Flying Sola

Just before Fletch left for the medical mission in Huehue, I had hit a new low point in being down. The nurses had informed us of two women who needed gynecological operations, so we were hopeful. Then they informed us that neither of them were willing to go. It was killing me. This would only cost as much as the trip to Huehuetenango and back, and make them healthier and happier in the long run. Yet they refused to go. As Fletch’s Sunday leave date approached and we heard nothing positive, I was getting anxious and upset. So, more out of frustration than anything else, I went to talk to the nurse Lucia on Friday morning. She was in the kitchen of the health center, having cookies and hot chocolate with the school director while the kids were at recess. They invited me to sit and she served me a mug of hot chocolate. I hadn’t realized it until I started talking to her, but I was so frustrated I was nearly in tears. She and Minor, the director, were both understanding and consoling. Minor had to get back to school before recess ended, but Lucia and I continued to talk for a few hours.

We talked about the women that weren’t going to take advantage of the medical mission. We talked about my frustrations with Manuel, and how I felt isolated from the community after not having worked with the women here for two months. She was so understanding and helpful. She has been like that since our first visit here. Together we came to several conclusions.

The first, that we would go talk to the mother-in-law and father of the ailing woman to try one last time to convince them to take Maria to the medical mission.

The second, that we need to start coordinating our work more than we have in the past. I usually give afternoon health talks when she’s already finished her day’s work and gone back to town, where she lives. This means she can’t help me translate. When we first arrived here, she was the sole employee of the health center, so there was no way we could do health talks and she could carry on consults at the same time. Her job was overwhelming as it was. In the last year the Ministry of Health has bulked up on the number of employees at health posts and health centers in the 45 prioritized counties in the country that are participating in a government welfare type program. We are one of those counties, so our little health post has 1 new full time employee, a registered nurse (whereas Lucia is only the equivalent to a nurse’s assistant), and usually one or two other folks who come in cycles as part of their nursing studies. In short, there are more people around to handle the bigger crowds that come to the health center as a requirement for receiving their wellfare check. The nurses generally plan health talks before they begin giving women and children their required vaccines, and their attendance is required. In other words, it would be a great time for me to help with health talks, for which I have a plethora of materials and ideas, and Lucia can translate. That’s how we scheduled two nutrition health talks for Thursday and Friday morning of the following week.

Third, she encouraged me to start the regular health talks again, with or without the support of Manuel. She agreed that I’d given him plenty of time to do something, and that I was wasting my time as long as I let him control the situation. She said she would talk to him beforehand to smooth things over. Suddenly a one-charla week had 4 scheduled, plus a workshop with the town leaders to learn how to properly weigh babies on our new scale, to detect malnourished children. Then we set out to find the mother-in-law and father of the woman we wanted to go to the medical mission.

I started down the road with Lucia in pretty high spirits. As we approached the church we noticed a crowd of people in the yard, all mixing compost (to sell as a church fundraiser, go guys!) and Lucia spotted the two we wanted to talk with. Since it was snack time, the church organizers brought us a sweet bread and rice atol and we stood on the side of the road talking. She began by asking them if they’d thought anymore about taking Maria to Huehue. They looked at their feet, shuffled. Her mother in law is actually the mother of a woman who was taken to the hospital by ambulance for an emergency apendectomy, so she began to talk about how this daughter, since the surgery, has had a miscarriage and she’s sure it’s because of the surgery. It would, of course, have nothing to do with the fact that this girl has a history of uterine and ovarian cysts and has miscarried before. This became her defense against taking her daughter in law to the hospital, because Maria might become infertile. That is surely a tragedy for a woman who’s never had children, but Maria has six children already. Really? Lucia was getting into the conversation. She kept forgetting to translate things for me. I was concentrating, trying to catch as much as possible. Maria’s father didn’t say much; he just kept looking at his shoes, eyes squinting against the sun. They said she was afraid. She wouldn’t go because she was too afraid. I pointed out that if Marcela (apendectomy patient) had been too afraid to go for her surgery and refused, she would be dead today. I tried to tell them that it’s normal to be afraid of what could happen, but that if she didn’t take a chance at all, she’d spend every day in pain for the rest of her life. Lucia talked a while longer, and then the conversation ended itself. We started walking back towards my house. I was so heartbroken. It felt like they just didn’t understand anything, or didn’t care enough to understand. I kept thinking about Maria, and the babies she could continue to have that would only exacerbate an already excruciating problem.

I was so upset, I called my mom and cried. This was one of those days I wished I didn’t care. If I didn’t care, then I wouldn’t be so upset that people constantly refuse to make good decisions for their health and happiness. If I didn’t care, then I wouldn’t imagine what it’s like to be Maria, and in constant pain while doing all the chores of a Guatemalan woman–washing, carrying firewood, hauling corn to the mill and bringing it home to make tortillas–and always in pain. Then I began to think about the bigger picture and realized, Maria’s situation is not unlike Americans who insist nothing is wrong with our healthcare system, who criticize and opt out of finding workable solutions to problems. The questions isn’t, “Is there a problem with our healthcare system?” The questions is, “How can we improve health care in America?” I’m all about criticism, as long as it’s constructive, and I’m generally of the belief that we can always improve. I understand people fear what they don’t know–like what it will be like to have an invasive surgery, or what it will be like to dramatically change a system we’re used to. Both of these things are likely to bring some discomfort, but if done right, there will be a net benefit for everyone (actually, that’s kind of how I felt about Peace Corps–pretty scared to really do this thing, but here I am and, look, it’s pretty uncomfortable at times, but I just hope that things will work out for the best).This is an example of the spiraling thoughts I get sucked into here. Being upset about one thing, leads to being upset about a lot of things. How can we expect this illiterate campesina to make a good informed decision about her health and happiness if so many people in the richest country on earth, inundated with resources and information, can’t even manage such a thing? My faith in people was sliding, on a very slippery downward slope. Naturally, my mom and dad are pretty accustomed to me freaking out. We started talking about my grandparents, my nieces and nephews, general news from home. I even managed a few laughs before we hung up and snapped back to Guatemala. I was done being upset. There’s no way I can help people if they won’t help themselves.

Fletch came home and I told him it looked like he’d be going to the Huehue alone. A few days earlier we’d discussed switching off as translators in the middle of the week so that we both got to have fun meeting Americans and seeing so much cool stuff, while still covering our bases here. Translating for the doctors is tons of work and fantastically rewarding. It’s so fun I wouldn’t mind coming back to Guatemala with a group of doctors long after my Peace Corps days are done. But in examining why I was feeling moody, upset, demoralized–down in the dumps Oscar the Grouch style–I felt like Jaime should probably go alone. I needed to reconnect with people here. I wanted to do the talks I’d set up with Lucia and meet with the ladies in Temux again, and that didnt’ leave any time for going to Huehue. And, honestly, I was thrilled about the prospect of flying sola for a week in our house. Part of the problem when we’re aggravated by things that are happening, or not happening, is that we spend a lot of time stepping on each other’s toes and causing more aggravation. This is pretty unavoidable living in a 14′ x 22′ box, but it’s not the common problem of a Peace Corps volunteer. I think most would complain of too much alone time, whereas we struggle with way too little. Fletch hadn’t been superbly happy lately either. I figured he’d get a lot out of using his Spanish a ton (without me correcting him for a week) and telling stories of our lives here to interested parties (without me interrupting him to add or revise for an entire week). Meanwhile I could schedule when the lights went out, and when I got up and what I did and never feel like someone was looking over my shoulder or taking my attention away from what I was doing at any given moment. In short, we’d devised a plan to maximize our working capacity and improve marital harmony. As soon as that happened, things started getting better.

Late Friday night Manuel showed up with Maria’s husband, José, to ask more questions about how this medical mission worked and how much it would cost, and what the couple would need to do in order to go. We explained everything to him, and there was a lot of feet shuffling and talking back in forth in Q’anjob’al, so we waited. It finally came out that Tuesday was pay day for the government welfare program many families are involved in, so if she was at the hospital she wouldn’t be able to pick up her money. They were also under the impression that if they missed a check pick-up they wouldn’t be allowed to participate in the program anymore. To make it worse, the welfare program hadn’t made it all the way up here last month, so she wouldn’t miss just one month of pay, but two. They wanted to take Maria to Huehue, but on Wednesday after she’d recieved her money. I explained that, while this was a good thought, if they waited until Wednesday the doctors’ operation schedules would likely be full and they wouldn’t be able to do anything for Maria.

Coincidentally, we have the number of the local woman in charge of organizing the program payments, so I called Marianna to ask her if there was anything that could be done. She explained that, if Maria couldn’t pick up her payment, her 600 quetzales would go back into the general program fund. There was no way for her to redeem that money, BUT if she made it home by Friday she could still pick up her money, as the program would still be distributing payments to other communities in our county. At this point I was practically begging José to take Maria on Sunday and try and make it back for the payment, explaining that even if they missed the payments this month, they could still collect their checks starting next month (provided the bursars showed up to pay them). Lucia had mentioned to me earlier in the day that the head nurse had only authorized this month’s payment with the understanding that Maria was going to pursue having an operation, and said that if they neglected to do it then the nurse could refuse to authorize further wellfare payments. So finally I just told him he was much more in danger of losing state assistance by not going than if he were to miss this check and go.

This was a huge deal, a ridiculous, complicated mess. I couldn’t believe the program has no system for redeeming back-payments. Later in the week I went with the nurse to visit a mother who gave birth on Monday night, and though they were worried because she’d had high blood pressure and incredibly swollen legs (two of about 6 major danger signs), she’d come out alright. However, she was in no shape to stand in line for 6 hours to get her money. It was her sixth child. Her house consists of two adobe rooms with dirt floors, smoke billowing from the kitchen door and into the adjacent bedroom door where she was resting with her child. The bedroom was cramped, wall to wall beds, I think 4 in total, made with sticks holding up wood planks and covered with blankets, more clothes, shawls and blankets strung from ropes and beams overhead. Seriously? It’s kind of heartbreaking that the government promises them this money, and yet in extenuating circumstances has no way to deal with getting their money to them. This woman couldn’t postpone her labor, and Maria shouldn’t postpone her chance at an operation. I feel certain people are forced into uncomfortable decisions every time their pay day comes up because of situations like these. But in the end, José said he’d think about everything and get back to us.

That was the last we heard of him until 6 am on Sunday morning. He showed up with Manuel, Don Tomax, and his father-in-law to announce that they wanted to take Maria to Huehue that day. Jaime told them he’d meet them in front of their house at 10. I saw them into town since I had to go the market anyway, but once I got home I was both thrilled that she’d gone, and wary that something would happen and she wouldn’t get the surgery, or something would go wrong and then we’d be to blame. I just hoped everything would turn out alright.

But now it was time to focus on my goals for the week: to reconnect with the ladies here through doing a couple of health talks; to enjoy my time alone; and to start feeling better about what I’m doing. At the beginning of the week I got an email from a former volunteer from Guatemala who reads our blog:

In our Peace Corps group we were warned the day would come when we would be wondering what we were doing in Guatemala. Sure enough, for me the day came, but having been warned it also passed. It wasn’t until many years later when I was talking to a young man in my PC town, who was very young when I was in the PC, and who later became a teacher, that he told me when I was talking to his father, trying to get his father to try new things, he (the young boy now an adult) was listening. And when he became an adult and teacher he tried all the things I was trying to get his father to do.

One of the most difficult parts of Peace Corps and/or development work is the persistence it requires; it gets hard to hold on to the hope or the faith, or whatever you want to call it, that we’re really doing something. Most of the time I believe it. But I’d gotten to the point where I was beginning to wonder if I was just fooling myself, especially when I thought that Maria’s family wasn’t going to take her to the hospital despite of all my (and the nurses’) pleading. But as Maria left for the hospital and I started the week off with a new plan I began to feel much better, and I continued to feel good even as things didn’t quite go as planned. That’s pretty normal.

It’s a good thing I’d had a busy week planned, because the wellfare program payments canceled half the activities before the week was out. The village leaders couldn’t show up to learn how to properly weigh babies because they were all with their wives (because only women can receive the money) in a mile long line in Santa waiting for their payments on Tuesday morning. Similarly, on Wednesday I strolled over to the neighboring community for our regular 3 o’clock talk and felt as though I’d stumbled into a ghost town; the house where we hold the talks was closed and locked. No one remembered to call me and say that Wednesday was their payday and that no one would be there. I had to call the town leaders to make sure they weren’t just all late (which also happens sometimes). And on Friday there was confusion about the dietary talk I was supposed to give, as in, they didn’t tell me I had to go somwhere that wasn’t the health center to give it, so I missed my ride and didn’t arrive there. Life is always exciting in Guatemala. But I did end up giving two talks in the community, starting the long awaited HIV/AIDS education series with the ladies on one day, and talking about a balanced diet the next. It felt really good to be with them again, and both talks went fantastically well. The HIV/AIDS info is pretty complex but their insightful questions led me to believe they were following me pretty well.

The other external challenges for the week included a case of bed bugs. Following local advice, I stuffed a ton of apazote leaves between the sheets and the mattress. I didn’t have time or the energy to wash our blankets (I can not express in words how tiring and time consuming this process is compared to the already tiring and time consuming process of washing the rest of the clothes which I had done the day before). So after adding the leaves and changing my pyjamas I hoped for the best. The number of bites went down considerably. No joke, my left leg had over 100 bites all over my knee and hip bone, ugh. We’ve had bichos in the bed before, but they always preferred to snack on Fletch–perhaps he really is much sweeter than I am–but he wasn’t here so they settled for me.

And then there was the announcement that the neighbors were going to remove my roof and build a room next to ours. We’d heard rumor of this for a few weeks, and then wood was purchased and stacked outside of our house. At first we didn’t understand that they were going to put the new room right up against ours rather than make another free-standing box. Even better; they were going to take off part of our roof and make it a continuous roof over the two rooms as well. This was sad for many reasons: 1) Fletch spent months making stone steps that led down to our latrine and the new room was being built over them. Now we’re back to using a slippery, muddy hill to get down there, and we have to run all the way around our house and then back toward the latrine to get there. This is not fun in emergencies. 2) They tore out all the pretty trees and flowers that were growing in the yard. 3) While our house privacy level, on a scale of 1-10, would have previously been about a 2, it’s now down to 1. I think if the neighboring room gets a stereo I’m going to have beg some of you to pitch in and send us noise-canceling headphones or some serious damage will be done to our hearing and overall sanity. So anyway, while Fletch was gone they decided to tear off the roof and do all sorts of construction that led to mountains of sawdust falling into the front half of our house, all over what is the “kitchen and study/work” area of our house. It made me very sad and stressed out while it was happening. I was literally praying they’d get the roof back on before the rain hit–and they did. But now the damage is done, and the only thing we have to figure out is how to secure our house from the dreaded ladrones (in case they really are more than myth) because one can just move a few boards outside and climb in through the roof. And we’ve got to cut down on the very cold drafts that blow through the now open roof. They aren’t planning on putting walls on the new room until all the planks stacked under the roof have dried out, so for a few months at least. I don’t know if this is a good or bad thing? As long as there are no walls we will have no neighbors, but it sure is cold.

All in all, I spent the week trying to go with the flow. The roof business was the worst that happened while Fletch was away. Other than that, I had a great time being on my own. I miss my independence (and I would be shocked if Fletch didn’t also) in our current living situation, but we’re doing the best we can. As predicted, and as is evident by his post, he also had a great time translating. Every time I walked over to visit the family they’d ask if I was sad to be alone, and I joked that I loved being single again. Then they’d ask when I was going to get a new boyfriend. But they were happy to hear about his work, and encouraged by the fact that he called me every night (evidence that he probably wasn’t going to up and leave me for some other mujer). One day I told them about the woman who was going to lose her arm, and shockingly Lina said, “Oh my God, she’s better off dead than left with one arm!” I asked, just to be sure, if she really thought that, and she said, “Yeah, can you make tortillas with one arm?” A bit of insight to their world view, but she had a point. Out here I’m not sure a one-armed woman could get a husband, if she can’t make tortillas and she can’t wash clothes–the two biggest jobs for local wives–then what good was she? I was glad to see, in the picture, that the woman looks ladina (she’s not wearing a traje) so hopefully she lives in a city, somewhere she can walk a few doors down from her house and purchase fresh, hot tortillas. At the very least the now one-armed woman can use a tortilla press, a thing our family would never stoop to doing.

We talk a lot about how painfully slow moving things are here, but in the last few weeks I’ve realized that some things have changed considerably since our arrival. I caught myself feeling like things weren’t going smoothly in the patterns I’d established, and then realized I’d better change the patterns, then, shouldn’t I? These changes, like the increased staff at the health posts, mean there’s more work I can do that I haven’t been doing up to this point. There really isn’t a whole lot of time left in our service, so I’d like to make good use of what’s left. Now that, at least for the moment, I have that figured out, adelante!