An Interview with a Primary Care Nurse in Guatemala: Isaías Quej

We spoke with Isaías Quej to get an insider perspective on what Guatemalan healthcare professionals face in Guatemala and some of the challenges that contribute to the issues facing the healthcare system as well as the ongoing drug shortage. Isaías is a professional nurse in primary care currently working with Impact Ministries at one of their clinics.

What kind of things does your role entail?

I do basic medical checks such as height and weight, blood pressure, and ear/throat/eye examinations. I help patients with ear washing, applying sutures (stitches) when needed, and deworming patients who have tested positive for parasites. I provide treatment for various illness and refer patients to more specific healthcare needs if required. I am also part of the development team for Impact Ministries’ HEALTH IN ACTION program.

What are the main challenges you face in doing your job?

One of the biggest challenges that I and a lot of other nurses face in our work here in Guatemala is the deterioration of important medical instruments and the ongoing drug shortage. A lot of these instruments are not only needed for basic medical checkups but they also aid us in our medical outreaches to remote and isolated communities here in Guatemala. Some of these instruments include: Sphygmomanometer (instrument for measuring blood pressure), Stethoscope, Otoscope (medical device used to look into the ears), Ophthalmoscope (used to examine retina and other parts of the eye), Syringes to perform ear drops, Nebulizer (device used to administer medication in the form of mist inhaled into the lungs), and masks. Many of these instruments are in very poor conditions and some of them have become unusable. We have also had trouble performing outreach checkups due to lack of stretchers.

One of the main challenges you mentioned earlier was the ongoing drug shortage, how does the shortage of medicines contribute to the challenges that you face as a medical professional?

The ongoing drug shortage is a major challenge that we face in our clinics and medical outreaches. The drug shortage that we face here in Guatemala not only increases the challenges that we already face with the health care system but it also breeds new difficulties. Providing adequate care is already very challenging and when you have limited facilities and limited professional faculty, adding the element of limited medications just makes everything worse.

Do you have any experience or example of situations influenced by the shortage of medicines that really resonate with you and highlight the weight and the impact of this problem?

There have been several instances where a patient would require treatment with certain medications but we would only be able to provide half of the required prescription. Due to the drug shortage, our clinics are greatly dependent on donations and for that reason we are rarely fully stocked on medications. Most of the time, we can only provide half of the patient’s medication and then we require them to buy the rest. This can often complicate the patient’s health further, especially since a lot of patients cannot afford to buy the rest of the medication or simply choose not to.

Image taken from http://www.impactministries.ca/medicalteams/

What specific medications are often in shortage and directly hamper the function of the clinic and/or patient care?

There are five major categories of treatments that are often in shortage at our clinics. The first category is scabicides. Scabicides are medications used to kill scabies mites and their eggs which infest the outer layer of the human skin and cause relentless itching and contagious rashes. Scabicides are often given as creams or lotions which can be applied all over the body. The second category is hypertension medication, this includes various diuretics (lower blood pressure by reducing excess sodium and water), beta-blockers (lower blood pressure by reducing heart rate and the heart’s output of blood), and ACE inhibitors (lowers blood pressure by relaxing and opening up the blood vessels).

Anti-diabetic medications are the third category of drugs that are often in shortage. For type 2 diabetes this includes medications such as alpha-glucosidase inhibitors (break down starchy foods and table sugar) and biguanides (lowers liver’s sugar production), as well as various insulin treatments for type 1 diabetes which are important specifically in emergency cases. The fourth category is gastrointestinal medications, this includes antacids (neutralize stomach acid) and histamine 2 blockers (lower acid production in the stomach). The last category is multivitamins, which are essential for human development, growth, and various aspects of health.

What is the best way for people to support and contribute to this cause?

Donations, donations, donations! Medical donations such as medical equipment and medications that we are in shortage of are the best way for individuals and communities to help support our work here in Guatemala.

We hope you enjoyed our interview with Isaías Quej as much as we did and were able to understand some of the challenges that healthcare professionals face in Guatemala and the importance of what HLH does in effort to support these teams. To learn more about Impact Ministries and what they do in Guatemala click here. What questions do you wish we’d asked? Post a comment below!

Together we can make an impact on the health of the nations and the generations to come.

The mission of HLH is to increase accessibility to medications and supplies for healthcare facilities in Guatemala. If you are interested in hearing more about the work we are doing, or in connecting with us, you can visit our website, check out our instagram or facebook, or sign up to receive our newletters. If you would like to support us in our work, please donate here.

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