A Clinic Visit in Guatemala

A Clinic Visit in Guatemala

As a cardiologist in Minnesota, I was eager to see how medical care was provided in Guatemala. The clinic associated with the Common Hope Foundation is located on site and staffed by family practice physicians. I had the opportunity to visit the clinic and see two patients with the clinic doctors.

The first patient was an older woman who had classic angina--typical chest and arm pain associated with coronary artery blockages. She had hypertension and high cholesterol. Initially, she had such severe symptoms with activity that she could not walk far. She was referred to Guatemala City to see a cardiologist and had a stress test done, which was essentially normal. She was started on medication and her symptoms improved considerably. She is now able to work again. She was exceedingly gracious and appreciative for the care that she received.

The second patient was a young woman with a history of arrhythmia and now having an exacerbation of myesthenia gravis, which is an autoimmune condition causing muscle weakness. She was having trouble with swallowing, speaking, and dry eyes. The clinic doctors and I decided on a change in her medication that might help improve her symptoms. They will see her back in a couple of months to evaluate her symptoms again.

I believe that the patients who are eligible for care in that clinic have much better medical care than most other patients in Guatemala. The doctors were well educated and very caring. The doctors even go to the hospitals to visit their patients and provide them with medications and tests that are not available in the hospitals. The clinic has basic evaluations available, including ECG, chest xray (although the xray machine was lacking the necessary batteries currently), blood tests, and urine tests. When I asked whether it was possible to refer patients for an angiogram, the doctor indicated that it was possible, but he did not recall any of their patients actually undergoing that kind of testing. They do their best with medical management, it seems. The wait for surgery may be many months, and is often provided by visiting surgeons on humanitarian visits. Fortunately, much of the emphasis at the clinic seems directed at prevention of disease. They have programs to address infant and young childhood malnutrition and cervical cancer screening, for example. Their formulary of medications include options to address hypertension, high cholesterol and diabetes.

Overall, I was impressed by the dedication of the physicians and their staff. They wanted to treat their patients well and had high hopes, despite the paucity of resources at their disposal. They have a computerized medical system, but also still used a paper chart. However, their use of computers in their patients' care creates an opportunity to collaborate with doctors in the U.S. more often, using the power of telemedicine. We can all hope to provide the best care possible for people, no matter where they live.

Eric Ernst