Post from the Field: Kathleen Bernard

Hello readers! It’s been a while since we’ve had a post from the field, so here I am with a new blog entry from intrepid volunteer Kathleen Bernard, writing to us from Santiago, Guatemala. Hope you enjoy reading about her experience!

We have had a very busy two weeks so far in Santiago! Our main point of contact has been with the Centro de Salud, the government funded health clinic here that sees the majority of individuals in this community when they are in need of care. Dr. Chumil, who runs the clinic, set us up with Dolores, a local nurse and midwife who has taken us under her wing. With Dolores, we’ve shadowed comadronas on pre-natal and post-natal visits, shadowed other nurses in the Centro, attended a TB support group meeting, attended a monthly meeting of all local health workers, and gone on rounds with the nurses vaccinating and weighing children. The Centro de Salud maintains a comprehensive, block by block map of all the infants, children and pregnant women in the different neighborhoods of Santiago. They have it color-coded to show which children are underweight/at risk of malnutrition and which pregnancies are considered high-risk. Nurses and health educators are constantly heading out into the community to check up on these patients- it’s really impressive. That being said, the clinic consistently falls short of government-set health goals.

Our days shadowing the comadronas have been the most exciting for us. We make sure to introduce ourselves as students of medicine who are interested in maternal health, and that we are hoping to learn from them about the work that they do. It feels like they appreciate having foreigners around who are looking to learn from them, rather than the other way around (at least we hope that’s the case!). Our goal at this point is simply to see as much of what the comadronas do as we can, in order to bring that information back to Saving Mothers. There are an astounding number of pregnant women here! Comadronas typically visit their pregnant patients every two weeks, although that increases to every 8 days once the due date approaches. They do abdominal massage, note the position of the fetus and check for signs that something could be wrong, for example swollen limbs or pain in the head or chest. We’ve learned a little about the herbs used during childbirth and after, but the specific medicines used are particular to a given comadrona, and many comadronas are guarded about their favored herbs. A lot of what has been interesting is starting to understand the complex relationships between the different health centers, the comadronas and the patients. There’s a tremendous amount of distrust of modern medicine from individuals in this community, although we’ve been told that that is changing rapidly.

Yesterday we met with Elena, a comadrona and curandera in San Juan, and tomorrow we meet with her again along with all of the San Juan comadronas. We are going to pick a week to live with Elena and shadow each of the comadronas there. Hopefully we will get to see a birth! We have been “on-call” to attend a birth with a comadrona here in Santiago for the last week, but nothing has happened yet. Here as everywhere, it’s impossible to predict exactly when a baby will come.

At this point in our trip, more than anything else we are overwhelmed by how giving everyone has been to us. Just about everyone we’re reached out to has responded generously and openly, sharing their time and knowledge. We feel so privileged to be here, to have access to a network of people involved in the health of this community, and especially lucky to have another month and a half to deepen the relationships we’ve made.

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