More Construction

This morning, Heidi and Charlie headed to Chichicastenango for her OB/GYN clinic. Charlie is going into Orthopedic Surgery, so it's not exactly up his alley, but he IS a medical student and all types of learning are useful.

Fortunately (or unfortunately), depending on how you look at it, they only had one patient. It was a Christian lady who Heidi diagnosed with a miscarriage last year. This time she had better news. She's pregnant with what we hope will become her 8th living child. It's a very nice family. The husband was hit by a car last year and walks with two canes, but he credits God with his ability to walk at all. When you take away all the "stuff" we have in the U.S. and all the "scientific explanations" we have, you find that God moves in more obvious ways.

When God moves, He wants you to know it was Him. Sometimes in the U.S., we don't give God "room to work". Not that He can't work or doesn't work, but we often feel like we have other explanations for the things that happen. We can credit medical science or luck or whatever, but when a man is run over by a car, receives little to no medical attention, and can later walk, even when it's with canes, it's a little more obvious that there was some supernatural intervention.

Anyway, some more pictures of the construction project. In the first pic, you can see that the guys were burning off the tall dead grass that is in the way of their work. It hasn't really rained here in about five months, though, and things are awfully dry. That's why you can see a guy in a yellow shirt RUNNING on the left side of the picture. He's trying to fill a bucket to get control of a small chunk of that fire that got away from them a little bit. Note the horses on the other side of the fence - owned by the guy who has that very nice house in the background. He's a lawyer. It would probably be best if we didn't barbeque his horses.

Next, you can see that guys marking off where the foundation will go on the extension. Tomorrow, a backhoe will come in and dig out the footings. This ground is HARD and full of football size rocks. The builders' original idea was to dig it out 80cm deep by hand. Duane, David, and Matt suggested that perhaps a backhoe would be better (and cheaper - even though manpower here is pretty cheap - around $13 per man per day).

The third pic is for Roy to see that we are actually using the plans he sent down. Of course, one guy is looking at them upside down, but these are details.

Matt climbed on the roof and got a couple shots of the layout just so you could see where everything is going to go. Roy, if it doesn't look right to you, please call immediately, as they start digging tomorrow! ;)

We leave at 6am to go to Canilla for the weekend. More stories and pics to follow!

Work Day and Good-Bye to Beth

Today was Beth's last day here in Quiche. She'll fly out of Guatemala City early tomorrow morning. She was a huge help and a joy to have around, and we hope she enjoyed her time here with us! Please keep her in your prayers as she travels and returns to her U.S. resident physician's life...

So Duane and David came in this morning to meet with the builder and discuss some details on the next step of the expansion project here at the dorms. The security fence is essentially complete (minus a sliding gate to be built in Canilla) and work will begin tomorrow on the foundation of the house.

After the meeting, Duane, David, and Beth headed for Guatemala City (by air).

Tomorrow is Heidi's OB/GYN clinic in Chichicastenango and Matt will work with the builders to get started on digging/grading.

The first pic is of Beth and Isaac in their favorite place in the house - Matt's office.

The next two are of the fence all in place and painted. And the last pic is of the "Executive Committee" meeting in our living room...

Jungle Trip - Last One for Today

Here are just a few fun pictures...

First is Rachel crossing the mouth of a spring where we "bathed". This means that we sat in three inches of freezing water and did our best to wash off the day's funk.

Second is Isaac just hanging out. Note that Matt's head is significantly higher than the level of the beams - a fact he managed to forget at least once.

Third is Duane with a couple of schoolkids who were our de facto guides. Very few adults in the area speak Spanish but most of the schoolkids do. The guy who was helping to sell numbers had to step out for a few minutes this morning when he saw his son running across a field and playing instead of being in school. He explained to Matt later that it's very important for the kids to be in school, even if the kids don't think so. There are no truant officers, so the parents have to police the kids themselves.

Fourth is a sheet hanging over the door of the local church. We projected the "Jesus" film overdubbed in Ke'kchi on that door last night. The entire town showed up and sat in complete silence through the entire film. One guy told us that no one in the town had ever seen a movie before, let alone one in their own language. We're hoping to go back in a few weeks and have them invite some neighboring villages who are in the same situation. (Note the "ladder" underneath the screen.)

And last is a picture of the runway. The local people had done some pretty significant work at Duane's direction to widen the runway and fill in some potholes. Even then, at one point (in the middle of the picture), the runway was only about 6-8 feet wider than the plane. That's a little too tight when you're coming in and out as fast as we are. So Duane, Matt, Tomas, and some local guys climbed down the cliff there and chopped back the foliage with machetes this morning to get it out to a little more comfortable width.

Jungle Trip - Post 2

The first pic is inside the clinic building. We had clinicians on either side of the building with a row of benches borrowed from the church next door in the middle with all our meds on them. At night we blew up air mattresses and slept on either side of the med bench.

The second pic is of Charlie checking out a little girl's ear.

Third is Heidi looking a little confused. Armando is there with her, but only speaks K'iche and Spanish. The local language there is Ke'kchi, which is completely different. Since so few people speak Spanish, interpreters are hard to come by - and totally inexperienced in interpreting (which is a lot harder than it sounds - something we didn't learn until we had to do it).

Fourth is a view from the main door of the clinic room. In the back is a makeshift private area for ultrasounds and more sensitive exams.

And last in this post is of Heidi and Isaac next to the sign that welcomed us to town. The community charged Q2.00 (which is about $0.26) for a consult, which is money they kept to help improve conditions in the community. Because their growing season is all year long, they are relatively well fed there, but have very little opportunity to actually make any money. They made over Q400 on the weekend, which is not bad for a village of only 250 people (and, naturally, we saw a fair number of patients who didn't have numbers but only remembered they had a health problem after they sat and watched a family member get some free medicines).

Jungle Trip - Post 1

Sorry if it's been a few days since we last posted, but we have a good excuse. Saturday and Sunday were our normal clinic days in Canilla and San Andres. Monday and Tuesday we were in San Pedro Somethingorother (I don't think gringos can actually say the word). It's a village of about 250 people in the northern end of the department of Quiche (an area called Zona Reyna). Other than by foot, there really isn't any way in or out of this area with any reliability at all (the people in the village only know of one person who even owns a vehicle).

We took five planeloads of equipment and medical people in. Clinicians included Heidi, Leslie, Katie, and Hannah Ficker, Beth (our Family Practice resident) and Charlie (our new 4th year medical student). Along to handle logistics and other issues were Duane, Matt, and Bev. Preaching and ministering were Armando and Tomas and for pure entertainment value was Isaac. (Isaac was SUCH a good baby all day on Monday!!!!)

There were lots of stories, but we'll try to tell most with pictures. The first pic is of Aaron, David, Matt, and Duane fueling the plane for the first trip. The second is from the air on the way out (it's only a 15 minute flight, but it's to an area with no roads, water, or electricity). The third is Armando (just to the left of Duane - the only gringo) preaching to the crowd. Fourth is a picture of our clinic building (and housing) - a brand new building in town. You can see in the background that this village lies in a valley between two long mountains. The only way out for the people is on foot over one of these mountains and back down to another little village. It's a full day's walk over grueling terrain on narrow muddy trails that even a four-wheeler can't get through.

And the last pic is what passes for a road around there. At least this section is relatively flat and wide (enough so that the photographer felt comfortable standing in one place long enough to snap a picture!)

Back to Work

This morning we had to say a very sad good-bye to Annie, who we hope is now safely back in the U.S. Duane flew in to pick her up, and came a little early to check out the progress on the construction. Pics below are of the progress that has been made on the fence, which looks pretty good. Matt bought paint and other supplies today to ensure that the work can continue over the weekend and while we are travelling to the Zona Reyna next week.

Yesterday's clinic at ASELSI was pretty routine, and today's at the Hospital Buen Samaritano was as well. We saw a few post-operative patients who are doing quite well, and even one lady who had her hysterectomy last May and was back in with her daughter for some minor problems today.

The more interesting news is about the patients who have shown up at the door this week, actually--

Little Tomas, the new cleft palate baby that Regina brought us a few weeks ago, was here yesterday with his very proud and happy parents. He has gained over a pound since we started him on supplemental bottle feedings just two weeks ago!! He looks so much better so quickly, and it was truly heartwarming to hear his parents talk about how "bonito" (cute) he looks. Unfortunately, this isn't a word used often to describe these babies. Please keep Tomas and his family, as well as all of the other cleft palate babies, in your prayers.

Today there was a man who showed up wanting to talk to the doctor about his wife. He was obviously very distraught, and it turns out he had good reason to be. The hospital here had diagnosed his wife with a brain tumor, which was almost 8 cm large by CT scan! He desperately wanted to hear that there were other options for her treatment.

Unfortunately, Heidi had to pretty much agree with the local docs that there is very little hope for her survival-- outside of a miracle, that is. So we prayed together for a miracle and for peace for the lady and her family. They are a very nice Christian family in crisis-- Please pray for Tomasa Tebelan and her husband and kids. We were able to offer some medications to help with pain and nausea, and assured them that our door is open if there is anything else we can do to help make her more comfortable.

We feel this is a good time to point out how we came to have medications to help this lady with-- From time to time, we will receive medications that are donated by family members of a deceased patient in the U.S. Often these are people that died of cancer or other chronic illness and acquired a large supply of meds. They are often very useful pain and anti-nausea medications which can make a big difference and otherwise be very hard to find down here. All this is really just to publicly answer the question that we receive from time to time about whether these types of meds/situations can be useful to us-- with a resounding YES! Just something to keep in mind...

This weekend will be our regular clinics in Canilla and San Andres, then on Sunday there is a new fourth year medical student joining us. Charlie will hopefully be flying in to Canilla to spend the night, since we are leaving early Monday morning for a village in Zona Reyna.

This trip will be to a village that is not reachable by any road, so we will be flying everything and everybody in and out. Lots of prayer coverage would be appreciated! Please pray specifically for the plane and safe flight, health (we are unable to take in enough clean water or food, so will be relying on local supplies), and our medication supplies-- We have no idea how much of everything to take, so we may be dependent on some "loaves and fishes" type action... Which is obviously not a problem for God; we've seen it lots of times before with our own eyes.

Our God is an awesome God.

Vacation!

With Heidi and Isaac in the US for a few days, Matt, Annie, and Beth took the opportunity to get some R&R. Monday morning, we got up and had a chance to meet with the builder for a few minutes, then headed down to Panajachel. We hired a boat to take us across Lake Atitlan to the village of Santiago. The girls did some shopping there. Then we took the boat to another village, had lunch overlooking the lake, then boated back to Panajachel where we got in the truck and headed to Antigua.

We had dinner and spent the night in Antigua, then spent most of the day Tuesday shopping and just enjoying the atmosphere.

Wednesday morning, Heidi called to say that her flight into Houston was going to be delayed and that she probably would miss her connection to Guatemala. Luckily, though, the pilot made up some time in the air and with some OJ Simpson moves (the running through the aiport moves, not the... ahem... other "alleged" moves), she made it to her connection and down to Guatemala on time.

The gang here in Guatemala had done some grocery shopping, including the purchase of a new microwave (one that actually works - the old one heated things up only slightly faster than putting them in the sun - and most of the buttons had quit working, so hopefully your desired time only had the numbers 3, 6, or 0 in it...), so after picking up Heidi and Isaac, we left immediately for home. We only had to wait about an hour for construction, so it wasn't too bad.

This morning, the girls went to ASELSI and Matt and Isaac stayed home to supervise construction. It seems that our builder got sick this week and is currently a patient in the next-door hospital, so we'll go check on him during visiting hour this afternoon.

Tomorrow is Heidi's OB/GYN clinic at the Hospital Buen Samaritano and we'll have to say good-bye to Annie. She has been a real pleasure to have around and we know that she will make a great missionary doctor (that's her plan). No worries, though, we have another student coming on Sunday afternoon who will be here for the month of March.

Weekend Stuff

The weekend started out rather typically, but took a turn for the... well... unexpected right away. We were about an hour down the road towards Canilla (13.8 miles) when traffic came to an abrupt stop. Matt walked down the road and around the bend to investigate and came upon a gasoline tanker that had failed to completely round a curve. (This is all off-road driving, mind you.) Its right rear wheels had falled off the edge of the cliff (down) on the right and its front left tire was nearly touching the cliff (up) on the left, completely blocking the road.

Pastor Rodi was the first vehicle in the line coming the other way, so Matt and Rodi talked for a few minutes in which we determined that there was no way that truck was moving any time soon. Heidi and Isaac had a flight to catch, so we turned around and went back an hour to Quiche, then drove nearly two hours to Canilla on the other road (which is significantly worse - thank God for the new Toyota!)

So a two hour drive turned into nearly four. Heidi and Isaac's plane to Guatemala City left about 20 minutes after we arrived in Canilla. So clinic was with Leslie, Katie, Annie, and Beth. They saw about 70 patients. There were a couple of kids with pneumonia, one complicated with a hint of asthma, some prenatal patients, and lots of families.

Matt worked with the guys, including a trip into the mountains to fetch a flatbed load of firewood, and a visit to Roscoe's old place in Chijoj.

This morning, Annie and Beth got to attend to a man who showed up at the gate with a sore foot (that's what happens when you're the "new guy").

Clinic in San Andres was relatively routine, with around 100 patients. There was a little boy who the family said had been to a doctor for something in his ear and can no longer hear. He no longer speaks, either, so he's been pulled out of school. One side was pretty impacted with wax and the other side looked like it had incurred some damage and scarred over. With the lack of speech, a hearing test was somewhat difficult but he reacted like he could hear some. Sadly, there's not really a whole lot that can be done other than to help with the wax impaction.

Another sad story involves a young woman whose parents brought her in with a pretty classic description of schizophrenia. There's not much that can be done for her, either, except a lot of prayer.

Heidi and Isaac were safely on the ground in North Carolina, so Heidi was consulted by phone on a couple of obstetrics patients (it's a small world, afterall).

Actually, we were rather lucky that we had some extra room in the truck (with Heidi and Isaac being gone) because we ended up giving a ride back to the hospital to an 11-year-old boy and his dad. The boy came in in some respiratory distress and some rather disconcerting torso pains. By the time he got to the hospital, he looked a little better (maybe it was Matt's driving) but the doctors here were very nice and said they'd take a look at him. Neither the boy nor his dad speak Spanish but it was very nice to see a dad who was so openly affectionate and concerned for his son. (Mayans aren't typically very demonstrative towards their children.)

Construction on the fence continued on Saturday and should be completed by the end of this week. It's going to be very nice to have a place to secure the vehicles and all of the construction materials that will start to arrive for the building of the new addition.

Tomorrow morning, we'll meet with the builder for a status update, then head to Panajachel for the day. In the afternoon, we'll leave for Antigua where we'll spend the night. Tuesday will be a tourist day in Antigua. Wednesday morning we'll head to Guatemala City, pick up some supplies, then meet Heidi and Isaac at the airport.

350th Post

Three hundred and fifty posts. Well, those of you who know us well know that we are not at all surprised that we've had that much to say. But keep those comments to yourselves.

Today was Heidi's clinic at the Hospital Buen Samaritano. She actually had some patients this time but nothing surgical, which is kind of good since she won't be around this Wednesday. She and Isaac will be leaving tomorrow around noon for the United States to run a few errands. They'll be back on Wednesday, which will give Matt, Annie, and Beth a few days to relax and enjoy Panajachel and Antigua.

The first pic is one where we're applying for Parents of the Year. Isaac would have voted for us, anyway.

The rest are construction pics, more for Roy than anyone else, but ya'll don't mind, do you?

They should be building forms for the concrete columns tomorrow and should start pouring either tomorrow or Monday. Then they'll start stretching chain link fence. That process should move relatively quickly. Then they'll need to finish the concrete to match the house and paint. The job should be done by the end of next week.

Tomorrow morning we head to Canilla, as usual. At noon, Heidi and Isaac will fly from Canilla Intergalactic Airport to Guatemala City, then to Houston. They'll spend the night in Houston, then head to North Carolina.

Thursday at ASELSI

Today was clinic at ASELSI in Chichicastenango. Matt and Isaac came along, too. Heidi took one room and Annie and Beth took the other, to start. (Sometimes, the best way to learn is by doing.) Annie and Beth are both doing a great job here and really bring a lot to the team.

We saw our pretty normal load of patients. Visits ranged from prenatal visits to a wicked case of psoriasis to a woman who thought she was diabetic because her mouth gets dry when she eats sweet or salty foods. Osny's mom (Osny was one of our cleft palate kids) is pregnant again, so we're adding her as a prenatal patient.

Cecy, our translator, signed up for nursing school last week and starts in March. She will have a year's worth of Saturdays in class, then six months in clinicals, then she'll be an auxiliary nurse. She'll be one of the best ones around!

The first two pics are of our psoriasis patient. The first is of his biggest affected area (that we can show on our website). The second is of Beth helping him to put some cream on for that. The third pic is of a short discussion between Annie and Beth on what the best course of treatment is for a patient (or what they're planning to do for lunch - one or the other).

The fourth pic is - well, we don't know. We'll be sending this and some others on to a dermatologist we consult with in the US. It's a little baby who appears to be completely flea-bitten. But we could be wrong on that. Hopefully, Dr. Hess can help us out with that!

And fifth is another shot of the fence foundation going in. Someone mentioned that it didn't look like there was any rebar in the driveway. There's not, but it's 6" of concrete. The fence, however, will have rebar in the foundation and in the columns that are spaced every two meters. Plus, we'll put in a conduit to run power up each column, in case we want to light them or place security cameras. Conduits are much easier to run when you're pouring...

Tomorrow is Heidi's OB/GYN clinic at the Hospital Buen Samaritano.

Wednesday

Wednesday was a bit of an unusual day. The woman we had been praying would show up for surgery in Chichi was a no-show. We did have other plans, though. Our friend Regina has brought us several patients in the past - some cleft lips, some microtias, even a spina bifida. Well, she called last week to tell us, rather proudly, that she found two more.

That was the nail in the coffin. We told her to bring those kids by and that, also, we'd like to meet with the local comite (think: town council) to see if we could maybe do a screening right there on site. It's not really Regina's responsibility to bring all of these kids to a place where they can be helped.

So she brought the kids to us on Wednesday morning (pics one and two), as well as the previous cleft lip/palate (from last week) so we could check on his weight. He had gained nearly a pound in that week and looks immensely better!!! (pic three).

Then we all loaded up in the truck (pic four) and headed out to Chujuyup. Three members of the local comite were there to meet us and were SO friendly. We explained that we are here as missionaries, to help the people and to demonstrate God's love for them. We told them that Regina has been so faithful in bringing us patients, but we don't believe that's her responsibility. It's our responsibility, along with the local officials, to help out. They agreed.

So we set up a date about a month from now to go out and see some patients. We told the comite that they have the perogative to give out 40 numbers. They know who has the most need and we'll see how that process works. If we need to revise it, we can. But if we don't work with them to get a certain number of numbers handed out, we'll have 1,000 patients and we're not really set up for that. Additionally, we're hoping to bring an evangelist with us - one who speaks Spanish and K'iche - to explain a little better to the people who come WHY we're there and maybe locate a local pastor we can also coordinate with.

So we'll see how that goes. Unfortunately, Annie and Beth will be gone, but we're expecting another student to be here during that month, which should help, too.

Lastly, there's a pic here of some of the construction work that's going on at the house. The guys dug some trenches to prepare for the fence that will surround the new addition. They're now starting to lay rebar and pour concrete.

Monday and Tuesday Clinics

Monday morning, Annie, Beth, and Heidi headed out to Chicabracan for our bi-weekly clinic there. Matt and Isaac stayed home to supervise the finishing of the driveway and to receive a few truckloads of construction materials. During Isaac's morning nap, Matt put another gallon of paint on the east side of the house, nearly finishing that side before Isaac woke up.

Clinic in Chicabracan was relatively routine but with many new patients. Most of our chronic patients there are on an every 4 or every 6 week schedule. This particular week we didn't have many chronic patients scheduled and we saw lots of first-timers.

One notable patient there was one we had suspected with a miscarriage two weeks ago and, sadly, we were able to confirm that on Monday. In better news (sort of), we have a patient there who we had feared had unstable angina and this time it sounds like she has stable angina and gastritis. Sometimes it's hard to separate the descriptions of actual chest pain with heartburn.

The last patient of the day told us that the number she had was for herself. She thought the baby strapped on her back had a broken arm, but the number was for the mom. Mom had a headache but the baby actually appeared to have a broken elbow. It was completely black and misshapen. Naturally, we spent a little more energy with the broken arm. We can't actually diagnose broken bones in clinic, but very strongly suggested a trip to the hospital.

This morning we met the builders here at the house and got them started, then went to clinic with Leslie and Katie in Chiminicijuan. On our arrival, we found that David was on his way to Chinique to get some more things from Roy Espinosa, who is moving back to the US later this week. So Matt and Isaac rode with him to help out and say Good-Bye to Roy.

This clinic was also pretty routine. We did, however, see a ruptured eardrum in a little baby. Also, Duane came out and did some eye exams and fit some glasses.

Arriving home, we found that the builders had made some pretty good progress on digging a foundation for the new fence. They got into a bunch of really big rocks, which they're enjoying thoroughly.

Tomorrow, we hope to make it out to Chujuyup, where Regina lives, and see if we can maybe do a clinic there at some point. We got some rain today, which is quite unusual for this time of year, so we'll see how passable the roads are in the Mazda, which we'll have to use because we'll likely have about 10 passengers. (No one ever goes anywhere by themselves, so we're expecting a full house in the morning.)

In pictures, the first is of Beth examining a baby in Chicabracan yesterday. The second is of Duane fitting some glasses in Chiminicijuan. The next three are of the construction project. One is of the recently completed driveway, one is of the chalked off border for the fence (yesterday) and the other is after nearly a full day of digging.