New brochure!

3/3/10, 06:38 pm, posted by Peter Rohloff

We have a brand new tri-fold brochure that you can download here. Please download and distribute widely.

Women's health in Paya'

2/7/10, 04:41 pm, posted by Peter Rohloff

Paya' is one of the remote communites where we provide women's health services. Last week we had the opportunity to provide prenatal and general gynecological services to a number of women there.

Dr. Melinda Dabrowski consults with a patient. Credit: Emily Tummons

Ana Lopez translates for Melinda. Credit: Emily Tummons

Cristalina and Elvia register patients. Credit: Emily Tummons

The view from Paya'. Credit: Emily Tummons

Another view from Paya'. Credit: Emily Tummons

Child nutrition pictures

2/7/10, 04:31 pm, posted by Peter Rohloff

Below please enjoy several pictures from our recent pediatrics trips to conduct well-child checks and development treatment plans for several malnourished children.

Dr. Jane Streigel performs a blood test for anemia. Credit: Emily Tummons

Dr. Mike Hill checks a child's growth chart. Credit: Emily Tummons

Elvia, a community volunteer, waiting for patients to arrive. Credit: Emily Tummons

Elvia checks a child's height. Credit: Emily Tummons

Dr. Mike Hill examines a newborn patient. Credit: Emily Tummons

A healthy two-week old infant. Credit: Emily Tummons

Water project updates

2/7/10, 04:21 pm, posted by Peter Rohloff

Several Wuqu' Kawoq staff and volunteers had the opportunity to visit Socorro to perform pediatric assessments last week. We took a few minutes to visit our water team, who explained to us the process of making and maintaining these filters. It is impressive to see this project develop so quickly; after just a few months already more than half of the filters needed for the community have been constructed. We look forward to exporting this technology to other communities as well!

WK water staff explain the various sediment materials used in filter construction. Credit: Emily Tummons

WK water staff demonstrate the filter assembly line. Credit: Emily Tummons

WK water staff demonstrate the filter assembly line. Credit: Emily Tummons

We were able to video record most of the filter demonstration and we have uploaded it to our YouTube video site. You can view it below:

Socorro site visit and updates

12/31/09, 00:37 am, posted by Anita Chary

Sarah and I just returned to the US after spending a week in Socorro conducting fecal exams, testing children for anemia, and catching up with families in the community. There still appears to be a high incidence of helminth infections, which we are hoping will decline as our clean water project progresses over the next three months. Anemia rates are also high, and we are accordingly exploring new treatment options.

Anita testing children for anemia. Credit: Sarah Messmer

During our home visits, we were able to check up on some of the sicker children of the community and evaluate Wuqu’ Kawoq’s child nutrition program. Community members expressed their content with the work of Mayra and Caty, two social workers who are now responsible for the majority of program implementation. In addition to working with us while we were in Socorro, they worked with community volunteers to deliver Incaparina and dewormers to the community.

Mayra, Caty, Ruben, and Tisha on their way to deliver Incaparina. Credit: Anita Chary

We were pleased to see several children who have made great strides in their growth since Sarah and I left six months ago. With continuous primary care, nutritional supplementation, vitamins, and iron, some of the community’s most severely malnourished infants are now running, jumping, playing, and talking. We had fun visiting with the older children, as well.

Wilber. Credit: Sarah Messmer

Fevin Liset. Credit: Anita Chary

Sarah encourages Jose Antonio to wear his glasses. Credit: Anita Chary

However, we noticed that several infants had grown weaker and sicker since our departure in July. One of Wuqu’ Kawoq’s major findings within this community is that malnutrition begins at about 6 months of age, in part due to delayed introduction and contamination of early complementary foods. We are thus in the process of re-shaping the program to target malnutrition in early infancy.

At the end of the week, we spent some time celebrating the holidays Socorro-style by making tamales with two community leaders, Maria Tahual and Toribia Suhul, who are an integral part of the child nutrition project.

Toribia making tamales. Credit: Anita Chary

Maria making tamales. Credit: Anita Chary

Thanks to the Gephardt Institute for Public Service, Washington University in St. Louis, for contributions to this trip.

Project featured in engineering article!

12/30/09, 11:22 pm, posted by Peter Rohloff

Read about engineering innovations being explored in our water filter projects here.

Water filter construction underway!

12/30/09, 11:17 pm, posted by Anne Kraemer Díaz

The implementation of the Socorro Water project, a collaboration between Wuqu’ Kawoq, Engineers without Borders at the University of Illinois, the Sylvan Lake Canada Rotary Club and the community of Socorro, is underway! From December 10-12, five community members from Socorro attended training near Santiago, Sololá to learn how to construct Bio-Sand Filters for all the families in Socorro. They were trained by members of Servants 4 Him, an organization focused clean water initiatives and brining Bio-Sand filters to communities all over Guatemala. This past week our community collaborators built the first filters for Socorro! The Bio-Sand filters are being constructed in many developing countries as point of use filtration systems. This will allow families to control their access to clean water in their homes. Filters will be located in every home in Socorro so everyone can enjoy the benefits of clean water.

The training of our community collaborators consisted learning in the classroom about the theory and background of bio-sand filters combined with the hands-on training of how to build filters. The classroom learning focused on the importance of water, sanitation, and health and how the filters can be utilized to promote better overall health for the entire family when used correctly. Following classroom learning they practiced building filters by sifting sand, mixing concrete, making filters, and washing materials to do a filter installation. This training enabled them to return to Socorro with a metal filter mold and begin building on December 14th.

On December 28th Anne and a team of six engineers from Engineers without Borders- University of Illinois will travel to Socorro for ten days to collaborate with the community members on filter construction and overall water conservation and health. Over the ten days the team will build filters and talk with each family on use, maintenance, and cleaning of the filters. The team will also paint filters with the children and help each family decide where their filter should be placed in the household so it can be easily accessed. We will post pictures, stories, and videos on this blog in mid-January about this trip- so please check back. We are excited that clean water is now a reality for the families in Socorro in 2010!

Wuqu' Kawoq receives funding for midwife project

12/6/09, 8:34 pm, posted by Peter Rohloff

Wuqu' Kawoq is happy to announce that, for the third year in a row, we have again received funding to continue our ground-breaking work with the ACOTCHI midwifery cooperative. We are exceedingly grateful to the Conservation, Food, and Health Foundation for their continued support of our work.

New Fall Newsletter online

11/9/09, 7:32 pm, posted by Peter Rohloff

A new Wuqu' Kawoq newsletter is now available online here.

Beyond Development Conference - Summary

11/8/09, 11:10 am, posted by Shom Dasgupta

The conference, “Más que desarrollo: construyendo futuros colectivos,” sponsored by Wuqu’ Kawoq, was held in Pa K’in from October 23-25, 2009 and was a huge success. The three-day event was the product of painstaking organization by several WK staff and board members, most notably Wicha, Anne, Emily, Graham and Peter.

Day 1: The presentations on Day 1 were organized around two themes: “Development – models, critiques, and histories,” and “International collaborations.” On this first day, participants eagerly began an exploration that would continue throughout the conference, examining the interfaces between different themes, perspectives and experiences. It was intellectually bracing to watch as people from a diversity of backgrounds – anthropologists, community leaders, midwives, health promoters and other members of global civil society – spoke to one another across the regnant divides in disciplinary focus and context-specific practice, building on each other’s insights to elaborate a unique and at times heated dialogue.

Kedron Thomas, Erika Yax Cujcuj, Anne Kraemer Diaz and Dominga Pic Salazar opened Day 1 with reflections on the first theme. Thomas, a Harvard anthropologist conducting fieldwork on maquiladoras in Tecpan, offered introductory commentary on the basis of her ethnographic investigation of community perspectives, identifying a number of “unforeseen consequences” of supposed “development” projects, such as the breeding of dependence and externally-driven cultural change. Yax Cujcuj’s talk, I think, challenged the idea of development critiqued in Thomas’s, marking one constructive effort to elaborate a different method—and thus alternative histories—of efforts to promote development. Kraemer’s enlightening presentation on the “third sector” - that is, the sum of social phenomena that fall beyond the limits of the State and the market - placed the preceding two within a broader geographic, historical and political-economic context, confirming the pitfalls indicated by Thomas as well as the possibilities exemplified by Yax Cujcuj’s overview of ACOTCHI’s history. Lastly, Pic Salazar’s brief testimony about her community’s struggle for land reform was a poignant reminder of the centrality of women and effective leadership in effecting structural change.

José Toasa, Ana & Carmen Roquel, Sergio Romero and Shom Dasgupta & Magda Sotz, addressed the second theme, “International collaborations,” from their divergent positions. Toasa, who administers Fundación Interamericana’s budget in Guatemala, described the latter’s objectives and methods in providing financial support for community-driven development projects. Ana & Carmen Roquel, health promoters for ALAS, described the articulation between this nationwide provider of community health services, and local communities that face the joint burden of poverty, gender inequality and ethnolinguistic marginalization. Romero, a professor of anthropology at Vanderbilt University, introduced the theme of North-South academic collaboration, describing successes in the promotion of local investigational capacity through individual, programmatic and institutional support. Dasgupta, a community health worker and student of medicine, public health and medical anthropology, offered reflections in Kaqchikel, with translation by Sotz, on the former’s experience of the impotence of engaged scholarship before the grave health problems of the indigenous poor in Guatemala.

The first day of the conference closed with heated debates about the responsibilities of universities and individual academic investigators to their study communities, and about the goodness of fit between allopathic contraceptive services and those who subscribe to “indigenist” Maya cosmovision. Later that evening, several community leaders continued the discussion by expressing misgivings about the claims of US-based investigators who defended the non-involvement of universities in the pragmatic aspects of development work.

Day 2: Apropos to the first theme of the second day of the conference, “Rural areas,” a contingent of attendees from the preceding day decided not to return for the rest of the sessions. In particular, one conference participant related with indignation how several peers had cited the humble ambience of the conference as the reason for their premature departure. Conference organizers were amused at this elegant illustration of the distance that many workers in the development and human rights industries maintain between themselves and the rural poor.

“Rural areas” included presentations by J. Vicente Macario Cosiguá, Erin Beck, Erika Yax Cujcuj, Peter Rohloff and Nelly Zambrano. Macario, who is a public health auxiliary nurse, discussed his work as the leader of a network of community health promoters that receives support from a Catholic mission in Sololá department. He detailed the gaps in government health services, the effects of which are worst in outlying hamlets where Macario lives and works. Beck, a Fulbright recipient and anthropologist from Brown University, presented a detailed and theoretically informed exposition of the limitations of liberal notions of "women's participation" in development, drawing connections to Yax Cujcuj and Pic Salazar's presentations from the day before. Yax Cujcuj described a new collaborative project between ACOTCHI and Wuqu' Kawoq that provides primary care services to women and children in a poor hamlet near Chiq'a'l. Yax Cujcuj discussed the unique challenges and importance of reaching out to remote communities, and detailed their efforts to build trust by engaging the entire community and prioritizing pragmatic services alongside needs assessment. Rohloff, the medical director and founder of Wuqu' Kawoq, reviewed mainstream press reports and scholarly publications on child malnutrition, emphasizing how supposedly neutral science has helped to elide the suffering of Guatemala's indigenous poor. Lastly, Zambrano presented the work of microcredit organization Namaste, which provides microloans in conjunction with wraparound consultation services which she informally described as "a MBA" for cottage industry entrepreneurs.

The second theme of Day 2, "Languages, technology, and human rights," was comprised of presentations by Deborah Greebon, Kara Andrade, J. Maxwell (Ixq'anil), and Diana Santana. Greebon, a Fulbright recipient and expert on Central American educational policy, presented data demonstrating the ongoing failures of bilingual education in Maya-speaking areas of Guatemala. Andrade, a Fulbright recipient and journalist, gave a dynamic introduction to HablaGuate, an effort to promote community journalism through the use of widely available communication technology. Ixq’anil, a professor of anthropology and linguistics at Tulane University, provided a historical and sociological perspective on the place of Maya languages in the plurilingual context of contemporary Guatemala. Lastly, Santana, a Miami-based spokeswoman for Planned Parenthood, sounded a rousing call to integrate community-driven development with the promotion of human rights in healthcare, developing a constructive discourse for combating the oppressive structures facing politically marginalized communities.

Several first-language Maya-speakers offered their personal reflections on the themes of Greebon and Ixq’anil’s talks. One of these contributors, a very close friend and collaborator of this author, shared a sense of shame about speaking Kaqchikel, and thanked foreign Maya-speakers for encouraging the use of Maya languages. In fact, that contributor has since made a point of speaking in Kaqchikel at home so that his son will learn to speak.

Day 3: The final day of the conference allowed a more informal atmosphere for reflection and solidifying connections between participants. Opening the day with a brief recap of the previous two days, the remaining attendees discussed important themes from the conference: the crucial role of funding, the importance of institutional change, linguistic choice as pragmatic solidarity, and the possibility for sharing expertise through strong inter-NGO and inter-community networking. With regard to this last point, several community leaders have reported promising developments that arose as a result of connections established during the conference.

The conference closed with a xukulen, or Maya ceremony, offered by Wuqu’ Kawoq and attendees and presided over by Rolando, an aj q’ij from Tecpán. The closing activity of the conference, a demonstration of the giant kites for which Pa K’in is famous, was a fitting metaphor for the conference. On All Saints’ Day, these kites allow families to imagine alternative modes of communication with their deceased loved ones and ancestors. It is hoped that the conference marks a new beginning for communities and NGOs, fostering imaginative connections and collaborations between them.

Two specific Wuqu’ Kawoq projects that grew out of the conference are an effort to develop a community-friendly guide to NGOs and development resources, as well as a bilingual publication of the conference proceedings.

To learn more about the conference, please see the official website: www.futuroscolectivos.com.

Beyond Development Conference website is up

10/9/09, 9:49 am, posted by Peter Rohloff

Website for the conference is up and can be accessed here.

Beyond Development Conference Flyers - Download and Distribute!

10/1/09, 11:00 am, posted by Peter Rohloff

Beyond Development Conference - October 2009 - Santiago, Sacatepéquez

10/1/09, 11:00 am, posted by Peter Rohloff

Beyond Development: Building collective futures in Guatemala October 23-25, 2009 - Santiago Sacatepéquez, Guatemala

With the signing of the Guatemalan Peace Accords in 1996, hopes were raised among many international and Maya scholars, activists, and community workers that the coming years would see new opportunities for the reversal of the profound health, economic, and social disparities between indigenous and non-indigenous Guatemalans. However, now more than a decade later, very few of these possibilities have materialized. Although there have been small advances in some areas, such as bilingual education, the continued implementation of neoliberal economic policies and the rapid erosion of the public service sector have had a stifling effect. Despite the promises of the Accords, Guatemala to date continues to have one of the lowest rates of social services expenditures in the hemisphere. Most indices of health and economic wellbeing have not improved in the post-war decade, and Maya in Guatemala continue to face the prospect of economic disadvantages, barriers to health care access, and food and water insecurity.

It is against this backdrop that the explosive growth of the development sector in post-war Guatemala must be analyzed. According to some estimates, the number of NGOs working in Guatemala has grown in the last decade from under 2,000 to more than 10,000. Although it is too early to know for certain what the full effects of this industry growth will be, the experiences of many community organizers and development workers, as well as an emerging anthropology and development literature, suggest that many development organizations in Guatemala have had considerable trouble building successful community movements and achieving lasting results.

In this conference, we will bring together international and national scholars, Maya community leaders, and members of the development community to discuss these and other issues related to development, civil society, and the creation of prosocial networks and alternative futures. In particular this gathering is envisioned as a "working conference" designed to foster exchange between local community based organizations and networks and international organizations and scholars. As such, preference will be given to proposals which address issues of accountability and collaboration, as well as those which have the potential to generate new ideas and partnerships.

To inquire about participation in the conference, please email us.

Child malnutrition team

10/1/09, 10:45 am, posted by Peter Rohloff

Here are some pictures of our staff and volunteers from Socorro, who are responsible for managing our child growth surveillance and malnutrition programs there.

DCSSMI launches in Comalapa

9/6/09, 9:44 pm, posted by Peter Rohloff

Some photos from the recent launch of the DCSSMI, the Desarrollo Comunitario Sostenible en Salud Materno Infantil, a pilot project designed to scale up maternal-child health initiatives in areas surrounding San Juan Comalapa. The project is a collaboration between Wuqu Kawoq, ACOTCHI, and VMM.

WK featured in Global Competency website

8/21/09, 6:05 pm, posted by Peter Rohloff

I was recently interviewed for several short film pieces sponsored by the American Counsel on Education to celebrate the 50th anniversary of Title VI legislation in the United States. You can see me talking about Wuqu' Kawoq's vision and work here. Also take some time to check out some of the other interesting videos on the website.

New work with rural women and children in Comalapa

8/11/09, 7:00 pm, posted by Peter Rohloff

There have been a number of recent exciting developments in Wuqu' Kawoq's work in Chiq'a'l (San Juan Comalapa), in partnership with ACOTCHI. Several months ago we received a generous grant from the Pajwell Foundation to expand prenatal care services in the region. In response to feedback from patients and collaborators, we determined that a significant component of this expansion must include outreach to rural villages (aldeas) surrounding Comalapa. For example, we had noticed that, with the recent economic downturn, travel to the central clinic was becoming an economic hardship for rural patients. Consequently, in July of this year, we launched the first of what we hope to be many rural outreach arms designed to complement Wuqu' Kawoq's and ACOTCHI's urban clinical activities.

These activities will be centered on the rural community of Paya', located approximately 7 kilometers from the town center. The community, composed of about 60 families, is heavily agricultural, largely monolingual in Kaqchikel, and has limited access to basic infrastructure. There are no health programs currently operating in the community.

In July, staff from ACOTCHI had a series of intensive meetings with members of the community of Paya'. Eric Sorenson, Wuqu' Kawoq's international volunteer based in Comalapa, was also present at these meetings. We presented our vision of beginning to provide basic primary health services to the community. In a large meeting at which representatives of most families were present, the community voted "yes" to the project.

The remainder of July was spent conducting extensive demographic and health surveys in the community, in an attempt to develop a better sense of the community's most pressing needs. This survey work was conducted by 6 students on ACOTCHI's school of midwifery. As part of their training in midwifery, they have received intensive training in public health concepts and survey methodology, and this survey work was part of their clinical practicum. We are currently in the process of analyzing the valuable data contained in these surveys, and we anticipate that clinical programs will be up and running this fall.

View of the entrance to Paya'

Wuqu' Kawoq and ACOTCHI staff collaborating on survey development

The field survey team posing before beginning the day's work

Members of Paya' voting "yes" on the project

Updates on the Socorro water project

7/28/09, 9:23 pm, posted by Russell Rohloff

The water project in Socorro took a significant change of direction over the last two to three months. Earlier in the year the University of Illinois chapter of Engineers without Borders had almost finished the design and implementation planning of a community-wide water treatment system. It was at that point that our previously willing landowner backed out of a verbal agreement to sell specific land to us to allow construction of the project. A review of other potential parcels did not turn up a good fit for the project flow and pressure needs and the project needed to be reassessed.

The UIUC-EWB team then approached the Wuqu’ Kawoq Board of Directors with a proposal to implement a household-based “point of use” approach. This approach uses the same technology that we were designing around for the community system, but packages it in a 12” x 12” x 36” concrete container. Each unit can supply 1 liter of purified water per minute and are designed to supply the potable water needs for a household of 6 to 10 people. The treatment effectively removes the majority of disease-causing bacteria, viruses, and parasites.

We are currently constructing a test filter and hope to begin project implementation in the late summer. Our plan is to bring two interns on board who will assist us in the in-country implementation of this project using local villagers to construct and install the filter units on-site. Each unit only costs $25 to $50 to construct and outfit and represent a significant cost savings compared to a community system serving 100 to 125 households. If you are interested in supporting the water project in Socorro please indicate that when you send in your contribution.

For more information on the point of use treatment units we recommend the following websites:
www.friendswhocare.ca
www.cawst.org
www.manzwaterinfo.ca

Exciting new book on the Ch'orti' Maya

6/15/09, 4:05 pm, posted by Peter Rohloff

Brent Metz, assistant professor of anthropology at the University of Kansas and Wuqu' Kawoq advisory board member, is co-editor of a recent anthology on the Ch'orti' Maya, published by the University of Florida Press. More information on the book can be found here.

Spring newsletter published

6/15/09, 3:41 pm, posted by Peter Rohloff

Our newsletter for Spring 2009, covering major events from January-April 2009 was mailed out several weeks ago. It can also be downloaded here.

Updates from Socorro

4/22/09, 11:30 am, posted by Anita Chary

In Socorro, one of our health corps volunteers, Shom Dasgupta, recently held nutritional consultations for the children most severely affected by malnutrition. On this trip, Shom brought along a friend and co-worker, Dominga Pic Salazar, who works as a nurse and health promoter in San Lucas Toliman. In the downtime between weighing children and conversing with patients, we were able to bounce ideas off of Dominga, who has a great deal of experience with both community health and development projects. We hope to continue collaborating with the health promoters of San Lucas in the coming months.

With the insights gleaned from this March clinic, we have been working to determine the degree to which supplementing children’s diets with Incaparina, a fortified corn-gruel, is improving their health. In difficult cases, where the children are not growing, we try to identify the social and family factors which may be contributing to the child’s poor health and address them. Overall, we have seen slow but encouraging changes in overall village-wide child growth since beginning Incaparina and vitamin supplementation. We hope to see even more improvements as the program continues throughout this year and into the future.

We are currently evaluating our program and soliciting community input through ethnographic research. Lately we have been focusing our efforts on interviewing the mothers of Socorro, sharing in their experiences of health, poverty, and the challenges of raising children. Through listening to these stories and discussing the difficulties these mothers face, we are coming to understand more fully the needs of the community and the most appropriate ways to combat malnutrition.

Currently the nutrition program is in transition, as volunteer members of the community assume more responsibility for the day-to-day operations. Once we leave for medical school in July, the community will take over administration of the program entirely. Consequently, we have also been devoting a large portion of our time to training some individuals from Socorro to use computers and the Internet. We will all use this method to stay in touch and to communicate child growth data among each other.

Finally, we have also been working to develop a bilingual, user-friendly and comprehensive electronic patient database with the help of Adam Fischer. Adam is a database expert who has generously donated his time and technical skills, as well as computer equipment, to assist us in this task. With the development of this database, we will be able to maintain portable medical records for all childen which can be accessed both locally, for data entry, and also abroad by WK staff.

Wuqu' Kawoq receives funding for prenatal care

3/4/09, 11:30 pm, posted by Peter Rohloff

Wuqu' Kawoq is pleased to announce that we have received new funding from the Pajwell Foundation for our work with midwives and pregnant women in the department of Chimaltenango. Specifically, this funding is targeted to the expansion of prenatal care services in the rural areas where our partner midwifery affiliate ACOTCHI works. We will keep you updated as this exciting work unfolds!

Children of the Americas

3/4/09, 10:34 pm, posted by Sarah Messmer

Anita and I have recently returned from another adventure in the always exciting and ever-changing lives of the two Wuqu’ Kawoq interns: road-tripping across Guatemala with a group of seven surgery patients to take advantage of our collaboration with Children of the Americas (COTA). COTA is a US-based organization that sends a large group of doctors and surgeons to Guatemala for one week each year to take over a national hospital and offer a blitz of free surgeries. This year, the COTA trip landed in the highlands—in Santa Cruz del Quiche—which meant quite a few hours in the car and a bit of unexpected chilly weather for our patients from Socorro. In the end, all of the travel and extra blankets were worth it: all seven of our patients--from Socorro, Comalapa, and Tecpan--are recovering well from their surgeries, and we could not be more grateful to all the hard work and kindness that went into organizing the COTA trip.

COTA brought down truckloads of medical supplies and surgeons of several different specialties—obstetrics, orthopedics, plastics, and general surgery—in order to provide a great range of surgeries to patients. The COTA surgeons were kind enough to allow Anita and me (as future medical students) to watch several of the surgeries. While not watching surgeries or taking care of our group, we worked as interpreters, helping out wherever we could in the general medicine, pre-op, post-op, orthopedic, and dental clinics. We were able to share some of the Guatemalan Spanish idiosyncrasies we have learned along the way: for example, that when a K’ichee’-speaking patient says that their “feet” hurt, they may in fact mean that their legs hurt, since in K’ichee’ the same word is used for both “foot” and “leg.” Although working as translators for many hours a day can be tiring, we had a fantastic time chatting with the patients, working with the doctors and nurses, and learning a great deal about medicine along the way.

We would like to take the opportunity on this blog to send out a great big thank you to all hose who made the COTA trip possible: we, and especially our patients, are very grateful for your hard work!

Nutrition clinics - January

2/4/09, 2:34 pm, posted by Peter Rohloff

Another of our core health volunteers, Shom Dasgupta, visited our child health project in January for three days to perform nutritional evaluations of village children. Working with our field team, including interns Anita and Sarah and the village women who are in the process of learning how to administer the program themselves, he was able to perform in-depth assessments for a number of children. These assessments allow us to individualize our approach to the nutritional needs of each child, thereby providing higher-quality care.

Shom evaluating a child

Point-of-care testing for iron-deficiency anemia

Wuqu' Kawoq obtains funding for child nutrition project

1/6/09, 9:30 am, posted by Peter Rohloff

Wuqu' Kawoq has just received word from the Child Health Foundation that our grant application "Addressing determinants of child malnutrition in a rural Guatemalan village" has been funded. This grant, which represents a significant expansion of our clinical activities in the region of Socorro and Chocolá, is focused on addressing the epidemic rates of childhood growth stunting in the region. It represents yet another effort by us and our community partners to integrate culturally and linguistically appropriate primary care services into the larger context of community revitalization.

Fecal Exams, Incaparina, and Anemia Tests in Socorro

1/6/09, 9:22 am, posted by Anita Chary

One of our major efforts in Socorro over the last few weeks has been anemia screening among children under 14. We have encountered a spectrum of reactions--some kids don't even show that they felt a prick, while others scream and cry so much that it turns into a four person job: I end up sticking the child with the needle, the mom ends up holding the child in her lap, an older sibling coos to quiet the screams, and Sarah squeezes the blood from the finger while sticking it into the Hemoglobin testing machine. One of us simultaneously fumbles around in our backpacks for one of our 150 cartons of Lemonheads, graciously donated to us by Alex Zadjel, which often proves to be the saving grace that makes the wailing stop. Although we have not finished with the tests yet, the rates of anemia so far are alarming. Nearly 90% of the children and several of the pregnant women we have screened so far have anemia, which we are treating with iron pills and drops for younger children.

In other news, after the clinic, we managed to collect all of the remaining fecal samples and are happy to say that we have conducted fecal exams on all of the children under 14 in Socorro. About 30% of kids in the village had parasitic infections, all of which have been treated.

Our other large undertaking of the month was starting to provide nutritional supplements of Incaparina, a fortified corn-based gruel, to children under 5 years of age with the highest risk for severe malnutrition. This so far includes a group of 33 children. Supplementing an additional 20% of their daily caloric intake through incaparina has already made a difference for several of the kids, whose parents are happy to see them getting chubbier and rosy-cheeked, playing with more energy, and attempting to take their first steps. We are also gathering information about families' diets, nutritional habits, and thoughts about receiving food supplements through interviews so that we can better our program and expand our Incaparina operation to include more children in the coming months.

November clinics and other activities

11/23/08, 4:50 pm, posted by Sarah Messmer

Over the last few weeks, Wuqu’ Kawoq staff have been busy all over Guatemala managing four clinics in Comalapa, Santiago, Tecpán, and Socorro.

Peter arrived to Antigua on November 6th with suitcases jam-packed with medicines. We left early the next morning for Comalapa, where we saw about 80 patients over the next two days at the clinic run by the midwives of ACOTCHI. ACOTCHI has recently moved into a new space, and as a part of the “clinic-warming,” children participating in the literacy program jointly sponsored by Wuqu’ Kawoq and ACOTCHI made beaded artwork and vibrant garlands that greet visitors and patients. Here are a few photos of the ACOTCHI-Wuqu’ Kawoq 2008 Exposition:

Wuqu'Kawoq-ACOTCHI art show

Wuqu'Kawoq-ACOTCHI art show

Another highlight of our clinic in Comalapa was the distribution of Tiqaq’omaj qi’, a bilingual (Kaqchikel-Spanish) manual on herbal medicine recently co-authored by Peter Rohloff and Magda Sotz Mux. Below is a photo of Peter in a session with the midwives, who were enthusiastic about the book not only as a medical resource, but also as a tool for literacy classes and study of Kaqchikel, as there are few books available in the language:

Midwife training classes with our new book

After two days in Comalapa, we headed to Santiago, where thanks primarily to the efforts of Wicha, our Santiago field manager, we managed to see several diabetic and elderly patients and made house calls.

The next day, we headed to Tecpán for another clinic managed by ACOTCHI and another midwife training class. As in Comalapa and Santiago, we were able to check up on several of our previous diabetic patients. And as always, working in the clinic was a great learning opportunity for us interns. One of us would sit down with a patient to collect an initial medical history and gather preliminary information, such as blood pressure, pulse, and blood sugar levels. Afterwards, we would accompany the patient into a consultation with Peter, where we learned of the diagnosis and treatment. However, we did not only learn about medical cause-and-effect. The entire clinic was a reminder of the importance of providing medical care in patients’ first languages. While we interns were able to collect medical histories in Spanish, we often observed patients opening up and talking more comfortably and freely about their ailments in Kaqchikel with Peter. In several instances, patients added several important details about their medical problems in the exam room in Kaqchikel.

As in Comalapa, the Tecpán midwives received Tiqaq’omaj qi’ with enthusiasm and had a lively question-and-answer session about various plant uses. The session made it clear that midwives’ roles as community health providers are not restricted to pregnancy and childbirth alone, as the discussion included a great deal of information about diabetic care, recognizing and treating anemia, and both allopathic and herbal treatments of parasitic infections in children and adults.

After six straight days of clinics, we returned to Antigua for a day of planning, logistics, and welcoming the medical team of Peter’s colleagues from Children’s Hospital. And then we set out before dawn on Thursday morning, armed with coffee, to make the drastic climatic transition from the cold highlands to the sweltering lowland sauna of Socorro.

After several weeks of preparation—from leading town meetings to delivering appointment slips and fecal exam bottles—the clinic in Socorro finally arrived. With the help of Meera Boghani, a nutritionist from Children’s Hospital in Boston, Dr. Enid Martinez, a pediatrician also from Children’s, and Jose Pagan, a good-natured immunologist with a knack for weighing children, we managed to pull off a very successful four-day clinic focused on improving the health and nutrition of the women and children of Socorro.

Before delving into the details, here is a glimpse of the Socorro clinic in numbers:

• Approximately 95% of the women showed up for their appointments with all of their children in tow—190 of the 205 total children under 14 passed through our clinic
• We received fecal samples from 142 of the 205 children of Socorro, performed seemingly non-stop fecal exams, and have treated all those with parasitic infections
• All of the most at-risk children for malnutrition, approximately 75 in total, received thorough pediatric check-ups
• All pregnant women of Socorro came in for prenatal exams
• We delivered vitamins to all children, pregnant women, and breast-feeding mothers, including iron supplements to those with anemia
• A toothbrush and tube of toothpaste were given to each child as the beginning of our dental hygiene campaign
• During our four days of work—generally lasting from 8 am until 4 pm each day—we managed to see a grand total of about 300 patients

To give you an idea of the clinic set-up, here is an overview of what a Socorro mother and her children encountered when arriving at the clinic:

First, all children were handed over to Jose and Ruben (a youth from the community) to be weighed, measured, photographed, and given a toothbrush, toothpaste, and their monthly supply of vitamins.

Jose and Ruben

After their heights and weights were plotted on growth curves, the most at-risk children moved on to have individual appointments with Enid and Peter to assess their overall health. During these appointments, Meera stepped in to provide her expert nutritional advice, discussing current eating habits with mothers and determining the most effective food supplementation plan to be implemented in the weeks following the clinic.

Peter seeing patients

Enid and Meera discuss patients

Meanwhile, we interns managed the ever-growing crowd of patients and collected poop samples from incoming mothers. Throughout the day, we conducted fecal exam after fecal exam with our trusty microscope, allowing us to provide mothers with the results and necessary dewormers as soon as possible.

Anita performing fecal exams

Throughout the clinic, we were also assisted greatly by Magda and Paulino, who tirelessly ran errands to buy everything from slide covers to food supplements and tracked down countless patients to deliver medicines and exam results.

Sarah and Mada discuss patients

Paulino

We also are deeply grateful for the help of Maria and her family, who allowed us to invade their house for four days, setting up exam rooms and a makeshift pharmacy in almost every room.

The whole team together

Overall, we are extremely happy with the results of the clinic and want to send out a big thank you to everyone who was involved!

Wuqu' Kawoq receives continued funding for midwife project

11/17/08, 10:14 am, posted by Peter Rohloff

Wuqu' Kawoq has just received word from the Conservation, Food, and Health Foundation that our grant "Training of Indigenous Kaqchikel-speaking Midwives" has been funded for a second year. This training grant is a collaboration with ACOTCHI, one of our major community partners.

The grant is a major expansion of the 2008 program. In additional to offering continuing education for currently practicing midwives, the program in 2009 will establish a pilot midwifery school for young women seeking to begin in the profession. This new pilot training school is an important part of our larger mission to revitalize the indigenous medical professions and enhance transmission of knowledge to younger generations.

Here is a longer quotation from the grant application we wrote which highlights why this is such an important program:

For some decades now, anthropologists, development workers, and medical professionals have been predicting and lamenting the demise of the indigenous midwifery tradition in Guatemala on the basis of three observations. (1) Midwives have no mechanism for self-organization or self-regulation. (2) Most midwives are elderly and do not pass on their knowledge to the younger generation. (3) High rates of illiteracy among midwives impede progress. Based on these predictive metrics, the Wuqu’ Kawoq/ACOTCHI collaboration has demonstrated great success and is poised for continued growth.

First, the ACOTCHI model has effectively demonstrated that midwives in San Juan Comalapa and Tecpán actively seek out professional education and improvement activities. ACOTCHI has broad-based community support and provides valuable community services, as evidenced by clinic attendance statistics which increased from 2,150 to more than 3,000 patients in 2008. The midwives of the cooperative provide direct prenatal and birthing services to over 2,000 women and children, and another 700 persons, mostly family of the affiliate midwives, benefit indirectly through the professional advancement afforded by membership in the cooperative. The cooperative is entirely self-regulated, and the training program is administered independently with minimal support from Wuqu’ Kawoq. In 2008, ACOTCHI successful prosecuted several human rights cases involving discrimination against midwives, thereby demonstrating its ability to act as a professional body at the regional and national level.

Second, the incredible growth and success of the project has attracted the interest of many young women who are interested in becoming midwives. The numbers of those who are interested is such that we have been unable to accommodate all to date. In other words, the ACOTCHI model has renewed interest once again among indigenous youth in the art of midwifery, thereby disproving the prediction that midwifery is about to die out with the current generation of elders. The project is directly contributing to the sustainability of this precious and ancient community health resource.

Updates from Socorro

10/23/08, 4:00 pm, posted by Anita Chary

The last two weeks have been very busy for us! As I write this update, I am surrounded by child growth charts, on which Sarah is plotting the data we have gathered over the past few months to monitor growth and malnutrition among children in Socorro.

Vitamin Program in Socorro

After returning to Guatemala with several heavy suitcases of medicines and vitamins, we interns became a walking house-to-house vitamin delivery service. In about three days, we were able to distribute the month’s supply of vitamins to all of the children and pregnant women of Socorro. Our visits also gave us a chance to check in on children’s health problems. There have been several new cases of diarrhea and skin infections in the past few weeks. We have been able to address some of these problems through performing fecal exams and sending pictures to Peter; many of these children will be seen in our November clinic.

Water Project

Yesterday, we worked with our community collaborator, Paulino Calva, to obtain water samples from the river that will be our source for the water purification project. We then sped off-- as fast as we could on a bus--to Guatemala City, where we submitted the samples for microbiological and chemical tests. As we await the results, we are looking forward to a visit from a member of the team of Engineers Without Borders from the University of Illinois at Urbana-Champaign in late November. At this time, we hope to assess and buy land near the river as our purification site.

Sarah holding water sample bottles

Preparations for November Clinic

We are excited to be in the midst of planning out the November clinics, when a team of doctors will be visiting for several days. Health centers in Guatemala typically do not follow an appointment system and patients often end up waiting for several hours (or even days) to see a healthcare provider. Thus, many of our patients in Socorro are glad to hear that we will be giving out appointments with fixed times and dates. In the clinic, we will focus on seeing children with severe cases of malnutrition and on seeing pregnant women. It will also be the site of our next vitamin distribution, and we hope to provide families with the donations of toothbrushes and toothpastes we received from the dentists of McHenry County of Illinois, from the University of Illinois Chicago College of Dentistry, and from the organization Plak Smacker in the United States.

Getting to Know the Community

As we are new to the area of Socorro, it has been our pleasure to get to know individuals in the community. We have been working very closely with two families in Socorro who have allowed us to use their houses for community meetings and clinics, and last weekend we had the opportunity to attend a family birthday party.

Ana Manuela, the birthday girl and her younger brother, Cristian.

Paulino Calva, our primary collaborator, with his children, nieces, nephews, and granddaughter.

Book released

10/12/08, 4:50 pm, posted by Peter Rohloff

We are proud to announce the release of Tiqaq'omaj qi', our first of hopefully many Mayan language texts. Tiqaq'omaj qi' is a community health resource, mostly dealing with the proper use of herbal medicines, written in Kaqchikel and Spanish. You can read more and/or purchase a copy here.

Photos from recent trip

8/26/08, 9:30 pm, posted by Peter Rohloff

Santiago Sacatepéquez

8/24/08, 9:54 pm, posted by Peter Rohloff

I am writing this update from on airplane flying somewhere over the gulf of Mexico on my way home to Boston. Yesterday I had the pleasure of spending the entire day in Santiago, along with board member Robert Henderson and our two interns Sarah Messmer and Anita Chary.

The purposes of this trip were multiple: (1) Move forward discussions on the acquisition of property. Talks with the owner of the building we are attempting to purchase have gone well. Unfortunately, the legal proceedings to acquire a property in an indigenous town like Santiago, where most properties are not truly deeded, are quite complex. We met with community members to select a lawyer and determine how to proceed. Things are going well, although we suspect that we will not finally close the deal for another 6-8 months or more. In the meantime, we have located a smaller vacant property and the owner is willing to rent it to us at a very reasonable rate. We will be moving into this space in the next month or so. Pictures will follow. (2) See patients, as always! (3) Pay our "tojik." In Maya cosmology the concept of "toj"--debt, responsibility, payment, duty-- is extremely important. Remembering where one comes from and considering where one is going is a critical action that must be performed at regular intervals. The proper way to do this is by participating in a type of ceremony called a kotz'i'j ("flower") or xuk'ulen ("kneeling"). We have been unable to perform one of these ceremonies for some months, as our friend and collaborator Roberta, who is an ajq'ij ("keeper of the days"), had been gravely ill. It was a great pleasure, therefore, to see her well and to reunite for a special ceremony in which the names of all of our patients were read aloud over the fire by Wicha, our Santiago field manager. Photos of this occasion will follow soon!

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August newsletter available

7/20/08, 9:54 pm, posted by Peter Rohloff

Download it here

Introducing the 2008-2009 interns

7/20/08, 9:54 pm, posted by Peter Rohloff

Hello! My name is Sarah Messmer and I am an intern with Wuqu' Kawoq. I recently graduated from the University of Illinois with a degree in Engineering Physics and am planning to study medicine in the fall of 2009. I first got involved with Wuqu' Kawoq when I came to Guatemala as an undergraduate during the winter of 2006 to work with Dr. Rohloff. During that trip, I learned a great deal about resource-poor medical work, linguistics, and the injustices suffered by the Mayans. I am very interested in the mission of Wuqu' Kawoq and the intersection of culture and medicine--particularly the importance of working in the language of the people. After graduating, I decided to come back to Guatemala to continue my work with Wuqu' Kawoq for one year. Anita Chary and I will be working in Socorro and Chocola on a child malnutrition program, water purification project, and other community health development projects. We are very excited to be back in Guatemala, especially because we will be learning K'ichee'! Beyond my interests in health and languages, I am also interested in sustainable agriculture--therefore, Chocola is a great place for me because of the current community agriculture development projects that are going on. I hope to learn more about these projects during my time in Chocola, particularly their impact on the health and well-being of the community. I am very excited to work with Wuqu' Kawoq and hope to continue learning from and working with this organization in the future.

Hello! My name is Anita Chary and I recently graduated from the University of Illinois, Urbana-Champaign as a chemistry and anthropology major. A few years ago over winter break, I had the chance to volunteer in medical clinics in Guatemala with Dr. Rohloff. Afterwards, I wrote my senior thesis in anthropology about Mayan midwifery and healthcare in the highlands. Both experiences exposed me to the high levels of medical need among Mayans and showed me how important it is to respect culture and language in providing healthcare. For years, I had known that I wanted to participate in a service project before entering graduate school, and volunteering with Wuqu' Kawoq seems like the perfect fit. I am very excited to be working on the forefront of social justice and advocacy for indigenous rights. Over the next year, Sarah Messmer and I will be learning K'ichee' and working together on a child malnutrition project in Socorro, Suchitepéquez. We will be writing a blog about our experiences (available at matyox.blogspot.com) and plan to create short films about indigenous experiences of healthcare. As I am currently applying to medical school, I hope that this internship marks the beginning of my long-term involvement with Wuqu' Kawoq.

May-June updates

6/03/08, 9:45 am, posted by Peter Rohloff

I am sitting in La Aurora airport in Guatemala City writing this update. Flights have been cancelled due to a number of hurricane-related rains squalls, so I have some time to kill. I am just finishing up a short 5 day trip that we put together mostly for administrative purposes (meaning lots of meetings, all weekend long).

ACOTCHI. On Friday I went to Comalapa to meet with the ACOTCHI board of directors, as we are trying to put together our common plan for the coming year or two. A major focus of the next few months will be securing continued funding for the training classes in 2009, which we feel fairly confident that we will be able to do, as our data are compelling. Additionally, however, we are really interesting in getting the concept of a midwifery "school" off the ground, as we have a large cohort of brand-new midwives, many of whom have not yet attended deliveries independently. I will probably be shopping this idea around to some funders in the next few months as well. Also in collaboration with ACOTCHI, we have managed to secure an excellent source of low-cost, high-quality medications in Guatemala. This is a major step forward, because it will allow us to avoid the headache of hand-carrying drugs, as well as putting this aspect of our programs more squarely in the hands of our local staff, which is where it belongs.

It remains as always extraordinarily stimulating to be able to hang out with the ACOTCHI folks. It is quite common in anthropology and other circles in Guatemala to bemoan the demise of the traditional health provider. The evidence used to predict this sad fate is three-fold: (1) Midwives are all old and do not pass on their knowledge to the next generation; (2) Midwives have no mechanism for self-organization or self-regulation; (3) High rates of illiteracy keep midwives from moving forward on the national stage. On the contrary, in our work with ACOTCHI, more than 25% of our affiliates are young women just beginning to learn the trade, the organization itself is strongly self-regulated and making good first steps toward sustainability, and many of our illiterate midwives are enthusiastically attending literacy classes.

Pa K'in. On Saturday, we had a clinic in Santiago. This included a brief review of the diabetic patients, but most of our time was devoted to a number of interesting new cases and complicated old ones. A few of these cases illustrate the larger problems of lack of access to care that we continue to try to address in our work. For example, we have one young woman, about 20 years old, who has had one leg amputated. She has a genetic nerve disorder which led to the development of a foot ulcer. Because she had no money to pay for antibiotics, this ulcer got so large that she had to have the leg amputated when she was about 16 years old. She came to us just a few months ago, because she was starting to develop an infected ulcer on the other foot and was afraid she was going to lose it as well. We were able to successfully treat the infection, as well as make some wound care suggestions. The ulcer is nicely healed at this point.

Another case is a young man who suffers from incapacitating agoraphobia and panic attacks. As a result of this condition, he has been unable to work for almost 10 years and, in fact, never leaves his bedroom. The fact that he does not work places considerable financial strain on his family, and his wife also is at her wits' end. He has had no effective treatment, mostly because there is no access to psychiatrists nor to basic psychotropic medications in Guatemala. For those well-connected few who do manage to find a psychiatrist who will see them, they quickly find that the requisite medications are among the most expensive they have ever had to purchase. For example, a generic antidepressant in Guatemala can easily cost the equivalent of two weeks' salary every month. Our treatment goal for this unfortunate man will be to find a steady source of affordable medications in the United States and get him hooked up as quickly as possible.

In other exciting news, it looks like we are approaching an agreement with the owner of a property in Santiago that we are attempting to purchase. This property is quite large, and would allow us to expand our services in a number of importants ways, including stocking a larger pharmacy, setting up a diagnostic laboratory, and have community space for health training classes. We will keep you informed of developments.

On "Alternative Medicine." Recently a friend of ours from Santiago went to see a chiropractor in Guatemala City. This was apparently after seeing an ad for relief of back pain. She describes the strangeness of the experience, especially of having someone pull on her neck, which she feels probably made things worse. Also, she called me after this appointment to ask my advice; the chiropractor had told her that she had back pain because her back molars where compressing her jaw and neck and, therefore, she had to get them pulled. This concerned her greatly, and she did not understand why she had to get her perfectly good teeth pulled.

What this shows is the number of cultural barriers presented to her by such a foreign medical practice. In particular for me it highlights what I perceive as a big problem in the area of current talk about traditional indigenous medicinal practices. Namely, "complementary and alternative medicine" (CAM) has become quite fashionable on the international scene, and this is tending to get rolled up with talk about traditional indigenous medicine, as if they were the same thing. Just to give one example, right now there is a good bit of funding available to teach acupuncture to Maya. There is no discussion at all about whether or not this is a helpful or useful thing to do. Rather, it is assumed that because they are "into" their own traditional medical practices they will also be "into" acupuncture.

The point here is not whether or acupuncture is helpful or not, but rather that we want to resist the tendency to conflate indigenous medical wisdom with all the various things that go under the fashionable heading of "complementary and alternative medicine". Although there certainly are similarities between CAM and indigenous medical practices, to assume that they are natural blood relatives without any sort of questioning is irresponsible, and also another example of telling indigenous people who they are and what they should do. CAM springs out of the luxury of postindustrial society, where we have now in our time of long and healthy lives seen fit to question and deconstruct the assumptions of our dominant medical culture. But for Maya, who have life expectancies more than 20 years less than us and incomes a fraction of ours, traditional medicines are neither alternative nor complementary, they are just what there is available at hand, at relatively low cost. Nor do they engage in the use of traditional remedies out of a sort of critique of Occidental instrumentalism, as we do with CAM. As our own research and that of others also has shown, they will use any and all remedies, including the most invasive, chemicalized ones, if they can afford them, if they trust the referring provider, and if they think there is a chance it will keep them alive. This is a dynamic of need, and one of poverty, and that is why we cannot conflate it with CAM.

Advisory Board. On Sunday, we had our first reunion of the Wuqu' Kawoq advisory board, which has representatives from each of the various towns we work in. Many of the members of the board work directly for Wuqu' Kawoq, but others are from ACOTCHI, or are affiliated with other NGOs. The purpose of this board is to guide Wuqu' Kawoq's programs and also to serve as a forum for folks from across the region to get to know the resources available and problems confronted in the various places we work. This is a tremendously productive activity, and one which all the participants enjoy. The people we work with have many experiences and insights that they are anxious to share with others. Just to give one example, a large portion of the discussion on Sunday had to do with the possibility of expanding ACOTCHI's midwife organizing work into all the other represented towns. We plan to have meets of the board every few months, both to keep all members informed about projects that they are not involved with day-to-day and also to maintain a forum for problem-solving, critical thinking, and planning for the future.

Socorro. Finally, on Monday we were in Socorro for the usual clinic but also and more importantly for a brief community meeting to bring folks up to speed on the water project, as well as on the child health work that Anita and Sarah will be doing there starting in July. It has been raining nonstop for 5 days, and the sound of rain beating on sheet metal roofs makes it almost impossible to hold a meeting without shouting, but all in attendance were content to be there. What's more, we prefer the rain to the scorching heat.

Grant-writing season is upon us

5/16/08, 9:31 pm, posted by Peter Rohloff

We apologize for the lack of a regular update in some time, but we have been very busy arranging plans for summer projects and also submitting all of the grant applications, which seem to all come due in late June and early July.

We were in Guatemala at the end of April for the usual round of adminstrative visits and also medical consultations. We saw about 200 patients, a rather light load actually, in the usual venues, including subspecialty consultations in pediatrics and gynecology with ACOTCHI, house calls to diabetics and bed-ridden elderly in Pa K'in, and child malnutrition visits in Socorro.Medically-speaking, there have been several gratifying experiences lately. The first has been our increasing success at making referral connections up to tertiary centers in Guatemala City. It has taken a long time to begin to develop this network, but it is nice to see it working. In one case, we had a woman pregnant with twins who had severe preeclampsia; we were able to participate in arranging transfer to a competent center where she delivered by cesarean and, after a three week hospital stay due to prematurity, her and the two identical twin boys were discharged in good health. In a second case, we encountered an 11 year old girl with severe kidney failure who were able to transfer to a specialist; she is doing much better after a brief hospital stay and is getting good followup.

Due mostly to the hard work of Wicha, our Pa K'in coordinator, we have begun to implement insulin therapy with our most severe diabetics, and the results and general compliance and satisfaction are excellent. Insulin therapy has been up to now a very frustrating experience for us, as the networks for ensuring follow-up and monitoring have not been in place. However, our health promoters are now very well-trained, and they are doing an excellent job.

The Engineers without Borders group that is collaborating with us on the potable water project in Socorro has released their final report and project recommendations. We can now see our way clear to a water systems solution, probably by early 2009, as long as we can get all the funding to fall into place. This project is essential to the health and well-being of this extremely impoverished village, where nearly all the residents suffer from chronic diarrhea and other consequences of unsafe water and where more than 50% of the children have growth stunting.

Very soon, you will become acquainted with the two newest additions to our staff. Sarah Messmer and Anita Chary will be Wuqu' Kawoq interns starting in July 2008. They will be primarily responsible for administering child health programming on the coast, as well as more broadly interfacing with all aspects of our work in K'ichee' speaking towns (Socorro, Chocolá, and environs).

Magda in the United States!

4/22/08, 10:47 am, posted by Peter Rohloff

March-April were busy months for some of us, as we were hosting the visit of Magda Sotz Mux, our friend and collaborator from Chiq'a'l, on her first visit to the United States. Wuqu' Kawoq helped to arrange a visiting scholarship for her at the University of Illinois, where she had a chance to give multiple lectures on life in Guatemala, development work, and of course weaving. She also made a side trip to the University of Kansas to visit with textiles and anthropology faculty there, as well as make guest appearances in Kaqchikel language classes.

The academic highlights of the month-long trip included a very well-received panel about language revitalization on the American continent (see promotional materials here) and a textiles exhibit at the Spurlock Museum with associated weaving demonstrations and lectures (more info here and here). These events were made possible through the support and collaboration of our friends in the Spurlock Museum and the Center for Latin American and Caribbean Studies at the University of Illinois and the Department of Anthropology and Center for Latin American Studies at the University of Kansas.

In addition to Magda's academic activities during the month, she also had many opportunities to fundraise both formally and informally for Wuqu' Kawoq and, as a result, we have had a successful fundraising month!

I have including a few pictures from some of the weaving events at the University of Illinois, and videos of this and other elements of Magda's stay in the United States can be viewed on our YouTube site.

Magda weaving in the museum/credit S. Steiner


More weaving/credit S. Steiner


Setting up the loom/credit S. Steinger


Magda with Peter at a university function/credit A. Brandon

Midwife training

3/28/08, 9:46 am, posted by Peter Rohloff

Several of us had the opportunity to be together working in Guatemala in the weeks leading up to Semana Santa. This included the usual suspects such as myself and Anne Kraemer, but we also had a return visit from Pat O'Brien from the Sylvan Lake Rotary Club, who is helping us to pursue some infrastructure solutions in Pa K'in. Part of this has involved looking at properties and engaging in fierce price negotiations. This is not the most enjoyable part of our job, but it is very nice to see how excited community members are at the prospect of having "our own" space.

For my own part, I was in country for just over three weeks, and I had the opportunity not only run the usual clinics (two in Socorro, two in Tecpán, two in Chiq'al, two in Pa K'in), but also to just some business done - community meetings, strategizing with the ACOTCHI board of directors, meeting with physicians and other interested parties. The highlight was being able to spend one day hanging out in midwife training without any duties other than picture taking. Some of these are included here.

Erika teaching the class


Following along in the Libros para Parteras text


Lots of joking


Role-playing patients interviews

It is high summer in Guatemala right now, which means hot days and cold nights. In Chiq'al and other highland towns, the bean crop is in flower, as can be seen here in these pictures taken outside the front door of the home of our friend and colleague Magda.

March Newsletter

2/21/08, 9:37 pm, posted by Peter Rohloff

Our March 2008 newsletter can be downloaded here

Another trip to Guatemala, video work, and more

2/6/08, 4:34 pm, posted by Peter Rohloff

We had another very successful whirlwind trip Jan 27-Feb 2.

Arriving on Sunday was pleasant, as I had not actually scheduled any work for that day, so it was much more relaxing than last time. It was also very exciting to be able to follow up on the patients who we sent to the COTA jornada in Tiquisate Jan 19. COTA is a very impressive surgery NGO that makes one mammoth trip to Guatemala every year to do hundreds of surgeries. We have established a good relationship with them, and they were kind enough to see several of our referrals during their trip. Additionally they donated hundreds of dollars worth of insulin and pediatric formulation lasix and digoxin. These are desperately needed, as we have several children with diabetes and others with congenital heart conditions.

On Monday, we were in Santiago to see the usual array of diabetics and other long-standing patients. We also had extra time to see several new patients. The most tragic of these was a young woman, perhaps 35 years old, with a massive, ulcerated parotid gland tumor perhaps 25 cm in diameter. She has been lying in bed for months as the tumor grew and grew and now can no longer eat solid foods. Apparently she did have an evaluation at INCAN, the national cancer institute, and had a CT scan and MRI, both of which she showed to us. No further interventions were performed, however, and it is unclear whether this is because the physicians told her the tumor was inoperable or because the amount of money required was beyond her reach.

Tuesday Anne Kraemer and I were in Socorro, where we saw a very large number of patients, about 80 I think, as well as got some general business done regarding the water project. Wednesday we had a site visit from Heart to Heart International in Santiago to show off mostly some of our work with diabetics there. Thursday and Friday I was in Comalapa and Tecpán, respectively, working with the midwifes in part doing follow-up for some of the patients that we saw at the beginning of January and in part seeing new patients as well. We saw about 30 patients in each location, and we also got a good deal of business done, as Anne and I had a long meeting with the board of directors for ACOTCHI.

On Saturday, I flew to Austin, where I spent two days working on various media projects with Laura Welch, our trustworthy media expert. One of the results of this was the new video spot which you can see embedded on this webpage or by going here . We also developed some new ideas for website architecture, which you should see unfolding over the coming weeks, and also worked on some of the other video projects which we have in the works.

More photographs

1/22/08, 6:33 am, posted by Peter Rohloff

Some excellent photographs, courtesy of Catherine Szalkowski.

Photographs and feedback

1/21/08, 10:42 pm, posted by Peter Rohloff

We continue to receive positive feedback from our recent trip from both our on-site partners and our United States-based participants. Dr Malcolm Hill, our pediatrician, writes:

I am honored to have had the opportunity to work with Cat, Emily, Hannah , Melinda , Kevin , Olga,Pat and Peter. We functioned well together and were a very effiecient MASH unit. I also want to thank the ACOTCHI midwives for their wonderful hospitality ... especially the incredible meals that they provided. I look forward to working with everyone in the future.

He also sends along the following pictures:

Finally, Catherine Szalkowski, the photojournalist who accompanied us on the most recent trip, is working through her images. We expect many more later, but for now you can visit her blog here to see a few samples.

Trip updates!

1/15/08, 6:35 pm, posted by Peter Rohloff

On Saturday, January 5, numerous friends and partners converged on La Antigua, Guatemala, including members of the UIUC Engineers without Borders, physicians from the Carle Clinic Association, and members of the Sylvan Lake Rotary Club. The purposes for this meeting were numerous, but included exploration of partnership opportunities with the Rotary; kickoff of the engineering component of our water and sanitation project in Socorro, San Pablo Jocopilas; and running of a subspecialty clinic in collaboration with our midwifery partner ACOTCHI.

I cannot speak at this point to the specifics of how all of these various activities unfolded over the week, as we are yet to have time to regroup and debrief. Consequently, I will just write briefly about the medicine side of things, as that is the part that I was specifically in charge of. Other components of the trip were run by other board members, and we will await blog postings from them. Also forthcoming will be a number of pictures, as we had the good fortune of having on board a professional photojournalist for the trip.

On Saturday evening, we took a trip to Pa K'in for an inaugural ceremony with our friend who is an ajq'ij (Maya spiritual guide) Roberta. We are in the habit of having a large ceremony on January 1st of every year, which is usually highly anticipated by the community, but scheduling problems kept us out of the country until January 5.

On Sunday, January 6, the physicans took a field trip to see our projects in Pa K'in. The purpose of their visit was to provide critique and perspective, and to help us prioritize how to grow this project in the most efficient way possible. Their feedback on essential medications, patient management, and other logistical issues will be most valuable over the coming months.

After this short day, we took a bus to Chiq'a'l Sunday evening in preparation for the real heart of the week, which was subspecialty work (pediatrics and gynecology) in Tecpán and Chiq'a'l with ACOTCHI. We saw patients for three days in Chiq'a'l and two days in Tecpán, entirely in Kaqchikel, with myself and Emily Tummons translating for our pediatrican Mike Hill and our gynecologist Melinda Dabrowski. Although we have been working with ACOTCHI for some time, this has previously been mostly in the realm of training and capacity-building. This was our first of what will become ongoing attempts to provide regular specialist contact for their patients, and it went very well. The pace was slow and leisurely, with much laughing and fun, and we provided a wide range of free medications and diagnostic services in addition to consults.

Two half-days during the week, one in Tecpán and one in Chiq'a'l, were also dedicated to midwife training. As part of our grant from the Conservation, Food, and Health Foundation, we are trying to foster regular training connections between North American medical specialists and the midwifes. In part these connections are designed to show the healthy, collegial ways in which physicans can interact with midwives--something that is sorely lacking in Guatemala. Additionally, as these sessions are all conducted in Kaqchikel, they are designed to introduce midwives to some themes in maternal and child health in a way that is comprehensible to them--most training sessions in Guatemala are conducted in Spanish and, as a result, much is lost on the participants. The training themes for this week included neonatal resuscitation and postpartum hemorrhage.

The latter theme of hemorrhage also served as a kick-off for another of our midwifery collaborative projects, which is the introduction of misoprostol (kindly donated by US organizations) into home-based midwifery practices, as a way to reduce the in-home maternal mortality rates.

The week concluded on a high-note in Tecpán with a field-trip and formal exchange of thanks and gifts at Iximche', the ruins of the Kaqchikel empire.

Newsletter available

12/26/2007, 1:15 pm, posted by Peter Rohloff

Greetings in the new year! Our first newsletter has just been published and mail to all current donors and supporters. If you have not received your copy, just send us an email to let us know! Alternatively, it can be downloaded here. Stay tuned for other updates soon, as we have a number of engineering and medical trips scheduled for the first several weeks of January.

Wuqu' Kawoq receives notification of grant funding

12/08/2007, 10:17 am, posted by Peter Rohloff

Wuqu' Kawoq has just received word that its grant application entitled Training of indigenous Kaqchikel-speaking midwives in Guatemala has just been funded at a level of nearly $10,000 by the Conservation, Food, and Health Foundation. This grant will provides support for our training programs in San Juan Comalapa and Tecpán working with the Associación de Comadronas Tradicionales de Chimaltenango. This training program is unique in two ways: First, all training is conducted in the native language, Kaqchikel, of the participants themselves. Second, an integrated and sophisticated data collection and evaluative component is built into the program. We thank the CFH foundation for its support, which will go a long way toward developing culturally appropriate, community-based health education efforts in the region.

Thanksgiving Dash

12/02/2007, 02:01pm, posted by Peter Rohloff

I was in Guatemala for a lightning trip over Thanksgiving, November 22-25. There was a lot of work to be done.

I was picked up at 6 am as I arrived in the airport by Ernesto, whom Anne and I feel is perhaps Guatemala's best driver-for-hire. We went straight to the San Antonio Suchitepéquez-Chocolá region, where we spent the day seeing patients in our Socorro project. As we are now entering the summer, we were able to work all day without dashing around avoiding the rain. I took advantage of having a vehicle and driver to visit some friends and collaborators from some of San Antonio's eastern aldeas, which are Kaqchikel speaking. We were not able to do this without providing some medical care of course, but it was mostly just sitting around, talking about life and plans for future collaborations. I immensely enjoy San Antonio's Kaqchikel dialect, which has taken on something of the neighboring K'iche's crisp delivery while still remaining pure Kaqchikel.

Also in Socorro, we held a community meeting to finalize plans for the visit from the Engineer without Borders group (University of Illinois chapter), who will be down in January to make a preliminary site assessment for a drinking water system. After finishing up in Socorro, we ran up the hill to Chocolá, where Anne (our board member currently living in Chocolá) had arranged for us to see a few patients as well. We do not have a project in Chocolá strictly speaking, but we have been asked to provide advisement and oversight for a medical project being developed by one of our collaborating NGO partners, Semillas Para El Futuro. Consequently, I have been spending some time there when able, trying to get to know midwifes and other community leaders.

One of the most difficult cases we saw this day was a young boy with type I diabetes. This is an extraordinarily difficult thing to take care of in Guatemala, as access to blood-testing equipment, insulin, and the like is limited and these supplies, even if available, are very expensive. The mother is currently spending about 14,000 Q yearly on medicines, which is a huge amount. We will try to help her simplify and optimize his medication regimen and will arrange an appointment with our pediatrician in January.

We spent the night with Anne, and were up at 4:30 am Friday morning in order to make it over to Comalapa before 9 am. In Comalapa, we gave a half-day training session to the assembled midwives which was a continuation of the sessions we gave in October. In the afternoon we had a planning meeting with their Board of Directors, Magda (our Comalapa field manager), and myself to plan the clinic week in January. We also finalized arrangements for our maternal-child health survey, which Magda will begin working on this month. Friday night I was back to Antigua for a dinner meeting with Earl and Susanne, board members from Semillas Para El Futuro to discuss our collaborative efforts in the Chocolá region.

Saturday, the final working day of the trip, saw us in Santiago, where we saw mostly established patients and reviewed the diabetes management program with Wicha, our field manager who is running this project. Most of our diabetics are doing very well and feeling great. There are a few however, who have not been taking their medicine nor watching their diet very well. This is, in part, why we have brought Wicha on board, to keep an eye on them, and she is doing an excellent job. Already a few patients who were previously not very adherent to their regimens are showing marked improvements, because of the weekly visits she makes to check in on them.

Sunday I flew back to Chicago. When I landed, the immigration agent remarked, referring to my passport, "Looks like you've got a few miles on this thing!" Which is the truth.

Peter's trip October 2007

11/04/2007, 04:50pm, posted by Peter Rohloff

October was a busy month for me. I was in Guatemala the week of October 14th.

Part of this trip was spent in Pa K'in, where we were attempting to iron out the bugs in our diabetes program. Wicha is now in charge of this, and she is doing a great job. Every diabetic in the program is receiving weekly visits now, to reinforce the need to continue taking medicines regularly and to check blood sugars. One of the greatest challenges to diabetic programs anywhere in the world, not just Guatemala, is that people stopping taking medicines or adhering to their diet when they start feeling better. Wicha is in charge of making sure this does not happen.

We had an emotional encounter with one family. The matriarch of this family has advanced Parkinson's and she has been progressively declining. In the space between this and our last visit, she has taken to bed and is refusing food and drink and drifting in and out of consciousness. The family was tearful and effusively thankful for "all that we had done" for their mother. Actually, we have done nothing for her medically; we have simply tried to be a supportive presence.

Another part of the trip was spent in Chiq'a'l with Ixkamey's family. Part of this trip was personal, since I am very close to her family and enjoy spending time with them. Ixkamey and I talked a lot of business too, since she is heading up all of our census and survey work in Chiq'a'l and elsewhere. We are working through the bugs of two large survey projects we are planning for this winter.

I spent one day in the Socorro down on the Bocacosta. We have an exciting potable water project in the works there. The University of Illinois Engineers Without Borders will be doing the system design and implementation, and Wuqu' Kawoq will be providing the community connection and doing the fundraising. Most of the day was spent with friend and colleagues from the village laying the groundwork for this.

Finally, I spent two days teaching midwives about the safe and effective use of herbal medicines. One day was spent in Iximché (Tecpan) and the other in Chiq'a'l. Both groups of midwives were very engaged and very smart, and the sessions were so successful that we have a second round scheduled for November (Thanksgiving). I hope to have some pictures of these classes up soon. We also delivered 50 copies of the Hesperian Foundation manual to the midwives during these sessions.

September updates

9/07/2007, 02:30pm, posted by Peter Rohloff

Collaboration with midwives

Our relationship with the ACOTCHI cooperative in Comalapa continues to evolve. We have recently built a a new ACOTCHI website, which you can see in its nearly-completed form at the link above in our menu bar.

Recently we purchased 50 copies of the Hesperian Foundation's Book for Midwives, which will be given free of charge to the ACOTCHI members. This represents half of our goal of 100 copies this year. Feel free to donate specifically to this at the 'help' tab above if you would like to see us meet this goal this year!

Recently, we also purchased equipment for ACOTCHI for the measurement of blood glucose and urine analysis, two very important items in any high-quality program of prenatal care. Just this last week we donated a high-quality microscope, which will permit them to perform more essential blood, urine, and fecal tests, such as for parasites and other infections.

New focus in Santiago

At the August board meeting, the future and direction of the work in Santiago was discussed, and the decision was made to exert effort to expand primarily in the direction of diabetes-related care, with a strong focus on community education classes and the training of local health promoters. Currently, the roster of regular patients is 150, of whom 57 are handicapped or very elderly and therefore visited in the home. We have 16 diabetic patients who are all received regular home visits, nutritional education, glucose testing, and financial support for medication purchasing. We would like to expand this number to over 50 patients this year, but your help is needed to make this happen!

In other exciting news, this week we hired our first official local employee, who will be overseeing the diabetes program as it grows, performing all the glucose testing, education, and intake of new patients as this program grows.

Clean water

Peter Rohloff and Anne Kraemer have been working on developing a clean water solution for one of our small partner communities on the Boca Costa. Recent work has including preliminary water quality analysis of several potential natural spring sources, a community-wide census and survey of water source and usage needs, and, most excitingly, a developing partnership with the University of Illinois Engineers Without Borders chapter, which has agreed to take on the project.

Maternal-Child Health Census

Wuqu' Kawoq has just taken on a major new project in Comalapa and Tecpan. In partnership with ACOTCHI, we will be performing a large ethnographic study designed to assess current midwifery practices and diagnoses major deficiencies in practice. Interviews in dozens of aldeas in both town will be conducted by locally-based collaborators (in Kaqchikel, of course) with both practicing midwives and their patients. This project has a planned start date of November 2007.

Training sessions

Peter Rohloff, our executive director, will be giving a training session in Comalapa on Sept 18 on the identification of parasites in fecal samples. He has two more training sessions scheduled on the safe and effective use of medicinal plants, one in Comalapa on October 16th and the other in Tecpan on October 18th.