We gathered outside our dorm, then strolled down to the main dining hall for breakfast.
The morning was sunny, but you could see the clouds roiling up in the mountains.
On the way to breakfast, we discovered that the thwonking sounds we
were hearing in the distance last night were caused by ripe avocados falling from the nearby trees.
Avocados were scattered throughout the grounds as we walked to the dining hall - an unanticipated hazard of walking here at night.
After breakfast, David led us in morning devotions at the dining hall, then we got ready for the arrival of the children and staff.
The hammocks just outside the dorm were a popular place to wait.
Once the children arrived
we split into two groups. While the rest of our group entertained the kids with bible-based puppet shows in Spanish,
as well as some Spanish language skits,
Dave, Lori, and I met with Linda, the
Canadian nurse who's been doing the checkups for the last two months here,
and also with Margarita, the local health promoter.
Margarita is from this area and speaks both Poqomchi' and Spanish. She was extremely patient with my pigeon-Spanish, helping me to communicate with the kids I was treating.
Pablo was another local worker with Food for the Hungry and helped with health-related translations this week. There's a better picture of him down here.
It took us a good 45 minutes or so to clear a space to work in one of the YMCA buildings,
learn the medications available, and learn the paperwork that needed to be filled out.
We had to haul equipment, medicines, a scale, and an exam table up to the small building.
Eventually we got started. Nathan worked with Dr. Hall translating from English to Spanish
and then either Margarita or Pablo translated from Spanish to Poqomchi' ( the
native tongue of the children we were seeing). Only the older children spoke Spanish;
the younger ones only spoke Poqomchi'.
As a sidenote, the homes here traditionally have a woodburning grill or stove of sorts
in the center of the house. As a result, the children have a great number of respiratory
infections, often a chronic sore throat and cough due to the fact that their home is perpetually filled
with smoke. Another interesting thing was that on physical exam, all the children
had large tonsils and large anterior lymph nodes, all pain-free. Presumably this
reflects the higher level of environmental pathogens they are exposed to.
The interesting cases of the morning included an unknown pregnancy, impetigo, and bronchopneumonia
(which were able to treat with the Zithromax we had brought with us). I am gradually re-remembering how to
do physical exams on kids and a bit nervous about what I might be missing. I saw a classic case of anemia:
a young woman presented with dizziness when walking quickly, had pale fingernail beds and pale conjunctiva,
and a resting tachycardia all consistent with anemia, presumably from malnutrition. We prescribed vitamins
and iron, and Margarita will be delivering a vitamin and iron solution or iron tablets to her shortly this week.
We continued with the checkups till around noon, then the gathered over by a little pavilion near the pool for lunch.
Two of the local FHI staff workers had prepared a delicious local dish (the name of which escapes me at the moment)
that was essentially a curried chicken with rice, served with tortillas.
The local convention is you don't use utensils when eating. You use the tortilla to pick up the chicken and eat the chicken without getting your hands gooped from the sause, then use the tortilla as a scoop for the rice.
After lunch, while Lori, David and I resumed doing the physical exams,
the rest of the group was leading the children in singing and games.
There was also some unstructured time for the kids to play soccer or basketball.
At 3:00 we loaded into the bus and the minivan and headed out to one of the villages from which some
of the children had come.
Dave and I rode in the minivan, and got to watch the bus turn around on the narrow mountain road.
Pablo, who had been translating for David and I in the morning, showed
us a two-room schoolhouse that they had recently had built for providing local middleschool and
high-school level education. Chairs and tables were provided through Food for the Hungry, and
they had also assisted with the construction itself.
It was one moderately sized room with a black PVC curtain dividing it. Education is provided via an "Extension Program"; the intent is that the children do most of the work on their own, but that the teachers are sponsored to come in several times a week. The teachers grade the papers and teach the details the children are still uncertain of.
Pablo also showed us one of the corn drying racks where they had fastened the special steel rims
around the base to prevent rats from climbing the structure and eating the corn.
In addition, Pablo showed us one of the steel silos that had been provided by Food for the
Hungry as a model for the village as a rat-proof means of storing corn.
In addition to his health care work, Pablo also has trained in metalworking and showed us a number of the steel tools he has made, by welding and metalworking, including a number of containers and even a rather elegant watering can. In addition, he stated that he planned to build silos similar to the one that his brother had but lacked the material at this time to do so.
One member of our group slipped on the trail to Juan's house, and I happened to be right behind her
and able to catch her, helping her avoid falling off the trail. At that point I felt that, even if I did nothing
else, I had been useful on that trip. I wasn't feeling particularly good about the small number of patients
we had seen that morning, and was unsure how we'ld ever make it through the week at that rate. That
event gave me something concrete to feel positive about.
After dinner, we retired for our evening debriefing and prayer session, then went to bed.