2 Weeks Have Already Flown By in Guatemala

Manos Abiertas is an NGO clinic that seeks to provide affordable, high-quality obstetric and gynecological healthcare for women and their children in Ciudad Vieja and surrounding areas. The vast majority of the patients at the clinic have few resources, so prices for all services are individually tailored to a level that works for each patient. The clinic maintains a focus on natural and minimally-invasive interventions for patients – in stark contrast with the methods of the public, government-funded hospitals here. For example – keeping the best interests of the mother and baby closest at mind, births here at the clinic occur with an aim to avoid invasive interventions such as episiotomies and cesarean sections unless absolutely necessary. The rate of cesarean sections in public hospitals in this area is about 54% and astonishingly even higher in private hospitals (92%). Many of these c-sections are performed without proper indication for a number of upsetting reasons (i.e. easier/faster for the hospital, more lucrative for the hospital). In addition to birthing services, Manos Abiertas provides pre-natal and post-partum care for mother and baby as well as a breadth of gynecological services (i.e. pap smears, family planning consultations, IUD implantations and removals, routine check-ups, etc.). The clinic also has a free pediatric program; every Tuesday, parents can bring their children for 100% free check-ups with a local pediatrician. This clinic is truly dedicated to improving the standard of maternal and child health in this impoverished area.

I heard about this internship very round-aboutly through a friend of a friend of someone who had previously completed the same internship. The chance to work in the field of obstetrics/gynecology sounded like a rare opportunity, and the added aspect of doing it in a foreign country provided some more intrigue and a welcomed sense of challenge. I decided to read a little more about the clinic and their mission on their website and felt very inspired by all the work they were doing and their intentions behind it (this clinic is by no means a business – the selfless intent to improve the lives of others through accessible, high-quality healthcare was and is evident). While the intern program was mentioned on their website, there was no formal application. I simply sent an email to the clinic with my cover letter and resume and they replied very enthusiastically. After some e-mail correspondence to make sure I would be a good fit for the clinic and the clinic would be a good fit for me, the intern coordinator offered me the position and I accepted. My past internship application processes had been much different – with much more formal applications entailing a healthy amount of essay questions. This new experience in applying for an internship taught me that it is well worth the time and courage to reach out to someone an directly state your interest in working with them. It may feel a little bold and vulnerable, but you never know what may come of it.

As an intern here – I assist the clinic staff (midwives, nurses, doctors) in providing all the aforementioned services. In my first week, I did a lot of observing and taking blood pressures and weights of patients (as that was all I really knew how to do at first). However – the teaching here is very hands on, so in my second week I have already learned to give birth control injections, consult on diagnoses of pelvic exams, perform a pap smear (with help – still getting the hang of this one, it can be quite tricky!), calculate probable due dates for babies, measure and assess the development of a uterus during pregnancy and after birth, discern the positioning of fetus in the uterus, and honestly much more! There is an obvious connection between the kind of work I am doing here and NCI’s mission; in supporting the health of these women and their children, we are empowering them and fostering an overall stronger community. I also feel that in the nature of my work, I myself am feeling very empowered. It is a very new and refreshing sense of independence I feel here. The professionals I am working with have a kind of confidence and trust in me that I have never seen before – perhaps it is part of a different culture here than I am used to in the states. Whatever it is, I find I am doing a lot of things on my own here (whether it is taking the bus in a new, foreign city to deliver a bunch of pap smears to a lab or speaking with a woman about her options for birth control in a language in which I am not quite so fluent), and that independence is very confidence-lending and empowering.

While coming to work at this clinic in Guatemala has been quite the adjustment (and maybe a little scary and lonely the first few days), I am definitely feeling quite settled now. I knew not a single person in this whole country when I first got here, and now I have a few friends already! The people I work with are all great – friendly, smart, excellent teachers, thoughtful, confident, and generous. I have learned SO unbelievably much in two weeks, and while I can feel the learning curve start its natural descent – I know I still have lots of learning ahead! Each patient that comes in is so completely different from any one that I have seen before, so I learn something new each time. I hope to continue to gain confidence in my abilities to communicate in Spanish and perform some of the procedures/techniques I have already learned. I also hope to learn and internalize more of the intricacies relating to the anatomy and physiology of women’s reproductive/obstetric health, as I have already learned a little and find it incredibly intricately detailed!




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