Teaching

One of the roles we get to play in rural (developing country)healthcare is that of patient educator.  Unfortuneately you don't get to focus on that aspect of medicine as much when you are in training.  In fact, in the world of managed care, patient education is relegated to other specialists so as not to take up too much consult time.  Of course the curative care is always interesting and exciting and gives you immediate satisfaction, but there are great moments to be enjoyed in the work of patient and community education as well.
Both Sheri and I spend a good amount of time investigating issues, studying statistics from our communities (thanks to Kemmel's actuarial gifting!) and developing teaching materials for one-on-one education, staff training and community classes. 
This last week, Sheri kicked off a three-part series of community talks on diabetes.  We have used some one-on-one techniques with our patients for the last couple of years, but felt like we needed to offer group classes to reach family members and encourage more interactive learning.  Well, after many hours of study and preparation, Sheri gave the first class in Chuchipaca on Saturday during clinic.  We invited all the diabetics to class first and opened it up to anyone else interested.  Well, all 25-30 people waiting for consult decided they were interested (or at least bored just sitting and waiting), and crammed into the tiny room to hear Sheri and Gaspar give their class while waiting for their name to be called for consult. It was a hit, and many people asked questions at the end and said they were glad to get such good information.   The next class is already on the calendar for April 30, and I bet it will be standing room only.
Today, I worked on materials for our infant and child nutrition program, while Sheri went out to clinic in Chutzerob.  When she got home she told me about one our diabetics out there who always comes in with her sugars out of control despite the medicines, diet counseling and encouragement.  Well, today she had a blood sugar of 140--almost normal!  The lady said she was finally getting to understand her diet and how to better control her sugars!  Talk about satisfaction--it's a treat when God lets us see the fruit of our labors.

Natural People

Without getting into a profound discussion of the difference of race, ethnicity and culture, suffice it to say that all people have a way of describing themselves and those who are different from them.  In the States we focus a lot on skin color, hair and eye color, name origins, language and regional differences.  Here in Guatemala, there are words like indigena, (the word Indian is not a respectful term in Spanish), ladino, mestizo to describe people of indigenous origin, hispanic origin, or mixed background.  Interestingly you can't really assign those labels based on skin color or facial features, but rather on cultural lifestyle for the most part.  Also the word Maya is used, but not by indigenous people unless referring to the religous ceremonies or people who worship that way. You wouldn't call an indigenous Christian a Mayan for instance.  Anyway, for a long time we wondered what word indigenous people used to refer to themselves, but were hesitant to ask.  But one day we were talking with some of our co-workers about the mayor of Chichicastenago and someone  said something to the effect of "this is the first mayor we've had who 'natural' like us."  So there you go. 

We are always learning intersting and usually accurate tidbits of knowledge and observations of the natural world from our Natural friends and thought we would share some here.

**If you cut down a tree during a full moon (or still large moon) the wood will be termite free.  (We googled this and found several articles concurring).

**If you watch the blue jays, you can predict the start of the rainy season based on when they begin to build their nests.  This year is supposed to be an early rainy season according to Gaspar's granddad and the national weather service.

**High feathery clouds in the morning in an otherwise bright blue sky usually mean a gullywasher is coming in the afternoon.--Very true!

**There is a bird that sings at night that can only be heard in March or April (before Easter) and announces the rainy season. (This is the third year we've heard it).  Grandparent wisdom says that it changes into a frog, because after the rains start, you can't hear it anymore, and the frogs start to emerge. 

**A black butterfly in your yard means someone died or is going to die.  Okay, so they have some old wive's tales too.

Saturday would have been a good day for cutting logs!

Class Act

Yesterday was our monthly class time for the volunteer health promoters and staff.  It was about the digestive system, touching on anatomy, physiology and common illnesses--we're tyring to build a good baseline knowledge of the body's different systems each month. One of the points that got some good discusion is that we have approximately 6 meters of small intestine.  Then we went on to wonder how many meters of small intestine (tripa) a cow has--they settled on 10-12 meters.  The guys from the Paxot II church have the most experience as they always kill a cow or two (and prepare the tripa) for their annual conferences.  We wrapped up the class meditating on the passage from I Corinthians 12 which talks about the different parts of the body all being necessary and important for the whole, and how likewise, each member in the church has an important role laid out by God.

Tomas and Juan demonstrating what 6 meters of gut would be.  Notice no one is seated in the shady section--it was pretty chilly yesterday.

Off Into the Sunset

Our spring break adventure continued this week as we hosted a team from Harding University's and Abilene Christian University. It was a big group, but full of hard working, service-minded people.  The students were undergraduates as well as nursing, PA, and pharmacy students. Helping out were Rick Harper, Dr. Cynthia Powell the pre-med advisor from ACU, Gary Hill a PA and assistant clinical director of Harding's PA program, as well as veterans  Drs. Jim Haller and Jeff Webb our dentists from Abilene and Dr. Cristina Stokes an ER physician and her husband Jeff Stokes from Austin. 

Clinics went well with the students taking turns presenting patients and helping in consults; in addition, another group of students accompanied Kemmel and Sheri to deliver the rest of the water filters to Xepocol, Paxot II, and Mactzul I.  They were so efficient with the water filters that we ran out of jobs for them on the last day--but everyone pitched in and counted medicine and children's vitamins without complaining (and without sampling the vitamins!). 

Unfortunately, I have no no photos to share as we sent the camera out to get pictures of the ABC families with their filters.  But, I highly recommend Sheri's pictures of our week!

I got a real kick out of working with the students in consult, remembering back to my clinical training days. Our patients were so good to be "patient" with us as we took time to work through histories and physicals.  One of the ladies from the church in Paxot bragged to her husband that she had a very thorough work up! 

On Friday, Tomas headed out to visit with all of the families in Mactzul V who had water filters delivered about 3-4 weeks ago to do some follow-up to ensure all filters were working well and that the families were using correctly.  The report was that all of the families in Mactzul V were doing well with their filters and loving not having to boil water.  One dad said his 11 year old son is in charge of filter care and already has his calendar sent up for maintenance days!  Great work everyone!

Spring Breaking It

Booger fruit!

Tis the season for spring break--hard to believe that some schools break in February! Our first team was from Pepperdine University and accompanied by Dr. Brian Cress, a pediatrition from Minnesota.  Despite the long days in clinic and especially delivering water filters to families, there were no complaints that we heard.  Kemmel and Sheri and our staff and visiting students were able to visit the families in two more ABC communities last week. Today we heard back from one of the coordinators from Mactzul VI and he reports hearing great comments from the families and overall thankfulness for the ABC program in their church.
Here are some pictures captured by the students during their visits in the communities.