A few months ago, my friend Erin was visiting with her boyfriend Connor, and I was super excited to be showing them around. We were heading to the market (a little hungover I admit), when I tripped on the sidewalk, and fell like a tree, straight onto my elbow.
While I’m naturally a klutz, in this case, I blame the sidewalk. Antigua has cobbled streets, which I initially saw as charming, and now consider one of the most annoying parts about living here. When it rains the streets have rivers flowing down the middle of them, they’re not kept repaired, and people trip and hurt themselves every day. If the sidewalks were any better it would be fine, but they’re cracked, uneven, and randomly have steps between shops so if you’re not looking where you’re going you could be in big trouble.
As soon as I fell, I immediately wanted to puke or pass out, which I’ve discovered is my body’s way of telling me I’ve broken a bone, since this has happened every other time I’ve managed to damage myself. The locals were lovely, and immediately rushed to help me, trying to get me off the ground (I refused until I could figure out how hurt I was) and a shopkeeper brought me a glass of water.
They immediately wanted to call an ambulance, which I refused for two reasons. The first, is I’m afraid of hospitals. I know, I know, I’m happy to jump off a bridge, go whitewater rafting or any number of activities that most people wouldn’t consider, but get me in a hospital or near a needle and I freak out.
The second reason is the hospital here has a really bad reputation. In fact, there are whole discussions on Antigua Facebook groups and on various websites about the state of the medical system in Antigua, particularly the hospital I went to: Hermano Pedro.
I had heard about people catching flesh-eating bugs (no joke guys), other serious infections, and even dying after receiving poor treatment at the hospital. I had also heard of foreigners having their passports confiscated, getting huge bills without being told what they were for, and being threatened with jail if they didn’t pay immediately.
Knowing this information, I did what any normal person would do. I went home to ice my arm in the hope that it wasn’t really broken. Spoiler alert: It was.
By 4pm I was crying with the pain and rang my friend Izy to tell her I needed to go to the hospital. Izy was celebrating her one-year anniversary with her boyfriend in the city, and they drove for two hours to pick me up and take me to the hospital (true friendship right there).
By the time I got to the hospital it was 6pm and no one was there. Dr Bonilla was called and we waited 20 minutes for him to arrive. X-rays were taken, and I was told I had broken my elbow and put in a full arm cast.
Dr Bonilla told me to come back in four weeks and he would do another x-ray, check if it had healed and either take my cast off or leave it on for another week.
The next four weeks were a frustrating experience. You don’t realize how much you use both arms until everyday tasks are no longer possible. My champ roommate had to do everything from cooking and washing the dishes, to tying up my hair and wrapping my arm with a giant plastic bag so I could shower. I was desperate to get my cast off.
Four weeks later, and I was back at the hospital. I walked in, and the Dr Bonilla told me I could take the cast off. “Wait, don’t I need an x-ray?” we asked. “Oh.” He seemed surprised. “Yes”, he replied, and sent me off to be x-rayed.
This time, the x-ray seemed a little different. I wasn’t exactly at my best for the first x-ray though, so I figured it was fine.
We went back to his office, and the doctor beamed at me. “Muy Bien”, he said, and I asked to see the x-ray. “Wait”, I asked Cristina (my roommate), “Why are my fingers in the x-ray and my elbow isn’t?”
He had asked for an x-ray of my wrist, even though he was the one who put my cast on four weeks earlier and I was sitting in front of him in a full-arm cast with my arm stuck at 90 degrees.
When we pointed this out, he sent us back down to get another x-ray, and became rather surly.
Each time we asked a question it was met with either a grunt, a wave of his hand, or a “si”, and no further information.
As he cut off my cast, he was extremely rough, and at one point got annoyed that he couldn’t get the cast off and tried to rip it apart, pulling my arm sharply in the process. I burst into tears at the pain (all of my muscles had locked up) and he could not have given two fucks, and was laughing the whole time. If you’ve ever experienced a doctor laugh at you while you cry and you’re already terrified of hospitals and can’t understand the language, you’ll understand how much I wanted to punch him in the face with my good arm.
I no longer trusted him, and would flinch every time the cast saw got close to my arm, causing more pain, more tears, and for him: more laughter.
I realized that our mistake was to question him- an old and obviously arrogant doctor. As a foreigner, and especially a woman, questioning the esteemed doctor (who has a well-known reputation for malpractice), was obviously unforgivable, and even when I enquired about physical therapy (I still couldn’t move my arm once the cast was off), I was just told “no.”
Because the elbow is such a tricky area and can stiffen up, in many countries it will only be casted for the first week or so, given a half cast, or even just a splint to prevent a long recovery. Because my arm had been stuck at a right angle for so long, I was in excruciating pain whenever I tried to straighten it even a tiny bit. Luckily my landlord knew a physiotherapist here, but it was also impossible to make an appointment and I would have to go, grab a number and sit in the waiting room for up to two hours- three times a week.
The good news? I had asked the doctor at every stage of my treatment how much everything would cost, so I wasn’t hit with a huge bill. I also made sure I had physical therapy, meaning I’ve got 90% of my arm’s movement back and I’m now focusing on strengthening my muscles.
While the hospital was fine (definitely not good) for a broken bone, if I had anything more serious, I would be getting my butt to the city and finding an international hospital.
Medical Care for Guatemalans
While the medical care here didn’t live up to my expectations, I had a wake-up call when I spoke to my Spanish teacher. Hermano Pedro is a private hospital, so only wealthy Guatemalans and foreigners can usually afford to go.
She told me that for Guatemalans without health insurance, they have to stop off at a pharmacy before they go to the hospital, since it usually has absolutely nothing in the way of bandages, drugs, and everything else you might need, you know, if you were seriously injured or sick, and needed a hospital. Locals without insurance are usually stuck with a student doctor, and if they have to stay overnight, their family is responsible for bringing them food every day.
This made me so mad. Guatemalans deserve better, and the corruption in this country and uneven distribution of wealth means that you only get relatively decent medical care if you’re earning much more than the average Guatemalan ever will. And that’s just not fair.
It’s experiences like these that make me recognize my privilege. While the whole experience was a shitty one, the fact that I was wealthy enough to get a cast on in the first place makes me luckier than a huge percentage of Guatemalans. Unfortunately, I don’t see this changing anytime soon, as the corruption is so ingrained and so many people are living off less than $1 a day and don’t have a voice to ask for more.
Sure, it’s easy to tell people to vote, protest, and try to make the government listen (and after the protests and election in September last year, I’m sure some people could say that this works, although I’m doubtful given that not much has changed so far), but it’s also important to remember that almost a quarter of the population is illiterate (60% for indigenous Guatemalans).
If I, as a relatively wealthy foreigner (and one that has no hesitation in speaking up when a doctor is being a moron) can have a terrible experience with the healthcare here, imagine what it’s like for someone who has no money and can’t read or speak Spanish?