Pediatrician's report with pictures.

My family went to Guatemala March 18th to 24th. We spent four days doing medical clinics-the first In San Andreas and the next three at the orphanage in Los Robles. We had read as much as we could about the health and struggles of those living in the Highlands but of course it is a different experience to see it first hand. We read from the World Health Organization and World Food Bank sites that over 80% of the Mayans living in the highlands are malnourished. We saw much evidence of that. Besides, heartbreaking story after story when a child would complain that their stomach hurt and they would say yes they eat but it was just a piece of bread or a tortilla in the past few days, there was also much physical evidence to support this is long standing. It isn't surprising that so many are anemic with the difficulty of getting enough iron-foods available to them are not fortified and meat is too expensive. This would leave the main sources of iron beans and green vegetables. Although many eat some beans they aren't able to get the necessary 10 mg a day. The frequent pregnancies have to leave the women who where likely anemic to start with even more anemic. Nearly everyone we examined had an elevated heart rate. Likely this is due to anemia and dehydration. There were other physical signs to confirm this problem of anemia. Virtually the only people we saw who didn't have an elevated heart rate were the women who were hypothyroid. The most likely cause is iodine deficiency. This is another thing that we don't have to think about but our thyroids need to work properly-it is added to salt in our country. We saw at least 20 women with obvious thyroid goiters-they also had many physical signs of hypothyroidism-fatigue, hair loss, decreased heart rate, skin rashes along with a feeling of hopelessness. I can't imagine trying to walk everywhere and take care of a large family when your metabolism is so slow as they said, "I feel like I can't even move, or get out of bed." We felt very lucky that with the exception of three adults with hypertension we were able to provide the medication or supplement that they needed. We brought about 200 courses of antibiotic treatment and were grateful that the Mercy ship had left several hundred more. We saw many people with infections that this medication will really make a difference. We saw several children with pneumonias. They had been unable to sleep and had difficulty eating because they were working so hard to breathe. They were likely malnourished before this infection hit but then with the fevers, cough and infection things had gotten worse. I wish we could have been there long enough to see what a difference it made but you would expect that there would be some difference within a day or two. We saw many women with bladder and kidney infections. Most of these women had been suffering with symptoms for years-all had symptoms for at least 6 months. It sounded like it had started initially in their bladder but by the time we saw them it had spread up to their kidney's causing increased fever and pain and the potential to spread into the bloodstream and cause an even more serious infection. These women likely felt better also within a day of starting antibiotics. One women had been suffering for several years. She explained that her husband had died and she had no way to get any help or medication. Everyone was very grateful. There were many also with common questions parents have about their children's growth and development. I was happy that there was much back and forth discussion. I wasn't just telling them what I thought, but, I would try to explain something and then they would have many questions. Dozens of children came by themselves to ask about things-some normal and others things that needed to be treated. We were able to meet with three teachers while we were there and talk with them about things we think they can do to improve the health of their students. We were happy that even with the large classes they have they seemed to know the families well. Many of the kids complained of feeling lightheaded and dizzy when they would play. For all of them, we saw that they were dehydrated and their blood pressures fell when they stood up. This would cause this symptoms. Drinking more water is a challenge since clean water is not readily available but it will help. We brought 120 lice combs from the National Pediculosis Foundation and these were much appreciated by the families we saw. We also saw many people with intestinal parasitic infections. We were able to treat this as well and also gave out 30+ bottles of Iodine which serves the dual purpose of purifying the water and replacing the iodine they need. We gave out thousands of iron supplements and over 3000 children's vitamins. We also have out 125 bottles of prenatal vitamins to women that were pregnant and or breasfeeding. Each bottle we gave out had enough supplements for at least 4 months. We went to a couple of pharmacies in Pana and learned that the cost of vitamins in Guatemala is about 5 times greater than what we had purchased in the states and also they were not as good-didn't have 100% of all the necessary micronutrients. We gave out a thousand or so calcium supplements and insufficient calcium intake is a big problem. Lack of refrigeration makes intake of cheese, milk, yogurt etc. almost nonexistent also with the high price. So, they do get some calcium from beans and some drink powdered milk. We saw several dozen people with frank rickets and most all the kids would complain of pains in their legs consistent with a lack of calcium. We handed out numbers the first three days that we had clinics. We had slips for 487 people. We treated extra people in many families and we saw at least 60-70 people on the day that we didn't count. Sister Cranney gave out vitamin and formula supplements for at least 50 more. On our day back, Pedro called and said about 30 people had shown up that day to be seen as well. The need is overwhelming but one person and family at a time we felt we were able to make some difference. For some, it was a better understanding of a chronic medical problem, or helping to arrange for follow up care, for others it was treatment of an acute medical problem or an explanation of what had or was happening to them. For all of them I have to think that our visit helped them know that their struggles aren't invisible. My kids had fun playing with their kids and so many things that happened brought home to me how similar things are around the world. They have the huge additional problem of malnutrition that puts them always on the edge and makes even somewhat minor problems big and the big health problems on top of malnutrition are huge. I will sign off now because I could write for days. The people were uniformly warm, gracious and kept saying God Bless You. I'm sure He will bless them. For our part we left multivitamins for at least 6 months for the feeding program. Nearly all the kids had huge problems with cavities. We are hoping to supplement fluoride as well-fluoride in our country has decreased the cavity rate by nearly 70%. We also want to add calcium supplementation to the multivitamins. Pedro, Gil and Dominga are doing a great job taking care of the kids at the orphanage. We know giving them the vitamins they need will help. They will feel better and do better in school etc. We are hoping this might also be a draw for others around the orphanage who haven't yet used their programs. We know people were excited about the vitamin supplementation and the new birthing center. Thanks for the opportunity and coordinating everything during our visit. Jerrilyn

Here are the pictures that gregg her husband sent.
https://mail.google.com/mail/?shva=1#inbox/127bb6c9d91010ad