Friday, September 29, 2006

Clinic in Pachot II

Today we had a wonderful opportunity to join Kemmel and Dr. Lisa Dunham at their clinic in Pachot Segundo, a short drive outside Chichicastenango. Lisa is a Family Practicioner, so we were very excited to have an opportunity to work with (read: learn from) her. The Dunhams are awesome, Godly people and they have established a really neat relationship with the people in Pachot.

The clinic is held in a beautiful church complex there and it seems like half the community shows up, whether they need a consult or not! There is lots of fellowship and smiles and laughter. It is a very loving community. Kemmel and Lisa have trained and are training several local folks as health promoters and the health promoters work with them on clinic day, rotating through the "stations" with their successive patients. A health promoter will check a patient in, pull their chart, gather their vital statistics, bring them into the consult with Dr. Lisa, translate for them (most locals are K'iche speakers), take the completed chart with the prescribed medicines to the pharmacy where Kemmel fills the prescription, and then pray with the patient.

The people in this community are very appreciative and hospitable. You will not make it through the day without being offered two or three snacks, some hot drinks, and a complete hot sit-down lunch. It is truly an all-day affair.

On our way out, we got our favorite thing "... solo una pregunta..." (only a question) which means that you're about to get a request that'll probably take the next half hour or more out of your day. One of the health promoters has a cousin who was injured while carrying something heavy up a mountain. He's at home with a "broken knee" and can't walk, we were told. He's been like this for a few weeks. It was on our way back to Chichi, so we stopped by. The injured party met us in the yard - on foot. His leg was wrapped in an ACE bandage, though, and he was clearly in a lot of pain. On exam, it looks like he probably has either a torn MCL or some damage to his meniscus. Not broken, but definitely "dinged".

Which brings us to our "Guatemalan Culture Lesson of the Day". In Guatemala, when something is broken, they throw a towel or a sheet over it and give it up for dead. This works for cars, appliances, and body parts. (We had a woman in clinic one day who hadn't used her arm in a few years because she had been shot in the shoulder. The wound was completely healed, but the arm was useless from atrophy, not from the injury. Of course, it had a towel over it.) Lisa explained to this man that he would have to stay off his knee for at least another week, but that he would have to bend and move it or he could lose use of it.

Anyway, we made it back to Quiche in time to grab a few groceries and tuck in for the night. We are heading to Canilla in the morning for clinic there with Katie. (Leslie and the rest of the clan are in The States for two weeks for their son's wedding.) Sunday is San Andres, then a full week of clinics awaits us....

1. Heidi on the roof of the church annex where the clinic was held.
2. Lisa, Heidi, a patient, and the health promoter share a laugh in clinic.
3. A cool shot out of the window in our clinic room.
4. The countryside from the roof of the clinic.

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Thursday, September 28, 2006

Updates from Chichicastenango

Today was another clinic day in Chichicastenango. We have a few updates on patients we've told you about before.

One was a three week old baby who had been born at 34 weeks. We had been quite worried about him but he was back in clinic today, still alive and growing well. He was only 3lbs 13oz when we saw him before. He's now seven weeks old and up to five pounds! His parents brought him in because he has developed an inginal hernia. We told them to just keep an eye on it and make sure it doesn't change in any way. We were able to consult with Dr. Edgar, a Guatemalan orthopedic surgeon, who does clinic once a month in Chichi. He said that they typically don't like to operate on those kids here until they're about 20 lbs (due to anaesthesia concerns). So please keep Miguel Saqueo Calel in your prayers - that he'll keep growing well and that no complications will arise with his hernia until he's big enough for the surgery.

Well, they say that these things come in threes. We saw a cleft palate here in clinic last week (Osni Arturo Peliz Peliz). He was back this week with a fungal infection in his mouth, but has put on 3oz in the last week! Last week, we told you about a mother who knocked on our door with a baby who had a cleft palate. And today in clinic, we got another one. This one is Maria Buchan Chitic (like Osni, she is from the village of Xepocol). She was born on September 7 and is in the milk program at ASELSI so she can get formula and special bottles. We have contact info on all three kids so when we find a surgeon who can work on them, we'll try to get all three down to Antigua for the surgery.

We have a sad story today, too. Fifty year-old Tomasa Ramos came in looking uncharacteristically disheveled for a Mayan woman. Normally, they take a lot of pride in their clothes and hair. She was wearing a torn blouse, her hair was a complete rat's nest, and had some cuts on her face. She told us that her 18 year old son had beat her up. Her husband tried to help but he used to drink a lot (and still does some) and was no match for the son. The son threatened to kill the husband if he threw him out of the house.

We called Sister Maruka at Casa Social here in Quiche to ask her advice. (Casa Social works with lots of abused and widowed women.) She suggested that Tomasa find some relatives she can go live with. Tomasa indicated that she had some relatives she could live with who were sufficiently far away that she could be safe. She broke down and cried a couple times and said that she was too afraid to go home. She is a church-goer (an Evangelical church) and said that her pastor might be able to help, too. She only speaks K'iche, but we prayed for her in Spanish and then she said she was going to her relatives' house. We gave her an appointment card to come back any time. In any case, she knows there are people in Chichicastenango who care about her and want to help...

We're also still looking for the two women who had molar pregnancies. Laura Hernandez was the one who had her surgery here in Quiche (after waiting ten days). We are worried that they did not get all of the tumor out, but we haven't seen her in clinic. Someone there knows someone who knows her, so we'll try to sort that one out that way. Jacinta Pol Suar is the woman we asked to come meet us here at the house last Friday morning and she never showed up. She lives in a small village outside Chichi, so we'll try to track her down through someone who lives there.

Some days are easier than others. Today was not one of the easy ones....

Tomorrow we're going out with Kemmel and Dr. Lisa Dunham from Chichicastenango. Lisa is a family practicioner we hope to learn LOTS from!

Tuesday, September 26, 2006

Market Day

Actually, there's a market every day in Quiche, but we thought we'd share some pics from today. Today is our second "day off" in a row - like an actual weekend! We had a few visits yesterday, including a run to the Pediatric Ward here at the hospital to check on Juana, the little baby we're working with. The doctors here think she's just malnourished, which is causing all her other problems. They probably see a lot more of that than we do, so we'll see....

We also treated a young man from the Utatlan school last night. Jacob brought him to the house because the wait in the ER was very long. He had been hit by a car in the street outside the school, but luckily for him, traffic doesn't move too fast around here. He just had a pretty good bump to the knee. Both Jacob and the boy speak decent English, so we taught them about RICE (Rest, Ice, Compression, and Elevation). It was pretty funny, because the joke became that the American doctor looked at his knee and told him he needed lots of "Arroz" (rice). What do you expect from a gynecologist, really?

We also managed to find the rat in our storage room in the hospital. We bought the only rat trap we could find in town today - a live trap - and when we got to the hospital with it, they said that the rat must already be dead - they could smell it. So we had the fun task of digging though the storage room until we found it. Sure enough, it had been dead awhile. Luckily, Matt is still a little stuffed up from his cold, though not quite enough.... Add that to the list of things Heidi never thought she'd have to do in a hospital.

Anyway, in the first picture, you can see what the street looks like during market. Lots of tarps strung up everywhere (none of them high enough for an American man to walk under) and stuff for sale everywhere. In this picture, you can see potatoes, flowers, pineapples, onions, carrots, tomatoes, peppers, cabbage, and yes, that's a popcorn popper in the middle.

In the second picture, it's basically more of the same.

In the third picture, you can see CDs and DVDs in the background (very popular here), commercially packaged fried chicken and raw chicken on the same table, including chicken feet, and some bananas.

The fourth picture shows a man walking a few goats next to our grocery store (the Dispensa Familiar). The sign just under the grocery store sign that says "Cajero 5B" means that there's an ATM machine there. Very handy. You can also see some more CDs, DVDs, some clothes, some more bananas, and a bunch of big umbrellas. This is the main street though the market, so it's not very crowded. People still drive down this street, the pedestrians just have to jump out of the way. The other streets have booths on either side of the street and in the middle. Not really for claustrophobic people....

Anyway, that's it for today. Matt spent about an hour and a half washing mud off of the truck from this weekend - the undercarriage alone took almost an hour. And we have more gardening and general housework to do. Dinner tonight will be something in a pressure cooker - it's really the only way to cook the local "steak"....

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Sunday, September 24, 2006

It's a very long story, but there's a chicken in it...

This will probably be one of our longest blog entries ever - at least we hope so. The last three days have possibly been some of the longest in our lives. It's Sunday evening here and Friday seems like it was two weeks ago. But we might as well start there...

Friday was clinic with at Roy Espinosa's church in Chinique. Roy is a good friend of ours and the organization. He was born and raised in Texas and speaks both English and Spanish fluently, so it's nice to have someone who can actually help us with our Spanish from time to time. (We're getting much better, but we're never going to sound like natives!). Plus, Roy is a neat guy and really cares about his people.

Friday night, a mother and her baby showed up on our doorstep from several hours away because they heard that there was a team here who could fix cleft palates. Sadly, no, but we got their information because we're looking for help with another baby, too. They don't have a phone, but their neighbor does, so when we find help, we'll get in touch with them.

Saturday morning, still before sunrise, we started our weekly trip to Canilla. Little did we know what was in store for us! The drive was horrible. It took us nearly three hours to travel the twenty-something miles (normally a two hour drive). The roads were horrendous for about the first half of the drive, then improved dramatically at the point we saw a grader on the side of the road. Apparently, it had run a portion of the road and hopefully will continue later this week.

Clinic on Saturday was an absolute zoo. It seemed like half the town had shown up. (The first picture is of Heidi and Matt working with a patient during clinic. The patient had explained that she wasn't making any milk. We asked her to demonstrate and she squirted milk all over the place, including on Matt. It looks like things are working just fine, thank you.)

Another patient, a 75 year old woman from a nearby village, came in with a "surgical belly", meaning that it was obvious from a minute or two after she came in the door that she needed surgery. An ultrasound showed what we believed to be a gall-bladder about the size of a grapefruit. We told her and her daughters that she needed surgery and that we would try to find an ambulance for them to get her to Quiche. Fine. So we began the process of locating an ambulance (you don't just call 911 here). As Matt and Joseph Ficker were leaving on a four-wheeler, the family changed their minds. They wanted to talk about it amongst themselves. What there was to talk about was beyond us, but it's their perogative. Twenty minutes later, they wanted an ambulance again.

Matt and Joseph went into town and found a member of the city council. He said the ambulance was there but might not be working. A few minutes later, it was confirmed that the ambulance was working, but they didn't know where any of the bomberos (EMTs) were. A few minutes later, two of them were located. Then the mayor had to be found and had to give his approval for the ambulance to go to Quiche. (A trip to Quiche takes the ambulance out of service in the community for several hours.) Approval granted. As the city council member was rounding up the bomberos, Rachel Ficker pulled up on another four wheeler and said that the family changed their minds again and were taking the old lady home, presumably to die.

Oh, and during clinic, every few minutes, we had to go check on Juana, the baby that the Fickers took in after clinic in San Andres last week. You may remember that this baby is 3 months old and weighs less than 7 lbs.

Leslie was a neo-natal ICU nurse, so she has an extensive amount of experience with sick kids. When we first saw the baby in clinic last week, she was obviously malnourished, so Leslie took her in and started her on the feeding tube. On checking her sats (the percentage of oxygen in the blood vs. what it can hold), they discovered that the baby needed to be on oxygen, too. Before long, it became apparent that the reason the baby wasn't growing was because she has some serious health problems.

Picture number 2 is of Heidi and Leslie studying the baby with our ultrasound. Not only does the heart appear to be abnormal, but the liver takes up about half of her gut. This is a very serious problem, meaning that this baby is probably not going to make it without some serious intervention (surgical and/or divine). The Fickers are leaving for two weeks, starting tomorrow, for their son's wedding in the U.S. Therefore, the baby cannot stay at their house. Truthfully, even if they were staying, at this point, they have done pretty much everything they can do at their house. The baby needs a hospital.

Naturally, during all of this, there is family drama. The baby's mother is 18 years old and speaks about a dozen words of Spanish. She and her husband were not getting along and her parents were trying to help her. At one point during the afternoon, her husband had arrived and talked with her for a while, then she told him to leave and that she and the baby were moving back in with her parents.

We took her and the baby to her parents' house in Xujeyup, a tiny village outside San Andres, Saturday evening. It turns out that her in-laws are her parents' neighbors. Lovely. Anyway, her dad, who speaks some Spanish, was informed that the situation was very serious and that they needed to get the baby to a hospital. (Mom didn't want to go by herself, as she doesn't speak Spanish and the hospital in Quiche has a reputation among Mayans as being a bad place to go.) His choices were to take the baby to Quiche or to take the baby to Guatemala City. We left the baby and mom with him and returned to the Fickers' in Canilla.

Later that evening (after dark), we got a phone call from the mom's father (the baby's grandpa) saying that the baby was very, very sick and that they wanted to bring her back to us. That not really being an option, we offered to come get the baby and take her to Quiche. Recall that the roads were REALLY bad during the day when it was sunny. At this point, it was dark and raining like crazy. But a dying baby is a dying baby, so we (Heidi and Matt) said a quick prayer and got in the truck.

Forty-five minutes (and about six miles) later, we were sitting in front of the chuch where the family said they'd be (they live a fair distance from the main road - the main road is marginally passable - their road is plain scary). Church was in session at 11pm on a Saturday night, but about half of the chuch members came out to see what the gringos in the truck were up to on a rainy night in Xejuyup. They all knew about the sick baby, but didn't know where the family was.

Finally, we decided to attempt the drive to the house. About 3/4 of the way there, here comes the mom, the baby, the dad, and the dad's dad in the rain with a flashlight - carrying an umbrella - not over the mom - just carrying it. Mom and Dad have apparently reconciled and all four of them want a ride to the hospital. So three adults and a baby all cram in the backseat of a small pickup truck, along with several bags of theirs and an oxygen tank. The dad had a gift for us - a gallina (a chicken - pronounced "guy-EE-na"). It came with it's own burlap sack and got stowed under Heidi's feet. Matt didn't hear what the dad said was in the bag and when he handed it to him and it started moving, Matt's first thought was that they had put the baby in a sack and were handing it in the window!!! A minor panic moment.

Anyway, the trip commences. After having to instruct grandpa (twice) that we don't spit inside people's vehicles, and teaching mom that when the baby starts to cough, you have to hold the head up a bit, things smoothed out some - but only IN the truck. Outside, the weather was bad, the roads were bad and getting worse. At times, the puddles in the road were more than a foot deep. Finally, rounding a curve and descending to a bridge, there it was. The river had crested the bridge and was flowing FAST. There was really no way to tell how deep it was on the bridge (probably around a foot), but these bridges don't have siderails, they're just slabs. Getting swept off the bridge would not be beneficial to the lives of six humans and a chicken.

Another truck pulled up and Matt talked with the driver some, debating the relative merits of trying to ford a river of unknown depth, and turning back with a very sick baby in the truck. The other driver said he would just go to sleep in his truck (it was about midnight at this point) and hope the river had gone down by the time he woke up. (Remember, also, that the roads were bad already, but were going to get MUCH worse as we drove - the graders hadn't done any more work since that morning.) Finally, we disappointedly decided to turn back. The baby's parents decided to catch a Chicken Bus in the morning, when the weather would be better. Heidi wrote a note explaining the baby's condition as she and Leslie knew it, and told the father to take it with him.

We pulled back up to the Ficker farm at about 1:30am (four hours after leaving)- completely locked out! Heidi climbed the fence to the compound and woke up one of the Guatemalan workers by tapping on her window. She had a key to the front gate and we were able to get the truck in and parked.

Earlier on Saturday, we had promised to cook breakfast for them, since they always cook for us, so at 6:30 on Sunday morning, we got up and headed into the kitchen in the main house to start breakfast. Imagine their surprise to see us in their kitchen! (they thought we were going to stay at our house in Quiche after dropping the baby off in the ER)

So we had an interesting breakfast conversation, telling the story of the night before, and informing them that we would be "re-gifting" this chicken to them, as we have no use for it at our house! The third and fourth pictures are of us with our chicken. (There are more of us chasing the stupid thing around the yard, but we'll save those for another time!)

Sunday clinic in San Andres was typical with our highlight patient being one who had crushed his finger somehow while walking his cows to market. His fingernail was hanging on by a thread and he graciously waited to rip it off until he was in our clinic room. How appetizing. At least Heidi got to play with some blood this weekend.

We finally arrived back in Quiche, after making the mistake of stopping to pick up a passenger at the edge of town in San Andres. One person flagged us down, but about twelve RAN to get in the back of the truck with all their stuff. We have a rule - no more than eight - and NOT with a ton of stuff. Those little springs can only take so much! Guatemalans tend not to appreciate physics, so it was a little difficult to explain that we weren't transporting the entire town back to Quiche, but they finally got it - most with less than loving looks on their faces as they got out.

The last thing we felt up to doing was walking down to the hospital, but we did, and were pleasantly surprised that the mother and the baby were there. (Again, Mayans tend not to want to come to this hospital.) She doesn't speak much Spanish, but at least she knows we're here. Which sometimes is all you can do.

Tomorrow, we're taking the day off. Or so we think....

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Thursday, September 21, 2006

Crazy Clinic Day

Well, today was even crazier than yesterday. Transportation was not nearly as challenging, as Chichicastenango is reachable by paved roads, but clinic was nutty. First, it seemed like every time we opened the door, there were more charts in there! Second, we found a few more patients to add to the prayer list.

One patient, Jacinta Pol Suar, had a relatively routine start to her visit. She is 38 years old, in her 11th pregnancy, and has 10 children living at home. Matt was "wheeling her out" while Heidi started the ultrasound when she said, "You've got to be kidding me." Our second molar pregnancy in this clinic in less than a month. (Molar pregnancies are not really pregnancies as much as they are tumors that need to be removed. If ignored, the mother can hemhorrage and possibly die.) Molar pregnancies occur in less than 1 in 1,000 patients, so to have two in less than a month is a bit of a bummer.

You may recall the story with our last patient with a similar situation. She spent 10 days in the hospital here in Quiché, had to pay two people to donate blood for her, had to walk into town to obtain a chest x-ray and a blood test, etc. And she was a "western dressing" Spanish speaker. This woman wears the traditional dress and only speaks K'iche. She's not likely to get preferential treatment here.

Anyway, she told us through the interpreter that her husband is a pick-up truck driver (not his truck, though) and was in the capital today. So she's planning to come to our house at 6:30 tomorrow morning for us to explain things to her husband and take her to the ER and help get her admitted and get her started on the process. Then we leave at 7:30 for clinic in Chinique. So please pray for things to go smoother for her than they did for Laura, the last patient (who, ironically, we were supposed to see today and she didn't show up.)

Also, please add Osni Arturo Peliz to your prayer list. He is a three-day old baby with a severe cleft palate. It's severe enough that he can't eat. The folks at ASELSI (where we do clinic on Thurdays) gave the family some special bottles for him and some formula.

Oh, and we got another argumentative male patient today. Fun, fun. He came in complaining of sore hands. His right hand looked pretty raw. He says he works in the fields, which would explain that. We told him he needed some cream and needed to wear gloves. He said that there was no way because the other workers don't need gloves. We tried to explain that each person is different and that some people need things that other people don't. He must have been able to tell that Heidi was two or three seconds away from asking him what medical school he went to because he finally quit arguing and just moved on to his next complaint - gastritis.

We went into our standard explanation that some foods are not good for that and he looked like he was ready to argue again, but just gave up, took his meds and his advice, and called it a day. Who knows whether he'll follow any of it or not (you know where MY money is), but all we can do is lead the horse to water...

One last tidbit for today. We got to videoconference with Matt's parents, who have his niece, Sophia, for a few days. We hadn't seen her since July, so it was really neat to see and hear how much she's grown! If you don't have Yahoo Messenger, you should really consider it. It's free!!!

Okay, gotta run. Please keep those folks on your prayer list, as well as a pregnant woman we saw this morning with a possible previa - and one friend we have in the US who's having some difficulties with her pregnancy... We know prayers work. We've seen the results firsthand.

Wednesday, September 20, 2006

Only in Guatemala

This morning we went to Chicabracan for our bi-weekly clinic there. We probably should have known today was going to be interesting when we picked up five women on the way there (still a few miles away) who referred to Heidi as "Doctora". Our second clue might have been the large number of people walking TOWARDS us as we headed down the last stretch of "road" to clinic. The trail, really, to Chicabracan is never good, but today it was quite bad. Typically, we're told, there are a few weeks of very heavy rains in September before the dry season starts. We're in those right now and the roads are suffering for it.

Anyway, we finally found out what was in store for us. Just before our final turn to the school, there was a massive pile of rocks in the middle of the road and a large crane working to move the pile. The guys at the pile guessed that we were headed to the school and told us to go back, take a left, look for an intersection, and take another left. Well, that's what we did, after driving through some yards, some very large mud puddles, and under a few low trees. Thank God for the GPS Heidi's aunt bought us, because this "intersection" wasn't exactly Main and 5th Avenue. Of course, the GPS showed nothing there, which was quite accurate, but since we had "tagged" the clinic, it knew we were west of there, so we turned.

Okay, no big deal. We got to clinic - and only about 15 minutes late, since we were probably going to be a bit early anyway. And we weren't swamped with people, like we thought we might be (even though 5 were in the back of our truck!). It turns out that the women we brought with us in the truck were from Quiche. We're not sure how they found out about our clinic in the middle of nowhere, but....

Grrrr... it did it again. Anyway, the computer decided that you'd like to see this picture now. It was taken after we turned around and headed back up the hill from the rockpile.

One patient we really wanted to strangle, but were prevented by the fact that we are MISSIONARIES, was the man who told us he couldn't work because he got a sore back when he did, but that his wife was just being a whiner when she said her back hurt from carrying two children and washing clothes all day. AARRGGGHH!!!!

Anyway, the second picture is of Heidi trying to get one of her patients to say "aaahhh". This, apparently, is a cultural thing. In the US, we're taught from birth that when a doctor is looking in your mouth, you say "aaahhh". Here, not so much. What's worse, is that they think it's funny and when you finally get them to say "aahhh", they start laughing and everything closes back up again. The struggles of doctoring in Guatemala!

The third picture is of that same very cute little girl showing us her "sonrisa" (smile).

The fourth picture was taken while driving back to the main road. Note the two ladies with their cargo on their heads, passing the ubiquitous "Coca-Cola" sign on the local tienda (convenience store). You can see some livestock tied up in the background (all the livestock here either runs free or is tied on a leash) and some small mud-brick houses.

Anyway, tomorrow is the ASELSI clinic in Chichicastenango. We'll be seeing Laura Hernandez again, the patient who had the molar pregnancy and spent 10 days in the hospital here in Santa Cruz for a 10 minute procedure. Heidi's not sure they even got all of the mole out, so we'll be checking again tomorrow. If not, we may work with Dr. Hoak to get the rest of it.

In additional news, the baby that the Ficker family took in is gaining weight but cannot be removed from oxygen without her "sats" crashing. Leslie is now afraid that the reason the baby is not gaining weight is because she has a bad heart problem that we couldn't hear before because the rest of her chest was so noisy. Now that that's clearing up, she thinks she hears something bad. Heidi will listen this weekend, but pray for this little baby...

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Tuesday, September 19, 2006

New Address for Matt and Heidi

It was possibly the easiest transaction we've completed here so far. We were prepared for "the long haul", but all it took was copies of our passports and Q185 for a year's lease on a PO Box. If you would like to send us something, we now have mail service here that doesn't require someone from the hospital to receive it and bring it to our house.

The box is not super big, so don't try to send a television set or anything (it's 13cm x 13.5 cm x probably 3 or 4" - they only gave us two dimensions!), but it's here. Duane and Leslie told us that they have the best luck when things come in manilla envelopes. Boxes tend to get opened.

So our address now is:

Matt and Heidi Bell
Apartado Postal #27
Santa Cruz del Quiché
Guatemala, Centro America
14001 Codigo de Area

We also spent some time in the hospital this morning, letting everyone we could find know about the eye team that's coming down in October. They are very excited about it, eye problems are very common here. They did notify us of a RAT problem in our storage room in the hospital. Apparently, rats have been seen climbing out of the windows of the storage room for some time now. Thanks for letting us know the first time you saw one! Anyway, we'll be throwing some of the food you can buy on the side of the street in there. That should kill them, pronto.

Anyway, this afternoon, we'll be doing none or more of the following: napping, working in the courtyard, working out, obtaining a signature stamp for Heidi, watching a movie, cooking dinner, and/or preparing for tonight's meeting with Jacob regarding this year's and next year's budget.

Adiós for now.

Monday, September 18, 2006

Monday Clinic Day

Today was our "cada quince dias" (every two weeks) clinic in Nueva Santa Catarina. It was a relatively slow clinic day with probably 15-20 patients, but some interesting ones. We're starting to see some "repeat customers" and it's wonderful to be able to pull up their histories on our computer and share some quality time with them. It's also nice to be able to see progress in some of the more chronic patients. One diabetes patient, we think, is going to be controllable on oral meds, rather than insulin, which is VERY expensive and quite hard to get.

Not quite sure why this first picture decided to embed in the middle of our text, but here's a picture of a very sweet family with Matilde (the pastor and translator) in the church clinic.

We're working on backing off some hypertension meds on another patient because his blood pressure measures just fine (a little low, actually), and he's complaining that he get's light headed when he stands up too fast.

We heard that one of our patients we referred to the Guatemalan eye team that visits Quiche every two weeks was able to go and was treated quite well. This is WONDERFUL news! Eye problems are very common here and we've referred several patients.

During clinic, a woman came in and said that she bought a number for her husband (that's how we control clinics, is by selling numbers for Q2 each - about $0.26) but that he couldn't be there. When we asked why, she said that he had broken his leg and was in bed at home. Matilde knew where they lived, more or less, and told us it was fairly close. So we decided to make a house call after the clinic.

Picture #2 is of Matt carrying Heidi's doctor bag towards the house. It turned out that he had a pretty good bump on his ankle, but had good movement and indicated that he could walk on it a little bit and that it was improving since he fell a week ago. On exam, it looked and felt a lot more like a good sprain than a break, but we told him that if he wasn't walking a whole lot better in another week that he needed to get an X-Ray. A few pain meds and an ACE bandage and we were on our way.

Picture #3 is of Sandra, the daughter of one of the church members. She is SOOO cute and friendly. She actually went on the house call with us. If you ever wanted a postcard of a really sweet Guatemalan child, she'd be the one to pose for it. So here's a sample.

And picture #4 is of the gas station we stopped at on the way home from clinic. It's not every day you see the "Thanks Be To God Gas Station", so we pulled in.

Tomorrow is our "day off", so we'll be going in to town to work on getting a PO Box (wish us luck!), grocery shopping at the market, and further toning our aging bodies (Matt found a weight room and Heidi is using the ultra-high-tech shoes her dad bought her for running. No kidding. Heidi has running shoes that actually talk to her iPod. Go figure.)

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Sunday, September 17, 2006

Clinic Weekend

As usual, we spent the weekend with the Fickers in Canilla and San Andres. Also, as usual, it was awesome. Clinic on Saturday was not terribly unusual, except that we had to inform a pregnant mother that the reason her nearly full-term baby wasn't moving anymore was because it had died. It was quite sad, but she lives close enough that she was able to fetch her husband and her parents so we could explain to them that this was not her fault. Sad, but when presented with news of this sort, people usually look for a reason and we wanted them to know that she had not caused this. Please pray for her and her family.

Yesterday afternoon, Matt went out to the Fickers' airplane hangar, which is still under construction, and helped lift some support beams into place. Keep in mind that this is all done manually, from the roof, and that Matt is pretty afraid of heights since a nasty fall he took in Boy Scouts. No worries, though, he knows that the key to safety is to not fall.

Today in clinic in San Andres, we saw a two month old baby who weighed in at less than 7 lbs and was SEVERELY malnourished. Mom probably only weighs 80 lbs herself and could probably use a good feeding. The baby had one of the worst cases of an oral yeast infection that Leslie has ever seen (and she was a pediatric nurse!). The situation was grave enough with the baby that Leslie told the mother to go get her husband in the market. The Ficker family is actually going to take this family in for a few days and put the baby on a feeding tube. Please pray for this baby, as she is in quite a bit of trouble right now.

Other interesting tidbits from clinic today included a woman who kept spitting on the floor, a couple of surprise pregnancies, and Matt escorting a drunk man out of the room. Not everyone here has gotten the message that drinking is not a recommended activity for Native Americans.

In the good news column, we found out today that the woman that Heidi and Dr. Hoak operated on Friday is recovering well and was sent home today. YAY!

Oh, one more piece of "local flavor". Remember the scene in the movie "Doc Hollywood" when he got paid with a pig? So far, we've been paid with oranges (and we had to tell the patient not to eat too many herself - she had gastritis), apples (twice), tamarind (a kind of fruit), bananas, and as of this weekend, a rooster. The rooster wasn't for us, thank God, but for Leslie. It even came in a handy carrying case. And as Leslie was carrying it out of the room, the woman said, "Canta" (it sings). Excellent news. We'll be sure to put it right outside our bedroom window - where it can join the other six roosters who think that 3am is a perfectly reasonable time to crow.

And in pictures, we have 1) a failed attempt to capture a really awesome sunrise from the "road" between our house and Canilla, 2) a failed attempt to get a kid wearing a "Simpson's" hat in clinic to smile, and 3) a failed attempt to get a good picture of Rachel Ficker riding her horse at the house. Yes, we were 0-3, but they're still better than the pictures we got of the aftermath of Heidi's brother's bike wreck last weekend....

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Friday, September 15, 2006

Independence Day - Guatemala

Well, today is Guatemalan Independence Day. September 15, 1821 was the date. It turns out that all of Central America shares this date (independence from Spain) and there are some celebrations that take place throughout the region. There is a torch that starts in Guatemala on Sept. 14 and is carried all the way to Costa Rica by the 15th. We saw several torches, and the Pan American Highway doesn't actually run through Santa Cruz, so we can only assume that there are a few "local" torches, too.

Anyway, our day actually started before 4am. We drove to Chichicastenango to assist Dr. Tom Hoak on his first vaginal hysterectomy and anterior repair on a 77-year old diabetic woman. The surgery went great, though, true to Guatemalan form, it started about an hour and a half late. Dr. Hoak is a very talented surgeon and actually performed the surgery while Heidi assisted and consulted. He had seen "one or two" and had the basic concepts down and Heidi really just filled in the gaps.

On our way home, we discovered that the local parade crossed our route to the house. After a brief tour of Santa Cruz, we finally found a way here that didn't cross the parade route. Since not all of the local streets are paved, we were lucky to be in a 4x4 truck.

We got home, grabbed our bikes, and rode into town just in time to catch the last 30 minutes or so of parade. Perfect! Now we're taking the rest of the day to relax and work in the garden prior to leaving for two days of clinic with Leslie and Katie.

The first pic you see here is of the Guatemalan flag going by. Note the Mayan woman in front of the camera with the cloth on her head. They often wear these to keep the sun out of their eyes.

The second pic is of some people waiting for the parade to come by. There are several women and kids there in traje (the traditional dress).

The third pic is of a marching band coming past the same spot as the last pic.

The last pic is of some more parade watchers.

We also shot and uploaded a few videos... You can see a little more of the festivities in the videos.

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Thursday, September 14, 2006

Back in Guatemala... Full Speed Ahead!

Sorry it's been a couple of days since we've written... AND that we don't really have any pictures to post this time! We hit the ground running again here in Guate after landing on Tuesday and getting the truck fixed, etc... Wednesday was a clinic here in Quiche (right down the street, really) at a new location, La Iglesia(Church) "Jerusalen". It's one of the larger Churches here in town, which provided a very nice setting for clinic. We mostly saw adults with high blood pressure and diabetes who have been receiving meds from Agape in Action long-term, but it was very nice to see how they have been doing on the meds. (There has really been no way to get their blood pressures and glucose levels checked for quite some time with no regular doctor here, so they were very anxious to get back on track!) Adults don't make for quite the "photo ops" that kids in our other clinics do, though-- so, sorry for the less colorful post today.

Today we went back to Aselsi, the well-established and well-run clinic under the direction of Sharon and John Harvey in Chichicastenango. We saw the young lady with the molar pregnancy again in follow-up, which is a continuing frustration with the care provided by the hospital here, really. She FINALLY got her surgery (a "D and C" for her abnormal pregnancy, which takes about 10 minutes) last Thursday night! For those of you keeping track, that's a full week from the time we took her in to the hospital the previous Thursday. The "run-around" she got in the meantime was ridiculous, and I'm very glad that she and her husband decided to stick it out and continue waiting to have the surgery done. Many patients, I think, just get frustrated and leave without the care they need.

She was sent home last Saturday with instructions to return the 20th after getting another ultrasound done and another blood test done in town at her expense. Again, frustrating... since ultrasound is pretty much the one reliable service that the hospital CAN offer and which should be done for free! Her appointment on the 20th, of course, is very unlikely to actually happen unless the doctors and government miraculously come to some decision that allows the clinic doors to be re-opened by then. We, of course, gave her another appointment with us "just in case" they don't! On Heidi's ultrasound today, it really looks like they really didn't get all of the tumor/abnormal pregnancy out, and we are afraid that we will eventually need to repeat the procedure. Please continue to pray for her (Laura Maria Hernandez) and her husband, who have been incredibly patient throughout this experience. We will see what continued prayer and her hormone levels do before making any major decisions...

Another prayer request is for a 30-something year old lady by the name of Tomasa Culax, who is suffering from symptoms of depression ever since her husband left her many years ago to provide for her two children. They are now 14 and 15 years old, but she still struggles to care and provide for them. Guatemalan women have very limited resources in general, and especially when they lose their husbands for whatever reason. We prayed with her today and started her on medication, but what she really needs is continued prayer support and to really feel God's love in her life.

Tomorrow we have a surgery (vaginal hysterectomy with repair of a prolapsed bladder) scheduled-- at FIVE a.m.!-- in Chichicastenango with Dr. Tom Hoak, a general surgeon and missionary working at the Methodist Hospital there. Heidi is very excited to have the opportunity to work on some gynecologic surgeries with him, and the facility there is very nice by local standards. Wish us luck with the early rising! But we've been up much earlier for much less fun reasons before, really...

Tomorrow (15th of September) is also Guatemala's Independence Day, so it should be filled with parades and other celebrations. Hopefully some better photo ops then... We'll skip the OR pictures this time, probably, in the interest of those of you who have told us you read the blog at lunch or other mealtimes! This weekend we'll be back up in Canilla with the Fickers, but will hope to update you again tomorrow before we leave.

Tuesday, September 12, 2006

Back Home in Guatemala

Well, it was a wonderful weekend. Thanks so much to everyone who showed us hospitality, especially the Shaw family, the Wamsley family, and Carrie (for letting us sleep at your houses). Again, sorry we didn't get to see more people, but time constraints and "Guatemala Gut" both took their toll.

The good news is that Matt got to spend some time with his friend Ken last night and Heidi got to see some more work friends, who spent much of the evening trying to plan a visit to Guatemala!

Obviously, we made it back to Guatemala in one piece, though we did have a minor moment with the truck. Oscar picked us up at the airport, took us to UNICAR to drop off some gifts for Dr. Cruz Molina, and then to Antigua to pick up our truck, which had had some maintenance work done on it. We drove it to Via Real, our travel agent's office, paid our bill, and came out to leave. The truck wouldn't start. Oscar had to go back to the shop and bring the mechanic to our truck, which was illegally parked under "the arch". Oops.

Anyway, we ended up with a new battery. No big deal, just one more thing you hope not to deal with when you have a limited command of the language (especially with a limited ability to name the various things under the hood in Spanish). But God took care of us by making sure we not only had the ability to pay the bill, but that we had our problem less than a mile from a place that could help us (and before it started to rain!)

Well, our first big clinic in Quiche is tomorrow. It's really combination of two clinics and we're well aware that the people have been waiting for us for some time. It will likely be a VERY long day. Pray for our patience as well as our patients!

Louisiana Side Trip (no pun intended)

So you know we took a quick trip to the US this past weekend. After a wonderful visit and some business with the support team (Russ, Bethany, Ray, and Carrie), we took a day for R&R. First thing in the morning, we went to Heidi's old hospital, LBJ, to visit some friends there. Then we went to lunch with some of Matt's work buddies in Orange. Then we ventured into Louisiana. We didn't have our passports with us, but luckily no one at the border could read.

We ended up spending a very enjoyable afternoon, evening, night, and morning with the Wamsley family. Trip is a world renowned bass player whom Matt toured with for a few years before our recent move. Trip and his wife Sarun have a wonderful son, Xander, who is living proof that God is great. Xander was born three years ago at 24 weeks and change and tipped the scales at 16 oz. It's been a long road for the whole family but Xander is progressing with amazing speed and before long you'll never guess he had such a rough start.

Trip, like we said, is one of the finest bass players in the world as well as a strong Christian and it is a real privilege to know him. He recently finished a tour with Caedmon's Call and is about to release his fourth solo CD (which contains a track that Matt played on!). Please, please, please, check out his website ( or his myspace page (

The weekend was SUPPOSED to include some drop-in visits on more of Matt's touring buddies, but ironically, after six weeks in Central America, Heidi's stomach picked this past weekend to act up and we ended up just trying to get back to Houston in one piece! (We did leave a Cinco Quetzal note in Big T's casino - a near miss, unfortunately) Sorry guys, we'll definitely catch up next time.

Anyway, here are a few pics of Xander, Sarun, Trip, and Matt solving the world's problems. Oh, and a link to a movie where Trip and Xander are enjoying a little "father-son rock-out" moment.

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Saturday, September 09, 2006

Re-Intro to North American Life

Well, here we are in the Texas/Louisiana area for a long weekend... and although our stories from here are bound to be a little less interesting, we felt inclined to blog at least one entry because the last one that Heidi wrote was just plain depressing! "Re-entry" in to the U.S. has been fun and interesting, but as you all and God are aware, "home is where the heart is"... and right now, for us, that's in Guatemala. It's truly amazing to feel the love that He has placed in our hearts for these people!

Many other missionaries warned us that things would look differently to us when we came back here to visit, and they were really right about many of those things! Things really ARE a lot bigger here, roads a lot smoother, toilet paper a lot more "flushable", and tap water a lot more potable (brushing our teeth without having to use bottled water was a big highlight so far!) There are displays of wealth here that would really blow some of the rural Guatemalans away, and sometimes it is sad to see the disparities. But the beauty of being here in the States for a few days is that we get to take advantage of some of that wealth to take back down there with us! We were able to make a "drug run" at WalMart yesterday for vitamins, cough and cold products, etc... to take back down with us. I know we all have a "love-hate" or "hate-love" or maybe even just "hate" relationship with WalMart, but we also know it's the first place we're headed to stretch a limited budget to it's fullest limit! Especially when the need is so overwhelmingly large...

Anyway, it was great to see all of Heidi's friends from LBJ and Matt's friends from DuPont yesterday... and last night and today we're hanging out with Trip and Sarun Wamsley and their little boy Xander. Those of you who have met and/or know Xander's story (born at 24 and 5/7 weeks gestation, weighing 16.5 ounces at birth) would be amazed to see him now! We'll try to post pictures and videos of him when we get back to our own computer, because he is a truly amazing answer to prayer. Thanks so much to all of you who have been praying for him-- most of you even longer than Heidi has known him!-- and please be encouraged to know that he represents just another "success" in a growing list of answered prayers!

We look forward to being here in the States for longer at Christmas, and travelling around to see everyone-- This is such a quick trip that we can't make it very far outside of Houston! But we are thankful to our support team (Highland Missions, New Beginnings Resources... a.k.a. Ray, Russell, Bethany, and Carrie!) for making this trip possible to "reset" our 90 day visa so we can make it through to our holidays trip. Keep up the good work, everyone! God bless you all...

Tuesday, September 05, 2006

Heidi's Random Thoughts

Today was a little bit different, and quite a bit of fun. We went up to San Bartolome Jocopilas to the Women and Children's Hospital with the ultrasound machine, and did 30 ultrasounds on pregnant women there! It was kind of a promotion they were having to get more women to come in for prenatal care, and they felt very positive about its effects. We'll see... They are really trying to combat the high perinatal and maternal mortality rates there, and I think they're really on the right track. They're working WITH the local midwives to encourage them to call in by cell phone if they encounter a problem with a delivery, and they'll send the ambulance to pick them both (patient and midwife) up and bring them in. Most patients they end up having to send here to Quiche, though, since they don't have an obstetrician or C-section capabilities there... but at least they're doing what they can! Currently they've only got one to four deliveries coming in per month, but please pray that they will continue to build a good reputation among the people there and that they will continue to come in to where they can (hopefully) keep them a little safer during pregnancy and delivery.

What I really wanted to write tonight, though, is more about my experiences Friday night on call here. It has taken me this long to "detach" far enough from it to write about it, so forgive the late-ness of the news... I have to say that the night I spent here at the hospital in Labor and Delivery last Friday was one of the worst and most disheartening experiences of my life, and definitely a low point of our Guatemalan experience so far! Matt gave you some of the details (just two vaginal deliveries, then the C-section for the already-dead baby-- which hurt me in EVERY SINGLE bone of my body-- and the miscarriage in the alcoholic who died before we even had to decide whether she needed any further intervention for that... that pretty much sums up the night)

More importantly, though, what I learned-- or at least had my eyes opened to-- during the night is that the value of human life here is just NOTHING like what we are used to in the U.S. The reaction on the part of the staff and the obstetrician to the dead baby was more like, "oh... another one, huh?" (There are 10 to 12 a month that come in here, apparently...) The OB looked at doing a C-section as basically the easiest thing to do, with no regard to the fact that mom now has to try to go bury her baby with a big painful cut in her belly OR for the risks to future pregnancies from this C-section. In fact, he kind of sees it as his little contribution to family planning, since they essentially only "allow" three C-sections before they very strongly encourage women to have their tubes tied. (They basically tell them after the first one that they need to sign the papers for the tubal ligation at or before the third one, so they don't run in to many problems with people not consenting...) I'll be the first to support most efforts to provide better birth control down here, with this level of poverty and the number of pregnancies many women go through, but it's really not our place to make that decision FOR them. Those who graduated from LBJ with me will be happy to know that they will not catch me patting myself on the back for that type of contribution to population control anytime in the foreseeable future!

The 22-year old alcoholic who died just really kind of sealed the whole tone of the evening for me-- It was such a matter of fact thing, and people even chuckled about it. In a developing country, people really do learn to deal with death differently because it seems to happen so much more often... But please pray for the hearts of the staff here at the hospital to soften at least enough to go out and talk to a family about whether or not they even realize that the baby is dead before they wisk the wife away to her C-section! Trying to work some here at the hospital, which my heart tells me I should try to do, is going to be very tough... so please pray for Matt and I, too, to have the patience to accept these people less judgmentally and the wisdom and strength to rise above the prevailing attitudes.

Sorry for the "downer" of a blog entry today, but these are the things that continue to weigh heavy on my heart and that I really need you guys to pray for if you will! I'll close by trying to cheer you up with a little "the rest of the story..." moment, and go ahead and divulge that the real kicker for the whole night was that I came home covered in (what I think are) FLEA bites from the hospital scrubs I used!! Guatemala... a country never short on entertainment value!!

Hope you guys enjoyed the video and pics from yesterday... Sorry we don't have any good ones from today to post. For those of you who may not know, we're actually leaving tomorrow for the City, for a Thursday morning flight--for a very quick long weekend in Texas... Our 90-day visas will expire before another good opportunity comes up, and we have some supplies we need to pick up, so it should be a fun quick trip! It doesn't even seem like we've down here long enough yet to be leaving! But anyway, our internet access will--very ironically-- be slightly less constant over the next few days... Plus, our "adventures" in the U.S. are unlikely to be much to "write home about", so to speak! But we'll keep you posted; no worries!

Thanks again for all of the love, support, prayers, and encouragement we receive daily from all of you out there reading our random musings! Love and blessings to you all--

Monday, September 04, 2006

Funny Video

Clinic in Nueva Santa Katarina

Today was our second clinic in Nueva Santa Katarina. For those of you who don't remember, this is a very small town at about 10,000 ft elevation just outside Quetzaltenango. The first pic is one of the church (where our clinic is) with our truck out front and some folks waiting to be seen. Note the clouds well beneath us in the valley.

We saw a smaller number of patients today - less than 20 - which was nice because we got to spend more time with each one. We have a couple of prayer requests. The first is Arimatea Valux (her last name is pronounced Va-loosh). She came in complaining that she has no appetite and that she feels "susto". This translates to "badness, awfulness". After several attempts to find out what's going on in her life, she explained that her husband works in a nearby town and lives there. She is living with her in-laws and is being abused. She had a few minor health complaints, which we addressed, but really needed someone to pray with her. Luckily, the translator is the pastor and he spent several minutes praying with her in K'iche (her language).

Another prayer request is for Manuel Tamloriz Cuj. He's a 13 year old boy with some eye problems. We aren't really qualified to address those, but we referred him to the Guatemalan eye team that's here every two weeks. It's very possible that he'll end up being referred to one of the eye teams coming here from the US in October. Please pray for his mom to follow up on him and get him evaluated so he can possibly be treated. He is awfully young to have problems with his vision.

Our third prayer request is for Juan Ixquiactop Guarchaj. He's a very, very nice young man (24 years old) who came in for treatment of "attacks". When we asked what happens when he has these "attacks", he basically said that he doesn't know. He blanks out and doesn't remember anything. His dad tells him that he doesn't convulse or flop around, but just basically goes blank. Heidi is going to read up a bit on Absence Seizures and see what we can do for him medically, but Matilde jumped right in and told this man that what he needs is Jesus. You could really tell that he was down in the dumps. He's been out of school for two years due to these attacks, but he told us what he really likes to do is read and study. Please pray that God uses this opportunity to open some doors in Juan's heart.

We have a good news story from two weeks ago. Maria Guaschaj is a prenatal patient who we diagnosed with pre-eclampsia. We were quite worried about her and even called Matilde a few times to check on her. Matilde took her to the hospital in Xela along with another local woman who needed some medical attention but they didn't really do anything for her. The local church has been praying for her every day, as have we. Today, her blood pressure was completely normal! We know because we checked it four times.... Good job, God! Please keep Maria in your prayers, too.

Ah yes, pictures. In the second picture, you'll see the pastor, who's name is Matilde, standing behind one of our patients and his mother. He was in for a rash or something. The point of the picture is just to show Matilde, the inside of the church, and one of the typical local families.

The third picture was the first child who let Heidi hold her all day long. For some reason, Heidi was especially scary to kids today! Her name is Kenya and she was in for a fungal infection on her leg that actually looked pretty scary (at least to the musician who was helping the doctor). She was very, very cute, though, and we think we can help her!

Anyway, we got back to Quiche from clinic about 3:30pm and decided we had time to run into town and buy some bikes before two patients were scheduled to show up at our house at 5pm (long story - don't ask). The 4th picture is of our new bikes!!!! We'll use them for in-town transportation and exercise. They're much easier to park than a pickup truck.

Dinner tonight was with Dr. Hoak and his wife. They are Americans who live in Chichicastenango and work at a local hospital there. The hospital is not free, but rather is quite expensive by local standards, but Dr. Hoak (who is a general surgeon) has started a mission that helps people to afford the surgeries they need by only charging what they can afford to pay and then covering the rest. Some patients may only be able to pay the equivalent of $6 or $7, some as much as $100. His mission covers the rest. We are really looking forward to working with (and learning from) him and his wife. God has certainly helped us to cross paths with some very special and talented people here. We will have NO excuses if we can't help people!!!

Well, that's enough for today. Except that we'll probably also post a link to a very funny movie we shot today on the road..... Only in Guatemala!!!

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Sunday, September 03, 2006

Interesting Weekend

Not one day goes by here that we don't learn something new. Friday, Heidi had an opportunity to take an overnight call with one of the local OB-GYNs, Dr. Milton Gonzalez. It was quite the interesting experience. Keep in mind that the girl we brought to the hospital on Thursday is still sitting here waiting for her surgery. The hold-up is that she has been told that for non-emergency surgeries, they need patients to get someone to contribute two units of blood to the hospital blood bank. This bank, before Friday night, had five units of blood in it. (Guatemalans are not really hip to donating blood.) Her husband will donate, but there's some debate as to whether she needs to have HER blood type donated or not. Hopefully, Monday will clear some of that up.

Anyway, Friday night, they had four deliveries. One was a fifteen year old with her first baby. Another was a rather interesting 26-year-old whom Heidi delivered. She was quite large by local standards, wouldn't lie still, and had quite the screaming contest with her new baby. Fun. Yet another was a 22-year-old who'd been an alcoholic for 10 years. She was in the process of miscarrying her 14 week baby. And dying herself. It turns out that becoming an alcoholic at the age of 12 is hard on the body. The cap on the night was the C-section they did on a baby that was dead when it came in the door and had an arm hanging out. Heidi wanted to try to get the baby out without cutting the mom, but the local staff simply insisted on operating. Yuck.

So Heidi got home at almost 5am and we got up at 6:30 to go to Canilla for clinic with Leslie. It's a good thing we went, too, because she was SWAMPED! Instead of working together, we simply set up two stations in her clinic and two-at-a-timed more than 60 patients. Then it was bedtime for Heidi!

Today, we did another clinic in San Andres. On the weekend, we saw an untold number of prenatal patients, some impetigo, a bike accident (nice road-rash on the face), a lady with something growing on her foot, a broken tailbone from a delivery four months ago, and a dog bite. Pretty standard stuff.

Anyway, this coming week, we are in Nueva Santa Katarina, San Bartolome, and Chicabracan. The first and last are rural clinics. San Bartolome is a Centro de Salud (Center of Health) that has recently been built for the purpose of decreasing fetal and maternal mortality in one of the worst areas in the country. We believe that God has placed Heidi in a position to help teach Obstetrics to the workers in that government clinic. Pray for that venture to go well and for us to really be able to help!!!

Okay, just one pic today. This one is of Matt holding one of the patient's babies today while she was being examined. Note the mother's shoulder on the left hand side of the pic, about Matt's waist level...

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