Sites: Guatemala

Location:  Santiago Atitlan, Guatemala

Academic Affiliation: no formal affiliation at present; emergency residents and medical and nursing students from University of Pennsylvania rotating through, emergency medicine residents from U of Arizona 

Site Director:  Doctora Irene Quieju Sojuel, the first female Tzutujil doctor

Background:  Originally opened 40 years ago, Hospitalito Atitlan had been one of the many casualties of the war that caused the death or disappearance of over a thousand Tzutujil from this hard hit city.  In 2003  several Tzutujil indigenous to Santiago Atitlan began work to reopen the hospital for patient care.  The nearest hospital to Santiago was over an hour and a half away by treacherous roads.    On April 1, 2005 they were able to reopen with a clinic, 24 hour emergency care, and limited inpatient hospitalizations.  In the first 4 months of 2005, Hospitalito Atitlan treated 1,200 patients.  A new operating room is nearing completion. This will allow emergency Cesarean sections, greatly facilitating care for pregnant patients who need this intervention.   Santiago Atitlan, a city of approximately 40,000 Tzutujil Mayans, has one of the worst maternal and fetal mortality rates in the hemisphere, near to that in subSarahan Africa.  An X-ray machine has been donated and should be functional in 2005.  Renovation of building 2 which will be the 20 patient inpatient ward is underway and scheduled to be completed by the end of 2005.  Community teaching and outreach is a high priority.  Currently, a maternal fetal program is being developed to provide maternal/child care at a nominal cost to pregnant women.  Local comadronas (midwives) have begun coming to the hospital for training by more experienced comadronas under the supervision of the hospital staff.  The hope is to enlarge the teaching of the hospital, work with the “bomberos” (the local fire and rescue workers), more with the comadronas and have ongoing teaching sessions for other community groups.  Outreach to medical students and residents from the US, Canada, and Guatemala is also a priority.  During the first 4 months of operation of the hospital, one resident and 4 medical students from the US have stayed for a month each, doing clinical work and research.  The hospitalito has been visited by dozens of other students and doctors, mostly from the US, a few from Canada and Guatemala.  There are ongoing plans to have interested residents do one month rotations.  The plan for the future would be to have both learners from the US and Canada and from Guatemala here at the same time to exchange knowledge, benefiting themselves and their patients.   A satellite internet connection has been donated to allow telemedicine opportunities.