Primeros Pasos Tierra Colorada Clinic

Here in Xela, despite finding respite from hurricanes, floods, and torrential downpours, in the dry season, we are welcomed every day with dustclouds stirred up by passing cars and buses.  The earth in Palajunoj Valley, where the clinic is located, is very dry and the roads are unpaved.  Primeros Pasos Clinic is just a 15 minute chickenbus ride from El Calvario, which itself is only a 5 minute walk from our apartment. 

Primeros Pasos: Clinic serving the Palajunoj Valley

It's been 3 weeks now at the clinic.  The clinic, as stated on the website, offers medical services to rural communities on the outskirts of Quetzaltenango -- Tierra Colorada, Bella Vista, Xecaracoj, and Llanos del Pinal to name a view.  Medical services for children less than 12 years old is 5 Quetzales (the exchange is Q8  = 1USD) and includes a checkup, labwork, and medication if available in the in-clinic pharmacy.  Medical services for adults and children 12+ is Q30 with labwork an extra cost.  Though the services are by US standards very inexpensive, the cost is still sometimes a deterrent to locals receiving care as is a lack in education regarding one's health.  The latter is one barrier that the clinic is tackling.

Volcan Santa Maria Mural

The 2 main populations targetted at the clinic are women and children.  In collaboration with the primary schools in the communities, the clinic provides a free yearly (or semi-annually?) medical exam for each student, in which students attend a class about topics pertaining to their age group.  All students are eligible to receive the exam and the educational component, as well as some nice parting gifts (a bar of soap, a toothbrush, and a banana).  In addition to the in-clinic health education, the children's education group goes out the schools to speak about topics suggested by the teacher.  For example, with 6th graders, topics about self-esteem, sex, and puberty are offered.  We are simply planting the seed to facilitate future discussion by their parents and their communities.

The Waiting Room

Walk-in patients are also seen everyday -- the majority involving gastritis (amoebas, parasites, and microbes....oh my!), infections, acute pain, contraception, tooth pain, and complications with malnutrition.  Very few men come to the clinic.  Fridays here are famously known as Mezquinos day (= Wart removal day using liquid nitrogen).

Above is a photo of our outdoor "waiting room."

Inside the clinic

The clinic has 3 exam rooms, with one equipped with a gynecological exam table, a small pharmacy, a laboratory (with all the fecal samples you could ask for), a classroom, a registration room,  an administrative office, a dental clinic, and an office for the medical director (see below) which can also be used for patient exams.

With the Young'uns, "national" med students

Med students at the University of San Carlos here in Xela (the "national" med students) have clinical rotations at the clinic for 2 months at a time.  And on occasion foreign med students come and volunteer.  My first week there, there were four: Esteban (Steven), Ken, Jenny, and Jessica...all from the States, the northeast to be exact.  Jenny and Jessica have since left.

 

Here, the medical students start their education at age 18.  So you can only imagine how old these guys are in the above pic.  In spite of their age, I'm amazed at their maturity and professionalism at that age.  At least with this group.  The medical director himself is 25 years old, hence, the nickname I've coined for him: Dr. Señor Joven.

Doctor Senor Joven, the Medical Director

My professional goal here was to find an opportunity in which I could acquire more clinical skills in women's health.  Several years ago, a nurse from the U.S. built up some momentum on a cervical cancer initiative, by outfitting the clinic with a gynecological exam table, other pelvic exam and Pap smear supplies, her clinical expertise, and her time.  The program has since lost some steam, and gynecologic exams happen infrequently -- only once since I've been here.

During my first few days here, I observed the med students perform physical exams on the primary school students and assisted with "discharge" teachings.  I felt ineffective and dissatisfied with this so I spoke with the other programs about their volunteer needs and day-to-day operations -- the Children's Health Education program and the Women's Health Education program (Escalera de la Buena Salud).

Maynor, Children Education Coordinator; Addison, Assistant Director

The Women's Health Education Program is a 2 to 3 year program, in which clinic workers Miriam and Marluz go out to the communities and meet with the women to discuss various health topics.  The program follows a very structured 2-3 year curriculum divided up into modules and phases.  While this seems most aligned with what I want, the opportunity is limited since a long-term commitment is preferred as it is difficult to build rapport with these women in such a short time.  The opportunity to hold a one-time talk for the women in my specialty/expertise may be possible.  Expertise?  Where can I find one of those?  The search begins.

In the meantime, I have offered to assist with Children's Education since they are short-staffed but I continue to look for more opportunities to meet my personal interests.  The children are wonderful and I certainly get to practice my Spanish, but I'm still looking for more...

Teaching the 6th graders about puberty.

Cather, US volunteer, teaching the kids proper hand hygiene.