6 March 2013
I have left Xela, a place which has come to feel like home, for places and realms unknown. For two months I’ll be in Santiago, a small town on the southern shore of a large caldera lake, where I will volunteer with Hospitalito Atitlan.
I’m always anxious before something new. Even when it’s fairly obvious that everything will work out ok, that the experience will probably be good for me. Which working in a hospital, after several months of a primary care clinic, will be. Hospital medicine is different from clinical medicine. Patients are more ill, so what one does and learns are not quite the same.
Hospitalito Atitlan is a small, private, non-profit hospital. It is the only provider of emergency, obstetric, inpatient, and surgical care within a two-hour radius. The hospitalito has a long history tied to the Tz’utujil Maya of Lake Atitlan.
After a measles epidemic in the 1960s the Archdiocese of Oklahoma City decided to support a small hospital and opened the first Hospitalito Atitlan. It survived through most of Guatemala’s 36-year civil war (1960-1996), only closing in 1991 when the war environment made it too dangerous to continue operations.
Twelve years later in 2003 a small group of residents and extranjeros decided it was time to bring the hospitalito back to life. After much work the grand reopening took place in April 2005. Hundreds of people received medical care each month.
Then Hurricane Stan hit six months later. The torrential rain caused a massive landslide that hit the community on October 5th. Hundreds died. Thousands were left homeless. And the hospitalito was not spared from the destruction.
A backpacker’s hostel was quickly turned into an emergency hospital so that staff could continue to serve the victims of the landslide. Foreign and local healthcare volunteers arrived to care for patients. But this solution could only be temporary. The hospitalito needed a permanent home.
Weather and land experts recommended against returning to the original location. The board and supporters worked tirelessly to fundraise for a new building. Two years later in October 2007 the new facility, finally, was opened.
I learned most of the above during my orientation to the hospitalito from an old fundraising video narrated by Isabelle Allende. I remain impressed that one of my favourite authors was recruited to help with the fundraising effort.
Unlike in Xela, where Spanish is native to most, a Mayan tongue is the first language here. Tz’utujil is the primary language of most of the patient population. Three languages will be present in most of my interactions: the Tz’utujil of the patient and their family, the translator’s Spanish, and my English and Spanish. The people here cling strongly to Mayan traditions, including traditional healing practices and often choose to go to hueseros instead of doctors when they fall and hurt a bone.
My new host family in Santiago is an interesting reflection of the general population of Lake Atitlan, albeit slightly more well off. The mother Candelaria barely speaks Spanish. For Santiago’s big market days she and her sisters in law prepare vegetables to be sold. We communicate with basic Spanish words and sign language. She taught me how to say “stomach” in Tz’utujil so that I can indicate to her when I am hungry. The father Juan came from a poor background but has done relatively well for himself. He looks after the lake house of a rich businessman and volunteers as a fireman. Juan pushed education in his grown sons. The men in the family all speak Spanish, the sons better than the father.
In Hospitalito Atitlan staffing by a few permanent Guatemalan physicians is supplemented by a steady influx of short and long-term foreign doctors. The nursing staff is all Guatemalan – they do an impressive job for the little education they receive, many only 1 year post secondary school, and serve as Tz’utujil translators. The support staff – the guardianes who function as both janitors and bodyguards/security, those who handle inventory and pharmacy – is also Guatemalan. The administration and the board are split between Guatemalans and extranjeros.
Already I can see that the hospitalito is a unique place where cultures and languages meet and mesh and sometimes clash.