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The Power of Language in Medicine: The UVa-Guatemala Initiative

For medical professionals in the U.S. today, Spanish-language proficiency and cultural sensitivity are invaluable. WMRA’s Kara Lofton looks at one University of Virginia program that’s attempting to teach these skills through a partnership program in Guatemala.

Picture this: you are a doctor who only speaks English. A woman, who speaks only Spanish, is your patient. No translator is available. She begins to tell you what is wrong.

[Sounds of woman speaking Spanish]

A word pops out at you: “la diabetes.” ‘Ok,’ you think to yourself. She has diabetes. But other than that you know nothing. You don’t know her medical history, you don’t know if she is in pain, you don’t know if she is on medication or has been in the past – so you begin running tests that she may or may not need – just to be on the safe side.

But what if you could change this scenario? Now, you are bi-lingual. All of a sudden you have the capacity to learn her medical history, her current medications, to find out whether or not she has access to resources. Diagnosis is quicker, more accurate and frankly, much cheaper.

DAVID BURT: You kind of intrinsically understand that as a doctor you should be bilingual…

That’s Dr. David Burt, director of the University of Virginia Spanish immersion and research program, the UVA-Guatemala Initiative. The initiative primarily emphasizes Spanish language proficiency, but also provides space for research, education and service.  Burt thinks it is the only program of its kind in the country.

BURT: Tons of foreigners come into Guatemala, and almost all of them have their version of how Guatemala could be better. But it’s rare that they actually sit and listen and work with Guatemalans to understand what Guatemalans are actually interested in.  

While Burt runs the project from Virginia, UVA’s in-country staff is mostly Guatemalan and the language school they use is Guatemalan owned and operated. Special projects include a water filtration project, a women’s health project and placing UVA medical residents in hospitals for rotation or observation.

In mid-October, I went to Quetzaltenango, Guatemala to visit.

[Sounds of road traffic in Guatemala]

The in-country director, Jessica González, and I are outside of a public hospital in Totonicapán where UVA residents are often placed to complete a rotation.  González set up all of my hospital tours and interviews for this trip and also made sure I didn’t do anything deemed inappropriate, such as take pictures of patients.

A Guatemalan medical resident gave me a tour of the hospital.

PAULA: Este es la farmacia…

The hospital is bare-bones and over-capacity. Supplies frequently run out. Only one antibiotic is consistently available. Mattresses, stained with old blood and fluid, are covered with clean sheets. Patients sometimes have to share a bed. It is a stark contrast to UVA’s immaculate, wealthy facility where labs and tests are readily (and cheaply) available and staff never worry about running out of gloves.

Only one UVA resident was there at same time I was – more come during the summer. We caught up later by phone.

JENN SILBER: The emergency department there only has x-ray and for part of the day has ultrasound as opposed to here at UVA we have x-ray, ultrasound, MRI, you name it.

That’s Jenn Silber, a senior emergency medical resident at UVA. She said one of the most valuable pieces of her time at Totoniápan was learning how to practice medicine in a resource-limited environment. The intensive Spanish classes allowed her to further develop her communication skills. She said she is already incorporating what she learned in Totoniápan into her first few shifts back in the US.

Meanwhile, Guatemalan public hospitals are running out of money, fast.

KAREN SOFIA ACEVEDO: It’s a national crisis, I think that right now we are heading to one of the worst situations we’ve had in health, public services.

That is Karen Sofia Acevedo, the director of Hospital Regional de Occidente San Juan de Dios in Quetzaltenango. It’s the third largest hospital in Guatemala with a 360-bed capacity – a volume she says is not enough.  And in our next report, we’ll take a deeper look at the severe government corruption in Guatemala, and how it has crippled health care there.

Kara Lofton is a photojournalist based in Harrisonburg, VA. She is a 2014 graduate of Eastern Mennonite University and has been published by EMU, Sojourners Magazine, and The Mennonite. Her reporting for WMRA is her radio debut.
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