Home for the Holidays

It is hard to believe that we have been in Belize for over 6 months now.  I told my father when we last spoke that it finally seems like we are settled.  Instead of seeing the many differences of people and way of life here, I have begun to notice the similarities.  There are many more things that feel familiar.  Quinn finished his first semester in his Belizean school including exam week and received the highest marks in his grade.  He has made some friends, learned to play marbles and is enjoying playing baseball with the guys.  Caelan is comfortable spending his days at the clinic with us, doing his homeschooling on the Internet.  He is often a big help around the house.  Will has been practicing his guitar everyday - sometimes for hours at a time - and is making real music now.  Both Will and Caelan have gone along on an overnight trip to a couple of the remote villages.

Path leading to the river in the village of San Vicente

I really wanted to make our home feel a bit like Christmas and was initially at a loss as to how to do it.  There is definitely not the commercialization and Christmas trappings here and I wasn't even able to find any red cloth.  Then one of the shops in town got in a small, plastic Christmas tree and some light strands.  We were able to set it up on our dining room table and decorate it a bit.  Caelan, Quinn and I made an old-fashioned paper chain of red and white paper.  It has been so nice to have it and has added a bit of the holiday cheer to our home.  Everyone has also been looking forward to Barbara and Bill's visit (Bill's parents) for Christmas.

It does seem that as we have gotten closer to Christmas, we have been a bit homesick for the States.  Celia (our nurse) and Chad, Natalie (our pharmacist) and family left last week for the states until the New Year.  It was hard seeing everyone leave. Before they left, we were visiting and they were talking about what they were looking forward to: different types of foods, carpeting, no bugs or bug bites, clean environments and not feeling dirty all of the time.... I think we were definitely wishing we were going up for a visit as well.  But then I realized, there are lots of things we miss but we don't NEED anything.



On a funny note, "superstitions" are abounding in our house.  The only hot water in our house is by an electrical shower head that heats the water as it goes through it.  For some reason, recently we have been without power a lot in the mornings which means cold showers. There have been several instances that the electricity has come on just after Bill has finished his cold shower.  Quinn has thought it hilarious that Bill has had to take cold showers and has gone into the bathroom with a battery-powered fan aimed at him in the shower as a joke. This past Sunday the power was again out.  After a couple of hours, Quinn started begging Bill to take a cold shower so that the electricity would come back on.  After awhile we suggested to Quinn that he be the one to take the cold shower and see if it made a difference. Quinn finally thought it might be worth it and after hearing sqeaks and squeals from the cold shower, Quinn emerged.  As he stood there dripping wet and laughing, the power came on.  Then Quinn was convinced, "Somebody has to sacrifice themselves for the family."   Caelan's dry, intellectual approach was that it was "not only a coincidence but an unfortunate event."



We wish you all, our family and friends, a wonderful Christmas and a Happy New Year!

                                          For to us a child is born,

to us a child is given,

And he will be called

Wonderful Counselor,

Mighty God,

Everlasting Father,

Prince of Peace

A Women's World

Most people are aware that my interest is in Women's Health but it has been more challenging to me here than anywhere I have ever been before.  The Maya women have me stumped!  As a physician I am trained to observe.  I will admit that I am not usually that observant of peoples' physical traits but when I walk into an exam room, it is data collection time.  What does the patient look like?  How are they dressed?  How old are they?  How do they interact and respond to me and to my recommendations?  

For starters, there are very little facial expressions.  I can usually judge if someone understands what I am saying by their face but here most faces are blank even when they are engaging in conversation with you.  I have watched them talk amongst themselves with more animation but with the "white doctor," it is a blank face.

Next, it is difficult to examine them.  They are very open about breastfeeding and will do it publicly without any covering until the child is about 2 years old, on the street, in church, etc., but the moment you want to examine their abdomen, they are pulling their clothes over themselves and hesitant.  It is very difficult to convince them to have a Pap smear or a pelvic exam even if they are symptomatic.  Many times they will simply refuse.

That said, I have great empathy for the Maya women.  From my industrialized country perspective, they live a very difficult life.  They marry young and have many children.  For some reason, it is very common for them to have 10 children.  Although we bring options for family planning with us, there is still some stigma associated with it.  We often see patients in open areas with very little privacy from the other villagers which makes it more difficult for the women to discuss these things.  The women often really want these services but are afraid of what the other villagers (or her husband) might think.

Women wait with their children to be seen in the village of San Jose

A Maya "washing machine" - stones set in the river for washing

Their daily work is not easy.  They have to carry their laundry to the river where they wash their clothes on rocks while their children play in the water.  They then carry these buckets of wet clothes home and hang them to dry.  They have to haul drinking water for their family from the village wells.  Most villages now have a communal corn mill powered by a generator but they still must take the corn to the mill before every meal to grind it and then make tortillas over an open fire in the hut.  They sew their family's clothes on a pedal sewing achine or weave cloth by hand on a loom.  Most of this is done while carrying their babies and even toddlers in slings from their heads.  Many go from looking very young when they are first married to looking 20 years older than their age within a decade.  They suffer from chronic headaches and backaches from the heavy work.  Many develop COPD (chronic obstructive pulmonary disease otherwise known as emphysema) and have carbon monoxide headaches from cooking over open fires without ventilation in their thatch-roofed huts.  There are a couple of organizations that have worked to provide well-ventilated cooking stoves for the Maya people in Guatemala however, the Maya of Belize have not been accepting of these.  They also develop significant degenerative joint disease, especially in their knees and shoulders.

So we give them a lot of Tylenol or Ibuprofen.  We treat their lung disease symptoms with inhalers and we inject many joints with steroids for comfort.  We have only seen a handful of cases of depression in these women even though we have asked and looked for it.  We just have to continue to educate them, encourage them to have regular pap smears and pelvic exams and otherwise to try and be there to care for them.