When a doctor on Doel Salcedo’s team in rural Guatemala began telling a patient to put all of her clothes and bedsheets in a washing machine and wash them in hot water, Salcedo gently suggested she reconsider her advice.
“First of all, they don’t have a washing machine. Second, to get hot water, they have to heat it up in a bucket somehow,” said the medical interpreter and Team Rubicon volunteer. “There are so many basic things that we take for granted,” Doel said, reflecting on his time serving as team leader and medical interpreter during Team Rubicon’s Operation Resolute Sentinel in June.
Salcedo was one of 13 Team Rubicon volunteers, or Greyshirts, who deployed in June to provide medical care to underserved, vulnerable communities in rural northeast Guatemala. The operation was a collaborative effort between Team Rubicon, the Guatemalan Ministry of Health, and the U.S. Southern Command.
In addition to providing humanitarian aid, the American organizations hoped to develop relationships with Guatemala officials so that if a disaster strikes in the future, they already have contacts in the local area and are familiar with the country and its infrastructure. In fact, in 2018 25 Greyshirts deployed to Guatemala where they served 4,913 patients.
A One Month Reprieve from Voting for Who Would Get Medical Care
What the two waves of medical teams found during the month-long operation was that medical infrastructure in Guatemala is stretched thin, not just in durable equipment but in personnel as well.
“There’s often only one doctor going out and about in the community, and this doctor doesn’t have the capacity to see many patients,” Salcedo said. “And patients will not go into town, because they’ll get charged a ton of a ton of money to see a doctor. So, the Ministry of Health decided to go out to the communities and provide these services.”
Without outside help from organizations like Team Rubicon, most of the rural villages don’t have access to doctors at all. In one area, explained nurse and Greyshirt Clara Wittman, there was a doctor who came in monthly but would only see 10 patients a day. “Every village would have to vote to see who got to see him that time around.”
Enter Team Rubicon. With the help of local health officials, military medical teams and Team Rubicon would take over a small school and open a three-room clinic. The military ran one exam room and a pharmacy, while Team Rubicon operated the other exam room. The Ministry of Health took responsibility for registration and record keeping.
“The main goal was to provide basic preventive care—vaccinations, diabetes screening and STD tests, that kind of thing,” Salcedo said. “And anyone from the community could come in and see a doctor for what we would consider annual wellness exams.”
Volunteer Medical Service Becomes a Dream Fulfilled
When a traveling nurse told Clara Wittman about the work he had been doing with Team Rubicon’s international medical teams, he didn’t need to make a pitch to recruit her. Wittman had been dreaming of doing international medical work even before she went to school to become an ER nurse. Soon, she was a registered Greyshirt; before long she was on a plane to Guatemala for her first op.
Though the op was a dream fulfilled, it was not without its challenges. When word from the Ministry of Health failed to come down that the medical teams were en route to one town, someone mounted a loudspeaker on a truck and drove around announcing there would be a free clinic the following week. “At first it was a little slow. But as people came through the first day, word started spreading. By the second and third days, we were jam-packed,” chuckled Wittman.
Over-the-Counter But Not Overlooked
Many of the clinic patients Whitman saw presented with similar concerns. “There’s a lot of general muscle aches and pains from working all day in the field, and then a lot of gastritis reflux kind of symptoms,” she said. Doling out things like multivitamins, ibuprofen, and antacids became a matter of routine.
Such over-the-counter treatments may be commonplace in the United States, but they can have a profound impact in these rural communities.
“There are people who have been in pain for years and years and years, and they’re just happy to get a handful of ibuprofen and have somebody tell them what the pain was probably from. Just knowing where it comes from gave a lot of relief to some people,” she said.
While Wittman was impressed by how well the military, Team Rubicon, and local officials worked together, it was the work ethic of the local nurses that particularly impressed her. “They were putting in seven days a week, daylight to sunset or later,” she said. “And they had to fill so many different roles by necessity. The nurses were doing all the evaluations, testing, prescribing medications, dispensing the medication, managing the health clinics, doing public education campaigns—everything.”
An Exercise in Flexibility
For Dr. Stanley Chartoff, a retired Air Force physician, the Guatemala operation wasn’t his first Team Rubicon rodeo: in 2019 he responded to Cyclone Idai in Mozambique. Last year, he spent three weeks supporting medical operations at the Navajo Nation. He’s since gotten involved in planning for medical operations as well, including for Resolute Sentinel. “I helped organize the Guatemalan mission and then decided to go myself,” he said.
The operation was an exercise in flexibility. “You have to practice medicine very differently there,” Chartoff said. “We’re used to having the technology and things we have available here, but it’s lacking there. Even in a hospital that was in the city, they barely had a functional X-ray machine, and they did not have any other major technology as well.”
Even though the people in rural Guatemala will continue to have limited access to medical care when the medical teams leave, Dr. Chartoff believes the operations are still having a profound impact.
“Realistically, I know that once they run out of whatever medications we gave them, they’re not going to be able to replace them. But, we also try to educate them about whatever problems they have, ways they could simply avoid getting worse, things to watch for. And just having a presence there is important so that the people realize they’re not isolated. We do care about them, and we’re there to respond if needed,” he said.
In the end whether the medical teams were offering ibuprofen, a sympathetic ear, or advice on how to prevent injuries from worsening, they did have an impact. Over the course of a month, 13 Greyshirts served more than 970 patients.