I want to share something that made my day. The mail a few days ago carried a letter and a donation (fairly standard for our growing non-profit) - what took all of us by surprise was the source of this very generous donation.
Two third grade classes, from Cresskil, New Jersey held a donation drive to support our partnership work in Ecuador. Ms. Regan and her classes held a penny donation drive as part of their community service work:
“One small penny can change the lives of many”
So 3rd graders, thank you for your generous donation - we know it will change the lives of many in Yambiro, Ecuador. Further, I’m sure your community service will change your own lives. We’re all proud of you and the global citizens you are becoming; we all have something to learn from your hard work….
So after 10 houses and 3 kids vaccinated it almost time to return to the centro de salud. We stop at one more house and a woman standing nearby sees us, takes off running and returns running, pulling behind her a very reluctant 4 year old. He digs his heels in, but his mother prevails delivering him and his vaccination card to us with a flourish. The nurse takes care of him and then does something remarkably resourceful. Frequently after they get a vaccine kids will have a slight temperature, part of the body developing an immune response as it is supposed to. But to keep them comfortable its generally recommended that they can have tylenol. Now this mother did not have any tylenol so the nurse I was with took the sterile wrapper from the syringe she had just used, dropped 2 tablets in it, folded it over and had a clean bag of tylenol to give the mother. I was impressed.
So as we head from house to house spreading the joy of vaccines to the small children I learn a few things about the public health system here in Guatemala.
First off, unlike in the US, vaccination here is not an obligation. Rates of vaccination for polio and measles are in the 50-60 percent range in this district. (The WHO estimates that for all of Guatemala the numbers are closer to 91 percent for measles and 85 for polio). In contrast, in the US rates are around 92 or 93 percent.
So in a country where the government sends people door to door to give vaccines and balloons out I am surprised when a few of the households we stop at state that they do not want the vaccine. I ask why expecting an answer that involves government conspiracy, or as at home, fear of long range developmental side effects. But the nurse I am with says that no, the families just think the vaccines cause fevers and they do not want them.
This, she says, is a population we need to work more with.
Today when I arrived at the Centro de Salud, the nurse who has taken me on said that today I could come with her on a vaccinating trip. Which was very exciting. Every day 1 or 2 of the nurses from the Centro go literally door to door through the town of Santiago Atitlan to vaccinate children who are behind in their vaccines. Here is what happened:
The nurse, who is wearing traditional dress for Atitlan, and an assistant put on their outfits from the Ministry of Health which consist of a bright orange hat and navy vest emblazened with the ministry seal.
And then we set out, we walk a few blocks from the Centro de Salud to the spot where they had left off that morning. We walk down an alley-way which is barely wide enough for one person and the nurse knocks and yells “VACUNA!” (VACCINE!)
The door opens and inside are a man, a woman weaving and a now very scared looking 5 year old boy. The next part of the conversation takes place in the Tzutujil language, but clearly the father says to the boy “Do you want a vaccine?” and the boy says a very definite no. The nurse holds out an uninflated green balloon that he’ll get as a bribe, and so (unlike children we encountered later), he didn’t run away, or scream. He just put on his bravest look until it was over and he safely had his balloon.
And then we continue on down the street, offering Vacunas and having children eye us suspiciously, like the opposite of the ice cream man.
So today was the end of my first week volunteering in the Santiago Centro de Salud (government run clinic) here in Guatemala. My Spanish is a bit rusty, and there is a whole new system of documentation to learn so I was surprised when as soon as I arrived the nurses said they had a big job for me.
Apparently they get donations for the clinic, mostly from the US, and the boxes are all labeled in English. Nearly everyone who works at the clinic is bilingual in Spanish and the native language T’zutujil, but hardly anyone speaks enough English to decipher the boxes. So my first big job was explaining for each box and tube, “Tylenol PM-tiene acetaminofen y benadryl tambien.” 
Over the weekend I’ll be putting together a list of medications in Spanish and English for the clinic to keep. But from now on when I bring or process donations in the states I’ll make sure that they are labeled in the language of the country they are going to. Such a small step to go from a meaningless and potentially dangerous action to a useful donation.
Travelers to Asian cities (or much of the developing world) know the site (and smell!) of the ubiquitous ‘Auto-rickshaw’ — a three wheeled taxi used for short trips around typically urban areas. Delhi, Mumbai, and dozens of other uber-urban are swarming with 2-stroke, 4-stroke, natural gas, and diesel models:
The Auto-Rickshaw - a staple of daily life in South Asia.
Imagine my surprise when I landed in Guatemala to find the streets of Santiago filled with Auto-Rickshaws! Here they’re called Tuk-Tuks and bear more than a resemblance to the Auto-Rickshaws on the other side of the planet:
Both are made by the Indian company Bajaj - a massive company whose distribution network extends from India to Central America, South America, Asia, and Africa. Most of the Global South seems to be Bajaj’s market - an icon of one upwordly mobile nation is becoming that of many more…
Good or bad, pros or cons, globalization is happening. Of course the streets here in Guatemala are filled with Toyota Trucks made in the Americas, Toyota sedans from Japan, US made school buses, Hyudais and Nissans from Asia, Fords from up north and even some BMWs and Mercedes from Germany. As the Chinese and Indian economies evolve I think we’ll see more Bajaj products around the world, and it won’t be long before we see the $2500 car, the Tata ‘Nano’, here in Central America.
I think it also won’t be long before we see Guatemalan products in India - what do you think? Do you know of other similar stories of a shrinking planet?
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