Christmas in North Carolina

After Christmas Day in Cleveland, we met up with Heidi's brother, Daryl, whose in-laws are in Cleveland, too, and made a mini-caravan to North Carolina. Isaac got to meet three more cousins for the first time - Pandora, Boone, and Della Scott. Both sides of the family combined, Isaac has five (soon to be six) first cousins all within three years of each other. Something tells us there are lots of fun days ahead with all of those cousins! And if you count second cousins, he's got somewhere in the neighborhood of twenty. WEE!!!

We spent several days with Granddad and Gran in Salisbury, NC (and some aunts, uncles, and cousins) and just today drove over to Cary, NC to spend two nights with Heidi's Aunt Mary Ann. We'll be taking Isaac to his first North Carolina basketball game tonight. Yes, he has a little Tarheel outfit to wear.

Below are some pics - three from NC and two leftovers from Michigan/Ohio.

The first is from his baptism with his cousin, Isabella (and Aunt Catherine and Uncle Joe).

The second is with his cousin, Pandora.

Third is one we couldn't resist. It's Christmas time and mangers are running all amok. That's Cousin Sophia in the back.

Fourth is swinging on Granddad's porch, and last is Isaac working on his first Cheerwine (a soda bottled in Heidi's hometown of Salisbury) in Graddad's "Man Room".

Merry Christmas

We're writing this from Cleveland, Ohio - at Matt's sister's house. We had a fabulous celebration of the birth of our Savior. We had lots of family, some good food, and the making of many wonderful memories.

Presents? Isaac made out like a bandit. And his parents didn't do too badly, either. It's nice to be in the land of plenty, but a little weird, knowing that so many of our patients and friends have nothing.

Tomorrow morning, we meet Heidi's brother and sister-in-law here in Cleveland (where Erin's family is, too) and caravan to Salisbury, North Carolina for a week with her family there.

Isaac has grown like crazy since we got to the US. Since we came here three weeks ago, he has started to sit up by himself, he can now roll over, has started eating rice cereal, and has grown his little Buddha belly by at least 50%!

His temperament is still day-to-day, though. Today was not his best. He was basically a fuss-butt all day and it only took us about 2-3 hours to get him to go to sleep. Arrrggghhh!!! When we get back home to Guatemala, we'll need to start him on a little schedule - at least for bedtime.

Anyway, here are a couple pics from the week. The first is our new truck we're so excited about. The next few are of Isaac, and the last one is of the Bell family on Christmas day.

Well, gotta run. More later.

New Truck!!

Many thanks to all of the very generous people who contributed to our truck fund, because we are now in a new (to us) vehicle. We prayed a lot about this vehicle, and have actually been looking for some time. God always closed doors, just when we thought we had the right one, and finally opened a door for us.

The vehicle is a 1999 Toyota 4Runner. It might sound a little long in the tooth, but it only has 50,000 miles on it and looks brand new. Toyota is the gold-standard in Guatemala, not just because it's a proven tough off-road vehicle (we see absolute rolling wrecks that are still climbing those mountains), but because parts are ubiquitous. Other brands may require a 4-7 hour trip to the capital for parts, but most Toyota parts are available in almost every little town.

Now we have a pick-up truck (the Mazda) and an SUV. This increases our flexibility for transportation and, hopefully, our reliability. Again, thank you so much to everyone who donated and helped make this happen. Special thanks to Matt's dad, who drove up to Detroit to check out the vehicle, negotiated a price, bought it, drove it home, cleaned it up, and went through a million gyrations to get all the paperwork done. We would have been in a big mess without that help.

And just one more indication that this was the vehicle God wanted us to have, when we went to go get the title, there were some... well... paperwork issues. We don't want to get anyone in trouble, but we'll just say that without divine intervention, we wouldn't have this truck titled in our name.

So, in January, Matt and John Villanueva will drive the truck down through Mexico into Guatemala. We'll be needing lots of prayer coverage on that trip and the two international border crossings, so please keep us on your prayer list.

In other news, we are now in Michigan/Ohio visiting Matt's family. We went to a Michigan State basketball game last night, leaving Isaac with his paternal grandparents for our first night out since he was born. WEEE!!!! Plus, it was a 40-point victory for the Spartans!

Sunday, Isaac will be baptised with his cousin Isabella. Family will be coming in from all over the place. All four of Isaac's paternal great-grandparents will be there, as well as Daddy's godparents, tons of aunts, uncles, and cousins, and some college friends we haven't seen in years. YAY!

The day after Christmas will see us meeting up with Heidi's brother and his family in Cleveland and caravaning to North Carolina for a week there with Heidi's family.

Also, please pray for God's wisdom and clarity with some other decisions we have to make. More details later.

Finally!

After three days of driving, we are now in Cleveland. (For some reason, it's more difficult traveling with a baby - we made this trip in one day last year!) We arrived ahead of all the weather that's supposed to come in today. Heidi and Matt's sister, Catherine, have gone shopping. Matt and Joe are home with the babies (Isaac and his cousin, Isabella). Three-year-old Sophia is at a Christmas party with her grandma.

Tomorrow we'll get to go see Alistair Begg, a pastor we listen to every day in Guatemala by the miracle of the internet. His church is here in Cleveland.

This week, we'll be splitting time between Michigan and Ohio. Next Sunday, Isaac and Isabella will be baptised together in a joint ceremony in Michigan.

Please pray for a good recovery for one of Dr. Hoak's patients he emailed us about this morning. Even as we're here on vacation, the work in Guatemala continues...

Northward Bound

We are writing this now from St. Louis, Missouri at Ken and Suzy's house. Some of you may remember the wedding we were in in April. Same Ken and Suzy.

Yesterday morning we left Dallas, after spending the night with Pavlos and Liz, two doctors we were very close friends with in Houston. They've since moved to Dallas and have a beautiful home there.

Isaac was a little trooper yesterday, enduring about 11 hours in the car. It wasn't always his favorite, but he did remarkably well, all things considered.

This morning, we'll visit Suzy's office for Isaac's 5-month check up. (She's a pediatrician), have lunch with Craig (previously from Guatemala, now back in St. Louis), then drive all evening and into the night to get to Matt's sister's house in Cleveland. Then we'll be in Ohio and Michigan through Christmas Day.

We heard from Paul and Lindsey, who are keeping an eye on our house in Guatemala and attending our clinics for us. They are doing well and were able to find a new home for themselves in Quetzaltenango, where they're attending medical school. Their landlord had informed them that their rent was about to double, so a househunting trip was in order. God always provides and this time was no different. Apparently, house hunting in Guatemala is not always as easy as it was for them this time.

Please keep the prayers coming for wisdom and clarity in all of the job search activities going on now. Our prayer is that God will open the doors He wants us to walk through, close the ones He doesn't, and that we'll have the sense not to fight Him!

Christmas Vacation - Week 1

It's been an eventful week! We arrived in the US last Monday night. We've been staying with Russ, Bethany, and Tye Leatherman. Little Tye just turned 1 year old this week and it's amazing to see how much he's grown since he was down in Guatemala a few months ago. It's hard to believe that Isaac will be doing all these things in just another 7 months!

We've had chances to see and talk to many old friends - both Heidi's and Matt's. It's so nice to be back in town and make contact again with people.

Today was our chance to go see some friends at The Woodlands Methodist Church. Many of the folks in the Sunday School class we visited are regular travelers to Guatemala. They usually stay at our house when they're down for mission trips. Lots of them prayed Isaac and Heidi all the way through the pregnancy. In fact, some of them were at the house when we went to the hospital to have the baby.

This class has been so amazingly supportive, financially and spiritually. We are very thankful for their devotion and support. It's so nice to be able to share some stories about our work with people who pray for us on a regular basis and have also been down to see where we live and what we do.

This week, we have a few more business items to take care of in Texas, then we head north. We have some people to see in Dallas and St. Louis on our way to Michigan and Ohio to spend time with Matt's family. Then it'll be down to North Carolina to see Heidi's family. Then we'll come back to Texas and return to Guatemala to meet up with the cleft palate kids in Antigua.

Oh, and Isaac likes America, too. Lots of stuff to look at and all kinds of toys to play with!

Safely in the United States

First, we'll say that we are safely in the U.S. now. Not "conveniently", but "safely". Continental has a long way to go to be "customer service oriented" in our book, but we'll just assume that they had a really, really bad week and let it go.

Update on yesterday's blog. On Leslie's way home from San Andres, she found the grandmother of Baby Juan waiting in the road for her. So they all went back to the house in Canilla together. Apparently, Grandma was sick, too, so she got the "knock out" treatment and slept from the time she got there until this morning. Leslie wasn't so lucky. She was up all night with a very sick baby.

By this morning, it was becoming apparent that the baby needs more than just feeding, so Duane and Aaron flew the grandmother and baby to Quiche. Jacob had offered to bring us to the Quiche airstrip to meet Duane for our flight to Guatemala City. Since he was there with his truck, we asked him to give this woman and her baby a ride to the Quiche hospital, which he gladly agreed to do.

Now, our luck with sick babies at the Quiche hospital isn't too good. We've watched at least three babies die who really should have lived. We will pray that this baby does better than the others.

In any case, Isaac was a little trooper today. He really likes flying with Duane. He slept through a good portion of our two hour delay in Guatemala City and was relatively quiet through most of the flight. However, being stranded on the tarmac in Houston for 30 minutes because another plane was at our gate was more than he could take and he had his first real melt-down of the day. We were both running out of patience ourselves and this didn't really help, but we finally got into the airport where we got to wait another 30 minutes or so for Continental to find everyone's luggage. AAARRRGGGHHH!!!

Anyway, we are now at Russell and Bethany's house and cannot WAIT to see Tye in the morning. He will officially be 1 year old tomorrow. My, how time flies!!!

Please continue to pray for Baby Juan...

Friday through Sunday

Friday was Heidi's last clinic at the Hospital Buen Samaritano before we leave for Christmas. She had a full slate of 12 patients. A couple were prenatals, a couple were post-ops, a couple were not really gynecological, and one was a surgery she'll do in January. One patient showed up demanding her hysterectomy that day. Heidi tried to explain that this was not going to happen, as it was the first time they'd ever even spoken or met (we have no idea where this patient got the idea that you could get a "drive-through" hysterectomy). Upon being denied immediate elective surgery, she got angry and started calling the hospital director (who happened to be in the car with Dr. Hoak). Eventually, she got tired of waiting and left the hospital (in a very nice car, according to the girls at the front desk). Who expected THAT at a mission hospital???

On the way home, Heidi got a chance to stop by and see Sharon Harvey at ASELSI, who just returned from her first real vacation in over 10 years!!!! Sharon and John do such tremendous work here. We really missed them, but were so happy that they got to take an actual vacation.

Saturday was clinic in Canilla. Aaron and Matt spent a lot of time talking about how to make the drive from Texas to Guatemala, in case we are able to purchase a new (to us) vehicle there in December. Aaron and Katie just made the drive within the last month and had some very helpful tips. The group in Houston looked at a possible purchase this week. Please pray that God lets us know if this is the one for us or not.

In clinic, a couple brought in their 8 year old granddaughter who they say has been having three seizures a day for the last 2 1/2 years. This is the first time anyone has sought medical treatment for her. Her mom and dad are both in the United States and haven't tried to do anything for her. We asked if there is an open fire in the house (many families have an open fire in the house for cooking). Yes, there is, they answered. Heidi brought Martina in to show them what can happen to a little girl who seizes and falls face first into a fire. By this time, though, the grandparents were more interested in their consults - tylenol and vitamin variety complaints. Please pray for this little girl that God will protect her even when her own family does not.

Today was our last clinic before our trip. They only sold about 50-60 numbers (roughly 1/2 the normal number), as it's the last day of the town "Feria" and people simply don't seem to get sick when there is drinking and partying to be done. Weird, huh? The first patient of the day was a two week old, 4lb 4oz little boy who was brought in by his great-grandmother. Mom died during childbirth and Dad is either in the United States or at the coast, depending on when you ask. The family has been buying milk but not feeding him properly. They said he didn't eat at all yesterday but he was quite interested in the bottle Leslie gave him. She recognized that, left in the hands he's been in, he's going to die, so she offered to take him in for a few weeks to get him out of immediate danger.

The great-grandmother called the father to ask for permission for her to go stay with Leslie while they help this baby. He said no. Then it came out that he has blood in his stool. Leslie suggested that the best thing for them to do was to bring him here to the hospital in Quiche. The great-grandma then left to go home "to get some clothes" and never came back. Now we're in a quandry. Has the baby been abandoned? Or has great-grandma simply gotten distracted? We certainly don't want to be accused of kidnapping, but we can't just sit and wait for someone to come back who doesn't appear likely to do so. Eventually, we decided that Leslie will take the baby by the orphanage in San Andres and get the paperwork filled out to declare the child "abandoned". This will cover us, legally. Then she was going to try to drive into the village where the lady said she was from and try to find her (it's on her way back home to Canilla). You can see this little boy, named Juan, in the two pictures below.

In the meantime, a woman came in with a pretty nasty cut on her thumb from her machete and our favorite "drunk grandma" came in for her weekly visit and touch-up (she gets drunk and falls down at least once a week and comes in for us to clean up whatever wounds she has this week). This week, "Grandma" had a nasty scrape on her elbow, which she had self-treated by putting a piece of newspaper on it. It was thoroughly soaked and stuck into the wound, making a pretty nasty job of removing it. Her biceps, literally, are about half the size of Matt's wrists. At around 4'6", she probably weighs 70 lbs. Please pray for her, too, that a moment of clarity will help her discover her need for help.

Tomorrow, Paul and Lindsey will come by around 7:30 to get the truck and go to clinic. We will do some last minute things here at the house and go to meet Duane at the local airstrip at 10:30 or so. Then it's a 30 minute flight to Guatemala City and a 3 hour flight back to Houston. We have some business (and pleasure) to take care of there, then it's off to Dallas, St. Louis, Michigan, Ohio, North Carolina, then back to Texas before we come back to Guatemala. As always, we'll keep you posted!

ASELSI Thursday

Tuesday, we took some time to run down to Antigua, relax, and do some Christmas shopping. We had a nice dinner there and spent the night in a hotel we found during our stay with the cleft palate kids last year. On Wednesday morning, Matt ran over to the Guatemala City airport to leave our heavy luggage for the trip back to the US on Monday. Since we have to leave our truck for Paul and Lindsey, Duane is going to fly us to the airport on Monday morning and there's not room in the plane for all our stuff.

Wednesday afternoon, Heidi had a quick surgery in Chichi. You may or may not remember the patient she had a while ago in whom they accidently cut her ureter. (When you're dealing with a 10 lb uterus, things are not always where they're supposed to be.) Well, to repair the ureter, they had to put in a stint - basically a plastic tube that serves as the ureter while the ureter is healing. Eventually, that stint has to come out. And thanks to Dr. Flavia Horth and the Wichita Falls team, we now have a tool to remove that stint without opening the patient back up again. The surgery went quickly and without complication.

Thursday morning, we headed to ASELSI for our last clinic of the year there. We saw several prenatal patients, a few new babies (whose moms were patients of ours during their pregnancies), a couple of cleft kids, and a microtia (it's an ear problem) kid. Heidi and Virginia have been working very hard to plan the cleft/microtia trip for this January. All of the preliminary work has to be done before we leave next week. So pretty much all of the kids and their families had to be reached (not always easy here - not everyone has a phone and some that do don't speak Spanish) and told where to be and when to get their pre-op labs done. Then all of the logistics to transport a dozen or so kids and their parents to Antigua for the surgery had to be done. Virginia and Sharon will be helping to arrange all of the labs and transport while we're on our way back in January. Like last year, we'll meet the kids in Antigua. (Also, thanks to Matt Capehart for loaning us his school bus to get everyone there!)

We did have a few interesting patients today. One was a 28 year old woman with high blood pressure. She appears to be in great shape but clearly something is wrong. We sent her for some studies, some of which we'll have to help her pay for. She's single and her dad has already died, so she really has no financial support at all.

Another patient came in as a prenatal patient but it appears that her baby has died at about 3 months gestation. She is 39 years old and this is her 14th pregnancy. She has 10 living children. Her husband has given her permission to go on birth control after this baby. Unfortunately, there won't be a living baby here. We prayed for her in clinic and she seems to be taking this rather stoically, but we know that it's very bad news.

Another patient is desperately seeking to get pregnant. She came in a month or so ago with her husband and we sent them both to get some lab tests. It was a little uncomfortable to discuss the sample procedure her husband had to go through, but he was very supportive and didn't complain, though we did get about a tenth of a second of a weird look! She came in today with the test results and it looks like there are no hormonal problems with either one of them. So we're suggesting a basal body temperature test for the month while we're gone. We'll look at the results when we get back and try to figure out the next step. We reminded her that throughout the Bible, there are many, many stories of couples who wanted kids and prayed and prayed and prayed and finally had them. Sometimes, persistence is the key.

Yet another patient came in with a story of post-menopausal bleeding. This is almost never good news. Heidi couldn't find anything obvious on exam, but she is so twisted and bent with arthritis and just old age that it's not unlikely that she's got some other badness going on. She's not exactly the best candidate for surgery, though, so we talked about prayer with them, too.

Our last patient of the day was a nine year old boy who is deaf and mute. He's also mentally retarded. He had had some type of plastic surgery to remove some scarring on his foot so he can wear shoes. Our job was to remove the sutures. It was pretty hard because it's hard to communicte with him and tell him what we're going to do, to encourage him, and to commend him for being so brave. We basically had to just hold him down and let Heidi work. He did really well and got a sucker for his trouble. He really liked Isaac, though. Isaac was having one of his good day/bad day days in which he's okay for a few minutes, then not. He and this little boy did take time to smile at each other, though.

Well, tomorrow is Heidi's clinic at Buen Samaritano, then this weekend is our last weekend in Canilla before we leave for Christmas. My, how time flies. We haven't been to the United States since April and that was only for a few days for a wedding.

Our plans will take us to Houston, Dallas, St. Louis, southern Michigan, Cleveland, Salisbury, NC, Raleigh, maybe to Atlanta, then back to Houston. All on the road. Wish us luck!

New Word

We learned a new word today: atrancado. We'll get to what that means in a minute. (Those of you who speak Spanish are already laughing, aren't you?)

Today was clinic in Chicabracan. There was a fiesta in town, so not too many patients were waiting for us. Besides, we'd given all of our chronic patients enough meds for a month the last time we were there (two weeks ago), so we had kinda hoped for a quiet day.

Paul and Lindsey were with us, which is also a huge help, especially since Isaac has not been a very good boy the last few days. It might be because some bugs tried to eat him alive in Zona Reyna. He's probably itching like crazy. We're doing what we can with hydrocortisone cream, but he doesn't really understand that. Oh well. Being a missionary (even a 4-month-old one) sometimes has its price.

We only had about 25 patients today and they were mostly quite easy. There were some good teachable moments - like the woman who gets a pain in her lower abdomen about once a month - between periods. Some months it's on one side, some months it's on the other side. Lindsey did a good job of diagnosing the problem and the patient felt a lot better when we told her that this was nothing serious or dangerous.

We had one 14-year-old girl who has had some very heavy first periods - so heavy that she got pretty pale and couldn't leave the house for a week each time. It's probably normal, but we'll send her for a blood test to make sure she doesn't have Von Willebrand's disease (the docs will know what that is - for the rest of you, it's rare enough not to clutter your brain with it).

We also had a patient who was complaining of chest pain. We're treating for that, but more importantly, we wanted to know the status of her soul. She told us that her husband left her 20 years ago, which was kind of a blessing, she says, because he used to beat her and he has kids with 8 other women. So she's had a hard life. It's a long road for single moms here. In any case, she attends church but hasn't really picked up on the key learnings. She knows that Jesus died for our sins but isn't sure what that means in relation to where she'll go when she dies. We got to spend some time explaining to her that His sacrifice was both necessary and sufficient for salvation. Accepting His gift is all we have to do. It's pretty ridiculous to believe that we can do anything to earn favor in His sight, especially considering that the Bible says that our good works are like dirty rags to Him. Clearly, works are a fruit of a saved soul, but don't ever believe that anything you do is earning you brownie points in heaven.

Anyway, we were lucky enough to leave clinic an hour or so before lunch. The fiesta at the school on top of the hill left a bunch of trash in the driveway we usually use to get out, so we had to turn the wrong way down the road to leave. We drove about 100 yards and saw a big grassy yard to turn around in. Instead of simply driving in and backing out, we just pulled a U-turn using the yard. I mean, it looked completely dry to us. It hasn't rained here in a few weeks. However, we soon got to learn that "atrancado" means "stuck". Not all 4 wheel drive systems are equal. Since we don't have full lockers, we were spinning one tire on each axle, effectively digging ourselves a pretty nice hole.

First, Paul, Lindsey, and Heidi tried to push. No luck. Then we flagged down a 2-wheel drive truck. We ran to the local tienda and bought some ropes (the truck was so full of meds we didn't bring our emergency box that has a really nice tow strap in it). All the 2-wheel drive truck could do was spin his tires and almost get stuck himself.

Then we flagged down a dump truck. He broke two ropes and nearly pulled our bumper guard off. We'll be without that bumper guard from now on. You know you can actually twist those???

So what's left to do when a DUMP TRUCK can't pull you out? You call Martin, of course. He's Paul's uncle, too - don't know if ya'll knew that. So 30 minutes later, he and Geronimo showed up and winched us out quite easily. For future reference, just because grass looks dry and it hasn't rained in nearly a month, don't assume you can just drive somewhere.

Yes, we're still praying for a Toyota!

New look and some pics

Do not adjust your computer screen. Yes, we changed templates for our blog. It's supposed to be better. Time will tell.

In theory, there will be a slideshow of some pics we've shot on the right hand side. Apparently, our technical skills are not up to the level of the average 8-year-old because it's still not working. Be patient. We're missionaries, not computer whizzes.

We're also going to try to embed a video or two here in a minute. God have mercy on us!

Today was church with the gringos in Chichicastenango. We had a bunch of guests, too. There were some Americans in to visit as well as about 20 kids from the Guatemala City Dump - no kidding.

Some of you know that tens of thousands of people actually live in the Guatemala City Dump. They scratch out a living by digging through garbage to find food and things they can sell. There are some ministries that reach out to these kids. One ministry provides a two week camp in Chichi for some of the higher achieving kids. The ones we saw today have learned some English and presented two songs to us and recited a Bible verse in English. It's so sad to think that in a few days, they'll be back in the dump, digging through trash trying to find something to eat or sell. Please pray for these kids and everyone they live with there. Poverty outside the United States is very different from what we think of as "poverty". Poor people here are not overweight and do not own cars or live in apartments. Poor people here do not have designer shoes or televisions. This is what the other 90% of the world is like.

Speaking of poor, here are some more pics from our trip to Zona Reyna...

Zona Reyna for Thanksgiving

For Thanksgiving this year, we decided to celebrate by going up into the rainforest/jungle of Zona Reyna to do clinic. This was our third time in this area. There is no electricity, no running water, and no churches in the area. The people do okay, more or less, by growing and selling Cardamom (a spice produced here in Guatemala) but the standard of living is still pretty low and these people are absolutely starved for the gospel.

As many of you know, this is the area we've been trying to reach for a while now. The enemy is clearly opposed to this. This is where Duane and the boys broke the nose gear on the Aztec airplane a year ago - and that plane is still out of commission. Every time we go to this area, we lose a vehicle (this time being no exception - read on). And we have had many, many small battles with the enemy here, logistical and otherwise. Things just always seem to be more difficult than they need to be.

In the past, we've brought a few friends along to help evangelize to the people. This time we kicked it up a notch by inviting the Stuckenburg family to come along. They are a missionary family who lives near Lake Atitlan (who took in Baby Sarah earlier this year, if you'll remember). They specialize in evangelism and outreach and have worked in probably around 50 different countries. Tom (the dad) brought 8 kids with him between 13-23 years old to help evangelize and work with the local children. They put on plays, taught songs and games, handed out coloring pages and crayons (which the adults seemed to enjoy as much as the kids), taught Bible stories, and showed the Jesus film overdubbed in the local language of K'ekchi.

Once again, the enemy was at work. We had been told to expect 1,000 patients, so we planned accordingly. We had 150, some of whom were "manufactured" patients. Clearly, someone is trying to discourage us. But no such luck. We had a great time and left even more convinced that this area needs to be reached.

Of course, since we were in Guatemala, every day was an adventure. We mentioned the Stuckenburgs, but additional members of this cast of characters included our friends Arlen and Deb from St. Louis, Dr. Jeff Lambert from the Woodlands, Craig Phoenix (also from St. Louis), Tomas and Juanito (two of the Fickers' workers), the Bell family, and the Ficker Family. All in all, 26 of us went, counting 4-month-old Isaac and 2-year-old Grace.

We all met at the Fickers' house in Canilla for Thanksgiving Dinner, complete with Turkey, stuffing, cranberry sauce, and pumpkin pie. Even outside the US, we can still eat like Americans! The logistical plan for the trip involved sending the big F-350 (loaded with equipment - and 8 passengers) and the Tacoma (with 9 passengers) up into the jungle at 4am on Thursday. (It's about a 5 1/2 hour drive.) We were going to receive a weather report from a local in Saquixpec at 7am and decide whether the rest of the crew could fly in or would have to drive. We prayed for good weather and got it. The doctors and the babies got to fly, as well as a few others - Duane made two trips (great because the docs were preparing to see a ton of patients and the babies really don't appreciate being locked in a car for 5-6 hours and it's only a 15 minute flight.)

However, nothing really happens quite that easily. When we tried to add just a touch more air to the front strut on the plane, something went wrong and we lost ALL the air in that strut, making the plane unflyable. Over an hour, a phone call to the US, a trip to the local gas station, and lots of prayers later, we got some air in the strut and we able to fly 8 people into the jungle. Then one more truck had to go with the remainder of the equipment.

Friday, it rained all morning, making a set of flights out look a little unlikely. But with some additional prayer, the skies opened up in the afternoon. Duane was able to ferry 8 more people out by air. Then the fun started.

Less than an hour into the return trip, the front bearing in the Tacoma failed. We had been nursing it for a little while and thought it would make the trip, but we were wrong. The front hub locked up and that was that. So we found a small church in the village we had just come through and asked the pastor if we could leave the truck in front of his church for a few days. We gave him a few Quetzales and a bunch of bananas. David, Aaron, Juanito, Joe, and Matt worked on tearing the front assembly out of the truck while Tom, Katie, and Deb supervised the consolidation of three trucks worth of people and stuff into two trucks. About six people ended up riding in the back of Aaron's old truck (the vehicle that came up after the plane left on Thursday) and a bunch of gear got left locked up in the Tacoma.

Later in the trip, the Ford punctured a tire. It had already lost one on the way up and the spare had been patched, sort of. Luckily, Craig had brought down a tire plugging kit and we plugged the tire in the middle of the street in another small town - while a police officer was trying to make us get out of the way of some chicken buses that were supposedly going to come through. David works fast, though, and we were ready to roll by the time they got there.

The crew that had left Saquixpec before 3pm finally arrived back in Canilla about 10:30pm. The group that had flown in earlier in the afternoon had been able to get dinner and some warm, dry beds ready for them with the help of the recently donated generator (of course, there was no power in Canilla Friday afternoon).

This morning was clinic in Canilla. Again, the power went out and we had to use the generator to finish clinic. Duane had a charter flight to Guatemala City, so he took that opportunity to pick up the bearings for the Tacoma. The boys will have to go back up into the jungle this week to fix the truck and drive it home. Fun, fun.

Since Leslie will have plenty of help at clinic in San Andres tomorrow (she'll have Katie, Arlen, and Deb), we're taking the opportunity to go to church in Chichi. Monday is our clinic in Chicabracan.

And here are some pics from the weekend. I'll post a few more tomorrow, maybe.

Nueva Santa Catarina

This morning, the alarm went off at 5:30 so we could get up and head to Nueva Santa Catarina. Isaac and Heidi had already been up for a while. Ewww! Isaac is falling asleep pretty early now which translates to pretty early mornings. We could try to keep him up later, but he turns from cute to monster at about 5pm, so...

Anyway, Nueva Santa Catarina is a little village about two hours away on some of the best roads in Guatemala (which ain't saying much, but at least they're paved). The good news is that our repaired truck isn't leaking antifreeze all over the floor anymore, but the bad news is that we think we're smelling another small leak. Time will tell. We'll keep an eye on it.

When we arrived at clinic this morning, one of our chronic seizure patients was sitting inside the church. He had just seized while waiting for us to arrive. If it hadn't been for two construction zones, we probably would have been there. Unfortunately, in his post-seizure state, he couldn't answer many questions, but we did our best to help him and will definitely pray for him a lot.

This clinic is at 10,000 ft altitude and the dry season just started, so everyone has dry, itchy skin, sore throats, headaches, and just general dehydration symptoms. We also saw a young girl with a rash we couldn't identify, so we're sending pictures to a dermatologist friend in the United States. Nothing really serious today, but we'll probably make some big quality of life changes in a bunch of people with simple OTC meds.

One group of three women came in who needed some evangelizing and Matilde (our translator and the pastor at the church) took over from there. It's nice to have him there. Evangelism isn't a big strength for either of us, especially in K'iche. We do our best, but it's better to have someone who really has a gift for it, right?

Many of you have followed our exciting adventures with vehicles. Well, thanks to some generous donations, we are in the process of looking for a vehicle in the United States to drive back down through Mexico after Christmas. We pretty much have the "looking for" part covered, but we could always use a few extra bucks to help buy the vehicle and pay the transport costs back to Guatemala (the best way through Mexico is on toll roads - fewer police looking for bribes, etc.) We're buying used, so we're not asking to help buy leather seats and satellite navigation systems, but just a reliable 4x4 to help us get to our clinics and make emergency runs when necessary. We're a 501(c)(3) organization, so donations are tax deductible. We try not to ask for money very often, and when we do we try to ask for direct donations for patient care, but if we can't get to our clinics, we can't help the people. Anyway, if you feel led to help in this way, we'll get you in touch with the necessary folks in Houston. End of commercial (sorry about that!)

Tonight we're entertaining some American friends who live here in Quiche. He's a volunteer fireman and they're both English teachers. They're a fun young couple we really enjoy hanging out with.

Tomorrow we're working on the truck and getting ready to go up into the jungle. Wednesday, we'll go over to Canilla, celebrate Thanksgiving a day early, then go to bed. Thursday morning, we will send at least one truck really early in the morning up to Saquixpec with all our equipment and meds. If the runway looks good, Duane can start flying doctors and nurses in. It'll save them 8 hours on the road if we can. The flight is only 15 minutes (crazy, right?). Yes, these roads are quite bad! We usually take at least one truck out of commission on each trip...

So here's a pic of Isaac hanging out with some of his Guatemalan friends outside clinic.

Fickers to the Rescue (again!)

As most of you will remember, we've recently had more than our fair share of vehicle problems. One of the omst frustrating things here is that it seems like we spend about half our energy just keeping vehicles running. The Mazda recently had two separate stays at the dealership in Guatemala City (the only Mazda dealership we know of in Guatemala). The reason we had to take it in originally was that we were blowing smoke all into the vehicle and overheating. It turned out that it was because there was a leak in our heater coil. So they replaced it. A week or so later we found out that because the heater coil had leaked, we had lost cooling to the head and cracked it. So it spent a few weeks getting that replaced.

This past week, Heidi thought she smelled antifreeze again in the truck. Matt wasn't sure, but on Saturday morning, there was no doubt. It was about 40 degrees and we made the trip all the way to Canilla with no heater. When we would try to use it, we were full of smoke again and the windows got so coated with antifreeze film we could barely see. Not good on windy mountain roads.

By the time we got to Canilla, our floorboards were completely soaked with antifreeze. So David and Matt spent the morning at the airport taking the dashboard out of the truck to get the heater coil out. We brought it back to the house and found a leak in it in a place we couldn't really get to to repair it. So the options were to simply bypass the heater (not really the greatest in November at nearly 7,000 ft altitude with an infant in the vehicle) or to try to repair it.

So we called our friend Martin in Quiche, he found a shop that was open that could fix it, we flew it to Quiche, got it repaired (sort of), and flew home. This morning, we re-installed it in the truck, replaced the dashboard, and were on our way.

When we say "sort of" repaired, what the guy had to do was pull all the fins out, coat the tubes with a special high temperature epoxy, and hope for the best. It pressure checked okay, but time will tell how well it holds. The dealership claims that it's a two day job to pull the dashboard and replace the heater coil. David and Matt did the entire job in about 8 hours - and it was their first time messing with it. There won't be a next time (we'll just bypass it and shiver) but if there was, it'd be a whole lot faster. We can only hope that it holds while Paul and Lindsey have the truck in December because they don't really have the resources to address the problem if it goes bad.

Anyway, that whole operation probably saved us another $3,000 repair job from another cracked head - which is what would have happened if we had tried to drive the truck without a repair. So nice to have friends, right?

With David and Matt tied up with the truck, that left Heidi caring for Isaac - even during clinic on Saturday. Luckily, Saturday was a very low key day and Isaac was very well behaved. The only notable patient from Saturday was a woman who complained that she throws up all the time - but only when she sticks her finger in her throat...

Today, Heidi and Leslie went to clinic in San Andres and were pleasantly surprised to only have around 60 patients. That used to be a pretty busy day there, but the word has spread and there are usually in the neighborhood of 100 patients every Sunday now. Heidi had a patient today who came in with some pretty vague complaints and they quickly arrived at the fact that what he really needs is some spiritual peace. So she talked to him quite a bit then got our translators' uncle to evangelize a little more. The patient was pretty interested in knowing more about Jesus and was asking some good questions. Please pray for his spiritual journey to continue from here, not to find an abrupt end.

A 45-year-old woman came in pregnant. She herself has a cleft lip and palate so severe it was hard to understand her when she talked. She had had one baby with a cleft lip that starved to death after only a few months (most can't really get any good suction on the breast). She was very early in her pregnancy, but Heidi told her that if we see a cleft on ultrasound or if the baby is born with a cleft, to PLEASE come to us for help. We can get special bottles to help the baby eat until he or she is big enough for the surgery (most anesthesiologists want to see babies at at least 10 pounds).

And we had to give the bad news to one of our chronic asthma patients that it's really not a good idea for her to try to have another baby. She wants one, but her last pregnancy nearly killed her about 5 different times and she's gotten worse since then. It's sad to have to tell her that any attempt to have another baby will likely kill her and leave her daughter without a mom, but that's the unfortunate situation she's in.

Pics. The first is David inside the truck with the dash torn out. The gas can is holding up the steering wheel, which we had to drop down to get the dash out.

The second is the offending radiator with its slightly... uh... unsightly repair.

The third and fourth are of Isaac helping out. First by supervising, then by taking a nap. Wow - those car seats sure are great babysitters!

And the last one is of Heidi's translator, Manuela, practicing her ultrasound skills (with some help from Heidi!)

ASELSI in Chichicastenango

Today was our nearly weekly clinic at ASELSI in Chichicastenango. We say "nearly" because that doesn't include the first Thursday in each month. Anyway, today was a pretty interesting clinic day. Luckily, most of the routine patients were very routine, because we had some that required quite a bit more time.

Our friend Regina (mother to three of our cleft palate kids - and who you'll see in the first picture below) has been pretty good about bringing us some patients that we really need to see. About once a month or so, we get a call from her at home asking if we can give some numbers at ASELSI. Because of where Regina lives, she can't get to ASELSI early enough to get a number (they start turning people away by about 5am every week!) Nearly every time Regina has brought us a patient, it's been someone who truly needs medical attention - not just a headache or a stomach that burns when they eat chili.

This time was no exception. She asked for three numbers and two of the three were in pretty bad shape (a father and son). Naturally, the mother had to come along and we treated her with Tums and Tylenol. The son had been working at the bus terminal in Guatemala City about 8 months ago when he got shot in the leg with a 9mm. Since then, he hasn't been able to walk (or work) and has been quite worried about feeding his family. He's on crutches and can't even put any weight on his leg. So we sent him to Buen Samaritano to get an X-ray. He came back with evidence of two bullet fragments still in his leg and an apparent spiral facture that hasn't completely healed. We referred him to Dr. Edgar, our orthopedic surgeon friend.

The dad presented with diarrhea and really swollen feet. We asked to make sure he wasn't pregnant (with the swollen feet and all) and got a pretty good laugh out of that. The part that's not funny is that his liver is huge. He used to drink - about 20 years ago, before he joined the church - but it looks like the damage is done. So we sent him to Dr. Hoak at Buen Samaritano, who at press time hadn't called us to let us know what's going on with his liver.

Later, we had one of the workers at ASELSI who has been married for 8 years and still doesn't have any kids. That's pretty unusual here. She's been to several doctors and if they actually told her what she says they told her, we shudder to think what the thought process is! Her husband came in, too, and will be a participant in the process to try to figure out what's not working right. Both will need to go get some labs and we'll pray a lot for them.

We got to see three or four babies whose mothers we've provided prenatal care for. Those are always fun! And we saw a dozen or so prenatal patients, too, including our friend who is on her 11th or 12th pregnancy, is diabetic, and had a c-section on her first baby but has delivered each subsequent child at home. As always, we're encouraging her to go to the hospital to have this baby and to at least consider some type of family planning, but history tells us that she'll probably ignore our advice.

One mother came in with her baby to check her weight. She's been in twice - asking for free milk each time. Apparently she's breast feeding about eight times a day and giving a bottle a few times a day, too. The problem is that she only breast feeds for about two minutes on each side. So we had a teaching moment. The problem is that moms around here think that because it comes in a can it must be better than what you get for free if you'll only breast feed. So we get a ton of moms who come in and want free milk. The milk programs we work with only give milk to malnourished kids, and only about half of what the baby needs. If Mom is not going to breast feed, she at least needs to participate and buy SOME of what the baby needs. ASELSI and the Fickers both spend insane amounts of money on milk and we can't afford to give it to everyone who asks - nor should we. Getting babies started on bottles can be downright dangerous. Hygiene isn't always the greatest and we're reasonably sure that not all moms clean the bottles well with soap, water, and bleach. If a baby is already a little malnourished, diarrhea could easily do them in.

Using that as a segue, our last patient of the day was a mom asking for milk for her baby since she didn't have any breast milk. 99% of moms who say that have plenty. Heidi always makes them show her and usually gets squirted with milk for her trouble. This woman had nothing. Plus, she's about 45 years old (or more). In Heidi's opinion, she didn't look anything like a woman who had just given birth. Yet, she insisted that this was her baby. Through our translators, we explained that we're not going to call the police or anything, but we need to know, for medical reasons, whether this is her baby or not.

Finally, she and her husband admitted that this is not their baby. They don't have any kids and are worried about who is going to take care of them when they get old, so they're "adopting", which basically consists of them going to the local health office and claming that this is their baby. Then they'll get papers for her. Mom has quite a large belly, though, and we wanted to take a look on ultrasound just to be sure. It looked like her bladder was completely full, so we asked her to go pee and come back. When she came back, she was still completely full, so Heidi catherized her and got nothing out. Clearly, the ton of fluid we're seeing inside her abdomen is not urine. So Heidi tried to get her to come to Buen Samaritano tomorrow where she has a lot more resources. But the patient is scared of hospitals and is not going to go. We've put them in the milk program at ASELSI, as the only thing they've been feeding the baby is warm water - milk is too expensive. We're not sure how they're going to care for this baby so it lives long enough to take care of them, but...

Anyway, here are some pics from the day. The first is Regina with her daughter Carolina (one of our cleft kids) on her back and Isaac on her front. The second, third, and fifth pictures are of the new babies we mentioned earlier. And the fourth pic is a woman who is completely riddled with rheumatoid arthritis and had an appointment with the orthopedic surgeon last week, but can't read and came in on the wrong week. We pulled her chart and continued her on the same meds he gave her last time and gave her another appointment to come see him when he comes back.

Tomorrow is Heidi's clinic at Buen Samaritano. Next week is Thanksgiving, when we'll be headed up into the jungles of Zona Reina for two or three days. Please keep praying for all of that to go smoothly. We're expecting about 1,000 patients. No kidding.

Chicabracan

Today was our bi-weekly clinic in Chicabracan. We had a full truck this morning. It was Heidi, Matt, Isaac, Paul, Lindsey, Juan Diego (our evangelist), and two patients we picked up on the side of the road on the way to clinic. Plus four boxes of meds, an ultrasound, a computer, our lunch, and Isaac's diaper bag. All this in a truck about the size of a Ford Ranger. Luckily we only live about 30 minutes from clinic!

We were on our vacation two weeks ago and had postponed this particular clinic, so it was no real surprise to have 50 patients when we're used to about 35. Many were first-timers, so it was great to have some fresh ears to hear Juan Diego's lesson. His lesson today was about the woman who had ten coins, lost one, and searched the whole house until she found it. The folks here really understand that concept. We have such a throw-away culture in the United States that we probably don't really feel the panic that these folks do when they lose a coin. The point of the message is that no matter how many followers Jesus has, He's always so excited when one more comes to the fold.

Our first patient, the one we brought with us, was our friend Gregorio Zapeta. He is probably our most confusing diabetic. He always looks like he's knocking on death's door - and he's not very old - maybe in his 30s or 40s. Sometimes he's almost completely blind from his diabetes. For a while, his blood sugars were in the 300-400 range, no matter what meds he was on. We were about to start him on insulin one week when he came in completely normal. For the next six months, he was absolutely normal. Then one day he came back in at around 300. He swears up and down that nothing in his diet has changed. Last time, he couldn't come to clinic because he was sick (more on that in a second). So he's now been without meds for two weeks. We expected his blood sugar to be sky high. But no, completely normal. We have no idea what's going on with his body, so we prayed with him. He is a Christian, which is great because with his blood sugar, he could fall into a diabetic coma and die just about any time.

We've often laughed to ourselves when patients tell us that they couldn't come to clinic because they were sick. Seriously, where else would you go when you're sick??? But think about it, sometimes our patients have to walk a couple miles up a mountain to the nearest road, then hitchhike to clinic. If you're truly sick, can you walk up a mountain? I sure can't. So with our American mindset, it's completely ridiculous to not go to the doctor when you're sick. But things are different here...

As we mentioned, Paul and Lindsey helped with clinic again today. It's so nice to have four extra hands. It makes handling Isaac easier, it makes gathering meds go faster, it helps to have native Spanish speakers, etc. Plus it's nice for the patients to see us working together. It gives us both credibility in different ways.

Another thing that's different between the American "immediate gratification" culture and here - we had a woman come in today who we could barely examine because she was hurting so badly. Her gallbladder has been bothering her for five months. And she has a seven month old baby! How miserable to be suffering with an infected gall bladder for five months - and caring for a newborn the whole time! She lives a long way away, but her sisters are regular patients of ours and they told her to come to us, so she's now staying with them for a few days so she could come to our clinic. We referred her to Dr. Hoak who can take her gall bladder out without giving her any kind of run-around.

Anyway, there were lots of stories and only a limited space here... so onto the pictures. The first is of Paul and Lindsey with a patient. The second is a little boy who had worms. He looked so sad while he was chewing his albendazol tablet! In fact, this picture was taken about 5 seconds before he threw it up all over himself...

The third pic is of Isaac and his daddy. (We had to prove that they actually came to clinic!) The fourth is of Heidi ultrasounding a pregnant patient. Note that the patient is laying on top of one of our medicine boxes - we don't have an exam table in this clinic. Lindsey is holding the patient's 19 month old baby, who screamed from the time she realized her mommy didn't have her until Mommy got her back.

And the last pic is Heidi and Isaac, Paul, one of our patients, and Lindsey.

Tomorrow and Wednesday are our days off. Hopefully, Matt will get some much needed recording time. And Paul will probably come over with some local musicians to talk about another recording session. We only have a few weeks when Paul is on vacation and Matt is in town, so we'll try to get some more work done...

Weekend Clinics

Saturday and Sunday were our weekly clinics in Canilla and San Andres. For whatever reason, Isaac has decided that he doesn't really like clinic days any more. He had done better for a few weeks, now he's on a down cycle. Patients continue to think that he's the cutest thing ever, but we have to admit that he's cuter when he's smiling than he is when he's fussing or screaming...

We continue to be a little frustrated by some of the differences in values between richer cultures and poorer cultures. (We find that the Latins and those in Guatemala City have values much more "American" than the Mayans do.) One patient came in pregnant. She's 21, is on her 4th pregnancy and has one living child. Naturally, the question is, "What happened to the other two?" They were breech and died during delivery. Her baby is breech now, too. We asked her if she was going to go to the hospital for delivery in light of the previous two bad experiences. Her answer was that she's afraid of the hospital and pretty unlikely to go.

It's not just her. We hear this from lots of patients in life or death situations. Not all, as one severely pre-eclamptic patient told us that she WOULD go to the hospital. We're not sure the family really understands the gravity of the situation, but they at least acted like they were going to go. But many patients and families are so afraid of the government hospitals that they refuse to go. Some of this stems from stories about how patients can get treated at the government hospitals. We've seen both good and bad treatment of patients there - it kind of comes down to the luck of the draw sometimes. The rest of the fear probably comes from fear of the unknown. Our patients probably average about a kindergarten level of education and don't really understand anything that happens in the hospital. Communication is difficult, especially when patients don't speak much Spanish. And even when they do, the education levels are so different and the hospitals so busy that very few doctors really take the time to explain the situation to patients on a level that they can understand.

Also, we occasionally get stories from patients that make us wonder if the doctors DID try to explain things on a level they can understand. The trick here is to try to guess what the doctor's thought process was so we can take a stab at what the docs think the problem is. For example, if someone tells us that the doctor told them their stomach was too small, what possible medical conditions could possibly be described that way? Fun, huh? Well, it can be!

Today, Heidi had a 13 year old boy come in who had sustained a blow a few years ago to... well... an unfortunate place for a boy. At some point he ended up catherized. Now, the catheter has been removed and he is incontinent. This would be inconvenient for anyone, but a teenage boy? He's completely aghast. We're referring him to Dr. Hoak to see if anything can be done. Heidi deals with female incontinence, but boys are plumbed slightly differently. Maybe she'll get a chance to learn some.

Over the last few weeks, Heidi has been working to teach her translator, Manuela, some medicine. Education is so critical, especially out in the rural areas. If we can take some of the mystery out of health and health issues, people may be more accepting of medical treatment - and more importantly, of the other things we have to say to them (specifically about Jesus). Last week, Heidi taught Manuela some of the basics on ultrasounds - mostly to check and see if there is, in fact, a baby in there. This week was Lesson #1 on how to take blood pressures. Matt had told Manuela last week that if HE can do it, SHE can do it. He was right. She mastered the concept on the first try (see picture). Maybe next week we work on taking blood sugars!

Tomorrow is our clinic in Chicabracan. We're hoping to bring Paul and Lindsey with us. They were very helpful last week and since they'll be covering clinic while we're in the US for Christmas, it's nice for patients to see us working together so they understand that we're all part of the same organization and all have the same goals - demonstrating Christ's love for us by providing medical care to those who often have nowhere else to turn.

Please continue to pray for people seeking God's guidance in their lives. We know of many people (including ourselves) who are contemplating major life changes and simply want God to reveal His will to them. Also, please pray for Baby Sarah. Duane is bringing her to Quiche tomorrow for a check-up as part of her adoption process. As you'll remember, some major prayers have already been answered for her and we continue to ask God to keep His hand on her. Oh, and if you still have prayer time, pray for the work that the community is promising us (to be done on the runway in Saquixpec) to be done well so we can safely fly in there over Thanksgiving.

Isaac's Four Month Pics (1 of 2)

We already posted one blog today, but it was all business. So if this is your first time here today, don't forget to scroll down and read about what we're actually here for.

In the meantime, is it four months already? Well, not officially until Sunday, but we feel pretty good about having made it this far anyway. (Considering that we really still know very little about babies... thank God for Leslie!!)

The first pic is one of Isaac's "old man outfit" pics. There's another one in the next post, too. We figured that since he has no hair, no job, and no teeth, he's practically retired anyway - might as well dress like it.

The next one is Isaac's attempt at the crooked Harrison Ford smile. Think the ladies will go for it?

Third is his most common face - you could put SO many captions on this!

The last two are his official Thanksgiving outfit. Since we'll be up in the jungle on Thanksgiving day, this'll be his only chance. Besides, he doesn't really like turkey or cranberries anyway.

Isaac Pics (2 of 2)

The first is Isaac in his little stick-horse outfit. We didn't have any other props, so we just used a cowboy hat that's a wee bit too big for him.

The next two are him being absolutely fascinated with a new (to him) Pooh Bear. We could hardly get him to tear his attention away from the bear!

The next is just a cute smile, but the last one is his "old man" outfit. If we had only had some tall black socks and sandals...