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A Piece of My Mind
April 5, 2006

Duffle Bag Medicine

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2006;295(13):1491-1492. doi:10.1001/jama.295.13.1491

While the self-styled medical missionaries are piling into the back of the truck, I spot a young man, at most 19, wearing a cowboy hat, smoking a cigarette, and leaning against the makeshift frame that converts the backs of pickups into the primary form of public transportation here in Guatemala. He is not a licensed medical professional; he is an American on vacation and he is about to distribute medication to patients.

I do not think he is aware of the power he radiates in this community. We are in a modest-sized village in the temperate green midlands of Guatemala, the coffee region. The most substantial source of income here is from day labor on the plantations, during the November-to-March harvesting season. Clean bottled water and fresh produce can be purchased at a lively outdoor market on Tuesdays and Fridays. However, for most families, these are luxuries that agricultural day labor cannot consistently support.

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