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Day 8: Asociación Corazón del Agua. Bridget’s Blog

Day 8: Asociación Corazón del Agua, Guatemala City

Today we were up with the roosters for our first day teaching at the midwifery school.  The school was recently completed and it felt sunlit, fresh, and comfy. At any given time there are about 15 women enrolled in the school’s three-year midwifery program.  They come from all around Guatemala and their goals are to eventually return to their home communities to provide care for women and babies, as well as provide additional training to local comadronas. Teaching these women was very different from teaching the midwives in Xela because they had a high school education; therefore everyone was numerically literate and could read and write. This made our job much, much easier. They were also relatively young and you could just feel their energy, passion, and optimism. I definitely felt like I was in the presence of strong women who were dedicated to making the lives of mommas and babies in their communities better.

After a long day of teaching, we decided to get take-out for dinner and bring it back to our hotel. I think we were all sick of taking the time to eat in restaurants at this point. On this next thought I cant speak for everyone, but I, for one, needed a shower.  Unfortunately, the showerhead gave me real pause. It was metal and had exposed wires running into it from the wall. Now, Im not an electrician, but I see metal, wires, and water and I see a real problem. I texted Nancy, who was one room over, to ask about this. Totally normal, she said, its called a widowmaker and you have to be careful to not touch the shower head whilst in the shower. I sat with that for a minute.texted some people back home.seriously considered bucket baths.  But ultimately decided to face my fears and take a shower.  Which I did..while standing in a low crouch. It was fine.

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Day 7: Fuego Eruption Zone and Antigua

We left Chiquimulillaand headed north to Antigua. Our route took us through the Fuego eruption zone and the road we were traveling on had only recently been reopened. As it was prone to be reburied by mudslides if it rained, which it had the night before, we were a little apprehensive.  We were in luck, the road was open. The eruption zone was stark and strange.  The view out our windows was green and lush and alive and then, boom.black and dead. It was a haunting landscape maybe 2 miles wide where we were, but stretching out as far as the eye could see. Rows of palm trees coated in ash with their leaves limp and hanging. Houses half-buried. Melted pavement. A new gorge was torn into the earth by lava and pyroclastic flow. Eric told us that what made this eruption so deadly was because Fuegoerupted in a direction it never had beforelike ever in the known history of the volcano, so there were villages in its path, whereas there are no villages on the other sides of the volcano. Driving through it felt a little bit like we were trespassing on hallowed ground.

By the time we reached Antigua, about 10 miles east of Fuego, it looked like nothing ever happened. Antigua is where you find all the language schools, ex-pats, and tourists. You also find some gorgeous examples of Spanish Baroque architecture, both intact and in ruins. This is also an excellent place to indulge your inner magpie, as there are lots of shops carrying shiny silver and jade jewelry. The outdoor artisan market is huge and set up as a series of square courtyards with a central fountain, each of them a little different from each other.  One of my favorite market purchases was a patchwork quilthandmade from different squares cut from old traditional shirts worn by women called huipiles. I had no idea if that quilt was going to fit in my suitcase and on top of that it was pretty heavy, but I was going to try. (spoiler alert: it fit and my suitcase weighed in at 50.4lbs.whew!). My other favorite market treasure was a small drawing of midwives assisting a laboring woman. It was just sitting on a random shelf by itself, and, of course, it caught my attention. Turns out, Nancy bought the same drawing here last February and this was the last one like it. Shortly before we left for Guatemala I found out I got into grad school for midwifery and Nancy was absolutely certain this drawing was there for me and I was supposed to find it. I completely agreed and added it to my basket. 

We had dinner reservations at  Casa Santo Domingo, a restaurant built gently and beautifully among the ruins of a monastery that dates back to 1527. The ruins are meticulously preserved and exist as an indoor/outdoor museum that guests can walk through at their leisure.  At dusk, hundreds of candles are lit around the site The food was amazing, but the setting amid the candlelit ruins was what really made it magical.  After dinner, we headed back to Guatemala City. Our first-day teaching at the midwifery school was the next day and we had to be up early.again. 

 

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Day 6: Boats in the Jungle Part 2 Bridget’s Blog

Montericco is a beach town along the Pacific coast near the Guatemala-El Salvador border.  It’s a popular getaway spot for local Guatemalans. It can only reasonably be reached by traveling by boat along the Canal de Chiquimulilla which runs from La Avellana to Montericco. The canal is a busy waterway and looks and feels a lot you’re going up the Nung river in Apocalypse Now (only without the violence). There are many little waterways off the main canal and it looks like you could very easily get lost….either on purpose or by accident. Our boat was an open, flat bottom wood boat with a small outboard motor.  Other boats were larger versions of this; some large enough to transport cars and trucks along with people. The other boats we passed were extremely crowded and there was definitely a festive air to them. Our little boat generated a lot of attention because we were probably the only white people for miles around. We were safe because we were with Denis and Sari who are well known and well-liked in the community, but even Nancy said she wouldn’t have done this trip without a local Guatemalan along.  I admit I would have felt very foolish and unsafe had we done this alone.

The southern part of the country is more impoverished than the rest of Guatemala and, honestly, it was a kind of heart-breaking abject poverty that I have never been exposed to before.  Of course, there are reasons for this. Guatemala endured a civil war that lasted from 1960-1996.  In a nutshell, democratically held elections brought a leftist, pro-worker government into power. The US had big economic interests in the country and a leftist government just wouldn’t do. A coup was staged and the first of many military dictators was installed.  Many Mayan villages were burned and people were displaced from their land during this period and when the peace accords were signed in 1996, they went back to reclaim their land only to find they were “owned” by someone else.  All these refugees had to be relocated somewhere and down south was one place with land available….likely because it’s so difficult to cultivate among other reasons.  The terrible poverty we see here today is a legacy of a 30-year war.

But I digress.  We stayed a couple hours at the beach watching the waves and the people and then trekked back through town to the boat landing.  Back in La Avellana, there was a place where you could buy fresh coconut and drink the water inside. Since I had never done this before, my traveling companions decided that I MUST.  So I got a coconut,

Dennis hacked off the top part with a machete that was standing around and popped a straw in it for me.  After being out all day in the heat and humidity, the cold, sweet coconut water was amazing!  Before I knew it, we were back at Denis’s compound having dinner and then tucking into bed. That’s when the storm hit. It came out of nowhere…an absolute deluge of rain that was deafening when it hit the metal roof. It was so cool! I stood outside my room and just watched and listened. Almost every time it would thunder and lightning the power would go off….then the generator would kick in and the power would come back on…..then go off….then on…..it was wild. I think this storm was the tail of Hurricane Michael.

 

 

 

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Day 6: Welcome to the Jungle Part 1 Bridget’s Blog

For all my love of wild places, I’ve never been in an equatorial jungle…until today. As we drove south to Chiquimulilla from Guatemala City, the temperature and humidity crept up and we shed jackets, cardigans, long pants and socks. With the change in climate came a change in vegetation. Sugar cane, coffee plants, and banana trees replaced the pines and corn that are so prevalent in the north. Spices like cardamom thrive down here, and I bought a bag of the most wild looking fruit I had ever seen from a young boy on the road. The air is damp, heavy and smells of plants and soil; everyone has a “sheen” to them, and you move a little slower. I started to wilt until I was reminded to drink a lot more water than usual which helped immensely.

We stayed with long-time friends of Nancy’s, Dennis and Sari. They live in a compound that they open up to a variety of groups from health care professionals, like ourselves, to more traditional missionary groups. For me, to stay in a place like this was like a dream….the dream had some scary bits, but a dream nonetheless.  The main gathering spaces of the compound were open to air….three walls and a corrugated metal roof and one side open to the outdoors. Our individual rooms were typical 4-walled rooms with a door, but all the other spaces were an indoor/outdoor combo.  For example, to get to a bathroom you had to walk outside (under a roofed corridor) to either another building or another part of the compound. And they had THE BEST shower ever here. There is no hot running water, which initially freaked me out,  but when its 90+ degrees with 90%+ humidity, you don’t exactly miss it.  The shower here is sufficiently indoor/outdoor enough that you feel like you are showering out in the open in the jungle but really you have a decent amount of privacy. The jungle tucks you in on one side,  and painted murals on the low walls create an air of whimsy on the others, and it is heavenly. It was also here in Chiquimulilla that I first tasted hibiscus tea.  It is a deep jewel red and can be served hot or cold. The taste is hard to describe, but a sweeter, planty version of cranberry juice sort of maybe gets close. Bottom line, its delicious.

Our purpose for going to Chiquimulilla was to conduct a focus group with as many local midwives as would come talk to us and answer our questions. It was possible no one would show up.  Instead, 8 midwives took a day off work, traveled many miles in the heat and humidity and very likely had to pay for transportation…all to sit down and share their experiences, their needs and their wants with us. After the focus group, we met with a local nurse from the Ministry of Health. Both these meetings resulted in a wealth of information that will help us tailor our future trainings to the unique needs of this community.

Our meetings ended mid-afternoon. Knowing my love of the ocean, Nancy planned a brief trip to the beach to round out our day.  It’s about a 15 minute drive from Chiqui to where you catch the boat to Monterrico.  It’s another 15 minute walk through Montericco until you get to the black sand beach where the waves crashing ashore last made landfall on some of the most remote South Pacific islands in the world.

This was my favorite part of our trip, so I have a lot to say about it. Tune in tomorrow for Day 6 Part 2: Boats in the Jungle

 

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Day 5: Back to Guatemala City Bridget’s blog

This morning we had to be back in Guatemala City for Nancy and Karen to attend a noon meeting which meant we had to leave Xela really, really early….like before the roosters could wake us up early.  I’d like to think that maybe we were up early enough to wake some roosters and I feel a certain warped sense of satisfaction in that. While Nancy and Karen attended their meeting, I was left to get lunch with the menfolk. The menfolk wanted McDonald’s. I said “absolutely not” in my full-on Mom Voice.  We had a nice, healthy lunch at a cute little café in the 4 Degrees North district. This district is a hip new mixed-use development designed to be walkable and lively with high-quality streetscapes and architecture.  Back in the day, I was a landscape architect working for a firm that designed similar urban spaces and it was fun to talk urban design again even if it was to a captive audience who mostly just nodded and smiled.

Before coming on this trip Nancy warned me about how these trips involve a million moving parts and that plans are always changing at the last minute. I mostly nodded and smiled but thought to myself, “the hotels are booked, the classes are scheduled, how much can really change?” Well, she was right…..I guess you learn a thing or two after 26 trips to a place. Today, Eric, our driver, informed us that the hotel we were planning to stay at tonight was safe, but getting in and out of the neighborhood it was located in was decidedly not safe. Pick another place, he said. So that was a scramble. We ended up with some of us at Jeanette’s (a friend of Nancy and Dave’s) and some of us across the street in an Air BnB. I was at Jeanette’s and not only was I crashing in their home, but I was crashing the party they were hosting that night. Nonetheless, they graciously welcomed me, a total stranger, into their home. I just tried to keep a low profile and stay out of the way.

Today marked the halfway point in my trip and that along with being in a kind stranger’s house with her little family and lots of her friends left me feeling incredibly sad and homesick. I connected with my little family and the one friend who was still up to text me back and made the best of it…..had a little Walmart Wine and went to bed. We had to be up with the roosters again in the morning so we could start heading south to Chiquimulilla.  Our adventures in Chiqui ended up being my favorite part of the entire trip.

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Day 4: Teaching in Xela Part 2 Bridget’s Blog

Last night I actually slept well…..let’s hear it for Benadryl, earplugs, and Nancy’s little travel fan that she graciously loaned me.  Day two of training begins with Helping Babies Survive: Helping Babies Breathe and ends with the ceremonial handing out of certificates of completion.  Teaching neonatal resuscitation in a low-resource country as a NICU nurse is emotionally difficult.  At home, there is so much by way of medicines and technologies and procedures that we rely on that simply are not available here.  So many of the babies that are lost here could be saved if….if it wasn’t so hard to get to a hospital…..if those hospitals had enough trained medical personnel……if birth attendants in remote areas were better trained. For me personally, it was incredibly difficult to butt up against limitations that I’m not used to hitting in my everyday practice and then having to be ok with that.

On a happier note, Training Day 2 is also graduation day and its exciting for everyone, trainers and midwives alike.  It was really wonderful to see the expressions of pride and accomplishment on the faces of the comadronas as they come up and receive their certificates from us. There is lots of laughter, lots of selfies and lots of fun!  We went out for pizza to celebrate another successful training in the books and it was delicious!

We head back to Guatemala City tomorrow so Nancy and Karen can attend a Rotary International meeting, leaving me in the company of the menfolk.  Menfolk who wanted McDonald’s for lunch. Tune in tomorrow to see how that went down.

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Bridget’s Blog Day 3: Teaching in Xela Part 1

Yes. The answer to yesterday’s question is Yes, there are roosters in Xela and they will wake you up early. Today was our first day teaching the indigenous Mayan midwives, comadronas, from the Xela region. The comadronas are similar to lay midwives here in the US in that they do not have any formal midwifery education, but rather their mothers and/or grandmothers were comadronas and they learned by working alongside them. Many of these women are quite elderly and unable to read. We travel with two interpreters who help us communicate with the midwives in their own language.  But even beyond that, it’s remarkable what a shared love of women, babies, and birth can do to dissolve a language barrier.

The first day of training is always Helping Mothers Survive: Bleeding After Birth which focuses on recognizing and managing a post-partum hemorrhage. Post-partum hemorrhage is the leading cause of maternal mortality worldwide, the US included. The maternal mortality rate in Guatemala is approximately 120 women per 100,000 live births.  Among indigenous Mayan women, the maternal mortality rate is three times higher. Since the comadronas are the primary birth attendants for women in their communities, this is life-saving training.

Our classroom for the day was pretty small and we “borrowed” several wooden tables that we found randomly hanging about in the walkways. There were 12 comadronas, 3 trainers and 2 interpreters crammed in that tiny space, but we made it work. The comadronas were bright, incredibly motivated to learn, and regularly expressed their gratitude for the opportunity to attend this training.  They shared with us their lively senses of humor and their many experiences in attending birthing women…..some experiences were funny, some were sad, some were straight-up tragic, and we learned from them just as surely as they learned from us.

Training days are long and tiring. At the end of the day, all I wanted to do was snuggle a dog and Guatemala has lots and lots of stray dogs everywhere.  My natural inclination upon seeing a dog on the street is to exclaim loudly, “Puppy!” and go in for a snuggle. However, I was told in no uncertain terms that I can’t do that here because the dogs all have fleas and/or rabies. It dang near killed me.  Today though, we stopped by our driver, Eric’s house and lo and behold he had a 3-month-old puppy named Bumper that I could love on as much as I wanted!  Happy day!  Speaking of animals, when we got back to our hotel, I looked out my window and saw a couple cows and goats grazing on the open lot next door.  In the second-largest city in Guatemala.  Next up: Training Day 2.

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Day 2: Mercado Central, Guatemala City

Well, “they” were right.  In the middle of Guatemala City, population: ~1 million, rooster racket will wake you up. Followed quickly by planes, dogs, and honking horns. Guatemala is a noisy place. I’m glad I followed the advice of seasoned Guatemalan travelers and tossed in some earplugs at the last minute. Before we get to the Market, I’d like to take a minute to rave about the tipico breakfast in Guatemala. Scrambled eggs, fresh fruit, plantains if you’re lucky, a little piece of fresh queso and black beans that are so delicious I miss them to this day.  French pastries have nothing on this ultra-fresh, bursting-with-flavor start to the day. Farm to table is a way of life here, not a fancy millennial “clean-eating movement”.

Today we planned to go to the big public market in Guatemala City before heading into the western highlands to Quetzaltenango which is also known by its Mayan name Xela. If you’re consulting a map, Xela looks to be maybe 2 hours or so from Guatemala City. Except just kidding, it’s more like 4-5 hours because of road conditions, that (in)famous Guatemalan traffic and mountainous terrain. But first, the market.

The Mercado Central is an underground market that has at least three levels with the uppermost level full of all the beautiful handcrafts and the lower two levels being all the meats, produce and other foodstuffs.  By and large, tourists don’t venture down below the artisan level. As with any crowded space in a big city, using some common-sense precautions will make sure you have fun and stay safe.  We had pretty limited time at the Market, so we focused on the level with all beautiful handcrafts.  Everywhere you looked were gorgeous, brightly colored textiles piled high, beautiful tote bags, leather goods, scarves, clothing, shoes, paintings and jewelry…..and all of it is handmade (well, not the “Guat’s Up t-shirts, but you know what I mean).  Now, the cultural expectation is that you haggle over prices, but given that we can afford the list price and the sellers could really use the money, it feels ethically challenging.  Our rule of thumb is to never, ever low-ball a seller and just don’t be a jerk.  Another cardinal rule of market shopping is that if you like it, buy it because you will not see it again at another stall.  Every single stall has something different and I am so glad I heeded this advice!  I had a blast picking out just the right little treasures for family and friends.

It was hard to leave, but we piled back into the van and headed UP…..Xela is located at an elevation of nearly 8,000’.  We arrived at our hotel in the early evening, but because Guatemala is located 4 degrees north of the Equator, days and nights are equal and last 12 hours each, so it is nearly dark by 6pm.  Our driving days were always way more fun than you’d think. I spent the hours flying from one side of the van to the other hanging out the windows with my camera completely agog at the passing scenery: volcanos, cows in the back of pick-up trucks, and farm fields that go straight up the sides of the mountains, I mean, volcanos.  No doubt I annoyed the crap out of my seatmate, Karen, as I launched myself across her lap for the 100th time that day because “OMG that’s an even better view of those volcanos out your window now that the road curved left”. But she was nothing but kind to me for which I am eternally grateful.

Tomorrow is our first day of teaching, so there was a fair bit of prep work to do after dinner. Will there be rooster alarm clocks in Xela?  Stay tuned!

 

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10 day Serial Travel-blog in Guatemala

About the Blogger:

My name is Bridget and I’m a NICU nurse and midwifery graduate student. I’ve known Nancy for several years and on serve on the Advisory Board for Supporting Safe Birth. I have done a lot of international travel, but this was my first trip to Guatemala and my first medical mission trip, both of which I had been looking forward to for a very long time.

Day One: Arrival

We landed in Guatemala City at dusk. It was a very easy flight and everyone’s luggage appeared in record time. Surprisingly (to me), it was only about 5.5 hours of flight time from Chicago to Guatemala City and Guatemala is only one time zone behind our CST. In spite of that, upon exiting the airport to wait for our driver, the overwhelming impression was “Toto, we are not in Kansas anymore”. “Overwhelming” was a word I would find myself using again and again as the trip went on.

Our driver, Eric, is someone Nancy and Dave have known for years and consider their Guatemalan son. He has a quiet, reassuring presence and I would quickly come to trust him and his judgement. Tonight though, he texted to say he was stuck in traffic. Meh, I thought, it’s a big city, of course there is traffic.  Well there is traffic, there is big city traffic, and then there is Guatemalan traffic.  I don’t remember how long we waited, but eventually Eric appeared and we loaded up the van and were on our way to dinner.

Driving through the city at night was a little bit shocking, intimidating and overwhelming. I was not prepared for the security measures that Guatemalan’s employ almost universally: walls topped with razor wire and heavy metal doors as the only passage through the wall.  I learned that this is the physical manifestation of widespread corruption and the subsequent lack of trust in the entities that are charged with protecting the populace.

We arrived at the restaurant the veteran Guatemalan travelers had chosen: Kacao. Like many places in Guatemala it was sort of indoors and outdoors at the same time, which I thought was very cool. It had a thatched roof that soared above us, billowy, white panels of fabric, hanging lanterns, string lights and lots of beautiful Guatemalan textiles. And the food was amazing!  Before dinner I was finally able to call home and speak with my husband and son and, admittedly, I got a little weepy.

After dinner we headed to our hotel which was located in a gated community. Gated communities in Guatemala are similar to gated communities here in principle. It looks a little different though. Here, there is a gatehouse with an armed guard letting people through (in our case) or not (as in the case of the car in front of us). But before we knew it we were safely ensconced in our hotel and ready to crash. The roosters, I was told, would wake us up early.

Check back tomorrow for the adventures of Day 2: Mercado Central.

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Recent projects in Guatemala

February 2018

A small team of two of us (Kathy, you’re the best!) spent 18 days in Guatemala (in conjunction with Hope2Others) revisiting some of the midwives and teaching Helping Mothers Survive-Bleeding after Birth (HMS-BAB) and Helping Babies Breathe programs in Chiquimullilia. We also completed a 2-day training with midwives in San Marcos La Laguna and at Manos Abiertos in Cuidad Vieja and also met with a doula group to talk about birth options. Statistics to come!

A short presentation to a Rotary group in Guatemala City was a surprise opportunity to discuss future training. We had such great connections with everyone we met! Thanks to the doula group for a great time of sharing and to all the midwives we met. Thanks to so many of our friends for help with lodging, transportation, and interpreting. As always, we were sad to leave.

 

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