After breakfast at the hotel, we returned to San Antonio, Tacaná for a morning of patients and an afternoon with Rachael Shenyo from USAID. After all the times I’ve been in Guatemala, this is the first time I’ve been in the town of Tacaná. There is a municipality of Tacaná, and the capital that has a main street with shops, a hotel and a few restaurants. Then there’s the village of San Antonio that I have been calling Tacaná. In fairness to my confusion, San Antonio has no real center and its inhabitants are spread over a wide area on the mountaintop in the municipality of Tacaná. Anyway, for simplicity’s sake, I will likely continue to refer to it as Tacaná. When Rachael told me she would take a Taxi to the town center and then call Luis to pick her up, I emailed back that we would probably see her since the town was so small. Later, when I found out there was an actual town in addition to the village, I realized my mistake.
The morning was busy as we had put up a sign with the half-day hours. The first patient was a 13 year old girl who had come by herself from a village three hours away. She was a soccer player and wanted to know what to do to prevent the muscle cramps that she got toward the end of games and at night. She was very earnest and paid close attention to the discussion of dehydration, pre, during and post -game water intake, and the role of salt in the form of a few crackers. She was very self-possessed – impressive. I saw a mother with two year old twin girls and a three month old baby boy. The girls were in her arms, screaming from the moment she entered the room; the boy slept, wrapped on her back the whole time. As I examined the girls on her lap, they cried and squirmed and kicked and pushed my hands away. Bette and I did our best to keep them from landing on the floor, and the mother smiled and kept a great sense of humor through the whole ordeal. Even when I had finished and moved away, the girls continued to cry and kick. Another woman from the village finally came in and took one of the girls to the waiting area where she continued to scream. Bette took a short video that I will post if Picasa lets me.
Though most of the kids I see in the remote villages come in their usual clothes, often their only clothes or one of two sets, occasionally I’ll see a freshly washed and combed child in what is clearly their “Sunday” outfit. I saw a brother and sister today whose mother had obviously washed and dressed them for the visit. The kids were four and six years old and were so proud of how they looked. They beamed when I commented on how pretty and handsome they looked, patting their hair and smoothing their clothes. The boy, who was four, told me he had new underpants, (ropa interior,) too, undoing his belt and pulling down his trousers to show me. His sister was torn between being mortified and wanting to show off her new undies as well. I asked if she had new underwear and when she nodded I said maybe she could show me when I was checking her. It all worked out. She sneaked up the edge of her dress to show me while Mom made sure her brother wasn’t peaking; modesty preserved.
Rachael arrived around 11:30 with a man named Bryan who is here with his wife for four years. They are from the Presbyterian Church Women’s Project and are supporting various women’s empowerment programs in Guatemala. He came along to see how the women in these villages were being treated. Domestic violence is a huge problem in Guatemala. It varies widely from region to region; I haven’t seen it where I’ve been. However, in some areas, the women are completely dominated by the men, and it’s not uncommon to see men beating their wives on the streets. One of the Cuban doctors worked in Comitancillo where the women didn’t speak at their medical appointments. Instead, the husband or brother or other male relative accompanying them did all the talking. They were not allowed to undress for the examination, and no gyn exams were allowed. Bryan’s wife is working with various groups and Bryan is working with some men’s groups trying to change their perceptions of women. He said it is very slow hard work.
We finished seeing patients around 1:00 and started off on a tour of the newly completed irrigation project. Nearly every family has a spigot on the top of a pipe near their house. They attach a hose to the spigot and the hose runs to another pipe that has a large spray unit on top. They can place this pipe wherever they have planted a garden. We saw multiple irrigated gardens with carrots, ayote, beans, broccoli, cauliflower and other vegetables native to Guatemala. Rachael gave suggestions about adding ground cover to retain the water, and discussed ways to combine some of the plants to maximize growth. Six months ago there were no animals in Tacaná, it was quiet. Now you hear the voices of sheep, goats, geese, chickens, cows, turkeys and pigs all over the village. Rachael has a degree in animal husbandry and spoke with some of the villagers about vaccination programs and ways to improve the care of the animals. Both she and Bryan were blown away by what they saw, both by the gardens and produce and by the energy and enthusiasm of the people. Rachael gave many suggestions for programs and people to connect with including a non-profit she’s involved with outside of USAID. Luis was very pleased and encouraged. Rachael will write up a report of her visit to send to the central office and assured us that it will be very positive. She is not in any decision-making positions, but I think her opinion will carry some weight.
After seeing the gardens at Tacaná, we drove to the nacimiento for a “quick look.” There has been a complete transformation of the spring and tanks. They are full, clean and painted white. The filtration system has been installed and is running smoothly. Rachael inspected every aspect and was amazed that the villagers had done all the technical work themselves. As we were getting ready to leave for Sibinal, Noe, the project leader at Tacaná called everyone together and made a lengthy speech of thanks to Bette, Luis and me for initiating and providing funds for the projects. We were each presented with a gift and then each had to make a short speech. It was a very moving ceremony, and I was deeply touched. The only problem was that it lasted until 3:00 pm and we still needed to show Rachael the Sibinal project and try to get her and Bryan back to San Marcos in time for the last bus to Xela.
In Sibinal, we toured the gardens and saw the roses in the greenhouse, all of which required hiking down a long, somewhat treacherous path. By the time we had climbed back up to the car, we were all lightheaded, having last eaten at 7:00am. Rachael and Bryan had left Xela by bus for San Marcos very early and then completed the journey to Tacaná by taxi. They had expected lunch on arrival in Tacaná so they also were in need of food. Since the time was now very short, we elected to forego a restaurant lunch, instead stopping at a tiny shop for crackers, chips, yogurt and bread. Rachael bravely opted for fried chicken from the street vendor outside, but then she lives here. We managed to make it to San Marcos just as the Xela bus was pulling out – mission accomplished. Bette and I, unwilling to face sitting in a restaurant, got ‘Cup of Noodles’ and yogurt from the store by our hotel. I’ve been posting photos on Picasa and will soon head to bed. Tomorrow, Luis’s wife, Bella who works as the receptionist in the Policlínica, has booked 50 patients for me to see!
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