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March 2, 2017: Comprehensive Care

Excitement filled the air this morning as we headed to our new location of Santiago.

I was especially excited, because last year, our clinic in Santiago was our very first clinic. I was curious to see if some of the same people would return for more treatment, or if we could see a significant improvement in the health of the people.

Over the past four days, and from my trip last year, I have learned more about the importance of comprehensive care. Medicine is not simply physical and medical care. It's the combination of physical, emotional, mental, and social care. All of these aspects must be addressed if we hope to make a significant and lasting difference.

This morning, as I was shadowing the physicians, I noticed a stark difference in the demographics of the population that came into this clinic. The doctors made a point of not only giving out free medicine, but also recommendations on how to prevent further damage from the diseases that they treated.

The community of Santiago and the surrounding villages is comprised of agricultural field and cottage industry workers. The common thread of symptoms among all these patients was pain. Whether it was in the arms, shoulders, spine, or legs, a lot of people that we saw struggled to cope with the pain from overuse of their muscles. This reality hit home as I was taking a woman's vitals, and she told me that she had been having shoulder and arm pain for over 17 years. She said it started bothering her about a year after she started working in the fields when she was 15. She has had the same job ever since and has been dealing with the crippling pain since she was just a teenager. Dr. Malik gave her simple recommendations on how modifying the use of her arms and wearing arm braces can not only significantly reduce her pain, but also heal her muscles and nerves in the process by reversing the damage. These simple changes can significantly increase her ability to work, which translates into her being able to support her family longer than she otherwise would be able to, as this pain can be crippling if left untreated. This situation demonstrates that medicine alone cannot completely heal disease without preventive care and health education.

A lot of us on this trip are just starting out our lives in college, and it is endearing to see that although we are not all on the pre-medical track, we are all able to play a vital role on the team. We all have our different strengths to influence positive change in peoples' lives.

It was also very humbling to see how many of us connected with patients with just a smile, even though we don't always understand each other’s language. By this time in our camp, most of us are reflecting on being thankful for the privileges that we have at home and realize that, at the end of the day, how similar we are to these indigenous people.

Providing education on prevention plays a large role in comprehensive care and combatting disease progression. As we shadowed Dr. Malik, I saw that handing out prescriptions was a very small part of the treatment plan of every patient. Whether it was discussing risks of sun overexposure, lifestyle and diet modifications, recognizing dehydration, the importance of sleep, risks of smoking and simple hygiene precautions such as adequate hand-washing, I saw her spend more time discussing these issues than writing prescriptions. Even though this camp was focused on general health and pediatrics, the physicians also took the time to see pregnant women and address women health issues.

In rural Guatemala, although the resources for education and the prevention of parasite diseases are available, many people are not aware of these resources. That is why camps such as ours play a pivotal role in bridging that gap. It was very encouraging to see how the municipality officials supported our efforts to provide these important services to their community.

As we were recapping our experiences at the end of the day, Dr. Malik shared her experience of touring the construction of Nasir Hospital by Humanity First USA, which is not too far from our medical camp. This hospital will open the doors to so many possibilities including: general surgery, OB/GYN, pediatrics, emergency services, radiology, and in-patient and out-patient care facilities. Upon completion, this will address the medical care deficiencies in this region.

Being at this camp is extremely educational and it is eye-opening to see the close relationship between the level of education of a community and its morbidity/mortality rates. One example of this that I can remember is when a 16-year-old patient that I saw with Dr. Malik came in complaining of extreme fatigue. With questioning, we found out that he was not going to school and slept all day. We saw that the appropriate treatment for this boy was not any prescription for medicine, but exercise and structure in his life, both of which would be achieved if he started going back to school. Later, Dr. Malik explained that his signs were suggestive of depression in teenage boys, which can be treated with behavioral therapy, through interaction with his own age group.

Anna Yin, one of the team leaders, said, "This trip has been a very humbling experience as we stepped out of our comfort zone, got to know each other, learn about each other, and work as a team."

As another team member, Elizabeth Dixon mentioned, she was touched by the display of gratitude from patients from her simple tasks at the pharmacy. Today we treated 438 patients and all I can say is how much we have all grown on this trip. We are better friends, leaders, and humanitarians.

- Danya Ziazadeh

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