Outback Medicine – The Rotation Begins with a BANG in Canton Xepocol

So the first day of the clinic began with a bang – 101 patients between the 3 docs – in the far-flung canton (Spanish for “precinct,” but in Chichi a small village) of Xepocol.  The educational organization I work with, ACEBAR, has a dozen or more scholarship students in this canton, and as the organizational support group for this clinic I would assume that has something to do with why we landed here rather than any other of the more than 80 catones that comprise greater Chichicastenango.  In any event, it was a good choice, because this isolated community is clearly very needful.

That was brought home to me by walking 3o or 40 yards over to the schoolyard patio and interacting with some of the primary students there. Time and again I asked what I assumed were 8 year olds how old they were and was told 11 or 12.  It was surprising, not only given their small size for that age, but the apparent intellectual developmental stage they were at.  They just seemed much too young for their chronological age.

This was very consistent with the data published by the UN and other multilateral organizations and large private charitable foundations that work in Guatemala, which uniformly report growth stunting rates in excess of 60 percent in Guatemala.  In such inaccessible indigenous towns as this, meanwhile, the rate is clearly even higher.  So I was very happy to see this very significant clinic event take place here, and equally happy to be very well received by the local population.

(continued below photo gallery)

As well, I was exceedingly happy with the performance of all members of the team – the only ones of which I have worked with before were Dr. Patricia Crane and Michael Egerman, for whom I’ve facilitated clinics for 9 and 5 years, respectively.  Dr. Crane did her normal thing – women’s exams, complete with discussions about fertility and detection of STDs to include diagnosis and removal of cervical lesions caused by HPV.  This critical service is almost never provided to women in the Guatemalan Outback, so the incidence of preventable cervical cancer is high.

But beyond Dr. Crane’s outstanding contribution to women’s health in rural Guatemala, she is also serving as the preceptor for the two students, Caitlin and Carly, who were in an adjacent room doing general medical consultations in two exam areas separated by a thin cotton sheet (see photo in gallery).  They did an excellent job, and demonstrated a high level of enthusiasm for learning about and understanding the cultural as well as the medical aspects of treating poor rural Guatemalan Maya.  They’ve continued to do great work all week, and I hope to have a lot more about and, hopefully, from them relating to their experiences here.

Meanwhile, the three Guatemalan support personnel – Angela, the clinical assistant to Dr. Crane; Kristina, the K’iche’ Maya translator; and Susana, the coordinator of the local clinics, registrar in chief, and all around problem solver, did a remarkable and truly admirable job with making sure that this was one of the best clinics ever.  They are doing so well, in fact, that our only worry relating to them is how to best utilize their very generous talents in future clinics.

So – we’re off to a great start with this clinic.  I’m so sad that I won’t be able to accompany the group to Quetzaltenango on Sunday – but it’s the way of life that I have to go back to my day job in New York next Monday. Lastima.  But the students have promised to keep sending me photos and information about their experiences, and maybe we can even get some good clinical stories and testimonials from them.