Here we are again.  The clinic has been dusted and the floors have been washed. The ORs have been disinfected and the patient cots lie in a pile ready to be set up. It is our third surgical trip to Camanchaj and it is nice to be back. Our thirty-person team arrived yesterday, unloaded our red bins, and today is the day we unpack, set up and triage patients for the week.

It is a busy day – in many ways the busiest of the week. Crowd control and patient flow are but some of the challenges we have to face. Candelaria is at the Reception desk by the front door. She fills in the name, age and the community of residence at the top of each patient’s chart then points them to the Nurses Station opposite her desk. There, two of our nurses take vital signs and a short history with the help of two translators each - one to translate from English to Spanish, and another from Spanish to the indigenous languages the patients speak. 

Our gynecologist is seeing his patients in the clinic’s consulting room and our plastic surgeon has set up in the dental room amongst the reclining chairs and instruments.  As the morning moves on the chairs outside each doctor’s room fill up. It’s not long before we run out of space. We explain to those waiting outside not to worry, the doctors will see them all, but right now they have to wait. Their eyes tell the story of the country in which they live. Will the doctor really see them or is this just another broken promise which living in Guatemala so often brings?

Their skepticism has deep roots in a country where poverty and need dominate and where indigenous people especially are oppressed and marginalized by thirty years of civil war and continuing abuse of human rights.  And as for healthcare, that is a barren word for government healthcare is under-funded, under-equipped, under-serviced, under-staffed and distrusted.  There are areas where there is virtually no healthcare at all. One in three people have never seen a doctor and hospitals are places to die. 

Our team comes once a year to Camanchaj to provide some of what doesn’t exist but it is a drop in an ocean of need. Some of our patients come from eight, nine, ten hours away in search of help.  Most live with tin roofs, plank walls and dirt floors, without electricity or potable water.  Their lives are rich in Mayan culture but poor in basic needs.  Some live for years with health conditions that still shock us to see because no one should have to suffer as they suffer when it takes so little to help. 

By the end of the day all those waiting have been seen and we have plenty of patients on our slates. The next day surgery begins but more patients arrive to be seen. The doctors see them between cases and we fit in who we can, but eventually we do not have any more room.  Jay puts names on a list for the next team that will be at the clinic in three months and assures the latecomers that they will be operated on then, but all we see is the disappointment in their eyes.

The week is busy and by the end we are all tired. We have had to rely on the emergency generator for the most part of one day, one of our team lost his passport, and there were a few delicate tummies amongst the team, but they were all blips. After suffering horrendous burns to her face Martina can now close her eyes. Felicita has had the lump beneath her eye removed and she can see again, and Margarito has had his rotting big toe removed.  Alejandrina and Anastasia are but two of the women who have had their hysterectomies done and will be able to return to normal lives.  In total we have performed fifty surgical procedures in the two small ORs in five days, and more importantly all our patients are well. As they prepare to go home from the temporary post op ward in the kindergarten classroom in the annex, they come back one by one to say goodbye.  One woman brings some woven bags for the nurses. Another brings some oranges. But most bring smiles and hugs.

They speak to us in their indigenous languages and we don’t understand their words but it is clear what they mean. There are many watery eyes amongst both them and us. They thank us for what we have done again and again and we feel somewhat overwhelmed and awkward at their thanks.  We wish there was some way we could let them know that they have given to us as much as they see us having given to them.

Barbara Maryniak
Project HANDS, Camanchaj Mar 2009