I had to write a reflection on my experiences in Guatemala for class this past week, and I am including some of it here. The entire thing is a bit long to add at once, so I am going to do it in stages. Here goes, I hope you like it....

I am not even sure where to begin something like this. Looking back over my journal/blog, and looking through my photos and those of others, I can see just how much we accomplished and how many different situations we experienced over a relatively short period of time. I have been thinking off and on over the past two weeks about how to try to write down my reactions and reflections about the trip. There are so many, and one thought seems to tumble into two or three or four more. This could (should?) be an everlasting exercise. The question may not be what did I learn from my three weeks in Guatemala, rather, what am I continuing to learn from the experience.

That being said, I will begin with some general impressions. Having lived and spent time in Latin America, I had some expectations of what Guatemala would be like. I expected to see poverty. I expected to see extremes in living conditions. I expected a slower pace to life and work than in the United States. In many ways these were the conditions that I also experienced. I did see a slower pace. The occasional two hour lunch, some quiet relaxation in the central park in Antigua. This is not to say that people in Guatemala are not industrious. Our visit with Franklin and As Green As It Gets showed quite clearly that there is an entrepreneurial spirit that is alive and well within Guatemala. If ever there was an inspirational success story, Angelica and her bag factory is that story. It showed to me how just a little money and expertise, used wisely, can make a huge difference in someone’s life. The time we spent with Franklin was of great value to me. It showed me that small changes can add up to meaningful differences in peoples’ lives. It makes me wonder if there is a model here that can be used for other endeavors or in other locations. Are there other people and organizations that have created similar systems in other parts of the world?

Dr. Oscar also made me wonder about systems and opportunities. One research project that I thought about doing (indeed am still thinking about) is how he and other like-minded doctors work together to take care of the health care needs of the poor in and around Sumpango. Dr. Oscar has a real passion for his work and a compassion for the people that he treats. The respect that others in the surrounding community have for him is fairly obvious to see. People come from miles around to be seen in his clinic. As he perceives new needs in his patient population he learns new techniques and gets further training. He saw a need for better prenatal care in Sumpango, so he went back and learned not only OB but also how to use an ultrasound machine. He saw an increase in diabetes and hypertension, so he went back and learned more about treating those patients. If there are cases which are out of his area of expertise, he is able to refer patients to other doctors who share his concern for the poor, and who he knows will treat these people regardless of their ability to pay. This informal network is an interesting concept for me. I was especially interested in it after talking with Carlos, my Spanish teacher at MAYA. We were having a conversation about health and health care in Guatemala. He works three jobs, and has a variety of options for his health care. One of the options is to use the national clinic system. It is free, but severely understaffed, overcrowded, and often lacks supplies and medications. He mentioned that often he will go to the clinic and be seen by a doctor, who may prescribe something for him, but the clinic pharmacy will not have any of the medication on hand. He them has to go to a pharmacy and purchase the medicine himself. He also pays a monthly fee for social security, which allows him access to a different set of clinics. These clinics, although not as understaffed and overcrowded as the public free clinics, are still not as well provisioned as a private clinic, and probably nothing close to most clinics here in the U.S. The costs at these social security clinics are paid for through his monthly social security payments, as is his medicine, but again, the pharmacy often does not have what he needs in stock. He can either try back later, as they tell him “maybe tomorrow, maybe not,” or he can go to a pharmacy and purchase the medication. Finally he can go to a private clinic, where he will have to pay out of his own pocket the costs of the visit and whatever medications are prescribed. Access to the doctor is better at the private clinic, but costs make this option prohibitive for all of his and his family’s health care needs. Dr. Oscar provides many of the services the public clinics do for the poor, and he is willing to work with whoever comes to his door at whatever level of payment they can afford. This is a very different image of Guatemaltecos than Freddie presented at Camino Seguro. I am sure there is truth in both images. Dr. Oscar is a compassionate man who has the opportunity to make meaningful changes in the health and well-being of the community, and I feel honored to have played even a small part in helping him make some of those changes.

Good morning everyone. Just sitting around waiting for class to begin so I thought I would do a little updating. I got the chance last Thursday to do a little presentation to the Kiwanis club in Belleville, WI. Spoke about 20-25 minutes about our trip to Guatemala and (of course) the importance of hand washing. Somehow I just can't get away from it. It was a wonderful evening in Belleville, and the audience, although small, was very interested and receptive. If anybody else wants a presentation, let me know. We'll see what we can work out. I've got plenty of photos to choose from.

Hope all is well for everyone out there in cyberland. I have to go learn something.

Today was the first Guatemala class since we came back. It was great to see everyone again, although we did miss Laura and Chris. So many plans to make, presentations to plan, papers to prepare. Three weeks in Guatemala seems a breeze compared to classroom work. It will be fun to see if we can inspire some "young" nursing students to try going to Guatemala next summer with our presentations. We will be talking to both the first and second semester students. First we have to figure out what to say. How do you distill three weeks of incredible experiences into a presentation of an hour or less? So much to say, so little time to say it. Anybody have any suggestions?

I leave you with a quote from Margaret Mead which I recently read and love. "Never doubt that a small group of thoughtful citizens can change the world."

As the weather turns cooler and fall approaches I look fondly back to the three warm weeks spent in Guatemala. OK, some of the days in Guatemala were downright hot, almost unbearably so, and a couple of days were quite cool, especially one I remember 2/3 of the way up a volcano in Sta. Maria de Jesus. But I really do look back on those days from time to time.

We have started school again at Edgewood, and I am both happy and sad to say it will be my last semester as an undergrad there. I am to graduate in December. But before I can graduate, there are a number of things I must do. Of course there are classes and clinicals to pass. But that pales in comparison to the most important tasks of the semester...Guatemala presentations!

Yes we must make some presentations about our trip and some of the research we did/are doing related to the trip. I know we will be presenting something that will be open to the college to attend on November 10th. I am on the syllabus for my community/public health clinical to speak on Nov. 21st. Fortunately I was warned ahead of time that I would be on there. Imagine my surprise if I hadn't been warned before the syllabus was handed out. I also may be presenting to the Kiwanis Club of Belleville later this month (I hope I find out soon) and some of us/all of us will be doing something for the first semester Nursing 210 class. Lots of work ahead of us in preparing our projects and presentations.

I am happy to report on that front that I do have a powerpoint just about complete on hand washing. Yes, I know many of you out there are surprised to hear that I have any interest in hand washing. But I do, and if I do say so myself, it is going to be a masterful presentation. I don't want to give anything away, because I think I may use it, or at least part of it, when I speak to my community/public health class. However, at some point I may figure out how to post it to this blog so that y'all can experience a little of what we did to promote hygiene in Guatemala, and maybe learn something about global health in the process.

On this wet, rainy, cool fall-like night I leave you with warm thoughts of black sand beaches and warm evenings in hammocks. Duerme bien.