A Guatemalan Journal

“Be diligent in serving the poor. Love the poor, honor them, my children, as you would honor Christ Himself.”

St. Louise de Marillac

In November, Sister of Charity of Cincinnati Montiel Rosenthal, MD, traveled to Guatemala for the second week of a medical mission trip with her residents and volunteers. Read her daily journal below.

Saturday, November 9, 2024

A family physician from western Cincinnati, her sister Jen and I arrived in Guatemala on Saturday to volunteer with Wuqu Kawoq (the Mayan Health Alliance). Jen came to volunteer and visit her own daughter who is working as a volunteer for a year with Wuqu. Our team this week consists of two family medicine residents from Christ/UC, a family medicine resident from Dayton, a pediatrics resident from Cincinnati Children’s, a doctoral pharmacy student and her professor from UC, another Wuqu volunteer and two Spanish translators and one Katchikel (one of the Mayan languages) translator.

We came to the old colonial city of Antigua on Saturday, where I went to Mass at La Merced to pray for safety and health for our team for the remainder of the trip. You can see the church lit up on the left in one of the photos, and the plaza was busy at night with food and souvenir vendors. The team from the first week had a major challenge getting through Customs with a special formula for a baby here with metabolic disease. They started out with road travel delays due to a washed-out bridge and their bus nearly caught on fire. All that and an injury on the team rattled them a bit. We appreciate the prayers for our resident who suffered an injury and traveled home early with one of our faculty physicians. She has completed tests and treatment back home and is feeling better.

Sunday, November 10, 2024

Our team is now based in the town of Panajachel, on the shore of Lake Atitlan. This scenic lake is rimmed by ancient volcanoes, and the area holds spiritual significance for the Mayan Guatemalans. African flame tulip trees are in bloom near the lake. We will travel from here for two days to the village of Chichimuch.

Monday November 11, 2024

Patients gather outside of the local community building in Chichimuch waiting to be seen by the doctor or to get their prescriptions filled. We see patients of all ages and provide acute care as well as help patients with their chronic diseases. Our teams from the University of Cincinnati now come five times a year to more remote villages, and Wuqu staff Guatemalan physicians provide interval care as needed for patients with special needs. This is a rural area with subsistence farms supporting families. I saw my first Guatemalan cowboy herding his cows by motorcycle. You can see his lasso by his side. The cows are wearing colorful macramé muzzles to keep them from eating from the neighbors’ gardens along the way.

Tuesday, November 12, 2024

We are back in Chichimuch up around 8,000 feet in elevation. Off to the northwest from here, taller mountains are wrapped in clouds and rain is washing the mountainside. The weather here is cooler today and I am glad for a scarf, vest jacket and down coat.

Today we saw an 8-year-old boy with seizures and developmental delay. His family had to take out a loan to pay the neurologist to tell them their son had encephalopathy, and uncontrolled seizures; and they have had no resources for him for further care. Physical, occupational, and speech therapy services fell off during COVID. Like so many parents with a child having developmental delay, they search for a diagnosis, a cause, a cure, and a balm to assuage their sense of guilt and helplessness. We will get him seizure medicine and enroll him in the complex care clinic Wuqu has for these kids and families, but resources are quite limited here. As in the U.S. and most places, his most important care has come from loving parents, and affirming his parents.

A 6-year-old girl with bright brown eyes and a shy smile has a rash we’re not sure of. It looks like a burn, but it could be scabies or a photosensitivity to being splashed with lime juice.

With each patient they present, I can see and hear my young doctors putting pieces together – learning of a new disease, a different way disease presents, another way of counseling, an approach to treatment that will work in this region. They are an altruistic and empathetic group. I do enjoy working with them, and teaching what I can.

We’ve had a succession of school-aged kids drop in our clinic each afternoon out of curiosity, a few who were very interested in our microscope. Usually, we keep them occupied with coloring pictures but today they got a brief lesson in seeing a leaf up close.

Wednesday, November 13, 2024

A very busy day today with almost 50 percent more patients seen by our four resident physicians. Today we are in the town of Chutiestancia where we will be working for the next three days. This is the site where we have more patients who are illiterate, speak Katchikel or K’iche’, and do not speak more than a few words of Spanish. This represents a challenge for dual translation. One of my residents is seeing the sweet lady, second from the left (see photo) who only speaks K’iche’. The young woman to her right translates her K’iche’ into Spanish. The lady in the right of the photo translates from Spanish into English, and they slowly go back and forth. Visits take longer, but patients are treated with the dignity of care, delivered in their own tongue.

Thursday, November 14, 2024

Poinsettias grow here in profusion, mostly as tall shrubs. The brilliant red flower bracts contrast nicely with the greenery along roadsides in the mountains, in yards, and here along the shore of Lake Atitlan in front of the twin volcano, Toliman, which is capped with morning clouds.

One of our young doctors is seeing an elderly man whose nose is disfigured into a bulbous tumor. He admits to feeling depressed after the death of his wife a year and a half ago. He volunteers that he still keeps her clothes because her scent lingers there and is so comforting to him. It is amazing how smells can evoke such endearing memories, and even despite his deformity.

We saw a little boy with cerebral palsy after a preterm birth. He has seizures which are well controlled, but we discovered today he has a serious rash from the medicine. We’ll get him changed to another medicine we can provide through Wuqu Kawoq. His mother does a fantastic job caring for him and continuing with his physical therapy exercises at home.

Friday, November 15, 2024

Today we are back in Chutiestancia for a last half day of clinic. We saw, for the first time, a 14-year-old boy, who has mostly been untreated for his rash. He has dealt with this since five months of age. He has permanent scarring and has been miserable from the constant itching and inflammation from the rash. We’ll get him started on appropriate skin care moving forward.

We are short another doctor today, so we are moving more slowly through our schedule for the morning … now afternoon. We do basic laboratory testing, bringing all our supplies. Here one of my residents is analyzing a sample under the microscope while Dr. Ruschulte offers nuances for patient care.

Moms with babies carry them everywhere in a woven wrap, a frazoda reboso. The gentle jostling, mom’s body heat, and snugness of the wrap lull the babies to sleep.

Yesterday evening we made it back to Panajachel a little earlier, enough time to enjoy walking to the lake. Here is my best shot of sunset over Lake Atitlan.

Saturday, November 16, 2024

We came to the town of Tecpan, still up in the highlands, for our last night in Guatemala. Today there will be a million people coming to the small city of Antigua for the Flower Festival, and we need to avoid the traffic and congestion when we go back to Guatemala City to catch our flight home.

We walked through the streets last evening, past an organized foot race, past the market stalls with children’s clothes, weavings, fruits and vegetables, and dried fish. I was curious that when we did dietary counseling in our clinics, even our poorer patients endorsed eating fish. It seemed incongruous to me that they could afford fish, so far from lakes or large streams. In the market in Tecpan, for sale, were wheelbarrow-sized piles of dried red shrimp with the shells still on; and one-two inch long dried salted sardines with little sunken eyes staring back. Not the fish market I expected, but that explains the limited options the poor have. We made our way past motorcycles winding through town, and buses barely making a way through narrow side streets. We stopped at the office for Wuqu Kawoq and said goodbye to some of the staff who are essential to the good work Wuqu does. We visited the host family for Eva, just off the main market area. Eva is from Cincinnati and is volunteering for this year after finishing college, helping with various projects and logistics for our medical teams.

We stopped at San Francisco Church between the Friday evening Mass and a wedding. Inside the old-style colonial church is an older statue of Hermano Pedro de Betancourt. He was canonized by Pope John Paul II in 2002, at his shrine in Antigua. Santo Brother Pedro was a missionary to Guatemala in the mid-17th century, who is revered for his simplicity and begging for alms to help the poor and those in need of medical care. Poor guy, his image is even used in marketing (see photo). He is a source of inspiration for me. Brother Pedro, pray for us all. May he continue to be a source of inspiration for Guatemalans and intercede for them, especially the poor.

This closes part two of “A Guatemalan Journal.” I hope to return next February with another medical team.

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