Tuesday, January 20, 2009

Home Safe

I’m just starting to realize that my latest adventure is over. It's back to cold Wisconsin and work/school. It was completely chance that Eva and I picked Guatemala for this trip – a combination of cheap airfare and a favorable exchange rate, plus the opportunity for me to work in the clinic in Santiago Atitlán. Retrospectively, we couldn't have picked a more perfect place to visit. The people we have met have all been incredibly gracious and hospitable and the fellow travelers we’ve encountered along the way kept things interesting! With the strong heritage of the indigenous people and Mayan culture, combined with the atmosphere of the cities such as Antigua and Guatemala City, and a little beach time in Monterrico, the trip has been the perfect balance of education and relaxation.

It’s funny how our first night in Hotel el Aeropuerto led to so many other adventures. I only hope that I can return a bit of the kindness Ricardo has shown Erich, Eva and I by encouraging others to check out his hotel in Guatemala City and Tabacos y Vinos Shop in Antigua.

Saturday, January 17, 2009

The Last Few Days

The last leg of our trip from Santiago to Panajachel to Antigua to Guatemala City stretched out over two days and was much more relaxing that I expected. It was fun to show Erich some of my favorite restaurants and sites in the cities that I have grown to love over the past three weeks.

Antigua is by far my favorite city in Guatemala and I was happy to be there for one last day and night before we left. While walking around the city, we came across an unmarked shop selling coffee and chocolate.

The owner, who processes everything by hand in small batches was taking a well-deserved rest:

We also found a small place selling pupusas. Pupusas are made by stuffing corn tortillas with cheese and your choice of ingredients. I chose chicken, sweet peppers, and olives for mine. The pupusas were delicious and filling!

We stopped by Tabacos y Vinos to see Ricardo and enjoy one some wine and some delicious espresso.

Ricardo was even nice enough to take us back to Guatemala City on Friday night before our Saturday flight back to Wisconsin. We dropped our bags off at his hotel and then headed out to see Zona 4 where many of the nicer restaurants and bars are located. I had mentioned my love of fondue (which I’ve managed to enjoy three times while in Guatemala!) so we ended up having meat fondue and chocolate fondue for dessert.

We also enjoyed an “obscuro” or dark, Guatemalan beer called Moza that Ricardo assured me was not favored by the locals who drink a lot more lager. Erich and I split the beer, which came in a very strange tall glass:

It was nice to enjoy a stout again, even though it was nothing close to my favorite – Guinness!

One thing I'm definitely going to miss seeing the "Chicken Buses" barreling down the streets that take the locals from one city to another and all over Guatemala City.

I’m writing this entry on our last flight of the trip, Miami to Chicago where we managed to get upgraded to first class, whoo! It was a nice surprise and almost helps me forget that we’ll be spending the night in the airport tonight as our flight is too late to catch the last bus to Madison. We’ll be on the road back home on the 6:00 AM bus after spending the night on a bench near the baggage claim at O’Hare. Ah, luxury….

Thursday, January 15, 2009

Santiago Atitlán, Part II

Despite the initial confusion upon my arrival at Hospitalito Atitlán, I have actually been learning quite a bit about healthcare in Guatemala and seeing more than I ever could have hoped. Because I am not tied to the Hospitalito, I've been able to visit two additional clinics in Santiago to learn about their approach to healthcare. I've been specifically focusing on perinatal care and the role of the comodrona (midwife) in the birthing process. Two midwifes from the United States, Rebecca and Karen (who is coincidentally from Wisconsin as well) and I have been talking to a variety of nurses, midwives, and administrative people to learn all we can about options that are available for the local women.

The staff at all the clinics have been incredibly gracious and candid and even allowed me to take some photos and have access to data such as number of births and causes of infant mortality that are collected by the government.

The government runs a clinic that is free to all of the local people. Even though most women (I've heard about 90%) prefer to give birth at home, some chose to give birth at the clinic due to complications or nervousness. The clinic sees about 6-13 births a month but has no capacity for cesareans or anesthesia if complications occur. These cases are taken by ambulance to the town of Solola. Hospitalito, on the other hand does have the capacity to do surgery, provided there is a doctor visiting who can perform it but there is a charge for all services provided since it is private.
The birthing "suite":

Hospitalito Atitlán is currently housed in a former backpacker hostel because the old one was destroyed by a mudslide in 2005.

A new one is currently under construction. We checked out the site and even though it is still two years from completion, we can tell it will be a big upgrade from the current facilities!

We also caught a funeral on our walks between clinics. One of the women told us that in general, the local people are buried in a plot of land and then once their body has decomposed the bones are dug up so the plot can be used again. The bones are then piled neatly by a cross honoring the deceased person.

The main method of transport here, other than tuk tuk, is hopping onto the back of a pickup truck with rails to help you stand upright!

It hasn't been all work though! We joined some of the medical students and other volunteers from the clinic for appetizers and some dessert at Las Posadas one night:

El ataque del corazon (the heart attack):

Luckily, we survived!

And of course, the promised pictures of our wonderful casita!

We can even see the Hospitalito from our balcony!

Monday, January 12, 2009

Santiago Atitlán

Erich's shuttle came in safely to Pana on Friday morning. Eva and I said our goodbyes and Erich and I caught a boat to Santiago Atitlán. We chose a cheaper boat, saving ourselves 5Q ($.75) each but little did we know this was the slow local boat that waited until it had enough passengers (50 minutes) and then plugged along at a glacial pace across the lake (another 70 minutes). Next time, we'll pony up the extra $1.50.

By the time we arrived at Hospitalito Atitlán, the administrative staff had gone for the day so there was no one to help us with accommodations. Luckily, the night staff was extremely helpful and we were able to get a little casita at Hotel Bambu directly next door to the hospital for only 800Q ($102) for the week. Our little house is the perfect size, it has two floors and I promise to have pictures in my next post. The only complaint is the same one I've been having the whole trip - a lumpy bed and inconsistently warm showers. Still, the price and location are perfect!

Erich and I spent Sunday exploring Santiago Atitlán and enjoying the sun. The city is a little off the beaten path for most tourists making it better to see what daily life is like for the indigenous people of Guatemala who don't rely on tourist dollars. The city has a small but crowded market as well as a Catholic church, filled with mannequins dressed up as saints as I've seen in other churches in Guatemala.

The men here are some of the few indigenos that still wear traditional dress. Most places the men wear western attire:

We ran across some avocados freshly picked that were being unloaded from the trucks:

We also sampled coconut milk, fresh from the coconut!

Unfortunately, I've run into some complications with my volunteer work at Hospitalito Atitlán. Even though I was sent an email asking me preferences for accommodations and acknowledging my arrival at Hospitalito, I found out upon arrival that my application was not officially accepted by the powers that be. The hospital is very new to the community and the founders are still working to earn the trust of the local people meaning they aren't accepting many volunteers except for practicing doctors, 3rd and 4th year med students and nurse practitioners. Even though there is a lot of work and education that could be done regarding public health, in the words of one of the NGO founders, "we just aren't at that place right now."

It was a huge bummer to find out I made the trip only to find out I wasn't expected. However, I was still determined to offer assistance wherever I could. I can't do any shadowing at the clinic, per policy, but the staff has been very helpful in setting me up with a public health clinic in town where I may be able to observe a little bit more. I also have permission to talk to all the staff members and find out ways I can help with staff and patient education. My hope is to return to the United States and create presentations and educational materials on health topics such as COPD and contraception that I can send back to the Hospitalito. In the future, the program may be able to accept Public Health students and I may also work to facilitate placement of students from Wisconsin in Santiago Atitlán with my connections in the Global Health program. I also will be spending time with some of the midwives working in the clinic and learning more about how local community health workers play a role in the clinic that is full of a revolving staff of mostly foreign doctors and medical students.

It seems all is not lost and that the experience may turn out to be mutually beneficial after all. I'll be figuring out things as I go for the next few days.

On the plus side, this means Erich and I have had more time to relax and explore. We've run every day since we've been here (I need to get back in shape!) and we also had a delicious dinner tonight at Las Posadas, which is probably the nicest restaurant in the area. The hotel and restaurant are run by Americans and our meal exceeded expectations. We had cheese fondue, homemade biscuits, salad, and blackened chicken. It's funny how being in Guatemala for almost three weeks and spending $4-9 per meal, the $20 (for two) price tag seemed hard to stomach! Well worth the "splurge" though.

Friday, January 09, 2009

Lake Atitlán

The last part of Eva and my trip is Lake Atitlán. Lake Atitlán is the deepest lake in Central America and one of the most beautiful in the world. In ancient times, it was thought to be a spiritual center, much like the Pyramids in Egypt. Today, the traditional indigenous people that live around the lake have found a way to co-exist peacefully with the dreadlock-wearing, pot-smoking, wonky gringos that also seem to be drawn here. There is a strong ex-pat population in a few of the cities!

Our base is the town of Panajachel, the biggest on the lake. From here, you can take a public boat and visit other towns around the lake including San Pedro and San Marcos la Laguna. We paid the 25Q fee (much higher than what the locals pay) and hopped on the boat for a 50 minute trip along part of the lake. We decided to get off the boat at San Pedro to explore the city across the lake. While in San Pedro we tasted some Guatemalan coffee and walked around the small town, all the while trying not to get run over by the Thai-inspired tuk-tuks that populate the streets:

We even saw some of the local ladies doing laundry in the lake:

We also saw some coffee plants, as well as a small processing plant where the fruit is removed and the beans are dried:

On the boat ride back to Panajachel our captain was a crazy gringa!

We were pleased to find that the food in Panajachel is much cheaper and more delicious than the rest of Guatemala. Dinner has been running us about $4/night here.

On Thursday we took a shuttle with Daniela (a fellow Pacaya climber) to Chichicastenango for their big Thursday market-the biggest market in Central America. We saw a variety of goods including: handmade blankets, hammocks, scarves, placemats, traditional clothing, various wooden masks, and plenty of food. In front of one of the churches was the flower market:

We said goodbye to Daniela, who is headed back to Croatia, and now we are enjoying the last bit of our time here together with some chocolate fondue:

Tomorrow Erich is coming (yay!) and we will start the last leg of my Guatemalan adventure. We’re taking a boat to the town of Santiago Atitlán, one of the most traditional cities surrounding the lake. While there we’ll be volunteering for a week in Hospitalito Atitlán through the NGO Pueblo a Pueblo. Eva will be heading back home (boo!) to get ready for another pharmacy school rotation.

Thursday, January 08, 2009

Volcano Pacaya

I think climbing the active volcano Pacaya, located a few hours outside of Antigua, will be one of my favorite memories from Guatemala. The trip required an hour trek uphill until we hit the tree line and then another hour scrambling through volcanic rock of various sizes until we hit molten lava. Especially near the end, it was very slow going, in the words of our guide, “se necesita caminar como niños,” or “you need to walk like little children [using hands and knees]”. It was quite cool until we got within forty feet of the lava. We could feel the heat radiating beneath our feet well before we could actually see the lava. We were so high up, mists of clouds swirled around us.

Our group consisted of eleven young people from all over the world – Canada, Croatia, Germany, Czech Republic, and the USA. We bonded over the experience and even took turns roasting marshmallows over the lava.

The trip back down was also tricky, especially because the sun had set for the majority of it. Luckily some of the other travelers came prepared with headlamps so we didn’t have to feel our way down in total darkness.

Once back to Antigua, we celebrated our adventure with schnitzel and drinks at a German restaurant near the hotel. In Antigua, we have enjoyed cuisine from all over the world – Thailand, China, Germany, France, and Italy. The city truly has a cosmopolitan feel.