Days 10 - 12

Day 10: Monday, August 19th, 2013

Things are going really well at UNAERC, my dialysis placement. I feel like I'm finally getting the hang of Peritoneal Dialysis and the many steps that have to be done with each patient. The repetition helps a lot. :) I'm still amazed at how big a role that families play with these sick patients. Very rarely are they ever left alone to complete their treatment... Their daughter, son, brother, significant other etc are always there to help or just a few steps away in the waiting room. I hope my children will do that for me one day (if need be!)

This afternoon we took it easy, as most of us were recovering from the weekend. I still felt terrible Monday morning and was extremely happy to be able to rest and relax instead of running around town some more. The shopping is getting a little old... Every place has similar things. It's frustrating that I'll assume that I got a great deal on some hot chocolate at one place, but then at the tienda down the street, they are selling the same thing for 10Q less!

After dinner, we had a guest speaker who talked to us about the healthcare system in Guatemala. Ready for some shocking statistics? In Guatemala, the population is over 15 million people. There are only 17,000 doctors. If you do the math, that equals about 886 people per doctor. The main hospitals in the country are both in Guatemala City,so many people in need of care who live anywhere outside of GC have to travel sometimes 10+ hours, either by foot, by horse, or some other route of transportation. Once these people arrive, it doesn't mean they will be seen immediately by a nurse or doctor. People wait in long lines for hours and hours. I won't ever complain about my doctor running 30 minutes late for my appointment again! We have it good in the US of A.

Day 11: Tuesday, August 20th, 2013

Volunteered again this morning, then went to an underground market. The top half sold the usual.... Hand made clothing, jewelry, hats, shoes, etc... While the downstairs was like our Madison Farmers Market on steroids. It was huuuuuuuge! And so was all the produce! It was fun to see all the different kinds of fruits that we don't have in the states, or at least not in Wisconsin. The point of going to the market was actually taking the place of our weekly Spanish lesson. Rosario, our instructor, took us there so we could shop and speak to the vendors in Spanish, versus our normal Spanglish. :) So much better than sitting in a classroom!

Day 12: Wednesday, August 21st, 2013

This afternoon we went back to Antigua to see an old convent / church from the 1800s. It's being rebuilt right now but it is still mostly in ruins. Santa Clara Convent y Iglesia still had the beautiful stone arches and a huge fountain in the courtyard. This was a cloistered convent, meaning, once the nuns said their vows, they were never able to leave there again. Family members could stop by and drop off food for them, but they were never able to actually SEE them. They used a small, rotating window that could pass the food off to the nun inside the building. A picture would be so much better at explaining what it really looked like but I don't have any on my phone! Lo siento.

The next part of our afternoon was my favorite - We went to a little Mayan village just past Antigua and were greeted by some lovely women. One was making tortillas and roasting coffee beans, the others were curiously watching us as we gathered in a group to sit and watch a weaving presentation. We were given a quick lesson in weaving... It sometimes takes these women a year to complete a blanket with detail. And then I started to feel guilty about bargaining them down from $20 to $15. A year to make one blanket?! And here I am trying to give them only fifteen dollars?! Ughhhhh I felt guilty. I still do and it's 2 days later! The women start to be trained as young as 7 years old - One of their projects is to make a shawl for their future mother-in-law. Sorry but at 7 years old I never thought about my unknown MOH. I was too busy happily eating McDonalds and watching the Chicago Bulls game to be weaving a masterpiece for someone I didn't know! #firstworldprobs

Once we finished weaving, we were able to make our tortillas! I was the first one to try and I started off with a bang. I dropped the dough almost immediately and the tortilla lady shot me a disappointed look and another ball of dough. I also ended up eating three tortillas instead of just the one that I'd made myself. She definitely thought I was a fat gringo as I dumped some salt on them and devoured them within seconds. (I was hungry, what!)

***

A few more days left and I'm already dreading packing.

Sam

Day 9

Day 9: Sunday, August 18th, 2013

Today, we woke up in the town of Panajachel, next to Lake Atitlan. I slept in, took a nice hot shower at Hotel Posada de Don Rodrigo, and enjoyed a delicious breakfast at the restaurant with a nice big cup of cafe con leche. A few of us walked around the town, doing a little shopping before we had to leave for Market Day in Chichicastenago. 

Chichi is about an hour drive from Panajachel - Cobblestone streets make the ride a bit bumpy, causing some of us to get a little motion sickness, especially me. I kept a nice little barf bag right next to me the whole time. I had to keep my eyes closed, because every time I looked around, I almost instantly became nauseated. So jealous of people who can read or journal on long car trips or airplaine rides. I took a few Dramamine to try and help with the mostion sickness, but it didn't help me very much unfortunately.

 After the drive, we made it to the market where we split up in pairs or small groups to do some serious shopping. Hammocks, necklaces, knives, backpacks, purses, and cigars were just a few of our purchases while there. We've all become experts at bargaining with the locals! After spending almost two hours at the market, we headed back to the bus for our long ride home, but stopped at a restaurant along the way. Outside the restaurant, a woman was selling fresh bags of strawberries and papaya. A man was playing an instrument on the steps of the restaurant, while children ran around the grounds playing games with each other. 

The drive home took about 4 hours, we caught up with a lot of traffic which only made the long drive, longer. More motion sickness, but not as bad this time surprisingly. Once we arrived home, our street was packed with people selling bracelets, food, shoes and other various items. It was nice to finally be in our own beds at home base. Funny how this feels like "home" now after just being in Guatemala for a little over a week. Once we all settled in for the night, we skyped and chatted with friends and family, then went to sleep for the evening. Tomorrow we start our last week here in Guatemala City, and volunteering at our sites bright and early. Cheers to a fabulous weekend and an even better week ahead of us!

Sam

Days 7 and 8

Day 7: Friday, August 16th, 2013

This morning we volunteered at our sites and worked with the hemodialysis patients. Sometimes I feel like we're more in the way rather than actually helping anyone. It's hard to interrupt the nurses and med techs routines, but i'm thankful that they have all been so accepting and helping us learn.

After volunteering, we headed home and had a delicious lunch, per usual. We were all enjoying some down time when we heard lots of music and singing in the street. We ran outside to see what was going on and saw about 100 children in a band, marching and playing their instruments. We all followed them around the block, taking pictures and videos. Some were dressed in school uniforms, and others dressed in shorts and t-shirts. It was amazing to see such a large group of children, marching the streets, and smiling for photos.

That afternoon, we went to a museum called Popl Vuh. We got a nice history lesson and saw so many  detailed clay pottery items and clothing from the indigenous people from many, many years ago. Once the short tour ended, we were able to make our own clay items! Mine turned out terrible, but I never claimed to be artistic! I had a rough time trying to mold it and keep it from breaking into two pieces. I'd post a picture of my "masterpiece" if I wasn't on an iPad! (It's way too much work, sorry.)

That evening, we had dinner at home base and then headed out for a few Gallo's at Taco Contento again, just down the street. There are a few other volunteers staying with us that are from Missouri and California - It was their last evening in town so one of them came out with us and we celebrated a bit. We paid 100 quetzals for a mariachi band to seranade us with three songs. They were dressed in traditional wardrobe and once they were done, we all cheered and tried to get them to play an encore with no success.

We walked home and headed right to bed.

***

Day 8: Saturday, August 17th, 2013

Saturday morning we woke up bright and early (5:30am) to drive to Panajachel, near Lago de Atitlan. Once we arrived, we hopped on a boat that was to take us to several little towns. The boat ride was bumpy and the ride to the towns was fine, but the ride home made me sick. The first town we stopped in was Santa Catalina, where weaving is the local trade. There were so many beautiful scarves, dresses, and blouses that it was hard to pass them up. I have been pretty good so far about not spending an insane amount of money. We stopped in a church and took some pictures and to hide from the rain that was coming down. It has rained every.single.day while we've been here! A few of the girls tried on a traditional Mayan wardrobe, and took pictures for a few quetzals. 

The next town we stopped in was San Antonio Palopa where their specialty is ceramics. It was raining even harder at this point and the boat ride to the next town was 35 minutes away. We tried to wait it out, but it kept on coming! We ran through the streets with our ponchos (or without them!) and hurried onto the boat to go to San Pedro where we had lunch. Out of the 10 of us on the trip, we've had several sprained or twisted ankles, lots of nausea from motion sickness or the food/drinks, and lots of exhaustion. As of right now, there are only 4 people who haven't had anything happen to them! Unfortunately, I am not one of those 4. :(

It continued to rain, but we had to get back on the bus and just tough it out. The ride back to Panajachel was LONGGGG. We all ran off the boat in the pouring rain and got soaked, stomping through puddles and trying to find the road that took us to our hotel. When we got back, it was sooo nice to see my bag of clean laundry that had just been washed by the hotel staff. It was DRY, warm and smelled so good. I'll never take for granted my washer and dryer EVER again.

That night, we searched for a restaurant for Tracy to eat at since she hadn't had much all day. We met up with a few of the others and had a couple drinks at a jamaican-style bar - Our bartender was born in Guatemala, but his mother was American/father was Guatemalan. He had lived in Austin, Texas for many years and then moved back to Guatemala. He said he would "NEVER" move back to the states. He is the second person to tell me that people in America "live to work" and do not enjoy life the way that we should. I agree. We live our lives in such a routine! Working 8 to 5, coming home to dinner, resting, sleeping, then waking up to do it all over again! C'est la vie.

That's all I got for now!
Sam

Days 5 and 6

What's the number one thing I miss the most about home? 

Reliable wifi...

...and my chicken noodle soup. 

Due to technical difficulties, blogging has been put on hold. If all 10 of us use the internet at once, it crashes and doesn't come back until the next morning when Virginia, the volunteer coordinator, comes and resets it. By the time she gets here, all of us are already at our volunteer sites and once we're done, we aren't supposed to use the wifi until after 5pm. Rough life... I know. I'm sure I am sounding like a spoiled American right now.



Day 5: August 14th, 2013

We started the day with a delicious, traditional breakfast and then headed to our clinical site. Karyn and I are now working with hemodialsis patients at UNAERC. Dialysis lasts anywhere between 3.5 to 4 hours. The patients range in age from roughly ages 12 to elderly. We've lucked out with the dialysis technician that we follow - He's extremely patient with my broken Spanish and he enjoys practicing his English with us as well. 

After volunteering, we arrived back at home base around 1pm, had lunch, then made an impromptu decision to stay over night in Antigua - The original plan was to go there, come back the same night, then leave early the next morning to go back again. Our hotel in Antigua was a-maz-ing. We had a gorgeous view of a volcano and the town is so much prettier than Guatemala City. We took a tour of a local coffee plantation and got to taste-test some yummy, medium-roast coffee. There was a shop afterwards where I immediately bought TONS of coffee beans, hot chocolate, and a few other souveniers for some lucky friends back home. 

That night, we went to dinner at a nice restaurant as a group - Tons of sangria, whiskey, cuba libres, and other various beverages, along with a huge meal, it cost me a whole $15.00. We visited a hostel and had a drink at the hostel club, followed by another round at Reilly's, an Irish Pub in Antigua. It was a fun evening, and I really am fortunate to be with such a fab group of ladies here.

Day 6: August 15th, 2013

Happy birthday to my main squeeze! He's 30 years old today.  <3

Today we visited Volcano Pacaya, just outside of Antigua. I rode a horse up and down the volcano in the rain. If you know me, you know that i'm not much of an outdoor person... Especially when it's raining! I'd forgotten my poncho back at the home base, but "fortunately" a few little children were selling "ponchos" just outside the office - I paid 5 quetzales, less than $1.00, for a "poncho", but after getting back on the bus to hide from the rain and opening the "poncho", I quickly found out that it was not a poncho, but just a sheet of plastic with no head hole! I had been ripped off. Those little stinkers were no where to be found! I don't think people here are big on return policies. (At least it was cheap!) Once we made it to the top of the volcano, we walked around on the volcanic rock and roasted marshmallow's in some of the lava vents. WHAT?! So unbelievable. I got to sit in a volcano sauna pit and warm up a bit before heading back down. Once we reached the bottom, we had a few Gallo's (a popular beer) and got back in our tour bus for the ride back to our hotel. Not 10 minutes after we left, the volcano had it's first eruption in 3 years. So bummed we had to miss that! What are the chances of that happening the day that we're there!?

Afterwards, we hopped back on the bus to head back to Guatemala City. Saying I was exhausted would be a HUGE understatement. My hot shower in the trickling water was amazing. No mas lluvia for this indoor cat!

That's all for now!

Day 4

*This post was written by myself and Karyn, my partner at our volunteer site.*

 

 (From left to right: Shelly, Sam, Brittany, Sara, Shea, Shannon, Amy, Serena)

Hola from Guatemala!

This post is being written by Sam and Karyn. We are identifying ourselves because we were the only pair that wasn't together during our first day of volunteering at a local renal clinic. We decided it would be best to be paired together versus in separate areas due to ones lack of Spanish, and the others lack of content. We spent part of the evening before working on our Spanish - It took us quite awhile to translate a paragraph stating that we wished to work together. Voila! It worked. I guess our español ain't so bad!

We are in the peritoneal dialysis (PD) clinic, treating seven patients with ESRD, or End Stage Renal Disease. Our day began with introducing ourselves to the patients, and getting familiar with the PD process. The patients ranged in ages from 16 up to elderly, and all were diabetic except for one. All of them appeared incredibly exhausted, but grateful to have the care they are receiving at the clinic. Each patient has a stoma, or an opening that enters into the peritoneal cavity to be the place where the exchange of vascular toxins come out of their bodies - This is typically what your kidneys do. The process is a little confusing at first, but once we came up with a descriptive word for each step in the process, we got the hang of it! Below is our personalized way of starting and disconnecting the drainage system.

Start Drainage: 

• Grab clamp
• Grab tubing
• Ring - Finger
• Remove tubing
• Drop bag
• Break green
• Place clamp
• Remove tip and drop
• Connect tubing
• Open tubing
• Cover connection

Disconnect Drainage:

• Cap
• Close connection
• Finger
• Drop bag
• Open cap packet
• Grab cap - Keep sterile
• Disconnect and keep in hand 
• Rapidly connect
• Release blue clip
• Tie bag and leave with patient
• Put clip in cleaning solution

When we had to disconnect the tubing, we were to keep that tubing in our hand. Karyn (on day one) forgot, and dropped the tubing so she picked it up. This meant her hands were no longer sterile, and Roxanna, the nurse, immediately corrected Karyn. Karyn, not knowing Spanish well, and being embarrassed in front of the patients, slapped her hand and said "BAD Karyn!" The patients all laughed and it eased the moment. The next day, Sam did the exact same thing. Sometimes we learn from others mistakes, and sometimes we have to make the mistakes ourselves. Moral of the story: Sam and Karyn need to make their own mistakes in order to learn.

 

(From left to right: Karyn, Roxanna, Sam)

Karyn and Sam have found that they work great together: With Karyn's knowledge of the PD process, and Sam's Spanish speaking skills, we are a nice team along with Roxanna. 

Culture that we noticed was how big of a role the family takes in caring for the patient. Whether it be a spouse, son or daughter, extended family or a good family friend, there was always someone there to help them through the treatment. One patient had an infection and was going to be admitted to the hospital - Her spouse and daughter were there to transport her, get her admitted, and be there for support. It's amazing the amount of time and energy that these family members put into this. 

After our volunteering site, we came back to our home base to enjoy an authentic Guatemalan meal - Chicken, rice and corn on the cob. Next was a Spanish lesson followed by a history lesson of Guatemala.  Both were received well and the history lesson was powerful. As human beings we just don't treat each other well... Greed is an awful characteristic of human nature. 

Our evening was relaxing and most of us laid low. Our previous days have been full and exhausting, so a little down time was necessary! 

Signing off for now - Buenas noches!

Days 2 and 3

Days 2 and 3:



Note: Yesterday's blog post didn't happen due to a small problem with our wifi here at home base. #thirdworldprobs

I didn't sleep well the first night, mostly due to drinking an energy drink at the airport, and partially due to my lumpy pillow. Last night, however, I fell asleep at 9pm and slept a solid ten hours. I had my first Guatemalan shower experience - They are electric showers, where you control the heat of the water directly at the showerhead. Basically, there's a heating element that heats the water as it flows through the showerhead. The more water pressure, the colder it gets. So I took a 5 minute shower in trickling warm water, that eventually turned to scalding hot water, and back to luke warm all in a matter of 5 seconds. That was a nice little experience.

Yesterday, Brittany (a fellow volunteer) and I went to a festival down the street. We people watched, ate some churros, drank some orange soda and took a few pictures. In Guatemala, they celebrate the Catholic holiday of the Assumption of Mary. The actual holiday is on August 15th, but they prepare for it a few days before and it lasts one week. There's music, good food, and carnival rides for the kiddos.

Today was our first day of volunteering! Two words: CULTURE. SHOCK. I was surrounded by patients, enfermeras (nurses) and doctors. Only one person, a doctor, spoke english. I was immediately separated from my partner, Karyn, and taken a few blocks away to a small dialysis clinic to help repare patients for treatment. It was easily the hardest thing i've done. The healthcare system is SO different, I can't even begin to explain! People wait for hours and hours just to talk to a nurse for 2 minutes. I saw people re-using needles, not wearing gloves, or washing their hands after treatments... definitely something you'd never see in U.S. hospitals. It's not that I didn't enjoy it, it's more that I just felt a little stupid that I didn't know more spanish and wasn't more helpful. Oh well, tomorrow's another day! 

 After volunteering, we took a city tour on a bus. It wasn't your typical tour where you're usually taken to historical sites, it was a tour of the slums, the city dump, and a national cemetery. The dump was insane... TONS of people digging through trash, others going through things to recycle. It resembled an ant hole because of how many people were down there! It's crazy to think that people live this way and it really makes you realize how lucky we are.

On that note, i'm tired and need my sleep! Buenas noches!

We Made it to Guate!

After almost 12 hours of traveling... WE MADE IT TO GUATEMALA!

We flew from Madison to Dallas, then Dallas to Guatemala City.
Our flights were on time and the the turbulence was minimal... I still had to pop a Zofran because i'm a baby and can't handle the tiniest bit of nausea. 

In Dallas, we ate as a group at TGI Fridays, had a few cocktails and talked about what we had planned for the next two weeks. All of us are getting along great and i'm excited to have these girls by my side!

Once we landed in Guatemala City, we picked up our luggage and headed to customs. I had to show my passport to a woman in order to pass through the gate... she kept saying "medico? medico?" I didn't know what she meant and just assumed she was asking me if I worked in the medical field so I said "si". Apparently she was asking me if I was a doctor. And I said yes. 

***

As we drove from the airport to our "home base", I realized this country is nothing like i'd pictured... We asked our driver, Henry, to play his favorite music, and suddenly "Truly Madly Deeply" by Savage Garden was playing. There's either a McDonalds, Wendy's, Domino's, Burger King or a Pizza Hut on every corner - And I thought i'd have to live off of beans, rice and tortillas for two weeks, HA! I learned that "night clubs" are actually strip clubs, and that we aren't allowed to flush toilet paper down the toilet (it goes in the garbage can).

For now, i'm comfortably laying in my bunk bed, listening to dogs barking in the distance, and seeing the red and green lights coming from the police motorcycles down the road.

....signing off for the evening,

Sam Thomas, MD