Helps International Medical Teams Back to Guatemala Guidelines

TEAM VOLUNTEERS

Helps and Guatemala’s Government requires the following to be allowed to come to Guatemala:
Evidence that you have received a complete COVID-19 vaccination course, with the second dose being administered at least two weeks before arrival in Guatemala.
Mandatory use of facemasks in public spaces from the team’s arrival to Guatemala until departure.
- Every person arriving in Guatemala must complete, before their arrival, the following Health Pass, available on this website: https://sre.gt/en/
- The U.S. requires evidence of the following for re-entry to the United States:
  - Negative COVID-19 test within 72 hours of arrival
  - COVID-19 vaccine completed at least two weeks before arrival or Recovery from COVID-19 within three months of arrival

VOLUNTEER WITH A POSITIVE COVID TEST

Any volunteer with a positive COVID-19 test will be removed from the rest of the team and sent to Hotel Barcelo in Guatemala City for a ten-day quarantine. After their ten-day quarantine, they must get tested to leave the country.

Laboratorio Juan Pablo (located in Antigua, Guatemala, 7832-0294) will perform the antigen test at the hotel. The tests will be done the first day the team arrives in Antigua (cost Q435.00). You’ll need to make an appointment 48 hours in advance.
Blue Medical if the test has to be done in Guatemala City.

ON-SITE

We will work in isolated locations to control the people and the crowd and, ideally, work in places exclusive to our teams. The facilities have to meet specific criteria to be eligible for our jornadas.

PATIENTS

Clinics

Staggered appointments, according to the number of physicians available per team.
The Guatemala staff will coordinate appointments with Municipalities, community leaders, local Health Centers, and strategic alliances.
Patients are required to wear facemasks; we will provide each patient with one quality facemask (KN95) at the door.
Temperature checks of all patients and companions were done using a small symptom questionnaire. A nasal swab for COVID-19 will be conducted if the patient has a fever.
A Helps staff member will give the proper information about proper social distancing, proper use of facemasks, and handwashing information at the door.

Questions to patients/companions before entering campus:

Do you have a fever, or have you had a fever in the last 14 days?
Have you had any respiratory problems (sore throat, dry cough) during the last 14 days?
Have you had tachypnea or a feeling of lack of air over the previous 14 days?
Have you had fatigue or general discomfort during the last 14 days?
Have you noticed a loss of smell or taste in the previous 14 days?
Have you traveled outside of the country in the previous 14 days?
Have you been in contact with a COVID-19-diagnosed patient?
Have you been in close contact with a person with a respiratory disease during the last 14 days?

If, during the survey, the patient indicates YES to any question and has a temperature higher than 37.5°C, the patient will be guided to the COVID-19 testing area.
If, during the survey, the patient indicates YES to any question and has a temperature lower than 37.5°C, the patient will be guided to the COVID-19 testing area.
If, during the survey, the patient indicates NO to any question and has a temperature higher than 37.5°C, the patient will be guided to the COVID-19 testing area.
If, during the survey, the patient indicates NO to any question and has a temperature lower than 37.5°C, the patient will be guided to the triage area.

WE WILL NOT EVALUATE POSITIVE COVID-19 PATIENTS. WE ARE NOT A COVID CENTER
Patients will be asked to wash their hands before the physician sees them.
A touchless hand wash station with running water, soap, and paper towels will be installed in the triage area.
Companions will only be allowed with minors or patients with mobility issues.
Kids under two years old will not have to wear a facemask.
We will set up a special and isolated area for children under two who are not wearing a facemask.
Every physician will evaluate three patients per hour.
Clinics, stretchers, chairs, etc., will be disinfected between patients with Clorox wipes.
Triage and clinic staff will require level II PPE (handwashing, scrubs, scrub cap, face shield, N95 face mask, disposable gown, gloves)
Hand sanitizer will be available in triage, waiting areas, and every clinic.
One Helps staff member will oversee the proper use of facemasks and social distancing in the triage area.

PPE according to Protection levels

Protection Level	Protective Equipment	Scope of Application
Level I	Hand washing Work uniform Disposable surgical mask Goggles or face shield Disposable surgical cap	Administrative staff
Level II	Hand washing Work uniform Disposable surgical cap Goggles or face shield Medical protective mask (N95) Disposable gown Gloves Disposable surgical cap	Triage General outpatient
Level III	Medical protective mask (N95) Work uniform Disposable medical protective uniform Full-face respiratory protective device or powered air-purifying respirator	When staff performs operations such as: Tracheal intubation, Tracheotomy, Bronchofibroscope, Gastroenterological endoscope., etc., during which, the suspected/confirmed patients may spray or splash respiratory secretions or body fluids/blood

Source: Handbook of Covid 19 Prevention and Treatment

Surgery

All surgery patients will require a negative COVID-19 test 24 hours before surgery. We use this time frame to avoid having patients and companions in the shelters for more than 24 hours.
Companions will only be allowed with minors or patients with mobility issues.
We will place an information phone number to update family members of patients with their post-surgery information and recovery information; this will be put in place to avoid non-essential people in recovery.
Mandatory use of facemasks for patients and companions.
A surgeon will evaluate patients one day before the surgery and then send them to a shelter.
In addition to the usual follow-up (7 days after surgery), there will be a 15-day follow-up after the surgery. If a patient has symptoms or a positive COVID-19 test, we will track down the patients who shared the recovery area, PACU, etc.
Surgeons must use level II PPE.

Shelters

Together with municipalities, we will put together shelters for surgical patients and one companion if they’re a minor and/or someone with mobility issues. We must search for spacious rooms with high ceilings and cleaning staff. Every patient with their companion will be set up in a 1.5 m² space and must be separated from the other patients with at least 1.5 m² of space. We will determine how many patients can be in each shelter according to the room size. It will have to have one exit and one entry.

LOGISTICAL SET-UP

The waiting area must be measured to allow people to keep a social distance of 1.5 m² between each patient.
The chairs in the waiting area won’t be allowed to be moved.
The chairs will be cleaned three times a day with Clorox wipes.
The exterior area (triage, waiting area) will be cleaned two times a day.
Clinics and recovery will be cleaned three times a day with quaternary ammonium.
Staff is required to use PPE level II.
OR will be cleaned in-between each patient with Cavicide (an intermediate-level surface disinfectant that is effective against TB, HBV, HCV, viruses(hydrophilic and lipophilic), bacteria (including MRSA), and fungi), and we will set up UV-C disinfecting lighting for 15 minutes in between patients.
The waiting area will be disinfected with a UV-C.

INTERPRETERS

For local interpreters:

Must be 18 years or older.
Sign a release form.
Have a negative PCR/antigen COVID-19 test done 72 hours before the medical trip.
Must sleep only with interpreters.
The interpreters must always use a facemask, except when they’re eating.
Local interpreters will be tested after the medical trip ends.