Thursday, August 31, 2006

Chichicastenango and More

This morning was our clinic day in Chichicastenango at ASELSI. As always, this was a tremendous experience. Due to a dozen crazy reasons, this was really our first full clinic there. We have a few folks for you to pray for, too. One person's name is Laura Hernandez. We saw her as a prenatal patient in our hyper-speed clinic last week and her ultrasound did not look right. The ultrasound at ASELSI doesn't have quite the clarity of picture that ours does, though, so we told her to come back this week and we'd bring our machine. This morning, Heidi diagnosed a "molar pregnancy", which is really more of a tumor than a pregnancy, and we asked her to come to the hospital here in Quiche. We drove her and her husband here and took her to the ER. The local doctor agreed with Heidi's diagnosis and has scheduled Laura for a procedure tomorrow morning to remove the mole. If she had not been diagnosed, she could have had some severe problems.

Another person to pray for is a 21-day-old baby who weighs 3lbs 13oz. He weighed 4.5lbs at birth (born at home at 34 weeks) and his mother brought him to clinic today because he's still losing weight. She was asking for some extra milk (ASELSI has a milk program for underweight kids). She's giving good milk, though, and we encouraged her to feed him breast milk. Formula really isn't the answer, especially since there's no guarantee on the quality of water she'll make it with. Please pray for this baby. He's on the jagged edge in this country. One case of diarrhea could kill him.

Also on our prayer list for today is Jose Larios. He's an eight year old boy who has had two heart surgeries in the capital for a mitral valve insufficiency. Jim had initially found this boy and shepherded the family through the process of getting the surgeries he needed (along with providing some money). He is recovering well and the family is still dealing with some bills (that we will probably help with) but he is definitely on the mend. The second picture below is that family on our couch! (The first picture is Heidi studying the manual for the ultrasound on the sofa we temporarily placed on the patio to take advantage of a beautiful day.)

Next on our prayer list is a beautiful four year old girl who weighs 22 lbs. (She's in the third picture on Heidi's lap.) Her family says she just doesn't want to eat. Her skin, hair, and nails don't really show evidence of malnutrition, but she is VERY small. We'll do what we can to help her, though most of our guesses are little more than stabs in the dark. Her parents look healthy and she has a younger sister who is "normal sized", so it's probably not a condition of not having food in the house. We're hoping to see her on a regular basis over the next few months to monitor her progress.

The last picture is really for Heidi's brother. Daryl, come visit. They have bike teams here. We have proof. Hope you don't mind mountains!!!!

Oh, for dinner tonight, we met some American missionaries who live in Chichi. Their names are Kemmel and Lisa Dunham and they are wonderful people. We very much enjoyed meeting them and sharing observations. She is a family practicioner who we will spend some time with in the next few weeks to further solidify some of the things we've learned from Jim and Kathleen, Leslie, and Dra. Karin. We feel like we have a much better handle on the FP side of things than we did a month ago, but we will NOT be turning down opportunities to learn from experienced people here in Guatemala!!!!

That's it for today. Please keep the folks we mentioned in your prayers, as well as Isabel Solorsano, one last patient we're following up on from the team that was here earlier this month. She is improving, so keep those prayers coming!

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Tuesday, August 29, 2006

Busy "Day Off"

Well, today was the second day of our supposed weekend. Heidi is still recovering from a nasty cold and is trying to lay low. But we got up this morning, returned a bunch of e-mails (we're starting to hear from other missionaries here and we're very excited about meeting some soon), Matt went to the gym, and then we went to town.

There is a place here called Aprofam, which is a low cost health-care provider. Example, they do vasectomies and tubal ligations for Q25 (about three dollars and change). The people there are very nice and we got to meet them and learn a little bit more about what they do. They can do EKGs, some vaccinations, ultrasounds, and other basic stuff. We will definitely be referring some patients there for services we cannot provide in our clinics.

Also very exciting, we found a new local nursery (plant nursery - no rumors, please) that's been here for four months, so we bought some tropical plants. We're working on sprucing up the east courtyard now. And at about 4pm this afternoon, Matt decided to discover what lay beneath the wild growth at the front of the house. Jim and Kathleen really did a nice job of setting the place up for some beautiful landscaping. Most of the front of the house has rock beds (currently overgrown with weeds) and Matt cleared about half of those out this afternoon. We'll see what comes of all that now that we know there is a really cheap local nursery (we bought six large plants today for less than $100.)

Anyway, the first picture is a shot through our kitchen window at the soccer field we've told you about. The second is a shot from the doorway of the great room out towards the east courtyard. It is really still a work in progress, but we have GRAND designs! And the third shot is the dinner Matt came into tonight. Barbecue steak, homemade mashed potatoes, and cucumbers with balsamic vinegar and cheese. No, we're not exactly starving here!

Tomorrow we have a morning meeting to introduce Dr. Valez (the Area Health Manager) to the Fickers. He is very excited to hear about their new plane and they want to be able to coordinate efforts. Tomorrow night dinner is with Jose and Pam Munoz, a local couple we know through Jacob.

The hospital is still closed. Please keep that situation in your prayers!!!!

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Monday, August 28, 2006

Day Off???

Well, the last time we wrote, there had just been an impromptu jam session/meeting about medical mission teams and the medical community here in general. Lots of stuff to think about. One thing we will definitely focus on is the atmosphere of a "foreign exchange" program where both sides (US and Guatemalan) get to interact, teach and learn from each other. And who better to work on that than a former foreign exchange student? Most of you know that Heidi spent a year in Sweden. So Spanish is really her third language. We are both picking up A LOT of Spanish. Heidi, of course, more that Matt, because she had quite a head start, but we're both getting much, much better.

Anyway, today was supposed to be Day 1 of a weekend, of sorts. The first knock on our door came at about 7:30 this morning. A local pastor brought by one of the boys from his congregation who had a problem with his pena. You can either look it up or guess what that means Matt got to look at first thing this morning. (Heidi was still sleeping, as she's battling a pretty tough cold.) The pastor explained that they had been given some medicine yesterday and it wasn't any better yet. Hmmmm... whether to wake Heidi or not. Well, let's ask some questions. The boy is four. Yes, that thing is quite red. No, mine does not look like that. What medicine? Ah, amoxicilin. No need to wake Heidi. This stuff will take more than one dose to fix your problem, if that's what your problem is. If it's not better by this weekend, we'll conveniently be in a clinic in your hometown.

An hour or so later, the phone rang. Matt's Spanish is improving, but he still uses a lot of sign language. Not so useful on the phone. So Heidi woke up and answered. It was Carrie, from Houston. No problem, we have lots to talk about and we need to talk anyway.

Just as we're hanging up, another knock. This one is Roscoe Canada, an American missionary who lives in Canillá, not too far from the Fickers. Just a "drop by and say HI" visit. Very nice.

Soon after, another knock. This one from someone who wants blood pressure medicine. We get a lot of these now that the Hospital's ourpatient services are closed. We will be doing a clinic in this woman's town in a few days, too.

A few minutes later, another knock. This one is a woman who is having continuing complications from her surgery (performed by the team a few weeks ago). Heidi has been working with one of the local OB/GYNs on her case. She just had a few questions. As fate would have it, we saw her two or three times today.

Soon, another knock. This was a girl trying to find out when there's going to be another clinic. So we broke out the calendar and let her know.

By now, it's lunch time. We have some business to take care of in town, but everything is closed between 12:00 and 2:00 (which means 11:30 to 3:00), so we ate some, sent some emails, then headed into town. Wouldn't you know, we stumbled across a mall. Yup, here in Quiché, a mall. Not a Galleria or anything, but it did have a video rental store. Heidi has been calling herself and her group of gyno-buddies "Mean Girls" for a few years now, but has never seen the movie. Now we have (subtitled in Spanish). We learned some new words tonight. Probably not ones we can use in clinic, though.

Well, that was our day off. There's another one tomorrow, though, so worry not!!

Please keep all of the people who are still waiting for the clinic to open in your prayers. We do what we can in our clinics, but anyone needing surgery that's non-emergent is just waiting....

Friday, August 25, 2006

Music... Another International Language (Illustrated Version)

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Music... Another International Language

Just a quick note to thank you all for your continuing prayers and love... and to let you in on why we didn't write much yesterday or today. Yesterday morning, we got (we thought) quite a bit of negative feedback from the hospital administration which really had us down in the dumps for a while. There were literally five doctors that came for coffee and a meeting, to tell us about some complications that had occurred with surgeries we had done several weeks ago, that we had no knowledge of beforehand! It was like "M and M", for those of you in the medicine biz... Anyway, when they all left, we weren't even sure how it went! Especially considering the fact that at best, we only understand about 85% of what they're saying when they get excited. As it turns out, though (and doesn't it always?!), God really knew what He was doing, and it looks like there is really an opportunity for a lot of good to come out of everything--

One of the doctors saw Matt's guitar case on the way out, and asked if he played. Even though Matt downplayed his guitar-playing, Dr. de Leon asked if he could bring a friend over who played very well... maybe tonight?! We said that would be great, assuming that in "Guatemalan time", that probably meant next week sometime. So we were a little surprised when he showed up later that night, with his guitar and his musician friend in tow. Matt started an impromptu jam session with his buddy (he, of course, soon got out his violin instead, though!) and we all sat down for coffee. A few minutes later, another knock came on the door... and in came the "Jefe de Area", or for us gringos, man in charge of the total health care system in the State/Department of Quiche. Apparently he had been invited by Dr. de Leon to come by and talk to us. We got to talking about some of the "problems", which both the visiting doctors were very quick to point out were not anything to worry about but only something that we could all learn from, and soon the guitar-playing friend left. Essentially, I believe it was a total set-up, and Dr. de Leon had sensed that we felt really badly about the meeting earlier and wanted to make sure we knew everything was okay. He used music as a way in to that conversation, and I believe God was using the whole situation to remind Matt just how important HIS talents are in this whole deal! It soon became apparent also that we have a Christian friend in Dr. de Leon, which is always welcome news.

I know, it's a random story, but I knew Matt wouldn't tell it... and I think it's important to remember how God can use us in so many different ways to accomplish His work here on Earth. Things are really starting to fall in to place better and better with each passing day, and we feel so blessed to be here doing what we are doing. Our hope for all of you is that you have found or will soon find the peace that comes from knowing that you are loved and led by Our Creator, which we have truly enjoyed to the fullest this week. God bless you all, and have a great weekend!

Thursday, August 24, 2006

Where We Live

Okay, we've gotten lots of questions about where we live. Are we in a tent, a mud hut, a tree house? Well, no. Jim and Kathleen built the dorm where we live about seven years ago and it is a tremendous blessing. Keep in mind that they actually lived IN THE HOSPITAL for a while. They slept in the ICU.

As most of you know, we live on the grounds of the National Hospital here in Santa Cruz del Quiche. As you drive in from the gate, the hospital is on the left, then at the very back, on the right, is the house. Our front yard is a soccer field where a lot of kids play while their parents are waiting for one thing or another at the hospital.

We basically live in much the same way as we did in the U.S. It's actually a bigger place than our Houston apartment (not that that was much of a challenge). We have electricity, hot water, high speed internet, seven bedrooms, eight bathrooms, a huge kitchen, a pharmacy, two washers, a dryer, and two large courtyards. Okay, maybe we're living a little BETTER than we did in the U.S.

Anyway, here's a picture of the front of the house, two shots in the living room (one is an action shot for Heidi - which she will roundly thrash me for when she sees it) and one of my favorite room (the kitchen). You'll note the two oven/stoves. We also have two refrigerators and a deep freeze. Oh, and don't forget the two pilas, one indoors and one outdoors. (A pila is a utility sink with two or three compartments. One is a deep one for holding water. The other one or two usually are ribbed like washboards and tend to be used by the locals for washing....)

Okay, enough of all that silliness. We have to go cook dinner. Tonight will be grilled chicken salads....

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Wednesday, August 23, 2006

LOOOONG Clinic Day

Today was our second "solo" clinic. We were in Chicabracan, a small village just outside Santa Cruz, where we live. There hasn't been a clinic there in some time, so we were not surprisingly swamped. We went straight from 8am to 6pm with no more than about a five minute break at one point to inhale a sandwich and maintain some semblance of sanity. We saw somewhere in the neighborhood of 60 patients.

Heidi, always a surgeon, got to cut someone, which makes it a successful day in her book. A nine year old boy came in with his parents, who showed us a small stab wound on the front of his leg, just above the ankle. His dad was kinda funny. He kept pointing out how small the wound was and wondering why he couldn't walk. Well, the whole front of his leg was red and the cut was pretty infected looking. So Heidi shot him up with some lidocaine, which he did NOT enjoy, and proceeded to "liberate pus" - one of her favorite activities.

We saw three month old twins, both with colds. They were SOOO cute! We saw a boy and his mother, who were both really sick with the crud. The son had a 103 degree temperature. We saw lots of high blood pressure and diabetes. We saw a girl who had headaches, probably due to a lazy eye (we referred her to an eye team that comes through every two weeks). And lots, lots more.

One funny thing about local custom is that they refer to a week from today as "ocho dias" or "eight days". Two weeks from today is "quince dias" or "fifteen days". They apparently count today as day 1. So forgive us if we mention that we're doing something in eight or fifteen days. Sometimes it's hard to keep our languages straight!

Anyway, the pictures. The first picture is a dozen roses Matt bought for Heidi in the market yesterday. Don't tell Heidi, but they cost Q10 (at an exchange rate of Q7.5 = $1). Matt suggests coming to Guatemala just before Valentine's Day!!!

The second picture is Dra. Heidi (Dra. = Doctora, the feminine version of Doctor) in the door of our clinic room in Chicabracan, surrounded by about 1/6 of the patients we saw today.

The third picture is Heidi again (in Guatemala, her name is pronounced HAY-dee. Just go with it, it's easier) with a baby who is less than a month old. Her mother came in complaining that she was very tranquil during the day but cried a lot at night. We told her that the good news is that she's normal. The bad news is that she's normal. So there you go. Kids are pretty much the same, all over the world. Except here they wear the cutest little trajes. (A traje is the traditional Mayan dress that the women wear. This baby had one that was SOOOO small!)

Anyway, tomorrow we're back at ASELSI in Chichicastenango. Always a very nice experience. Please keep us and our patients in your prayers. And pray for us to be able to get some insulin soon! We're out and it's not very easy to get here....

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Tuesday, August 22, 2006

Just To Give You an Idea...

Today is, thankfully, mostly a day of rest here for us at home. Matt is working on some gardening and things around the house, but Heidi is mostly hanging out on the couch waiting to feel better... which gives her some time to catch up on blogging and a couple of other things she's been meaning to do!

There were a couple of follow-up patients from the team scheduled in the hospital clinic today for her to see, which was no big deal. But going down to the outpatient clinic gave us a big reminder of exactly how bad things are here for patients needing routine care here these days. We mentioned before that the outpatient clinics in the state/government hospitals are closed in protest of not being well-equipped by the government. Specifically, what is happening is that the doctors are refusing to work in the clinics until they receive better support, equipment, medication, etc. with which to do so. There are no non-emergent surgeries, no routine prenatal care, and no follow-up or new patient clinic visits for any reason available in any of the state hospitals in the nation as we understand it. (Most cannot afford to go to the private hospitals). There argument is that the government has not kept up its end of the bargain in the "peace accords" that ended the civil war here around 10 years ago. This is a common theme here in Guatemala, and there have been lots of protests involving many different topics over the years since the war. People do not want to go back to war, but also do not want the things they were fighting for to be forgotten.

Anyway, Dra. Karin Garcia Pinzon, who is one of the administrators in the hospital, gave us a copy this morning of the list that the hospital is presenting to the government, which contains all of their requests/demands that they want met before they will work again. Apparently, there is a meeting this weeks in Guatemala City, but if it doesn't go the way the doctors want it to, things could go from bad to worse! There is a possibility that even the Emergency Rooms may shut down in order to "get the government's attention". Can you imagine a countryside without any ERs in this day and time? Many people could die unnecessarily, and there are pretty big moral/ethical implications if it comes to this.

I write all of this "un-fun" stuff here, though, for three reasons. One is to remind our friends and family reading this of just how blessed they are to live in the U.S. The health care system there is not perfect by any means, but you won't be denied care there. In Guatemala, 0.9% of GNP is spent on health care (versus around 12% in the U.S.), and that money is trying to support what essentially boils down to a national health care plan! No wonder the hospitals feel under-supplied. The second reason is to solicit prayer for the Guatemalan government and doctors and, more importantly, the indigenous people here who may suffer greatly from this conflict. Pray that peace in this nation will continue and that the leaders will continue to work towards improving the lives of their people here. Thirdly, if you happen to have access to any of the equipment they need and want to donate it, please let us know and we can make that happen! It's sad to think that some of this stuff is literally laying around in American hospitals in closets, unused...

I wanted to just put the list in as a "link" in order not to overwhelm and bore you entirely, but I couldn't figure out how to do that, so here it is:

Immediate Needs (within 15 days)

Enough scrubs and bedding (sheets) for all of the medical personnel and beds/cribs in the hospital
Purchase and improvement of disposable equipment and medications, with at least 6 months of supplies
3 Ventilators (2 adult, 1 pediatric)
3 EKG machines (1 for outpatient clinic/surgical work-up, 1 for ER, and 1 for the wards)
4 Neonatal Monitors
2 Pediatric Monitors with Defibrillators (1 for wards, 1 for ER)
4 Fetal Dopplers (ER, Clinic, Labor & Delivery, inpatient)
Long gloves (with coverage up to past wrist) for extraction of placentas

Short-Term Needs (within 1 month)

Disposable impermeable surgical gowns, with masks and eye protection
10 IV infusion pumps (5 adult, 5 pediatric) with the appropriate cassettes
10 Pulse-Oximeter monitors
1 Cardiac Monitor
2 Capnography devices (adult and pediatric)
5 Blood Pressure cuffs on pedestals (rolling/portable, but a little more difficult for people to “walk out” with, I think…)
1 Peak Flow monitor
6 Ambu bags with respective reservoir for adults
8 Water-seals for adults (I assume for chest tubes…)
7 complete laringoscopy sets (4 adult and 3 pediatric)
Implementation of a post-op recovery room (equipment and personnel)

Medium-Terms Needs (within 3 months)

Pediatric operating room table/bed with heated mattress
4 heating lamps
4 water-seals for pediatric patients
4 water-seals for neonates
2 portable pulse oximeters
2 neonatal cribs with phototherapy, oxygen, and suction capabilities
4 incubators with controls
2 kinesiotherapy devices for patients on vents
20 hospital beds (10 pediatric, 10 neonatal)
6 neonatal ambu bags with respective reservoir
7 portable oto/opthalmoscopes and 12 wall-mounted
10 adult blood pressure cuffs
4 pediatric blood pressure cuffs
10 pediatric stethoscopes
5 heat lamps for episiotomies (I assume lights for episiotomy repair…)
2 portable oxygen tanks
4 respiratory suction devices
5 nebulizers
10 complete Pomeroy sets (for doing tubal ligations in the OR)
10 pairs of asbestos gloves (for handling hot things out of the autoclave, I assume… Not something that can be bought in the US, of course, but if anyone knows what they’re using for that purpose there, we’d love the information…)
1 colposcope with ?double vision and conization
5 kevorkian biopsy forceps for cervical biopsies
4 uterine immobilizers (?I think they mean tenaculums…)
5 Novack canulas for endometrial biopsies
6 fetoscopes
2 electrocautery devices

Longer-term Needs: (within 6 months)

2 portable X-Ray machines, one with fluoroscopy for use in the OR and the other for ICU
1 orthopedic operating table/bed
1 gynecology operating table/bed with padded stirrups
4 intermittent suction devices
8 full sets of water-seals
1 rectosigmoidoscope
1 endoscope
1 gastroscope
OR/Surgical instruments: pliers/forceps, scissors, retractors, yigli saws 2.5 and 3.5 mm screwdrivers, a few other things I can’t translate…

Thanks for your time, and for your prayer's for these people. Have a great day, and don't forget to be grateful for what we all have!

God bless you...

Monday, August 21, 2006

First Solo Clinic

Well, today was our first solo clinic and we didn't manage to kill anyone. We did diagnose a case of mumps, a case of pre-eclampsia, saw a guy who had been badly injured in a wreck in Houston (and spent two months in Ben Taub hospital), looked at some very fun rashes, and a couple of yeast infections. Add to that a few diabetics and seizure patients and it was a full day.

Then we went into Quetzaltenango (a.k.a. Xela) and shopped in a real grocery store for the first time in a month. We spent $200, which is hard to do on food in Guatemala. But we have a freezer full of meat, which makes our carnivorous friend Matt very happy!!!!

So we thought we'd share a few pictures. Only one is from today, but they're fun anyway. The first one is of a Guatemalan traffic jam. We were headed down a mountain when we suddenly got stopped by traffic. We later found out that a semi-trailer had nearly fallen off the road, closing one lane. You'll note that the vehicle directly in front of us is a Suburu Brat with the tailgate tied on with a rope. There are six little girls in the back, eating apples, and passing a kitchen knife around. When they saw us, they yelled, "GRINGOS!!!!" The vehicle in front of them is a chicken truck. Which is funny because the vehicle driving southbound on the northbound shoulder is called a Chicken Bus (think, Guatemalan Greyhound). Chicken buses stop for NO ONE! Our lane is stationary. You can see that there's a northbound car coming - it's their turn to use the one open lane. But don't tell that to the chicken bus. He's driving down the shoulder and his spotter (who rides in the open door) is yelling at the northbound traffic!

Anyway, the second picture is at the Ficker's house. Why we took that picture, I don't know. But Rachel and Joseph are sitting on one of their tractors while David, Aaron, and their dad are fixing the four wheel drive system on their F-350 so they can drive it to Guatemala City in the morning.

The third picture is Matt, getting ready for clinic this morning in Nueva Santa Catarina. You can see the Toughbook (donated by David Dickson) with the custom software (donated by Rob Emanuel) and the two tubs we're carrying (with meds donated in large part by the Wichita Falls team that just left). Yes, we're a walking repository for donated stuff. Keep it coming, though, the people need it!!!!

Anyway, we have some patients to look after here in Santa Cruz tomorrow - follow-up patients from the Wichita Falls team. Hopefully we'll have a quiet afternoon so Heidi can get some sleep and rest. She's a little under the weather herself. Just a case of the creeping crud. So keep her in your prayers.

Thanks so much for all your notes, thoughts, prayers and emails. They really help us feel closer to home. Please keep them coming!!!

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Sunday, August 20, 2006

More Clinics

Another weekend, another awesome visit with the Ficker family. We had dinner with Jacob, Minchi, and Jacobito on Friday night, then had a short night of sleep and a trip to Canillá for morning clinic with Leslie and Katie. Heidi got to do a minor procedure on a man (probably a first for her - at least the first in quite a while!)... You can ask her where it was, but she probably won't tell!

This morning (Sunday), we went to clinic again in San Andrés where Heidi got to look at a few more male problems. Where's Francisco Orejuela when she needs him!?!?! We got Leslie and Katie out of there before 1pm (the goal was noon) so the Fickers could head out on a well deserved two-day break in Antigua. Of course, you know they'll work the whole time, but at least they're not at home!

Tomorrow is our first "solo" clinic. We'll be in Nueva Santa Catarina. It's a small village at about 10,000 ft. altitude just outside Quetzaltenango (a.k.a. Xela - pronounced "Shay-la"). The church there seats about 12 people. They have been waiting for a clinic for quite some time and we are excited about our first one without any "across the room consults" from more experienced medical missionaries like Leslie or Dra. Karin or Jim and Kathleen. Pray for us to have patients we know how to help!!!

After clinic, we'll get to go to our first "real" grocery store in about three weeks. We're getting a little tired of Jamón Americano, which is one of the few items we've found here in the local shop... (Jamón is ham. And we like ham sandwiches, but only so much!) Xela is a pretty modern city. It has an Hiper Piez (think, Walmart) and a shopping mall. We have a list. Imagine that!

Anyway, this afternoon we're just packing stuff for clinic tomorrow (hoping we bring the stuff we'll need!), washing about 3" of dust off the truck, weeding in the garden, and resting up for tomorrow. If you count Saturday and Sunday (which you should), tomorrow will be Day 3 in a 9-day-stretch of clinics. A week from tonight, we're coming home and unplugging the phone for a day!

That's it for now. Keep us and our patients in your prayers. Our first week solo. Cross your fingers!!!

Friday, August 18, 2006


I have no idea how to even title this one. What a long day! We went to Chichicastenango yesterday morning to do a clinic at Aselsi. We saw mostly routine patients, except for a woman in her 70s who's uterus has been falling out for 14 years. She needs surgery but isn't convinced she wants it. Surgery is scary enough for those of us who (kind of) understand it. When you're completely uneducated about it, it can be terrifying. We might have convinced her daughter that it'll help, though. We'll see.

We then went to the market in Chichi and were completely overwhelmed by entirely too many gringos. Chichi is quite the tourist town and Thursday is a big market day. Many of the white folks were quite obviously European, but there were a fair number of Americans. The image of the Ugly American is based on a lot of truth. We're big, we're loud, and we know everything. Heidi and I have only been here a month and we're already noticing these things. Jim and Kathleen had warned us about that and they were exactly right.

Anyway, we came back to the house to find that we had no power. So a siesta was in order. Two hours later, still no power. So we made some sandwiches and headed back to Chichi to spend some time in Dra. Karin's clinic. She is one of the administrators here at the hospital and we were interested to see how she runs her personal clinic versus how we've been shown how to run clinics "afuera" (outside). It was a very educational experience. She treated an 11 year old with migraines and a 1 year old with Scabies. The other three hours we just spent picking her brain! She is very knowledgeable and very helpful. She will be supplying us with a "wish list" of things the hospital needs just in case we know anyone who has one they're about to get rid of. For instance, the entire hospital has only 1 EKG machine! They really could use 2 more. Also, we've been approached by EVERYONE in the hospital about whether we have blood glucose strips. Apparently, the manufacturers give the readers away but you have to use their strips, which can run up to $1 each. The hospital, of course, has the readers, but they're out of strips. In a country where a large portion of the population is diabetic, that's a problem. So if anyone has access to a boatload of strips and a reader, we'd be very grateful if you sent them this way.

Anyway, we figured that the power problem might be related to the Festival Santa Elena this week. Santa Elena is the patron saint of this city and it is a BIG festival. There are parades and parties that last all night long. And we mean ALL NIGHT LONG! Guatemalans are normally pretty fond of firecrackers and M-80's, but this week is particularly bad. It sounds like bombs are going off 24/7. We're starting to get an idea how Francis Scott Key felt! Well, when we got home, still no power. The hospital had power, but we didn't. So we walked down there and asked around. One of the maintenance guys named Jorge was very helpful but couldn't get the power back on. So this morning, we went back and Jorge's counterpart on days was there (along with Jorge - 12 hours after we first saw him!). His name is Edgar, and between the two of them (and climbing into part of the building through a window - they don't have a key) they got our power back on. WEE!!!

Oh, additionally, all of the Consulta Externa's (clinics) in the entire country are shut down in protest of the government refusing to buy the equipment the hospitals need. The ER is open, but not the clinic. Apparently, this has been going on for nearly two months, at least in some places. We saw in the paper today that they have come to an agreement with the government and that the clinics are going to re-open tomorrow. Pray for all of this to come to some sort of resolution that is going to benefit the people of this country. It had gotten bad enough a few weeks ago that doctors had actually gone on strike.... Like we said, pray for them to get this figured out.

Anyway, sorry for the long note, but a lot of stuff happened yesterday. (And we left out the part about the semi-truck we saw them digging out with shovels that had traffic backed up for half an hour...)

More later!!!!

Wednesday, August 16, 2006

Driving Videos

Okay, I had to enlist Daryl's help on getting videos to post to our blog, and I still don't have it down quite as well as he does... but here are the promised videos of our driving experiences yesterday. In one, you can really see the hood bouncing around, trying to break free from it's rope tie-downs! These roads are actually not uncommon at all for us to encounter on our drives to the remote clinics we find ourselves doing. No wonder the Fickers have been praying for a plane for so long!

Thanks to God's angels and the Fickers though (Who we are actually quite convinced are one and the same...), we are up and running safely for another day today! No clinic scheduled for today, so we'll spend the day playing a little "catch-up" and cleaning up and re-organizing the place (again... but all of the supplies that the Wichita Falls team so generously left us are still literally in piles on both of our couches!)

It's 55.8 degrees here currently (just before 8 a.m.)... just thought I'd throw that in there for any of you who are currently sweltering in The States and might otherwise need a little extra incentive to come check it out down here! :-)

Anyway, hope the links to the videos work out OK... Enjoy! (We'll try to figure out how to put the actual videos on here in a more convenient way later)

Tuesday, August 15, 2006

Exciting Day, Post #2

We mentioned in the last post (the next one down if you'll scroll) how exciting our trip to and from clinic was. Now you can see some pictures from clinic. The first is a beautiful Guatemalan girl we treated for worms. Heidi is feeling her belly, which gave us the tell-tale signs.

The next two pictures we will need to have looked at by a dermatologist. If you know one, we'd appreciate the "e-referral". We have the full size pictures here if he/she needs them. This baby has had this rash for a month and we're not really sure what it is. Leslie has seen a lot of rashes in her day, but this one has us all stumped. It isn't spreading but takes up her whole arm. She doesn't seem to be in a lot of pain from it - we were allowed to move her around without any screaming or fussing. Anyway, please help us if you can!!!

The last picture is what our patients get to see every day when they're walking around. That's a shot from the trail leading to clinic. The life might be difficult, but the view is hard to beat!!! It's amazing to us how much we can help some people with nothing more than Ibuprofin and vitamins. They have such an incomplete diet (mostly just corn tortillas) that they are all so vitamin deficient. And they have no corner drug store to run to for headache or muscle ache medicine (and when you work as hard as they do, you're bound to have muscle aches!)

Please pray for these wonderful people, that they may know that the struggle they live with every day is only temporary and that, if they'll give their hearts to Jesus, that they can spend eternity in a place where there is no hunger and no pain.

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Exciting Day in Guatemala

Well, today was supposed to be exciting and educational. God filled that bill and then some. We were supposed to go to clinic with Leslie and Katie in Chiminichijuan, a small village outside Canilla. We were told to drive towards Canilla and we'd see a sign that was left for us. It turned out to be a pair of sticks laid in a cross in the road, prompting us to look at a nearby tree. You can't actually drive all the way to the clinic. The last mile or so of road is barely passable with a 4-wheeler. So we were to park, then walk for a while until we saw a building that "looks North American".

The 2nd and 3rd pictures depict the sign. The 4th picture is Heidi on the "road" to clinic. She doesn't mess with her white lab coat here in Guatemala unless she's in a hospital. What you're seeing in the pic is her prized "Doctor Vest". It's actually a modified fly fishing vest from Cabella's. Go figure.

You may be wondering about the 1st pic. Well, it turns out that Guatemalan roads are quite hard on vehicles, particularly on the latch that holds your hood down. We learned this morning that it's quite difficult to see where you're going when you're trying to look THROUGH YOUR HOOD! Yup, the latch broke and the hood slammed up against the windshield, not breaking the windshield, but severely testing both Heidi and Matt's continence. We tied it back down with a rope and went on our merry way. Thank God that Aaron and David Ficker can weld. They repaired our hood at their house after clinic. Just a small burn mark on the hood and we're good to go. Don't worry, the truck wasn't about to win any beauty contests anyway. It's a truck, it's not supposed to.

Well, that was our excitement TO and FROM clinic today. The next post will have some details about the clinic itself, then if we can figure out how to post movies, we have a few from the drive along the "road" to Canilla.

Keep us in your prayers and God Bless.

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Monday, August 14, 2006

Simply waiting

One of the things we've learned here in Guatemala is that time doesn't operate on the same scale as it does in the U.S. You go to the bank to pick up a check card on the day they tell you to and they smile and say to come back tomorrow. You get the same smile and advice the next day, too... You can't be too concerned about WHEN anything happens.

When it's hard, though, is when you realize that health care has the same issue. There is a young boy from Leslie Fickers's clinic who has a colostomy. He's had it essentially since birth and he's 2. The family has done a tremendous job of keeping it clean (even though there are no bags for that here) and has patiently waited for a team to repair the colostomy. When the team arrived last week and began the surgery, it became apparent that the actual problem was different from what was expected and that we did not have what we needed to fix it. So he waits another year.

This morning, we got a knock at our door from a family from here in Quiché along with 2 of their American friends. They were looking for a specific doctor from Houston who they had heard was here with a hand team. Obviously, if a hand team is here, they aren't staying with us. The friends had flown in from the US to ensure that there wouldn't be a language barrier problem with getting a surgery. The prospective patient is a 3 year old boy who was born with only four fingers on each hand. Actually, on his left hand, the middle and ring finger were grown together and on his right hand, there was no ring finger. He is a special needs child who is not really walking or talking yet. He was told as an infant that they couldn't operate on him due to a heart condition. Unfortunately, we had no good answers for them. We don't have a hand team coming, the boy's medical records are two years old (which is a long time for a 3 year old!), and even though the American couple hoped they could take him back to the US for surgery, we've found that that is a VERY difficult (and expensive) proposition.

So we took down their information, told them that they'll need an up-to-date diagnostic series run, and that we'd spread the word. Sadly, his name has now been added to a very long list of people who are waiting. Unlike the 2 year old we talked about before, this little boy doesn't even have a target date to wait for. He could be a teenager before he has a chance at some surgery, if ever.

Please pray for both of these boys and their families, as well as the innumerable people here in Guatemala who simply wait.

Sunday, August 13, 2006

Awesome Weekend!

So the team left on Friday afternoon and we spent the entire rest of the day doing laundry and cleaning the house. We still have to add everything the team left to our pharmacy and get that all organized, but it is a tremendous blessing to have all of these new drugs here now!

Friday night we discovered that you can download TV shows on ITunes and we watched the season finale for CSI - a show we became completely addicted to in the U.S. At least we'll be able to satisfy THAT craving!!

Saturday morning, we got up and headed to Canilla to visit the Fickers. They have a wonderful home and clinic set up there. They came down from St. Louis about 7 years ago and have a wealth of knowledge to share, as well as being a tremendous spiritual rock we can lean on.

We worked in their home clinic with them on Saturday, then went to visit some Mayan ruins in the area. There are these tremendous man-made hills built on the side of the mountain. It is believed that, when the conquistadors came, the Mayan rulers were afraid of the horses and had themselves buried in caverns underneath these mounds with tons of treasure. The one cave we explored had already been stripped of any bones or treasures, but it was still very neat.

Sunday, we went to clinic with the Fickers again in San Andreas. It was another amazing clinic day. Heidi got to see some more prenatal patients (it seems that every woman we see is pregnant!) and some pediatric cases. Leslie (the mom, a nurse), Hannah (the daughter, a pre-med student), and Adrian (a teacher from the US who is a good family friend) did a lot of teaching for Heidi, Matt, and Katie (a nurse who just moved down to work with the Fickers for a year). We're looking forward to maybe attending another clinic with them on Tuesday, WAY up in the mountains.

Now for the pics. The first picture is a buddy we found in our shower on Saturday morning. The second is a group of us in the Mayan cave we explored. The third is Katie, Heidi, and Leslie in clinic this morning. And the fourth is a picture of Hannah in the doorway of the clinic, greeting patients and assigning numbers.

That's all for now - we're taking tomorrow as a rest and recovery day - our first in three weeks!

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Thursday, August 10, 2006

Medical Team Day 4

Our last full day with the Wichita Falls team :(

We hosted some of the hospital staff for dinner tonight (Gencha was cooking, not us. Don't worry!) The first picture is a shot of the room during dinner. The next few shots are the required surgery shots. Okay, two are surgery shots and one is a couple guys goofing off, but there's a very fine line between the two. Really.

Anyway, that's it for today. We're very tired. Just a few more surgeries tomorrow, then the team leaves right after lunch. We'll write more tomorrow.

Pray for the rest of our patients and for the team to have a safe and fun journey to Antigua, then back home to Texas.

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Wednesday, August 09, 2006

Medical Team Day 3

Today our general surgeon arrived and completed an AMAZING number of cases. Dr. Mercer is a machine! Additionally, Heidi and Dr. Flavia Horth did two very difficult gynecological cases. All of the surgeries have been amazing, life-changing surgeries that the people would never have been able to afford or even to get here in Guatemala (money or no money). We were able to remove two very large facial growths, one from a 14 year old girl who was teased so much that she was pulled out of school. In a few weeks, she'll have just a very thin scar that will probably be barely noticeable. It was really touching to see how appreciative the people were for their surgeries. To them, this medical team performed unimaginable miracles.

One of the most amazing things for Matt has been to learn about the incredible number of people necessary to make these events happen. There are nurses, scrub techs, surgical equipment sterilizers, runners, clinic doctors, surgeons, recovery nurses, prep nurses, etc. It's also been amazing to see a side-by-side comparison between American health care professionals and Guatemalan health care professionals. Anyone who doesn't believe that the United States produces the best health care workers in the world needs to watch them work close up. It's absolutely amazing.

Okay, only one surgical picture today, and no blood and guts. The other pictures are of some of the team members shopping at an impromptu stand set up by a very enterprising young woman who heard that there were some American doctors and nurses in town. She set up her wares in the lawn between the hospital and the house. She sat there all day waiting for the team to leave the hospital for the day. She was richly rewarded for her time.... We learned that if you don't have time to go to the market, they'll bring the market to you!!!!

As an aside, Heidi and Flavia were in the hospital last night performing post-operative checks on their patients when they encountered the local OB-GYN, walking around with his arm in a sling. He dislocated his shoulder just a few days ago and was in an obvious amount of pain. Heidi mentioned that she hoped he didn't have any surgeries to do and he said he was on his way to a C-section. She asked if he wanted help and he said yes. A few minutes later, Heidi performed her first C-section in Guatemala.... YAY!

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Tuesday, August 08, 2006

Oops - more pics

This is actually our second entry for the day - be sure to read the one below. Apparently, we can only add 4 pictures at a time.... More tomorrow!

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