First time in the community of Hoyo del Guamá

In 2014 I graduated with a degree in nursing, a new way of seeing life began for me, nothing to do with what I could perhaps imagine, although I knew that everything here is different and too complicated in every way. When you are a student, you see everything in a different way, even though you are working in a certain way while at the same time you are teaching the career. But there is also that important part to keep in mind that you are young and everything is happening before your eyes at a thousand kilometers per second.

When I received my degree in nursing, I was placed in the Abel Santamaría hospital, the highest category hospital unit in the province of Pinar del Río, which everyone calls "the new hospital". Nobody asked me when I graduated where I wanted to go to work, it was simply where I spent my first five years in this profession. For internal reasons that are not worth explaining, I decided after that time to leave this institution and try to move from secondary to primary care, which would be the polyclinics.

I was looking for improvement in all senses, proximity to my home because of transportation, spending more time with my family. To lighten the workload that one faces in a massive hospital, of social category like ours, in other words, better working conditions. In this first attempt to leave for Primary Health Care, I had the help of my friend Juan Carlos. At that time, he was the head nurse at the Raul Sanchez polyclinic, where I wanted to start working.

As much as we insisted, that fight was lost, despite the fact that the municipality had the plaza where I would be placed. Supposedly in an office in "el Hoyo del Guamá", at that time I did not pay much attention to the subject. I didn't know where this place was, but I had heard about it. Someone told me that it was quite far away, but I was so attacked with the idea of leaving the hospital, that anything would do. But the provincial directorate of health was very firm and did not want to release me to go to primary care.

For my part, I gave this situation a slight pause for another five years, which, in a certain way, were spent little by little working at the León Cuervo Rubio Hospital. The second institution of this type of reference in the province, which everyone calls "the old hospital", I'm sure you can deduce that they call it that way because it was the first of its kind here in western Cuba. Why "the old hospital"? Well, it turns out that I spent practically the first years of my career there during my training.

The good memories, both of the teachers and the identified comfort that came hand in hand with that sense of belonging, encouraged me to give it a try. However, I also left and decided to try again to go to Primary Health Care. Not much time has passed since then, just two years at the most. I was again helped by my friend, who this time had been promoted to Head Nurse of the polyclinic, until I was finally able to make the transfer.

From then on everything has been different, I was not used to the way of working in a different health institution. With the characteristic of being the closest to the patient, practically in the community. You may wonder where I am going with all this, well, you remember the medical office in "Hoyo del Guamá". It turns out that today I came with a medical commission from the polyclinic, which came to supervise this health area that belongs to the Turquino plan.

It is the first time I came to the place, it turns out that it is not as far as I imagined, it is much farther still. It all starts with a 14-kilometer truck ride on a mountain road, where stability as such does not exist because of the deterioration of the road, if there ever was one. This is precisely one of the factors that makes it impossible to enter this place, where they say that when it rains the road is a jabolina.

When we arrived at the supposed Hoyo del Guamá, we found that there was not a drop of internet connection, nor coverage for calls or SMS. I think right now I can hear my wife saying to me in a sea of laughter: "papo, you got punished". With a population of about two hundred people, the place has a bodega, a bakery and as such the structure where the doctor's office, the infirmary and the pharmacy coexist.

At first I didn't know it, but it turned out that with us came a recently graduated doctor with her family. The girl was the one who was going to relieve the doctor of the place, who would be released after a whole year of social service in this place, practically away from everything we call comforts. After seeing the conditions of the place, where this family would spend a whole year, I realized how lucky I was at the time, when they did not let me come here.

Then one realizes that, sometimes, what is convenient. On the contrary, for those who like the tranquility, the remoteness of the countryside with all its goodness, it would be a paradise. But it is clear that this is not for me, despite the fact that a year is spent wherever I want. At least that is the time range of the medical rotation here.

The nurse at the clinic, if she is permanent, does not seem to me to live here. Apart from the lack of communication with the outside world, due to the connectivity issue, I think that the transportation issue, both to get here and to leave, is quite closed. This being the most alarming when it comes to even think about coming here. I really do not want to imagine myself in the shoes of this recently graduated doctor, she will have to put her life on hold, for a whole year in which the locals will be able to contact medical care in Hoyo del Guamá.

The images used in the post are my property, taken with my mobile Xiaomi Redmi Note 10 S. Texts translated into English by Deepl Translate.

Edited in canva.