I applied my Newcomb-Tulane College grant funding to finance a 2-month long summer internship with Asociación Manos Abiertas (AMA), a health clinic in Ciudad Vieja, Guatemala that provides a variety of health services for women. Services include gynecological consultations, education about sexual and reproductive health, assistance during natural births, and free pediatric care. In a country where only 31% of women have a health professional attending their birth, AMA provides a safe and supportive environment for women to experience a natural, humanized birth outside of a hospital. On call 24/7, I spent most of the summer with two highly trained midwives and assisted a total of 5 births. I provided assistance to the mother and midwives to ensure the birthing room was comfortable and properly equipped. When there wasn’t a birth, I assisted gynecological appointments. I observed many pap smears, IUD placements, ultrasounds, and more. I also learned how to measure the patient’s blood pressure and weight, test hemoglobin levels, give birth control injections, and find the fetal heartbeat.

As an aspiring physician, this experience allowed me to dip my toes into the water of providing healthcare in a rural setting. Additionally, I was inspired by the employees’ genuine, caring treatment of each patient; AMA offers equal health care to any woman that walks in, regardless of their ability to pay. As a public health major, it was eye opening to observe first-hand the stark contrasts between health care in Ciudad Vieja and the United States. Firstly, the transparency of cost of health care was very surprising to me. Each service had a set price, with a gynecological consultation costing 40 quetzals (~ $5 USD), birth control pills costing 25 quetzals (~ $3 USD), and a natural childbirth costing 2000 quetzals (~ $300 USD). Additionally, AMA prefers natural treatments to medicinal ones; women often left with herbs and nutritional advice to cure their ailments unless pharmaceutical drugs were deemed absolutely necessary. The cultural differences of the clientele in Ciudad Vieja were noticeable from those I have seen in the U.S. Many of the pregnant women who entered the clinic were under 20 years old, anemic/malnourished, and uninformed about family planning and childbirth. Finally, as a Spanish minor, I was immersed in a Spanish environment with very few English speakers. The consultations were completely in Spanish and challenged me to learn and communicate with many new medical terms different from my native tongue.

Overall, I cannot think of an experience more congruent with my aspirations as a future health care provider. With a gratitude for rural healthcare, a proficiency in Spanish, and a knowledge of gynecological services, I feel extremely motivated to promote and provide healthcare for women in the future.

Written by Amanda Strang, recipient of a Dean’s Grant sponsored by CELT, 2018-2019