This past October, I was able to travel to Quezaltenango (Xela), Guatemala and study Spanish as well as provide medical care at Pop Wuj Spanish School. Pop Wuj is a Spanish school as well as a medical clinic that is working to provide the community with medical and social support that is desperately needed. During my stay in Xela, I worked in the medical clinic providing primary care services as well as the pharmacy. I also spent the afternoons working on my medical Spanish to improve my ability to communicate with my patients here in Ventura as well as globally.
My first week in Xela was spent in Spanish class and learning about the history of Guatemalan Medicine and the role of Western medicine today. This lecture series highlighted the differences between the Western view of health and medicine and the natural medicines and Mayan view on health and how they influence the decisions made by the people of Central America. After these discussions, I feel that I have a better understanding of my patients from Central America and how their thoughts about health may be affecting the care that I provide.
My second and third weeks in Xela were spent working in the clinic. Pop Wuj’s medical clinic provides primary care services to all ages as well as providing referrals and dentistry services. During my time in clinic, I focused on chronic disease management – malnutrition, diabetes, hypertension and parasites being the most commonly seen diagnoses. I was able to work with medial students who were also visiting and use my improved Spanish to interview and counsel patients. At the end of clinic, we held education session with patients about healthy diets, management of chronic disease, appropriate medication administration and food safety. The clinic visits were very rewarding for me as a provider because the patient’s were very grateful for the care and education. We also provided 1-2 months of medications at each visit because the patient’s we worked with could not afford them and would go without in order to buy food for their families.
For me, the biggest challenge of this experience was understanding the health system of Guatemala as well as the care provided by Midwives and healers in the more rural communities. Midwives are one of the most common care providers in rural Guatemala and many receive no formal training but are trusted and considered very wise by many of the patients. Figuring out how to communicate effectively and practice evidence based medicine while being respectful of cultural beliefs and practices proved to be more challenging than I had first anticipated but with the teachers and colleagues at Pop Wuj I found that by the end of the three weeks I was much more comfortable with the cultural differences and able to connect with my patients because I understood their background.
I am so grateful to the Family Medicine Educational Fund for giving me the opportunity to practice medicine and Spanish in this setting. Using the Spanish I learned as well as an increased understanding of the cultural background of my patients, I will be more effective in my work in Ventura over the next two years and will be taking the lessons I learned with me where ever I travel to next. Traveling and working in other cultures and other health systems is invaluable to my medical education and will make me a better physician no matter where I practice in the future.