Today we drove out to a small clinic that served three communities - Tierra Santa, Totolya, and Por Venir. The clinic has two small exam rooms, a waiting area, and another small room with a sink and storage. From the moment we got there, women began to fill the waiting area, along with their children. The girls (there are 10 of us nursing students on the trip, along with two maternity professors) split into pairs of two and rotated between collecting medical histories, performing basic prenatal exams (blood pressure, hemoglobin, fetal sounds, & fundal height), and playing outside with the kids.
Truck life
Everyone here is so beautiful - big brown eyes, smooth dark skin, and glossy long hair that would make Cher totally believe in life after love. The women (and little girls, for the most part) wear long patterned skirts, colorful woven blouses, and embroidered cloth belts cinched tightly around their waist. And everybody is short, in part due to malnutrition. You can really see the stunted growth and development in the children, where you could easily mistake a 10 year old for 5 or 6. The irony is they start having babies so young ... and their poor nutritional state has an effect on their childbirths and children's health. The cycle continues.
We give prenatal vitamins to all the moms and iron to those with anemia, which seems to be a large majority of women. Meat is expensive and not commonly included in their diets, so the only source of iron most people get is from black beans. For a healthy, well nourished person in an altitude this high, their body would naturally compensate and you would actually see an elevated hemoglobin level. However, because of their nutritional status, it is common to see hemoglobins around 7-8, rather than in the normal 12-16 range. This puts women at a huge risk for post-partum hemorrhage and death. So... we give the iron pills, which hopefully they take, but who knows.
The kids are so much fun. We brought coloring books, bubbles, books, balls, and a couple other toys for them to play with. They are seriously so happy sitting and coloring for hours. Little boys asking for besos and shamelessly flirting. The harsh divide between gender roles is immediately apparent. Little girls dress just like their mothers and you see girls who can't be more than 5 around town carrying baskets on top of their heads, with younger siblings in tow. Boys are in jeans and t-shirts and act much more aggressive and confident. It's interesting to see how socialization plays such a huge impact on people's expectations, traits, and mindset about life and their role in it. We learned about a Mayan ritual that perfectly reflects this division. After birth, if they've had a boy, they throw the placenta of the baby up into a tree so that he will be brave and adventurous. If they've had a girl, the placenta goes into a cooking pot. So she'll be good in the kitchen.
When we got back into town, Dr. Chaperone walked us around and showed us some of the landmarks to orient us, as though the town isn't tiny and incredibly simple to navigate. Hopefully this means she is going to let us off our short leash and allow us to explore a bit in our free time (about 2 hours between getting home from clinic and eating dinner in the parish at 6). She is definitely a bit of a control freak and has difficulty letting go. Just smiling and nodding a lot and trying to use this time without phones and constant internet to allow for some simplicity in my life and immerse myself in the experience. Did I mention we can't leave the hotel after 9pm? It's a little odd to have "rules" again and be babysat, but there is also something sort of nice in the structure and habit of it all.
Michelle, Alaina, Christen, & Sandra
i love this blog.
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the best.