Walking in Mary Breckinridge’s Shoes (Melissa)

After winding along bumpy stone and mud roads and crossing swollen rivers, we arrived in the village of Guadalupe el Zapote on Tuesday, October 26^th in the early morning.  After crossing the fourth and final river and seeing the water come up to the hood of our car, the motor steaming, I thought: “So this must have been how the Frontier Nursing Service nurses felt crossing the rivers on horseback.”  Already, people waited outside the clinic where we were to see patients along with Dra. Rene, a retired Guatemalan doctor who is kind enough to volunteer her time to attend to this community once a week in the clinic.  From 8am to 2pm we cared for 18 pregnant women seeking prenatal care and various primary care visits as well.

After a break for lunch, we headed up another winding, bumpy road through the hills to the small hamlet of Ceylan, where we were graciously welcomed into the home of Felina, one of the local health promoters.  Health promoters are the foundation of the Guatemalan health care system.  They are literate, educated, and respected members of their village who are trained in basic public health measures.  Many of them are trained as nurses.  Once again, I was reminded of the early public health work done by the Frontier Nursing service midwives.  Vamos Adelante works with the health promoters from the villages surrounding El Rodeo to improve the health of the people, training and equipping them, but the hard work falls on the promoters themselves.  Day and night people of the village would seek out Felina for her advice and any treatment she could give.  Common maladies included upper respiratory infections, gastrointestinal infections, and malnutrition.  Felina cares for the pregnant women in Ceylan as well, dispensing prenatal vitamins and recommending techniques to ensure a safe pregnancy and birth.

Wednesday morning we went with Felina to the house of her mother, who worked for Vamos Adelante in their nutritional program.  There we observed the once daily meal prepared for the malnourished children and seniors of Ceylan and we listened to the miraculous stories of transformation brought about by proper nutrition.  We helped served rice, beans, and incaparina (a hot, fortified, corn drink).  However, before we could finish, Felina sent word that pregnant women from the village were gathering to seek care with us.  By the time we returned home three of them were sitting on the front porch, waiting and chatting.  More were soon to arrive.  As the morning passed into afternoon, we offered to visit some of the women in their homes to spare them the long wait, but they refused, saying they preferred to be seen at Felina’s house, where there was more privacy.  As Felina pointed out, they also had the rare opportunity to sit and do nothing but chat with neighbors.  Others came too, children with diarrhea, a woman with an inguinal hernia, a man with a machete wound, and several cases of upper respiratory infections.

After finally finishing with all the patients for the day, we enjoyed the last remaining rays of sunlight by splashing in the stream behind Felina’s house with the neighborhood children.  As the sun set, we returned to the house, but the children were not done with us yet.  We turned Felina’s front porch into a discoteca, complete with Merengue and marimba music.  We danced until we collapsed, exhausted, speckled with insect bites, and thoroughly satisfied with the day.

I fell asleep thinking of the parallels between our experiences with Vamos Adelante and those of Mary Breckinridge’s nurses on horseback, providing basic public health in an isolated place of few resources.  I found it ironic that we had to travel to Guatemala to get a taste of what it must have been like for those nurses, and I must say: I like the taste.  They may not travel by horse these days, but Mary Breckinridge’s nurses continue their work nearly a century later many miles from the Kentucky mountains.

-Melissa Poole, CNEP 59