Three-year-old Maynor sits in his mother's lap, barely conscious. He is pallid, exhausted and falling limp in his mother's arms.
With a caring smile and comforting voice, Dr. Mercedes Sanchez discusses Maynor's health with young boy's mother. Occasionally, she asks Maynor questions in Spanish, to which he weakly nods or shakes his head.
Over the past few hours, Sanchez learns, Maynor has thrown up five times. He's also suffering from a persistent fever.
"It's a stomach virus, a bad one," Sanchez explains. "It's been making rounds in the villages."
Sanchez prescribes an injection and regular doses of hydrative fluids for Maynor. The clinic staff will keep him in observation for three hours. If Maynor can't keep the fluids down, he will spend the night at the clinic.
Maynor is the first of more than 35 patients Sanchez will see today. Over the next several hours, the doctor might see patients suffering from respiratory problems, acute diarrhea, physical injuries, parasites or malaria in the next several hours.
During the year she's spent as a doctor in the Tucuru health clinic, Dr. Mercedes Sanchez has seen it all.
A commitment to serve
Sanchez has been a doctor for 13 years, most of them in her native Cuba. Wanting to do more to help poor families, she came to Tucuru in 2003 as part of a Cuban program that posts well-trained physicians to some of Latin America's most underserved areas.
"In Cuba, there's a volunteer service for doctors - we can serve in a randomly selected country," she said.
Cuban doctors have served at the Tucuru clinic for the past five years on a rotating basis. The volunteer service lasts two years.
Halfway through her time in Tucuru, Sanchez has seen some progress in the area's health services and awareness.
"We've seen small improvements in health, but the living conditions in the villages are still poor. Part of the population is starting to see the advantages of better hygiene. There's a lot to do still - especially in the villages," she said.
Sanchez and another doctor serve more than 70 villages in the Polochic Valley, making monthly visits to villages in addition to maintaining a rigorous schedule at the Tucuru clinic.
She is pleased to be a part of the Mercy Corps team in Tucuru.
"Mercy Corps offers us a lot of support. It facilitates communication between doctors and patients, helps with the educational gap and bridges cultural differences. We've also been able to participate more actively in the villages," Sanchez said.
"There's still a lot of work to do. We need a lot of health education in the villages. If we continue to work as we do now, we can achieve our goals," she explains. "I've been a doctor for 13 years, but have never seen the severity of cases that I have here. Most of these people have never seen a doctor in their lives."
Local culture and tradition often make change slow in this part of Guatemala. However, Sanchez is optimistic that area families are becoming better-informed about health and learning some lifesaving lessons. She is encouraged that Mercy Corps' Health Citizenship Project is having success in reaching out to indigenous Q'eqchi and Poqomchi households.
In the Tucuru area, there hasn't been a single death in childbirth this year.
"The Mercy Corps project has greatly improved our health facilities, communications, community organizations and health extension services. Working as a team has been a great success," Sanchez said. "The advances we've had have been gained with dedication and sacrifice. This has to be a long-term commitment. It happens slowly but, little by little, through direct contact with the patient, we succeed."
While she misses family and friends in her homeland, Sanchez is committed to making a difference for families in the Polochic Valley.
"It's hard to leave one's family, but knowing that you can help save lives is enormous satisfaction," she said.
"It's very important for people with means to help the most needy. The smallest bit of charity can save the life of someone here in Guatemala."