Centro de Esperanza Infantil

I climbed the short steep hill from my hostel to the Centro de Esperanza Infantil with a spring in my step at the excitement of starting my next placement, of exploring another new culture and set of health beliefs and of meeting the people I will be working with for the next three weeks. Ringing a grand bell on a huge old oak door, I was ushered with smiles and warm greetings through to a pretty red tiled courtyard, sunlight streaming down on the welcoming children´s paintings adorning the walls and smiling faces of families waiting politely in white gilded patio chairs. The whole building was very pleasant, clearly having received a lot more funding over the years than Primeros Pasos in Guatemala, with a well-stocked children´s library, kindergaten full of bright plastic toys, office full of computers and a shiny, clean doctor´s office.

I was invited to join the families in these chairs, small children hopping about with boundless energy up to teenagers sitting a little more sullenly, but friendly nonetheless. The Centre sponsors children from the age of four or five right through until they leave school, providing the poorest families in Oaxaca with the means to put their children through school (which is not free in Mexico), providing the fees, school books, bags and uniforms necessary, provide a nutritious meal which the children all seat down to enjoy together in the relaxed and social dining room, provide social care and help through the community centre based here and healthcare and education for all the families. It is not clear as to how many streetchildren there are in Oaxaca, but I do know that when I stroll contentedly through the Zocolo (the city´s main plaza), I see countless small children skipping barefooted with baskets of chiclets, or a shoe-shining box, hoping to lure in a customer so they can afford to eat that night.

The only problem with the shiny, modern doctors´ office is that is goes too frequently unused. The organisation (Oaxaca Streetchildren Grassroots, http://oaxacastreetchildrengrassroots.org/) cannot afford to employ a full-time doctor, so they can only provide medical care when special funding or grants are received, or they have visiting medical volunteers. This means that the provision waxes and wanes over the year, being greatest during the summer months when more people take time away from studies or work to volunteer (like me).

I am working with a team of pre-med students from Stanford University, led by an intriguing, hard working infectious diseases doctor (Professor of all sorts, actually) and an honest, open, well-informed social worker, to carry out a survey of the health needs of the families visiting the centre. Each child is measured and weighed, their vital statistics and general health inspected, and then asked a questionnaire on health habits (the good old washing hands, brushing teeth, diet - a seemingly simple set of questions not to be sneered at in community preventative health), as well as being asked about their access to healthcare.

I will also be working on my own project designing some health education materials, just a simple leaflet, that could be given to all the visiting families even at the times when there are no health professionals available at the centre. For even when we cannot be right in the action, education is a legacy which is passed from person to person, word spreading like the communicable diseases we hope to minimise.

It is incredible the difference visible between the children out on the streets, and those enrolled at the centre. Whilst they are still clearly poor, some hardly having eaten in the last day, the children here are clean, educated, polite, full of life and fun, take pride in their clothes and belongings, are more confident in their shy, reserved smiles than those working all hours just to feed their families, let alone have the chance of going to school or receive any kind of medical care.

What worries me is that all of this work is sponsor-funded; without the kind gifts of donors, all the children would still be out there touting tourist on the Zocalo. There seems to be very little governmental support for the plight of the poor, with the Seguro Popular government-supported health insurance system only accessible to the ´richer´ of the poor: infant mortality is ten times higher in the Ministry of Health system than in the private healthcare sector (http://www.medtogo.com/mexico-health-care-system.html).

I returned to my sparse but pretty little room, overlooking a courtyard with a sweetly-scented fuschia-blooming pomegranate tree hanging by my small window, to rest from the noise and bustle of the streets below. Such a tranquil spot to take in my thoughts from the day, but never too far from reality, with views of the building tops of Oaxaca over the balcony and the honking of bus horns to remind me that peace and comfort and prosperity does exist here, but that you have to work hard to get it.

A Oaxacan Welcome

After nearly 12 hours on the surprisingly comfortable night bus, save for the inexplicably frequent ´security checks´ by burly guards rudely awakening us with glowering flashlights, I arrived in Oaxaca (pronounced wo-ha-ka)just as the town was warming up with the morning sun. NOt many youth hostels here, but I found a cheap, basic but clean hotel to dump my heavy rucksack before setting off bright-eyed to explore the place I will be living for the next three weeks. http://es.wikipedia.org/wiki/Oaxaca

And what a day to be introduced to this wonderful city. Unbeknown to me before I arrived, this weekend is the annual ´Guelaguetza´, an all-singing all-dancing festival of Oaxacan folklore and custom. I orientated myself a little to the main streets of the Centre around the architectural Zocolo, street after street running into treasures such as beautifully crafted churches and temples, peaceful, cosmopolitan squares, countless interesting art galleries and museums, artisan craft markets and the buzz and pace of a youthful, vibrant community. Oaxaca is famed for its cultural prowess in Mexico, leaflets being thrust into my hand as I paced the streets inviting me to private gallery showings, free open-air music concerts and traditional cooking courses. I got the feeling I was going to like it here.

The most pervasive posters for today were those inviting all and sundry to the Guelaguetza Auditorium, a ridiculously steep climb up the hillside to the highest point in Oaxaca. I joined scores of crowds, mostly Mexicans from the Oaxacan state, mixed with some intrigued foreigners as myself, to ascend the steps to the sky-high show. Opportunistic traders lined the narrow pathway, creating even more of a cattle market of the crowds, and there certainly was no queuing to enter the grounds: we bumped and jostled, tightly packed, vendors squeezing between the masses to sell ice cold drinks and lollies, to obtain the best free seats. I managed to squash myself in next to a family of about eleven on the stone steps, and had the height advantage to e able to see over the countless bobbing heads in front of me. All in all, 10000 sombrero-topped, excitable spectators crammed into that auditorium, with astounding views down to the stage and then on out across the whole of the city to the mountains in the distance. What a stage for a performance; and performance it was, a band blaring out traditional songs whilst luridly costumed dancers performed their magnificent, sometimes comical dances with utmost professionalism and sincerity, each dance greeted by roars from the crowds as patrons of the different regions in Oaxaca State cheered for their local dancers. The Guelaguetza is a strange fusion of indigenous Zapotec and Mixtec rites with Christian celebrations for the Virgen del Carmen - a fantastic example of the seamless joining of two seemingly worlds apart cultures I have seen all over Guatemala and Mexico.

As the skies opened into a thundrous downpour and umbrellas popped upover the sombreros, suddenly hundreds of people whipping out plastic capes to sell to the unprepared (such as myself), I scurried back down the hill into the centre of town. As evening fell and the skies cleared to a warming, clouded sunset, tourists spilled out into the Zocalo to enjoy the free performances there: weekending families, couples and myself happily strolled around watching clowns perform, a live marimba band play sonorous, beautiful tones into the warm night air, local artisans selling traditional pieces such as tiny carved painted animals and all sorts of hand woven materials. I sat, happy and relaxed, at one of the cosmopolitan square-side cafes to enjoy a famed Oaxacan hot chocolate and watch the world pass by.

The only flip side to all this delight were the street children. Having come here to work with a streetchildren´s charity, I was expecting the problem to be visible. But I didn´t account for how much it would affect me: a I sat, late at night, large, doleful eyed children with ruffled hair and bare, tiny feet would walk up to my table holding out little trinkets to sell, sent by their parents from across the pavement. And walking back along the tourist-thronged streets, I had to step around countless whole families preparing to sleep on the streets that night, holding out hats for money but never intruding on people, quietly accepting their fate as they all huddled together, the youngest children fast asleep in their others arms while their sleeps ran and played and laughed in the road. Whilst the playful kids didn´t seem unhappy as such, you could see the look on the parents´ faces, pleading with you ´Please don´t let my children grow up like this´. I returned to my room, upbeat yet disheartened, excited yet bewildered as to my day of explorations.

As I sleepily clambered into bed, I wondered how I would be able to resolve myself to the fact of enjoying being a tourist here, taking in all the wonderful cultural opportunities, whilst stepping over less fortunate young people trying to make a living playing accordion or selling gum on the clean, cobbled streets. But then that is why I am here, to work with an organisation who is trying to tackle this problem: as ever, not one person by themselves, but joining forces to try to improve the situation for at least some people. Tomorrow, I will discover the work they do, and for that, I will prepare myself with sleep.

Mayan medicine and mythology

San Cristobal has so much to offer. Much like Xela, it is a town of two halves: tourist trappings in the centre, including a beautiful architectural main square, Mercado de Artesanias and a obsolete tram tour of all the sights (you can walk them in an hour, which I did instead) enclosed by interesting streets full of delights such as hidden taco shops, old women selling hot, fruity `ponche` drinks from metal flasks with soup ladles, and local people celebrating in one of the many churches, most of which are up a thousand steps - perhaps to prove their faith, but for me worthwhile for the views of the small, compact city with numerous steeples breaking the clear skyline.

I spent an intriguing morning at the museum of Mayan medicine, learning about the traditional rituals, plants and beliefs still used today. Lotions and potions included ground up cactus leaves (sounds more painful than the sore throat it is to treat), crushed armadillo shell for rheumatism (though surely an armadillo walks a little like a man stiff in armour anyway?) and the use of a live chicken rubbed over the body of a woman in labour to ward away evil from the baby (I think a squawking chicken would be enough to scare anything off...). It is an odd thought, to think that even some of the young people I see in the streets dressed in modern, fashionable clothes with their ipods blaring in ears will still go to their traditional healer over the modern hospital. Whether it works scientifically or not, one thing I think they definitely get right is how close human healing is to nature and to the heart; there are numerous studies, starting decades ago, and much anecdotal evidence, suggesting people heal faster when they have hope, and believe they will get better (http://focus.psychiatryonline.org/cgi/content/full/4/1/140). Faith and time are definitely the greatest healers - where modern medicine steps in is where our time is almost up for this world, to work its own magic.

I experienced more tradition and rituals on a side trip up the mountain to the quaint village of San Juan Chamula. I had heard rumblings in town that it was a very odd place, that I would feel rather like an imposter and to watch what I did and try not to upset the locals. Now I am not one to upset anyone on purpose, and pride myself on my ability to fit in places, but when I stepped off the truck I had hitched a lift in with returning market traders (and of course their many boxes and baskets containing all sorts) I began to understand the feeling. That little jumping in the pit of your stomach that says your every move is being watched; that feeling which is so often imagined, when we are too aware of how we appear to others, only in this case I really was being watched from behind doorways and market stands by beady, intent eyes black as coalpits, and hiding as many secrets it seemed. To make it even stranger, all the locals dressed in their traditional garb of black shaggy wool skirts for the women, and white goats hide tunics for the men, all of whom seemed to be carrying rather large sticks. I hoped for walking along the unpaved roads, rather than chasing intruding tourists down them... For this is an insular community of utter faith in their church, which I was allowed to enter only on paying a `tourist fee`, having my bag hastily searched, and told to take photos on pain of death. Now I was really intrigued to see what the duck egg blue and yolk yellow church held inside - such fun, happy colours on the outside. On the inside, I gasped as quietly as possible - it was like stepping into Narnia through the back of the wardrobe, which was the great, heavy clad door. Thick, herbal smoke blurs your vision and mingles in your nostrils with the scent of crushed pine needles sliding under your feet across the whole wax-covered floor, the billowing smoke of thousands of candles adding to the thickness of the air and the heat of the room. The atmosphere created is one of intense concentration yet letting go, allowing spirituality to seep through you and calm you; much the same effect one feels when stepping into a sauna with the sap of the wood and almost unbearable heat forcing you to empty your mind and senses of anything except the reason of being there. I carefully stepped around kneeling locals, murmuring enrapturing prayers and incantations loudly to their chosen plastic-doll saint, and giving up offerings of candles, eggs, herbs and... fizzy drinks. This I really could not understand - when the addition of soda to their ancient rituals happened I have no idea, but I am sure Mr Schweppes was very happy about it. The live chickens sat at some of their feet seemed less happy with the whole affair... The whole process was enthralling to watch, but I was acutely aware I was stood staring at people trying to pray, though they seemed completely oblivious to our jaw-dropped gazes (and I suppose you would be if the tourist fees paid for the upkeep of your church).

Anyway, I escaped alive, to pay a quick vist to the Cafe Museo, where I saw the ancient Mayan techniques of farming coffee and cacao, many of which adaptations are still used today, Incredibly, there are still pavements and patios of land in the hills around Chiapas used for farming that were first created over 2000 years ago. And it certainly produces a fragrant, eye-opening strong cup of steaming coffee (nothing to do with the tequila or rompope (local version of advocaat) they add to it, of course).

I enjoyed a late-night snack of honey-soaked cake with preserved fruits which is rather popular here, women selling all kinds of sticky delights from chequered cloth-lined baskets all through the warm night, to prepare for the long journey ahead: 12 hours on the bus to Oaxaca. The bus turned out to be ridiculously comfortable, with fully reclining seats, complimentary coffee and the cleanest toilet I have seen in weeks. So I happily settled back in my chair, disturbed only by the countless `security checks` by burly guards all through the night, to look forward to the new challenge of working at the next place, and considering all the Mayan magic I have seen and how I could incorporate their ideas into my own practice. I`m sure I could make a business out of curing people with kindness and cakes.

Micheladas in Mexico

I tried to keep my sleepy, drooping eyelids open on the long, bumpy drive through deserted villages and plantations to the Mexican border, for my last view of Guatemala. But weeks of new and exciting experiences, conversing in two languages, desperately trying to get my head around the mindset and medicine of another culture, have left my head spinning and my brain exhausted. A disconsolate lancha ride across a muddy river, from one desolate frontier town to another, took me from Guatemala to Mexico in two minutes flat. No time for gushy, soppy goodbyes, though that wouldn´t be very British now, would it? I do feel sad though, that whilst I have had a short chance to explore a bit of the Guatemalan culture and countryside, that however much time you have in a place, whether it be days or months or years, it never seems quite enough. Perhaps that says something about human satisfaction, and the need to achieve something in a place, to leave our mark like cats on a territorial tree.

My sombre, pensive mood was deepened by the oppressive mugginess of Sothern Mexico, breaths caught dead in an atmosphere as warm as my own moist lungs. And for this, I was thankful I was not in a crammed, oxygen-depleted Guatermalan collectivo, and instead in a modern, clean, spacious air-conditioned Mexican version, on the way to Palenque. I would never consider Mexico rich, but compared to its´Central American neighbours, it is far more modern (though this, I have discovered, means no less organised...).

The town of Palenque felt like a strange reincarnation of Flores, a few years down the line, already gentrified (or ´gringofied´, I suppose). Here, the neat promenades were finished, tour agencies bustling and restaurants thriving. My tired senses were reawoken anew, a lively marimba band playing in the main square whilst large Mexican families enjoyed comidas tipicas whilst the children laughed and danced in that special, unhindered way reserved for unembarrassed toddlers. I sat in a nearby restaurant with my first michelada, a spicy, refreshing cross between a beer and a Bloody Mary (cerveza spiced with tomato, chilli, lime and black pepper and salt).

I discovered what seemed to be my ultimate tour - bus rides to the Palenque ruins, to cool off at nearby waterfalls and ending up in my next destination, San Cristobal de las Casas - for only a few pounds more than the direct bus there.

So the next morning, we set off to the much talked-of Mayan ruins. I wasdn´t sure what to expect, having been to Tikal so recently. I wondered with a guy called Tim whether it was possible to become ´ruined out´, as you can become ´churched out´in Europe or ´templed out´in Asia. We agreed that you can become accustomed to a type of scenery, or building, but that you never get over the wonderment or beauty, justy the shock of such. Shock can only arise from the unexpected, the unbelievable, the never before seen. It is much the same with physical shock: people only begin to recover when they accept what they have seen or experienced was real, and that they have survived. But it never leaves for good, flashbacks or memories forever plaguing (or in the case of the tourist, delighting) the beholder.


Palenque was swarming with tour groups, even early in the morning, and similar to the town, is a version of Tikal a few years and a few thousand dollars down the line. Perfectly gravelled walkways snake neatly between the temples, which seem a little less magical for their ease of viewing, but which none the less are magnificent. These walkways are edged by a continuous string of sellers tidily laying out rows of jewelerry, maskd, carvings and etchings, sadly drawing tourists´eyes from the real attraction to the more immediate gratification of gifts. I began to enjoy Palenque more as I searched out the smaller, crumbling structures hidden deeper in the jungle and a little off the beaten track, crumbling sandy rocks seemingly growing themselves out of the twisted knotted roots and soft furry mossgripping to its sides. And some incredibly detailed artefacts and freizes have been preserved in the museum, the Mayan artists putting many more modern painters to shame for their detail and accuracy.

After the sweltering heat of Palenque, we were all glad of the cooling jets of spray hurling off the caverns at Misol-Ha waterfalls, and the tempting aquamarine and azure pools of water at Agua Azul. This was another reincarnation of Guatemala, I feel like I haven´t quite left it behind, the glassy shallow pools reflecting those at Semuc Champey. The difference in Mexico is the crowds: they have had a few more years to advertise to tourists, and more of the locals can afford weekend trips.

Happily relaxed after reading with the water gently washing over me, myself and a few others were dropped off at the ominous ´crossroads´for the final leg of our tour, the bus to San Cristobal. Here is where my cunning tour fell apart, and explains my earlier comment on organisation - the bus didn´t show. And instead of doing something sensible about it, the tour guides stood there blankly and dumbly, blindly panicking but pretending to us there was ´no problema´. As the lighht started to fade, we suggested they ring the bus company. We suggested they send one of their minibuses back to Palenque, and use the other to take those of us that were going on to San Cristobal. We suggested they find us a hotel for the night. And then we suggested they gave us some compensation. Instead, we stood there, at the crossroads, doing nothing. And then their (and my) bacon wasd saved, by the bus showing up, only an hour late. Arriving in a new town at 11.45pm, on my own, with nowhere to stay, was hardly ideal, but of course the tour company got away with it, it was ´no problema´to them once I was packed on the bus. This made me wonder where human responsibility comes from; at home, I would have demanded some compensation, or that they ensured I had somewhere to stay when I arrived, or at least the company would be required to have in writing something disqualifying them from responsibility. But here, they just shrug their shoulders ambiguously.

Our responsibility is our own. It is our expectation of others and what they should or should not do for us that leads to ridiculous health and safety rules, to our lives being hindered and all the excitement of exploring our world for ourselves taken out by rules and regulations. This is not to say we shouldn´t look out for others, or to be protected when necessary; but with the right information, we should be free to make our own informed decisions. I guess the reason for all the regulation is that some people are not in the position to take such responsibility for their own, and as such it falls to the state to do so. But we need a better way of judging who is, and is not capable of consenting themselves and putting themselves or taking themselves out of risky situations, not only in the medical world, but in day to day life.

Some things seem to happen for no reason, to be out of our control, and this is what leaves us feeling a little frightened, angry and out of our depth. But as Stephen Hawking said, ´I have noticed even people who claim everything is predestined, and that we can do nothing to change it, look before they cross the road´.

Turisticas en Tikal

After a slightly-more-difficult than supposed trip (I managed to convince some friends, Josh, Duncan and Rachel, to do it my way and skip the expensive shuttle in favour of the cheap-as-chips chicken bus), which involved our bags being chucked atop one bus then returning to find it full (that really means full here), being told to get another and change at the mysterious `crossroads`, having to cross a muddy river with all of our backpacks aboard a flimsy wooden raft then sweltering in a minibus with blacked out windows, we eventually reached Flores.

We were soon refreshed by giant, bowl-like glasses of fresh, sour limonada and fruity licuados in the peaceful ambient garden of our hostel, cooling our boiling blood and dispelling any hint of dehydration from the dusty drive. So I set off to explore the little island. As the most convenient town for the ancient Mayan ruins of Tikal, Flores is beginning to flourish as a tourist centre. It is beautiful in itself, sitting astride a small mound of earth linked to the land by one bridge, and so surrounded on all sides by a glistening, calm lake. But at present, it is a very odd combination of high class hotels and restaurants designed for the rich American tourists looking a little lost on its streets, which are currently being regenerated in the style of expensive Mediterranean resorts without quite being finished yet. Rusty spades and wheelbarrows lie abandoned on the half-paved streets, and the one section of promenade that is actually finished is conversely still lined by old shacks and rubbish dumps, yet to be converted into the swanky hotels! I liked Flores for this, for its backwards, unfinished charm, a hint of prosperity yet still hanging on to its poor roots.

We were up ridiculously early for the bus to Tikal (http://www.tikalpark.com/), in order to combat the already rising heat at 5.30am and to try to avoid the promised hordes spilling out of tour buses. Whilst it was still swelteringly hot, we did achieve the second of our aims, finding ourselves the sole people at some of the crumbling, mystical temples.


I would have been impressed by the magical setting alone: small paths weave themselves through dense tropical jungle, branches (replete with ´stay away from me` coloured spiders and bugs) hanging across at face height and the screeching and squawking of hidden animals surrounding your ears. Though they weren`t always hidden, on the walk we spied spider monkies acrobatically leaping aboves our heads, exotically plumed toucans and woodpeckers flapping from tree to tree in the maze of foliage, and a startled (both us and it) snake on the canopy floor. Then suddenly, magestically soaring right out of the heights of the canopy above, rose forboding temples, still standing with solidarity 1500 years after they were built with bare hands. The sheer vastness of the structures is incredible, let alone the hints at their once highly decorated plaques and freizes and the magical quality of the imagined rituals, prayers and colourful dances, fires blazing and drums runbling into the echoing forest.

You can climb many of the temples, up steep rickety wooden ladders that are certainly not as strong or stable as the edifices we were ascending - a `don`t look down`job for sure. The views afforded at the top take your breath away more than the climb itself, gazing out over impenetrable, a neverending carpet rainforest to the hazy horizon in the distance, the view broken only by the tops of distant temples, blending in as if they were a natural part of the forest and not a manmade structure. Modern architects could learn a lot from the ancient Mayan designers.

Returning to Tikal, mesmerised, we cooled off with an early evening swim in the lake, which was as warm as a bathtub and expelled delighted sighs and smiles from oour expoler-weary feet. The skies blackened, a tumultuous roar of thunder and huge drops of rain falling about our submerged bodies, but we stayed it out and the threatened thunderstorm thinned to become the most beautiful awe-inspirng sunset I have seen, flames of gold and ochre lapping the lakes`edge, splitting through the eery yellow-grey clouds with laser-like accuracy, lighting up our floating faces.

We had a perfect end to a wonderful few days travelling together eating freshly charcoal-grilled pinchos (kebabs of meat, peppers, chillis and pineapple) and enjoying creamy pina coladas at the lakeside.

You cannot get a better day than one filled with exploration and relaxation, to keep both sides of your brain happy. Even the rain cannot dampen that.

`Let the rain kiss you. Let the rain beat upon your head with silver liquid drops. Let the rain sing you a lullaby.` Langston Hughes

Lazy days at Lanquin

I allowed myself the luxury of travelling by shuttle for the trip to Lanquin, expecting a simple half-day minibus ride over the mountains to the North. But it never happens like this - an overturned lorry on a highland pass, blocking the entire precipitous road, put a halt to our proceedings for nearly three hours in the sticky, sweating heat. The thing I found most frustrating was my own irritation at being hindered in my travels; I could not shake the feeling of annoyance that I had been hindered on a journey I had paid good money for, that it was a situation out of my control. I realised as time went on it was perhaps an irritation of shame and guilt that my minor inconvenience was overriding worry for the driver and that noone was hurt, because there was nothing I could do about that either. Eventually it was resolved, and three lanes of vans, horns blazing, continued on their journeys.

Any feeling of disquiet in me was dispelled as we descended in the darkening clouds to lush valleys, the minibus steeply crunching over gravel roads to the sleepy, somnolent town of Lanquin. Here I somehow managed to meet Josh, a friend from Xela, after a short hunt in the quiet village. Tired, hot and ready for bed at 8pm, we found the only can of cold beer in the whole place and settled down under flimsy mosquito nets for an exhausted, travel-weary sleep.

Early to bed, early to rise - woken by off-key singing through a crackling microphone from the church opposite our hotel at 6am, we set off for the travellers´ultimate destination in Guatemala - Semuc Champey - a set of limestone pools sat astride a cavernous cave cut into the soft rock by the tumultous river below. The excitement of standing precariously in the back of a pick up for the short 11km journey wore off within about 1km, as the bone-crunching jerks of the vehicle twisted and turned into ever-denser forest at impossibly steep angles, us ending up at odd angles to countebalance the tilting truck.

But was the pain of the trip worthwhile? Judge for yourself by the photos - ascending slippery, mossy walkways in dense tropical vegetation, with insects screeching out their calls around us, we caught enticing glimpses of glassy turquoise pools, promising a refreshing coolness to the clammy climate. The pools themselves are a wonderment of nature, with the river tumbling and crashing its way over and under the limestone, leaving perfectly and incongrously calm pools on the cave´s surface.

You can jump, and swim, climband cave with candles, and do as I do and sit on the edge of one of the tranquil pools, admiring the view and clearing your senses with the water rushing below you.

Those senses were filled again in the evening, with graceful fluttering and mystical wonderment, as we sat perfectly still in a bat cave at dusk. A deathly silence descended upon all of us there, the only ripple of sound waves the rapid but delicate beating of the bats´wings and the odd squeak as they fluidly navigated around our frozen bodies. It was beautiful to behold, their movement en masse and ability not to disturb another living thing, all with total blindness. A lone blind man walking along the path has some of that grace, I think, but a blindfolded group of people become a wretched mass of bodies bumping into each other.

The next day was spent at the beatiful El Retiro lodge, on the edge of Lanquin, soaking up sunrays on the deck like cats on a hot tin roof, the river splashing its way rapidly past our feet, cooling off by squelching through the mud upstream and hurling ourselves into the icy, turbulent water, hoping we could grab hold of the rope provided to haul yourself back to the safety of the bank. A day of ultimate rest, intermingled with babbling fear matching that of the brook as the floated downstream!



A young girl came to try to take advantage of our Western riches, and sell us sadly melting chocolate sweetly scented with cardamon (70% of the worlds´ cardomon is produced here in Guatemala). I didn´t want the sickly bar, but she told us that she was one of eight children, whose father had died when she was 5 years old and so she had worked ever since and not gone to school in order to help support her many siblings. She asked us if we liked nailvarnish, and what music we listened to, and told us our blonde hair was beautiful. I realised she was just like any other 13 year old girl, interested in fashion and makeup and boys; but her grown-up frown did not reflect this. We bought the chocolate.

We ended our wonderful few days here in some style with a candlelit ´English´ buffet at the lodge (nutroast, chicken, salads, roast potatoes, brocolli and cauliflower - not too far off I suppose!). I was asked too many times what it is to be English tonight - and all I could think was retiring, stoical and snobby as seems to be the presumption! But I am less of a loner than I kid myself, and will travel to the next place with Rachel, Donald and Josh too early tomorrow morning.

Leaving the mountains of Xela behind

It is impossible to believe I have reached the end of my time here. As a beaming sun bore down on my last morning up in the dusty hills at Primeros Pasos, I looked around me and pondered whether I had achieved what I would like to here. And I realised that what you want to achieve will always be a step away up the mountain path, your work in a place will never be done, there will always be another stone that can be climbed, but that we have to learn to feel good about where we have got to so far and optimistic about what can be extended over the summit and into the future.

If all I have achieved is a sense of understanding even a little about medicine in another country, of broadening my viewpoint, and of sharing experiences with the people here, I am happy.

And I got to indulge my artistic side, painting educational materials onto the rough block walls with thick, gloopy paints and designing posters to adorn the waiting area. A tiny suggestion, but each tiny change improves the service provided.

Thoughts tumbled through my mind as Carlos, Zach and I tumbled onto an alreading exploding chicken bus headed for Antigua - at one point we were in the doorway, hearts racing with the whistling wind through our hair as we hung onto the bar for dear lives. The rush of adrenaline reflected my mood - a sense of excitement and challenge, but a deeper rooted fear of not overcoming the challenge. But holding on to each other, we survived unscathed, babbling as we fell out of the precarious doorway at our destination.

Guatemalan health is like the chicken bus ride; full of promise of the end destination, but a bumpy, dangerous path to get there. There are many undeniable problems faced by Guatemala if they are to improve healthcare. Decrease the social division between rich and poor. Actively improve women’s rights. Increase access to basic sanitation and potable water. Remove the sort of corruption that allows people to pass degrees if they have the money or the standing to pay examiners off. Work hard at education programmes to widen people’s healthcare beliefs. There are many voluntary organizations working here, providing much-needed services. What needs to be done is to integrate these provisions; to put human enterprise and willingness to help each other into its most powerful position – by uniting its forces. One person can be influential, can be intuitive and devise many fantastic ideas; but it is always the resourcefulness, hope and inspiration created by people working together that moves mountains.

We could learn a lot from this at home. It is rewarding to take the credit for achieving something ourselves, but the real reward comes from being part of that incredible force of nature, humanity.

Claire gets H1N1 (almost)!

Considering the title of the blog, I have been wanting to write that all trip, so much so that I can almost accept the choking, coryzal cough I seemed to have been endowed with.

I had that impending feeling of itchy, tickly throat last night and this morning woke without a voice. So my faltering Spanish now comes out in a squeaky falsetto, making it even harder to understand.

But hey, if all I pick up during the whole elective is a bit of a cough, considering small children and adults and grandparents cough and splutter in my face every day (they do not understand the concept of covering your mouth here as fine droplets spray onto vulnerable surfaces all around - we pretend in the UK it is because it is polite, but it is functional too) I will think myself lucky.

And from the looks of things, with rising cases in Cambridge, as emails from the University keep flooding my inbox telling me to watch out for symptoms, I think I am actually less likely to catch the disease here.

This map is a bit old, but I think it proves my point quite nicely

http://www.who.int/csr/disease/swineflu/history_map/InfluenzaAH1N1_maps.html

Pinatas and La Parranda

Today was Fergus’ birthday. We worked hard this morning, teaching a health education class about worms and parasites, Fergus having the special birthday treat of dressing up as ‘Valentin’ the evil ‘vorm’. The screaming, enchanted children with their cheeky smiles and playfulness certainly created a good atmosphere for a birthday, and made Fergus feel younger!

We then enjoyed moreish doughnuts from the Mennonite bakery here in Xela, and I scrupulously searched the thronging streets of the lively Demogracia market to find the best Pinata in town.

A party in the evening ended with dancing in La Parranda – think any cheesy British nightclub, remove measuring of shots, add some latin beats to the music and salsa flairs to the dancing. The photos probably say it best.

At one point in the evening, I looked around the partying crowds, and felt pleasantly surprised about how many faces I recognized and people I knew there. In four short weeks, in such a welcoming and friendly town, it is all too easy to make friends and feel settled in one place in this vast world. I feel excited about exploring new places, but sad to be leaving at the end of this week.

I now understand why one in three of the people I meet here have postponed their flights home. It is because when they are travelling, they think they are looking for something; and what they realise is that they are looking for companionship, a shared mindset, a feeling of belonging in the world. Which can only be fully realised by sharing experiences with those around us.

Dulces, pasteles y gaseosas

A busy Monday at the clinic - it seems that patients all over the world store up their complaints over the weekend and unleash them on sleepy-eyed medical staff on Monday mornings. Our own slow reflexes were helped along by the entrepreneurial lady across the road from the clinic, who has realised she can make a tidy little profit by opening up the back of her house to sleepy-eyed workers and offering them nourishing breakfasts of eggs and tortillas, cooked from her own tiny kitchen along with her childrens`meals, and hot, sweet coffee to spurt them into life.

Everything here has a tonne of azucar (sugar) added. They squeeze wonderful fresh , sticky orange juice then add four tablespooms of sugar. They make strong, aromatic Guatemalan coffee, add four tablespoons of sugar, then bring it to your table with more sugar for you to add yourself. The towering, brightly iced cakes adorning the windows of the many pastelerias seem to be sugar, flour, sugar, eggs, sugar, food colouring and a sprinkle of radioactively-coloured sugar sprinkles on top. Everywhere you go, you are accosted by young boys selling dulces (sweets) out of carrier bags. Even that sweetest of condiments, ketchup, is abnormally high in the addictive white crystal here. They make tart, refreshing limonada by squeezing fresh limes, and then take the taste away with sickly sweetness. And you cannot buy a `diet` fizzy drink (gaseosa) anywhere - the only one I have found is CocaCola Light, and that is a rarity, most drinks being lurid green or fluorescent orange and leaving a sticky coating over your teeth and gums.

Needless to say, dental hygiene in Guatemala is poor. Glints of gold flash at you from all directions as mothers smile when they bring their children to the clinic, and the children themselves have holes in teeth, whole teeth missing, and when they say `aagh`for you to inspect their throat, globules of cakes and sweets and slimy orange specks from `tortrix`crisps grin out at you, promising future damage.


In three weeks so far, I have seen five dental abscesses, at least fifty sets of damaged teeth, and one hundred children lining up for the dentist before hearing the pneumatic drilling sound that makes your bones shiver, the children leaving shell-shocked with their sore mouths stuffed full of wodges of cotton wool.


We try to teach them about dental hygiene. We sing a song about brushing your teeth three times a day, after every meal. We talk about not drinking fizzy pop, or eating sweets. And we give every child a toothbrush. But Guatemalan children are the same as any others - they love sweet things. Poor families associate sweets and cola and cakes with affluence and the developed world, and so desire them. Isn`t that a wonderful legacy to put our names to? The sugar trade seems to have caused rather a large amount of damage in this world, both political and physical.

I was bitterly disappointed when after one health education class, I watched the childrem, who had so attentively joined in the lesson, ran out to their waiting mothers and starting gulping down cola, munching on crisps, playing in the mud first and not washing their hands. Someone told me once you have to hear a message seven times before you start to either remember it or believe it, and therefore act on it.


So this is one long-term project of changing human habits, always a difficult task. But it is being achieved, bite by little bite.

Sun, sand and... pigs?

This weekends´trip was to a tiny Pacific village called Tilapa.

What the guidebook said was that it was a traditional fishing village, relatively clean for Guatemalan beaches, and set in a mangrove swamp which you could do nature tours in. Sounds idyllic.

What the guidebook didn´t tell me was that turning up alone, I might actually be alone. After 4 hours on a dusty bus, the humidity thickening and encroaching on the limited breathing space we had each, I was desperate to get to the beach, jump in the sea and have a cool beer. But my high hopes dissipated with the body odour of the bus as I stepped off into a dirty, sandy square lined by empty comedores, plastic tablecloths flapping quietly in the warm breeze as if not to disturb the eerie silence. Not another tourist was in site, just a few dusty kids playing in the shade of one of the deserted huts. I began to think I was going to have to get straight back on the next bus and leave again, as locals stared at me curiously as I lugged my bag through the ´main´street. This led along a rotting boardwalk, replete with pigs wallowing in the cooler mud underneath my feet, to the river which separates the town from the beach. Here I encountered a boatman, dozing in the midday sun, who instantly jumped up when I arrived saying ´You want a mangrove tour chica?´

So, I had two options. Get back on the sweaty bus, or try to find at least some kind of life in this place, if not human. I foolishly went for the second.

But as with all foolish mistakes, they either turn out to be the best in your life, or the end of it. Luckily, this was the former. We pootled along the mangroves, spying wild boars, vultures, wading birds, and strange mud-dwelling amphibiasns, beady eyes and resonant croaks infiltrating my senses from all directions. Eventually we grounded on some charcoal grey sand, made so by the volcanic ash that forms these beaches, and the boatman pointed me in the direction of the ´hotel´.

I stumbled around in the burning sand, which may as well have been the lava that once made it, it was so hot, between delapidated straw shacks and empty-looking beach huts. The only life I saw were some chicks pecking in piles of rubbish and some more pigs, lazily snuffling along the makeshift path. I was beginning to worry I was a character in the Lord of the Flies, and that I was stranded on this slightly grubby beach-like wasteland forever. Just as I was giving up hope, and that sick feeling in the pit of your stomach that appears when you have made a grave mistake was beginning to settle in quite nicely, I spied a huge ´Gallo´beer sign - and lo and behold, it was a hotel! The guidebook was telling the truth, after all.

Beaming, I walked confidently up to the owner and asked for a room in my best Spanish. I thought he must have understood, as he said ´No room at the inn´or words to those effect. No room? But the whole place seemed to be deserted. Little did I know that this was the weekend the entire Guatemalan football team had turned up for training at the beach...

Dispirited, I slumped in one of the plastic chairs and asked for a beer. Then suddenly I heard a girls´voice call out to me in English. It turned out four other girls from Xela had arrived there the hour before me, and were just sitting down to lunch. So again my emotions were flipped over, and the beam returned as I joined them for a delicious luch of camarones, fresh fried fish, tortillas, salad and green chilli sauce. And after reassuring one of them that the rash she had on her foot was not scabies, as her friends had been telling her it was, I was graciously accepted on their weekend trip, and we spent the rest of the afternoon lazing on the beach, cooling off in the sea and drinking fresh coconut juice brought out to us by the hotel owners´daughter.

As the sun began to set, we all became quiet, along with the mangrove dwelling creatures we could hear preparing for sundown. The sunset was magnificent, the sun a roaring fireball of reds and oranges over the darkening slate grey sand, the whole effect was like a huge oil field on fire, the firery sky battling the awesome watery power of the waves.

Thoroughly relaxed, we thought our day couldn´t get better. But on the return lancha trip through the knotted mangrove roots, at first we giggled nervously at the darkness and stillness, our boatman teasing us and pretending we were in a horror film and some slimy creature was about to erupt from the lake. Our girlish giggles were stunned to silence as we broke out into open water - directly above our heads a whole forest of stars twinkled in the inky black sky, whilst in the distance huge bolts of lightning ripped silently through the billowing clouds, lighting up the rippling water around us. Fireflies buzzed nearby, adding to nature´s spectacular lightshow.

We ended the day which a slap-up meal of frijoles and tortillas in one of the tiny local tiendas, cooked with love by a typical Guatemalan Mother, who watched over us as we ate at the streetside stools. Then for an outside shower, still watching the storm, and reading by candlelight under the mosquito net, before an incredibly restful sleep on my simple straw bed.

The next day I visited Champerico, a better known resort further down the coast. We bumped along the coast road, lined with colossal plantations, excited children jumping about on the plasticworn seats. And I saw why I had made that decision to go to Tilapa (of course, I always knew it had been the right one all along and never doubted myself...) Champerico is a busy ´resort´full of weekending Guatemalans who sit in huge groups of friends or family at the plastic-bedecked beachside restaurants, drinking fresh limonada and eating camarones. But the beach is so dirty, strewn with the litter of thousands of humans, beach debris not being seaweed but strings of beercans and leftover piles of food. The humans are the pigs on those beaches, and they need the unpicky creatures to work their way through the trash. There is no such thing as rubbish collection is this country, and certainly no collective social behaviour to do anything to change it. People discard used items, whatever they are, wherever they are.

I stayed for a few hours, having a dip and reading, I would have stayed longer, if my happy blissful peace was not ruined by a huge wave suddenly galloping up the beaching and soaking me and all of the belongings I had with me in my bag! One of those situations where you want someone else there to laugh it of with, as I collected up my dripping towel and scurried away further up the beach like a crab. Problems, embarrassments and downright disasters in our lives are dispersed like the fine particles of sand rolling together in the waves when they are washed up the shore with others. So I will have to rely on you all laughing at me now, imagining me standing there, the stupid girl trying to wring out her towel and scrape away the gritty black sand from her skin...

When I had dried out as best I could I ran for the last bus home - the most packed chicken bus I have been on yet - seven or eight sandy, sweaty bodies crammed along each row, with more managing somehow to squeeze into the aisle. We really were a tin of sardines, and not fresh ones. And most of the Guatemalans, the holidaying ones at least, are not small people - so their squishy bits all just squidge between the seats until we are all packed in quite nicely. I´m not scared of accidents in those buses, as if we toppled, noone would budge and inch, we would all be aircushions for one another. What I did like is that a doctor, still in his scrubs, climbed aboard with the rest of us ragamuffins, not flinching when a snotty child leant against his leg or a market woman spilled her leftover bananas on his lap, and standing to allow a mother with baby attached to bosom to have his tiny corner of seat.

Home to shower thoroughly, to remove the sand and DEET and prawn shells, and prepare for my last week at the clinic. How time flies. If I could have imagined myself in the situation I am now three months ago, exploring and meeting interesting people and learning so much about myself and others, I would have thought pigs might fly.