As a registered nurse, the “nudge” to serve as part of a medical mission group has been in my heart for as long as I can remember. After attending the 10th anniversary gathering of MDP in October 2016, I told my husband that I wanted to be a part of that group someday. He looked at me and asked, “Why wait” Before the month was over, I had submitted my application to join the Medical Mission group for their March 2017 trip to Guatemala.
As I prepared for this trip, I listened carefully to the leaders, Susan Peller CNP and Cathy Davis MD, as they described the culture we’d experience. It seemed so different and foreign from what I have known! Susan and Cathy introduced “our team,” which would venture together to serve in the medical clinic at San Lucas Toliman. Inside my heart, I was apprehensive about what this adventure would be like, but I trusted all would work out if I kept an open heart and mind.
There were many personal “firsts” for me on this trip. The Mission of San Lucas arranged to pick us up at the Guatemala City airport and transported on an unfamiliar 3-hour trip through narrow, bumpy backroads to San Lucas. After treacherous mountain roads, we were delivered to our motel just one block away from the Mission. My first few glimpses of the city of San Lucas were amazing – there were very small homes with tin roofs producing wood smoke. The sights of chickens, dogs and Guatemalan people of all ages, in native dress, and in a rural setting added to an experience of other worldliness. Gone were the familiar sights of Minnesota; this seemed like an alien place, with beat up pickup trucks, children playing amidst dusty dirt ground and the smell of firewood burning, mingling with dampness in the air. Women carried bowls of tortilla dough on their head while men were bent over, under heavy loads of limbs used for family fires, walking upon cobblestone narrow streets with pastel colored businesses.
My experience of a Third World culture was heart moving and ambiguous. Everything seemed different from the moment we arrived. As I observed their city it was fascinating - yet it was difficult for me to imagine living in these conditions. I adjusted my outlook and knew that when we would do clinic, I would be able to “feel at home,” applying my nursing skills to help serve the people. I was partnered up with Katie, a paramedic, to manage the triage/intake area. While not speaking Spanish, I quickly picked up on key words and phrases to say and I relied on Katie who knew a lot more Spanish than I did. The two of us quickly learned our role and responsibilities. Once the intake process was completed, Katie and I would look for a provider who was open to providing care to the next patient.
From village clinic to village clinic, patients comprised mainly of women and children would arrive dressed in their brightly colored woven clothing. They were so polite and patient, waiting in line for hours for their turn. The children were well behaved and sat calmly on their mother’s lap just watching us. As different as they looked to us, we also looked different to them! Yet as each patient was triaged the universal need to be listened to, and to have someone offer care for them, was not much different than the patients I’ve cared for at home in Minnesota. Our team provided care to over 200 patients during our 5 days of clinic. Within the first hour of clinic on the first day, a young 19-year-old woman came dressed in a wool sweater and her traditional woven skirt. She appeared weak and could hardly speak, so her mother spoke. She had come to the clinic because of headache and inability to eat. When doing our triage assessment, I recall she had a high fever of over 103, her heart rate was in the 120’s and her blood pressure was dangerously low. She was very sick! Fortunately, Cathy Davis was nearby, ready to receive the next patient. Clearly, she needed to be hospitalized. There was no easy way to transport the patient to the hospital, 30 miles away, in San Lucas. This young girl was escorted to a back room and laid down on a wooden bench until a pickup truck could come and deliver her to the hospital. She was diagnosed with Denge’ fever, a mosquito born illness – that if left untreated could lead to death. She was treated for three days in the hospital and Dr. Davis and our team were able see her on the day she returned to her home. She had the energy to stand up right and the sparkle had returned to her eye. I had never experienced this patient’s illness in my 35 years as a nurse. The diagnosis of Denge’ fever was new to me, but the “eye-opener” was the limitations to the care available: transportation challenges, inconsistent resources in their healthcare system and issues of private payment created extreme risk - for the care this young woman received as well as countless others. I have thought of this young woman often since being back, I wonder how she is today. hoping she has returned to living a healthy life with her family.
The days we were in clinic went by so fast. The patients we cared for were so grateful. Medical symptoms our team cared for included: headache, abdominal issues (parasites), skin irritations, vision limitations, muscle aches, fevers, coughs, pregnancy health, child wellness and nutrition. At the end of our clinic day, our team rode home snuggled together standing in the back of a pickup truck. I would recall the people we served that day. I realized that though they lived in a culture very different than our own, their needs, challenges, and pain was so poignant and personal. And their fears were relieved by the care they received in their time of need. The interactions we had each day broke down my feelings of separateness. And it was clear that by being someone who listens and cares about suffering, our team offered many means to help relieve the pain.
Beyond the medical services we provided, it was being with the Guatemalan people that changed me. It was moments in between the care that mattered. These personal connections left an imprint on my heart. Separateness that seemed so stark at first melted away. Moments such as holding a small infant while the young Guatemalan mom was being cared for bridged whatever divide I had previously perceived. In another moment, I recall looking into a young woman’s eyes that were filled with joy when she learned that her pregnancy test was positive, and her cultural role would be fulfilled; I remember receiving a hug from a small, elderly woman as she left the clinic as she passionately stated, “mucho amore’”.
The children we met during our time in Guatemala were a great joy! They sat quietly at the clinic, their big brown eyes watching our team “do clinic.” I can only imagine their thoughts of how different we appeared; how strange we were because we talked in a funny way. I imagine they wondered: “where did these people come from and what will they do to me?” One day of clinic there were several young children sitting on the steps just watching us. This was one of the “moments in between” clinic duties, when I reached out to a young child looking at us. An open hand would initiate a “high five” and a smile. A basic “Hola, como se llama?” would start a bridge between two different worlds. I then remembered from my childhood a catchy childhood poem about “two little birds, sitting on a hill,” which I shared with the children using bits of Kleenex on my fingers as the birdies. Katie, my partner at the clinic intake area, helped me translate the poem into Spanish. The children’s’ eyes sparkled with delight, as they said, “de nuevo” – again!
The last day of clinic was a highlight. Clinic was on a Saturday, so there were more children than usual, sitting on the steps and playing in the streets of the village. There was no school that day! At lunch time, I wanted to take a stroll along the streets of the village because I knew in a week I would be back in Minnesota. As I walked up and down the hilly, brick road, I saw the cement block homes, the chickens out in the yards, the bowl of fresh tortillas cooling in the sunshine and few stray dogs appearing randomly between the houses. Then from behind a tree I heard young boys playing, and they shouted, “Hello, how are you?”. I stopped and responded, “I am fine, how are you?” We both had a good laugh and they tossed me a ball to catch. We engaged in limited English/Spanish and they walked with me awhile and giggled all the way. Then, when I was just a few yards from clinic, three young girls who had been sitting on the steps of clinic in the morning were sitting on the curb. As I walked by I greeted them with a smile and “Buenos tardes”. They excitedly responded. We exchanged high fives and learned how old each other were, they were all “ocho anos” and I was “cinco-cinco anos”! Again, we had a fun laugh together. They followed me back to the clinic and we continued to chat as best we could to find out each other’s name and I shared the story of “Two little birdies,” confidently spoken in Spanish. They so loved it and wanted me to repeat it time and time again! They also were fascinated with the Kleenex tissue. I reached into my backpack and asked them if they would like one, they reached out and smiled as I placed a brand-new tissue in their hand. You would have thought I gave them a piece of gold.
Just as we were about to pack up our final day of clinic, the young Guatemalan girl named Jessica came and tapped me on the back. She then reached up and presented me with a fruit appearing-like object that had a very wooden like stem. I smelled it and held it close, then gently handed it back to her. She motioned she wanted me to come and walk with her. I followed, and she led me to a place near the clinic and pointed to a fruit tree where many of these fruit-like objects were hanging. Asking her a question, “Su casa” …. she said “Si’”. She then handed the fruit-like object again, and shook her head yes….as meaning it was for me! She was honored when I asked her if it was ok for me to take a photo of us together, and she said, “Yes”!
When I returned to clinic, our group was about to head back up the very steep hill to the pickup truck to take us back to the mission. I asked one of our interpreters from San Lucas for the name of this fruit. The interpreter responded in an excited voice, “That is a cashew fruit – the stem is the nut (which you had to roast and then crack to get the seed out of) and the fruit tastes like a peach!
My “first” medical mission trip turned out to be more than just a gesture of “good will”. My heart was “moved to serve” – but in doing so my heart was “cracked open” by the Guatemalan people with whom we lived with and experienced life, side-by-side, for one week. The human connection of what we had in common brought a joy that I am unable to describe in words. I will close with this quote from Mother Teresa of Calcutta, “We can all do small things, with great love and together we can do something wonderful.”
Barb is a registered nurse from Mankato. She made her first MDP trip to Guatelmala in March 2017.