We visited a malnourished and abused child, named Cesar, who is doing much better. My hosts and I visited him in the hospital yesterday and he looked like a different child. He had been given a much needed hair cut and had gained about five pounds. He was watching cars and motorcycles out of his window and jabbering away in Q’eqchi’ about them. We did understand “beep, beep!” He is expected to be transferred to a rehabilitation center next week.

I have spent time this week continuing data analysis on a malnutrition study. The results are staggering. Of 954 children, 63 percent were chronically malnourished, with stunting as a result. Eighteen children were acutely malnourished, but improved to normal weight for their height by subsequent visits after receiving nutritional supplements based on the United Nations protocol. Another fourteen were acutely malnourished at their last or only visit. We will be following up with these children to retake height and weight measurements and provide the supplements according to the UN protocol. We hope not to find more situations like the abused boy, but are prepared to help children in whatever way is necessary.

I have also assisted with two dental health fairs. The first had 266 participants including children, parents, and teachers, and the second included 231 participants. There were four stations through which participants rotated. The first station taught participants to brush teeth and learn a little song about how to brush them. They practiced by brushing the teeth of a stuffed monkey. The second station educated participants about what causes cavities and allowed them to do a fluoride rinse. The third station was on healthy eating for healthy teeth. And the last station was a demonstration of dental sealants available through CAFNIMA, my host organization. All instruction was done in the local indigenous language. Toothbrushes, toothpaste, and fluoride are made available for purchase at a very small amount. There was a positive reaction and many purchased toothbrushes and toothpaste.

A large part of my job has been crowd control with hundreds of children to manage. A double language barrier has prevented me from direct educational involvement. We will be doing two more dental health fairs during my stay.

I have attended two community meetings while I've been here. The culture of this population is very communal and all decisions and important events are discussed in community meetings. Therefore, my host organization participates in them to get permission for projects and to promote participation in events. I have found this experience important to my understanding of community health and working with communities to improve health.

It is worth noting that this population is spread out over a mountainous terrain and that putting on events and attending meetings often requires intense hiking. To get to one community meeting, I and my hosts hiked an hour and a half down a mountain and half way up another. There was a bridge in the middle to cross a river. It rained, so the hike back was a two hour slip-and-slide climb on hands and knees at times. In other words, a two hour event actually takes most of a day to accomplish. This is fairly typical and another interesting part of community health when working with a rural population.