Peter Rohloff, MD, is a third year resident at Children’s Hospital Boston, as well the founder of Wuqu’ Kawoq (pronounced woo-ku- ka-woke), an NGO organization committed to providing cultural and linguistically appropriate healthcare to the indigenous people of the Guatemalan Highlands. Starting tomorrow, ABC News begins airing a year-long series, “Be the Change: Save a Life” which will take viewers to three continents and nine countries, focusing on the health conditions of some of the world’s poorest people– as well innovations that could save them. As part of a special airing of ABC’s 20/20, Christiane Amanpour will cover the efforts of Rohloff’s organization, as it strives to improve care for many of the indigenous people of Guatemala. In the following interview, Rohloff discusses the organization, why it’s so desperately needed in Guatemala and how practicing medicine in one of the nation’s poorest areas complements his medical training here in America.
What’s your connection to Children’s? I’m a third year resident here, which means I’ve graduated from medical school and am nearing completion of my formal hospital training. I’m enrolled in the Internal Medicine-Pediatrics Residency, which concentrates on both adult care and pediatrics, so I spend about half my time treating patients at Children’s and half my time seeing patients at Brigham and Women’s Hospital. I also spend about 4 months out of the year focusing on my efforts in Guatemala. I’m there about every 6 weeks or so, so I consider it a very integral part of my training as a physician as well.
Please describe the mission of Wuqu’ Kawoq, as well as your role as medical director for the organization. The organization’s main focus is improving the disparity gap in heath between indigenous and non-indigenous people in Guatemala. Specifically, we’re striving to create care that’s culturally and linguistically appropriate for the rural Mayan communities there. All of the health care available in Guatemala is provided in Spanish, but for many of the country’s Mayan citizens, who make up a majority of Guatemala’s population, Spanish is a second language or not spoken at all. Outside of Wuqu’ Kawoq, there are few Mayan language health services, which puts them at a serious disadvantage when it comes to getting even the most basic health care.
What inspired you to start Wuqu’ Kawoq? I started the organization when I was in medical school, at the University of Illinois, where I was doing research on Guatemala. Based on the disparities I saw in the care available to the indigenous people, I realized how great the need for improved care in these rural communities was. With the help of a number of other people, both Guatemalan and American, we started an organization to address those needs.
Why aren’t there more health care or development programs providing services in the native languages of the indigenous Guatemalan people? In many ways it’s the continued legacy of Spanish colonialism, which in turn became a form of Guatemalan nationalism, and echoes the sentiment that the indigenous languages aren’t really languages, and the people who speak them aren’t all that important. The idea spills over into the way the Guatemalan government, and development organizations working in the country, approach these indigenous cultures. They see them as cultures that are vanishing or about to die out, which isn’t true. They’ve been there for 500 years and aren’t going anywhere.
What conditions did you see on your most recent visit? I just came back from a two-week trip to Guatemala where I saw a lot of cases dealing with malnutrition, most notably where stunting was taking place, which is when physical and developmental delays are caused in children because of chronic malnutrition. We have a number of community-based feeding programs set up in the country, which we were evaluating, and also treating a number of complex cases of nutritional deficiency in many children under the age of two.
How important for your mission is the coverage you’ll receive from ABC’s 20/20 segment? We’re very excited, for an organization this small to receive this type of media coverage is a very big deal. We’re hopeful it can do a lot to increase our website traffic and our fundraising volumes, but more importantly is the fact that it will help in raising awareness about the overwhelming malnutrition that takes place in Guatemala. It’s a country that’s only a couple of hours away from us by plane, but the staggering heath care deficiencies there are largely under-reported. We’re excited that their story is going to receive some international attention and that we’re able to play a role in that happening.
What was it like having their cameras and reports around while trying to work? It was business as usual; their videographers and reporters were very good at capturing what was happening without impeding our work in any way.
Treating patients at hospitals like Brigham and Women’s and Children’s must be vastly different that seeing patients in Guatemala. How does practicing medicine here effect your treatment of Guatemalan patients? One of the nice things about working in high tech hospitals like Children’s or Brigham and Women’s is that it really helps you keep pushing the envelop in terms of what’s possible when working in a resource poor environment. When you’re treating patients in poverty-stricken environments it’s easy to develop a scarcity mentality, where you feel like there are a lot of things you can’t do because of a lack of resources. But in reality there’s a lot you can do you in those situations, you just need to be creative in how they’re executed. Being surrounded by colleagues at a world-class medical center helps me reevaluate what’s possible when I return to Guatemala. Because of the access to great people and technology I have in Boston, which challenges me and helps me think outside the box, I’m able to provide higher quality care to the kids I see in Guatemala.
Does treating patients in Guatemala effect your take on medicine when seeing patients in the US? There’s a lot to be said for returning to a hospital like Children’s after being in Guatemala, because it reinforces the idea that in many situations, medicine really is more of an art or practice than a technique. When treating people in resource deprived areas you rely more heavily on physical exams and less on tests, which makes you think about the art of medicine and it’s costs in a more critical way. I think it’s healthy to go back and forth between the environments because it gives you a better perspective on the many facets of overall medical care.
Children’s employees do a lot of medical work abroad. Trish Lincoln, a Children’s nurse, recently was part of a relief team from the hospital that went to Haiti to help address many of the country’s still staggering medical needs. To read her reflections on the trip and see photos click here.