Kristi’s Blog

The last 3 days, Guatemala City

Zona 3

The day began rather uneventfully, as most do.  Awakening early, after my first night’s sleep in SETECA (Seminario Teológico Centro Americano), I slowly dressed and made my way outside where I jogged around the soccer field.  It was my first view of the grounds in the daylight, and the beautiful simplicity of the unexpectedly small grounds surprised me.  As I ran, I found myself observing the old trees and green grass, listening to the chirping of the various bird species within the rhythm of the pounding of my feet, and admiring the faint scent of the flowers wafting through that of the night’s fresh rain on the earthy ground.  Intermittently chatting with a young student of SETECA as I rounded the field where he was stretching and later discussing life as we made our way to the barely existent gym, I found myself happy with the simplicity of the start of the day.  Finding hot water after a thorough search of the bathrooms of the second floor, I showered and made my way downstairs to speak with Tito, the Director of the Guest Department.

I noted the closed door of Tito’s office as I approached.  As I turned, waiting expectantly for an answer to my knock, I saw him rushing across the lawn back toward his office, talking on his cell phone.  It was as he entered his office and I waited in the entryway that I noted the fresh stains on his shirt.  Blood.

Nearly arriving at SETECA around 8 am after walking through Zona 3, two sisters working housekeeping on the grounds were assaulted by a group of men.  Carrying no money or other objects of value, one of the men proceeded to simply shoot Doña Hilda, a mother, a daughter and a sister, in the head.  Leaving her lying in the street to die, her sister Sylvia held her bloodied face helplessly, screaming, crying, and begging for help.  Still alive when the ambulance arrived, Hilda was lifted out of the rocking, loving arms of her sister Sylvia and slowly taken to the hospital.  Those same rocking, loving arms, then held Tito, who had arrived in the street, as Señora Hilda was brought to the nearby hospital.  The next several hours marked the arrival of Hilda’s large family, gathering and waiting, outside of the Emergency Room entrance, where several hours later, the news of Hilda’s imminent death, was delivered.

As I sat, shocked and silent, in the chair in Tito’s office, the injustice of the world slowly bagan to sink in.  Even without knowing this woman, without having interacted with her, she had still entered my life.  Watching Tito attempt to gather himself as he made phone call after phone call, I could see the fear and sadness in his eyes, the love he had for this woman.  And I cried inside for her death, her loved ones, and the heaviness the day would bring.

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With that, I proceeded to Potter’s House.

Jeremías 18:1-6

Palabra que vio a Jeremías de parte del Señor, diciendo:

Levántete y desciende a la casa del alfarero, y allí te haré oír mis palabras.

Entonces descendí a casa del alfarero, y he aquí, estaba allí haciendo un trabajo     sobre la rueda.

Y la vasija de barro que estaba haciendo se echó a perder en la mano del     alfarero; así que volvió a hacer de ella otra vasija, según le pareció mejor al     alfarero hacerla.

Entonces vino a mí la palabra del Señor, diciendo:

¿No puedo yo hacer con vosotros, casa de Israel, lo mismo que hace este     alfarero?—declara el Señor.  He aquí, como el barro en manos del alfarero, así     sois vosotros en mi mano, casa de Israel.

Merely four blocks from SETECA, I nonetheless arrived at Potter’s House Ministries with Mandy de Herrera, one of the volunteer coordinators, after she arrived at SETECA to drive me over.  After exchanging a few minor pleasantries, we proceeded to the building housing the Asociación Guatelmalteco Casa del Alfarero, a mere block from the holding place of the city’s 1,500 tons of new garbage each day, the 90,000 square yard dump.  Arriving after driving by the mountains of garbage lining the streets and the multitudes of guajeros (scavenger’s) carrying their sacks of guajes (finds), we were admitted into the solid steel gate.

Casa del Alfarero was started 23 years ago, after a group of Americans happened by the dump and saw the need that existed there.  The non-profit Christian organization has grown today to offer a multitude of services to the more than 11,000 people, 7,000 of which are children, who depend on the dump for their livelihood.  The $47,500 worth of monthly expenses supports the 5 ongoing programs and growing staff, all of whom choose to work with Casa Alfarero despite the opportunity to make far more money elsewhere.  Casa del Alfarero dreams of a place where scavenging no longer represents the livelihood of any of the people of Guatemala; slowly, their dream may become a reality.

The life of the guajero requires 14 daily hours of digging through the fresh garbage looking for things of value.  Broken glass, used needles, industrial chemicals, electronic metals, infectious rats, and thousands of flies add to the danger of the potentially fatal mudslides and fires in the ravine that houses the capital’s waste.  Added to that the danger of the zone itself, home to many of the poorest citizens of the city, and renowned for its violence, it is a wonder the guajeros survive.  Owing to the large fire that swept through the dump in 2005, guajeros must now carry government-issued, annually paid, identity cards to gain entrance to the dump by the guards.  Children under the age of 18 are technically not allowed into the dump, though many jump the fence before the guards arrive at 6 am or merely hide in the garbage at closing and sleep within the ravine for the night.  What once was an object of collecting plastic, metal, cardboard or glass to sell, at an unfairly substantially lower price than in other parts of the city, the recyclable materials scavenged from the dump, has now become a much different game.  Owing to the economy, the recycling companies are no longer sending trucks to weigh and buy the materials, and what once easily earned Quetzales everyday, may now bring no money home.  Many scavengers now merely look for food to feed themselves and their families, while others search for broken electronic equipment to fix and sell.  All hold the hope of the lucky find of someone’s functioning watch or piece of jewelry, easily sold in the market.  Some still collect their recyclables, stacking them high on the roofs of their homes, hoping one day to sell them again.  Despite not entering the dump, children still spend much of their time helping their family, and are often responsible for 30% of a family’s annual earning.  Washing and repackaging used plastic utensils or preparing other finds for carrying to sell at the market is one of the primary ways in which children are responsible for bringing home part of the 20 Q many families live on daily.

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The programs of Casa del Alfarero:

Proverbios 31:8-9

“¡Levanta la voz por los que no tinenen voz
¡Defiende los derechos de los desposeídos

¡Levanta la voz, y hazles justicia
¡Defiende a los pobres y necesitados”

SALUD (Health)
One of the most important aspects a productive lifestyle, is having the health to work, think and learn.  In this line of thought, attention is paid to every aspect of health of the elderly, parents and children served each day at Casa del Alfarero.  Physical needs such as clothing and well-fitting shoes, blankets and beds to keep people from sleeping on the ground, and money for wakes and emergency medical care are all provided to those who require assistance.  A healthy, well-balanced lunch is served daily to the children attending classes in the building, and twice weekly the elderly come to enjoy a good meal.
In addition to these basic physical needs, both an OB/GYN and Pediatrician (Doctora Angélica de Rosales) work twice weekly in the small clinic.  Prenatal care, such as vitamins and ultrasounds, is provided while children’s growth is monitored and acute illnesses treated.   Working as a general practitioner in the clinic, Doctora Angélica also treats the elderly and and others in the community with each complaint they bring.  The ill are provided with prescription medication from the in-house pharmacy, stocked entirely by medications donated by visiting nurses and physicians.
Doctora Angélica’s connections through her teaching position at the medical school, allow her the ability to organize necessary laboratory, radiologic, surgical, and other care for those who need it.  And volunteer doctors of all types, dentists, hairdressers, and any one else willing to help support the physical needs of the community come from the US and other countries to provide care to these human beings, children of the Creator, with whatever gift they have to offer.

EDUCACIón (Education)
The importance of the education of both the children and adults of the community has not been overlooked.  Children come daily to this refuge from the danger of the streets for additional teaching beyond that which they receive in the public schools.  Tutoring in schoolwork in addition to classes in English, computer training, physical education, music, and Bible classes are all provided, helping to prepare each child with the basic abilities necessary to find work outside of the dump.  Scholarships are provided for children to attend Christian Básicos (3 years of high school), Carreras (three years of training toward a specific career after high school), and Pre-Universitarias (two years of study after high school to be eligible for entry into a university) as well as University, including Universities in the United States.  The scholarships include tuition as well as support for buying books, paper, pencils, and other necessary items, removing all cost for families to allow for the child to be an active student.
Beyond children, education is offered for parents and adults twice a month.  Here parents learn basic nutritional needs for a family, pregnant women, and children, and other basic education needed to live a health, productive life.  Biblical ideas and concepts are used to teach parenting concepts and proper treatment of children, helping families to break out of the communally accepted and normal cycle of child abuse.  Slowly, each generation is being educated for life outside of the dump.

DESARROLLO PERSONAL (Personal Development)
While basic education for all is desperately needed, specific training for leadership of some of the trustworthy members of the community is also necessary.  These leaders are provided with the education to help their community petition the government for necessities such as water and sewer service, electricity, and road construction.  When government help is offered, they assist in the actualization of the promised assistance.  And as they lead their community toward betterment, they impact the lives of all with whom they share not only their skills of leadership but the Christian principles and character they have learned and lived.

APOYO DE LA COMUNIDAD (Community Support)
In addition to the community leaders, Casa del Alfarero also helps within the communities themselves.  Volunteers, seeing the needs of specific communities, help build roads, water and sewer lines, and electric lines through a community.  Homes are built for those living in the street or illegally hiding in the dump, and the dignity of the lives of others is raised merely by fixing up a home with a leaking roof or other problem.  In emergencies, food and other necessities are prepared and brought to communities, and legal advice is offered when needed.  The impact of these small pieces of development is always greater than one could imagine as the self-worth of each member of a family is lifted up and the dignity of the community is improved.  Every little change matters.

MICRO-IMPRESA (Micro-Enterprise)
Finally, financial assistance is available for owners of small businesses that have been functioning for over one year.  These “businesses” often include fix-it shops of electronic or other items found in the dump, but are a business nonetheless.  In order to receive assistance, business owners, with the help of Casa del Alfarero, develop a business plan that includes how the money will be used, improvement or addition of services, necessary wages for employees and appropriate prices for goods.  Business owners are assisted in becoming associated with the bank, taught how to use the bank for loan repayment, and are required to open a personal savings account.  A plan for repayment is then addressed and the business owner receives 1,000 Quetzales, which must be payed back in full in four months.  After successful repayment, business owners are eligible for successive increases in loan quantity by 500 Q as well as repayment time by 2 weeks.  Eventually, Casa del Alfarero hopes to see the small businesses thrive, improving the quality of life of the entire family of the owner, providing the family with a means of support in old age with the money they are now saving in the bank, and adding wealth and value to the community.

While all of the programs that Potter’s House provides are important for the development and improvement of the lives of the human beings of Zona 3, they are also all used as an excuse to teach and show these worthwhile people of the grace and love of God and Christ Jesus, as well as the important principles the Bible gives us.  Showing that love means always being aware of and prepared to provide for at least one of the needs of the people of the community.  And letting that love show allows Casa del Alfarero the credibility to share their joy in Christ.  Additionally, being treated with dignity and respect gives the people of this community a reason to live, to better themselves, and to strive to improve the lives of their children.

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After arriving to Casa del Alfarero, I spent the morning learning about the ministry and program that had existed here for the past 23 years and then found my way to the two small morning classes.  Spending time with these children, those whose parents worked daily in the dump, and showing them that they are loved despite their situation, was memorable.  For beyond the dirt and grime, the ill-fitting and unmatched clothes, were the young eyes and hearts still filled with hope for the future; not yet lost in the violent world of their upbringing.  Merely jumping rope, taking pictures, sharing laughs, teaching English, and learning the alphabet brought joy to these youngsters.  Just the touch or hug of a Gringo showed them that they too, mattered and were loved.

After enjoying the Guatemalan meal served to the children with some of the staff of the mission, I enjoyed a small Bible study about God’s love and our return of that love.  The difficulty of seeing His love through the trials of life, the intellectual discussion of looking for that love, and the personal stories of the joy of finding it, gave me the hope that even I may see, someday, His love twisting through my brokenness.
That same love of Christ is physically and visibly offered daily to the young children in Potter’s House, over and over again, day after day, simply and joyfully.  Doing the same, showed me once again, just how easy love can be.  Serving the second group lunch after our short discussion, I saw the meaning of that love as young, thin children devoured plates of food in minutes, a young boy grabbed and held me for the sake of the hug he would receive, and the occasional English “thank you” followed by “you’re welcome” brought giggles of joy to many young faces.  Love was sought in every corner and received by each child according to the need they expressed that day.  Love without question, without conditions, and without expectations.

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Driving down the street of Zona 3 later in the day with Doctora Angélica, carrying medical equipment and headed to the home of an elderly woman dying of ascites, I was struck by how much busier the streets had become.  As we parked and walked through a narrow alley between two windowless brick walls, turned the corner and walked through another alley of barred windows and steel doors until we arrived at her home, I noted the young people roaming the streets, women and young children selling in the cramped alleys, and the dirtry garbage from the nearby dump blowing through the air and streets.  Inside, the home was dark and dusty.  A television was turned on, and the elderly woman laid in a bed placed near the entry way.  Her tense belly was obvious even under the layers of blankets; the size even more striking when her small bony arms and legs were exposed.  A large stasis ulcer on her right leg, which had covered nearly her entire pre-tibial area, was healing nicely.

As we helped this elderly woman, once a Potter’s House volunteer, out of bed and into a chair, two young, shoeless children peered at us from the hallway.  Their dusty bare feet, unwashed faces and hands, and dirt-ridden clothing screamed of the conditions in which they lived.  Blankets were draped over random items, a small gas camping stove in the hallway heated water, and the bare dirty floors continued as far as I could see.  Mom’s jeans, t-shirt and sweatshirt were all covered with grease and grime; observing her clothing led me to believe she worked as a guajera. As her son explained their fears about his mother’s health and currently high fever, I continued to note the depressive atmosphere of the visible part of the home even while examining the woman, looking for a source for the sudden onset of this obviously high fever.  Eventually attributed to a right lung base pneumonia, we left after praying with this slowly dying woman, with the promise to have another member of the organization return with the appropriate antibiotics.

The rest of they day I spent with the doctor, treating some of the elderly of the community who had come for lunch that day.  Everything from scabies to dermatitis, gripe to heart problems, was treated with the available drugs in the pharmacy as many of these elderly women spoke of the work they continued to do in the dump, despite their age.  Again, the simple touch of a clean hand and the gracious care of a doctor, showed the love that man are missing completely from their lives.

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Returning to the safety of SETECA, the atmosphere of the day changed dramatically as I cheered the third year soccer team to a huge win over the pastors, had dinner with a few of the students here (Nery, Jon, Arturo, and Julio César), and sat and had coffee and chatted with Julio, a first year from Honduras for a few hours.  However happpy the day, however, hanging in the air was the death of Señora Hilda with the upcoming wake tomorrow afternoon.  We lamented the life that was taken so liberally and suddenly; the family member lost to the violence of this place.  We imagined the grief of her mother, in the middle of a trip to the United states visiting relatives, receiving the news of the death of her daughter over the telephone and now waiting, alone and away from home, with the tremendous grief a mother has for a child dying too young, for her sudden return to the grief Guatemala brought her.  The violence of the streets had hit way too close to home today.

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Zona 3, not even mentioned in my tour guide of Guatemala, remains in its contradictory and dichotomous well-known obscurity. Certainly, my presence here made no perceptible change in the injustice of this place and the lives that form it, however, Zona 3 definitely made a perceptible change in me.  And the hope that in reality, one day, the dump can merely contain garbage, not human lives, and the streets can be walked without worry of being robbed, assaulted, or killed, lives in me now as it lives in the souls of all who live and work here, in the Guatemala that never should have been.

Clinic’s

Clinic in Guatemala

Serving Tuesday and Wednesday in our own traveling clinics, carrying our medications and equipment with us, as well as serving in the permanent clinics of ASELSI and Canillá Thursday through Saturday, provides a huge variety in the type and number of patients we are able to see, the availability of clinical exams, and the types and amounts of medication necessary.  Working in these varying environments taught me how to use my history and clinical skills to reach reasonable differential diagnoses, determine the risk of misdiagnosis leading to non-treatment versus the risk and cost of treatment based on the amount of time it would be before the patient would be able to be seen again, and adjust treatment plans based on the availability of medications, ideal or not.  I also learned of the simplicity of reassurance, the importance of education, and the difficulty of communicating instructions due to both lingual and cultural differences.  Finally, I was shown the amazing grace and love anyone is able to share with another, and the incredible hope that that love and grace can bring to those lacking it most.
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Las Montañas de San Pedro Jocopilas

High in the mountains above the town of San Pedro Jocopilas, between the villages of San Bartolomeo Xocotenango and San Andrés Saj Cabaja to the north east, and Santa Lucía la Reforma to the north west, the blue Iglesia Misión Evangelica Pentecostes; JesuCristo, es él fundamento, sits high between the dry valleys below.  Above the entrance into the church is painted Isaías 1:18, “Venid luego, dice Jehová, y estemos a cuenta.”

Within the fairly dark church, wooden benches line the central aisle, small windows open to the sunlight, and bright flags decorate the ceiling.  The front of the church expresses hope to the people with several verses from Isaiah.

Isaías 41:18  Sobre las cumbres áridas abriré ríos, y manantiales en medio de     los valles.  Convertiré el desierto en lagunas, y la tierra reseca en fuentes de     agua.

Isaías 59:21  En cuanto a mí, éste será mi pacto con ellos: “Mi Espíritu que está     sobre ti y mis palabras que he puesto en tu boca no se apartarán de tu boca, ni     de la boca de tus descendientes, ni de la boca de los descendientes de tus     descendientes, desde ahora y para siempre”, ha dicho Jehovah.

Isaías 1:18  Venid luego, dice Jehová, y estemos a cuenta: si vuestros pecados     fueren como la grana, como la nieve serán emblanquecidos; si fueren rojos     como el carmesí, vendrán a ser como blanca lana.

Creating spaces between the rows of benches, we create spaces in which patients can be seen.  Behind these spaces, patients sit in the cramped rows of benches, patiently awaiting the call of their number while young children run around the building, both in and out.

Between treating patients, I play with the several young children bouncing through the church, dancing with them on my shoulders, chasing them around , and playing other little games as they look on as I work.  The parents and other adults smile as they watch their children giggle and laugh, run and play, without a care in the world.  It struck me just how little it took to show love to these youngsters and bring joy to the faces of the whole community.  It struck me how much I had to give.  Money was nothing; just the love of another who could easily reject these youngsters and their families as hopeless, dirty and worthless, was all it took to show the whole community their worth.
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CHICABRACáN SEGUNDO

Every other Wednesday, heading south out of the city as though headed toward Chichicastenango, before getting very far down the well-paved road we would suddenly turn and head east down another typical dirt road.  Passing by small groups of shops, large hoed fields, small homes made of wood or mud brick, and animals grazing in the pasture, we would eventually arrive at a small, three classroom school.  The fourth room in the building, a tiny 12 by 12 foot room, used as the teacher’s lunge at the school, is where we set up clinic.

Being one of several of the traveling clinics we ran, four large, plastic containers, each around 4×2x2 feet, carried all of our medical equipment and treatments in the back of the SUV we drove.  Additionally, an ultrasound and a few blankets along with the computer we used to try and keep track of the patients we saw at each clinic were loaded up and carried along.  After setting up all of our equipment in the small room, there was barely enough room for two people to move around.  We would therefore set up just one station inside for seeing patients while I saw patients around the corner, outside, near where people lined up to buy numbers.

Unlike the clinic in Canillá, devotions with us as staff and the people who had come for treatment followed by a communal prayer, began each session.  As is the case in most instances in which a prayer is offered in Quiché, everyone at the site lifted their own voice in praise, thanks, or petition.  My first experience of this, occurring here at Chicabracán Segundo, my second day in the country, was one of the most unforgettable and impressive experiences of my life.  Hearing voices raised; shouting, crying, singing, speaking; in different tongues; Spanish, K’iche’; and in different tones; begging, thanking, hoping; was an extraordinarily moving, musical, and beautiful sound.  And, opening my eyes to see gringos in jeans, Mayan women in traditional cortes and huipils, men in pants and long sleeve shirts, children carried in the blanket around their mother’s shoulder, and Ladino men, women and children dressed in typical western clothing, standing or sitting, heads bowed prostrate or raised to the sky, hands reaching to heaven or clasped in supplication, fists pumping or still, created a perfectly natural, variant sight.  These sights and sounds resounded within my soul, moving me as I have never been before, enjoying the serenity of a moment I wished would never end.  As an Amen from the leader led to quiet, the sound of the wind and birds, of animals and children, slowly overtook the unnatural quiet within me, and we proceeded to complete our set-up and begin to see patients.

Being out in the open, sitting on the three foot cement rise along the side of the building,  perfectly placed fro sitting, patients would sit in the chairs I had placed in front of me to express their health concerns.  Blood pressures and glucose checks, heart and lung sounds, abdominal exams, and eye and ear exams were all completed outside, often with many other patients looking on.  Occasionally, groups of patients would gather round to hear another’s story, sometimes attempting to help translate but often just listening out of curiosity.  The lack of privacy and indifference of the patient to it was striking as a US citizen with privacy being such a huge general, as well as legal part of medicine, to accept and believe that this lack of privacy was not a problem.  No patient, however, ever even mentioned the situation.  It may be that the concept of privacy, while so much a part of our society in the US, is so little a part of the society of rural Guatemala, that these patients expect privacy only in the realm of sexually-related information.  It is not unusual, for example, for a mother to sit and breast-feed a child while working at the market, being examined by a doctor, or chatting with a group of women.  In addition, many of the homes we pass as we drive down dirt roads, along fields waiting to be planted with maíz, are apparently only one room, providing privacy to no one.  Lastly, the desperation for medical attention for themselves and their families and our presence representing their only option for reception of that care, may also lead these rural poor to be willing to see a doctor in nearly any circumstance.

Despite the relative inadequacy of the area for being able to help patients as we may expect to be able to, treatment quickly began with the person holding the first nuber sold that day for 2 quetzales.  Hours were spent reassuring parents of children with colds, getting children medication to lower fevers, treating ear infections and diarrhea, encouraging safe yet effective scabies treatment, and providing pain relievers, heartburn medication and vitamins to many.  In mid-afternoon, we would once again pack up our medication and equipment, repack the truck, and head back to Quiché, hopefully having left a footprint in the lives of the patients we treated that day as large as that that the many patients in that beautiful place left on my heart during my first day of work.
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SANTA CATARINA

One Wednesday a month, between visits to Chicabracán Segundo, we make the long trip to Santa Catarina.  This small village is located hours from our home in Santa Cruz del Quiché, up in the mountains near Lago Atitlán.  After heading south out of town, passing through Chichicastenango, and arriving in Los Encuentros, the town at the divide of the main highway through the country leading one toward our home, Guatemala City or Lake Atitlán, we continued our long journey toward the clinic.  As with all of our traveling clinics, we once again carried our supplies with us toward the place in which clinic would be housed.

Santa Catarina, a small farming village in the mountains, is home to small one room, rough-strewn church connected to the pastor’s home.  “Iglesia Evangélica Metodista Primitiva ‘Belén,’”  as the small, painted, cardboard sign hanging above the doorway proclaims, is roughly 12×12 feet.  Around the walls are wooden benches and a couple of small tables.  A few chairs litter the room.  A single lightbulb hangs from the ceiling near the back, just above the only electric outlet in the church.  Cardboard boxes line the walls within, presumably to insulate the room or help prevent the entry of the wind, dust or rain that could easily fit through the large cracks between the weathered 1×4’s responsible for forming the outside of the church. From some of the walls hang pieces of cloth to help decorate the room while at the back, a wooden-framed metal door is held shut by a brick from within.

Arriving late on my one trip to Santa Catarina, the people expressed worry that we were not going to ever show.  The trip that morning had been rough, having sat, unmoving, for nearly an hour in two separate parts of the highway through the mountains, owing to construction.  Work on the roads would stop traffic in both directions for a period of time and then, when a stopping point was reached, would allow passage of traffic one direction at a time for a small while before resuming work.  Knowing of the continual, long-term, unmoving traffic jams, people from the village would pedal goods up and down the long line of stopped cars all day long.  Everything from food and candy, toys and jewelry was available out the window as we awaited the continuance of our journey.

Outside of the small church, a crowd from the village had gathered well before our arrival, awaiting our help.  The majority spoke only K’iche’ and, owing to the lack of an official translator, the pastor served to interpret the symptoms, needs, and desires of the people of his community.  Being a relatively poor translator in that very few of the actual words spoken were re-spoken to us in Spanish, we nevertheless were able to get the necessary information to treat each patient.  It was a relatively frustrating experience for me, receiving pre-interpreted information through the eyes of the pastor rather than plain fact from the patient, and by the end of the day, my patience was wearing fairly thin.

Interestingly in this small community, a number of patients are treated continuously with anti-seizure medications, complaining of “ataques” in which they would fall, shaking, to the ground.  Beyond this unusually common complaint, the typical cold, ear infection, and diarrhea were also presented, as well as the occasional woman requiring prenatal care.  My most striking patient, an elderly man wearing typical Mayan dress, a generally rare sight in all areas of the country, presented with complaints of itching, as well as a large traumatic wound on his right pretibial leg.  This wound, owing to a run-in with a stick on a walk up out of a valley, was wrapped in a dirty cotton strip, soaked with blood.    Being able to help him with proper wound care, antibiotic cream and oral antibiotics to control and prevent infection as well as medications to control his itching, was as truly satisfying experience.

Despite the lack of light, little privacy, poor translation, dirt floors, and eveything else working against us, we are still able to do significant good in this small village.  This little church proves that place matters not; merely love, good intentions, and the desire to help are necessary to be able to use our training to provide the struggling poor with the care they need.
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TABIL

Filling the last of the Wednesday’s in the four week cycle, Tabil sits a fair drive east of the city.  Heading out of town as though headed for Canillá, we turn left off of the gravel road far before reaching Canillá, following another gravel road up into the mountains.  The simple brick building housing Iglesia Misión-Evangélica-Pentacostes JesuCristo-es-el-Fundamento El Tabil, is a large mostly empty room with plastic chairs lined up against one wall, all of which are painted white both inside and out.  The small stage near the front, mostly empty save a few chairs, a small table, and some speakers, provided the space we were to use to see patients.  The door of the brick church faces out toward the beautiful valley below.  Driving away, climbing the mountain roads, the white church stands out among the fields and small mud-brick and wood homes within the valleys.

Setting up some small groups of chairs to create patient stations on stage, maintaining a small area on the corner of the stage for performing ultrasounds, and finding a place to set up our computer, brought us once again to the point at which we could begin to see patients in the less than ideal circumstances in which we usually found ourselves.  Performing ultrasounds with another person holding up a sheet or blanket to at least block the view of the line of people waiting to be seen, and laughing at the dogs entering the church to sniff through the garbage the waiting had thrown on the floor of the church, we once again slowly made our way through the typical complaints.  The atypically short line of patients were quickly seen and, after packing up, we were able to spend a short time rediscovering and enjoying the beauty around us, photographing the nature so typical of the highlands and hanging out in the weather that is rarely less than perfect.  The hope that the beauty I was surrounded with seeped into my soul, fairly represented the hope I dreamed my small gift of improved health was able to begin in the lives of the patients in Tabil.
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ASELSI

Just before reaching the brick arch announcing one’s arrival to Chichicastenago, we head east along the typical dirt road winding toward and through a small pueblo, following the handwritten signs directing us to the beautiful, yellow/brown two-story brick building with white pillars housing ASELSI.  The wide, rounded building with open hallways running across both stories, is fronted by a large flower-bed around which, the cobblestone driveway curves, after leading one in through the tall, wrought-iron gate.  The Asociación Equipando Los Santos Internacional, is used both as a seminary-like school holding classes to teach and help maintain ministers in the Quiché area, as well as a clinic treating both the acute and chronic illnesses of the poor in the surrounding areas  (Efesios 4:12 “… a fin de capacitar al pueblo de Dios para la obra de servicio, para edificar el cuerpo de Cristo”).

Being that ASELSI stands as a permanent building and clinic, is able to train and pay many staff, and can house various medical and laboratory equipment, many services are available in the clinic that are unavailable elsewhere.  Urine tests for pregnancy, infection, diabetes and more, fecal screens for infectious parasites and blood and vaginal smears for some basic infections are all immediately available.  Well-trained medical translators, all of whom speak fluent K’iche’ and Spanish, are available for all patients who do not speak sufficient Spanish to communicate their needs.  And a permanent pharmacy with pharmacist is open to provide patients with the medications they need, helping the flow of patients by allowing us to avoid searching for and preparing the various prescription medications.  Often missing is the privacy that people within the United States expect, however, the desire for treatment and cure it seems, far outweighs any embarrassment this lack of privacy may cause.

Each Thursday, arriving around 8:30 am, we begin to prepare ourselves for acute-care clinic while the well-trained translators worked checking in the long line of primarily K’iche’ speaking Mayans waiting to be seen.  The 5 Q tickets sold early Thursday morning to a minimum of forty patients are always in high demand with the majority of people traveling to the clinic unable to be seen.  Many travel several kilometers, often on foot, carrying a young child and food for the trip, merely to get affordable treatment for a sick child or ailing parent.  And many arrive as early as 2 am, hoping to be one of the lucky few to leave after receiving care.  Waiting in line in chairs lining the hallway of the balcony to be seen at one of four stations in a large upstairs room, or crammed into a small waiting room where often-times two patients are seen concurrently in one of the small patient rooms, those lucky enough to enter patiently sit, without complaint, listening for their name.  Short histories, clinical exams and ultrasounds are performed for patients who are part of the fertility clinic, while other acute-care patients are given a careful work-up including a history and physical, often including minimal lab-work, before being diagnosed.  After being seen by a doctor, patients proceed to the pharmacy where, often more than two hours later, they receive their medications and instructions for use, and finally head home.

Friday, always considerably less busy than the day before, is chronic clinic day.  Patients being treated for life-long illnesses such as diabetes or hypertension, are assigned a particular date every 4 to 8 weeks to return to the clinic for a short history and physical, review of their prescriptions including current use and efficacy, and need for treatment for other acute problems illnesses. Pre-packaged bags of medication for each expected patient make prescription refills substantially more simple, even with minimal changes, and the ten patients seen that day often do not have to wait past noon to receive care.  ASELSI and the people who work there become like family to these patients, who come in each month to receive care.  And the patients become like family to the staff, too, who know the patients by name and illness, and know how well their treatment program is going.  And although there are many more people in the area who would be blessed by this service, the amount of money it costs to treat someone for a chronic illness for the rest of their lives, inhibits the clinic from expanding the program.  No money, no guaranteed drugs; no treatment.

ASELSI stands tall and proud within its community, representing hope and love to the people who are continually or occasionally treated there.  While the number begging for treatment and care far outnumbers those served, the local population still walks kilometers for the support and love of the hands of those who serve in the building.
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CANILLá

Every Saturday, the two and a half hour bone-rattling ride east down a winding, mountainous, dirt-road, brings us to Canillá and the large compound belonging to the Ficker family.  It is here, surrounded by mountains and pieces of land hoed for sowing, that the Ficker’s live and work.  Chickens, cows, and horses graze in their nearby pens, fenced in behind the family home.  Large farm machines and various vehicles of all types are parked in the tool-ridden garage and around the yard.  Bordered by flowers, a short sidewalk leads to the back entrance of the clinic.  A few bedrooms and the pharmacy break off the large room into which we enter, often smelling of the freshly-baked muffins or bread Leslie has brought over from her home to offer us before clinic.  A short hallway leads one into the clinic itself where two rooms, separated  and accessible to both by the large bathroom and entryway, each house two desks for consults as well as an examination table, walled off by a privacy curtain.  The walls, brightly painted, carry Biblical reminders of what this clinic and the people within it mean to those waiting inside the gate.  It is here, within this space, surrounded by medical equipment and prescriptions, and just beyond the door behind which no less than fifty people sit, that hand-in-hand, our small group prays for guidance and grace.

Opening the door to the bright sunshine to admit the first four patients, a sea of faces with looks of desperation mixed with hope, gaze into the hallway beyond the door, wondering when they too, will have a chance to meet with the doctor’s within.  As histories are taken, ultrasounds completed, medication handed out, and instructions given, the numbers slowly creep upward as the crowd outside dwindles.  Packing up our instruments, collecting the waste and other things that have found their way to our desks, and slowly unwinding over a glass of water, we prepare to leave after the final patient is seen, well after one o’clock in the afternoon.

Driving back through the beauty of the mountains and valleys, away from the exhausting clinic, the terrain never ceases to show its beauty.  The dry, dusty roads of April, now in the rainy season, sport rivulets, floods, and the new hazard of areas of missing gravel.  Meanwhile, the fields in which the cows once grazed amongst the browned leaves of last year’s maíz harvest are now freshly sown and planted; the cows graze nearby in large, magnificently green pastures that have suddenly burst forth from the dry ground.  The once dry river beds now run with muddy water, and the green of the trees is spotted with the color of flowers.  We head up along the road until we are driving through the clouds, and then begin to head down again, out of the sky and into the valley.  What earlier was a relaxing return trip has now become a race with the dark clouds toward which we head, threatening to make the road ahead nearly impassable.  Rain, thunder, and lightening lead us home.  Could it be that the storm within the eyes of our desperate patients, rained upon by the grace of a doctor’s hands, may also bring the green of life to the dust living within?
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All in all, the lesson I learned from the poor of Guatemala was that each clinic was more about sharing love and understanding along with whatever medical care was available given our limited resources, than it was about treating each patient the way they would be in the western world.  Medical care was more about hope than cure.  Doctor’s visits, more about grace than knowledge.  I was also shown the simplicity of these very things; the ease with which love is shown.  It is my hope that I was able to show my love to an entire people; to give hope to all with whom I came in contact; to cure most of those who came to me for assistance.  Most importantly, though, is my desire to continue to be able to provide love and grace to all of my patients, whether or not I can offer them a cure, and to leave just a smidgen of hope in the souls of all with whom I come into contact.

Pascual Abaj

Visit to Pascual Abaj

After my thoroughly eventful journey to Chichicastenango on Mother’s Day, I made my way directly to the mountain on the south side of the city, the sacred place where Pascual Abaj, god of the Mayans, resides.  After switch-backing along the narrow, uneven, rock-filled dirt trail, I finally reached the top of the small hill and walked along the path lined with trees toward the smoke-stained rocks before me.

There in a circle stood several altars, all filled with the ashes, flowers, candle-wax, and other evidence of offerings from the past.  The flat rock upon which the altars were placed showed the same scars of the offerings of hope of a poverty-stricken, struggling people.  As I stood and took in the sacred place, a small group of Mayans came to begin a ceremonial prayer to their god.

Pascual Abaj (Spanish and Mayan name for the god) is La Madre de la Tierra (mother of the earth), representing white, yellow, red and black corn as well as the rain.  Five crosses surround Pascual Abaj, four of them representing the cardinal directions of the earth, while the fifth, the only cross with a human form on it, represents the former Chaman of Pascual Abaj, still present and working to intercede for the people, bringing their prayers to the god.

In the worship of Pascual Abaj, the Mayans offer a specific sacrifice along with their prayers.  Candles are lit and placed on the altar itself, amongst the flowers and grass already present.  The main sacrifice is built on the flat rock upon which the rock is built.  First a circle of sugar is created, representing the earth, and a cross is created within the circle, representing again, the four cardinal directions.  Copal, the incense used in Mayan ceremonies, is place all around the circle of sugar, and within that circle, four candles, representing the four cardinal directions, are placed.  A large chocolate is placed in the circle of candles, pan dulce (sweet bread) is added, and finally, candy is sprinkled around the entire circle. The candles will be lit and the entire offering will be burned while the ceremony of prayers is performed.

The remaining, smaller, altars around Pascual Abaj, allow for other prayers and offerings to be made in this same sacred place.  Clockwise from the large altar to Pascual Abaj lies a small pile of stones, representing frijoles  the other fruit of the land of Chichicastenango.  It is here that man prays for his land to be fruitful and to provide for his family.  Next to the small pile of stones lies a small cross, representing the god of rain, and beyond it, the small semicircle of stones representing the sun.  Together these three altars provide the Mayans with the opportunity to pray for their needs, to pray for their welfare, and to pray for their way of life.  Directly across from the large altar to Pascual Abaj, lies another altar, a cross with large stones forming a semi-circle in front of it.  This altar is used by the family members of alcoholic men to beg god to help them stop drinking and once again become productive members of society.  Alcoholics within the Mayan community are commonly thought of as being unable to provide for their family due to all of the time they spend drunk on the side of the street and unable to work as well as all of the money they spend on alcohol.  For this reason it is especially important to the Mayans that god helps their family member leave drinking behind and support their wife and children.  The final cross in the circle is for begging for the health and well-being of women and children.  Family members come to pray for quick healing and survival of the women and children they love, many times knowing that these prayers to the god above are the only offering they have to offer their loved one.   With no doctors available or close enough to journey to and with no money to offer for medical care, Mayans must turn instead to the gods they believe will save their people.

As I watched this small group of three Mayans quietly and precisely prepare their offering to Pascual Abaj and prepare to burn their gifts, I thought about the prayers they would offer to their god as they begged for fulfillment of their needs, gave thanks for the blessings they had received, and sat in communion with their hope.  I thought about the Mayans I had seen offering incense to god in front of the doors of the catholic church, on the altars in the many plazas of Quiché, on the steps or grass in front of a clinic, and within the Protestant church I have attended.  I remembered the intense hope and concentration, the undistracted worship I had always seen.  And I thought about the intense hope of all in this world, that one day we will be saved from this world and live in peace and prosperity, without suffering or pain.  We are all, in all corners of the earth, in all imaginable ways, searching for the same thing.  We are all seeking our savior.

Education in Guatemala

Every morning, afternoon and evening as I drive, bike, or walk down the streets of Quiché or the neighboring communities, I see young children walking down the road with their mother, carrying a load on their head and back with their father, selling trinkets at the market, working around the home or in the fields, or simply running around the streets.  At the same time, I see young people walking in their uniforms, headed to one of the many surrounding schools.  While it is compulsory to attend school for 11 years here in Guatemala, the average of three and a half years of completion of adults today is far below that.  With so many people living in poverty in Guatemala (56.2% of total population), it is easy to see why parents need their children to work to help support the family.

Beyond the overall low level of education in the nation, there are differences in the amount of schooling received by Mayan vs. Ladino children.  There are many reasons for these differences.  Access to a school with a teacher is much more difficult in the rural areas where the majority of the Mayans live as compared to the urban areas in which the majority of Ladinos live.  Poverty is a much greater problem within the Mayan community, with 75% of the (primarily Mayan) rural population versus 32% of the (primarily Ladino) urban population, living in poverty.  Additionally, it is not unusual for Mayan females to marry between the ages of 14 and 16, ending any chance for further education.  Beyond these reasons, the civil unrest of the 1970’s and 80’s and the still-strained relations between the Mayans and Ladinos, continue to maintain school enrollment low, with Mayans averaging 1.3 years and Ladinos 4 years of schooling.  The lack of education prominent within the country leaves Guatemala with an illiteracy rate of 30%.

For those who do get the opportunity to attend school, there are many options available.  Public schools, including those advertising their desire for a united Guatemala with the mixed Mayan/Ladino student population they encourage are plentiful in urban areas, and seen throughout rural Guatemala.  In addition are Catholic and Evangelical-based schools, some of which provide scholarships and housing for students given the opportunity to attend a more prestigious system.

Despite the system, all schools in Guatemala follow the same basic requirements.  Sección Pre-Primaria (Pre-Primary School), students attend Kinder (Day-Care), Párvulos (Pre-School), and Preparatoria (Preparatory), beginning at age 4 and finishing at age 7.  They then enter Sección Primaria (Primary School), where they finish years 1 through 6, at which time they begin Ciclo Básico (High School), which lasts 3 years.  All students are expected to wear uniforms to school, though Mayans are permitted to wear their traditional dress if preferred.
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In the Evangelical School which we toured, students pay attendance fees in addition to buying their own uniforms, school supplies, and books.  Cost of attendance in Sección Pre-Primaria is 140 Quetzales ($17.50) per month plus a 200 Q ($25) enrollment fee.  Students in Sección Pre-Primaria attend school only in the morning, returning home for lunch.  Sección Primaria also carries a 200 Q enrollment fee with a monthly attendance fee of 150 Q ($17.75).  Finally Ciclo Básico has a 250 Q ($31.25) enrollment fee and 190 Q ($23.75) monthly attendance fee.  Additionally, each student must complete a Mecanográfia (Typewriting) course, usually during the second year of Básico, with enrollment and monthly attendance fees of 35 Q ($4.35).  Students in Primaria and Básico have long days owing to the one and a half hours, starting at noon, that permits students to return home, have lunch with their family, and then return for afternoon classes.  For those students who live too far away to be able to arrive to the school daily, dormitories are available.  The cost of living in the dormitory, 700 Q ($87.50) monthly for females and 750 Q ($93.75) monthly for males.  The dorm charges include a small room for four, lights and water, meals, and care around the clock.  Girls and boys live in separate areas of the building and dine on separate sides of the cafeteria style dining room.  Many students who live here receive scholarships for both their living and school expenses, owing to the high cost of the opportunity.

After completing Ciclo Básico, students are still not prepared to go out and apply for a well-paying job.  At this point, they may choose to complete either a Carrera (Career) or a Bachillerato Pre-Universitario (Pre-University Bachelors).  Carreras are three years in duration with enrollment fees of 315 Q ($39.38) and monthly fees of 300 Q ($37.50).  Carreras available include Spanish-English Bilingual Secretary, Quiché-Español Bilingual Teacher of Pre-Primary School, or Accounting with Specialization in the use of Computers.  These carreras are designed for students who do not intend to continue on to the University level and provide them with the education to attain a skilled position.  Students planning on continuing on to the University level are offered a Pre-Universitario Bachillerato en Ciencias y Letras Diplomado en Computación. (Bachelor of Arts and Sciences Qualified in Computers).  While students finishing this program are then qualified to attend University, they can also choose to search for work instead.  The cost of enrollment for the Pre-University Bachelors is 350 Q ($43.75) with a 480 Q ($60) monthly fee. With the exception of students having completed Básico, all attendees must also pay 25 Q ($3.13) monthly for use of labs and receipt of evaluations.

Unlike many of the public schools around the city, the Colegio Evangélico Meodista “Utatlán” de Quiché, (The Evangelical Methodist School) is housed in beautiful, expensive red brick buildings with classrooms arranged in two levels around two separate courtyards.  The courtyards have benches, fountains, flower beds and trees woven around a cement walkway and provide a place for students to hang out during their break time.  The school also has a separate multi-use building used for conferences with the entire student body.  Currently, the addition of a cafeteria with both indoor and outdoor seating is underway and the school plans to build third floor classrooms in the future.  The school is truly impressive by its continual drive to improve and change it’s curriculum to help students achieve the skills they need in today’s world.
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The disparity in education today in the República de Guatemala is not only amazing to consider within the nation itself, but also frightening when compared to a nation like the United States.  Considering the interconnectedness of the world in which we live, the lack of education and literacy in Guatemala, though seemingly disconnected from everything we do, truly affects the people of all nations of the world.  As poverty leads to ineducation and ineducation leads to poverty in a seemingly endless cycle, the people of Guatemala continue to struggle with health and sanitary issues, high parity (birth rates), high infant and maternal mortality, poor nutrition, lack of access to healthcare and many other problems.  These problems, though perhaps un-seemingly, affect us all.  Illness spreads through communities and nations, eventually reaching every nation in this ever-increasingly small world.  Poor nutrition, lack of education, and limited healthcare all affect the potential achievements of many young children, raise the necessity of free or low-cost healthcare, and add financial and personnel burdens to countries around the world who have the ability to help those who deserve to receive care.  High infant mortality and early mortality itself, end any potentially amazing accomplishment offered by the deceased to the world in which we live.  Seemingly likely or not, each person on this earth makes their mark, one which touches merely several loved ones to one that influences the millions or billions of a nation or trillions of the world.  The loss of that ability is worth mourning for anyone who, without reason or cause, is denied the basic human right to the life they deserve.  Especially obvious and prevalent in the small clinics in which we work, I mourn each day the effects I see due to lack of access to basic proper sanitation, nutrition and healthcare, leaving the potential of youngsters far below that which they should have been.  And when one loses, we all do.

Pics

For those interested, I added some pics at the end of the Mayna Religion blog I posted.  For some reason I couldn’t when I wrote the bog but I got someone to fix it now.  Have a good day all!

Kristi

Mayan Religion

5/5

The Religion of the Mayans

The ruins of K’umarcaaj (Gumarcaaj; Utatlan), lying on a plateau surrounded by deep valleys and ravines, was once a grand Mayan city, captured and destroyed by the conquistadores in 1524.  While very little archaeological work has been done here, it is still a grand place and, for the Mayans, remains a sacred place of worship.  From the entrance, after walking up a steep incline to reach the top of the plateau, is a winding dirt path lined with trees that quietly bend in the winds.  The ravines are located not far from this path, and their steepness shows the natural protection provided to this area.  Walking along, one arrives at the Plaza Central, today used by the Mayans to worship and make offerings to the Mayan gods.

The unearthed buildings surrounding the Plaza Central, provide great vantage points for taking pictures of this amazing area.  While drit and dust covers everything, one can still make out where grand buildings once stood, where ball courts and gladiator fights once took place, and where, as the tallest building in the Plaza, the Templo de Tohil remains today.  Walking up to this sacred place, still revered as a temple to the sky god Tohil, one notes several areas around the one-time entrance to the temple where Mayans have burnt sacrifices to Tohil.  A small indentation has been dug into the earth enveloping the temple as a place to leave offerings for this Mayan god.

Beyond the plaza and down a flight steep earthen steps lies the cueva.  According to legend the cueva was built to house K’iche’ women and children to save them from the attacks of the conquistadores.  Mayans also believe an important K’iche’ princess was buried in the deep, 8 foot shaft, just to the right of the main path through the cave, and the Mayans still revere it is the place where K’iche’ died.  Sacrifices and offerings are burnt at the entrance to this important cave as well as in the deep darkness of the end of the long, flat walk within.  Trees hovering over the entrance to the cave are blackened by smoke and fire, as is the ground in various areas surrounding the entrance.  Flowers of various colors are seen scattered everywhere, as are candles and wax that has dripped into the rock and dirt.  A small pile of used flowers and candles slowly seeps its way down into the valley as they are removed for new ceremonies.  Entering the cave is like entering a grand church or beautiful palace, as the Mayan reverence of the place you stand envelops you like the darkness you enter.  Following the inadequate beam of my small flashlight, I slowly entered the cave and soon passed the deep, legendary, burial shaft and made my way to the back of the cave.  There stood a small altar with flowers and candles, blackened rock surrounding me evidenced many past sacrifices.  The awe of the place overwhelmed me.  Returning from the back of the cave, the view from within awed me as I headed back toward the lit valley.

Further down into the valley lies another smaller cave, also used for burning offerings and sacrifices.  One can easily walk to the back of the cave in very few minutes, where the cave dead-ends into a flat wall where an X marks the spot.  Again, flowers and candles litter the ground, evidence of ceremonial offerings to the Mayan gods.  Continuing down the steep ravine, through the sandy, littered ground, a path wound by trees of various types to the bottom of the ravine.  A now dirty river peacefully flowed down its rocky bed, gurgling as it passed over rocks and sticks.  Vines from the trees along its edge dropped down into the river, seeking out water for their survival.  The steep cliff across the river represented a natural barrier to the place from outside of the city.  The beauty of this place, surrounded by the sites and sounds of nature without interruption by the continually automated world above, was peacefully noisy.

Returning to the plateau, I noticed that here too, the noise of the modern world surrounding it did not reach the eyes or ears of the visitors to this place.  Wind whispered through the branches of the trees as they creaked and bent; birds sang and fluttered through the sky.  The smell of earth surrounded you and, in many part of the plateau, no evidence of man could be seen.

While the traditional Mayans still revere K’umarcaaj as a holy place, the syncretistic Mayan Catholics also come here to worship.  Creating a circle of life, with green grass and beautiful flowers, the adults begin to set up their area of worship.  Four large groups of candles stand within the space and a burning can of incense, likely copal, smolders, emitting its sweet, piny, earthy smell over the worshippers.  Once ready, the worshippers kneel around the small area of worship, and led by a teacher, review the five Glorious Mysteries, reciting, prayer and response style Our Fathers and Hail Mary’s, led by the group leader.  As the worship continued, other prayers were lifeted up giving thanks for life, the earth and sun, the world they live in.  A song wafts through the air:
“God we give you thanks for
Life, earth, sun
Lord we love to sing
Of the blessings of your love”
as the voices of the worshippers are raised toward heaven, together woshipping the Lord and begging him for his continued blessing.  Finishing their worship, the people sat quietly around, eating some of the food they carried with them and quietly chatting amongst themselves.  A few of the young men cam to chat with me about the meaning of their worship and the Catholicism they practiced.  Although they still came to what their people considered to be holy places to worship, they consider themselves sufficiently Catholicized.

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Catholicism grew rapidly among the Mayan population after the Spanish conquest.  The Mayans believed, prior to their introduction to Catholicism in the unified structure of the world, the heavens, and the underworld, represented by the towering Ceiba tree.  The tree united the heavens with its leaves and branches, the earth with its trunk and the nine levels of Xibalbá with its roots.  The cross-like ceiba tree, or world-tree, also reminded the Mayans of Itzamná or Hunab Ku, the great creator of all.  The teachings of the first friars as God as the supreme creator of heaven and earth and the representation of him by the venerated cross, was therefore easy for the Mayans to incorporate into their own religion.

The Mayans also believed that the great cosmic dragon shed his blood as rain on the earth, and in the same manner, it was important for humans to shed their blood onto the earth, linking themselves with Xibalbá of the underworld.  They revered the blood of kings as the most powerful blood sacrifice and bloodletting rituals were used to attempt to gain greater responsiveness from the gods.  This bloodletting ritual then fell in easily with the Catholic teachings of the crucifixion of Jesus, who spilled his blood on the earth to gain the attention of God and to allow God to hear and save His people.

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Today, syncretistic Mayan Catholicism can be found throughout Guatemala, including Iglesia Santo Tomás of Chichicastenango.  To enter the large Cathedral, one must climb 18 steps, the first 15 separated by the final three with a small plateau.  The last three steps represent the Father, Son and Holy Spirit while the 18 total steps represent the 18 months, each consisting of 20 days, that form a solar year within the Mayan calendar.  This calendar, marking time within the world in which they lived, allowed for remembrance of the past and prediction of the future for the Mayans who used it.  Mayan symbols are present throughout various parts of many of the Catholic churches built in Guatemala by the Mayans as slaves to the Spanish conquistadores.  It has been said that as the conquistadores were not educated about their ways nor did he pay attention beyond the fact that work was being completed, the Mayans could easily add their religious symbols into the Cathedrals they were forced to build.

Upon entering the large Cathedral, one sees the typical Catholic displays along the walls and front of the church.  Images of Saints, including Saint Mary and Saint Thomas, patron saint of Chichicastenango along with several images of Christ are evident.  Traditional Catholic worshippers light candles and kneel before these images, begging for the intercession of these Saints with God to bless them in a particular area of life.  The front of the church is adorned with a large crucifix, the bleachers of the choir are noted and the priests position for preaching adorned with a beautiful pulpit.  Rows of wooden benches line the front half of the church, providing space for worshippers to kneel and pray during the Catholic service.

Noticeably added, however, are the large, square, cement altars leading down the center aisle of the church toward the front.  Flowers and candles litter the altars as do cans of Copal, the incense used in Mayan ceremonies.  Other areas of Mayan worship can also be seen at the back of the church, tended, as are the others, by Chamanes, the spiritual guides of the Mayan people.  150 women and 150 men serve as these guides, leading the believers in prayer to the appropriate god to which to beg for an answer to a request.  The Chamanes also offer healing to the Mayan people with candles, flowers, silence and herbs; flowers of different colors adorn each altar with its burning candles; red representing love, pink representing wealth, and white representing peace.  In addition to offering prayers to the gods, without whose intercession prayers will not reach the god to whom you are praying, the Chamanes preside over all of the important Mayan ceremonies.  As guides capable of seeing both the present and past, Chamanes offer valuable advice on marriages, business proposals and the like and are often visited at home for a person to find out when a prayer for a particular need, days based on the Mayan calender which the Chamanes read and follow, can be executed.

Immediately inside the door, against the back wall to the left as you enter, is the Mayn baptismal font.  At birth, a Chaman enters the home to check the birthdate of the newborn against the Mayan calendar.  If the baby was born on a weak day one must uplift and help him, as often as possible, so he can attain equality in society, avoid failure in all of his intentions, and attain a good job.  If the chile was born a very strong day, parents must be careful to break that attitude from her, allowing her to become once again even in society and to experience success without forcing desires on others.    Once the baby reaches his first year of life, he is brought to be baptized in the church.  During this ritualistic baptism, the Chaman announces the job and life the youngster will grow to have, giving the parents the opportunity to raise him for success.  If a chile, at baptism, is announced as a new Chaman, the child begins to practice the rituals of the Chamanes at the age of 10.  At 18 years, the child must marry, and once married, is considered a true Chaman, capable of interceding for the Mayan people.

Across the aisle from the baptismal fount, is the altar of the children, dedicated to praying for health, growth, learning, and survival of children.  Parents can come talk directly to the Chaman about the problems their child is having in order to have prayers sent to god for them, or they can bring the child to the Chaman to receive prayers and be healed.

Beyond these childhood altars, the remaining altars, all standing around 6 inches above the floor, flow down the center aisle of the church.  The first is the altar of fertility, with prayers offered to the god of impediments.  Women come to ask for a cure for infertility of the womb, for good health and strength to bear children, or for children of the opposite sex as that which they have already borne.  Following the altar of fertility is the altar for protection from the natural disasters of the world.  The Mayans pray for protection from earthquakes and volcanoes wind and rain, fire and flood.  Four candles are placed, one in each of the cardinal directions to represent the world.  The current Mayan calendar is set to end the 22nd of December, 2012, which in the Mayan belief system marks the cataclysmic end of the time in which we live.  Should the world continue beyond this day, the Chaman will no longer be able to use the experiences from the past, intricately interwoven in the calendar to predict the future.  Many of the teachings will be lost.

Beyond these first two altars, the three related altars of  maiz, frijol, and fruta are reached.  The altars serve to worship six gods; four for the four colors of the maiz, and one each for the altars of the beans and fruit.  The four colors of maiz, each representing a different god, include white, representing man, yellow, representing woman, black, representing night, and red, representing blood.  The following two altars, each to their own god, beg for the growth of beans and fruit and the nutrition these items will bring to their families.

Following these three altars is the altar for preparing for marriage.  Before beginning the ceremony the Chaman is consulted to look into the past and future of both the man and woman to determine their faithfulness and love for their prospective partner.  Once both the man and woman have been declared good for one another, they proceed to climb, with a live rooster and hen, up the mountain to the east of Chichicastenanago, a holy place for the Mayans of the city.   Upon their arrival, the bride and groom, along with their respective animals drink a small amount of liquor, the quality of which depends on the wealth of the families of the engaged.  One the liquor is taken, the Chaman pokes the finger of both the man and woman and allows the blood from each of them to flow and mix in a cup.  This signifies the promise of continued faithfulness to one another for as long as they both shall live.  This promise includes the ability of the male to remarry should his wife die, though the wife promises to remain single for the rest of her natural life should her husband pass away.  The heads of the rooster and hen are then cut off, representing man and woman, and the blood of each drained into and mixed in another cup.  This mixture symbolizes the promise of the parents of the new couple to support and love, care for and enjoy their new family.

Finally, is the altar for giving thanks.  Men visiting this altar pray to the god of the sun, thanking him for the day, the work, and the field that the sun provides him.  Women pray, on the other hand, to the god of the moon, giving thanks for the health and tranquility of their family, as well as the blessing of their children.  This final altar, ending at the front of the church, in front of the priests pulpit, is the last of the Mayan altars within the church.

Interestingly, not all altars are functional on all days.  Home visits to the Chamanes to find out the date, according to the Mayan calendar, of the day of work, heath, children, etc, allows the Chaman to advise the Mayan worshipper of the day on which their prayer request is likely to reach the ears of the appropriate god.  this information serves as a guide, then, for the people which represents the day in which they should head to the cathedral to pray and produce their offering, often at the same time as the ritualistic Catholic service.

Beyond the Mayan worship of the gods discussed here, many statues of ancient gods have been discovered on Mayan land.  A god for man, represented with an eagle and a toucan, as well as a god for woman, represented by pierced ears; were once worshipped.  In addition are gods for love and prostitution, the mother of the earth, and more.  In the mountain of Chichicastenango is believed to reside the god Pascualeab ax de Quiché, residing over the city below.  Yet, while more and more gods are discovered, more is learned about the ancient yet modern religion of the Mayans, and the syncretic relationship between many Catholic churches and the Mayan religions continues and strenghtens, many Mayans are converting to evangelical Christianity.

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The conversion to evangelical Christianity, like that to Catholicism, has spread rapidly through the Mayan community.  Many of the Mayans joining the church do so due to the opposition of the church to alcohol, gambling, and domestic violence.  Hope exists for these women that their husbands will become better providers if they come to believe in this church.  Many husbands are know in the Mayan community to be unable to provide for their family as they spend all of their income on alcohol, remaining drunk in the streets day after day.  Domestic violence is also a problem, as women with bruises on their face and chest frequently present to the clinic for treatment.  The hope that this new church provides is immense.

Evangelical churches of several different denominations have sprung up in the city and country, with Mayans and Ladinos alike coming together to praise only one God, the Christ of the Holy Bible.  The sight and sound of the raised hands and voices, begging, crying out, thanking and singing to the God that gives each of them hope, surrounds me each time with the power of faith and trust.  Together, these people become one, worship as one, and pray as one, even with the individual prayers of all reaching toward the sky simultaneously.

The Mayan religion has survived, been syncretized with Catholicism, or left behind with evangelical Christianity, all within the same nation.  Yet the immense faith and trust of this hard-working people is visible in all three of their ways of worship. As they struggle to survive, to live peacefully, and to thrive in their world, they all worship the way they know how; they worship with all of their heart and soul.  The give thanks for blessings, beg for necessities, and plead for guidance.  And they survive.  And if asked, many would say they are blessed.

Antigua

5/3

With clinic canceled on Friday and Brad and Kristy returning to the US on Saturday, the five of us decided that Thursday afternoon, after ASELSI clinic, would be a good time to head out to Antigua.

Antigua lies about a 31/2 hour drive SE of Quiché, somewhat near Lago Atitlán.  Like the lake, it too is surrounded by volcanoes of various sizes.  Known as La muy Noble y muy Leal Ciudad de Santiago de los Caballeros de Goathemala, the Spaniards made the city the capital of Guatemala in 1543.  It was the third national capital established under colonial rule, the first being Iximché, a city in which they could keep a close eye on the Kaqchiquel Mayans, the present-day mayans of the Lago Atitlán area.  When the Kaqchiquel continued to rebel,the capital was moved to what is now known as Ciudad Vieja, a small town along the side of Volcán Agua.  The city was destroyed in a massive mudslide in 1541 and the new capital, today known as La Antigua Guatemala (The Old Guatemala), was founded.  In creating the new capital, the Spaniards stopped at no expense, creating elaborate cathedrals and monasteries, a university, and other beautiful architecture.  Despite the constant rumblings of earthquakes, the Spaniards continued to grow and expand the capital until in 1773, “the great earthquake” completely destroyed the city and it was evacuated.  It was at that time that the capital was moved to Guatemala City (usually simply referred to as Guatemala), the present-day capital.

Antigua today is a beautiful place to visit.  The main attraction for locals and visitors alike is the Parque Central.  The park is woven with sidewalks lined with trees and flowers, with pathways interrupted by beautiful fountains.  Along the entire east side of the park is the Catedral de Santiago.  The main entrance of the building has been nicely restored, though without most of its original decoration from the 1500-1600’s, and stands over the entirety of the city proudly, seen from almost any rooftop of the area. The white Cathedral is lit throughout the night, standing guard over the ancient city.  Along the entirety of the South side of the the park lies the Palacio de los Capitanes, a building lined with arches outside of the sidewalk that cruises along its front.  The sign on its center proclaims “Palacio de los Capitanes  Generales del Reyno de Goathemala.  Durante 231 Años ESTA CIUDAD FUE LA METRóPOLI DE CENTRO AMéRICA”  Finally along the NE corner of the park lies the Palacio de Ayuntamiento, or City Hall, dating from around 1773.  The remainder of the street space lining the outer street of the park is lined with stores, coffee shops, and more.

With many ruins from the 1500-1700’s, carefully recostructed ancient architecture, and new buildings from beyond the earthquake to today, you never know what you are going to run into as you wander around the sidewalks of Antigua.  The home of Bernal Díaz del Castillo, a grand historian of the Spaniard colonial area, stands proudly just two blocks west of the Parque Central.  The sign announcing the presence of his home reads, “AQUí ESTUVO UBICADO LA CASA DONDE VIVIó Y ESCRIBIó EL CELEBRE HISTORIADOR SOLDADO HéROE DE LA CONQUISTA DE MéXICO Y GUATEMALA, BERNAL DíAZ DEL CASTILLO, AUTOR DE LA VERDADErA HISTORIA DE LA CONQUISTA DE NUEVA ESPAñA.”  The ruins that remain demonstrate the grandeur and beauty that once graced nearly an entire block.  Las Capuchinas (Iglesia y Convento de Nuestra Señora del Pilar de Zaragoza) is yet another building which, from its ruins, rises up and declares its former beauty.  Tall arches which, without any doors, allow one to look directly through the tall, spacious, entryway to the street beyond demonstrate the stateliness within which the nuns existed.  Having been abandoned and only recently begun to be restored, its beauty, like that of the home of Bernal Díaz del Castillo, is still evident.  Yet, directly next to these ancient buidings lie new homes, large businesses, movie cinemas and more, reminding you that you are still in the 21st century.

The Arco de Santa Catalina, a large arch across 5th Avenue, was the only thing to survive the great earthquake.  It was originally built for the nuns to be able to cross the street without being seen, and in the 1800’s a large bell tower was added to its center.  Looking south through the archway, the huge Volcán Agua is visible.  Looking north, one sees the Iglesia y Convento de Nuestra Señora La Merced.  The building is beautiful, one of the few ancient churches nearly fully reconstructed to its former beauty after the great earthquake.  Painted in the typical earthy yellow tone of much of the town, decorated elaborately in white with lily’s, the symbol of power for the Mayan lords, as well as other designs, and portraying images of Christ, the disciples, Saint Mary and many of the Saints, the church stands tall and proud in the small plaza in which it stands.  The large cement cross directly in front of the main entrance announces the presence of the monastery which also occupies some of this space.

Beyond the architecture, is the natural beauty that surrounds Antigua.  Seemingly surrounded by volcanoes and large mountains, Antigua feels like it is it’s own world.  Volcán Agua, directly south of the city, stands tall and proud and serves as a great way to orient yourself within the city.  The twin-peaked Volcán Acatenango, the highest of the three volcanoes, lies just north of Volcán Fuego, partially hidden by Volcán Acatenango and lying NW of Volcán Agua.  Reaching Volcán Fuego is dependent on recent volcanic activity.  Volcán Pacaya is located 25 km SE of the city of Antigua, and reaches 2552 meters.  It too, is still active today.

Sleep came less quickly in the busy city, with cars and truckks rumbling by, people yelling and playing, the lights of the city providing paths to fun.  I felt a long way from Quiché, where each night the birds sing me a lullaby, uninterrupted by the noise of cars.  My alarm woke me at 4 am, again reminding me I was not in Quiché as the birds morning song failed to flow through the windows.  I found that the hot water was turned off during the night’ the delightfully cold shower started the day off.

Sitting on the terrace at 5 am,  finally found the city was dark and quiet.  The Catedral de Santiago, in the east, stood brightly out and above of the other lights in the city, sending its message of protection.  Despite the lights in various part of the town and barrios, the city allowed a few stars to twinkle in the dark of the night sky.  As the roosters crowed, the sun slowly made its way over the mountains of the east, lightly brushing the sky with pastel pink, yellow, and orange colors.  As I sat thinking and reading, I watched the sun awaken the “Old Guatemala.”

Boarding a microbus at 6 am, our troop of 5 headed to Mount Pacaya, paid our entrance fee into the national park, and began to troupe up the mountain.  Children surrounded us, peddling walking sticks while young boys followed our group up the mountain, horses in tow.  The beauty of the climb itself was overwhelming.  The innumerable tree and plant species surrounding the path, simple homes with large maíz fields climbed the mountain with us.  The view of the valley below with its various pueblos and barrios, fields and roads continually came into view.  And the volcanoes and mountains beyond and surrounding us as well as the villages below, created the illusion of living within our own crater.  We stopped to see the thermally-powered power plant, providing electricity to many Guatemalans within the country, harvesting through large tunnels the thermal energy continually created by the active volcano deep below the earth’s crust.  Shortly thereafter, we stopped at the picturesque Laguna de Calderas.  Located in an old volcano crater, potable fresh-water, filled by the mountain streams that surround the Laguna, this small lake provides potable water to 14 of the small pueblos that surround it.  It is a much as 100 meters deep and remains around 10 degrees celsius.

Before long, continuing our hike, old towns now covered in black, hardened, lava rock demonstrate the power of the volcano to destroy.  The last large eruption, May 22, 1928, was the last large eruption of the volcano, forcing the evacuation of 13 million persons and closing the Guatemalan airport for 2 days, owing to the ash covering the nation.  The lack of life below was striking as I compared it to the usual use of every available space normally seen within the valleys, towns and villages of the country

Continuing our climb, a great river of lava rolling down Volcán Pacaya suddenly caught our attention and we stopped to watch the rolling, molten rock, move along its course.  Having not yet reached the volcano, our hike continued, as we crossed a large field of ”lava sand”  Following this short trek, we ban to climb through the worn paths leading hikers through the sharp rocks.  Closing in on the river of lava, the heat rising from the lava could be felt as the wind whipped up along the mountain.  The sight of the red, molten rock; the smell of the sulfur coming from the earth; the popping, crackling, and snapping melody sung by the lava as it flowed down; the feel of the sudden increase in temperature, all added to the splendor of this place.  Rocks still several feet from the flow were hot enough to burn your skin, and getting close enough to the river of lava to place a stick in it was impossible.  As wind whipped up the mountain, crossed the river of lava and blew over us, the heat in the air burned our face and eyes as it passed by, leaving in its wake a group of people ducking into the fetal position, backs turned to the flow.

Brad and I, having satisfied ourselves with the view of the lava river from below, began to pick our way up the volcano, through the sharp yet beautiful lava rocks rising from the earth in spires, small urchin-like stones, and large statues.  Apparently sturdy rocks piles of small rocks suddenly crumbled beneath our feet as we continued.  moved with little pressure and large masses of small rocks were more than capable of crushing beneath  your weight, leaving your foot to fall a foot further down than expected.  Feeling the rocks for heat as we continued on our way, we moved further and further from the river of lava as the rocks began to heat up,  Stopping along the way to watch a “waterfall” of lava, we were both struck by the plasma-like material we sat and quietly pondered.  As the liquid, molten, lava flowed a foot down the small cliff toward the river of lava running down the mountain, chunks of the more solid-like lava would break off and fall down the rest of the trip.  The sight was absolutely amazing.  It reminded me of just how little of the natural world I have seen, spent the time to contemplate, and begun to try to understand.

Continuing further, we eventually reached the height to which we felt we could safely climb, surrounded above by small hills with smoke curling out from within the lava rocks that created them.  Brad and I rested and enjoyed our accomplishment, enjoying the simple idea of sitting on a currently active volcano.  Before heading down, one of the small hills near us began to newly erupt, as fresh lava seeped out of the earth and traveled to join the quickly flowing lava river below.  Watching as this new lava poured out of previously normal ground was absolutely breathtakingly incredible to see and watch.  Slowly turning to return to the group below, we slowly moved through the rocks, following old paths formed by lava flows, until we reached the lava sand below.  Here we slid and jumped as though on a sand dune, reaching our friends within mere seconds from far above them.

Heading back again to the city where our microbus was parked, I was again struck with awe as I climbed the mountain passes more or less alone, fully behind the group of fellow travelers.  The beauty of the sun, the valley, the mountains, the trees and plants, the small shrubs growing in lava sand, the dirt path spattered with small flowers after being trampled by many, all struck me with awe.  Payacal surrounded me with beauty and peace.  It provided the kind of peace in which a person can sit and thinkd for days, reconsidering life, the directionin which they are headed and the changes that need to be made.  My time there was just enough to bubble them to the surgace, leaving me to think within the beautiful countryside that is only just an arms length away.

Arriving back in the city, the hustle and bustle quickly replaced the tranquility of the rugged volcano.  Preoccupations, requirements, plans, and needs came rushing back into life more quickly than they had left, returning to my restless soul upon leaving the mountain of apparent peace.

Roads

4/28

The roads of Guatemala (the roads to the clinics; the roads of life).

The distance of travel matters not as we climb into the truck and begin our journey.  It is inevitable that before reaching our destination, the road will offer lessons beyond which were asked and demand attention beyond that which was desired.

The straight, narrow, paved roads of the city offer continuous hazards.  As large trucks and buses pull over to the side of the road, passing in the remaining space becomes undeniably impossible.  Old speed bumps and deteriorating cement or pavement add unavoidable bumps along the way.  Adding to that the multitudes walking rarely the sidewalks but instead the streets; carrying babies or leading young children, heaving loads of wood tied across their head and back, or carting building materials in wheelbarrows; the propensity to hit a pedestrian is high.  Continuing, a number of one way streets and stop signs posted at various levels beg your attention.  As in life, the straight and narrow, which from the start appears so easy, demands constant care.  And as in the clinic, the apparently straightforward illness demands questions and answers, constant decison-making and a commitment to evaluation followed by reevaluation for the length of the road.  But what started seemingly straight and simple…

Becomes a highway.  Speeding along, the world quickly passes you by, yet for only a short time.  Suddenly a slight curve in the road slows you down.  Gaining momentum again, a speed bump or two in a small town slows you substantially, or, if missed, throws you nearly uncontrollably through the air.  The herds of sheep or cows using the highway as their own personal path also force patience.  The road lends itself for your protection, providing you with the opportunity to look at the world in which you live.  As in life, the fast lane quickly demands that you take the time to really choose to see your surroundings, noting them for what they are in your life.  In addition, you are suddenly presented with the opportunity to fly over those little problems, slowly pass them by, or patiently wait for a resolution.  Directly in your path, small bumps and simple roadblocks demand yet offer you the time to give, all of your attention.  New opportunities are suddenly upon you.  And as in the clinic, small problems continually present themselves.  Breakdowns in communication due to lack of common language, poor translation, and lack of fluency require patience.  Cultural misunderstanding forces the necessity of looking at the world around you.  Everyday, small problems, as in the small towns, arise, and are passed by.  But what began as a roadblock….

Becomes a steep mountain pass.  The speed regained after the roadblock suddenly falters again as the slope of the climb, the hairpin turns, and the mountain cliffs in which to crash or fall, require, once again, a change in pace.  Upon arriving at the top of the slope, relief at the end of the climb briefly overwhelms you. As in life, constant demands for speed lead to climbs up steep mountains of despair, hairpin turns away from the beauty ahead, and steep cliffs over which to fall or into which to crash.  Desperately, you climb, dreaming of reaching the end of this seemingly hopeless situation.  But each step leads you closer; each turn presents new beauty; each fall gives you the unusual ability to try again; each crash the time to stop and think.  And as in the clinic, patients may at first present with an unfathomable health problem.  But each little step, each time they visit, brings them one step closer to health.  Each turn, each treatment, takes them in a different direction.  Whether or not that direction leads to new beauty or to a heartbreaking failure, the road continues.  The doctor learns, the patient is led toward a more fulfilling life, or in death, the patient becomes an opportunity to try again.  But what began as a steep hill of despair…

Becomes the steep downward slope back into the valley.  Gear braking to avoid losing control of your vehicle when your breaks fail, trucks speeding by you in the opposite direction using half of your lane, and the whirring of the increasing RPM’s races you down the hill through potholes, around turns, and over bridges.  Reaching an uncontrollable speed is easy; controlling the vehicle a constant challenge.   Heading into the valley seems fast and easy next to the climb up the steep mountain.  As in life, reaching the end of a long road of despair brings us overwhelming joy.  We speed through life, taking chances but constantly braking so as not to miss a turn, continually moving and overcoming small problems in stride, happily heading away from our desperate climb.  And as in the clinic, finally reaching the appropriate tools, knowledge, and personnel to lead a distinctly unhealthy patient into a fulfilling, relaxing, joy-filled life takes the caregiver and patient whirring together away from the pain of previously unfulfilled desire.  What began as a free fall…

Becomes a gravel road.  Large rocks, gaps from previous rivulets, and consistent unevenness sends you bumping along.  Removing your seatbelt prevents you from choking yourself but still leaves you bouncing off the seat, hitting your head against the side of the car and falling into the person next to you.  The cloud of dust you leave behind is a dense as the deepest fog, completely obscuring the path behind.  As in life, sliding along eventually brings us to a place with unavoidable obstacles.  We are seemingly uncontrollably tossed through days and weeks, unable to have any type of self-maintenance.  And the past is completely obscured, unable to lend its lessons for the future, unable to show from which we came.  And as in the clinic, continually being thrown and tossed around as both a patient and doctor eventually becomes normal.  Patients having to change medications for chronic conditions because of lack of access by the clinic to the medicine upon which they were started leads the the necessity of becoming accustomed to new and different regimens, results, and side-effects.  The doctor must continually change their methods to fit with cultural norms and, again, availability of tools within the clinic. And using past medical history to assist a patient present today, is almost always impossible, as a distinct cloud of dust robs the patient of the knowledge of past problems and treatments or the lack of any previous treatment, while inefficient storage of information robs the doctor of previous charts.  But what began as an uncontrollable ride…

Becomes a destination.  As in life and in clinic, we are always headed towards a goal, a final destination.  The seemingly straight and simple, the road blocks, the steep hills of despair, the free falls, and the uncontrollable rides, eventually bring us there.  The process may need to be repeated for days, months, years, or even a lifetime, but eventually, the destination is found.  There, there is joy, peace, patience, understanding, and trust.  There, there is healing, improvement of suffering, and gratitude beyond words.  And there, at that place, you find that the road was worth it.

Joy and Suffering

4/22

First, the joy of new life with the birth of Genevieve Noemi Jentoft at 6:05 am.  I am still not quite sure how the 7lb 6oz, 19 inch ball of life fit inside the tiny tummy of Missa, but I am glad she did.  Missa looked amazing after the birth from the pictures she sent me, no drugs and all, and she and Topher were both happy to report that baby and mom were healthy and doing well, and according to Miss “she’s absolutely perfect.”

The news came the morning before our trip out to Tabil, a small farming town straight east of Quiché, where we set up our supplies and interview stations on the stage of the small church in which we worked, with a line of people along the wall in what would be the seating area on Sunday.  The privacy was minimal with all of the open space, interpreters, friends and acquaintances and church employees wandering around, peering onto the stage and watching from the line.  However, as things usually go, the gratefulness for care provided for the small price of 5 Q was grand compared to the lack of privacy and long wait.

Strikingly, on this day of extraordinary joy as friends and family celebrate with Toph and Miss the birth of a healthy baby girl, I was presented with a 6 month old boy with the largest defect due to apparent spina bifida that I have ever seen.  The fluid-filled cavity protruding from the young infant’s lumbar spine appeared to have, minimally, a 6 inch diameter.  Having visited the Tabil clinic before expressing the same problem, and having been instructed to take their young child to a hospital for care, the parents reported being turned away from Hospital Nacional Santa Elena, being told that they were unable to assist them there.  And here they were, sitting before us again, silently begging for some way to help their young boy, for a ray of hope in their lives.  Without the assistance of the free national hospital in Quiché, affordable options suddenly seemed out of reach.  Sadly, none of the surgical teams coming down to volunteer in Quiché in the near future specialize in this fragile surgical procedure.  At the same time, none of the contacts we have in ASELSI or in the clinic at Canillá could come up with ideas on how to procure care for this young infant.  This left only a trip to Guatemala City for a consultation and surgery to give their baby boy a chance at a normal life.  And on the 300 Quetzales, or $37.50, the family of four is living off of each month, it is practically inconceivable for them to take off for a hospital in the city.  The thought of paying for medical care, food, and housing is to this Guatemalan family as grand as that of a middle class citizen in the US considering taking a year long vacation around the world.  On top of the spinal defect for which we had no helpful plan, the young boy had other medical issues with which I was unable to assist as well.  The curdy penile yeast infection resulting from a lack of appropriate washing of the head of the penis owing to the foreskin, I hoped would slowly cure itself with the consistent, appropriate washing I explained to mom was necessary.  In addition, a scabies infection covered his small frame, evidenced by the red, raised burrows of his legs, arms, back, and stomach.  And yet, as the risk of ingestion of the poisonous creams used for scabies treatment is so   high in a breast-feeding youngster, treatment for him and the 3 year old at home must be held off.  With luck, we will find a method to treat youngsters with scabies that does not pose such a risk, however, until then, the only option is to wait. The hopelessness the young parents must have heard in my words that morning continues to pain me as I explained over and over again, my inability to help their young boy with any of his maladies and hinted toward the money that would need to be spent to cure their nene, their baby boy.

While the line of patients appeared short this morning, with only about 30 numbers sold for access to treatment, the weight of the apparent helplessness of the situation with the youngster I saw early in the morning, pressed upon me and dragged the day along.  While I continued to enjoy my contact with the Mayan people presenting for care; the pregnant patients and their ultrasounds, the typical complaints of dry eyes, stomach pain, musculoskeletal pain throughout their small frames, and the constant chatter of children running about the empty cement church; I still could not begin to fathom how to help this young child or the empty, heavy spirits his parents carried home.

Why do we continue to do what we do, never being able to reach all in need nor even having access to the appropriate care to help many of those who do mange to arrive?  Why do we suffer with those whom we cannot help and yet rejoice in the smallest of conquests of another?  Why do we, without question, help the smallest of percentages of people suffering in this world?

It makes a difference to this one.

Lake Atitlan

My trip out to Lago Atitlán began at one this afternoon.  I took the Mazda and headed out toward Chichicastanango.  It was nice riding solo, checking out the countryside as I drove along the always uphill and downhill mountain passes, curving around cliffs and boulders, switch-backing along hairpin turns.  The constant down-shifting for climbing and motor breaking makes the always interesting driving of Guatemala even more entertaining.  I laugh as I imagine driving like this in the US, as cars and trucks pass on all parts of the road, especially the smooth curves that allow them to see ahead one or two turns.  I cringe as buses cruise around corners mostly in my lane, pausing to hit the breaks, quickly turning the wheel, or hitting the gas so as not to fall into the large, unmanageable, ditch along the side of the road, or worse, the valley below.

Passing through the small towns are signs for speed-bumps everywhere, but rarely any exist worth mentioning.  If they are there, they always make for a great spot to pass the slow-moving car, bus, or truck ahead.  The painted or metal signs for obligatory turns to avoid one way streets and stop signs at sudden losses of the right-of-way are hidden among the many-colored corner homes and buildings, behind street lights, and placed at all imaginable heights.  I follow the troupe ahead of me, hoping eventually to come to another sign directing me toward my goal as I avoid pedestrians, stray dogs, bicycles, and motor vehicles parked every imaginable way along the roadside.

As I approach Sololá, the volcanoes of Lago Atitlán suddenly appear ahead of me as I steadily drive along.  The nearly audible gasp as I gazed at the valley below, the cloud-covered volcano, and the fields and homes around me barely expressed the immensity of the sight.  As I continued, the lake came into view and I stopped along the side of the road to take a picture of its beauty.  I eventually came to El Mirador de San Jorge La Laguna, a small overlook on the side of the road of Lake Atitlán, the volcanoes beyond, and the mountains surrounding it on all sides.  A few vendors haggled their wares; paintings of the lake and the typical Mayan life and dress, leather gifts, and jewelry; prices dropping steadily as I climbed back into my truck.

As I finally descended to the city of Panjachel, parked the truck, and headed to the shore, a giddy excitement overwhelmed me.  Along my route were vendors of all types, and I barely turned to notice the sales.  As I headed along, several boat owners offered me solo trips to various places around the lake.  I finally settled on a trip east, heading back west as the sun began to descend over the mountains.

As I settled into the small boat next to my guide, Jorge, I found it difficult to believe that I was sitting on Lago Atitlán, in Sololá Guatemala.  I gazed at the three volcanoes beyond me, Volcán Tolimán rising in front of the large Volcán Atitlán with the small Cerro de Oro, rumored by the Spaniards to have gold, sitting quaintly on the lake shore in front of these grand volcanoes.  Volcán San Pedro rises to the west of them and the lake extends, invisible from where I am, between these volcanic rises, leading to the city of Santiago Atitlán as it lies amongst these giants.

As we head east, Jorge points out the many private homes along the shore of the lake.  The owners of these homes spend only holidays and some weekends along the lakeshore, yet the homes they have built in the cliffs and hills surrounding the lake are much grander than any of the local people could imagine.  Employees of these home-owners live in separate quarters on the grounds, continually cleaning the ever-accumulating dust of the country-side and maintaining the grounds.  The salary for such work ranges from 1500 to 2500 Quetzales a month, the equivalent of around $185 to $315 a month, a beautifully high salary according to my guide.

We continue east to the smallest town around the lake, Santa Catarina Palopó.  Heading up the main street, Kaqchiquel Mayan women sell their hand woven scarves, huipil’s, blankets, cortes, and more.  A small piece of woven cloth, requiring three weeks of work, sells for just 125 Q, or $15.  Continuing up the road, the same process is repeated over and over until we reach the first turn.  Here we find small shops selling the typical Mayan paintings and wood carvings, popular work among the people of Santiago Atitlán.  A small carving of the national bird, the Quetzal, with its long green tail feathers and red breast is shown to me in one of the small shops.

Continuing along, we visit the Ancient Catholic Church of the city and enter the darkened building, lined by wooden benches.  At the front of the church, a large statue of the Patron Saint of the city, Santa Catarina, hangs in the highest place of honor.  Other saints hang below and beside her while several representations of Jesus hang just outside the area of the saints.  A young woman is kneeling in prayer in front of the Patron Saint as we enter, the tone of her voice indicating her longing and desire for assistance in her life.  The begging tone of this woman is moving, and I kneel on the wood before me to pray.  As we leave the church and reenter the streets, a sense of the holiness within unwraps itself from me.

Continuing east, I swim alongside the boat in the waters of Lago Atitlán in a place known as Agua Termal, where a natural hot spring feeds the lake with warm water.  The sulfur scent and hot water is calming and relaxing, and as I climb back into the boat, the sun is beginning to set behind us, beckoning us back to the west.

Heading back to Panajachel, I watch as the sun descends through the clouds towards the mountains lining the west side of the lake.  I climb out of the boat and walk down the shore, eventually finding a dock between the volcanoes where I can gaze out at the lake, the colors of the setting sun, and the beauty of the land surrounding me.  Emerging from behind me are the sounds of the hustle and bustle of the city; televisions, barking dogs, people laughing and talking.  Instead, however, I surround myself with the songs of birds, the rippling of the water as fish surface, and the waves lapping the shore.  I focus on the volcanoes in front of me, clouds nipping the rims of their rising peaks; the sun setting to the west, sending dazzling oranges and reds across the water; and the already dark east side of the lake, asleep now that the sun no longer reaches it.  I allow myself, even in my anxiety and impatience, to remain until the last glimmer of light can be seen above the mountains and allow the beauty of the place to entrance me.

I walked back to my truck along the dark and steadily deserting roads of the town and began the long drive home.  I allowed myself to dwell on the beauty of my surroundings, including the bright stars shining upon me as I ascended the mountain away from Panajachel.  The dark streets were not deserted, as locals biked and walked home up and down the mountain passes and in the cities, trucks continued on their routes, and small autos raced to their destinations.  Arriving back in Quiché, I recounted some of the events of the afternoon, delighting myself again with the experience.