DOCTORS, DENTISTS and GUATEMALA CITY

 Since beginning this sailing thing, at least one of us have been to dentists and/or doctors in Mexico, Belize, Guatemala, Honduras, France and the United States.  And we're healthy.

To help kick this blog off, last week Delana was kind enough to get stung by a bunch of fire ants. They got her while she was helping build desks for a school the cruisers at the Marina have adopted.  

Delana had a very severe reaction to a wasp sting a number of years ago, so was concerned when she began to break out in hives. At the dock we used Benadryl along with ice and frozen meats to ease the itching. Then when her tongue began to swell we used our neighbor's Epipen. However, I didn't leave it in long enough to deliver the full dose, so we took a boat to town so we could go to the Estacion de Bomberos  (fire station) where they have a paramedic.

After docking the boat, we picked up an antihistamine on the way to the station. Once there, they monitored Delana's heart rate and blood pressure, as well as administered the antihistamine. After an hour or so, the swelling and hives were pretty much gone, so we went back to the marina. Though tired, Delana was pretty much 100% by the next day. Even though the facility and equipment aren't up to US standards, the Bomberos were very qualified/professional. Plus, there wasn't any charge and not one piece of paperwork had to be filled out. When back in the States, several friends had given us money to distribute among a few of the local service organizations. Coincidentally, the Bomberos was one of them.

This dog bite happened when I was in Isla Mujeras. One of those "gentle, wouldn't hurt a fly" Golden Retrievers did the biting.

The Doctor and his assistant came to the marina on a Sunday morning to treat the bite. The charge was only $80 and there was no fee for the shot I received at the clinic the next day.

This is my dentist's dock.

The clinic was recently opened by husband and wife dentists who had practiced in Guatemala City for years. I just had a check-up and cleaning. The charge was $30. However, they didn't polish my teeth, so they didn't feel that clean.

This dental office is downriver from the marina about 15 miles. A couple solar panels and a gas generator meets their electrical needs.

This is the eye clinic in Fronteras. I seldom see any patients there. 

There are a lot of pharmacies, especially in Guatemala and Honduras, where you can get antibiotics and serious pain killers over the counter at a fraction of what they charge in the States.

Of course some pharmacies have less inventory than others.

While in Roatan, Delana was bitten by what she thought was a sand flea. By the time we sailed to Placencia, Belize it was infected and pretty painful, so we bought some antibiotics at a pharmacy and sailed out to see more of the cays. After a few more days Delana was getting worse so we sailed back to Placencia to see a doctor.

The Cuban-born/educated doctor spent a good 45 minutes debriding and then dressing the bite. He couldn't tell for sure, but since the bite had become necrotic he figured it was probably from a spider. He also prescribed a stronger antibiotic and gave us an antiseptic cream. The total cost was $110. However, that did not include any anesthesia during the debriding process, which Delana would have gladly paid a few extra dollars to get. Regardless, she was fine in a couple days.

This is the building in Roatan where Delana visited a gynecologist and had an ultrasound. The total cost was $75. The office inside was much nicer than the exterior, but still pretty modest compared to the US. 

While in Roatan, we also went to dentist. A check-up and cleaning, including polishing, was $30. And Delana had a filling removed/replaced for $40. The dental office was as nice as any in the States. 

Each of the past two summers I've gone to a doctor in France for a very basic physical. The cost is $25. And since I didn't remember the last time I had any blood work done, this year I also had very comprehensive blood tests. The blood tests only cost $60. I made it through the physical and blood tests with flying colors. 

The doctor's office is just as austere as the hallway and waiting room, no plush wall/floor coverings, no big glass atriums and no art work on the walls.

While in France, Delana had an outpatient procedure which involved full anesthesia that had her in a private women's hospital for the better part of the day. Again, the hospital was very basic and the rooms were shared, but Delana's out of pocket expenses were only $75.

While living in France, Delana had her dental work done in Budapest because it was quality work at a low cost. So the original plan was to have her remaining dental work completed last summer, again in Budapest. However, after doing some research and talking with other cruisers, we learned that Guatemala City also offers excellent dental care at reduced costs. So Delana set up an appointment for a week ago last Monday.

The trip from the Marina to Guatemala City is normally a six hour bus ride, not counting getting from the bus station to where you're staying. However, the owner of the Marina offered to have us ride with him and his nurse on his trip back to Guatemala City. The driver was fairly aggressive so we made it to where we were going to stay in less than four and a half hours. 

Whether on foot or stopped in traffic, there are always people selling, but they are never pushy.

It's a pretty drive going from the jungle at sea level through lush farmland, a very arid mountainous area and then to Guatemala City at an altitude of 4900 feet.

And for some of us, the drive was just too much.

We had driven through Guatemala City before, but that was on the Trans-American Highway, which goes through some pretty poor areas.

So we were absolutely amazed to get off the highway and see a very modern cosmopolitan city. At 3.3 million people, Guatemala City is the largest city in Central America. And at 4900 feet in elevation it is much cooler and dryer than the jungle, which was a welcome relief.

This was taken from the Marina owner's eighth floor apartment, which is in one of the most affluent areas of Guatemala City. And it so happened that the place we were staying was only a block away.

We actually stayed with the dentist's mother, who often hosts her son's out of town patients. Even though her home is in a guarded/gated community all of the yards are walled with spikes and/or razor wire on top. 

The home was beautiful and Ursula was a great host. We were within walking distance of a couple very nice malls, Taco Bell, McDonald's Burger King, etc. The cost was $50 per night, which included a nice breakfast and interesting conversations.

The dentist's office was on the ninth floor of one of four ultra-modern 20 story buildings.

On that Monday they examined Delana, cleaned her teeth, did a difficult root canal and took molds of the teeth that needed new crowns. Two day later they put the new crowns on. This was obviously a higher end dentist, but even at that, the examination, cleaning, root canal and two crowns was only $1200. Plus, he examined my teeth and took x-rays at no charge. Delana says it's the best dental care she's ever received.

As far as getting around went, even though these buses were everywhere, we didn't ride any. One reason is that we could never tell where they were going. The first day, the dentist picked us up in his Mercedes. After that we used Uber. We had at least a dozen Uber rides, with some taking more than 30 minutes, for a total cost of less than $40, including tip. There always seemed to be a lot of traffic.

We were in 3-4 shopping centers that were as nice as any in the US and they included quite a few US stores. There was a lot of high rise construction going on. This was a total surprise compared to the part of Guatemala we were most familiar with. It is hard to reconcile people living without electricity and running water in thatched roof huts with dirt floors, versus the obvious wealth in portions of Guatemala City. In one of the malls we even saw the newly released "Joker". The movie, popcorn and drinks were all about half what they'd be in the States. 

Not only were we surprised by the obvious prosperity, but also by the number of traditional Mayan women living in that prosperity. We were also somewhat surprised by how few people spoke English. 

On that Tuesday, while Delana's crowns were being made, we bought a sheet of laminate to replace our existing galley counter tops. Our dentist gave us the name of the store.

Guatemala City has long been known for gangs and drugs, but I guess things are slowly improving. We felt safe all the time, but I guess there are some areas you don't go into at all. Like everywhere else in Central America there are plenty of armed military, police and private security personnel.

By that Thursday all the dental stuff was done so we became tourists. Our first stops were a couple museums.

The Museo Ixchel showcases the Mayan textiles, dress, arts and crafts. The techniques they use to create, dye and weave thread is really amazing and beautiful. 

Named after the ancient Mayan sacred book, Museo Popol Vuh uses figurines, statues, masks, burial urns, traditional textiles and other Mayan artifacts to take you through the history of the Mayan culture from the pre-Columbian period through today. 

Then we went to the Plaza Mayor in the old town. This is the hub of Spanish colonial architecture and home to the city’s most spectacular buildings, including the National Palace. Guatemala City sits on the site of a Mayan city that was founded around 1500 BC. Following the Spanish conquest, a new town was established, and in 1776 it was made capital of the Kingdom of Guatemala. In 1821, Guatemala City then became capital of the newly established Federal Republic of Central America. In 1847, Guatemala declared itself an independent republic, with Guatemala City as its capital. The city was almost completely destroyed by the 1917-18 earthquakes. Reconstruction following the earthquakes have resulted in a more modern architectural look.

The Catedral Metropolitana.

This was Halloween and people were getting into it. However, we were getting a little concerned trying to find some type of internet access to contact Uber, while our phones were running out of battery power. Trying to figure out how to get home on Halloween night in Guatemala City without working phones would have been a little stressful.

In conclusion, it doesn't seem like cruisers, or people from other parts of the world, obsess over medical insurance/costs like we do in the States. That's probably because it's so much less expensive. Obviously the cost of medical care is a complicated subject, but what seems obvious to me is at least a partial reason medical costs can be so much less expensive elsewhere, is that the facilities are VERY modest, the number of people on staff is minimal, there is much less paperwork, the doctors/dentists don't get paid near as much and there seems to be less demand. I also suspect there are fewer third party payments, less regulations and fewer law suits. With that said, I have Medicare Parts A, which I have paid into for years. Plus, I pay premiums for Parts B (non-hospital medical), D (drugs) and G (overseas coverage). Delana is a French resident so has paid the higher taxes that covers most of her medical expenses where ever she is. She also buys a supplemental policy to cover most everything the national insurance doesn't.

As far as Guatemala City goes, there are so many really interesting and beautiful places in Guatemala, it wouldn't be at the top of my list.