Let the Rotation Begin!

Drs. Patricia Crane and Julie Hettig are the preceptors for this clinical rotation. This is Julie’s first trip with us, but I’ve been working with Patricia coordinating women’s clinics since 2008.

The March 2018 University of Texas Medical Branch PA School clinical rotation has begun!  And with us this time we have Megan Runge, Charlotte Peeters, and Holly Matthews.  We (or at least “they”) will be working in six clinic sites during the weeks of March 5, 12, and 19.

In Chichicastenango the clinic sites include two remote “cantones,” or “comunidades,” as the nearly 90 village or hamlet units that comprise the greater municipality are called.  The first of these was held yesterday, March 5^th, in the eastern part of the “muni” in the community of Quiejel (click to see satellite image).  The clinic (or jornada as medical missions are generally called in Guatemala) is also working today (March 6) in the cantone’s newly finished Centro de Convergencia.  It’s a lovely, freshly-painted facility, and a far cry from many of the more primitive and much older or, on occasion, still incomplete buildings where the UTMB PA School clinics have been held.  Perhaps nothing makes the relative luxuriousness more clear than that there are, in fact, not just one but two indoor toilets in this building!

The first and perhaps most important chore of the morning is to grind the coffee, as Megan is doing here. Our host, Pedro Macario, buys the beans from a cooperative in Chajúl, a town an hour or so up the road, and roasts it in the patio here at the hotel. It’s always good, but this batch is great, and all of us are planning on buying pounds to take home.

We are told that this is the first medical mission to come to Quiejel.  I’m not sure I’m buying that, since Chichicastenango is pretty often blessed with medical clinics missions sponsored by various governmental agencies and visiting missionary groups.  But If that’s true, it’s somewhat understandable, for while Quiejel is actually not very far as the Cuervo (crow) flies from the town of Chichicastenango – maybe a mile or two?  Or even less? – that straight-line mile crosses a broad, 2,000 feet deep gorge.  So to get there in a motor vehicle you have to go back a mile to the entrance to the pueblo of Chichicastenango, then 1,500 feet down and up the switchbacks to cross the gorge at a narrow point, then way out and around on the other rim of the gorge.  In all, the drive takes about 40 minutes, most of it on a dusty, unpaved country road.

We are a small clinic, but still have to lug at least one exam table and all the equipment, in addition to a staff of nine or ten people, meaning a pickup and a van are needed on the first morning to take the equipment, and on the second afternoon to bring it home.  Early yesterday morning on the way to the clinic I invited the students to do something that’s just a real option in the US any longer, which was to ride in the back of the pickup.  I’m in my mid-sixties, but I still get a kick out doing this, and Holly, Meghan and Charlotte, who are all considerably younger, also seemed to enjoy it.  I wish, in retrospect, that I had gotten a photo of us all in the back of the tiny little pickup.  But while I didn’t do that, I did take a few fairly nice photos of the outstanding scenery we saw as we drove along.

The team on our Sunday afternoon pre-clinic planning meeting at the Posada el Arco in Chichicastenango. From left to right, Sonia, Max, Julie, Patricia, Megan, Holly, Margarita, Charlotte

Tomorrow, Wednesday, March 7^th, the clinic will set up in the Salon de Usos Multiples in the cantón of Chulumal III.  This community, which is much closer, is down in the canyon just north of the pueblo of Chichicastenango.  On Thursday and Friday, we will have two clinics operating simultaneously in Chichi itself.  One of these will be at the office of ACEBAR, where the clinical staff will conduct a wellness clinic for ACEBAR scholarship recipients and general medical consultations for whoever might drift in with a health problem.  The other clinic will be the Ministry of Public Health’s Centro de Salud, and will do women’s health consultations, with a particular focus on detection of and immediate treatment for Human Papilloma Virus (HPV).

Approaching Quiejel. Across the goerge at left is the pueblo of Chichicastenango.

Should be a good week, following which, we’ll do a tourist weekend at Lago Atitlan, where we’ll take a launch to explore the fascinating and beautiful pueblos on one side of this most beautiful lake in the world.

Stay tuned!  More text and photos to come!

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