Upcoming return to Guatemala!

I am pleased to report that the pieces are all falling into place for return to Guatemala! On May 1st, I am flying back out west. From there I will drive my ’94 Toyota pick-up truck "White Thunder" down through the southwest, Mexico, and all the way to Guatemala. I couldn’t sell it for much, and it would never pass inspection back in Vermont. But half of the economy in Central America seems devoted to squeezing years of life out of trucks much like my own. And there’s a real need. By putting a topper on the bed, putting in a gurney, shelving, and some simple medical equipment, it will be reborn as an ambulance for three of the poorest communities in Santa Cruz.

The villages of Pajomel, Chuitzanchaj, and Laguna Seca are not able to use our ambulancha boat as they are a several hour hike up from the shoreline. They lie at the terminus of a rutted and treacherous road that connects to the department hospital of Sololá several hours away. Since none of the residents own a vehicle, they presently depend on hitching a ride with scare daytime traffic should an emergency arise.

Expanding health care to these communities has been a goal of mine since early on to my arrival in Santa Cruz. The villages lie an hour or two's trek nearly straight-up the mountainside from Santa Cruz. Each has a population of around a thousand inhabitants, entirely Mayan. Most families subsist on under $5 a day. Other than a piecemeal immunization program and traditional midwives, there is little access to healthcare.

The lack of healthcare is a major contributor to the region’s poverty, leading to more illness and yet greater impoverishment. Gastroenteritis from contaminated water is the leading cause of death in young children, and intestinal parasites, lice, and skin infections are endemic. Families respond to high infant mortality by having more children which contributes to malnutrition. Chronic illness prevents many adults from working, which means children must leave school to help in the fields.

The socio-economic disparities that contribute to the cycle of illness and poverty are deep-seated. But the ailments themselves are often inexpensive to treat. A few dollars’ worth of antibiotics and rehydration salts can save the life of a child with amoebic dysentery. Early treatment of scabies can prevent the infestation of an entire extended family. Many obstetric complications can be prevented through prenatal screening, and almost all can be resolved with prompt hospitalization.

The truck lies at the heart of a plan we've developed to expand healthcare and an ambulance service for all three villages. I’ve made arrangements to rent a two-room cinderblock casita. Besides serving as my lodging, it will become a supply depot for medications, supplies, and simple diagnostic equipment. This equipment will greatly aid the physicians and staff of Mayan Medical Aid as they make the grueling hike weekly from Santa Cruz to provide outreach clinics in the area. I’ll be able to conduct simple consultations myself and refer more serious ones to the hospital or clinic. As almost no one speaks Spanish, I’ll have to hire a full-time interpreter to help communicate.

The truck will function in collaboration with local volunteer “emergency committees"to provide the townsfolk with 24-hour-a-day access to the hospital. The emergency committees are respected local citizens. They receive the "knock on the door" in the night, provide initial first aid and evaluate the situation, and contact the hospital and operate the ambulance if necessary.

As an EMT lead instructor, I’ll train committee members through an adapted first-responder curriculum based around an illustrated and translated reference manual. Working with an existing committee in Tzununá over the past summer was one of the greatest pleasures of my stay. Witnessing local farmers and housewives become empowered and engaged in their community through membership in a committee was a never-ending source of inspiration. Through independent networking and fundraising, the Tzununá committee was able to acquire an outfit of two-way radios for the entire municipality, including Pajomel and Chuitzanchaj.