Fluoride Program

This week we may have finally made some headway on a program that we have been interested in for quite awhile. For those who have been here, you have probably noticed the poor condition of peoples teeth and in particular those of the children between the ages of 5 and 18. We have seen many of these young people loose quite a few permanent teeth and it always seems to be the 2 front teeth. So we have been discussing with various dentists the benefits of a fluoride program. When we first looked into this it seemed the cost could be high and it could be a difficult process.



We have been reviewing this for last couple of months with the dentist that works with us, Marcos Lux, and he was involved in this type of program during his internship with the university and the government health system. They focused these programs in certain schools and have continued to see improvements in the children. Thus, we finally found a good time and a location to purchase the fluoride. It turns out that the cost will be extremely inexpensive, about $50 for a bottle of 1000 fluoride tablets. Then we only need 3 tablets for about 60 children. The kicker is the children must swish the treatment every week.



Since the cost is extremely low, we decided to run the idea by some churches and so far the interest has been tremendous. We have been trying to educate the churches and people in our clinics to focus on better oral hygiene and one of our promoters, Gaspar, has done some classes in his church and has also started to do these classes in some of our ABC Program (child sponsorship program) communities.



This provided us a great time to discuss a program with some of the churches and they are very interested in taking on this project themselves. So this last week we met with 2 communities who were going to start today - Mactzul 6 and Xepocol. We tallied the cost and it will be under $2 per month for most of the churches (many will be under $1) to be able to start using fluoride for each of the children in the church between the ages of 6 and 19. Each church will pay for a month worth of the pills and we will supply the fluoride once a month during our clinic visits. In turn, they will administrate the program with the children in the churches and keep a running log of the children that are participating in the program. Their goal is to reach 100% of the children in the church and not just the ABC sponsored children and the cost will be bore solely by the church. We also have some other churches discussing the program as well and we feel that we will have buy in by most of the churches.



The beauty of the program is it is inexpensive and relatively easy to administrate as no application is necessary as the child must swish the solution in their mouth for at least 5 minutes. I tried it and it is a little taxing, but there is not much flavor so not too bad.



Our goal is to reach all of the churches where we have the clinic ministry and then to reach all of the other churches in the area. Then, we have also spoken with the churches that our combined goal could be to eventually reach the school of the community. Lofty goals, but we think achievable as do the churches we have discussed this with.



Please pray for continued positive reception and that it can work out to be a long lasting program administered and promoted by the local churches.

Hospitality

Romans 12:13
Share with God's people who are in need. Practice hospitality.

One thing that is done exceptionally well in the churches here is hospitality. No matter how little a family has, they always seem willing to share it with you. Today, we had lunch with Juan Quino's family--his mom, Manuela is especially gifted at making people feel at home. One of our students, Nick, is staying with them right now.We had great beef stew and plenty of tamalitos, with everyone gathered around tables they brought out to the covered porch.

Then we marched up the little foot path single file to the church building for worship services. It was good to see everyone, and our students seemed to be comfortable with their families.

After church, we marched back to the house and finished the afternoon with hot cups of pinol (ground dried corn steeped with cinnamon and sugar) and bread. We enjoyed good conversation and Roger McCown practiced his language skills on the family. It was a great time spent with our brothers and sisters in Christ.

Su k'ax chawe? (What sickness do you have?)

The MET students are doing a great job here with us. They tried their hand at patient interviewing with the help of our health promoters and then presented the patient to me. I was impressed that they gleaned so much information from the patient and even wrote down the chief complaint and history in Spanish on the chart! 100 puntos (A+)! They were even tuned in to emotional and inter-relational issues.

Clinic was in Chuchipaca today and we were unfortunate enough to be following a 2-day clinic offered by another group in the area. Usually this means just a handful of people, but today we had 13 loyal patients who waited until today to seek care. We are thankful that people feel comfortable coming to us and pray that they will put the same trust in the church members.

Busy Day

After waking up to a strong earthquake this morning (actually the epicenter was off the coast of Honduras-- a 7.1!), we got to work fine without any evidence of local damage. All worked hard today with Josefina's team in San Jose and our team in Clinica Caris. We sent two to the hospital one with pneumonia and a diabetic with severe hyperglycemia and dehydration.
We always get started with a devotional and prayer as a team, and today Gaspar told us about a couple that he had been studying with several months ago, who showed up at services on Sunday and said they wanted to accept Christ and be baptized. He was previously involved with gangs and drinking heavily. She is from Mexico and recently moved into town where she doesn't speak the language (K'iche') but is very friendly. Be in prayer for them as they start their christian walk.
Our students are doing great. They are learning fast and are now vital signs experts. Here they are learning to use the glucometer.

"Tengo Hombre"

Well, we got our first group of visiting MET students up here in Chichi without any snags. Yesterday we took them out to Paxot II to move in with their host families. It's a real hoot, because it's become a tradition that we start at the first house then make our way to the next, carrying along a few family members from the each house we get until a huge group ends up at the final house. Everyone wants to see the students and the host families' reactions. It's kind of like a Posada procession at Christmas! Anyway, we ended up at Manuel Sut's house and we got to see his sister-in-law and her newborn (her third and only living baby). They seem fine and she told me she was very happy.

Today, all the students got their first taste of complete frustration as they tried out their limited but useful Spanish vocabulary on host families and patients who only speak K'iche'. One student (name withheld to protect the innocent), told the brothers at the church "tengo hombre" (I have a man) instead of tengo hambre (I'm hungry). That'll learn ya fast!

Here is a hilarious video to check out if you have ever endured the frustration of wanting to express yourself with limited Spanish skills.

http://www.youtube.com/watch?v=ngRq82c8Baw

Good stuff!

Admin Day

And in the church God has appointed first of all apostles, second prophets, third teachers, then workers of miracles, also those having gifts of healing, those able to help others, those with gifts of administration, and those speaking in different kinds of tongues. I Corinthians 12:28

Yesterday Kemmel and I stayed back from clinic to finish out the calendar for the year and make some progress on some education materials (You think sex education is hard to teach in English, try in Spanish--to be translated by one of your co-workers into K'iche').
The calendar has become a complex piece of work that has taken on a life of its own. Kemmel, whose is gifted in the administrative realm has devised a special hieroglyphic system that encompasses information about all of our whereabouts each day of the year. This includes our daily clinic schedules (Me, Josefina, Sheri and Marcos attending about 20 communities), scheduled days off and holidays, admin meetings, education activities, surgical weeks and who is out to attend those in Montellano, mobile medical groups in town, interns in town, visitors in town, and MET students, including how many are assigned to each team each day. Whenever there is a change, Kemmel dutifully reprints the calendars and passes them out to all staff, as we destroy any past copies. At first it was a challenge to learn the system, but now we pretty much have the hang of it. It's kind of like a palm pilot on paper. Gaspar says he needs extra copies for home and backpack so he can whip it out and answer any question from the communities!
We are blessed to have someone like Kemmel who helps us keep order in our crazy work lives. And praise be to God for giving us all different gifts.

They're Here!

Our students made it just fine and are tucked away with their families waiting to start language school. Welcome, Phillip, Nick, Lisa, Holly, Nathan, Esther and Katie. We look forward to our time together!

Friday and Saturday Clinic

We enjoyed good clinics in Choacaman and Chuchipaca with several new patients from outside of the church. This is such a great opportunity to reach out and touch the lives of people and put them in contact with the physical body of Christ on earth. Sometimes we forget that we christians working together as a whole, are Christ's body--his actual physical presence here on earth. That is humbling and makes us think hard about what we say to people and how we react to people's problems and questions.

We had a favorite patient of ours (Sheri and I) come back for more artritis meds. He doesn't speak spanish and is very deaf. This time he brought us a section from the newspaper with photo spread of an excavated skeleton to show us exactly where his pain was. He was so serious in showing us the paper. It would have been so easy to laugh but it would have hurt his feelings. It was helpful and it is good to see someone working to empower himself to communicate his needs.

This next couple is from the church and had never been to clinic. They were really appreciative to get their medicine and came back after their pharmacy visit to thank us again. What a great job we have sometimes!

Fun in the Dirt

This past Wednesday and Thursday Kemmel and I took off to Montellano to spend time with the University of Tennessee group working in the little town of La Fortuna. Unlike its name, this town is not so fortunate and lacks basic resources like water and electricity. In the past they have gotten their water from the river, a community well (not well kept) and various springs. One particular spring was 5 Km away and they lost a lot of tubing due to hurricane damage and theft.

But, in the last few years, they have had a school built and a water cistern project put in. This year, thanks to the UT team returning, a spring was dammed up to secure it and provide protection of the water source and also re-tubed to the existing cistern that will serve the school and one sector of the town. They also put in a series of raised bed vegetable gardens for the school kids to take care of and provided four families with smokeless stoves. Each day a group of men from the community was assigned to help out. It is encouraging to look at children and many pregnant mothers who are obviously suffering the effects of malnutrition, lack of education and poverty and think about how these projects will go a long way to help improve the situation in the long run.

Hmmm.... Now what?

Who's got the duct tape?

Picking out seeds--decisions, decisions.

Wood-burning, smokeless stove--saves large amounts of firewood and limits the chronic smoke inhalation by the families (especially the women).

Happy Birthday, Anyla!

We are sending out a big Happy 3rd Birthday to our niece, Anyla. Hope you have a great day. We love you.

The Spice of Life

The thing I love about family practice is the variety of illnesses we see in clinic. Today was a great example. We saw several diabetics, policystic ovarian disease, foot fungus, neumonia (suspicious for H1N1 influenza--referred to the health department), a very large uterine fibroid (about 16 week size), prostatits, cleft lip and palate, and hospital discharge followup of a little boy who had a chest tube for a pleural effusion. I know there is a need for specialty medicine, and I appreciate the work that specialists do. But I feel blessed to be a regular old G.P. because it is such a rush to be the first to see a patient, to diagnose the problem and to see how the patient progresses through treatment. It also gives us endless opportunities to share Christ with people as they confide in us. It was a great day today, and here are some pictures.

Here is a foto of Santos Elias showing off his chest tube scar. He is doing much better, perky and able to eat and play again. His parents were pleased with the care they received in the National Hospital, so that is always a plus!

This is Maria from a town in Huehuetenango about 8 hours away. One of her sons lives in the States, and her daughter-in-law found us on the internet and arranged for her to come see us. She is doing great and today, and Sheri gave her and her sone some pictures that her States-side family sent by email--they were so excited!

Before heading home it started raining--hard. No one wanted to wait around for a minivan back to town, so all six of us crammed into the Super Samarai. Here is a shot of us before Kemmel got in.

Count Down to MET

For those who are not familiar with MET, it is a program we have for college students called Medical Evangelism Training. They get a taste of what it's like to live/work in medical missions and enjoy some of the culteral differences in family life. Kemmel and I actually met as MET students way back in 1990, and this time of year brings back great memories of our own experience here and of previous years' students who have shared their summer with us.
Our students will arrive on May 16, and head to Quetzaltenango for a week of language training. After a couple of days of missiology training and orientation, they divide up into two groups, half going to Montellano working with Drs. Walter, David, Sylvia and Jessica; and the other half coming up to Chichicastenango to work with us. They will all stay with host families and work in clinics with our staff. After two weeks, they will do the switcheroo, thus being exposed to both regions. Kemmel has been working hard getting plans and families organized for the big day and says things are looking good. We pray for our students as they make this big step into the unknown, and will work to help them have a great experience with us. Keep watching for updates.

Weekend Update

Friday
Friday was Labor Day here in Guatemala, so we had a free day and decided to take the opportunity to go do a home visit in the Panajachel area. As you may have read in Sheri's blog, one of our little patients (Diego) who had had cleft lip and palate repair got sick last month, dehydrated and passed away. He had just celebrated his first birthday a week or so earlier. It was such a shock for everyone, especially his young parents, Josefina and Alex. We were reluctant to make the visit, not knowing what to say or how to comfort them, but decided it would be a good thing to do. Fran Sutton (one of our board members visiting this week), Sheri, Kemmel and I hit the road early. The couple was glad to see us and asked about another little boy and his family and we exchanged pleasantries. But then lended an ear as they told us about all of their memories of their son and the sadness they felt, although they were trusting in God's will.

It is always hard to know what to say, but sometimes people just need you to listen more that anything. We promised to gather together any pictures we had of Diego so they could enjoy some more moments.

Saturday
Clinic in Chuchipaca was good with 17 patients and Fran helping me and Sheri out with prayers. It seemed to be geriatrics first, then internal medicine and finally pediatrics. Plenty of good teaching cases for us to discuss.

Sleeping In
Today, we lazed around until about 5:30 AM and got up and started our Winter Cleaning. Rainy season means no more dust we took advantage and rid ourselves of dirt in the house before heading out up to town. About 10:30 or so there was a very long earthquake, not too strong, but the street was moving!

Sunday Market
Market was crazy with people everywhere and you could hardly pass from one table to the next to buy veggies. I guess everyone wants to be back home before it rains in the afternoon. We got some good looking produce and headed back, checking out the Snake Oil salesman selling big red pills that work on everything from kidneys and liver to bumps on your skin and intimacy problems. Looks promising.

Worship
Lesson of the day: Maybe we christians should focus more on loving our neighbor and forgiving our neighbor 7 x 70 times and then people would believe our message.