Al fin

Time's up. I'm back in the states. Just wanted to wrap a few things up. First of all, I apologize for my last post. I sound like a rich white girl who thinks she's better than everyone else. As for being rich, I'm $100,000 in debt. And as for being better, I'm not. I just wanted to point out a fundamental difference between the way that we approach hygiene and infection control in the US vs Guatemala. I didn't bring up this topic until my last week so that I would be sure that I had the full picture. And I'm sure. On the hospital floors, the doctors, residents, and students do not wash their hands until they have finished seeing all of their patients. Hand washing is seen more as a protection of self than as a protection of patients. Sterile procedures are often not sterile at all. It is a different, older way of thinking, one that I think needs to be changed.

Now, back to the wrap up. February was a good month. A month that made me angry, made me sad, made me laugh, and made me think. Working on the hospital floors did not turn out as I had hoped. I had little independence for the majority of the two weeks, and when I was finally able to think and act independently, the suggestions made by our team were not followed by the hospital attendings. Many patients died - children, young adults, middle aged and elderly. There was no discrimination by age or gender when it came to being wrapped up in a plastic bag and left in the hall to rot for a while. The clinic, on the other hand, was like an oasis in the middle of a desert, a place of refuge for HIV positive patients, where everyone worked together to improve the health and well being of the patients and community. It was a pleasure to be a part of that reality.

Living and working in Guatemala for a month as a medical student was probably the closest that I have gotten to what it would actually be like to live and work as a doctor in a developing country. We worked with limited resources, making the best of the medications and interventions available. We confronted fellow physicians when our patients were not receiving appropriate care. We worked on research projects with hopes of being able to incorporate the results into an evidence-based medicine approach to HIV/AIDS care in Guatemala. And none of it was easy. Nothing was handed to anyone. The HIV clinic doctors had to do more than just advocate for their patients, they had to fight for them.