We spent the early part of the morning on the phone trying to figure out how to get the nitrous oxide tank here for treatment for the women with the cervical dysplasia. For 2 weeks, I’ve been back and forth with this company. As with everything else, nothing is available in the Peten and it requires sending it on an 8 hour ride from Guatemala City. And of course, the only have the “large” size which looks like a missile! We can’t get a straight answer about cost and the terms change with each phone call. Finally, Randy asked me if there wasn’t any easier way to treat these women; he’s always so good at looking at problems in different ways. Bing! The bulb went off in my head – we could use the cautery machine that we sent down here last here. So off we went to the storage facility where we keep the KAH food and found it. Later in the afternoon, we got it all hooked up and no, it wouldn’t work. I almost cried. Seems like EVERYTHING here is such an effort. So, I called the OR at Toledo Hospital and spoke to one of the nurses. She gave me a couple of ideas which didn’t work; I felt so defeated. But we didn’t give up and after a long series of button pushing, success! There was a lot of high-five-ing going on and we made a smiley face in a mango with the cautery! It’s kind of amazing what gives you joy down here! So tomorrow the little ladies from all the villages will hopefully be treated and maybe in some small way, we’ve prevented them from being the victims of cervical cancer.
As we drove along the bumpy dirt road this morning, a young woman came running out of her house waving us down. Ismael pulled over and she frantically starting telling us that her daughter fell and hit a wall and “died” last night. As my heart skipped several beats, I then Irealized that she actually meant that the girl lost consciousness for a while. “Dying” is actually the term they use down here when someone faints. While my Spanish continues to improve, some of these “cultural” terms totally crack me up! The first time I heard this usage of the word “death”, I had asked a woman if she had any complications with her first delivery. “Yes”, she said “I died”!!! Long story but you can imagine my confusion!
Anyway….getting back to the woman on the road. She explained how her daughter had fallen and was “dead” for 8 minutes. When she “woke up”, she was completely confused for a long time. She vomited throughout the night and cried with a terrible headache. Now wouldn’t you bring your child to the hospital if this happened?? No, not here. By the morning she was able to walk, so they sent her off to school!! But the mother was clearly alarmed and wondered if we could make a house call on our way back from the clinic tonight. So at 7PM we pulled up and they eagerly welcomed us in to evaluate the girl. This home was in a village called “Mango”. Mango is a big step up from Pueblo Nuevo since they have electricity, a better school system and some minimal infrastructure. But in the home you felt the same sense of despair, filth, poverty. The girl way lying in the hammock above the dirt floor. Ten years old, she looked more like five. She shyly talked about the pain in her head but assured us that now she felt hungry and she could easily walk and talk. As we chatted, a small pig came over while a more massive one wasn’t able to get in the door! Seriously, can you imagine having a pig in your exam room!!! A cursory neurologic exam from the obstetrician showed that the girl was probably getting over a minor concussion. Now try to explain that in broken Spanish to people who have no concept of anatomy! After much grasping for words, Ismael, Orfe and I finally figured out that she had a “cuagulo” (basically a blood clot in her brain!). “Ahhh”, now it all made sense to them!
Knowing that the local hospital would never admit a child who could walk and talk, I gave them the warning signs to look for that should cause them to bring her there. Of course, the first question was “how much would it cost?” So many children die here that paying any significant amount for treatment is always weighed against how many meals they wouldn’t have.
As we drove back to the hotel, Orfe received a couple of phone calls from the local minister of health. They will be coming to meet us tomorrow as we all celebrate the new classroom that we just finished. And now the bad news…..the hopeless teacher who did almost nothing last year will be returning again. School started the first week in January and she hasn’t shown up yet. But she’s the girlfriend of the other teacher there who’s “politically” connected and so that’s that. The village families hate her and she really didn’t teach anything on the days she did show up. Randy, Ismael, Orfe and I looked at each other dumbfoundedly. Hmmmm…….OK we put money into a school structure, we give books and supplies and we send people who are happy to provide guidance. But how do you make any inroad when you’re faced with this nonsense? Sometimes it seems that there are nothing but blockades. Then we remind each other of the small but very meaningful steps that we see. For the first time, the leaders really are getting together to discuss the school situation. Knowing they have us behind them, they are finally speaking up and starting to believe that they are entitled to have a voice in what happens. There is a young man in the village named Mario who seems to be an answer to prayer. He’s been at all the meetings and is one of the few who genuinely cares. Along with Ismael, he supervised the construction of the classroom all for no payment. Apparently, he’s trained as a teacher and has an official certificate. Because he’s not in the “click”, he can’t get a job and has chosen to go back for another certificate so that he can be the teacher for the adult education classes that we are sponsoring. I didn’t even know we were sponsoring them!! Ismael and Orfe never stop astounding us with their efforts. With the small salary we are giving them, they work night and day for us!!
Apparently, Orfe herself was not permitted to have an education beyond 6th grade when she was young. Her father wouldn’t allow the girls to continue beyond that level. But she always dreamed of a real education and she completed her university degree in social work this year at the age of 37. There is an organization called CONALFA that helped her succeed and so she contacted them to see if we could start one of their programs in Pueblo Nuevo. She set it up so that Mario will be paid to teach the adults to read and she will be the other teacher though she won’t be paid. She is so passionate about this work. Her energy and faith and compassion always humble me. She told me yesterday that her life completely changed when she starting working with us 2 years ago. She said that before she used to be always tired and worried. With a huge smile and tears in her eyes, she said that now she has received the purpose in her life that she had prayed to have for years. She feels completely surrounded by God’s love and care and has boundless energy. She and I laugh constantly in the back of the car as Randy and Ismael sit in the front. She is so patient with my Spanish and sometimes we come to tears laughing about the things we hear in the clinic. Gynecologists really do get to hear things the rest of the world is protected from!! When the women want to tell me something about their “private parts”, they call it their “thing”!! Deena had told me this before but somehow I had forgotten so I was quite confused early in the week with all the references to “my thing”!! The other word that is so hilarious is their term for their period. Being the good little Spanish student that I am, I know at least 3 Spanish words for this. But oh no…..they call it the “infermidad”…..basically the “sickness”. So now when a pregnant woman comes in, I ask “Do you remember the first day of your last sickness?”
Randy had quite a day. Wait till you all see the photo of him climbing into the village water tank which is higher off the ground than I want to think about. Since he’s been quite the scientist this week and has proven to the people that their water is filthy by demonstrating the bacterial colony counts on his agar plates, he wanted to show them that the water from the tank is clean. Since he was worried that the pipes were contaminated, he wanted a sample directly from the tank. How to do that? Just climb up and get it!! He is truly in his element here. If anyone is going to stamp out intestinal worms here, he is!! We continue to be frustrated that the people don’t quite believe the necessity of using the latrines so it’s a constant battle to convince them. On the first day, I literally saw 3 moms bring the children to the back of the clinic to poop right in front of the window!! But after Randy showed the community leaders the results of the agar plates, I started hearing new pleas from help from the moms about ways to convince some of the villagers that they had to start paying for the diesel to run the water tank. The cost is really negligible and if they’d stop paying for the injectable vitamins that some idiot brings around here every month, they ‘d have the money.
I know I’m digressing but I hope all these things give you a sense of what it’s like here. Oh… one last visual…..early in the morning I saw a 70 year old Mayan woman. She was the epitome of the photos you see of these people. When she told me what village she was from, I asked how she got here. She left her home at 5AM, walked for an hour and then got on a horse and rode for another hour. When I asked if I could take a photo of her on her horse, she was joyous! After her visit, we went outside and she literally ran to one of the homes to grab her saddle and horse blankets. Within 2 minutes, she had the white horse saddled and up she popped. All the women waiting at the clinic were hysterical laughing and a couple came over to ask if I could photo them on their horses! Oh….what a difference to Maumee Ob/Gyn!!