Emergency Room

Let me tell you how I pictured my day going today. It's my first week back on my normal schedule, my first real opportunity to get back to researching for my upcoming charlas. I was going to sit at my table in the back room of the clinic, eat a bowl of oatmeal and listen to classic rock all day while I looked up information on childhood nutrition. Well, sadly my little bubble got burst. As I was pouring the water into my oatmeal and getting ready to assume my position in my comfy office chair for the day, the doctor told me that we had a boy with possible appendicitis who would have to go to the hospital. Usually a Tio would bring the kids for an emergency appointment like that because it's assumed that we have stuff to do in the clinic and can't drop everything last minute. Unfortunately, the Tios weren't working since it was a school day; they leave when the kids have classes and come back in the afternoon for their next shift. I pouted a bit to myself, then scarfed down my oatmeal and headed out. Once I saw the kid and realized that a) I knew him and liked him and b) he was genuinely in pain, I softened up. Besides, this was a great opportunity to see what an emergency room is like in Guatemala AND being out of the office was going to help the day fly by.

We got to the hospital in Chimaltenango, a 15 minute car ride away. He was having a little trouble walking because he was in so much pain, so I helped him up the ramp into the ER. When we got inside I was a little surprised by how empty it was. All the clinics that I've been to so far here have been super crowded and usually involve a several hour wait. Ad we walked in, a doctor approached us and asked what was going on. I explained why we there and he walked us over to a set on beds on one side of the room. The beds were really metal gurneys with a sheet over them. The sheets definitely aren't changed between every person and you could see obvious stains on them, but I didn't see any blood and the kid was still fully clothed, so I figured it wasn't worth making a fuss. The doctor did a quick assessment and agreed that it was probably appendicitis. An added benefit of all this was that I learned/was reminded of what to look for when you suspect appendicitis: pain in lower right abdomen, rebound tenderness, nausea and positive obturator sign (too complicated to explain, but basically involves twisting at the hips with your knees up. Man did that kid scream.)

After the doctor finished his assessment he told us that the kid would need surgery right away and whisked us into the hallway to begin surgery prep. We had been at the hospital for all of 15 minutes, I couldn't believe how efficient it was! I told the kid that if we were in the States we would have been waiting in the ER for at least three hours before anything was done, and most of that time would be waiting to hear from the doctor.

He got dressed into a gown (complete with cap and booties) and laid on another gurney. A few minutes later one of the ER nurses came to start his IV. Oh my God. This lady BUTCHERED this poor kid. She was sticking the IV in his wrist and twisting it in tons of directions trying to find the vein. When that didn't work she kept pulling it out and sticking it in the same hole over and over. She tried in three different places before finally going into his bicep (I didn't even know you could get an IV in your bicep) and that took. Every time she couldn't find the vein she would tell him it was because he wasn't breathing enough. I'm no IV expert but it seems like "breathing" is a shitty prerequisite for being able to have an IV placed. Choking victims must be shit out of luck then. I'm sure she was referring to him being too tense, but I thought he was doing remarkably well for a 16 year old in severe pain who was being stuck repeatedly.

Here he is all set for surgery:

Once she finally got the IV in she took a blood sample in the most medically horrifying way I've ever seen. She left the needle in his arm (where the IV was going to hook up to), uncapped a vial and then basically let his arm spray out blood through the needle. She held the open vial under it while blood coated the glass, splashed all over her fingers and hands (ungloved, naturally) and finally dripped all over the floor. I seriously considered asking him if he had taken his HIV medication that morning just to wake her up a little bit, but decided against it. A few minutes later I saw another nurse do the same thing with another patient so apparently it's a hospital wide problem.

Here's the wall I stared at for my time there! Notice that the sign in written in Kaqchikel, the Mayan language that a lot of folks speak in Chimal.

Once the IV was set up we waited for the surgeon. And waited. And waited. We waited through two separate shift changes, all while I stood there in the hallway since there were no seats. I started getting really nervous because three different people came to me and said that this part of Chimal was dangerous at night and I shouldn't be outside of the hospital after dark. We kept waiting and the sun kept getting lower in the sky. Then I started getting worried because the last bus back to Parramos was at 7:30. It was now 6:30 and no sign of anything changing. Finally after a little over 8 hours of waiting, the surgeon finally came and said it was time for us to go in. As we're getting pushed down the hall, an ambulance pulls up and runs a woman right into the operating room. The surgeon says we have to wait some more and leaves. I felt like a total dick leaving, but I had no choice. I told the kid I needed to catch the last bus and he said he understood. A lady had been there with her father also waiting for surgery, and she told me that she would keep an eye on him.

A view of the bodies piling up in the hallway:

The only thing of any value I had on me was my iPhone and Q3 for the bus fare. I didn't want my iPhone to get taken should I have issues in the now-dark Chimal, so I put it inside of my shoe which made me walk with a considerable limp (which actually looked convincing since I was stumbling away from the hospital). I walked up to the main road and stood by a family also waiting for the bus. After fifteen minutes of waiting there, I figured it would be safe to put my phone in my pocket now since there were a bunch of us waiting together. Two seconds after I did this, the family crossed the street and walked away. Now I was alone, in the dark with my iPhone in my pocket, EXACTLY the situation I didn't want to be in.

I looked around and saw a couple of guys hanging around smoking and figured them to be the most likely people to rob me. I brainstormed my options, then decided to hide the phone again. Luckily I was wearing a T-shirt tucked in and a super tight belt. I walked up a few feet so that their view was blocked by a tree, then pretended to scratch the back of my neck while I dropped my phone inside my T-shirt. At first I thought it fell all the way through to the ground, but then I felt it against my back. I tucked it into my waistband and felt a lot better. Let em rob me now. I have nothing on me but Q3 and my crappy Guatemala phone, no big loss there.

I waited for the bus and after convincing myself that none was going to come and I was going to be stranded in Chimal for the night, finally one came down for me. It was insanely crowded but I didn't care, I was getting out of there. Unfortunately the only place for me to stand was on the first step getting into the bus. I had to hold onto the handbars along the outside of the bus and ride with my ass swaying in the breeze. This would have been stressful enough WITHOUT having to worry about my phone slipping out of my pant leg and onto the road. I tried to maintain this position while sending a text to the clinic and to Stephanie to let them know that I was on my way home. As I was doing this I glanced at the driver who was also using this time to send text messages to his friends. I realized that we were all going to die and started laughing. To make matters worse, the dude who collects money on the bus had to try to stand behind me with only his toes on the first step. His arms were wrapped around me and he was also trying to hold onto the outside rails. All I could think was "I'm not going to let this guy die because my butt is too big for him to fit in here." I tried to squish my body in as much as possible. I had no choice but to put my head on the shoulder of a woman on the next step up from me which gave him a valuable two more inches. After a few moments I realized that it wasn't actually her shoulder that my head was on but actually her breast. I had a fleeting rush of embarrassment but then I realized that it would probably be more embarrassing to her if I drew attention to it, so I just stayed there. At the next bus stop a bunch of people left and we had room to rearrange ourselves, so it was all ok.

To help me get over my traumatic day Stephanie and Charlotte treated me to a pizza dinner in Antigua (complete with BBQ Chicken and Bacon pizza which was scrumptious!). So anyway, long story short: the ER in Chimal was terrifying and unhygienic. But hooray for new experiences! And the kid is fine, surgery went well and he's on his way to the clinic for a while.

Water fight!!

Today was our second Kermes (the day when the volunteers need to organize an event for all 400 of the kids). The theme for today was Water Day, basically a bunch of different water games outside in the soccer field. It made me think a lot about field day as a kid (which I loved despite absolutely hating sports. There's just something fun about a whole day of playing outside and eating snacks in the grass.)

Here's Steph, Mark and Liz getting ready to hand out some Jello to start us off...

...as Kristina and Antje drag their water balloons up the Hundred Stairs of Death. (Notice how helpful I am by taking a picture and then frolicking merrily away.

The weather was awesome, probably close to 80 degrees and sunny out. All the volunteers had to choose a station to man for the day; Charlotte and I lucked out with the babies activity: Splish Splish Splash (basically Duck Duck Goose but with water. When you find the person you want, you dump a bucket of water on them). We had zippo prep work for our station other than bringing a bucket, so compared to the other groups we got off easy. We mentioned many times this past week how lucky we were that we didn't need to spend time planning anything, only to realize once we sat down on the field that neither of us could remember how to play Duck Duck Goose. (Do people sometimes have to sit in the middle of the circle? If so, why??) In the end it didn't matter though, we ended up changing all the rules anyway, especially after the special needs kids joined us. Everyone understood that they needed to splash a little water onto people's heads and then dump the whole thing on one person, but things got cloudy after that. They didnt understand the whole tagging part but knew they had to run, so once someone got soaked they would stand up, run away, and then come back to the circle after a minute for their turn to wet someone. Really the game was just an excuse to dump water on someone's head.

Here's me and Rosita after getting thoroughly soaked the whole game. She was cold so she wanted to cuddle up, so cute :)

Rosita spots her target...

Axel was a good sport. He has autism and usually does his own thing away from the other kids, but he sat with everyone today and therefore was fair game for the buckets. He ended up really loving it and was the favorite target of the day

Though I was also rather popular. I love everyone laughing at me here

Soon I enacted my revenge...

More random splash shots

Charlotte looks like she has a demon tongue here (which is why I posted it)

Everyone had a good time, even the spectators. Here's Gloria with a big smile on her face

And the eventual aftermath:

To everything (turn, turn, turn)...

There've been so many things that I've had to adjust to since moving to Guatemala. I expected there to be challenges here, but I've been surprised by how many things I've found that are actually better here than the states. Their health care system is one example (and something that I'll talk about in more detail in the future). Another example is the fact that folks live in a way that is much more in sync with the normal cycles of nature. While I'm sure this can be found in places in the United States as well (I'm looking at you, farming towns), it's something that has never really played a large part in my life and has kind of taken me by surprise here.

We live in a small town with no grocery stores. There are small corner stores that sell dry goods, but these are very small, usually just a counter that you can walk up to. There will be a few shelves behind the counter with bags of rice, beans, flour, etc that the owner can get down for you, but it's not a store like you would think of in the States. There's no browsing, you simply walk up to the owner and ask if he has what you're looking for.

The bulk of the shopping gets done in the market. On Saturdays and Sundays, farmers set up stands in the streets selling all their fruits and vegetables. Fruits, vegetables and beans are the mainstay of the Guatemalan diet because they're so damn cheap here, far cheaper than packaged goods or meats. Despite having limited income, people are generally very healthy here because it's far cheaper to buy a weeks worth of vegetables than to bring your family to a fast food restaurant or even cook up a pot of spaghetti, the opposite of how things run back home.

Because of everyone's dependance on fresh vegetables and the inability to pay for costly imported items, folks here eat only fresh, local produce. As delightful as this is, this means that all of a sudden I have to pay attention to growing seasons, something we can be blissfully unaware of in the States. Aside from fresh Jersey corn in late summer, we pretty much have everything available at all times. There's no need to plan meals around what's in season, everything can be purchased when we want it (albeit for a higher price). Here we only have access to what's ready for harvest. That means that since right now is mango season, we'll be eating mangoes for weeks until the crop is gone. It also means that there are no avocados for the next three months (unless we drive to a larger town that has imported produce for tourists), but when they come into season in July we'll be up to our ears in guacamole for the month (something I'm looking forward to immensely).

Aside from the food, there's also a season for all the animals! I guess we have this at home too (like fireflies and ladybugs in the summer) but it just feels way more extreme here. A few weeks ago we started what is lovingly referred to as "fly season". It's about as fun as it sounds. It felt like overnight we all of a sudden had the most disgusting infestation of flies imaginable. It was like Amityville horror level. I'd estimate that we have about 100 flies in the house everyday which makes it pretty much impossible to cook or eat anything without having flies bombard you. The last few weeks I've had to hide in my room during the day to avoid them which sucks since the internet doesn't work from there. Thankfully at night they go dormant and sleep on the ceiling so we can actually have some peace.

Every black dot you see is a fly. Click for a larger, nastier picture.

Last week marked the start of beetle season. At night we get these enormous beetles flying all over the place. They look exactly like Japanese beetles, only they're two to three times as big. They're attracted to light so they always crawl into the houses, but they like to fly like two inches off the ground and slam into your feet and the walls. You hear them all night long slamming into things and buzzing around. They also love to crawl on the floor so everyday I'm accidentally stepping on them and squishing them. It's disgusting. And apparently fly season doesn't end when beetle season starts, so we're dealing with both things right now. The older volunteers tell me that when they arrived in July there were no flies, so I'm hoping that'll end soon.

I have been noticing an increase in the lizard population here (probably because it's full-on feast time for them right now.) I caught four lizards in the clinic in the last three days, something I've ever done before this week. Actually, before this week I'd only seen two lizards in Guatemala. I totally welcome them, I'd much rather have lizards falling on me during the night than huge nasty beetles. Here's a little guy I caught. He kept jumping out of my hand when all I wanted was a picture. Eventually he got pissed at me for picking him back up yet again, so he bit me. At least that kept him still enough to snap this :)

I'm keeping my fingers crossed that this means there's a lizard season here, and I can sit back and watch while they destroy all the bugs.

Randomness

Just cleaning off the ol' desktop and wanted to throw in a few random pictures.

Here is an old picture of Dr. Nicole and I in the Montessori school (well technically it's just a picture of Nicole since I'm the one taking the pic). We went there to teach the kids about physicals to prep them for coming to the clinic for their exams the next day. It was tons of fun, they all wanted to play with the stethoscope and blood pressure cuff. I've hung out with the babies a lot since then, but this was my first official interaction with them :)

Here's a random door I saw somewhere (Antigua?). I loved the detailing around it (and the hand-carved doors!)

Two of my favorite boys. The little dude is the one had all those hand surgeries done, and the older boy is Alex who has big dreams of going to culinary school if he can save up enough money. I already have him on my short list for boys to support when I get home. He's such a good kid and he keeps me company in the clinic a lot :)

Here's pizza from the restaurant that we visit a lot in Antigua. It's good pizza, but it's a little too fancy for me. Charlotte, Steph and I have all been dreaming about finding regular American pizza: floppy, cheesy and greasy. Hopefully we'll find a good place soon, until then we're going to eat the artisan stuff.

Here's one of my kids with a random stray cat. The kids (like most kids) have a bad habit of finding stray animals and bringing them home. The only difference is that here they don't really have parents to tell them to forget about it. The Tios seem not to mind so much; they let the kids keep the animals until they inevitably grow bored of them in a few days and release them back to the wild. I hate it. Every time it happens I start nonchalantly talking about rabies. It also bugs me for the animals sake. The kids have no access to the supplies they need, nor do they understand about taking care of animals. They found a young puppy the other day and when it came to me it was listless and just laying there occasionally looking around, definitely not puppy behavior. Turns out the kids hadn't fed it in two days! I kind of went off on them about being irresponsible and made them sit through a lecture about how to take care of animals, but the truth of the matter is the kids don't even get milk, they definitely don't have any to spare for pets (though that doesn't deter them from dragging them home).

Here are some chickens being sold on the streets at one of the markets. A lot of folks buy their meat fresh here (aka alive). Tia Rosa told me that her husband bought a cow and butchered it for her wedding, but I can never tell when she's lying to me. She thinks its funny to make up stories about crazy things Guatemalans do.

At our house we all have these iron doors on our rooms. We can write each other messages on them with chalk which is really cool. Each of us has our names written on our rooms which is a huge help to me because even know I forget the names of people in my house.

One of the funniest calendars I've ever seen. Each month has a picture of a different young preist. Holger has it hanging next to his bed. I'm still trying to figure out if it's supposed to be sexual or inspirational or what.

And that's the end of my photo dump! My brain was too fried to write a real blog post tonight, but tomorrow's my day off so hopefully I'll find a bit more motivation ;)

Earth Lodge

(As a reminder, you can click on any photos to see a larger image)

The last few weeks here have been really, really tough for all the volunteers. Since Semana Santa is so huge here, all the regular employees have the week off. The volunteers have to pick up the slack and work around the clock for a full week which is really friggen hard when you have thirty kids who refuse to listen to you and make fun of every little mistake you say in Spanish. I totally lucked out though. Usually the nurses don't have off during this time, so I would be expected to go and work in the kids' houses with all the other volunteers since they dont really need me in the clinic. Fortunately, one of the nurses decided to take her vacation time and since Tia Rosa was away on her honeymoon, it fell to me to cover the nurse's shifts. I got to work what would otherwise be considered a tough schedule: 24 hours on, 48 hours off, but next to the grueling schedule of the other volunteers, mine was a cake walk. Sadly though, once Semana Santa ended and all the employees returned, I had to jump back into doing my inservices. I'm not allowed to be out of the clinic for that long during my shifts, so I had to move all the charlas to my days off, so now I've been working 24 hours on, followed by half days in between. It doesn't sound like much, but having those two days off in between made the shift worth while, it's completely draining otherwise.

Anyway, we all decided that we deserved a little getaway, so all the volunteers went to the well-hyped up Earth Lodge. I had been hearing about this place since I was in language school. It's a resort tucked away in the forested mountains overlooking Antigua. The only way to get there is to have their driver pick you up; the resort is down a long unmarked dirt path that DEFINITELY didn't look suitable for driving on. We had gone up the side of the mountain for about fifteen minutes, then we drove along the ridge for a while on the dirt road. One side dropped down into a steep slope that went down to the bottom of the mountain. I'm pretty sure our wheels were riding the edge of that cliff; the people on that side of the van were squirming in their seats quite a bit. Eventually we came to a dead end and we all had to get out and walk the rest of the way. They definitely get points for being remote.

The walk down to the resort

Misty jungle...

They had the two healthiest dogs in all of Guatemala!

The place was really great. They had cabins tucked away on little trails and a huge meadow of avocado trees (they're a fully functional avocado farm. Too bad we weren't visiting in harvest season (which I now know is January and July))

They also had cool succulent plants everywhere. Check out this one, it's like a tree!

One of the rooms that my friends rented. It had a tree growing right through the center of it, so cool!!

Here's our cabin. I stayed in the cheapest option, an 8-bed dorm for $7.50 a night. It was amazingly clean, way better than any camping experience I'd ever had before.

Right outside our front door was the Mayan sauna, basically a small stone house with benches inside. There was a metal barrel cemented into the back wall; you can make a fire from the outside of the cabin and it causes the heat to radiate inside the home. I had big plans of taking this baby for a whirl, but sadly I got way too busy relaxing to find time for it.

The main lodge was where we spent most of our time. They had a lounge area with the same couches Jamie and I had in Jersey! I love these couches! Needless to say I spent a lot of time spread out on one reading.

They also had a bar with a good happy hour ($1 drinks from 5-7)

But the best part was definitely the view. This picture doesn't even begin to capture it.

Liz and Vero contemplate the meaning of life while looking out over the beautiful vista

Okay, so this place has a reputation of having really great food. We had to prepay for the dinners, but they had a menu for breakfasts and lunch. Gotta say, it lived up to the hype. At Q60 for dinner ($7.50), it was definitely worth the price. The first night we had lentils with shredded carrots, roasted vegetables,

Here's supper the second night. Saturday nights you can choose to add meat for an additional Q20 ($2.50). I had a BBQ pork chop, beer bread, sweet and sour vegetables, AMAZING potatoes au gratin, mixed black beans and a side salad. These pictures aren't doing any justice to the food, it was really delicious (and healthy!!). Their dinners are also family style so every table gets a bowl of everything that was served, that way if you want more you can grab some!

Here's the pila (sink) where the local folks do their laundry. Unlike other towns that only have their water running one day a week (and thus it becomes everyone's "laundry day") this pila was fed off of a natural spring so it always had a nice flow of fresh water :)

Edith and Bianca testing out the hammocks and deeming them to be good quality

I spent Friday night taking full advantage of the happy hour specials, then playing my favorite Swiss board game, Brandi Dog! (Which I now know is spelled as Brandi Dog and not Brandy Dock. Sometimes it's hard to understand accents :) This is the game that we had been playing at the volunteer houses that reminded me of Sorry. Erika has a nice version of it (rather than our paper version with the noodle pieces). Turns out that this game is somehow affiliated with a large residential center in Switzerland for people with developmental disabilities. All proceeds go to help with their care. I'm going to buy this game when I get home!!

Saturday I woke up and ate a fantastic American breakfast of sausage, bacon, eggs and toast. After reading for a few hours, me and a few of the girls went for a hike in the mountains. It was really gorgeous, lots of farmland surrounded by jungle.

Great overlook

And because Guatemala loves to surprise me, we stumbled upon a (abandoned?) zip line! Who needs gates? Kids will learn to stay back the hard way.

It goes straight across to another mountain, then people can walk up a bit and take a return line back. If this was working I would have totally done it!! (though its really easy to say that when the option isn't there)

After our hiking I went back and relaxed some more. I got a ton of reading done on this trip which was a nice change of pace. All in all, I really loved Earth Lodge. There were some down sides for me (it was really hippie-dippie for me, lots of white kids in dreadlocks running around.) It annoyed me that they were visiting Guatemala and staying in a resort like this, completely separated from the real experience of Guatemala. I had to remind myself that I had no clue who these people were and they could also be volunteers just looking for a break. Luckily there was plenty of room for all of us to do our own things with limited interaction. Everything was a good value, even if it was a little expensive by Guatemalan standards. I ended up getting two nights in the room, five full meals and countless drinks (alcoholic and not) for under $65. Not a trip I'd be making every weekend, but definitely do-able again in the future when I want some quiet time :) Now we're back to the orphanage and back to the grind for one more week until the nurse gets back. I have an entry in the works about my experiences in the clinic these last three weeks, so be on the lookout for that!