Week 1 - Guatemala

After a hectic trip of 18 hours due to delays and then the airline delaying my bag, I finally arrived in GA Saturday morning July 13th at 7:00am. I spent the weekend with a friend visiting a variety of groups of people affiliated with different organizations here in GA. I also made a connection that I hope to use to go into La Limonada one of the most impoverished portions of Guatemala city.

I arrived at my home stay on Sunday night and met my family which consists of two parents and two young boys as well as another OT student in the field school. They are in GA terms around middle class and the mother loves to cook and explain her cooking for us. We began the fieldschool on Monday and I don't know that I have ever been more excited for 4 weeks before in my life. We are a group of OTs, anthropologists, a biomedical engineer, and a doctor who are first and foremost attempting to understand Guatemala from a holistic and structural perspective.So far we have had lectures looking at its history and health systems from a birds eye view. I am learning a lot of big picture systemic reasons why occupational therapy meets barriers in its delivery as well as the cultural differences that face potential therapists or other healthcare workers.

An interesting factor is the historical memory of the recent civil war and the desire to remember what happened has created a distrust in medical workers because many who reach out to the rural communities are employed by the government, a government, supported by the rich, that committed genocide during the civil war. Many indigenous are fearful of any interaction with government workers therefore they choose not to receive medical care.

Another interesting cultural difference is that, in many ways, humoral medical beliefs still permeate the populations, both indigenous and ladino. This can sometimes cause confusion or distrust of certain medical interventions because from this perspective they may seem counter productive

Our fieldschool is divided into three groups researching a different topic. One group is researching infant nutrition and cultural norms relevant to it. Another is researching the systemic barriers present to surgical referrals and reception. And finally my group is partnered with a pretty great organization called Common Hope and we are researching how social workers are supporting the progress of children's education within the program by visiting their families and how educational promoters (pretty much teachers teaching teachers better classroom management techniques) are being received by teachers. We talk a lot about the occupations these two groups (Social workers and educational promoters) use to create effective results and change within each of their respective settings.

 It is a wonderful exercise in using occupation to create social and structural change on an individual level as well as within the classroom as a whole. My job within this group is to do qualitative observations of educational promoters interacting with the teachers and students and social workers interacting with students and their families. I am responsible for taking notes on every single conversation that occurs within the class and between the teacher and the promoter.

I have 3 hours of one on one Spanish class/ 3 times a week with a Guatemalan Spanish professor. That can be pretty tiring but I have found my professor to be a rich resource for understanding structures and norms relevant to medical service delivery.

I have been surprised at how well my Spanish has held up, I have also been wonderfully surprised to find a great group of OTs who are really ready to think outside the box from the occupational perspective. I was pretty tired after the first week for sure and slept for most of Saturday morning.

I am ready for the next week.