Welcome to San Lucas Toliman, Guatemala.
As most of you know
, I moved down to Guatemala in August to spend the year as a pediatrician hoping that I could put my new-found ¨real doctor¨ status to some good use helping people who have very little access to medical care. In the process, I´m hoping to support and strengthen a system of local health workers who volunteer as first responders in their own communities. And I will be happy if I can shore up my Spanish, learn about medical conditions we rarely see or treat independently in the States, and get to know some of the history, culture, and people of this beautiful country of Guatemala.
I started this website as a way to share something of this experience with my friends, family, and other volunteers. I am planning to post some interesting cases, or routine cases that are not routine in the States, to demonstrate some of what is seen here and the special challenges we face here because of lack of resources. I also hope to muse a bit about the social, cultural, and economic environment here as a way of processing the experience. It is very challenging to witness the extreme poverty that exists here in SLT and each day brings me some level of frustration and indignation. Clear solutions and ´right answers´ to the problems are very hard to come by. I know that much of what I will get from my time here is an education in the realities of poverty and lack of health access that affects the vast majority of the world and exists in large part because of the way those with abundant resources choose to live. I hope you enjoy the notes, cases, and pictures that I post here over the course of the year and I hope that you share your comments whenever you can. Welcome!
To give you a little background about where I am living....
San Lucas Toliman (SLT) is a village of 17,000 people situated on the south-eastern bank of Lake Atitlan in western Guatemala. The town is largely populated by indigenous Mayan people, though there are also some locals known as ladinos who identify as having decended from the Spanish. Relative to the indigenous people, ladinos tend to have lighter skin, dress in western clothes, and have more money. The Mayan people in SLT, like any other g
roup of people, are diverse in their dress, beliefs, and way-of-life however I´ll try to paint a picture based on my first impressions. The men usually dress in western clothes (slacks and button-downs for the older men and jeans and t-shirts for the boys) and the majority of women dress in traditional clothes they call ¨traje.¨ The skirts are long and very thick. They are rectangular woven pieces that they wrap around the waist many times and tie with a woven belt. The shirts are called huipil (said wee-pill). They are thick fabric with short sleeves and are ornately adorned with flowers embroidered along the neck line. It can take a month to sew a huipil, which may cost as much as $100, so they are treated with incredible care. Each village around Lake Atitlan (¨the lake¨) has it´s own distinct huipil and the shirts are worn with pride. Because most women and young girls still wear the traditional dress, you are treated to a shower of bright colors each time you walk down a street. Nearly all the women also wear their hair long (very long) and tie it back with a single low pony-tail. Older women sometimes tie their hair up in a ribbon encircling their head.
There are more than 20 languages spoken by the Mayan in Guatemala. Those from SLT speak Kaqchikel. Many of the people, especially the younger generation, also speak Spanish and it is relatively easy to communicate here if you speak Spanish because people speak clearly and relatively slowly, in part because Spanish is their second language.
In terms of the houses, most here in town are made of cement or narrow, vertical logs. Each is sheltered by a tin roof. Typically the front of the house comes right up to the cobble-stoned street. Inside the
re are several rooms, usually shared by many people. Within many houses, there is also a courtyard-of-sorts, which has a dirt floor. Off of the courtyard is usually a small structure with a wood-burning stove. As the cooking is done, the room fills with smoke. Women spend a lot of time around the fire so frequently suffer from respiratory ailments, acute and chronic. Many families eat their meals in this same room in order to say warm. Also off the courtyard is a latrine, which may have a toilet or may simple have a hole in the ground. And there is a working area where dishes and clothes are washed in a cement sink (pila) outside. Families that don´t have running water (which is pumped up from the lake), carry water from the lake each day and also do their bathing and washing there. The lake stays pretty warm and is quite swimmable, though it is also where much of the waste ends up.
The landscape here is incredible. The lake is surrounded by a ridge of hills behind which rise several volcanos. The biggest, closest volcanos are Atitlan (active) and Toliman (dormant). Atitlan is a popular but challenging climb to its 11K feet and gives an amazing view of the surrounding area. Around the lake are 6 or 7 larger towns, the largest of which is
Solola (which is also the name of the department that contains the town of SLT). Solola is about a 40 minute drive and has a hospital with considerably more resources than the Parish Hospital here in town, so the sicker patients (and all surgical patients) are sent there. SLT is largely a farming community which harvests coffee, beans, and corn. The hillsides are lush green with coffee plantations and smaller individual plots. It rains each afternoon during the winter (May-October), so the crops look very healthy right now.
I am here in SLT until the end of June of 2008. I am planning to work as a pediatrician in whatever capacity would help people the most and am still clarifying what that will m
ean on a day-to-day basis. For the time being, I work each day from 8:30AM-6PM in the Parish Hospital and Clinic. In the mornings I join Rafael Tun, the local general practitioner who grew up in SLT, and the nursing staff for rounds on all the patients. Typically there are 1-3
pediatric patients and 2-6 adult patients. Then I see the newborns (typically 1-2). Finally, I see pediatric patients in my own clinic while Rafael sees adult patients in his clinic. The day is punctuated by seeing patients in the Emergency Room, which tends to be like an urgent care but sometimes more acute. I walk to-and-from work each day about 1 mile and enjoy the time to think and take in the beauty.
More to come...
As most of you know
, I moved down to Guatemala in August to spend the year as a pediatrician hoping that I could put my new-found ¨real doctor¨ status to some good use helping people who have very little access to medical care. In the process, I´m hoping to support and strengthen a system of local health workers who volunteer as first responders in their own communities. And I will be happy if I can shore up my Spanish, learn about medical conditions we rarely see or treat independently in the States, and get to know some of the history, culture, and people of this beautiful country of Guatemala.I started this website as a way to share something of this experience with my friends, family, and other volunteers. I am planning to post some interesting cases, or routine cases that are not routine in the States, to demonstrate some of what is seen here and the special challenges we face here because of lack of resources. I also hope to muse a bit about the social, cultural, and economic environment here as a way of processing the experience. It is very challenging to witness the extreme poverty that exists here in SLT and each day brings me some level of frustration and indignation. Clear solutions and ´right answers´ to the problems are very hard to come by. I know that much of what I will get from my time here is an education in the realities of poverty and lack of health access that affects the vast majority of the world and exists in large part because of the way those with abundant resources choose to live. I hope you enjoy the notes, cases, and pictures that I post here over the course of the year and I hope that you share your comments whenever you can. Welcome!
To give you a little background about where I am living....
San Lucas Toliman (SLT) is a village of 17,000 people situated on the south-eastern bank of Lake Atitlan in western Guatemala. The town is largely populated by indigenous Mayan people, though there are also some locals known as ladinos who identify as having decended from the Spanish. Relative to the indigenous people, ladinos tend to have lighter skin, dress in western clothes, and have more money. The Mayan people in SLT, like any other g
roup of people, are diverse in their dress, beliefs, and way-of-life however I´ll try to paint a picture based on my first impressions. The men usually dress in western clothes (slacks and button-downs for the older men and jeans and t-shirts for the boys) and the majority of women dress in traditional clothes they call ¨traje.¨ The skirts are long and very thick. They are rectangular woven pieces that they wrap around the waist many times and tie with a woven belt. The shirts are called huipil (said wee-pill). They are thick fabric with short sleeves and are ornately adorned with flowers embroidered along the neck line. It can take a month to sew a huipil, which may cost as much as $100, so they are treated with incredible care. Each village around Lake Atitlan (¨the lake¨) has it´s own distinct huipil and the shirts are worn with pride. Because most women and young girls still wear the traditional dress, you are treated to a shower of bright colors each time you walk down a street. Nearly all the women also wear their hair long (very long) and tie it back with a single low pony-tail. Older women sometimes tie their hair up in a ribbon encircling their head.There are more than 20 languages spoken by the Mayan in Guatemala. Those from SLT speak Kaqchikel. Many of the people, especially the younger generation, also speak Spanish and it is relatively easy to communicate here if you speak Spanish because people speak clearly and relatively slowly, in part because Spanish is their second language.
In terms of the houses, most here in town are made of cement or narrow, vertical logs. Each is sheltered by a tin roof. Typically the front of the house comes right up to the cobble-stoned street. Inside the
re are several rooms, usually shared by many people. Within many houses, there is also a courtyard-of-sorts, which has a dirt floor. Off of the courtyard is usually a small structure with a wood-burning stove. As the cooking is done, the room fills with smoke. Women spend a lot of time around the fire so frequently suffer from respiratory ailments, acute and chronic. Many families eat their meals in this same room in order to say warm. Also off the courtyard is a latrine, which may have a toilet or may simple have a hole in the ground. And there is a working area where dishes and clothes are washed in a cement sink (pila) outside. Families that don´t have running water (which is pumped up from the lake), carry water from the lake each day and also do their bathing and washing there. The lake stays pretty warm and is quite swimmable, though it is also where much of the waste ends up.The landscape here is incredible. The lake is surrounded by a ridge of hills behind which rise several volcanos. The biggest, closest volcanos are Atitlan (active) and Toliman (dormant). Atitlan is a popular but challenging climb to its 11K feet and gives an amazing view of the surrounding area. Around the lake are 6 or 7 larger towns, the largest of which is
Solola (which is also the name of the department that contains the town of SLT). Solola is about a 40 minute drive and has a hospital with considerably more resources than the Parish Hospital here in town, so the sicker patients (and all surgical patients) are sent there. SLT is largely a farming community which harvests coffee, beans, and corn. The hillsides are lush green with coffee plantations and smaller individual plots. It rains each afternoon during the winter (May-October), so the crops look very healthy right now.I am here in SLT until the end of June of 2008. I am planning to work as a pediatrician in whatever capacity would help people the most and am still clarifying what that will m
ean on a day-to-day basis. For the time being, I work each day from 8:30AM-6PM in the Parish Hospital and Clinic. In the mornings I join Rafael Tun, the local general practitioner who grew up in SLT, and the nursing staff for rounds on all the patients. Typically there are 1-3
pediatric patients and 2-6 adult patients. Then I see the newborns (typically 1-2). Finally, I see pediatric patients in my own clinic while Rafael sees adult patients in his clinic. The day is punctuated by seeing patients in the Emergency Room, which tends to be like an urgent care but sometimes more acute. I walk to-and-from work each day about 1 mile and enjoy the time to think and take in the beauty.More to come...
