This summer, my daughter Joanna, and I traveled to Santiago Atitlan, Guatemala, to work in Hospitalito. We road from Guatemala City to the beautiful city of Antigua. Then on to Panajachel on the spectacular Lake Atitlan. In the rain we sped across the lake in a “lancha”, the ferry boats that go back and forth all day, to arrive in Santiago.
We found our landlords, Suzanna and Giti, who helped us to our home, which turned out to be a vacation home like dwelling with all modern conveniences. This was not exactly roughing it as we had done before on a mission trip, but we certainly did not complain.
The hospital serves a region on Lake Atitlan accessible by both boat and a very narrow road. The Tzutuhil people occupy this south western edge of Lake Atitlan. They are a hard working, industrious group of people. They receive support from numerous groups in Guatemala City, Spain, and the United States. The hospital, which was founded years ago by Oklahoma missionary Father Stanley Rother was closed after he was martyred for his support of this community in 1981. With the civil war over, the hospital reopened in 2005 only to be destroyed in a devastating mudslide that same year which also took the lives of some 700 people.
Undaunted, the hospital was reopened in a house built to accommodate back packers while a new hospital is being funded and built. In July of 2008, I joined the staff of volunteer and permanent workers.
This was really an extremely pleasant place to work. The staff is hard working and efficient. The building, though not ideal for a hospital, is placed in a lovely location on the lake and was certainly functional. I worked part of the time in the outpatient clinic and part time in the ER/Hospital. A full surgical suite is also available, but currently there is no full service anesthesiologist.
The dominant need is OB but there are also plenty of Internal Medicine problems to be seen and treated. Almost everything that would be needed to diagnosis and treat the patients is available; drugs, x-ray, lab, even ultrasound capability. The volunteer staff added much depth to the experience, including doctors and nurses from Spain, Germany, England, and the US, medical students, nursing students, and medical anthropology students.
My work with the patients was conducted in Tzutuhil, with the help of my translators who were locals that had also received medical training. Many people are being educated with help from clinic sources. Dr. Chuk, the medical director, was raised on the lake and sent to medical school by his parish. His involvement is key to keeping this clinic in the capable hands of the local people. He and Dr. Suzanna keep spirits high and enforce/model a strong work ethic. While utilization of the clinic by the Tzutuhil is mixed because of the ways that western medicine clashes with local ways of healing, the enthusiastic staff has come up with innovative ways to encourage the traditionalists into the clinic. Rather than fight local midwives about a dangerous habit of bring laboring women in late during difficult labors, they offer weekly educational meetings with the midwives, which are very well attended. These meetings offer opportunities to increase their knowledge and are conducted by local staff.
In spite of the local skepticism of western medicine, the hospital is quite busy, especially in the outpatient department and in OB. I felt I was able to contribute the most by caring for the long line of older people with congestive heart failure, depression, diabetes, hypertension. The people who came to the clinic felt sure they would be treated well at Hospitalito. However, if a serious problem was diagnosed that would necessitate a referral to another facility, the anxiety of having to leave the Hospitalito for specialized care often precluded the patient seeking further help. There were many instances of care refusal. Families do not wish to travel to area outside their language zone to receive help. Denial, fear, and the reputation of government hospitals contribute to their reticence. Santiago Atitlan is the largest village in their language zone. Sadly, there have been several tragedies because of their unwillingness to seek care beyond the area.
What did my daughter Joanna do? She took the opportunity to study Spanish with a local family who has formed a language school. All the gringo volunteers at the hospital have studied with this family. It is a booming business. They were extremely nice to Joanna, who headed off to her first year of college when we returned to California.
We loved our time on the beautiful Lake Atitlan, our new friends and an opportunity to work with the people of Santiago Atitlan. We look forward to helping out again in the future.