Guatemala Medical Mission 2012

A huge hello to all the friends, family, acquaintances, UD students, distant facebook friends (lest I forget them)… and all others who have stumbled upon my new blog! My name is Joseph Zarraga, a Junior Biological Sciences Major at the University of Delaware. As some of you know, I traveled to Guatemala in July 2011 for a Medical Mission called “Now Is The Time,” hosted by Christian keynote speaker and songwriter Shawn Smith. 

I am going to Guatemala again this year for a week, from July 15th to July 22nd. I intend to share all my experiences before, during, and immediately after through this blog.

This blog also aims to accomplish three additional tasks: 

1. Damage Control: By actively updating this blog while on my mission, it’ll serve as proof that I am still alive in Guatemala to all those worrying about my current state and condition (IE my beloved mother, who took much convincing to go on my original mission). 

2. Reminders And Memories: After last year, I discovered that something concrete is the only way to remember everything that occurs on trips like these. This may seem obvious… and it is - as that is the whole reason why we take pictures at milestones in our lives. But on a journey in a different country - a medical mission in a third world country - there is so much that happens in such a short week. A combination of mixed emotions, culture shock, and sheer differences between our worlds… you tend to forget small details until you relive them through pictures or words. 

3. Document My Experience In Guatemala: This is not only for my own benefit, but also to serve as a token of appreciation for the generosity of the University of Delaware Honors Program, who have assisted greatly in funding my trip. It is because of their kind donors that I am able to visit Guatemala once again.

At the time of me typing this - June 18th - there are 27 days until I depart for Guatemala. I will try to keep this blog interesting for people to read… although I literally have no idea what I am doing. Although being a complete nerd… I’ve never used my 5 year old twitter (where I have an impressive 2 followers), the format of Google+ have my head in circles (terrible pun), and I still have no idea why I keep getting notifications on FB from Instagram, Classmates, and that farming game thing. 

So, despite my lack of experience of “blogging,” I’ll try to keep this spontaneous, organic (for lack of a better word), and true to what actually goes on in my mind, at least regarding Guatemala. So for what it’s worth, I hope some this blog provides some enjoyment, even if only for a few (my parents HAVE to like my stuff, right?). Thanks again for taking the time to visit my blog, I hope you continue to do so. Welcome! 

-Joe 

So apparently I’m doing this wrong. 

But it’s too late to change it, carrying on… I guess I should post a little more about myself, some background - the usual who, what, when, where, why jazz. So here goes. 

The who is pretty painless and easy. Again, I’m Joseph Zarraga, the token Asian guy in every cluster of friends that I am a part of - I think. I’m the guy with foreign parents (whom I do love, no matter how funny their accents - see my facebook videos…), the one who uses a spoon to eat their rice, the one with a general lack of body hair… that guy. As can be inferred, I have hopes of someday being a physician to of course bring honor to my family, as well as a multitude of slightly more worthy reasons. 

I’ll delve a bit deeper into who I am, with less emphasis on… easily observed characteristics. First and foremost, I’m a pretty stubborn person, in all senses of the word. I… learn the hard way. It takes a good amount of convincing before I decide on something, but when I do, I ultimately accomplish those goals or tasks. My… stubbornness is the sole reason why I found myself in Guatemala last year, well other than sheer chance (more on this later).

I have high expectations for myself, which often leads to… disappointment. A vast amount of it. I often think of the biblical phrase, “the spirit is willing, but the flesh is weak,” when I contemplate how I make so many mistakes. However, I try to regret nothing, as every experience (including my abysmal C+ in Chem103…) comes with a gift - motivation in either the positive or negative direction. 

The last adjective that I think is fitting for me is… random (I know, I sound like a nutjob). But within “random,” I think I can fit things like spontaneity, multifaceted, and diverse under its realm to make it a bit better. I make many impulsive decisions at times, some of which, fared drastically better than others. I have many hobbies and interests, too many in fact. These include everything from sports, deejaying, paintball, mountain biking, and traveling to much less… attractive ones like computers, cooking (did not say I was good at it), my car, etc. Again, random. 

The what, why, when, where? Thats the point of this blog. These were all questions I had early last summer. I did not know what the summer had in store for me; I was desperate to do something different and much more exciting that what I was accustomed to (volunteering, working at my parents office, being the pool boy…). I finished my Freshman year at the University of Delaware and realized I needed to take proactive steps now if I every wanted to make it to medical school (considering I couldn’t rely only on grades unlike my friends with 4.0GPAs…). 

And an opportunity fell on my lap. I bought 2 LED lighing fixtures for my DJ business on eBay - I had my cousin’s wedding reception to DJ in 3 days. I asked the seller if he could expedite the shipping process for me as a favor, and after some kind words and good faith, he paid for the extra shipping before I agreed to pay for it. I truly felt in debt to this man, who literally acted with not knowing me, with no reassurance that I would pay him back, etc. That… just doesn’t happen today, especially on the internet. Being the curious person I am, I went to his personal website (his email was self hosted) and saw he did mission work in Guatemala. I gifted him extra money online for his troubles and for the favor, thanking him and also commending him for doing such work. Long story short, he actually was bringing down a medical mission that year and invited me.

So truly the answer to what, why, when, where? All came from this one interaction. If I chose a different seller… if my cousin didn’t ask me to DJ his wedding reception… If I was a much more reasonable person and ordered more than 3 days before my event… well lets just say my last minute tendencies actually paid off this time.

More on Guatemala 2012 in the future! Back to MCAT studying… 

I know I’ve been a bad blogger. It’s barely been a week since the formation of this blog and I’ve put up 2 posts (the picture was cheating). Meanwhile, those with better understanding of the ways of the internet (IE my sister), have shared much more, proving to be far more entertaining than my page - I know my writing and my experiences in Guatemala can’t compete with youtube videos of Welsh Corgi puppies, funny memes, and trending topics on the “Twitter-sphere.”

So I had an idea - fight fire with fire so to speak and include more media in my posts to break the monotony of my blog. As I’ve previously said, a lot went on in Guatemala, so much that I can barely recall it all. Instead of trying to describe everything in these huge, lengthy posts (I don’t blame you if you don’t even reach this far…), I’m going to attempt to illustrate my experiences and findings more effectively (and hopefully make it more enjoyable to read).

Posted below is a Photobucket Album Slideshow of some of my favorite pictures I took during my Guatemala trip last year. Each picture has its own story, a story which, I would argue is worth much more than a mere 1000 words. When I feel particularly nostalgic (which occurs MUCH more often when studying for the MCAT)… I open up my iPhoto and look at these pictures, which, for a brief moment, allow me to totally disregard the other tabs I have open on Google Chrome, which usually display things like my shameful scores on my last Kaplan practice tests. 

With the help of this slideshow, I hope to better convey my trip though both images and words. I will try to highlight a picture on the blog daily, commenting on why that particular photo was meaningful to me. It’s as simple as that - I call it my “photostream.” Attempts will be made to keep it short, sweet, and interesting, lest I disappoint my millions of followers out there.

If you haven’t exited my blog yet… here’s the promised “photostream.” You may click on it right now and peruse the pictures I chose at your leisure, or you can wait for my daily highlighted picture updates and commentary. There are over 70 pictures in the album, all of which I think help define what my trip meant to me. We will barely get through a third of them, but I’ll pick the “worthy” ones depending on how I feel that particular day. The idea’s still in the works.

And with that, I need some sleep - long day of Verbal Reasoning practice tomorrow. I’ll pick my first picture of the day soon, and see how this idea works. 

- Joe 

The Photostream

Picture One - The Family Photo 

I figured I would start the photostream with this photo, I thought it was fitting for some reason.

If memory serves me correct, this picture was taken on the forth day of our mission. It was a pretty busy day in the medical clinic, with a line of at least 100 people present when we arrived that morning (a sight we had become accustomed to over the week). We started seeing people immediately, triaging those most in need of attention to the front of the line. A mother of three brought one of her sons to our clinic to be seen for a rash that had appeared all over his body, most likely from exposure to a poison ivy-like fungal derivative. We supplied the appropriate hydrocortisone cream to help treat it. Before they left, the mother spoke to me. She spoke quickly in a Guatemalan dialect of Spanish, and hurried off before I could ask her to repeat it. 

She came back, 3 hours later bringing her second son, a five (I think) year old boy (he’s the one in the orange shirt behind me). By far, my favorite patient of the trip. Sporting his newly acquired clothes - a Spiderman 3 shirt and some classy corduroys - he was cheerful, always smiling, and just… carefree.

When I asked his mother, “¿cuál es el problema de su hijo?” - what problem does your son have (I only know a few phrases in spanish…), she proceeded to use words that I had never heard of before. Except I did catch a word that I did know - orina. I wasn’t completely confident in the rest of my… translatory skills, but I continued to ask the boy anyway, “dolor con orina?”

Sure enough, he responded, “Si.” As in yes - he has pain during urination. “Para dos anos” - for the last two years.

As many of you can probably tell, I surely butchered the spanish language over this week in Guatemala, but somehow was able to understand the gist of most conversations with patients. I consulted Dr. Keller - the head physician leading the medical mission - as to what action to take for what I thought was a possible Urinary Tract Infection of some sort. He wanted to confirm the diagnosis and after a brief discussion and quick visual examination of the boy, he confirmed the presence of a yeast infection and gave his mother even more medications and antifungal cream to help remedy the problem. 

However, the mother yet again spoke to me, saying that she was going to come back before the day was over. All I could say was… “Si” - I didn’t know how else to respond.

My watch read 4:30 - we were leaving at 5. Somehow she had traveled across the village and back in 20 minutes, picking up her last son who had been at school all day. This last son, the eldest, was easily twelve or so, and had the trademark smiling tendencies of the rest of the family. But as he walked in I noticed something (as did the rest of us) - He was blind. 

We were told going into Guatemala that many people rely on these medical clinics for their primary care as there is no healthcare in these rural villages. That we were going to see many people who come to us for treatment of chronic ailments that we are unable to do much about (hypertension, diabetes, etc). But Blindness? I was taken aback for a second; I had barely encountered a blind man in the United States, let alone in a Third World Spanish speaking country. My… hesitation is not to signify disrespect in any way… but it was just a new experience. He was a smart boy - the only one of his siblings in the only school in town (which was private) who never let his lack of vision stop him from doing anything. His mother ran to get him not because of any particular sickness, but mostly to make sure he was in good health. 

These events speak a great deal about Guatemalan culture in general. The mother is the foundation of the family, often sacrificing time, what money they have, and resources to provide what they can for their children. This woman - this single mother - scrambled around the village for the whole day to have her children seen by our clinic. For what? - 2 tubes of ointment, a ziplock of advil, and 3 boxes of Flintstones vitamins? Well indirectly, yes. But the point is that she did everything possible to ensure the well-being of her children. 

I severely lost my train of though while writing that - this picture will probably remind of different stories and feelings tomorrow… but for what it’s worth. Until picture two… 

- Joe 

Picture Two - The (Original) Crew

Back Left to Right - Dr. Sherry Keller, Dr. Ray Keller, Erin Keller, Me, Kim Barron; Front Left to Right - Emily Keller, Sarah Christian, Lindsey Pretsch, Janine Davidson, RN

I wanted to upload a picture of the Medical Crew early on - so here’s picture two.

The Now is the Time mission trip brought over 80 incredible people from many different places to Guatemala over a span of four weeks, with many of them staying multiple weeks. I knew only 2 people coming in - the aforementioned founder of the mission, Shawn, and one of the lead physician for the medical mission, Dr. Ray Keller. Moreover, I had only contacted these men through phone and email, and still had yet to match a face to the names. Despite all the precautions I took to ensure the validity of the mission, there was still that… feeling - that 1% of doubt, of uncertainty - that still lingered in the back of my mind. But that quickly subsided as I met Shawn, Dr. Keller, his family, and the other 35 or so at Hotel Candelaria in Antigua, Guatemala. 

The other eight people in this photo immediately became my second family in Guatemala. Although it may have only been a week, the experience seemed to last for many more. I couldn’t have had a more enjoyable mission with any other group of people. 

I had many great conversations during the daily hour drive with Janine Davidson, a nurse from Florida (bottom right). Lighthearted and armed with a good sense of humor, she was one of the most approachable and down to earth people I have ever met (and was just as fluent in Spanish as I was…). 

Kim (back right), Lindsey (front, second from right), and Sarah (front, third from right) all were in college (or recently graduated) and allowed me to actually be myself. It was welcome to see so many people of my own cohort/age group on the trip, helping me be more comfortable around all these new faces and people, Guatemalan and American alike. 

The rest of the crew… had a bit more chemistry than the rest of us - at first. The Keller family from Williston, Vermont was composed of Dr. Ray, Dr. Sherry, Erin, and Emily. Love this family, plain and simple. They were welcoming and were quick to take me under their wing, even before the mission - If it were not for Dr. Keller’s reassuring words to my mother only a month before the mission, Guatemala would probably not have been a reality. Both doctors were great mentors in and out of the clinic and I cannot wait to see the whole Keller family once again this July. 

I will always have a soft spot for this group - the first - the original - medical crew. 

Until tomorrow (beat midnight by 2 minutes!). 

- Joe 

Picture 3 - All For A Dollar  

Taken in Santo Domingo Xenacoj, Guatemala. 

This is the typical house in Guatemala. For those lucky enough to even have a roof over their heads, that roof is often a thin sheet of tin, rusted and weathered from the sun, humidity, and torrential rains. Drinking water is collected in (donated) water jugs, as there is no plumbing outside of the few major cities. Even in this day and age, electricity is still out of reach for many in a country such as Guatemala as well. 

The large metal canister in the back corner of the photo is actually common in many Guatemalan shacks, provided by an nonprofit organization called the Guatemala Healing Hands Foundation. The canisters serve as storage place for grain and corn, crops that are usually susceptible to animals, pests, contamination, etc if otherwise stored. It only took yours truly ten minutes to decipher the instructions on the side of it…

This family was kind enough to allow our mission see how the people of Santo Domino Xenacoj live. Those living here are actually much better off than the majority of the natives, demonstrated by the cinderblock walls and actual glass windows. Them being able to afford such luxuries is a testament to how hard the family works - despite the lack of a male presence to help earn money in the traditional ways of farming and agriculture. Instead, this woman, a Grandmother, works over 14 hours a day - in that position - weaving garments - to be sold for a daily wage of under two American Dollars.

That is literally 14 cents an hour. 15 Guatemalan Quetzals a day. 14 American dollars a week. And if she works from January through December, provided the demand is constant and her arthritis does not hinder her efficiency, she will be lucky enough to earn a little over 700 dollars for the year. 

Shocking how a whole year of grueling work in Guatemala can barely purchase the newest Apple iPad in the United States - and somehow these people make it stretch to feed, clothe, and shelter a family of 3. Oh, and be happy while doing it. 

- Joe 

Picture 4 - The Marketplace 

Santo Domino Xenacoj was actually a rather large town in comparison to many of the surrounding villages. It had a rather large town square, a place that all locals take special pride in. City hall rests on one street corner,facing the catholic church - the one building in the town that has stood the test of time (more on that another day). A fountain lies between the two landmarks, with twin basketball courts and a garden adorning its sides. To the left of the square lies streets and small houses, eventually thinning out to dirt roads going up the side of a sizable mountain. And to the right - the marketplace of Santo Domingo Xenacoj.

With it being a monday at noon, the side street is densely populated with local vendors selling whatever they can. Produce, crops, and fresh fruit are naturally the hot ticket items, with fresh tortillas not to far behind. We fight the temptation to sample the enticing food, and continue walking down the road where the items start changing to speciality goods. Blankets on the street are filled with everything from newly woven garments to an assortment of electronics freshly trashpicked from the richer city dwellers (even though things such as wireless routers and dvd players have little use in a town with little to no electricity). 

The marketplace is a joyous part of town - it’s not only an area of trade and commerce, but also is a time for the locals to socialize and take a break from their long days, if only for an hour or so. Children play with deflated soccer/volley/basketballs, families talk and laugh, and music is often played, accompanied with Guatemala’s version of line dancing. This place and time is their livelihood - where they come for everything: to sell, to buy, to share, to enjoy. More to come. 

- Joe 

Picture 5 - A Quality Education 

Remember my first post of the photostream? The mother who came back 3 times throughout the day to ensure all of her children were seen by us? And how she brought her eldest son to the clinic right before it closed - the blind one? This is a photo from his school. 

Santo Domingo may be bigger in population and size when compared to majority of other mountain towns in Guatemala, but it is still far too small for the Government to even contemplate building a school in the area. Unfortunately, the same goes for all but a select few towns - public education simply isn’t a big enough priority to try to expand its reach past urban city districts. Due to this, Guatemala is known to very limited options when it comes to education, with very few public schools and secondary schools  supported by the Government. Even is there is an institution present (offering free education) in the area, the cost of books, uniforms, and supplies not supplemented by the state often deter families from placing their child in such programs.

The school uniforms that many of the students wore reminded me of my Catholic Middle School days. The presence of the all too familiar embroidered male sweater vests, the collared shirts, and the plaid skirts completely surprised me given the financial state of most of the families here. I know all the students and parents at my school complained incessantly about the inflated prices of our uniforms - I can only imagine what percentage of these Guatemalans’ savings went to sending their children to this school clothed in the correct dress code. 

This alone is a testament towards how much of a priority an education is now. Guatemala, as you know by now, is an almost completely rural country, with small mountain villages and valley towns making up most of the population. Of this population, almost 30% cannot read - a statistic not beaten by any other South American country. The fact that over 50% of all families live below the poverty line also does not make for an environment conducive for learning and educational prowess.

However, schools like this one in Santo Domingo shows promise - attendance is now at an all time high. It’s not a “state of the art” facility by any means; as you can see, the building seems like it was converted from a barn - probably because it was. But these children want to learn, and now that the majority of books, uniforms, and supplies are donated, there is little in the way of stopping them. The students genuinely seemed happy to be there when we visited - possibly because they rarely see Americans… But regardless, when asked if they like school, they all replied that they love it. Try to get that same response and fervor from many of their American counterparts… it’s likely much tougher. 

- Joe 

Picture 6 - Celebrity For A Day 

This picture was taken moments after my last picture, when we were taken into another room for a special lunch they had prepared for us.

Meet TJ, a 10 (I think) year old boy from Florida that I met along with his mother on my trip to Guatemala. His mother Carrie thought that the trip would be a great experience for young TJ to experience the world - in an effort for him to see the harsh realities that many still call life in this day and age. For this moment however, instead of feeling grateful and appreciate for what luxuries he has at home… he perhaps got the wrong message.

Being a white youthful boy in Guatemala made him a somebody, a celebrity, a superstar. While many mission trip groups do choose Guatemala as their target country, seldom are adolescents (let alone a 10 year old) brought for safety reasons. TJ’s presence made it easier to approach these young boys and girls - he somewhat… bridged that gap so to speak. This White American boy was like them, a notion that made all students flock to him. TJ was never without a Guatemala companion tagging along next to him. And yes, all Guatemalan children are that cute - the one sporting the KIM POSSIBLE T shirt was a crowd favorite. 

Being 10, TJ was probably in the fourth grade or so. It was his first time out of the country. He stuck out like a sore thumb across a sea of dark Guatemalan students with his pale freckled skin and freshly buzzed mow-hawk. And he knew not a word in Spanish. Yet the children immediately took him as one of their own. While all this attention may have given TJ a short ego boast, he ultimately had a great mission trip, experiencing events that hopefully will pave the way for a life of continued altruism. 

-Joe 

Picture 7 - The Pharmacy 

Our medical clinic was run out of an “outdoor” classroom. As a whole, we saw and administered medicine to over 300 people in a week. This small corner of the room was converted into our pharmacy. 

To keep costs low, many medical missions buy their medicine from international foundations who sell in bulk. These companies sell random allotments of medication for a low price - the medicine is donated by pharmacies and organizations because they were not needed or because they are near of slightly past their expiration date (almost all drugs are actually conservatively dated to ensure effectiveness, while they tend to last much longer after their “sell by date”). This system is cost efficient and effective for situations like this. A huge amount of medication can be purchased cheaply (and can get through customs that much easier) and for a small village that has no pharmacy, any medication is helpful. 

It was actually exciting for us to open the boxes to see what we were given in this… “pharmaceutical lottery.” The first box was… somewhat demoralizing however - half of the prescription bottles were in German. Or Italian. Or Latin. Or something. Luckily, after opening the rest of the packages, a list was found documenting all the medication, their quantity, and their generic American name. 

Surprisingly, a good amount of the medications seemed promising, given the people we were helping. Cough and Flu syrups were abundant in number along with a good supply of prenatal vitamins and antibiotics, which ultimately proved to be very useful. However, common over the counter items such as tylenol and advil were completely missing from the boxes. Hydrocortisone and other fungal and bacterial creams were donated, but in very limited quantities. Hypertension and diabetes often plague those of hispanic descent, and yet we had nothing to administer for those conditions. Perhaps the most aggravating aspect of our allotment was the absurd amount of Diflucan given to us. Diflucan is an oral antifungal medication that is usually taken to combat yeast infections - only 3 people had such symptoms out of the 300 patients. 

Despite our somewhat random supply of medication, the pharmacy kept busy and we seldom came across a patient that we were ill equipped to assist in some way. 

- Joe 

Picture 8 - Christine 

On the morning of our first day at the clinic, 100 teachers and students from the local school were lined up in front of the Church’s stone gates, patiently waiting for our arrival. The local women who helped Shawn organize the clinics for Santo Domino Xenacoj greeted us at the door with wide smiles, excited to finally open the doors to the church courtyard that housed the Vacation Bible School and our medical clinic/eye glasses clinic. 

As we headed towards the door, one of the female elders was holding onto a baby stroller - the one you see in the picture. The team members who were in front of me all peaked in to make the obligatory guttural baby noise (in broken Spanglish, no less) at the infant, trying to evoke a simple smile or laugh. When I looked in, I quickly realized that the baby looked familiar. She was the spitting image of my cousin, Christine.

When Christine was born, the life of my Aunt (and her family) changed forever. On the day of her birth, she was diagnosed with Down Syndrome. Also called Trisomy 21, it is caused by complications in Meiosis (cell division), specifically during nondisjunction of Chromosome 21. This extra chromosome not only affects the physical growth and development of a child, but also tends to limit academic performance and cognitive abilities. My Aunt and Uncle knew what such a condition entailed - extra care, attention, schooling, supervision, health care, etc. Despite this news, they quickly vowed to give all the time and love they could provide to Christine, just as they did to her sister, Grace. 

And somehow my Aunt and Uncle foolishly choose me to be her Godfather. ME. I was chosen to help lead Christine through life, assisting her in discovering and defining her faith - when I am far from accomplishing the same with my own ideologies. We’re talking about the guy who finds himself sleeping more than listening in church. The one who never gets it right the first time. The one who tucked his tie in his pants for the family portrait 10 years ago. And I was supposed to be qualified to impart wisdom to Christine? 

The baptism still happened nevertheless, which turned out to be a milestone not only for her, but for me as well. As unsuited as I may have been for the job, I promised that day to take an active and permanent role in Christine’s upbringing. Two and a half years of being a godfather have instilled in me a sense of great pride of Christine, a feeling that I could not help but be reminded of when I saw that baby in the stroller. 

When I discovered that my cousin had Down Syndrome, I did some research and parents everywhere all shared similar stories. They said that their child became a role model for others on how to love - these people exude it in such an unconditional and perfect way.

The baby I had seen in Santo Domino resembled Christine almost perfectly. Seeing “Guatemalan Christine,” as I remember her, gave me fitting inspiration for the first day of the medical clinic, reminding me of that impartial and unconditional care that I hope to strive for when I become a physician and a father.

- Joe  

Picture 9 - Tengo Tos  

In less than a week, I will be once again in the country of Guatemala! All forms filled, all dues paid, and… my sister is in the process of getting my 100 pound quota of donations ready. Just gotta finish another week of MCAT studying first… 

On to the clinic itself. As mentioned before, when we arrived on the first day, a long line of school children greeted us, all eager to be seen by the “Americans” (the more plausible reason is because they were missing school). Students ranged in age anywhere between 6 and 12 years old, with the younger given priority. Most were pretty timid, understandable when considering that this may have been the first interaction with Americans in quite some time (or ever). We found that there was this discernible quality in all of them, a quality of innocence that just seemed… different. 

This innocence was soon put to the test. As we talked to more and more students, the crew all started to notice something. Apart from a few who actually had a noteworthy diagnosis like asthma or a real runny nose, all had the exact same complaint - “tengo tos.” Simply translated as, “I have cough,” these seemed to be the key words. The key words that they were instructed to tell us by their teachers and or parents. Some felt uneasy uttering this downright lie, feelings made evident to us by their tapping feet, changing stories, and their continuous hesitant glances to the back of the room where their proud teachers stood. 

Some could barely muster the courage to say the phrase - and when they finally did spit it out, they had nothing else to say. Others went along with the lie and embraced, adding a host of other problems to the list such as headaches, runny noses, itchiness (with their duration of their ailments, no less!) when there was no physical signs of any such problems. Either way, we knew to expect it - in a town with little to no medical medicine, students were told to tell the little while lie to try to get as many medical supplies as we would give them. And we couldn’t just let them leave empty handed. 

Each student that walked in left armed with some children’s vitamins (of the Flintstones variety if they were lucky), a lollipop in hand, possibly a box of Batman band-aids, and a tablet of Abendazole (an antiparasitic medication) digesting in their stomach - after praying with them for continued watch, as we did with every patient. More [interesting] patient stories to come. 

- Joe 

Picture 10 - Toms 

This picture has very little to do with our medical mission, but It’s still one of my favorites. 

Blake Mycoskie was a competitor on The Amazing Race in 2002. He traveled all around the world for the show, battling other duos in many events that required stamina, endurance, intelligence, direction, and intuition. After Blake and his sister Paige finished third in the show, he traveled to Argentina for a short time, discovering that thousands of children here (and around the world) walked with no shoes. Feet were susceptible to cuts, infections, parasitic invaders, etc, and many die due to complications each year. In countless cases, education is also limited by the lack of shoes, with them being a requirement to attend school even in third world countries. 

While in Argentina, he grew fond of the local “alpargata style” footwear that many farmers wore there, and was inspired to create a company that vowed to help those without shoes around the world. He sold his current business and started TOMS Shoes in 2006. Adopting the alpargata style to his line of original products, sales in the United States took off not only due to their fresh take on footwear, but also because of the company’s promise and mission - for every pair sold, another would be put on the feet of a child who previously did not have shoes. 

Sure I had heard of the company… the girls on my freshman floor at the University of Delaware all had 20 pairs of them. And their collection keeps growing. But in this day and age, seeing is believing. Scams and scandals are everywhere, and skepticism is… somewhat needed to ensure that you’re not on the receiving end of a bad deal. To see TOMS Shoes being worn by children over 2,500 miles away from my home… well, it was unreal. 

It was reassuring to see an honest company - a company actually doing exactly what they said they would be doing. My medical clinic was in Santo Domino Xenacoj - a small mountain town that doesn’t even have its own Wikipedia page! And yet a substantial amount of children were running around and playing in TOMS. 

Of the 11 in the picture, 6 had TOMS on their feet, a percentage that seemed accurate throughout the whole village. Again, not totally related to my mission, but noteworthy, at least to me. 

5 Days Left! 

-Joe 

Picture 11 - Back To Back 

When this young man walked into the clinic, I couldn’t help but think to myself, “this looks bad.” 

Diego (I really think that was his name…) was the typical 16 year old Guatemalan. He farmed with his family during the day, and played many sports in his free time, including soccer and basketball. I questioned him about his arm, expecting a response relating to a work injury, etc. It looked pretty serious, with a makeshift cast and enough gauze wrap to measure 3 inches thick. His explanation for the cast was this: “Mi amigo me golpeo con un palo.” - My friend hit me with a stick. 

Given my comprehension of Spanish at the time (and at present time…), I didn’t know what else to say in reply, apart from “lo siento” - I’m sorry. But he quickly informed me that the injury was not the reason he came to the clinic. He complained of chronic headaches and pain, all stemming from his neck and shoulder area. He allowed us to carefully take off his shirt to exam his back visually, as light touches triggered facial expressions of intense pain. 

With his shirt off, the problem was obvious. For reason, his right scapula (shoulderblade) was lower on his back in comparison to left. Much lower. We were perplexed - this type of condition does not just occur overnight. Nor should it have been taken lightly in the past; the pain that potentially comes from this… we could not have imagined. The scapula is a vital part of the back, being the origin and insertion point for over a dozen muscles, including the biceps and triceps. 

Our best hypothesis? The excruciating pain due to its position (whether due to improper development, a severe injury, etc) day in and day out continue to aggravate Diego to the point of developing migraines and headaches. Again, his current state must have taken years to get to this point, provided that he truly didn’t sustain any major trauma to his back. 

The lack of medical care in his village means that Diego is on his own. Pain medication like Tylenol, Advil, etc are rare, and surgery is almost out of the question. He stated this was the first time that he had seen a real doctor, as is the case with most of these people. He barely makes enough money to feed himself and help with his family; we know that our advice to seek further medical attention will most likely be ignored. And so the vicious cycle starts where he will be unable to work, unable to relieve his pain, unable to provide. 

We gave him what we could - extra gauze for the arm and ointment (in case there was a wound), and extra ziplock bags of ibuprofen and acetaminophen in hopes of relieving even a fraction of his pain. Even knowing that the medication was by no means a panacea for everything, he was extremely appreciative, clinging on to the hope that one day he’ll be able to work again and ultimately recover. 

- Joe