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Hello from Guatemala!

Penn Nursing’s Mamie Guidera, MSN, CNM, FACNM, checks in after week one in Santiago Atitlan, Guatemala. She is part of a faculty-student team who will spend two-weeks providing clinical care and health education in the local community. 

We arrived in Santiago Atitlan, Guatemala a week ago, and will be staying for almost two weeks of clinical care, health promotion, and community health – the in-country portion of our course Maternal Infant Health in the Americas.

Our team includes Dawn Durain, professor in our midwifery program, Kathleen Brummer Torres, a midwife who teaches in our fetal evaluation course, four graduate students (Anne Koch, Kelly Nichols, Kateryn Nunez, and Erica Schlatter), four accelerated BSN students (Erin Andrews, Sydney Hausen-Cohen, Elisa Dolowich, and Ryann McChesney), and two undergraduate students (Dana Demnitz and Ashley Payne).

The town of Santiago sits on Lake Atitlan in the Guatemalan Highlands. It is an interesting mix of gorgeous tropical flowers and uncollected hillside trash. Women wash their clothes on the edge of the lake, old men fish daily starting at 5 am, and adolescent boys jump in the lake from high docks. The students (and faculty) don’t seem to be able to stay out of the lake, either. The days are hot and sunny, though it clouds up into a heavy mist around 4pm and pours rain by 8pm most evenings.

Penn Nursing students come here to learn about the culture and health care system by rolling up their sleeves and taking part. They rotate through several partner programs:

  • Hospitalito Atitlan – the private hospital;
  • Caimi – the public hospital;
  • Home visits with the community nurses at the Centro de Salud; and
  • Home visits with the traditional birth attendants

They also provide charlas, or lessons in health promotion:

  • Breast feeding charlas in the out-lying clinics;
  • Classes at Saving Mothers, a midwifery education program;
  • A training day for traditional birth attendants;
  • Classes on reproduction and sexual decision making at Estrella del Mar – a program for the empowerment of girls and young women;
  • Charlas at the local elementary school for children and parents; and
  • Classes for the hospitalito nurses on pre-eclampsia and fetal monitoring and medication administration.

The students are doing a fantastic job of teaching life-saving assessment and skills to local health workers with little-to-no literacy. Through drama, games, and conversation, they have taught concepts ranging from nutrition to birth emergencies.

The first few days were tough because the schedule changes by the hour. Absolutely no-one in Santiago wears a watch, and incredible flexibility is required of the students. Yesterday, we really turned a corner – 3 students set off in a pick-up truck with Juana, one of our favorite midwives, for a day of home visits; Dawn and Kathleen went with a group of students to the fincas for breast-feeding charlas and pre-natal care, and a few students spent the day at the hospitalito. All had stories to share at our nightly de-briefing.

Though work in the hospitals has been slow, our work in the community has been busy and more sustainable. The students love the home visits, and the faculty love seeing midwives and nurses that we have now known for many years. Beyond the work, everyone’s Spanish is great, we are cooking and eating from the market, and today a large group set off to hike and bird-watch at 6 am. We are all grateful for this incredible learning and living opportunity.

- Mamie Guidera, MSN, CNM, FACNM