So many updates!!

Well, here I am on the plane again home.  Except for the fact that I will have to travel through Miami (my least favorite airport on the planet so far…), it should theoretically be a smooth day—and most importantly, now less than 14 hours or so before I get to see my family again!!!  As a bonus, it sounds like Matt will be home around the time I get there tonight, so I get to see him FIRST! 

I find my head is nearly literally spinning with all that I have seen, learned, and been convicted to pray about this trip!  So if you feel inclined, please join me in prayer first for a few special patients—there is a lady who likely has severe preeclampsia very early in pregnancy who did NOT, unfortunately, come in to clinic for us to see her today.  She was told she needed to be delivered by the National Hospital in Quiché a couple of weeks ago, but refused since her infant would not live due to prematurity.  Now if the diagnosis is correct, both lives are in danger.  So, we pray. 

And another sweet lady who has lost two pregnancies, including one that was a two-pound baby born prematurely after her bag of water broke too early, and is now pregnant with her third.  We have little to offer her, either here or in the U.S., for prevention of preterm labor or PPROM, but we did are going to be able to start her on progesterone injections just like we would do in the U.S.—and lots of prayer, which is likely more effective.

There are several patients struggling with infertility, which is a huge issue in Guatemala as anyone who can’t have kids is so likely to be left by their spouse for someone who can.   And then there is sweet Cruz, the lady whose bladder fistula we fixed on our last trip…

Apparently, Cruz’s husband hasn’t really spoken to her since her surgery, for some unfathomable reason.  For the first time in many years she doesn’t reek of urine constantly, but he’s mad that she accepted surgical treatment instead of “just taking a pill or something” (which doesn’t exist)!  She is still smiling somehow, though, since he has not become physically violent or anything and the kids are still friendly towards her.  He could use some pretty serious prayer in his alcoholic tendencies for sure!  It wasn’t even a money issue; she only paid about $12.50 for her surgery if I recall correctly.  From a medical standpoint, though, we can give thanks that her recovery has been smooth and she is doing really well!

In terms of what God is doing down in Guatemala, though, there are many, many prayers of thanksgiving to pray—as well as some specific ongoing needs to lift up!  The Ficker family, my dear friends, continue to ask for wisdom and patience (as well as continued economic resources) as they are meeting so many new people who want to help with the hospital project and trying hard to discern what is best for everyone.  This hospital is happening, my friends.  The property is purchased and paid-for in full, ground has been broken and is being prepared for construction, fencing is going up, and plans are drawn!  We definitely need to pray that we all continue to stay on the same page (God’s) as much as possible and that all of this is done to His Glory. 

Pray for the doctors who will be working here at the clinics and in the hospital—for wisdom, favor on their families as they work, peace of mind, and unity of thoughts and goals.   Pray for the nurses who will be graduating from the Nursing School that is now open, that they will be faithful providers of loving care for the patients.  Pray that some people with pastoral care gifts will show up with a heart to serve the patients and staff full-time.  Pray for me to continue to stay focused in prayer for these things.  Pray.  Pray.  Pray.

(Little David "helping" Mom in clinic, and playing outside with some new friends he found!)

And remember, God is good.  God is in control.  God is faithful, and God is working in Guatemala as you read this!  Pray that they would see His faithfulness and His love through the service of the missionaries there and that they would KNOW HIM. 

(And in case anyone missed the fun of our "ice bucket challenge", here are some more clips and pics…)

"Home" sweet Canillá!

Well, those of you who have ever talked to me for more than a few seconds about Guatemala know how much I do NOT mind having to spend a little extra time out in Canillá this trip!  We got to fly out here yesterday and spend the afternoon catching up, chasing kids, and unpacking treats.  It's so awesome to see firsthand what God is doing here and all of the projects going on.

Ground has officially been broken for the hospital, of course, first of all.  The Nursing, English, and Premed school is up and going strong.  The new home has been moved into, and renovations are under way to turn the big house in to two apartment homes for the doctors who will need to stay here.  Work is being done on laboratory equipment, the pharmacy, the water system, fences, and hearts!  Days are long and nights are short, but love abounds and most of all we see so very, very clearly the joy of serving Christ lived out in a way that few are privileged to see in this world.

The Fickers (and all of the "honorary Fickers" that are part of this place) are an amazing family, truly on fire for The Lord and His work.  Read more about them, if you haven't already, at adonaiinternationalministries.org and be sure to link to some of the blogs from there.  And if you ever have any extra funds lying around and are looking for a way that they could go to further the Kingdom of God here on Earth, feel free to send them here ;-)

Today we got to do clinic in Chumisa-- Leslie, Dr. Jared Cardwell, and I saw about 100 people with just our two Quiché translators, who are likely even more exhausted than we are tonight!  About 30 prenatal care visits and bazillions of general consults later, I do have some pictures and stories to tell… the first pictures are just of beautiful Flor, one of our translators, and some of our first prenatal patients today.

Flor has really gotten good at ultrasounds, and it was fun to work with her some more today on doing prenatal care and being sure to point out what is abnormal and how to deal with it.  One example is a lady who is just 14 weeks pregnant and has very high blood pressure, which meets the criteria for a diagnosis of chronic hypertension even though she is very, very young!  We went through what we would need to do to manage her and what to watch for in this pregnancy and if you all could continue to pray for Manuela Barrera, that would be great.  

The last picture is one of our last patients-- he is 87 years old, and his complaints were that he can't see or hear and has no energy to walk in his legs!  (Never mind that he probably walked many miles to get to clinic today)  His ears are clogged with wax, although he probably has some age-related hearing loss, too.  His eyes are blocked with cataracts.  And his legs are really just fine but understandably tired!  The picture doesn't really capture what I was trying to, which was him leaning closely in to Flor as she was yelling near the top of her lungs to tell him about his treatments.  After that failed, the man standing next to him tried the same thing at even louder volume.  Everyone got a kick out of it, and I'm not at all sure if the man understood any of the instructions but he definitely felt paid attention to!

Tonight we are all relaxing around a table full of tacos and hopefully will rest a bit this evening.  Not sure what tomorrow holds, but then… do we ever really know that?

God is good.  God is sovereign.  God knows.  And that is enough.

Wrapping Up… Already?!

Well, this has been a strange and short week, but we did find out that the "feria" (Fair or celebration) for one of the Saints is in Quiché just up the road this week.  That is the reason no one is coming in to be seen!  Even the hospital waiting room, which usually looks like a kicked-over ant hill, was empty before 9:30 this morning when all of the consults (maybe ten total, five were ours…) were done!

So that means tomorrow we will go ahead and go out to one of the happiest places on Earth for me-- Canillá with the Fickers!  Can't wait to see them again and catch up; God has truly blessed us with amazing friends and Godly counsel through them for years now.  Can't wait, also, to see the broken ground for the new hospital with my own eyes!!  Melissa and Jared are looking forward to getting back to their own sleeping quarters there, too, I'm pretty sure.

Tomorrow we will, of course, round on our patients and likely send them both home.  They looked fantastic this morning!  I am convinced anew every time I come down and operate here that the fresh AIR here in the hospital courtyard where patients recover is just good and healthy for them.  No, my academic friends, I of course do not have any data to support this.  Might be an interesting study to try to figure out though!  It warms my heart each time I see a patient of ours sitting out in the sun with her friends and family as she recovers.

Thursday will be a long and busy clinic day with the Fickers-- it's a clinic they do once a month in a rural area (the one just outside of Cruz Chich that I can't remember the name of for those of you who know the area…).  It will be nice to feel useful there, I hope!  I'm hoping I'll get to do some prenatal ultrasounds with Flor in pseudo-teaching mode ("pseudo" because she is pretty much at least as good as I am with them by now…)  Then maybe I'll do some "translating" for Jared and Melissa and learn a little something more about primary care from them surreptitiously through that ;-)

Today's pictures are random but fun… and oh-so-Guatemala!  The first one is a sweet patient of ours today who was just as enamored with David as everyone else who sees him… I love how this culture loves and cherishes children even more than ours, and how no one is ever concerned about us having a small child running around or even making some noise during their consult.  They really live out the "village" concept of raising children (since typically enough people to fill a small village may live inside the walls of single home anyway here!) as well as caring for the sick, widowed, or poor (-er than themselves).

The greatest part about mission work is that I learn more from it than I teach any of them, I am sure.  Even after two years living here and six years now of quarterly trips (over 20 total!), I learn something new or at least appreciate some of God's graces anew each time I come.  I am so blessed and fortunate to be able to continue having these experiences, and I pray they never end.

Oh-- and the second picture (I lost my train of thought for a second, "shockingly"…) is even more classic Guate clinic-style--

Yep, that's little David with Play-Doh in one hand and a (CLEAN) speculum in the other!! What can we say?  An 18-month old is GOING to be curious about what's in the bucket on the floor, right?

And with that fun thought, I will sign off for the evening-- be sure to check out Docs for Hope when you get a chance at  www.docsforhope.org -- what an amazing work God has done in and through them to turn this hospital in Canillá in to a reality!

And we're off!...

… to a rather slow start to the week, to tell you the truth!  We saw only 13 patients today, which would be awesome if more than ONE of them could have been scheduled for surgery :-/  My prayers will now be strongly renewed for God's continuing work and purpose here for me, as I always get a little paranoid when the numbers dwindle.  I'm also going to be praying even harder for Tom and Jana Hoak, as they continue to try to work out a plan that shares more time with their family and friends in the U.S. while continuing some work down here.  The hospital is much quieter without them around (and NOT in a good way), and I personally miss them dearly!

So now paragraph two after two heavy prayer requests already-- time to lighten up a bit maybe?!  We did have some delightful patients in clinic today, and I for one really enjoyed working with our mixed Guatemalan-U.S. group of physicians.  Lindsey and Paul were a great help and joy to have around.  Dr. Jared was also awesome-- so patient and wise, and working really hard to master some more Spanish but starting to catch on a bit!  

So the patients we saw today-- the only one I remembered to take a picture of is Maria Ren, the lady we will operate on tomorrow.  She was there with several of her 11 living children who are also pictured, and you can see Dr. Paul in the background also.

Unfortunately we had another lady who really could benefit greatly from vaginal surgery but had a blood sugar of 466!!  Fasting blood sugar was only 237, but we figured it would be a lot better to wait and get her sugars under control first.  So, Chris Schwering, that is our gift to you in November (assuming the metformin we gave her will be effective).

The best part of clinic by far, though, was that being less busy we really had some time to just have some fun with patients-- We had one patient that initially confused us, since she had three different daughters translating and often giving different stories!  My favorite part is when we asked if she has a husband-- one daughter said yes and the other no!  Dra. Lindsey picked up right away that she actually has a "boyfriend", but the girls's father has passed away.  I was just baffled by the higher difficulty level of that question than I had anticipated.  We all had a good laugh, though, which is healthy and fun.

We also had a little fun in the market and teaching little David to "meech" or be tied on Mom's back like a Guatemalan baby.  Both Mom and David were pros by the end of the day! The first picture here you can see he's not quite sure about this new deal, but I love the family shot on the way to dinner of the Cardwells…

Our last patient today actually just came in asking for a pap smear, which I have had happen very rarely here in Guatemala.  It is always nice to see a little bit of progress being made in preventive care education!  "Poco a poco", my friends…  (little by little)

And as we go to bed tonight (at a little after 8:30, although we all feel like it MUST be 11:00 or so), we are so blessed to know that God is good, God is sovereign, and God is IN CONTROL.  We will see what tomorrow brings.

Arrival Day (posted yesterday to the WRONG BLOG… yeah. I'm good at this ;-)

Well, the first blog post of the week is usually a “Meet the Team” post where I let everyone know who I am travelling with… but this week is a little different.  I flew down by myself this week and my team is essentially joining me down here from in-country!  I was certainly a little bummed when I had no one stepping up and able to come down this time, but as usual, God has provided.  Now I’m as excited about the team as any recently… “God is good, and God is sovereign” will be somewhat of a theme here in case you are a new reader to this blog!

Anyway, I’m headed up to Chichi in a nice bus now that God also provided, this time through reaching out on facebook to some of the other local missionaries and hitching a ride with a team coming up (from Michigan and North Carolina, no less!) to work with Manos de Jesus and Pray America.  They’ve been great travel buddies and it was really nice to get to meet some of their long-term missionaries that I had not come in to contact with yet.

Tonight I will get to meet Drs. Jared and Melissa Cardwell, another one of the couples who are down here with Docs for Hope.  Some of you remember they are the amazing physicians that have agreed to staff the hospital now BEING BUILT out in Canillá (because God is good, and God is sovereign!) full-time for the foreseeable future.  All of the docs in their group are Family Practice-trained but very surgically minded and trained also.  They have an 18-month old son, David, who I can’t wait to meet either.  I love how kids are becoming a more regular part of these trips lately!

Please pray for their family as they are just recovering from a recent and seemingly quite nasty stomach flu, and pray that this week would go smoothly as far as their travels and our medical care.   I’m not sure where they are with Spanish, either, so some supernatural language lessons wouldn’t be a bad request.

We are also hoping to be joined by Dra. Lindsey, a Guatemalan-trained physician that has been working with Agape in Action for the last several years since her graduation from Medical School.  She and her husband Paul are such bright lights in this country and the ministry!  She started working with Jim and Kathleen Street now many years ago as a bilingual secretary, and became interested in the medical side of the practice.  She put herself through Pharmacy training without even mentioning it to Jim and Kathleen, and then Nursing  school as well!  When she and Paul then decided they wanted to go on to Medical School, Agape and Jim and Kathleen personally helped them with some scholarship money in hopes that they would serve in the capacity they are in now with Agape. 

God is good, God is sovereign—and God provides.

Lindsey’s infectious smile and love of learning all things in women’s health care and medicine will be such a joy this week, and her English skills are amazing (although she would never admit it).  I’m hoping I’ll get to see that fun look on her face again this week that Sarah Gore and I caused several years ago when we handed her a scalpel and guided her through a surgery for the first time!  Oh, how I WILL miss formally teaching medicine…

But God is good, and will provide.  Please pray that we never forget to give thanks for His grace and His goodness as we work a likely quite tough week.  We will try to post some pictures of faces to put with names tomorrow, but for now there’s just me crashed out on the bus here since I left the house shortly after 1 am local time to start travelling.  Tonight’s sleep will be sweet, friends…

Wrapping Up and Winding Down

 Well, here we are at the airport to head home after a fantastic week!  Yesterday morning we were able to discharge our last two patients from the hospital before flying out to meet up again with my dear friends the Fickers (http://adonaiinternationalministries.blogspot.com) in Canillá, El Quiché, Guatemala by small plane.  If only every morning we went in to round at the hospital our patients were taking in a bit of sunshine on the balcony like sweet Maria was that morning!  Love this picture…

Please continue to pray for healing as these last two patients especially recover from tough abdominal incisions at home.  Their names are Maria and Sebastiana.  Sylvia somehow managed to talk Sebastiana in to giving us a picture of her beautiful (somewhat toothless) smile on the last day—those of you who have any experience photographing Mayan women know that is quite the feat!  Dr. Sylvia used her own beautiful smile, though, to convince her to flash hers long enough to capture it…

Then out at the Fickers it was time for spiritual sanctuary, catching up with my “family”, making new friends, learning new prayer requests, and seeing the amazing things that God is doing is down here right now!  Here are some new shots from the nursing/English/pre-med school and the Fickers’s farm and clinic area also.  What a nice time of spiritual and physical renewal and rest before traveling home today. 

We look forward to the next trip!  Thank you all for following along and continuing to pray with us…

Girls' selfie in the plane:

Walking out to the new house, which will be ready to move in to soon!

The inside of the new house!  Beautiful work, guys!

At the school, the Mission and Vision Statements (obviously, this was in the English classroom!)

The computer lab… Might not look too impressive by North American standards, but trust us when we say that it rocks the worlds of the Guatemalan education system!

The entrance to the school… Love this!

The front of the Ficker property, taken from the back...

Walking out to clinic… 

Adrienne checking in patiently waiting patients this morning...

Anna checking and recording blood pressures and glucose measurements on prenatal patients this morning before we flew out.  We managed to see maybe 2/3 of the pregnant patients before we left, I hope...

A view of the clinic entry way wall:

Cultural Appreciation Day?

 So this morning we were able to "sleep in" a little and didn't go down to the hospital until 8:00.  There is a worship service there every morning, and it is always a special privilege to attend.  We worshipped, listened to a brief message from sweet Pastor Julian who preaches and visits with patients there each day.  We then prayed corporately for the patients we had operated on as well as for several other requests that the group had.  I was asked to pray, which is always intimidating in front of a group in Spanish—good thing God even speaks a little “gringa español”!!

We then got rounds done and discharged several more patients who looked great.  Thanks especially for your prayers for Marta, the hematoma from yesterday who looked much better this morning.  We were much more comfortable sending her home after watching her overnight and seeing her hematoma shrink significantly.  One more patient was begging to be seen this morning so despite our prior plans we caved and saw her, and will hopefully save her jumping through a bunch of hoops and spending a lot of money to get a surgery at the National Hospital in Quiché that she doesn’t probably need!

After that it was off to the market!  Much damage was done to many wallets and the soles of our feet, and there was full-blown sensory overload with all of the colors and products.  I think everyone made some great purchases and definitely enjoyed the experience and a little down time.

This afternoon we sat around at a café where there was WiFi, and I have to say it’s the first time this group has sat around and been in front of computers and iPads this week instead of talking and really having meaningful conversation.  What a great group.  I continue to be really impressed. What a blessing!

Here are some scenes from around Chichi… captured mostly by Hale, who has a great eye for photography.

And then there are some scenes from the hospital: Hale snuck a picture of prayer with a patient on her way to discharge home this morning…

And then breakfast trays were brought, and he surreptitiously caught this shot of sweet Cruz blessing her meal before eating it.

This one was from earlier in the week, but apparently I was getting a little tired of the camera in the OR-- sticking your tongue out at it has a little different effect with the mask on, though!

One of my favorite things to teach people that come on the trip is how the family of the patient wants to see the removed organs after surgery when we are telling them how everything went!  Here is Angelica, the sweet nurse that is a huge help in the OR helping Sylvia, Hale, and Anna tell the family of yesterday's last patient that surgery went well-- "thumbs up"!

T

Then there's some really cute shots of the team from the roof of the hospital, one of my favorite places!

 And this last one is probably my favorite… this little girl, Gladis, is the now SEVEN year old daughter of (the late) Maria Suy Chan, who some of our very long-time readers may remember as the lady that we diagnosed with breast cancer when she was pregnant with Gladis.  I always see her husband and other kids in the market, and today when Gladis was there he took special care to point her out to me.  She followed us up the street and chatted for a while, then let us take her picture (for which she was somewhat handsomely compensated with enough cash for ice cream for her and her siblings, of course!)  She is beautiful, and reminds me of her sweet mother, God rest her soul.

 Tomorrow we will round, hopefully discharge our last two patients, and fly out to Canillá to see the Fickers, which is like my spiritual retreat and a place where God is really moving!  Check them out at their own blog for further reading at http://adonaiinternationalministries.blogspot.com !