7 – 9 Chuj/9-12 visit patients/lunch/2-6 visit more patients/dinner/wait for birth.
So on Saturday, we did more or less that.
The Chuj is essentially a steam room, located outside many houses. It is constructed with cement sides and a tin or cement top. One corner has a big pot with room for a fire underneath and the other side has a bench to lie on. You fill the big pot with water and start to boil it to produce heat and steam in the chuj. The chuj barely fits two people, so it doesn’t take that much to heat it up. Many indigenous houses have built outside because they are commonly used for healing or post birth. A mother who has just given birth traditionally is given a bath in the chuj for the first 4 days post birth and the newborn is given one when it is 8 days old. The mother’s chujs are supposed to relax the body, warm the shoulders and chest to produce milk and close the uterus. The newborn’s is to relax it after the umbilical cord falls off. (This is a picture of Dona Esperanza's Chuj - not the one we used for the woman. That one was at her own house)
We walked over to the new mother’s house at around 7:15am. After being introduced, we began to prepare the chuj. As was pretty standard for most of the weekend, the father/husband of the family was not around. The son (about 12) and one of the daughters (about 10) chopped wood for us to use and we began to make the fire. About an hour later, the chuj was nice and hot. While we waited for the chuj to get hot, we made sure everything else was ready. Dona Esperanza asked for some branches of a particular medicinal leaf that she would use for the massage inside the chuj. The grandmother went for the leaf and in the meantime, the other children and family members did the household chores around us. Once ready, the new mother and Dona Esperanza got in. They put a cloth over the door of the chuj, to keep the heat in, but I was told to stay close and look over the cloth so that I could see what was going on.
Dona Esperanza and the mother to be got undressed, and the mother laid down on the bench. I was relived to see that they got undressed, but also surprised. Traje, typical dress, is very heavy to begin with. However, given how covered and modest the women usually are, I was surprised they would get completely naked. The entire massage lasted about 30min and the woman rotated positions throughout the entire massage. From what I could see, (it was a little difficult to see everything given the angle I had) there were two basic techniques used. One was wetting the bunch of medicinal leaves with the hot water and swatting them all over the woman’s back, stomach and chest. The warmth of the leaves and bath on the chest and upper back is to help produce more milk and I think something else that I’m not sure of. The second was massaging the stomach and uterus. Dona Esperanza later showed me exactly how she massaged the woman. With both hands she started on the outside of the left and right side of the stomach and massaged inward, then worked her way in to tuck under the uterus from the outside. This massage is supposed to help close the uterus.
After the chuj, Dona Esperanza and the woman put on a few clothes and crawled into the woman’s bed to bring their body temperatures back down. The family provided some Atol, a typical corn drink, to restore energy. It was a special kind of Atol to be good for the mother, and it was so thick and tasteless that I could barely drink the 10 sips I felt obliged to take down.
When Dona Esperanza was dressed and ready, we said goodbye to the family and headed off to visit other patients. She was very tired and hot from the chuj for the better part of the morning. It was probably a mix of her heavy and hot dress and a little bit of being tired from the long work week she had just had. We visited 4 patients total through out the day. We would have visited more, but it was raining pretty heavily in the afternoon. I learned that this means we don’t go visit patients, instead we stay in the house. (I have often gotten stuck places since the rainy season has started, and learned that Guatemalan’s don’t like to travel in the rain.)
The routine for the prenatal checks was pretty much the same for all the women. Dona Esperanza isn’t medically trained, but she is trained to be able to identify the basic warning signs, advise her clients on what to eat or what to do for pain, and when to tell them to go to the health center and be seen by a doctor. She doesn’t make appointments with her patients. She goes to where they live, knocks and the door and tells them that she’s here to check up on them. The women lead us to their rooms, we close the door to prevent kids from looking in, and the woman shows Dona Esperanza her pregnant belly. Dona Esperanza felt the woman’s belly to check the position of the child. I got to feel some fetus’ heads, elbows, and a butt as well. It was pretty cool as I had never touched a pregnant belly, or poked and prodded one. I don’t know if the women loved me “learning” on them, but Dona Esperanza wanted to teach me. After that she asked if they had constant headaches or saw lights, pain in any part of the body, if they were taking their vitamins, took blood pressure (which I learned how to do too) and how they were feeling in general. We saw women who were 5,7 and 9 months pregnant and only one was told to go to the doctor.
I’m not really sure how many checks she does before the women give birth, but I think it just depends on how much energy and time she has on the weekends. Dona Esperanza works at PIES Monday through Friday doing trainings for other midwifes. She gets paid 350Q (roughly $40) per birth, including prenatal checks and the chuj, which is a fair amount of work given that she’s always on call.
Other than seeing how Dona Esperanza works, it was fascinating to go into so many people’s houses. In half of the cases, the house consisted of 2-3 big beds per room and a kitchen. In others where people appeared to be a little more well-off, there were more rooms and the houses were just a bit bigger. They were rarely decorated, with minimal furniture, accessories and wall decorations. Some had gas burners, most had just a place to burn wood, but thankfully there was a chimney so the smoke didn’t fill the kitchen. Only a few had a TV as well. Space was really tight and I tried to imagine 5,7,8 or more people living together in these houses. These were the houses that I had walked by in small towns, or passed while on the bus from one place to another. Entering them, and being with Dona Esperanza, was a rare opportunity that I was thankful to have had.
(this is Dona Esperanza's outside kitchen - the wood burning stove for long cooking items)
And another shot of the land right around her house