02 March 2008

Jornada

jornada: n. 1: A day trip 2: a day's work

While on Tuesday, March 3, classes were cancelled at Liceo de St. Sergio, it was teeming with students and parents. Why? Fifty American doctors had arrived in a medical jornada, or travelling medical group, from a hospital in Michigan for a week in Guatemala to treat their illnesses, hand out vitamins, and offer a free pharmacy for the day. I had volunteered to translate.
Upon arriving to the school, it was pulsing with by chaos. It’s not that I haven’t visited events where hundreds of barely supervised children, wandering indifferent adults, and crying babies bewilders my audible, visual, and olfactory senses – but there were gringos, and hundreds of them. The crinkled brows and tight frowns all seemed to show the collective thought, “there’s no order here.” The insanity of an ER still holds no candle to a Guatemalan school.
As I began to approach a huddle of concerned-looking gringos, a Guatemalan doctor who I know entreated me to explain to a white giant in scrubs that the patients had already been triaged. I smugly explained the situation to the doctor, who then asked me if it had been by doctors of nurses. That was when my superior smile fell of my face. I realized that I had no idea what triage was. Their navigation through Guatemalan language and culture was no murkier than the fog of bilingual medical jargon I had signed up for.
A resident who was exhibiting the symptoms archetypal of a failed attempt to live without caffeine tried to gather the handful of translators at the center of the basketball court (read cement soccer field). As the ten or twelve of us, surrounded by 400 impatient patients and 50 beleaguered medical professionals, were assigned one per room of three doctors. I volunteered for a pediatric room.
Luckily, my room included one doctor with excellent Spanish and one that knew body parts. All morning, we treated children from the school. It felt like we were treating three students over and over. In the dozens of children treated, nine out of ten followed three different patterns: no hunger and vomiting food (stomach parasites), no hunger and exhaustion (vitamin deficiency), or legs that hurt at night (bowlegs due to malnutrition as infant). Most of them also had compacted earwax (from not cleaning their ears), causing hearing problems or ear pain. Treatment? Stomach infections got antibiotics, compacted earwax got warm water washes in the ear, almost everyone got vitamins and was told to up clean water intake Any indigenous woman complaining of hunger or stomach problems was told to loosen their faja (belt), which was preventing stomach growth.
During the afternoon, I went to work in general medicine (located in the third grade classrooms). Many of the parents I saw in the morning were now treating their own health problems. If pediatrics was dominated by malnutrition and stomach viruses, general practice was dominated by neglect. One of the questions I always had to ask was how long the symptoms had been going on, and the answers were often unbelievable – poor hearing that had been unchecked since birth, urinary tract infections that had spread to the kidneys over three years, ten years without checking to see if shooting pains were nerves or a heart condition.

Through the day, I learned more and more medical terms: NSAIDS, H/A's, Hg, among others. The day was incredibly rewarding: people walk in with a problem, walk out with a bottle and a belief their problem is solved. However, I became more and more aware of snags in the long-term: not explaining what medications were, so people couldn't buy them once they ran out. We told women with babies to stop carrying them on their back, diabetics to stop eating so much sugar, and women to wear looser belts. We didn't however, explain how to carry a baby right, wear a skirt without it falling down or altering your digestive tract, or how to purify water to avoid getting stomach parasites.

Although I felt warm and fuzzy about the day, it really demonstrated to me the importance of long-term work in development. While these doctors provided an invaluable service of charity, they weren't working in development. Solving a systemic problem can't be done in a single day's work.

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