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Nursing students find new ways to heal Hands-on training in Guatemala shows limits of Western medicine By WENDY SIPOREN ASHLAND -- Imagine holding a health clinic outside with no running water. Cloth drapes create private exam areas while farm animals mingle with the dozens of people waiting to be seen. Speaking to your patient requires two translations: English to Spanish and Spanish to Mam, the Mayan language. You wonder what gets lost in the translation. It wasn't a typical practicum. For the seven Oregon Health Sciences University nursing students who spent four weeks in the western highlands of Guatemala, the 12-hour days put all their classroom training and life skills to the test. "I learned the limitations of Western medicine," said Marie Uhtoff, who will graduate from the Oregon Health Sciences University School of Nursing at Southern Oregon University in June. "Yes, we have antibiotics, but it's not going to cure the sadness of a boy's father leaving to work on a coffee plantation. Or they have a sore back, but it's because ... they lift 100-pound sacks in the sun all day. ... We don't have a pill to cure that." The Oregon nursing students, along with two others from the University of Alberta, Canada, and a team of seasoned health-care practitioners, treated the Mayan people who live in isolated villages surrounding the town seat of Txolja (Cholha), 120 kilometers from the Mexican border. Because it can be a six-hour walk to the nearest health clinic, the villagers do not get regular health care, despite Guatemala's national health-care system. While the people suffering from untreated hernias, infections and cervical cancer receive an obvious benefit -- free medical care -- program participants say the rewards were mutual. The students received hands-on experience in diagnosing patients and performing pap smears, tasks reserved for more experienced nurse practitioners here. They also saw a range of health problems such as malnutrition and skin problems not commonly found in the United States. They learned to work with limited resources. "For some of the students it's a big shock," said assistant professor Wendy Neander, who began leading teams of nursing students to the region in 1993. "Everything is so different that they really start to reflect on themselves. ... They learn what their limits are and what their strengths are and in the end, provide better care." Neander brought the clinical experience with her when she began teaching at SOU this past fall. It's part of a unique partnership between a nonprofit called Pueblo Partisans and the two schools of nursing. Neander, her husband and their three children have a long-standing connection with the Mayan people of the highland area. It began after a major earthquake in Guatemala in 1976. Her husband went down to do reconstruction in Guatemala City and worked with a woman from the area. Pueblo Partisans gradually grew from the desire to improve conditions in a culturally sensitive way. "Really the program is rooted in the idea of community-based health care," said Neander. "The community decides what health topics we will address, where the clinics will be held. The students get to see people in their actual environment, and this exposure leads to a fundamental understanding that the true answer to health care is not how many doctors or nurses you have. ... It comes from the people themselves, from the internal community support system." That philosophy is the basis of all the work Pueblo Partisans does in the communities which includes agriculture, education, cultural retention, income generation and nutrition programs in addition to the health clinics. It's also a philosophy that Neander has come to appreciate in her health-care work with the Mayan people. "The work of Pueblo Partisans is focused on building the resources that already exist in these people," explained Neander. So during the women's health clinics, a local midwife or traditional healer works in conjunction with the nursing students and local medicinal plants are respected. "When I first came there they used to say `you need to bring more medicines,"' she said. But over the years, Neander said some have grown to recognize the advantages of the medicinal plants. Now they are grown as part of Pueblo Partisan's agricultural program. "They are actually recognizing the value that their traditional knowledge in plants has for them as a people." It was this same strength that most impressed the nursing students. "My first impression was just how poor the country was," said Keyanoosh Ostovar. "It did not matter how poor they were, they were just so generous." Uhtoff put it another way. "It was realizing that there's not just one way to live. People are living very well with a lot less and they're very happy." Today's Edition : News | Sports | Business | Weather | Tempo | Classifieds Mail Tribune Copyright � The Mail Tribune 2000, Medford, Oregon USA