Busy day

Well today was crazy busy at clinic.  Thankfully we had our PA intern Elaine Brown with us and also Jennifer Hoines a local missionary PT.  We had the usual diabetic followups and aches and pains and acute illnesses, but then saw a man with probable kidney failure and severe anemia. I think we finally convinced him to go to the hospital for a work up and a blood transfusion.  Then one of our prenatal patients a 45 year old lady in the last month of her 10th pregnancy came in pre-eclamptic with severe headache and a blood pressure of 190/100.  I tried and tried to get her to go in to the ER today, but she insisted that she needed to wait for her husband to return from the capital tonight and would go in tomorrow.  I even talked to the husband, but they felt like they could wait a little longer despite the risk of seizures and death. So, we'll see.  She said she would bring the baby next time for a visit.....On the sunnier side,  Elaine saw an asthma kid with an exacerbation probably from the RSV virus going around, and he responded very nicely to his breathing treatments--that was a happy customer when he left. 
Right now I'm waiting for Kemmel to come home from his meeting with the church at Mactzul VI.  They are changing coordinators for their ABC program due to some complaints against the current ones.  We always leave this up to the church to choose their own coordinators, but they asked Kemmel to come sit in on the meeting.  Kemmel decided it would be wise to take Manuel Sut with him since he is the coordinator in the church in Paxot II. Manuel decided it would be good to take Juan Riquiac the other ABC coordinator in Paxot for backup as well! So hopefully things are going peacefully!
Always exciting!

Kemmel and I have had a good week knocking out some administrative duties.  Kemmel's has been working away on the pharmacy order for the quarter (and beyond) and also the budget for next year and got those taken care of.  We also received a grant recently that enables us to add on some new construction to our Clinica Caris building, so Kemmel got started talking with our building contractor about plans and costs of materials this week.  The plan is to add more storage space, freeing up rooms for dental and for medical exam rooms.  We also have scholarship applicant interviews coming up soon, so he has been contacting all the students to schedule their appointments--every year we have more interest from kids wanting to continue on to high school and even college.  This is at the same time exciting, but also worrysome due to limited funding for scholarships.  We pray that God will give wisdom to the Board as they select the winners o scholarships.
I have been working on continuing education for my board certification maintenance (fun!) as well as class material for our volunteer promoters' class--this month we study the eye and its function and diseases.  I've also been working on putting together our flipcharts for a nutrition program we are starting.  We found good pictures from the World Health Organization to add to the flipcharts and had one of our scholarship students "change wardrobes"  on people in the pictures to better represent ladies from this area. They turned out not too bad. The program will be offered to first-time moms starting during pregnacy, teaching them about proper prenatal nutrition, prenatal care, and the importance breastfeeding exclusively for the first 6 months. After the baby is born, we will continue with education about breastfeeding, child nutrition and illnesses and routine care.  The fun part, is we a looking to have female volunteers from the target communities to train to do one-on-one education during home visits as well.  These ladies will be older moms who have experiene rainsing children and now, training in nutrition.  Our goal is to involve the young mothers, their mother, their mother-in-law and the community volunteer in all of the education encounters so that we are all on the same page.  We will try to encourage open dialog and exchange of ideas so that familes/in-laws can better support the young mother.  It's a small program, but it should begin to address  the chronic malnutrition in the area on a community and family level.
Tomorrow back to clinic!

Motivated by Fear

Preventive medicine is a hard sell, no matter where you are in the world.  Now, I know there are some very health-conscious people out there who will disagree with me, but most people don't like to go to the doctor, especially when there is nothing obviously wrong.  This is especially true in Guatemala.  Here, the name of the game is sypmtom relief. If the patient can only afford one medication and had to choose between cough syrup and antibiotics the syrup wins every time.  Encouraging vaccines and healthy lifestyle choices and regular checkups is hard work.  Take for instance the Pap smear.  We have finally gotten to the point where where we do 10-15 pap smears a month.  That doesn't sound like many, but it's up from 0. However, being the prevalent cancer that it is, cervical cancer rears it's ugly head in one of our communities at least 2-3 times a year that we know of.  And this usually gets people motivated to come in for the dreaded exam.  We even get husbands bringing in their wives to be checked.  Last month, a lady from the church in Santa Cruz passed away from advanced cervical cancer. She was 50 years old and still had children at home.  The news made it around the churches quickly and the ladies started asking for appointments to come in.  In the last two weeks we sent in 10 specimens already.  We usually do these on a special pap smear day because it takes longer.  But two weeks ago, two sisters came in on a regular clinic day and, of course, were the last patients of the day, wanting their pap smears.  They were scared to death of having an undiagnosed cervical cancer and begged me to do their paps right there.  So, I did (but not without some inward grumbling!).  They were grateful to say the least and went home knowing they had been proactive in their healthcare.  Thankfully all of the paps have come back negative so far.   We hope the interest continues, but we'll see.....

Happy 15th of September!

It's Independence Day here in Guatemala and people are serious about their parades! Everything got started last weekend actually, with various school groups making their processions down the main streets of town. We have high schools, junior highs, elementaries, kindergarten and all of the adult education and weekend secondary school classes. So that makes for lots of parades! We got out yesterday and snapped some pictures of the kinder and pre-K kids--pretty cute. Today we went up to town for our walk and forgot the camera--but I'm sure it was like all the other parades! Last night we had dinner with our intern Elaine Brown and Sheri and got to see the running of the torches throughout town proclaiming independence. The runners would go by so fast, it was hard to capture them on the camera.  

So here are some shots for you to enjoy.  Happy Birthday Guatemala! 

 "Ce-le-brate good times!" Evidence of recent fireworks announcing the start of the parade.

Mayor Jose Turquiz and local crowned beauties leading the parade.

 So cute!

Independence Day Girls

"Solidarity and Tolerance"

Las Torchas--teams running through downtown and sometimes from one city to the next announcing independence.

Okay, we are still here, despite the deafening silence on the blog. We have had a blogger's block lately.  Sometimes there are plenty of things to report on or comment on but you just don't feel that creative.  We have been feeling mentally draggy lately and realized we were just getting a little burned out.  So when it came time to leave the county to renew our visa, we decided to take advantage of some cheap tickets to Ft. Lauderdale and just recharge for a few days in the English-speaking world.  We just vegged in an old hotel on the most beautiful beach/boardwalk.  The hotel was close to everything we needed, so there was no need to rent a car.  (Time shares are a pain, but they come in handy sometimes!) We got back into our walking/jogging program and enjoyed  luxrious dips in the ocean afterward to cool off.  It's a good thing the real estate in coastal Florida is cost prohibitive for us or we would be tempted to buy retirement property! We got day passes for the city bus and set out to discover what the area had to offer (it had Olive Garden and PF Chang's and several malls full of foreign visitors from all over the world, taking advantage of good prices and unbelievable selection-just to name a few places). 
Well, armed with great tans and decluttered minds, we are back and feeling very refreshed and glad to be back in our own cozy home.  God is good to give us respite  as  well as renewed desire to serve.