Highlights from the Highlands in Guatemala

It’s hard to believe another month has gone by and that I am wrapping up my practicum very soon!  During the second half of my time with Curamericas in Calhuitz, Guatemala, I continued collecting and analyzing data on neonatal outcomes, modifying my interview guide, and then conducting and analyzing these group interviews with the nursing staff to collect their perspectives on managing and improving neonatal outcomes.

I am lucky to have shared most of my time in Calhuitz with another Gillings practicum student, Kay, and for both of our projects we needed to visit the neighboring Casas Maternas of Santo Domingo and Tuzlaj.  This was a great opportunity to learn first-hand about the different catchment areas covered by the organizations’ projects, meet more staff, and switch up the scenery.

We were told the Casa Materna in Tuzlaj had a different feel, that the area was more remote and unaccustomed to seeing foreign volunteers, and that it would be close quarters due to the Casa’s small size.  After a jostling two hours up and down rocky mountain roads, it’s true we found a cozy atmosphere, but with welcoming vibes.  We walked into what felt like a data-organizing party serenaded by Romeo Santos and reggaeton.  There was hot chocolate for breakfast and Philly cream cheese.  Dogs sprawled lazily on the grass rather than lurking fearfully for scraps.  A 13-year old was admitted to the Casa, and rather than experiencing a prolonged and difficult labor, delivered a healthy baby within a couple of hours.  Tuzlaj was full of surprises.

Entrance to the Calhuitz Casa Materna.

One of the main objectives for visiting Tuzlaj, and one of the most engaging parts of my practicum, was to conduct these group interviews with staff about their perspectives on neonatal complications and deaths.  I continue to admire these nurses and mujeres de apoyo for their hard work with limited resources.  These conversations convey a strong initiative and sense of responsibility to prepare and educate oneself due to their isolation and limited access to cell signal.  They share a holistic view of health and social determinants that’s at the heart of nursing, but which we hospital-based nurses can lose during hectic days.  As with many public health issues, it was clear these neonatal and maternal health challenges we were discussing had deep roots in longstanding gender and socioeconomic inequities, discrimination, and language barriers.  The staff knew the solutions still lie in preventive measures such as continuing to strengthen their health education outreach, community engagement, and garnering more support from civic and government partners.

View of Calhuitz and the Casa (tall green building) at dusk.

At the end of my time in Calhuitz, we were pleased to step fully back into tourists’ shoes for a couple days and visit Lake Atitlán on my way back to fly out of Guatemala City.  It’s one of those places that pictures don’t do justice and distance perception must be altered due to the enormity of the volcanoes and the beauty of the water.  We walked to a popular lookout and cliff-jumping site and after Kay confidently took a birthday jump, I of course had to follow. Only afterwards we learned that it was almost 40 feet—twice what it had looked to me.

Numbers that balance at Lake Atitlán, unlike in spreadsheets.

Back in NC I am continuing to work with both the quantitative and qualitative data in order to report back findings to staff and discuss next steps.  It is interesting to see how the data complement each other and also the amount of information available from a data set that was a bit confusing to piece together.  It’s been very meaningful having a practicum that places a foot both in global health and nursing, and hopefully this research work will offer the organization some insight into their outcomes and assist in determining next steps for reducing neonatal mortality.

– Emily