Thursday, December 9, 2010

Holiday LIVING with HIV-Positive Kids

Dear you - Let me first admit this... I'm about to cheat on you. I haven't spent endless hours writing to you today, today you get something different, you get an article (which is why I'm cheating). That's right, an article, don't worry it's still MY article, so here goes and I hope your interest in this might one day forgive today's unfaithfulness:

It’s holiday season in Guatemala once again, and for those of us who are sticking around, this often means endless days of snowy day-dreams, turkey-gravy drools and general hot-cocoa nostalgia. This is my second holiday season here in Guatemala, and while I find myself thinking of all of those things once again I’m also thinking about children. No, not the millions of children that seem to rule Guatemala and our lives, but a few orphaned Guatemalan children I had the chance to encounter in a recent visit with a few other PCV’s to Hospicio San Jose. Like many orphanages, the children there are ordinary, happy and giddy, except for one minute difference: most of them are HIV positive.

Hospicio San Jose was opened in 1989, in San Lucas, SacatepĆ©quez, as a clinic for individuals who were terminally ill from tuberculosis and other infections. As the HIV epidemic spread to Guatemala, the Hospicio also began taking-in individuals infected with HIV/AIDS, as many hospitals at that time refused to take such patients due to stigma and general lack of knowledge about HIV/AIDS. It didn’t take long for the hospice to begin receiving their first HIV-positive babies and children who had been abandoned by parents all over the country. Today, the hospice has over 70 children and offer external services to hundreds of HIV-positive adults. The hospice employs over 70 personnel, including doctors, nurses, care-takers, educators, psychologists, social workers, lab technicians, volunteers, a dentist, and even a physical therapist, all working in a vast and sophisticated complex of buildings which include a clinic, chapel, research laboratory, offices, cafeteria, dormitories, and playground.

During our visit, we got the chance to observe a waiting-room charla, where an educator was giving a charla on stigma and discrimination to HIV-positive adults. One particular moment caught my attention when the educator asked, “What happens when an accident happens, what is the first thing you will have to say at the hospital?” Only one woman shyly bowed down and answered, “Soy VIH positivo.” At that moment, I realized this had been the first time I had been around so many HIV-positive individuals, I bowed my own head down too, trying not to stare, as if I were rudely intruding in their private, personal lives. I was perplexed by my own reaction, why did I feel so out of place, so ashamed? Was my own verguenza my way of playing into stigma and discrimination too? In the end, what was so different about these individuals? The answer I know now is this: nothing at all.

And this is the exact message that the Hospicio tries to convey every day to their patients and visitors. It is a space where individuals can become comfortable and talk openly about their problems and their every-day lives, and realize that they are, after all, just like everyone else. You don’t have to sit-in a waiting room charla to understand this, it can be seen all over the walls, with messages and articles of hope, happiness and life. The hospicio’s logo says it all, “Estoy Feliz de Vivir.”

The hospicio is a perfect metaphor for the transcendence of HIV/AIDS since its emergence in the 1980’s; it is no longer about death, but it is about a culture of life. Exhibit A - While at the hospicio, we were shown pictures of babies that had arrived at the hospicio at the brink of death, but the pictures we saw subsequently completely shocked me: pictures of those same babies, older, bigger, full of life and even quite plump (the educator even joked about dieting one of the kids). But perhaps this is the most important point - With the help of clinics such as Hospicio San Jose and the advancements in antiretroviral medications, the face of HIV/AIDS is changing. It is no longer an epidemic portrayed by a scrawny, lifeless body on a hospital bed, but rather by a happy and healthy child. And I hope that if there’s anything that you can take away from this article is that you start thinking about HIV/AIDS as life, as opposed to death.

As I step back into memories of walks through halls filled with children, Christmas trees, adornments and toys, I remember what one of the educators mentioned to us, “Lo que mata no es el VIH/SIDA, es la estigma y discriminaciĆ³n.” So I challenge you. I challenge you to visit the center, heck to talk to my crazy-ass, I challenge you to help end this stigma and discrimination in your communities. Finally, one of the last things I asked was how the children would be celebrating Christmas this year, the same educator answered something like this, “Well, the same as everyone else, with a big dinner, and of course, lots of fireworks.”

Anyone who wants to donate school supplies for the children next year or is just interested in visiting or learning more about the center, please contact me, Esther, at or anyone else you know on the HIV Committee.

Wednesday, November 17, 2010

Sharing Shameless Shame

I suppose blog entries are a 21st century e-journal, only difference is that in today's journal entries, nothing is kept private at all. Month after month, I shamelessly share bits and minutes of my life with you, via memories that have been forever engrained in technological gadgets, such as exhibit A, this photo:

What on earth is litte esther doing? I'm cutting toe nails. That's right, I decided that for one day, one of my women's groups (who are receiving the stove and cement floor projects) would get their very own FREE special treatment at a Guatemalan beauty salon, complements of me, Esther, the salon owner (products sponsored by mum's Burts Bees delivery a few weeks ago). I know what you're thinking, I'm crazy!!! Maybe I am... But every great idea has to come from a touch of dillusion right? So that's right we did it, with the help of two other women, we set up shop in the house where we regularly meet in the village, and went at it.... At the first station, the women washed and soaked their hands and feet, and then applied a home-made hand/feet scrub (made of sugar, olive oil and water):

They then proceeded to station #2, where I cut their finger and toe nails (Still got that first picture stapled to your brain shutter right?), this was the toughest part... And I gotta admit, I shed a few sweat drops, some of these women's toes had probably never been cut in their life. Some of the toenails were rotting, some were so thick I couldn't even cut trough because of the thickness, some had funguses and just plain old weird things. I don't want to gross you out, I just want to make you understand some of the hygienic conditions that we often take for granted in our American sterilized world that's all. Was I grossed out? Not really... Was it hard? Yes. Many of the feet and toe nails were disfigured by the lifestyle these women endure. These women remind me of war generals, holding the fort in the barracks, cooking on dirt floors, hauling wood, constantly cleaning, and taking care of the little soldiers. What was hard for me was holding their hands and feet, being so close to them, and yet feeling so distant from them, being useless to do anything other for them, but to make them feel nice for one day.

Station #3 - Wash away the home-made scrub and apply lotion (the now worlldy famous coconut Burt's Bees, holla mum!) I kept trying to explain that only a little was necessary, but the women were too cute, taking huge chunks of the cream at one time, soaking their arms in coconut goodnness:
So Why do I do these things? Because of moments like these:

Those are some of the 60 somewhat-odd women, two hours later, smiling happily heartedly for one day. So you get your answer right? I love my job.

Among some of the completely ridiculous things that happened to me in the last week were my health promoters feeling-up my bum-bum. Yes, you read correctly, and I didn't misspell either. Their one year training is almost coming to an end, and they have been begging me to learn how to inject. Yes, that's right, I said inject. Obviously, I was hesitant, but after thinking about it long and hard, I decided heck why not? they're committed, they're few in numbers, and heck, I'm not gonna do it, I'll get a nurse to show them. Well joke was on me, because Ms. nurse wanted me to be their bum dummy so they could learn exactly where to inject on a butt cheek:

Conclusion: Hem, awkwardness = confianza at its best (ie/ when health promoter jokingly drums my buttcheek a few times)

Hot dang, sharing shameless shame is fun.

On a more serious note, one of the little soldiers I've mentioned here and there is little Juan Carlos. I met little Juan Carlos over a year ago randomly in one of my villages; at the time he was about to turn two and weighed only 14 pounds. He could not walk, could not eat, he was non-responsive. Dad was a drunk and mum did not speak much Spanish for me to communicate with. I spent an entire day running around trying to get them help with different agencies; the hospital wouldn't take him because he was not "acute" enough, while another agency could not give him the formula he needed to get better (bureaucratic bs I won't bother going into). All that could be given to them were bags of food at a later time (which was never given).

I worried alot about the little fellow, wondering if this family would just disappear off the health center's radar; I thought that little Juan Carlos would just become another marked grave. This was a really tough time in my service because I realized how useless I was to the complex problems that turmoil Guatemala and poor rural families.

I found the family again randomly in July while doing house visits for my stove and cement floor projects. I was ecstatic to meet them again, but Juan Carlos had not gained that much more weight... Here is a picture of him during that time:

The mother agreed to participate in the project and came to every single health lesson (she hasn't missed one to date). Meanwhile, I came in contact with a new nutritionist who began working in my municipality, and we agreed to have her come with me during a house visit. Words are alot easier than actually coordinating work in Guatemala... That never happened, and I still kept bothering the NGO who works in the village about him; they told me that medicine was being given to him, but the last I had seen him last month, he still looked in bad shape.

Then, yesterday, I decided to pop in the family's house during lunchtime to see how the little soldier was doing, and this is what I saw:

Juan Carlos was smiling, trying to talk, attentive, looking at me, looking at everything around him, trying to play with my camera, calling for food, EATING food! I don't think I could ever make you understand how happy I was, how happy his mother was, as she spoke the most Spanish I had ever heard her talk to me in my life, talking about he's going to start walking soon, and how much better he's doing after finally receiving medicine. We talked a bit more about her children, and she explained how she has 5 children, or rather she had 7 (as she let out a small laugh), but 2 died. And that's not a laugh because she doesn't love her children, but because that's just life and death in rural Guatemala. But this time, I know she understands that it's different... Juan Carlos is going to get better, he's not going to die. Juan Carlos is up to 18 pounds, he'll be three on December 27th, and I'm still thinking of a present to get him on his birthday... Any ideas? Let me know!

Ok novel is almost done, I swear. I ran into the nutritionist today, by chance. And I told her the great news about Juan Carlos, and she just responded simply with something like this, " well when you told me about him, I contacted the NGO and was able to get him started on the formula treatment (basic mix of peanuts and chocolate formula), so thank YOU for not letting go of him." And it was as simple as that, a matter of life and death in the hands, words and contacts of the right people.

It's 7:44pm, which means novel must end so a tired brain can rest. Thanks for letting me share the shame.



Tuesday, October 26, 2010

I'm a sucker for shelters.

I'm a sucker for shelters. I've always been. This last week, I finally finished shopping with two psycologists who work with kids at a domestic violence shelter in a city near me. My brother and mother raised $250 dollars back home which was oh so plenty to buy toys and school supplies for the many kids hidden away at the shelter (thank you inflation!).

When I walked in, it was great to see all the kids running toward me, holding my hand, smiling, as I saw them play with all the toys we had bought a few months prior when we did our first round of shopping. When I walked in to the psychologists' office, this is what I saw (all bought with just $100):

Lesson learned folks... Cherish your dollar! For these kids, it's bought alot... Not just ordinary games, but stimulation that help these psychologists work and open up these kids to talk about what has happened to them.

I didn't stay long, but walking through the shelter never ceases to surprise me.... The smiling kids, and the girls.... The girls who should just be kids at the shelter, but are actually mothers (many as a result of a father's or brother's rape)... I'll never forget that image - Their young faces, pre-teen bodies all laying there staggered among the patio, taking in the sun, altogether unphased by my presence as their children happily ran around on me...

We all have our soft spots I guess and as I said I'm a sucker for shelters. I've always been. I guess it all comes from my own inner philosophical debate... What makes me so lucky to be me? Why should I be so lucky, while others not? How could I not do anything to help?

Anyway back to the point... Most recently I came into contact with a hospice looking after orphaned children with HIV/AIDS, and now well... damn it, I can't stop thinking about it. I'm even thinking about spending my christmas there. HIV/AIDS is not a hot topic in Guate, although the country has one of the highest infections rate in Latin America. Although there are over 13,000 cases reported to the Ministry of Health, UNAIDS estimates over 60,000 cases in Guatemala. Many will never know they have HIV/AIDS as access to health care, resources, and education are so very limited here... HIV/AIDS education is virtually non-existent especially in the rural indigenous communities where PCVs work since many organizations focus their work out of the capital city. Many of these communities also do not speak spanish.

PC Guatemala has an HIV Committee, which I am part of, that mainly promotes education initiatives in part of the volunteers and their counterparts. And the truth is, we are way in over our heads as workshops have increased in large numbers, and we'll be coordinating a host of activities with upcoming PEPFAR funding....

But as I said, I'm a sucker for shelters. So drumrolls please.... Finally, to the point of this entry... I'm hoping to organize an activity or fundraiser for the hospice for christmas in part of volunteers and the HIV Committee here in Guatemala... I'm sort of fixated and very excited about this.. So I guess that's all I got for now, that's what I wanted to tell you.



Monday, October 18, 2010

Heart to heart with Loneliness

It´s October. It´s fall in NY, and somehow I find myself nostalgic. But yet, I´m not, I know that the world I left a year and a half ago is changed. I´m changed. I´m anxious too - I have 9 months left of my service. I know this seems like a long time to you, heck that´s an entire pregnancy cycle I guess... But to me, it´s all coming fast and yet so slow at the same time, which is resulting in a minor self-reflection crisis.

This minor self-reflection crisis has led me to the following potential conclusions for my future: getting a Masters in Spain/Belgium, becoming a hermit and writing a shit ton, studying Buddhism in Nepal followed by a sneak entry into Tibet, becoming a real socialist in Cuba, going back to NYC for a 9-5 job, working in the amazon with displaced indigenous populations, being lazy in Brazil, or extending my service for another year. I guess now you understand why this is a crisis right?

I know what you want to tell me - ¨just follow my heart¨ right? But what happens when you´re heart is splintered in a few different places at once? Adaptability is suppose to be a good thing right? But what happens when you´ve become so adaptable that you yourself start to have an identity crisis?

I guess that´s my problem. This is an identity crisis. Damn it, I should have known this would come one day. The problem is this: I´m no longer the Esther you used to know. I´m not even the Esther that I know.

Maybe this crisis all came to a head with the wedding of a close friend of mine´s in San Diego. I hadn´t been back to the U.S. in one year, and I was nervous. I was nervous about civilization, reconnecting, and socializing to people other than my dog. The wedding was good, and seeing old friends was great. But yet, I found myself to be out of place, a different person, not being able to relate to friends or things around me. The only things I could get myself excited about talking was well, hum, Guatemala, to people who well, don´t really care about Guatemala. So you can
imagine that as I saw familiar volcano peaks on my plane back into Guatemala, I exhaled a smile of comfort and relief.

And I guess that´s what I´m wondering... How will I ever be able to relate to a world who probably could give a rat´s hooha about two years of my life that have meant the world to me? Thus the hermit option (seriously it´s on the top 3 choice list along with Nepalese Buddhism).

So yes, I´m adaptable, but do I really want to reintegrate myself into a world that does´t really care about the person I´ve become? I suppose that´s where my heart is, in the middle of the splinters. That´s the billion dollar question.

Well, what can I say, you probably thought you were going to read about my actual experiences and not about my feelings. Sorry, but you´re kind of my journal once in a while too.

I´ll keep you updated, unless you don´t hear from me ever again (that means I went with the hermit option).



Sunday, September 26, 2010

A perfect day

Esther's feet, 6:34PM Guatemalan Standard time.

Gross... feet. I know, it's not your typical breath-taking Guatemalan picture you were probably expecting to see on my blog. But those are my very happy feet on a friday evening. Right around the time the picture was taken, my feet were excited, having just brought me home after walking, hiking, and living a perfect, happy-hearted day. That's right, I said a perfect day. I'm not even sure I know what a perfect day means, or let alone make you understand how out of the ordinary this particular perfect day was. In a land where rain, inefficiency, miscommunication and culture differences are everywhere, a perfect day is a rarity.

The sequence of events begin early in the morning when I find my glasses I had lost a few weeks ago... I know not a big deal to you, but HUGE to me! I hop on a pick-up out of town to head toward one of my rural villages where I have a meeting with my health post and local village leaders to discuss garbage management solutions. As always, I'm anxious... it's 8:15am, the meeting starts at 9:30, and it usually takes at least an hour and a half to get there. I look down at my skirt, my stupid plastic flats and then up at the cloudy, brewing sky... It'll surely rain, foolish me.

Out of sheer luck, the pick-up I caught a ride out of town with took me all the way to where I could catch the bus directly to my village (this NEVER happens!)... After a 20 mn. windy ride in the back with chickens and local villagers I get off at my stop, shaking off the cold, only to look up and to see none other than my NGO pick-up going right by to go up to my villages.... I jump up and down, throwing my arms, I get their attention, they stop. I get a tough, bumpy ride all the way up to my village. I arrive at 9:15AM! As I shake off my stiff knees from the ride up the mountain I think to myself "that never happens, weird."

Next up, the meeting. In typical Guatemalan fashion, the meeting doesnt start until 1030ish. I'm a little flustered though, out of the many people we invited to the meeting, very few showed up. But I calm myself down, after all, it is Guatemala. The purpose of the meeting is to come to a resolution about the garbage problem in the village (this is the same village where I am doing my recycled bottle project) between local leaders, vendors, sports athletes, and the health commission. Slowly but surely, everything comes together, the mayors are committed to improving garbage management, agreeing to have subsequent meetings with the vendors and sports athletes, finding an appropriate spot to have a land fill, contracting a person to clean the plaza, and there's even talks about enacting an ordinance that would prohibit the use of plastic by vendors!!! Say what??? I'm obviously excited as the health post and leaders agree on meeting dates, and coordinating joint-petitions. As we were ending, the mayors asked to keep the Action plan and follow-up posters we had just elaborated. Again, maybe not a big deal to you, but to me, it meant the world to me. Guatemalans actually caring and being active about garbage management?!??!?! The meeting ends. I feel so happy, overwhelmed as Nelson Mandela must have been at the end of Apartheid (I'm trying to make you understand my heart quivers here folks). I look at the sky again, I'm looking for those stars that seem perfectly aligned just for me, just for today.

I"m happy, but I'm still nervous. I still have another important afternoon meeting at a village next over (where I am also doing my stove and cement floor project). At this meeting, I'm hoping to convince a group of health vigilantes (same thing as promoters but paid), to continue on their workshops and meetings with me although I won't have any money to give them each month. I start the 40 mn. walk over, I look at the sky, it's surely going to rain. I make it to the house right as it begins to rain. Lucky. The atmosphere in the small room is tense. The health vigilantes slowly start strolling in, most of them speaking to me in ki'che. They sit in the empty room. During any other ordinary week, the room would have been filled, tight-quartered with busy ngo workers who coordinate their work with the health vigilantes here.

But on this friday they're not there. They won't be there ever again. The ngo, whose services are rotated in days in three of my rural villages, can no longer work in these villages because there's no more money. The ministry of health can no longer contract out their services, in fact they hadn't gotten paid in months because, well.... the ministry of health is broke. By the time I found out a few days earlier, I was upset, sad, angry at the backwardness of it all, and the ineffeciency of the Guatemalan government. These poor villages (16,000 people) would have no local access to health care services any more. I know right away that I need to convince the different health vigilante groups in these villages to keep going with meetings with me, these groups can't fall apart. But I also know that I don't have 50Q a month to pay them each to come back each month. After all, most of them are very poor and depend on that small amount of money. I have a meeting with Don Alberto, the president of the health commission/vigilantes, he agrees with me, I'm invited to a meeting this friday.

Back to the empty room... The meeting starts late as usal, I give a charla on the importance of hygiene, and then I give them the news. The NGO would no longer be there, they would no longer get money, but I wanted to continue the meetings with them, we couldn't give up, they would be the only health workers and facilitators in the village, the community needed them. As I stood in the awkward silence that followed, I wondered how I, a gringa, had ended up being the person to tell them the news... How would the rest of the villagers find out? Would they just show up to an empty office? My thoughts are interupted by the really fast Ki'che' conversations that are now filling up the room... I desperately look at Don Alberto for any signs of clarity, I can't quite understand all of it, but I know they're not happy. I repeat that I want to continue with them without the NGO, it goes back and forth for about 20 minutes. It's getting late. I suggest they take a confidential vote on whether to continue on or not. They continue to speak in Ki'che', I think I understand, but I'm not sure... Could it be???? They all raise their hands, they're all looking right at me, as someone says, "Why should we do a secret vote, when we are all in agreement?" And then another voice in broken spanish... "You know, we've gotten used to you anyway..."

I feel like crying, I'm so happy, as they ask me things like, "what should we tell the rest of the villagers? where should they go for health services?? Can they still go to the health center in San Andres? what about vaccinations? Should we still tell people to go get their vaccination in the health post in the village next over." And I answer, "yes! yes! YES!!" And the final question..."So when's next month's meeting?"

As I walk out, I wonder to myself... could everything be possibly working right?? There must be a star looking after me. I have two more health vigilantes groups to convince as well in other villages within the coming weeks, but after this meeting, I feel optimistic. After they all leave, I do my last three house visits for my stove and cement floor project with two health vigilantes. It's pouring now, but I don't care, my stupid plastic shoes are sliding all over the mud, but today I don't fall. One by one, we do the visits, suprisingly they're all home. As I finish the last visit, I feel great, I've just finished my very last house visit out of hundreds I've done over the last 5 months.

It's still raining and muddy, and there are no more buses at this hour, I have to hitch a ride. Luckily, as I say goodbye to the health vigilante, I am picked up right away by an old man in an even older pick up that gives me a ride to the main road. On the ride there, the man wants to talk, and talk about.... FAMILY PLANNING! Could I be having this conversation with a 70 year old conservative Guatemalan? I sure was! This never happens. As I get dropped off on the main road, I start walking down to the main town to try to hitch a ride. But not 5 seconds too late, I hear someone trying to get my attention... A company snack vendor says he'll give me a ride into town in his van. Great! This never happens (and he even gave me free gum!)...

As I take my final walk to my bus stop back home, I see my bus patiently waiting for me there... It's all meant to be.... I look down at my dirty feet squished in my stupid plastic flats, and look up at the night sky, I look for her, I look for the star... It's out there somewhere looking at me looking for her. I know right then just for one day, we're one in the same in one perfect day.