Many Diseases, Few Amenities in Guatemala : M.A.S.H. Amid the Maya: Teams From the U.S. Battle to Save Lives

The tiny Indian girl was beyond help. Just 3 months old, she was blind, severely dehydrated and stricken with pneumonia. The baby’s illness, her mother said, began with a compliment.

“It’s a superstition here that if somebody tells you your baby is pretty, something bad will happen to it,” said Pamela Lear, a nurse practitioner from Greenville, Ky., and a first lieutenant in the Kentucky National Guard.

The baby also was coated with dried herbs when her mother brought her to the mountaintop clinic. A zahorin , or traditional healer, had tried in the ancient Mayan way to ward off the spirits believed to be afflicting the child.

To Lear and Lt. Col. Paula Maionchi, a Richmond, Ky., physician, it was obvious that something bad had surely happened. It was equally obvious that it had nothing to do with compliments or curses.

A Tragic Decision

It had to do with a severe deficiency of vitamin A, debilitating diarrhea, intestinal parasites--and a young mother’s tragic decision to turn first to a medicine man for help. Maionchi arranged the baby’s transfer to a hospital two hours away, in Guatemala City, but she died en route.

It was the gravest illness that the 475th Mobile Army Surgical Hospital and 973rd Dental Detachment would face this day in the Sierra Madre, where the guards spent part of a two-week training and humanitarian-aid mission.

In a larger sense, the child’s illness was a severe example of problems that are widespread in a society where infant mortality is high and life expectancy is short. Half of Guatemala’s 7.7 million residents are descendants of the ancient Mayan people.

Lear and Capt. Douglas Stevens, a Lexington, Ky., physician, were seeing ailments they didn’t encounter at home, including tuberculosis in young people. Parasitic diseases were rampant; malnutrition and bronchitis were common.

Many Die in First Year

Perhaps 80% of infants born in this region die before their first birthdays, said Col. Michael McConnell, chief surgeon of the U.S. Army’s Southern Command. The guards were seeing “the ones that made it through,” said McConnell, who observed the training and treatment here and at Choatalum and Chemachoy.

At each site, the guards set up shop in a tiny clinic of a standard government design--three small examining rooms off a compact waiting area. The clinics were equipped with cold water and almost nothing else.

The clinic in Xepatan was without heat or lighting. Capt. David O’Banion, a Louisville, Ky., dentist, and Sgt. Charisse Newton, a Frankfort, Ky., dental technician, extracted teeth by the light of battery-powered headlamps.

Part of Roof Blown Away

At Choatalum, the line of patients was long but Dr. Joseph Dobner wasn’t seeing unusual cases. The tiny, bullet-riddled building in which he set up his clinic, however, was a far cry from his Frankfort office. Part of the roof had been blown away and the windows shattered. Electricity came from a generator “so loud that I can’t listen to the lungs. . . so we tend not to use it.”

“I’m high-tech in a very low-tech situation,” said Dobner, a lieutenant colonel in the 475th and an orthopedic surgeon.

“When you put any organization through a rigorous situation, they’re going to learn and it’s going to forge them into a more cohesive unit, and they learn how to work with adversity. And, boy, we’re working with adversity.”

The Indians have suffered in Guatemala’s 30-year-old civil war. Government critics say the military engaged in a “scorched earth” campaign to rid the countryside of rebels and their potential supporters among the Indians.

Multi-Agency Effort

National Guard units from Iowa and Georgia preceded the Kentucky teams, under an agreement with the Guatemalan government. Each exercise was conducted with the army medical corps, Ministry of Health and the Animal Health Agency.

Like his colleagues, Dobner spent his time treating parasitic infections and lung ailments, and dispensing ointments and pain relievers for the aching joints and muscles that are part of life in the rugged Sierra Madre.

“I’m amazed at these people. You don’t see much in the way of major orthopedic problems because they’re dead. They don’t have a chance. If they’re at all infirm, they’re gone,” Dobner said.

There is “no training opportunity that even comes close to this” at home, said Maj. Allen Youngman, assistant chief of staff. “This is an opportunity to do something right that maybe we haven’t done right in the past.”

Maj. Beverly Vance, an Eastern Kentucky University nursing instructor, said: “It was the most gratifying experience I’ve ever had.”

Needs Change With Seasons

“It will make my unit better. Support of the operation is not what it should be, but it never is,” Dobner said. Because pharmaceutical needs change with the seasons, the mission also taught the Southern Command a few things.

The unit was learning to do without medical supplies that were in short supply or were used up rapidly, he said. Everyone seeking treatment at Choatalum had head lice, for example, and the anti-lice medicine was quickly gone.

“Three days into the exercise and we were out of something that would make life lots better--but the last group down here (from the Georgia Guard) didn’t use what they had because it was a different season,” he said.

The Mayan stoicism was underscored at Xepatan, where O’Banion and Newton, on average, pulled about two teeth per patient. Extraction was the only practical treatment, under the circumstances, for scores of people with rotted teeth.

He Didn’t Flinch

One of the patients, a slightly built 27-year-old man, had a badly abscessed tooth. He probably was seeing for the first time a long needle like the one used to shoot anesthesia into his gums, but he didn’t flinch.

“They live with chronic pain. The needle is no big deal,” O’Banion said.

But the acidity of the man’s infected gum tissue negated the anesthetic and he soon was in obvious pain. He gripped the sides of the examining table as O’Banion worked to extract a tooth that was crumbling with each touch.

“It’s like trying to take a piece of glass out of concrete,” he said. “You just have to be patient and work at it. . . . He’ll feel noticeable improvement after a couple of hours.”

His ordeal over, the man eased himself off the table, plunked his battered hat on his head and moved toward the door. There he paused and gave a broad wave to O’Banion and Newton.

O’Banion nodded in return.

“Another satisfied customer,” he said.