Worlds Apart: Part 3

Worlds Apart 3by Aetna’s Tom Sopel

Read Part 2 here…

As for Guatemalan EMS, we were very fortunate to be introduced to Mr. Arturo Pineda, Chief of Services, EMT, who was a longtime friend of Jorges. Mr. Pineda was kind enough to show us their base of operations.

He explained that most services, like their own, were Fire/EMS, and that EMS was provided under three different systems in Guatemala. There were the private companies that catered to the wealthy, the semi-private system that catered to the elderly and special populations, and lastly there was the public system, which he operated under.

The public system, although free, was extremely overburdened and having a waiting list of calls was sometimes an unfortunate reality. Mr. Pineda and his team at Cuerpo de Bomberos Municipales de La Antigua would run one or two ambulance for all of La Antigua, covering everything. It’s more understandable when you see that La Antigua’s population of 34,000 pales in comparison to Hartford’s 125,000. They had about three ambulances total, all donated from Japan from what appeared to be the 1980s.

When asked if I could inspect their equipment I found an oxygen tank, a stretcher and an AED/3 lead ECG that dated back to what I’d assume was the 70s, a long ways away from what is available to us in our ambulances. The medications they are legally allowed to provide are oxygen, glucose, albuterol and epinephrine, however they only carried oxygen, the other 3 would have to be provided by the patient. It’s moments like these where you really appreciate being able to collar a patient, or having things like trauma pads and nasal cannulas.

As for the paramedic level, medic positions will usually be filled by doctors, because the political and financial environment pushes them into field. Even then, whether they have any medications to give is a game of chance. This all being said, the work that the men and women working for the Bomberos Municipales de La Antigua is nothing short of amazing.

Worlds Apart: Part 2

Worlds Apart 2

Aetna on top of Mt. Pacaya!

by Aetna’s Tom Sopel

Read Part 1 here….

“So how long does it take for an ambulance to show up to these places if people need immediate attention” I asked Jorge and Dr. Vela. Hours. Not one or two, but possibly five or eight. An overburdened, underfunded EMS system meant for longer response times and some of these villages are so remote that they can only be accessed by vehicles in the dry season (summer months), otherwise the rivers grow too torrential to let cars pass. One clinic we ran was particularly deep into the jungle and hadn’t seen a clinic in over 25 years! That was the day a child saw my white, foreign face and ran away crying. It’s like he didn’t even care that I have an awesome personality…

Ok, so let’s say something happens and you can wait the few hours for an ambulance to get there. You were somehow able to stretch that golden hour of your stroke into a tarnished eight, then what? Hop in the back and start burning rubber, right? Wrong. The Guatemalan healthcare system won’t take you unless have all your paperwork signed and filled out for that particular trip, as payments need to be established BEFORE the trip, not after. That brings the interesting question: What if you’re unconscious? Well, you better hope that a loved one is around to do the paperwork for you then! Ok, stroke survived, paperwork filled out, hospital time! Wrong again.

As it turns out, treatment in Guatemala is based on a graded scale where treatment isn’t necessarily catered to acuity. You’re bumped up to progressively more and more developed health care facilities until you reach the one you need. Where first you’re dropped off at a clinic like the ones we ran or an average doctors office, and then they slowly pass you up the chain until you’re finally allowed to be transferred to a hospital. All they do in the meantime is stabilize the patient and pass them along – often a stark contrast to Hartford.

Worlds Apart: Part 1

Dr. Rafael Vela and myself nearing the end of a successful week of clinics.

Dr. Rafael Vela and myself nearing the end of a successful week of clinics.

by Aetna’s Tom Sopel

La Antigua, Guatemala — Hello, my name is Tom Sopel and I’m an EMT here at Aetna. This past January I flew to Guatemala to work under the Medical Humanitarian Society of Uconn in order to provide patient care to rural areas of Guatemala. The culture was as vibrant as it was care free, the kind of atmosphere that lets you slow your clock down and loosen up your laces. I guess you can say that an important medical lesson I learned out there was that the human body naturally wants to smile when it’s never been exposed to (Hartford) winter. But seriously, the place was amazing. We spent two weeks in various villages across Guatemala running health care clinics, working with hundreds of patients to provide much needed medical treatment for those in need.

Out there we were met by our friend and translator, Jorge Hernandez who helped us with organizing patient care sites and Dr. Rafael Vela, who was an amazing doctor who would volunteer his time to go with us out to the different villages and coffee plantations spotted across the jungles of Guatemala. Continue reading