GENERAL INFORMATION and PREPARATION TIPS

Including notes from Students Who Have Gone Before

PEDS 316I, Dr. Paul Wise, MD, MPH

General Safety

San Lucas Toliman is a poor town in a poor country. Students should familiarize themselves with the risks associated with traveling to Guatemala. Guatemala has had chronic problems with crime, particularly on roads and in Guatemala City. Information regarding general levels of crime can be found on the U.S. Department of State consular information website http://travel.state.gov/travel/warnings_consular.html. San Lucas Toliman is relatively safe; walking alone late at night should be avoided but other precautions are similar to those suggested whenever one travels in developing parts of the world, including locking rooms when not occupied, no elaborate jewelry, etc.

Getting to San Lucas Toliman

• Air transportation to Guatemala generally costs about $650. When you fly in and out, try not to arrive in Guatemala late at night or fly out very early, because this means you will have to spend a night in the capital. 

• One student says “Don't be afraid to take a ticket that flies through El Salvador or Cancun on your way -- there are quite a few of these, and they can be cheaper.”

• Car transportation from Guatemala City to San Lucas (about 2 ½ hours) runs approximately $60 each way. Dr. Wise is often able to help arrange for car transportation to San Lucas.

Housing

Housing usually involves staying in a small hotel or in a local home. The costs are minimal, usually on the order of $10 per day.

Health and Health Insurance

• Review the Vaden Travel Clinic website for general information: http://vaden.stanford.edu/medical_services/travel_clinic.html
• Book your travel clinic/general check up at least 1 ½ - 2 months before going
• There is an international component included in the regular Cardinal Care plan that seemed quite comprehensive.  If you are not going to be enrolled as a student for the full quarter, it may be cheaper to get travel insurance. Call the Travel Clinic at Vaden for more information (498-2336)

Attire

Attire is very relaxed.  Bring things that are comfortable, lightweight, and dry quickly.  Jeans are probably too hot.  Long pants (like hiking pants) are best.  Don't bring anything that shows a lot of skin.  Bring sturdy shoes -- the streets of San Lucas are rough cobblestone, and the outlying areas are even less paved.  If you can bring a pair that you can leave in San Lucas when you go, they'll probably be torn up by then.

Diet

• The water is unsafe to drink and unpeeled fruits and vegetables should be avoided. Bottled water is readily available throughout San Lucas.
• Students eat most meals cafeteria-style at the church parish with lots of other volunteers. 

• Consider your food needs carefully. The food at the parish tends to be heavy on carbohydrates and meats. Vegetarians, especially, may want to bring protein-rich foods (powder to add to drinks, energy bars, nuts, etc.).
• There are not many restaurants in San Lucas, and not always access to a kitchen.
• Some students have complained of intestinal trouble while in San Lucas. Be sure to bring your meds just in case.
• One student makes the following suggestion (although Dr. Wise notes that he cannot vouch for its efficacy!): “Before you go, start eating yogurt at least once a day.  Take a bottle of Acidophilus (available at Trader Joes or other vitamin retailers) with you and take it every day; it will help.”
  
  

Student-recommended Readings

• Silence on the Mountain: Stories of Terror, Betrayal and Forgetting in Guatemala, by Daniel Wilkinson
• I Am Rigoberta Menchu, by Rigoberta Menchu
• Any book on the history of Guatemala and the civil war in particular (“It will come up!”)
• Review everything you learned in GI, particularly parasites. 
• One student highly recommends using the Footprint guidebook (“Lonely Planet wasn't my favorite, Rough Guide is a little more focused on the off-the-beaten path stuff”).
  
  

Travel Outside of San Lucas Toliman

This clerkship is structured to provide a rigorous work schedule that includes preventive, therapeutic, and didactic experiences.  However, there will be time for local travel and sightseeing on selected weekends during the rotation.  In addition, more extensive travel in Guatemala could be arranged both prior to and after the rotation.  While traveling and getting to know the country more generally is strongly supported, it is important that students expect to be involved in rotation activities Monday through Friday, including early mornings and some selected evenings (informal sessions to discuss cases and general issues).  Therefore, this rotation is not appropriate for students who are looking for an opportunity for general sightseeing and tourist activities.

All that said, Guatemala is a beautiful country, and former students are enthusiastic about leaving enough time before or after the rotation to travel around a bit.  “You can see a lot even in a few days, so squeeze every day you can get out of your schedule.”  Specific suggestions from students:

• Use Antigua as your base close to the capital (it's about 45 minutes to an hour away, and shuttles run there for $5-$10 all day).  Antigua is a gorgeous, small, tourist-centered city with great food, a busy nightlife, and inexpensive accommodations.  Then you can get from there to anywhere else in Guatemala pretty easily.  It’s a great stop on your way in or out.
• If you have a couple of days, consider adding a trip to the other side of the lake from San Lucas (Panajachel, etc.).  One student says “I highly recommend spoiling yourself and visiting this resort (http://lacasadelmundo.com/); make a reservation at least 2 weeks in advance there.  You can live in pretty luxurious conditions for 2-3 days without spending more than $100 total.”

Travel, continued

• If you have even more time, choose between a trip up to the north of the country to see Tikal, the Mayan ruins, or a trip west to Xela and its surroundings to hike volcanoes and see more traditional highland life.  You must fly to Tikal; there are many tour operators in Antigua or Panajachel that will book a trip for you.  The trip runs around $200 for everything, and takes at least 2 days.
• If you have time before you start in San Lucas and want to brush up on your Spanish, it'll pay off.  Guatemala has tons of language schools where you can get 1-on-1 instruction for 5-7 hours a day and stay with a family, all for roughly $100-125/week.  Antigua has lots of schools, as does Xela.  “Xela is much less expensive and much more normal city, less focused on tourists -- you'll get more of an immersion experience there.”

Contact information

If calling from outside Guatemala, dial 011-502 prior to 8-digit phone number

Parroquia main number

7722-0112

Andres Chagil (friend and neighbor to Sue and Will)

7722-0055

Adrian de Leon (a safe driver who often makes the airport runs)

7722-0079

Angel Mejia Juluju and family (host to many students; live across the street from the Parish Church)

7722-0215

PACKING CHECKLIST

Medications

• Cipro 500-750 mg tabs (15-30 tabs)
• Metronidazole 750mg tabs (30 tabs)
• Any medications you are currently taking or expect to need (ibuprofen, etc.)

Clothing

• Conservative dress (long pants/skirt)
• Light shirt/T-shirt
• Light sweatshirt/sweater/fleece (sometimes cool at night)
• Waterproof rain jacket
• Sturdy walking shoes (running shoes fine)
• Extra pair of shoes (expect one pair to get wet)
• Shower flip flops

Additional Items

• Pocket Spanish/English Dictionary
• Medical Spanish dictionary (available online at http://www.ucop.edu/cprc/cmhidictionary.pdf)
• Drug reference book to look up dosages
• Medical reference books, e.g., Pocket Ob/Gyn, Pocket Peds and Pocket Internal Medicine
• Stethoscope
• Otoscope with disposable covers (if available)
• Opthalmoscope (if available)
• Medium gloves (box)
• Hand Sanitizer (large bottle and pocket size)
• Wet wipes/face wipes
• Insect Repellent
• Sunscreen
• Sunglasses
• Small Flashlight
• Water bottle(s)
• Towels
• Sleeping bag (if available)
• Waterproof shoes and other rain gear (if it’s the rainy season)
• Ear plugs (“the roosters crow at all hours”)
• Day backpack
• Sturdy shoes
• Protein/nutrition bars and any other packable food you can bring – especially if vegetarian
• Books
• Writing materials (pad/notebook, journal, pens)
• Camera
• Games (cards, etc.)
• A gift for your host family (movies, games, etc.)