Angela Ugorets

Hey everyone, Angela here. Like most 4th year medical students in the US, I was looking for a way to wrap up my medical school career with a bang, preferably a fun, international experience that would put my expensive education to use. That’s where Primeros Pasos comes in. I was looking for an adventure abroad, but I got so much more than that during my 4 weeks volunteering here.

Some background for those who don’t know yet, Primeros Pasos is a primary care clinic near Quetzaltenango (also known as Xela, the 2nd biggest city in Guatemala), but this clinic serves a more rural, impoverished, Mayan population that couldn’t afford to get care in the city even if they wanted to. Primeros Pasos offers all basic services to these patients, and also has a pharmacy that sells every essential medication at a very cheap price. The attending doctor is fantastic, she can accurately evaluate these patients without imaging and lab work, but she also knows when the pathology is too complex and they need to be referred to the general hospital. The clinic runs almost exclusively on donations and volunteers, so the work you do here actually matters.

I thought I would come and see a few patients per day to earn the credit my school required to allow me to graduate. And then I would focus the rest of my time on exploring Guatemala (what I thought I really wanted to do).

But each day, the patients I saw were overflowing with gratitude for my services. Their medical issues were mostly simple and easy to treat, but they would thank me as if I just heroically saved their lives! Something I hadn’t felt in the US in a while. I looked forward to seeing new patients more and more each day. My 30 minutes of attention could relieve their weeks of suffering (as they usually waited quite a while before coming to clinic). My happiness in Guatemala began to revolve around the Primeros Pasos clinic, and the weekend excursions I went on became an “extra bonus.”

One thing that stuck with me during my time at Primeros Pasos was the emphasis that the attending doctor put on psychological wellbeing. She wasn’t afraid to tell patients that their physical pain could very well be related to emotional pain they were experiencing (such as an unfaithful partner, or financial stressors), and she quickly recommended a good psychiatrist to see them. This topic is almost “taboo” in the US. Physical pain seems to always treated with pills, not “talk therapy.” But often, that’s exactly what the patients need! I was so inspired by the doctor for bringing the psychological wellbeing of a patient to light.

The second thing that impressed me was how none of the Guatemalan patients took a daily, chronic medication. Not even the elderly! It’s just not part of their culture. Sure, they’ll take some ibuprofen tablets when their pain becomes insufferable, but only for a few days. They would rather work through their problems, or live with them, than get hooked on life-long medication. The US is the total opposite. With any minor inconvenience, patients come running to the doctor demanding a cure in pill form. I rarely see elderly patients in the US on less than 10 medications. In Guatemala, it’s seldom more than 0. I truly admire their resilience and their attitude towards medication, and I hope to hold onto it as I start residency in the US.

If you’re also a 4th year medical student and you want to be reminded why you applied to medical school in the first place, come to Primeros Pasos. It’s the only volunteer experience I’ve done where I felt like I made a difference; that I helped the patients who really needed it, and who were so grateful for it. I urge you to sign up to volunteer at Primeros Pasos too and come see for yourself how rewarding it can be!