Going out in Guatemala

It is not all work in Guatemala. About 1 hour away, we have the more up-scale haven of Antigua. In the 1700's Antigua was the capital of Guatemala, however, after a series of earthquakes that destroyed the city, the capital was moved to present day Guatemala City. Today, while Guatemala City is poor, industrialized, and occasionally dangerous, Antigua has become the tourist capital of the State, clean streets, lots of restaurants, bars, and hotels, and, of course, plenty of folks who speak English.

Our two top bars in Antigua are MonoLoco (Crazy Monkey) and Rileys. MonoLoco was founded by 2 former Bostonians. As such, there is a wall devoted to the Red Sox, and always some type of football, baseball, basketball or hockey game showing. The burritos are a little smaller than a football, and the drink selection is pretty reasonably priced.

Rileys, I am pretty sure, is the only Irish bar in all of Guatemala. It is the place to go for a Guiness or other export - of course, you pay for the luxury, around 8-9$ US for a Guiness (as a comparison, you can buy a whole litro - liter -of the local Gallo brand for around 4$). Still a fun place to be, lots of different folks from around the world. And, of course, once you are tired of the pub scene, the local dance club is right across the street.

Los Puestos

The puestos are really where we get the bulk of our clinical work. Each student has their own puesto for 4 month, I have been working with students at different puestos. As you can see from the pictures, the puestos have very limited supplies / medications / resources. However, they serve as a first contact for the most impoverished people of Guatemala


A typical puesto clinic / office. Below, one of the puestos had a hands free stethoscope – pretty advanced technology, I'm thinking of taking it with me back to the states. Additionally, some pictures of the surrounding houses. Most are wood / siding, with dirt floor. Many families live with livestock, and have no access to clean water / sewage systems.

The people living in the rural areas are usually of Mayan descent (note the difference in appearance from the Guatemalan medical students and the local people). Thirty years of civil war, which ended just 10 years ago, has kept many of these populations living in extreme poverty, often living off of about 30-40 cents per day (approx 2-3 Quetzal)

Typical diet depends on level of poverty. The most impoverished will typically have 1-2 tortillas (corn) – the staple food of Guatemala, tea, and occasional frijol (black beans are the most popular here in Guatemala). With a bit more money, the diet adds rice, plantains, eggs, and occasional chicken. The most well off surrounding the puestos will add in fruit, vegetables.

Of course, there is a downside. Here, soda, chips and cookies only cost around 15 cents. And, with effective advertising and low levels of education, many of the Mayan people think that beautiful, healthy people drink soda and eat chips / sweets. As such many of the kids have rather poor diets / rotting teeth. It is pretty sad when you have to pull permanent teeth from a 15 year old kid.


That is what has been amazing about medicine in Guatemala - in such a poor country, you really see the effects of disease. My mom always warned me that soda would rot my teeth, but, coming here, you actually see the long term effect. Diseases like cancer, diabetes, congenital malformations are not detected until they have advanced far beyond what we normally see in the US. Of course, it can be sad as well, as, usually, there are few resources to help these individuals.

My First Two Weeks

During my first two weeks, I was with a group of students who were finishing their four months here at the Centro de Salud. It was quite a culture shock in the beginning, my last rotation was in the ED at Children’s where we were well supervised and had access to any test we wanted. Here, we are the primary doctors, performing procedures, making decisions, often with little to no laboratory / imaging data. The outgoing Guatemalan students, after almost 4 months, were very comfortable in their role, and, according, they let me manage almost any situation I wanted. Below, I am suturing a child head post trauma. Also, I was the “attending” on 4-5 births, an incredible experience, seeing as we have only stethascopes and Leopold Maneuvers. Also below is a picture of us out on the town. It is a funny change, the Guatemalan students are, medically, at the level of our 2nd year residents, but, for many, this is their first time living away from their parents.

First Blog from Guatemala - Centro de Salud Barbara

My first attempt at blogging from Guatemala, only 42 days into my trip. I -will try to include lots of pictures since they are more interesting than my ramblings anyway.

I arrived in Guatemala on September 18th and, later that day, started my 2 month clerkship at the Centro de Salud Barbara, located just outside San Juan Sacetepequez, one of the suburbs of Guatemala City.

The Centro de Salud is the headquarters for students from the Francisco Marroquin Medical School during their required 4 month Rural Medicine Rotation.

During their rotation, students serve as the attending doctors in the Centro de Salud, managing patients, stabilizing emergency trauma and attending deliveries. Doctors are available by phone for consult, but do not normally provide care at the Centro.

The Centro de Salud has 2-3 consultation officies, 4 observation beds, one delivery room, and a fairly large post-partum ward, consisting of 8 beds. In addition, there is a basic laboratory for various blood tests, as well as an ultrasound room and ophthalmology room, each of which is open once a week and stationed by local radiologists / ophthalmologists.

There is a dormitory attached to the back of the Centro de Salud, which has been my home away from home for the past 1.5 months. There is one common room with a combined kitchen, living area, connected to 8 bedrooms and, thankfully, 4 bathrooms. The dorm is home for the international medical students, as well as about half of the guatemalan medical students as well as a designated call room for students covering the Centro de Salud at night. Having spent the last 3 years of my life in a dorm, it is really not much of a change.