Fellow: Lindsay Plaisted
Fellowship site: San Lucas Health Project, San Lucas, Guatemala
March 20, 2003
Report of International Experience
My international experience consisted of two main parts. The first was one month of intensive Spanish study and part-time volunteer work in Antigua, Guatemala. The second was four months of full-time volunteer work in San Lucas Toliman, Guatemala. First, I will briefly discuss the shorter and comparatively less significant portion in Antigua. Next, I will offer a more detailed discussion of my time in San Lucas Toliman, including an analysis of what I gained and what I felt I contributed to the international community as a result of this experience. The report will conclude with an outline of how the money from the fellowship was spent.
I arrived in Guatemala in mid-October, 2002. My first destination was the quaint colonial city of Antigua where I would spend four weeks learning Spanish and volunteering. The Spanish school was called Don Pedro de Alvarado and I enrolled in their intensive track: four hours a day, five days a week, one teacher/one student. The volunteer site was a program called Familias de Esperanza (or Common Hope) that provides multiple services (social work, medical, dental, educational, housing, etc.) to poor families in and surrounding the city. For four weeks, my days consisted of four hours in the morning volunteering with Familias de Esperanza and four hours in the afternoon learning Spanish. In addition, I lived and ate all of my meals with a family, as arranged by the Spanish school. Overall, the combination of these experiences made for an excellent, if exhausting, introduction to the culture, language, and way of life in Guatemala.
At Familias de Esperanza I was asked to perform an assessment of the maternal and child health related services offered by the medical clinic. Doing this assessment involved interviewing clinic staff, reviewing patient records, looking at available data and statistics, and talking with collaborating departments such as pharmacy and social work. I found that this assignment was an excellent way for me, as a public health practitioner, to learn about the needs of poor families and the effects of poverty specific to this country. My work concluded with preparing a 20-page document and debriefing the clinic director with my findings. Although I initially had concerns about my, as an outsider to the program, capacity to perform such an assessment in the time available, I feel that these conditions ultimately proved to be advantageous. By offering an outsider’s unbiased view, I was able to easily identify program strengths and weaknesses and provide some suggestions for service improvement.
Overall, I was very pleased with both of these experiences. Spanish lessons, although intensive and challenging, were taught in a structured and professional manner. These lessons gave me a good foundation to build on through the daily experiences of the rest of my time in Guatemala. Familias de Esperanza was a well-organized and highly successful program. In addition, its coordination and support of volunteers was well developed and organized. Even as a short-term volunteer, I felt that I was offered appropriate supervision, guidance, and support. I felt welcomed by all staff members and respected for the work I did.
I moved to the small town of San Lucas Toliman, the location of my second volunteer site, at the end of November, 2002. I had arranged to spend the next four months there, volunteering with the San Lucas Health Project run by Dr. Steven McCloy. I understood that the San Lucas Health Project was a medical/public health initiative that was linked, but technically separate from, the local Catholic mission.
Upon arriving in San Lucas, I discovered that the San Lucas Health Project was not currently running. Mission workers informed me that Dr. McCloy does bring university students twice a year to conduct this program, but was not scheduled to come again until the following summer. The mission, however, knew that I was coming and offered me housing and meals in return for the volunteer work I would, presumably, do for them instead. At this point I realized that Dr. McCloy’s Health Project was more intricately linked with the mission than I thought. The San Lucas Mission began about 40 years ago and over this time has developed an impressive network of programs (from buying land for the people to building a local medical clinic) that serve the town of San Lucas Toliman as well as 53 surrounding communities. Dr. McCloy must have assumed that, even though he wouldn’t be there, I would have plenty of opportunities to apply my public health skills within the network of the mission’s efforts. He was right, but it was still disconcerting for me to find out that he had never planned to be in Guatemala the same time I was, and never told me this in our conversations prior to my departure from the states.
Not being Catholic and unsure of my feelings regarding religious-based programs abroad, I was apprehensive about volunteering for four months specifically with the San Lucas Mission. I decided to further investigate the situation and take some time to learn more about the role of volunteers in the mission’s work. What I immediately found was that the mission is extremely unorganized due, in my opinion, to a lack of power distribution. The priests ultimately run all the programs, in addition to holding multiple daily masses, and so do not have time to perform smaller tasks such as volunteer coordination. As a result, volunteers are left without supervision, guidance, and other resources. Despite a lack of volunteer coordination, the mission has a policy of accepting “everyone who wishes to volunteer.” This leads to a constant rotation of volunteers, most of whom come in groups and stay for only a week or two, who numbered as many as 150 during my stay. To the skeptical eye it appears, therefore, that the volunteers are not valued for their capacity to work on the programs as much as they are valued for the donations they are more likely to leave the mission once they have seen first hand the poverty of the people in this area of Guatemala.
Although I did search for volunteer options in other areas of Guatemala, it would have been difficult to arrange for a new site on such short notice. I ultimately chose to stay in San Lucas Toliman and work with local fringe programs that were affiliated with the mission but not directly under its large umbrella. For a few weeks, I dabbled in different types of services including picking coffee, tending a community garden, assisting a nutrition program, and painting a school mural.
By the beginning of December, I had med a nurse who had the idea, supplies, but no help to start a program involving distributing prenatal vitamins to isolated indigenous women. Before long, Marie Emmer and I became co-founders of the Vitamins for Indigenous Mayan Women in Guatemala project and working on this project would occupy the rest of my time in Guatemala. With the help of local midwives, community leaders, and health promoters, Marie and I identified three communities where we could distribute monthly supplies of prenatal vitamins to every woman between the ages of 15 and 45 for one year. One of my main functions was to establish health indicators to track the progress these women and their newborn babies made as they continued participating in the program, and to devise a way to collect, organize, and analyze this information. I was fortunate to participate in the first two months of distributions and which was rewarding; to see indigenous women in their traditional dress, most with babies on their backs, lined up to receive their vitamins. When I left, we had 100% participation rate across all three communities for both of the first two months of the project. Now that I am back in the U.S., I will apply for Non-Profit status as well as additional funding so that we can continue to expand the program in the future.
Another important experience I had in San Lucas was developing a close relationship with a local Mayan family. For the last month of my stay I paid to eat dinner every night with a poor family who could benefit from my meager addition to their low income. Every night, I was exposed to the traditional Mayan way of life; their dress, food, work, beliefs, and values. I grew close to the parents and all six children and began to spend unpaid time during the day with them as well. I watched them sell fruits and vegetables in the market, accompanied them at a mass at their church, helped them pick coffee, and even attended local midwife classes with the mother. I also got to know the extended family, learning that the strength of a Mayan family expands far beyond its nuclear core. Within this short period of time, I was made to feel as though I was part of this family.
My experience with the San Lucas Health Project, as I indicated earlier, fell far short of my expectations to work with Dr. McCloy on local public health initiatives. Although I had no prior knowledge of the San Lucas Mission, I was also disappointed in their programs and utilization of international volunteers. However, the very fact that these two options failed allowed new doors to open for me. Without being committed to one particular organization, I was able to develop my own experience that satisfied all my expectations and hopes for this international experience. Aside from serving one aspect of the public health needs of the local people with the prenatal vitamin project, I learned about a new culture and developed relationships with some of its members by spending time with a local family. I also began to understand what living in extreme poverty is like and how these conditions can directly lead to poor health. I learned more about racial oppression, civil war, and corrupt governments. I even gained professional experience in program development and management. Finally, on a more personal level, I defined my own role as international volunteer.
I went to Guatemala with grandiose ideas that I was going to make a difference. I knew that I had to be humble and respectful of the people; my training in public health taught me that the best way to help people is to empower them to help themselves. Still, I thought that four months would be enough time to learn the culture, make connections with the people, and either significantly contribute to an existing program or implement some type of public health intervention on my own. I think that most international volunteers have similar romantic and unrealistic expectations of their first experience abroad. I quickly found that the reality of international volunteer work is much different than I imagined, and rightly so.
What I eventually learned was how to swallow my pride. I realized that several months was not nearly enough time to become part of the local community and be in a position to initiate change. In contrast, the most influence I could have is by supporting local programs, especially those run by local people, and to empower them by respecting their work and efforts as-is. Even if I noticed, for example, certain needs of the people that were going unmet, or a way to improve the implementation of a certain health program, I had to remember that I was an outsider. Being an outsider automatically incapacitates me to appropriately prioritize the “needs” and “improvements” of a people that I have no history with.
After I had let go of the fantasy to improve the public health status in this area of Guatemala, I had to figure out what I would gain from this experience instead. I came to the conclusion that I had to think more selfishly, and come to terms with the selfish motivations that inspired me (along with all other international volunteers, I believe) to pursue this experience in the first place. I believe that I have a unique ability to sympathize with those who have been victims of unjustice, and have been drawn to helping these people my entire life. For example, my main interest in graduate school was minority health and the disparities that minority groups experience. Being around these people, taking to them, listening to their story, and sympathizing with them makes me feel good. Getting to know the struggles of a Mayan family served this purpose for me. I would like to think that by offering this family a genuine and caring ear that I gave something to them as well, if only to let them know that outsider’s are capable of understanding and sympathy. But, again I have to remind myself that what I personally gained is all I can be sure of and all that I can really take home.
What I personally gained from this experience seems infinite in scope. I gained skills to communicate with Spanish speakers. I gained experience in building relationships with people who are living in poverty, and as a result, now better understand the hardships of their situation. I learned of my own need to serve people. I developed strength and a sense of confidence for international travel. Living out of one back-pack for five months, I learned how little I need to live on. I gained a new perspective on the excessive materialism of my own culture. I realized how much I take for granted (potable water, efficient transportation, and accessible health care, for example). And this is just the beginning…
I feel that the best way to utilize all that I learned in Guatemala is to apply it to my own life, my family, my community, and my society; everything that I can influence. I can learn more about, and try to develop relationships with, the diverse people that live in my neighborhood. I can advocate for the rights of these people. I can continue working to end health disparities that minority groups experience. I can constantly ask myself “do I need this?” Ultimately, I can always consult the memories of my experience in Guatemala to help make me a better person.