The Truth Behind Guatemalan Hospitals

Hello there,
Sorry i haven't written for a while, i can't bring myself to write posts all the time, but i assure you, when i get back to Canada I will personally share stories with you, if you ask.

Anyways, this blog is about the shock i have endured when i had the wonderful oppertunity to witness a birth at the hospital and when i got to bring a senior from the nursing home there.  I would like to note that although the things I am going to share with you don't seem fair, not one person is to blame and I do not wish to blame specific people, the reason these things are the way they are is more because of the poverty in this country.

So first of all the birth.  When i entered the room there was a women on the table like delivery bed, it is old fashioned (as most things in the hospital are) and she wasn't quite on it properly so she was clearly very uncomfortable but no one was comforting her.  In Guatemala no one can go into the delivery room with the women so despite the fact that this was her first birth and she had no idea what was happening, and was not being informed of anything she labored very much emotionally alone.  When her pains got closer together the nurse told her to push.  This nurse by the way went to school for one year, and the other people attending the birth were nursing students.  With each push her hands reached out wanting to hold someone but there was no one there, i walked over to hold her hand, but the nurse said she needed to hold the handles of the bed, so instead I just rubbed her arm.  Her pushes weren't quite working so the nurse began to get impatient.  I am rather then saying good job and I can see the babies head, like we say at the birthing house, no one told her anything, except for me.  I am sure the pushed weren't working because she was scared and alone and hadn't been explained how exactly she should push and breath.  Eventually without warning the nurse gave her freezing and again, without warning she gave an episitomy (if you don't know what that is, look it up, i am not about the give gorey details).  The womans hip rose in pain and she screamed.  The nurse demanded her to stay still.  (again i don't beleive this was the nurses fault, she hasn't been taught otherwise).  According to what i have learned at the birthing centre i didn't think she needed an episitomy because the baby was crowning.   she just needed to relax (this helps the baby to descend, but how could she in this environment), and to walk around a little.  After a few more pushs the baby was born.  it was still and unnaturally brown.  Meconium, i guessed.  right away the nurses started doing things in a hurry to help the baby.  They were working at the end of the deleivery bed.  No one told the new mom what was happening, even the nurse that wasn't doing anything.  The mom stared at her baby worried.  Pretty soon it seemed to be stable so they weighed it, wrapped it and put it under a light.  They still didn't tell the mom was had happened, the only words they they had told to her in the last 2 hours were, push, and its a girl.  Next another nurse came in to give the baby an IV through the umbillical cord opening.  Still nothing was told to the mom.   Another doctor came in to giver her stiches and to assure the baby was stable.  The mom was then wheeled into the hot hall way, where she stayed for the hours before she was brought to recovery room.  Oh yah throughout the process the electricity went out several times, (normal for guatemala), the hospital had a generator but it took a few seconds to kick in so each time the incubator light was shut off.   After it was all done the doctor was talking to me about health care in Guatemala.  This hospial is public and basic things are free but for example if they need a complex surgery or a catscan that costs money and they must go to the city.  He explained to me that the hospital didn't always have everything that they needed because of lack of funds, so the nurses have to use whatever objects they can find for things they weren't intended for because they don't have the proper supplies.  He told me that thats what they did this day, and that ehy have to do that alot.  Another thing the hole time the mother wasn't offered water, from the time she was admitted she didn't drink anything.  That is standard in case they need to have a c-section, but it makes them dehydrated.  Also they get their water broken at 5cm ussually, so it makes it hard to walk around.

Another time at the nursing home one of the seniors was sick so i and another nurse pushed him to the hospital which is right next door.  We entered to wear the clinics were.  There was people everywhere, after a few minutes i realized that this was the line up to see the doctor!  This hall way wasn't ait conditioned like the delivery room had been so pretty soon i was sweating bullets.  We entered the line and waited for so long, he went in and got his blood pressure taken.  Thhen we had to enter another line to see the nurse.  We waiting again. After the nurse told us that we had to go see the doctor so again we entered a huge line.  the nurses room and the doctors room were little areas seperated from the next by dirty sheets so that you could here the patiet next to you.  There was an old table where the doctor sat and a simple bed.  that was it.  After we saw the doctor he told us that the man would have to stay for observation.  We wheeled him over to the mens part of the hospital, and were given clothes to change him into.  In this room there was 5 beds extremly closer together.  It was about the size of a canadian hospital room that would be for one person.  But here it was being used for 5 men.  thats all the room at was 5 beds.  Each had a simple white fitted sheet.  no pillow, not other sheet, no side table, no bed rails. there was a simple sink at one end.  There was only one working celing fan that was broken so it made a noise  every time it spun around.  There was also beds lined up all in the halls full of people.  the halls wre already small but now that they were being used as hospital rooms it was ridiculously tight.  When we dropped him off they told us that he would need medicine that this hospital didn't have in stock to just give away to the patients, but that his family would have to purchase it, but of course this man doens't have family at all, thats why he lives in the nursing home so we had to pass up on this medicine.  We left him there.  We got to the hospital at 1 and after waiting in 4 lines and changing him we left at 4:30!

Five days later the nurse at the nursing home and I went back to the hospital to pick him up.  Not because they hadling called us to tell us he was ready, just the opposite actaully because, we hadn't heard anything, and he had been there for long enough so we went to go ask if we could take him home.  This time when we entered the room i was overwhelmed by a smell.  As a nursing student i am told not to let it be obvious that i think somehting smells, but this room stunk, i am not sure what of but it stunk. foot boards becase there no garbage cans. Everyone in there was sweating so much and there was mud all over the floors and garbage stuck between the mattresses and foThere was even more people in the beds in the hospital this time then the last.  I said hi to him and rubbed his back which felt extremly dirty with dried sweat.  I wondered if anyone had come to change his position has they are required to do in canda to bedridden patients. I noticed he was wearing the same clothes that we had put on him 5 days before, i couldn't help but wonder if they had changed him at all.  Also, the hospital doesn't have enough funds for adult breifs (diapers) so instead they used pads that they attached to him using medical tape.  Because there was no table a clean pad that he would wear next was jamed between his mattress and the foot board.  This day the bored was so incredibly hot, i have honestly never been in a hotter room.   Within seconds i was soaked with sweat.  The outside temperature in Guatemala is 40oC, and this room was much hotter.  We bought him gatorade and gave it to hi with a straw, he drank it so fast, you would think he hadn't drunken in days.  All the other men in the room also had huge water bottles tat their families had brought for them.  it made me wonder how much the hospital gave them to drink.  A nurse came in while we were there and gave each of thhem a small cup of hot liquid (like hot chocolate).   As i looked down at him in his bed I noticed that he looked sicker then 5 days before, his beard was unkept and he had green goop dripping from his eyes, his eyes were also dry (a sign of dehydration). It was then thay i noticed that he had absolutly no sweat on this face or arms or chest, nothing!  How could he not be sweating?!  The only answer is heat stroke, a sign that you are so overheated your body can't even produce sweatt!  I though back to first aid, for what you are supposed to do in this situation.  I remember the book said to "take them out of the heat" (he hadn't been out in 5 days), give them lots of cold liquids (i don't think he had gotten much) and bring him to the hospital for medical attention, because heat stroke is serious (well he had been in the hospital and the staff was too overworked to notice this incident, or too understalked to help, or to uneducated to be concerned.  Either way i felt trapped.  This was the only hospital for hours, the only people that are supposed to help and they didn't even notice how sick he was.  There was nothng I could do but feed him more gatorade and bring him home to the slightly cooler nursing home. We did get medicine from the pharmacy on the way out, i am not sure who funded for that but then we left, the electicity was out at the nurrsing home so we couldn't give him a fan to cool down we could just give him a coolish room, and bed to relax on.   So there you go.  I am not sure how horrible this entry made the hospital sound but trust me if you saw what i saw, felt the dirt, smelt the smells, didn't see the soap, and waited in the lines, you would never take free QUALITY health care again.