and his hands as much as he does with his mouth. He's very energetic! |
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