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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Hospitalito Atitlan 2008

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I am spending a week working at the Hospitalito Atitlan in Santiago, Atitlan (state of Solola) in the highlands of Guatemala. I have visited the hospital twice in the past (2007 and 2006), but never before worked as a clinician at the hospital. The building is a temporary solution that must serve the people here until such time as a new hospital can be built to replace the structure that was destroyed in the mudslides associated with the hurricane in October of 2005.

Santiago is a busy small city of very friendly and industrious persons, although it appears to have become more intense and less relaxed than it was a year ago. In the morning, the air is dense with smoke from wood fires used for heat and cooking. Not surprisingly, many of the local people suffer from pulmonary diseases associated with exposure to this smoke.

The purpose of my visit is to learn better how this hospital can be supported with doctors, staff, and money. A new hospital is being planned, but construction cannot accelerate until there are more resources identified.

The patients are certainly in need and very appreciative. The volunteers and paid staff are phenomenal in their dedication and rapidly improving expertise. My participation in just the first few days has been filled with moments of improvisation, because the supplies are limited and decision making must take into account conservation of supplies, the expense to the patients, the relative inability to easily obtain tests we take for granted in the U.S., and the wishes of the patients and families. It is a collaborative process, and I am hindered somewhat by my inability to speak Spanish or Tz'utujil, the Mayan language spoken in this region.

The patient mix is varied - the first day saw a mixture of obstetrics, neonatology, trauma (tuk tuk accidents are quite common, as these three-wheeled taxis are driven by individuals as young as 8 years of age), infectious disease, an acute urological emergency, lung problems, and much more. My wilderness medicine training has helped in at least a few situations, and as is often the case, duct tape is quite valuable.

I can't say enough about how important it is for local medical facilities like this to be successful. This hospital provides an extraordinary service to the Santiago residents and other inhabitants of this locale, and it is clearly understood that for this to be a long term success, it needs to be based upon the recurring expertise and efforts of the community and Guatemalan physicians. I will collect more of my experiences and my thoughts at the end of this experience, and write more.

Back to work...


photo by Kathy Roach

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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