Mud, mud, glorious mud

This week has been a bit of a ´muddle´(sorry) of events at the clinic.

I took part in my first nutrition and hygiene class with the schoolchildren. Twenty or so grubby children grin shyly at you as they are weighed, measured and checked over by the doctors and dentist, whispering to each other with that nervous excitement reserved for children let out of class for the day.

The lesson is fantastic fun, including jumping up or down for ´bad foods´and ´good foods´, practising washing hands with chalky white bars of soap, learning about keeping animals outdoors, scrubbing paper plaques off of a giant tooth using a broom as a toothbrush and them being petrified when one of the volunteers bursts into the brightly painted room dressed as a parasite in a papier mache hat with goggly eyes. It is incredible how quickly these kids, some as young as five or six, pick up the all-important messages, and many of the mothers join in too. It is also incredible to think that they don´t know these messages already, as at home we would be disgusted if someone went to the toilet without washing their hands and we take for granted that our fruit and vegetables will be clean and bug-free.

Children around the world like to play in dirt; I remember as a child myself loving to make ´mud pies´ in the garden. But the children here are so grubby - their clothes are splattered with nondescript stains, their shoes are caked with dirt, their fingernails are black with grime and their hair is full of dust (and the odd headlouse). Just by getting them to be as clean as their outdoor environment allows, so many health problems are avoided: they don´t have scabies in their clothes, they don´t catch zoonoses from their pets and they don´t ingest too many amoebae or worms. Most of the things we see here are related to hygiene and nutrition and so the education is invaluable in trying to prevent some of the cases of tooth abscesses, skin diseases and diarrhoea we see daily.

Having said that, each child brings in a ´muestra´(stool sample) for examination on the day, and this week we found that 3 in 5 children had evidence of some kind of worm living and growing in their intestines. As Chris, the American whose joyful job it is to study these samples intensely, put it, Ít´s actually uncool not to have a worm here. The kids that are parasite-free get bullied...´. So if anyone wishes to send a donation of Metronidazole to the clinic...

I should probably admit here that I had ascaris lumbricoides myself after I had been travelling in Ecuador, even though I tried to be scrupulously clean and eat from reputable places, so it is not quite as simple as washing your veg. Still, I am glad that each child goes home with a goody bag of any medicines they need, soap, a toothbrush and a cartoon about hygiene.

I have also been rather muddy myself this week. One of the volunteers is planning to start a vegetable garden to help the communities learn about preparing nutritious fruit and vegetables (every piece of greenery here is boiled to a brown sludge - whilst this may kill the bugs, it also kills any goodness in the vegetables, and no wonder all the children complain ´No te gusta las verduras´...), and so for this reason, and to try to decrease the enormous mud puddle that sits ominously at the clinic entrance, we have had a load of soil dumped. But the soil just kept coming and coming, truckload after truckload, until we were peeping over the clinic wall into a wasteland of giant molehills. And then the landlady announced that the digger couldn´t get in, because the piles were too big, and the lectric line that is propped up by a warped wooden pole was in the way. So we have graduated from medics to manual labourers, doing as the locals do and hoeing and denting the land with shovels to make it flat. Backbreaking work, but intensely satisfying, moving mounds of earth from one place to another, you can see the dent you have made in the problem, whereas in the clinic each little spadeful of problems you scrape away you cannot see the bucketful.

Not all of the children in Guatemala are so dirty. In fact, the slightly better-off children we share the school bus home with at lunchtime are squeaky clean with shiny black hair and wide, white grins. Their uniforms are better than any smart schoolchild you see in England, matching tartan skirts and hairties with black patent shoes and glo-white socks. They are incredibly, unabashedly friendly and suffuse the air with a young, refreshing vibrance, their smiles hold the future hopes of the country. Unfortunately, the school curriculum here has not been updated for generations; my Spanish teacher told me that her great-grandfather could remember doing the same exercises she was set when she was a little girl, and she had the same workbooks as her daughter uses. Countries will not develop and improve if education is not progressive. Many of the (very small) middle class here worry that mistakes in this countries turbulent past have not been learned from; many of them express the opinion that things will never really change here until something is done about the huge inequality gap (whilst statistics quote Guatemala as one of Central America´s richest countries, in reality this welath is owned by a tiny proportion of the population w

ith the majority living in poverty. As in many places, it is not seen, as the rich live in the cities and the poor live in the countryside, where their plight remains hidden in the tangled forests of corruption).