Megan Grudem – 2013 Guatemala experience

Guatemala 2013 YAM Trip

I am a Nurse Practitioner in Medical Oncology for GYN cancers at Mayo Clinic and had the honor to see patients in Guatemala along with Dr. John Wesley. I saw both men and women from age 14 through age 90, while Dr. John focused on the children. Thank you for this incredible opportunity to experience what life is like in a third world country and to be humbled by their daily struggles and at the same time awed by their generous humanity, never once witnessing an act of anger or entitlement. Each of the five days we saw patients, a long line would be forming before we ever arrived to the clinic location for the day. Dr. John and were able to see from 36 to 39 patients daily, and unfortunately some were turned away, but never was there any anger or plea to be seen, only quiet disappointment. Some of the people only receive healthcare when a mission group travels to their village, making it difficult to effectively manage chronic conditions such as htn or diabetes. I would like to tell you about three of the patients I pray I helped.

You are a young 24 year old woman, married and expecting her first child. The pregnancy has been uneventful without complication even though you live in a small concrete room with a metal roof and dirt floor. There is no electricity, heat, or air conditioning. The water is not safe to drink and you have one basin that is filled daily with water to be used for drinking, cooking, cleaning, and bathing. All the water must be boiled for safe consumption. You are poor and your husband works hard away from home everyday and out of communication. Today is January 9, 2013 and you hear that a medical team from the USA will be near your village today and you plan to make the long walk, in shoes that have a sole less than 1/8 of an inch in depth, in the heat, alone, because you were told that your baby was due on December 27, 2012….. I will call her Maria…..I fear the worst, that the baby has no heartbeat….Upon asking questions I learn that she feels the baby move every 15-20 minutes and hasn’t felt pain or been bleeding. I am excited to examine her belly and am able to feel the head in the downward delivery position, the butt at the top of the uterus, and the back to her right side. I tentatively place my stethoscope over the baby’s back in hopes of finding a heartbeat, difficult without a Doppler that magnifies the sound, and I listened intently…..and there it was a fast but normal fetal heartbeat clearly echoing in my stethoscope. A sigh of relief spread throughout the room, to the interpreter’s face, the nurse’s face, and to the young Mom to be. I was able to tell her that the baby sounded healthy and that first babies are often late. I wanted her to be checked at a clinic with a Doppler in a week if the baby hadn’t been born, but she said if her husband could take her she would, if not the baby would be delivered at home without further medical intervention.

You are an 82 year old woman with a loving husband, but you have worked hard labor all your life, washing clothes, sewing and weaving clothes to wear and to sell, cooking for a family, and tending to the household. Your eyes are dry and burn from the sun and heat, and your vision is poor from years of focusing closing on needle work. You have arthritis from carrying heavy loads on your head, your back, and from kneeling on your lower legs and ankles working. You are at most 4 feet 5 inches tall because you grew up without the nutrition needed to grow tall and strong. For some time now you have been vomiting and having diarrhea multiple times a day, and are taking in very little food, and no pure water. You hear that a medical team from the USA is coming to you village today and you want to find out if your condition can be helped. Your husband accompanies you on the long walking journey. ….. Rosa sat down next to her husband and they both began to talk in Quiche, rapidly, with hand motions I could understand…the interpreter confirmed she had been vomiting and having diarrhea uncontrollably and need help. The triage sheet stunned me…she weighed only 55 pounds. On exam I was horrified at her emaciated body and signs of severe dehydration. Her tongue was full of deep crevices from lack of water and her body looked like a concentration camp victim. In addition, the interpreter leaned over and explained that her husband was drunk and upon further investigation her son was also an alcoholic and she had not been cared for. I spoke with Heather, one of our team leaders who has dedicated 3 ½ years of her life to the Guatemalan people, and I explained that Rosa was near death, and could we get her to a hospital. Much conversation ensued between Heather, a local interpreter, and Rosa and her husband. Rosa could get a ride from a local man to a hospital in Chi Chi, 30 minutes away, and Salud y Paz would use an emergency fund to pay her way. But in Guatemala, food is not provided in the hospital, only doctor care and medicines, so social services would need to be involved. Rosa wanted to go to the hospital, but her husband wanted to take her home, as it is believed that to go to a hospital at her age means she will not come home. He was crying and pulling on her sweater, but because he was intoxicated, we could send her to the hospital without his consent. It is through your support of this mission and Salud y Paz that Rosa has been given a second chance.

You are a 65 year old woman living with your granddaughter. You have worked very hard all of your life washing clothes, sewing and weaving clothes to wear and to sell, cooking for a family, and tending to the household. Your eyes are dry and burn from the sun and heat, and your vision is poor from years of focusing closing on needle work. You have arthritis from carrying heavy loads on your head, your back, and from kneeling for long hours on your lower legs and ankles working. Your daughter lives in Guatemala City so that she can earn a better living, but your granddaughter stayed behind to finish school. In Guatemala school is free through the 6th grade only. Today you hear that a medical team from the USA is visiting your village and you decide to make the long walk to see them. ……. Manuela sat down and explained to me through tears that her heart was hearting. Throughout our conversation and upon exam I did not find anything physically wrong, but discovered that even in a third world country, where their physical ailments are not the same as ours, the emotional and spiritual illness are very much the same. Manuela’s granddaughter had just moved to Guatemala City to work with her mother, leaving Manuela all alone in her village, and she felt all alone in the world. This was one opportunity for me to discuss seeking counsel from her pastor and church members, and to show her that I cared about her and that God cared about her. I gave her a month’s supply of vitamins, that I learned are a placebo for hope in Guatemala, but I also offered to pray for her, and both she and I knew this was more powerful than a vitamin.

Thank you again for allowing me to take part in this incredible opportunity.

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