La Tierra y La Conmadrona
I've been really busy this week, and haven't had a lot of time to write on the blog. I've started volunteering in the clinic, where I help triage, and have also been shadowing an indiginous midwife who works in the outskirts of Xela outside of a town called San Juan Chamelco. Her name is Dona Ana, and she has delivered 12,000 babies at her house since 1996. All of her patients are poor indiginous women. Dona Ana is a force to say the least. She never sleeps, and when I met her on monday, she had delivered 3 babies the night before in her house, while she saw dozens of women during the day. In Guatemala, midwives don't just deliver babies, but also prescribe medications and perform the role of doctor. In the rural areas, there are no doctors or hospitals that are within reach, and the midwife is one of the only sources of medical care.
Dona Ana perscribes a mixture of western and traditional medicines and is highly competent considering the circumstances. She really is amazing.
As I take the bus from the polluted smog filled air of Xela to Aldea Buena Vista where she lives, the landscape tranforms into heavily deforested land. Whole bunches of pine trees are dead, presumably from some kind of pine beatle courtesy of global warming. The few trees that are left that line the valleys are sickly and lonely, waiting for their final days before they are chopped down for firewood by locals. 80% of arable land in Guatemala is owned by 24 families. Land is expensive to the poor, and the little that they have, they build on or cultivate for food. Sides of hills are scarred with landslides that people attempted to cultivate. This does not bode well for the forests, and it is safe to say that the majority of rainforests in Guatemala are going, going, or are gone. To make matters worse, cars are shipped from the US that would never pass a smog test in a million years, so they are sent down here at twice the cost, to belch black smoke and acid rain into the air. The air quality is lousy, and when the rains come in the afternoon, it is a welcome relief as it washes the soot away.
The land in Guatemala to Dona Ana's house looks like a sad neglected dog with mange, who no one really cares about. Dogs run across the road, dodging crazy drivers. Most make it, but some casualties line the road. It makes me think of the precarious nature of life in the third world. Poor people here are like dogs trying to cross the street before a car hits them. No one really slows down to let them cross as they desperately try to cross. It's purely a game of chance if you survive. Small children perform juggling acts for drivers on the streets for a quetzal. This is life in the third world.
A young woman had a baby last night at Dona Ana´s house. It was premature. When I arrived at Dona Ana's, her family was sitting around her in a bed just outside the waiting room. There are bunks next to the waiting room where women can rest after a birth. Later, Dona Ana spoke to her in her native language, and helped her relieve some of the fluid in her pelvis by having her squat over a bowl. We changed her bloody sheets while Dona Ana gave her antiseptic for a tear that happened during the birth. The walls were lined with mold, and during all of this, there was a minor earthquake as the single lightbulb flickered precariously as it was about to go out. Dona Ana didn´t blink.....I asked her if she ever rested, and she said who has time to rest when there are so many patients to see?
She let me feel the head in the mother's stomach during each prenatal exam. All of the women looked like they were about 15, this being a common age for new mothers in rural Guatemala. Indiginous women can have anywhere between 5 and 8 children. I met one woman at the clinic on Tuesday who had 14. Some of the women had potential breach babies at 8 months, and Dona Ana would move the baby around with her hand to move them in the right position. This woman really knew what she was doing. She would ask me, "Do you feel the head?", as she would place my hand on the woman´s pelvis. And I would say, yeah! And she would say "No, it's the foot!". I finally got the hang of finding the head when she would ask me "How many months and weeks?" and I would say "seven". She would say "no, it's 8 and one week!". She could tell how old the fetus was by feeling the stomach for half a minute!
She finally took a short break, and sat in her courtyard in the sun. Her son is a healthy looking 16 year old who wears western clothes, while Dona Ana wears traditional clothing, and has a hat that says "Nike" on it. He wears his new jeans low, like a hip hopper in the US. Midwifery is solely a women´s domain in this country. Men are not allowed in during exams or birth, and many local women work at Dona Ana´s home as her assistant. Considering many indiginous women are treated as second class citizens in Guatemala, it´s quite amazing to see this commaraderie. Dona Ana is building an extension to her house, and provides well for her family. She's not rich, but she also isn't poor. She charges her patients, and the medicines are really really expensive because, as in all of Guatemala, the pharmeceuticals make money. I was shocked to find out Ibuprofin cost $14 for 50 capsules. Considering many people make less than $1 a day, that´s a fortune. A pharmeceutical representative just happened to pay us a visit as we were seeing patients. He had nice clothes, a nice new cell phone, and was probably just trying to provide for his family like anyone else. I asked him what company he worked for. He worked on commission. It was all in a day´s work. Selling medications in bulk that would later be paid by a poor peasant who may or may not be able to save their child´s life with an antibiotic...
After a crazy night and morning, Dona Ana relaxed in the sun as she put her sweater on her head to cover her face from the rays, as all the Maya women do. Her grandmother sat and weaved some cloth in the courtyard. She was missing an eye and told me she couldn't see very well. She was probably 70 or 80 years old. Dona Ana's son put his white baseball cap on the stairs, and the most amazing butterfly sat on it, as if it was looking for food. It probably thought the white cap was a flower. I stared at if for atleast 5 minutes and it just kind of sat there, touching the cap with it´s long, tentacle tongue. I have never seen a butterfly with silver wings before, and I tried to show the old woman, but I don't think she could see it, or navigate my terrible Spanish as I tried to explain. It made me think of the contradiction of that moment, of the old ways and the new, of traditional Guatemala, and the exploited, globalized Guatemala... of the disappearing forests and the lonely loss of that butterfly´s existance.
Another woman came in later who was carrying a large child on her back. The woman seemed very upset, and the girl, who was about 5 years old, was listless. Dona Ana diagnosed her as having parasites, and gave her some medication. The cost of the medications for this woman, who barely had shoes on her feet, was $10. She gave Dona Ana all her money. When the child was outside about to go home, she threw up most of the medication.
Child mortality in this country is through the roof, and this girl obviously needed to get to a hospital. I felt really in an awkward situation as I am not a doctor, and Dona Ana has a lot of experience. Also, the mother of this child has no money and is miles from a Hospital. She walked away from Dona Ana´s house before I could interrupt Dona Ana´s exam of another patient. I don´t honestly know if that little girl is going to make it...
I am hoping that the medical brigades that are coming next week will be stopping near Dona Ana´s village. But as in all of Guatemala, with its 13,000,000 people, there is a huge need for qualified medical personnel. It feels overwhelming for someone with no current qualifications, but a deep desire to help. It´s a somewhat painful position to be in.
I brought Dona Ana some Ibuprofin from the city, as I felt that was the least I could do....
Anyway, that´s all for now. Studies are going well, though I need more time here if I am really going to know Spanish well. I hope to return some summer during or after nursing school when I have more medical training. I really love the people here.
Dona Ana perscribes a mixture of western and traditional medicines and is highly competent considering the circumstances. She really is amazing.
As I take the bus from the polluted smog filled air of Xela to Aldea Buena Vista where she lives, the landscape tranforms into heavily deforested land. Whole bunches of pine trees are dead, presumably from some kind of pine beatle courtesy of global warming. The few trees that are left that line the valleys are sickly and lonely, waiting for their final days before they are chopped down for firewood by locals. 80% of arable land in Guatemala is owned by 24 families. Land is expensive to the poor, and the little that they have, they build on or cultivate for food. Sides of hills are scarred with landslides that people attempted to cultivate. This does not bode well for the forests, and it is safe to say that the majority of rainforests in Guatemala are going, going, or are gone. To make matters worse, cars are shipped from the US that would never pass a smog test in a million years, so they are sent down here at twice the cost, to belch black smoke and acid rain into the air. The air quality is lousy, and when the rains come in the afternoon, it is a welcome relief as it washes the soot away.
The land in Guatemala to Dona Ana's house looks like a sad neglected dog with mange, who no one really cares about. Dogs run across the road, dodging crazy drivers. Most make it, but some casualties line the road. It makes me think of the precarious nature of life in the third world. Poor people here are like dogs trying to cross the street before a car hits them. No one really slows down to let them cross as they desperately try to cross. It's purely a game of chance if you survive. Small children perform juggling acts for drivers on the streets for a quetzal. This is life in the third world.
A young woman had a baby last night at Dona Ana´s house. It was premature. When I arrived at Dona Ana's, her family was sitting around her in a bed just outside the waiting room. There are bunks next to the waiting room where women can rest after a birth. Later, Dona Ana spoke to her in her native language, and helped her relieve some of the fluid in her pelvis by having her squat over a bowl. We changed her bloody sheets while Dona Ana gave her antiseptic for a tear that happened during the birth. The walls were lined with mold, and during all of this, there was a minor earthquake as the single lightbulb flickered precariously as it was about to go out. Dona Ana didn´t blink.....I asked her if she ever rested, and she said who has time to rest when there are so many patients to see?
She let me feel the head in the mother's stomach during each prenatal exam. All of the women looked like they were about 15, this being a common age for new mothers in rural Guatemala. Indiginous women can have anywhere between 5 and 8 children. I met one woman at the clinic on Tuesday who had 14. Some of the women had potential breach babies at 8 months, and Dona Ana would move the baby around with her hand to move them in the right position. This woman really knew what she was doing. She would ask me, "Do you feel the head?", as she would place my hand on the woman´s pelvis. And I would say, yeah! And she would say "No, it's the foot!". I finally got the hang of finding the head when she would ask me "How many months and weeks?" and I would say "seven". She would say "no, it's 8 and one week!". She could tell how old the fetus was by feeling the stomach for half a minute!
She finally took a short break, and sat in her courtyard in the sun. Her son is a healthy looking 16 year old who wears western clothes, while Dona Ana wears traditional clothing, and has a hat that says "Nike" on it. He wears his new jeans low, like a hip hopper in the US. Midwifery is solely a women´s domain in this country. Men are not allowed in during exams or birth, and many local women work at Dona Ana´s home as her assistant. Considering many indiginous women are treated as second class citizens in Guatemala, it´s quite amazing to see this commaraderie. Dona Ana is building an extension to her house, and provides well for her family. She's not rich, but she also isn't poor. She charges her patients, and the medicines are really really expensive because, as in all of Guatemala, the pharmeceuticals make money. I was shocked to find out Ibuprofin cost $14 for 50 capsules. Considering many people make less than $1 a day, that´s a fortune. A pharmeceutical representative just happened to pay us a visit as we were seeing patients. He had nice clothes, a nice new cell phone, and was probably just trying to provide for his family like anyone else. I asked him what company he worked for. He worked on commission. It was all in a day´s work. Selling medications in bulk that would later be paid by a poor peasant who may or may not be able to save their child´s life with an antibiotic...
After a crazy night and morning, Dona Ana relaxed in the sun as she put her sweater on her head to cover her face from the rays, as all the Maya women do. Her grandmother sat and weaved some cloth in the courtyard. She was missing an eye and told me she couldn't see very well. She was probably 70 or 80 years old. Dona Ana's son put his white baseball cap on the stairs, and the most amazing butterfly sat on it, as if it was looking for food. It probably thought the white cap was a flower. I stared at if for atleast 5 minutes and it just kind of sat there, touching the cap with it´s long, tentacle tongue. I have never seen a butterfly with silver wings before, and I tried to show the old woman, but I don't think she could see it, or navigate my terrible Spanish as I tried to explain. It made me think of the contradiction of that moment, of the old ways and the new, of traditional Guatemala, and the exploited, globalized Guatemala... of the disappearing forests and the lonely loss of that butterfly´s existance.
Another woman came in later who was carrying a large child on her back. The woman seemed very upset, and the girl, who was about 5 years old, was listless. Dona Ana diagnosed her as having parasites, and gave her some medication. The cost of the medications for this woman, who barely had shoes on her feet, was $10. She gave Dona Ana all her money. When the child was outside about to go home, she threw up most of the medication.
Child mortality in this country is through the roof, and this girl obviously needed to get to a hospital. I felt really in an awkward situation as I am not a doctor, and Dona Ana has a lot of experience. Also, the mother of this child has no money and is miles from a Hospital. She walked away from Dona Ana´s house before I could interrupt Dona Ana´s exam of another patient. I don´t honestly know if that little girl is going to make it...
I am hoping that the medical brigades that are coming next week will be stopping near Dona Ana´s village. But as in all of Guatemala, with its 13,000,000 people, there is a huge need for qualified medical personnel. It feels overwhelming for someone with no current qualifications, but a deep desire to help. It´s a somewhat painful position to be in.
I brought Dona Ana some Ibuprofin from the city, as I felt that was the least I could do....
Anyway, that´s all for now. Studies are going well, though I need more time here if I am really going to know Spanish well. I hope to return some summer during or after nursing school when I have more medical training. I really love the people here.
posted by Mr. Sophie at 6:28 PM
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