Last day in Guatemala

three neighboring volcanoes

The morning started at 6am with a group of us taking off to hike a local volcano, Volcan de Pacaya.  This is actually an active volcano that last erupted in May 2010.  What made the hike so challenging was the very steep incline.  There are actually people who follow you up with horses hoping you'll give up and ride the rest of the way.  I almost gave in a few times, but eventually we made it to the top. 

Our final destination

The closer to the top we got, the more the trees thinned out and the ground became more sand like.  I felt so accomplished once I reached the top.  We got to walk about and explore all the nooks and crannies.  There were hidden hot spots with little green plants trying to grow around them.  Other than that it was just black lava rock everywhere.  Our guide showed us how to roast marshmallows over one of the hot spots.  That was really cool! 

 We started to head down a different way than we came up but halfway on this other path a sign stopped us saying it was too dangerous.  After some backtracking and walking around the dangerous part, we finally found the right trail to lead us down.  It was a very tiring and sweaty morning, but definitely worth it!

After the hike we got to go to a local coffee plantation.  The farmer himself met us and walked us around the land.  We learned about the different kinds of coffee beans and how they have to be planted with trees since they like shade.  Next we were taken to the farmer's home where we met his wife and learned about how the beans are processed.  First the husk is removed using a bicycle powered machine.  Then they are left to dry out for days and are surprisingly a pretty yellow color.  Once they are dry they are sorted.  Beans with imperfections are removed to be used for energy drinks while those that pass inspection become coffee.

We next got to roast our own beans.  The strength of the coffee all depends on how long you roast them.  Strong coffee is roasted for a longer time.  The beans are put over an open flame in a hot and smokey room.  They have to be kept moving so that they roast evenly.  Then we got to grind them by hand.  It was hard work and I did not do very well at all.  In the end we made wonderful cups of coffee!  It was a fun afternoon.     

After all that hard work our group wanted nothing more than a shower and clean clothes.  I also had one last trip to the market to make.  I am my mother's daughter and therefore get a high striking a bargin.  It's all about bartering at the market and I loved it!  The secret is to walk away.  Pretty soon my friends were having me barter for them. 

Back at the hotel one of our hikers had gotten a little too dehydrated.  Luckily we are a group of med students all eager to help with a bunch of medical supplies.  So it was decided that we would use an IV of saline solution to help our buddy feel better soon.  And I was the lucky winner allowed to put in the IV!  I was more nervous than the patient.  Good news though is that it went great!  He was feeling better in no time.  With the doctoring done, it was dinner time. 
 

 Our last night in Guatemala was spent hanging out on the rooftop of our hotel.  It was nice to see the city all lit up from up there.  The next morning after one last cup of coffee we loaded the bus to head to the airport.  Of course there was a group sing-a-long on the way. 

Overall I had an amazing experience in Guatemala.  I got to see and do and learn so many things.  I strengthened relationships with my classmates and met many new amazing people who became my teachers.  My passion for medicine and mission work is bigger than ever.  I can't wait for me next adventure.  Unfortunately it is now time to crack down and study for boards.  But in a few months I'll be in the hospital daily learning and working with patients.  That is what is keeping me motivated. 

From Ziplines to Chocolate

 

Friday was a day for fun and travel.  We started the day off with a Tuk Tuk ride, the local taxi, to a neighboring bay to go zip lining.  It felt like a clown car when we all got it.  The zip line was a series of 7 different lines with 3 of them taking over a minute to complete.  Once we were all geared up and had been taught how to break, we had a 30 minute hike up the mountain to the starting point.  Along the way we saw monkeys and some other animals I can't name.  We passed waterfalls, crossed swinging bridges, and saw beautiful views looking out over the lake.  It was a very tiring, but rewarding hike. 

So I really don't like heights all the much but I do enjoy the feeling of getting a little freaked out beforehand and then overcoming the fear.  It's exhilarating!  What a fantastic experience!  And it was a great way to see the sites.  Panajachel looked beautiful down below. 

After our adventure we had a little less than two hours before we had to be on the bus for Antigua.  Well of course I used that time to finally do some shopping in Panajachel.  On the way back to Antigua, we stopped on the side of the road in order to get a picture of the cemetery.  So the cemeteries here are really colorful little structures.  They sit above the ground like in Louisiana but are painted bright colors. 

Once back in Antigua we had more time to explore.  A few of us went to the chocolate museum and learned all about the history of chocolate.  The we did some taste testing and made our own concoction of hot chocolate.  It was really good.  We also stopped by McDonalds.  The McDonalds here are fancy.  They have a separate section called McCafe that looks more like a Starbucks.  It was really weird.  There was even a fountain in an outdoor garden eating area.  The night was causal for all with dinner and relaxing games.  I went to bed early since the next day began with a 6am bus ride to hike a volcano.   

Last Day of Clinic

Thursday brought us back to the town of Solola, but this time in a firehouse.  It was my favorite day, for we just saw children only.  I was in pediatric heaven.  We saw a lot of kids complaining of stomach pain.  Turns out the majority of them had parasites or worms.  Also a lot of cavities again.  We handed out multivitamins, toothbrushes, soap, lotion, shampoo, and lots and lots of stickers.











It was our fourth day of surprise lunch.  The generosity in this country is amazing.  In the middle of the afternoon we were visited by the office of the First Lady of Guatemala.  We were all given a certificate of appreciation to thank us for our service.  Dr. Bentley has been taking groups to Guatemala for 13 years and she says that this is the first time anything like that has happened.  It's also the first time that lunch has been provided. 

After an amazing four days it was nice ending with the kids.  I learned so much, not only in medicine but in mission work in general.  I definitely want to do another one in the future.  I would go back in a heart beat.  There is so much work that can still needs to be done. 

That night we had a group dinner with everyone.  It was really nice and a delicious meal.  Afterwards we went out for some drinks, games, and dancing.  It was so much fun!  I always am up for dancing.      

 

Day on the Water

 Wednesday we said goodbye to Panajachel via boat.  We were off to the town of San Antonio.  Before we left though, I had the most amazing banana pancakes for breakfast.  The veterans would not stop talking about them since the beginning of the trip so I had to try them.  The boat ride across the lake gave me a different perspective of how the towns are situated.  Panajachel is appeared to be the only one that had some flat land.  All the rest we passed, San Antonio especially, are built vertically up the mountain from the shore of the lake.  Walking up those hills to the center of town was difficult, especially for those hauling the medical supply bags.

San Antonio

That day I worked with Dr. Kesden who is in primary care in Florida.  He makes this trip every year.  I learned so much working with him.  He let me take charge and run the show.  They were my patients and he was there for support and to answer my questions.  Once again children and women dominated the clinic.  The big winners were cataracts, joint pain, and cough.  No wonder they all have joint pain.  I would too climbing all those hills with a child strapped onto my back and everything else on top of my head.  Also, the chronic cough is from having an open fire to cook with in the home without proper ventilation.  It's incredible how much these women endure in their everyday life.  Just add to the list of things I take for granted.

I did become a pro at checking eyes and using my ophthalmoscope.  It was another day where we were gifted with lunch, once again unexpected but greatly appreciated.  I feel like I really got to try some truly authentic food.  This time it was a spicy chicken soup and tamales.  Also hibiscus tea, which is a specialty drink there and also a natural diuretic.  After all our work was down, we once again had time to explore.  San Antonio is known for it's Palopo Pottery.  It is really beautiful.  I made sure to gift myself with a coffee mug or two.  The boat ride back to Panajachel was uneventful.  It was another early night with most of us turning in shortly after dinner.   

 

 

Day of Surprises

Monday night Panajachel called bedtime with a power outage.  Now we were warned that this could happen but usually only lasted a few hours or so.  Therefore I went to bed without thinking too much about it.  Tuesday morning dawned with, surprise! no power.  Which meant no water and no shower for Danelle.  I felt worse for those who had to work with me that day but at least we were all in the same boat.  Luckily, the saving grace that morning was the fact that there was still coffee due to a gas stove.  After my first cup, my dirty hair didn't seem like such a big deal. 

  


The bus that day was taking us to the town of Conception in the mountains.  We were to work in a school.  On the way, our bus driver suddenly pulls over on the side of the road.  Looking out the window, I realize we are right next to a beautiful three tiered waterfall.  We all got out and some of us even climbed up part way.  We could see all the volcanoes surrounding Lake Atitlan. 


The school at Conception was really fun to work in.  The walls were all decorated with the kid's artwork.  We worked at miniature table and chairs.  We had many curious visitors peeking in on us.  They were fun to interact with.  They loved having their picture taken and then shown to them on the camera.  Such a simple thing that I take for granted all the time brought so many kids joy that day. 

My job for the day was to run the pharmacy.  I learned how to properly dose patients, especially children who need a special calculation.  I sorted medications and filled orders.  I learned even more Spanish explaining to the patients how to properly take the medications or when to apply the cream.  Luckily everything was written out on labels so I could try to explain in my butchered Spanish and then point to the label I stickered on.  Hopefully one of those ways made sense.  The big medical winners of the day were scabies, GI worms, and rashes.  Once again we were surprised with a lunch of black beans, rice, and corn tortillas from the local women.  During lunch break, I played some soccer with the kids.  Now I haven't played soccer in years and am completely horrible.  These kids definitely schooled me but it was a lot of fun.   

After all our work was completed, we got some time to explore the town.  The church in the center of town is simply beautiful.  It is in it's final stages of being repainted so is this bright white beacon up on the hill.  Another spontaneous soccer game broke out in the streets.  It was amazing.  As soon as the soccer ball was placed on the ground, several children came out of the woodwork to play.  On our way out of town, we got stuck behind a funeral ceremony.  A whole bunch of people were gathered around this small fire in the center of the road.  The coffin was then carried down the road while the crowd followed.  Though I understood very little of what was going on, it was interesting to watch. 







Later back in Panajachel, we stopped at this special shop that the trip veterans knew about.  Turns out every year they order a tres leche cake from the same woman.  She makes it special for our group.  It was the best tres leche I have ever had!  We all enjoyed our appetizer that evening. 

Afterwards we watched the sunset behind the volcanoes across the lake.  We were blessed with electricity when we got back so my shower did happen that day.  It was still fairly early so we all went to the hotel pool.  After working (really playing) off our cake we grabbed dinner.  I had the best guacamole I've ever had.  The night ended with a specialty rum from the area and more card games.  Overall a very fun day. 

 

First Day of Clinic

Monday was our first day of clinic.  We worked in the town of Solola.  I was paired up with a fourth year, Erik, for the day.  We had three wonderful fourth year guys two weeks away from graduation on the trip.  They were so helpful and very patient with all of us second years.  It was good practice for next year working with Erik as my attending.  He made me present to him as I will next year and I got to run the show with all our patients.  It was so much fun and very exciting to finally put all my knowledge to use.  Working through an interpreter was difficult at times but by the end of the day my Spanish vocab had increased 10 fold.  I was very nervous for my first few patients but as the day went on I got the hang of it. 

The children were my favorite.  I won them over by passing out stickers.  The nurses running registration knew how much I want to specialize in pediatrics so they sent all the kids my way!  I was in heaven!  We were surprised at noon with some local women bringing us lunch.  It was very unexpected and so generous.  We saw about 120 patients that day.  I was exhausted by also very satisfied. 

Back in Panajachel we all went out for a delicious dinner and some live music.  Some of the English translations on the menu were really amusing.  My favorite was "tasty breast of a plump and obese chicken".  The night ended early with us all curling into bed ready to face the next day of clinic. 

  

Antigua to Panajachel

Sunday morning started with a group breakfast.  We had a typical Guatemalan breakfast with eggs, cheese, black beans, and fried plantains (which tasted delicious)!  And the coffee!  It was amazing!  No cream or sugar needed. 
Our group in altogether equalled 23 people and this was the first time we were all together.  After breakfast, one of the group veterans Dr. Kesden took us on a tour of the local market.  He is very knowledgeable about the local fruits and veggies.  We found the row of meat stalls with all the wares hanging from hooks.  The smell is so hard to describe but it was very overwhelming.  There were even full chickens split open with un-laid chicken eggs inside (a local delicacy).  The vegetables here are grown in volcanic soil and get really big.  The carrots appeared to be on steroids. 

Also there were avocados at every stall!  Turns out Guatemala is one the the avocado capitals in the world.  Dr. Kesden bought some of the more unusual fruit for us to try like granadia (dragon fruit) and zapote.  Most of them were really good.  He lead us to the spice section of the market and explained all the medical properties of the local spices.  Turns out that cinnamon fights ulcers and beets help lower blood pressure.  The market was a very eye-opening experience.  Before the bus left for Panajachel, we had some time to explore Antigua in the daylight. 



The arch is the most photographed place in Antigua
  

On the way to Panajachel we fit in some history and culture by stopping at the Iximche Mayan Ruins.  Our bus driver turned into our very own tour guide while we walked around.  One part of the ruins is still used, the ceremonial center.  A shaman was there performing a ritual.  People still come there to pray and light particular candles for health and prosperity.  It was really interesting to watch.  



Second year med students

We were suppose to have lunch at a local village after the ruins, but we were informed that the town was quarantined.  Turns out there was an E.Coli outbreak and the entire town and surrounding areas were unsafe.  So to add to the adventure we had to find a new place to eat several miles away from the ruins.  We were lucky that our bus driver knew of an excellent place.  A few hours later we were at Panajachel which is located on Lake Atitlan.  This lake is surrounded by several active volcanoes with little villages nestled on the hillsides.  Our hotel, which we took over, was right on the shore.  The gardens surrounding the building were incredible!  So much bougainvillea.  We spent the night playing card games and then all went to be early to prepare for clinic the next morning. 



Hotel garden

 

view from room balcony

Denver to Guatemala

Last Saturday I started an amazing journey to Guatemala for a medical mission trip.  I'm home now (which means safe drinking water, Internet, and warm showers) and will update this blog about my adventure.  We left Denver bright and early at 6am.  Flight to Houston was unremarkable while Houston to Guatemala City caused some excitement.  We were all prepared for landing when the captain made an announcement that another plane was broken down on the landing strip and that we might have to land in Honduras instead.  Needless to say that would really put a damper on our plans.  Luckily, after circling the airport for about 20 minutes we were given the all clear to land at 1:30 pm.  Customs was uneventful and we were met at the door with our transportation which was a Chicken Bus.  This bus was brightly painted and all the luggage was loaded onto the roof and strapped down. 

The drive out of Guatemala City was crowded and it took us about an hour to reach Antigua.  Our hotel in Antigua was beautiful.  All the rooms lined an indoor hallway on one side with windows and doors of the rooms entering this hallway.  We were all together and it reminded me of college dorms.  We set out quickly to explore the town.  Some of the fourth years on the trip with us had been before so they steered us in the right direction of excellent food and the places to see.  Our hotel was right on the main square which housed a very unique fountain and a great big church. 

There's a lot of ruins just scattered throughout the city.  The roads and sidewalks are all made of cobblestone, which is not nice on open toes.  The doorways the line the side walk open into gorgeous courtyards decked out with flowers and fountains; little hidden gardens in the middle of the buildings.  Our group contained a husband and wife with their 6 year old daughter that they adopted from Guatemala when she was born.  They had actually lived in the city while completing the adoption process and therefore knew all the secrets.  The entire family was just a joy to get to know.  They explained how the women in the city come to this one fountain to wash their clothes.  It was really nice of them to show us the sights. 

 

We ended up watching the sun go down on the roof at a place called the Sunset Bar. It was there I discovered how delicious real cane sugar is.  While there we actually met with another group of doctors doing some surgical work in the city.  It was fun swapping stories and talking shop. It's always nice when doctors take the time to share with students.  The extra encouragement never hurts.  The night ended with some dancing and live music in one of the hidden courtyards that we just happened upon.  Then it was to bed for us all for the next day was a group breakfast followed by several hours on the bus heading to the next location.