Stories from the Field and More!
In Guatemala, each person, on average, throws away one pound of trash a day between organic and inorganic waste.
It is worrisome to realize that most of the things that we buy or take to our homes are much more garbage than the actual items we have purchased.
Previously, this critical situation was only seen in urban areas of cities, but nowadays, unfortunately, we see rural communities with a buildup of trash in homes, schools and in the community. Our rural communities have fallen into the lie of consumerism and forgotten our habits of good, nutrition. For this reason we are buying much more garbage in material things as well as processed foods.
In response, we have taken some actions as the Environmental Health team.
We believe that these environmental issues relate to our surroundings as well as our relationships between human beings and nature. Therefore, as an environmental health team, one of our focuses is environmental education with young people in the schools of several rural communities in our department of Petén. We coordinate this work with teachers, principals, community leaders, midwives, and health promoters.
What is a healthy environment?
Talking about health problems from too much trash
Environmental health workshop in community schools
What to do to avoid producing excess trash, including eating what we naturally produce in our own communities.
Short reflection during a workshop with health promoters about trash, recycling, and reducing consumption
Environmental health training with health promoters
Speaking with school children about environmental health
We want to take a moment to thank MPowered for their donation of Luci Lights to the work of Concern America. Over the past 5 years health promoter practitioners and midwives in Guatemala and Colombia have been able to count on Luci Lights to help suture machete wounds, repair tendons, receive and support mothers with complicated deliveries, and attend to patients in the night where there is no electricity.
The people at MPowered have engineered Luci lights to be a go-to way for our field personnel to access light when they are without electricity. Having access to Luci Lights has meant 100s of people being able to provide care when needed. The majority of the lights have lasted in some communities for over 2 years despite the difficult climate.
The lights have not only helped our projects in Latin America but also locally, as an organization, we have been able to use the Luci Lights when setting up for our Walk Out of Poverty to light the way at 5 am for over 750 walkers to help raise funds for our fieldwork.
Thank you to our friends at MPowered for their collaboration and their inovative technology!
With field volunteer Julia’s support, we had the opportunity to provide the team with information regarding the Heimlich Maneuver and CPR. The Environmental Health team has been able to learn and perfect first aid techniques such as in cases of drowning. The team then shares these teachings in the communities, and they have been very well received by students, teachers, and the population in general.
The decision to take this topic to schools comes because the team has observed the frequency with which disasters occur in communities because they do not have basic information on what to do in case of respiratory arrest or drowning.
Several months ago, Julia shared the case of a child who choked on a rambutan seed and tragically died because the family could not find help in time to save him. A short time later, Environmental Health team member Alba shared a case of a drowned teenager. Nobody knew the procedures of how to help someone with asphyxia by submersion. In this case, the boy’s friends managed to get him out of the lagoon. Despite the fact that a large number of people from the community arrived quickly, nobody was able to apply first aid.
As a result of these accidents, we decided that this was an important lesson to share in schools; not only with the traditional groups of students at a primary level, but especially with students of the higher levels and teachers. Mothers of the community were also invited to observe and participate in the activity.
The recent National Survey of Chronic Disease revealed that there are 2.5 million cases of diabetes in Guatemala. It is a growing challenge that we are seeing in every community where we work. The average household income of a rural family here is less than 400 USD a month, while treatment for a chronic disease such as diabetes can cost an average of 100-300 USD a month. The cost would also rise significantly if there are complications related to diabetes such as cardiovascular disease, kidney, nerve, eye, foot, and skin damages. On a recent visit to the La Gloria clinic working with the health promoters there, a 47-year-old indigenous Q’eqchi woman with uncontrolled diabetes of 5+ years came in with a horribly infected diabetic foot ulcer. The unfortunate progression of the disease leads to a very deep infected foot ulcer (13cm x 5 cm). The family waited until she got progressively worse, not because they wanted to but because they knew the cost of her treatment would be something, they couldn’t afford without drowning in more debt than they were already in. They were hoping it would get better by itself or/and God would do his miracle on her foot. They waited until her foot began to ooze foul-smelling yellow, greenish liquid which, just by a light touch, flowed like jam on a sandwich. The affected foot was double the size of the other foot. The infection was deep tunneled to her toes and her tendons were exposed. However, she was not in pain. The nerve damage was already too advanced and she did not feel pain nor a subtle touch. She has lost much of her sensation to her foot, the cause for her foot ulcer to begin with. She wore paper thin sandals that did not protect her foot from the usual things on the dirt floors of her house nor the street such as rocks, nails, needles, scraps of metal, and glass. With much loss of sensation to her foot, she didn’t even remember how the ulcer began. She was febrile for days but that had gone down due to some injection that the hospital gave her.
They first took her to the public hospital where she was referred to a private doctor. The private doctor, without examining her foot, told the family that he would charge 100 USD for every visit, in other words, for every day of wound care. From our assessment, this wound would have taken at least 2 months, or 60 days to heal. We can all do the math here. The family could not afford the treatment. The family then brought the patient to the health promoter clinic in La Gloria.
When I saw her in the clinic, the promoters had already been treating her for one week. Every day for the past 7 days, starting at 7 AM, they have been cleaning her wound for two hours a day using sterile technique. All their hard work of debriding all damaged, infected, and dead tissue, then packing the deep ulcers and covering them with wet-to-dry dressings, was working beautifully. They had already started her on antibiotics, medicines for diabetes and neuropathy, and counseling. The promoters showed me a picture of her foot the first visit with pride of their amazing work and joy for the patient’s recovery.
For all her treatment that day, which included a month of medicines for diabetes, wound cleaning, 10 days of antibiotics and consult, she paid 5 USD. This was 4 weeks ago from today and the promoters are still diligently treating her foot, and they have also incorporated the family members for wound cleaning and teaching them how to boil purified water with a pinch of salt to make saline and use gauze (cut and sterilized in the clinic) for packing. On every visit, they counsel the patient and her family on the importance of keeping her blood sugar controlled for better wound healing and to avoid complications from uncontrolled diabetes.
The passion, empathy, and accessibility of the care provided by the promoters have spread a positive reputation across Petén. In a recent patient/diagnosis count of the clinic, diabetes and cardiac diseases were now the most diagnosed, respectively. I think the change is in part related to more diabetics being diagnosed but also very much related to the quality of care and the low cost of treatment provided by the promoters. A month treatment of Metformin can cost an average of 50 USD in the pharmacy while we charge 1 USD. Insulin at the pharmacy can cost an average of 90 USD while we charge 9 USD. If the prices are still burdensome we absorb the cost with our emergency fund so there is never any hindrance to receiving treatment.
In recognizing that more diabetic care needs to be accessible, we have added two new diabetes clinic locations, La Libertad and Sayaxche, working in conjunction with the municipality to care for diabetics. The team has also expressed the necessity of preventing diabetes by proposing diabetic prevention talks to school children in the communities.
Above is a short video of Oneida, a Health Promoter Practitioner AND midwife who is an emerging leader in Concern’s health program in Colombia, in which she describes a complicated delivery she attended. The care and accompaniment Oneida provided during the birth most certainly saved the life of the new child, and possibly the mother.