Women's Health

Sisters from the Church in Xejox--about 3 hours from Clinica Caris 

It's a beautiful sunny morning and has been pretty dry the last few days.  Our road situation is still not great but at least the mud is less.  Today Kemmel is driving us (Lisa, Sara and our scholarship medical student Nidian Patricia) head to Salama', Baja Vera Paz to attend a week-long training on cervical cancer screening using appropriate technology--vinegar solution and a bright lamp.  This is called Visual Inspection with Acetic acid (VIA) and is at least as sensitive as a Pap smear, but gives immediate results and has no additional lab costs--perfect for Guatemala's rural poor. Although we have been offering Pap smears for years, we are not reaching as many women as we could, due to lab cost ($4) and transportation cost to come to clinic ($2-5)--about a day's wage.  So if we can take this screening to the communities where the women live we offer a valuable service.  Sheri had a class for two women's groups already talking about the importance of cervical cancer screening and she reports having a great deal of dialog and interest from the ladies. 

The VIA course is being offered by Faith in Practice, a non-profit organization here in Guatemala.  Many thanks to them for sharing this with others!  We hope to take advantage of our all-female provider team to help improve the health and lives of women in our area.

Out of the Mud



The ever-growing sink hole in the highway behind our house.

This last week has been pretty trying on the transportation front.  Thankfully we have been able to get to all of our clinics, but not without effort.  The back road that is open from Chichicastenango to Saquilla to Xalbaquiej to Mactzul I to Lemoa (the entrance to the paved highway to Santa Cruz) has been closed at many points due to heavy trucks getting stuck in the muddy narrow passes.  This has added 30 minutes to an hour to our drive time sometimes as we look for alternative roads.  Thankfully we have two co-workers Manuel and Tomas that live out on that road and have been bringing the trucks in to which ever side of the road block we need and the rest of the team walks across the blockade to meet them or transport to another meeting point.  Friday we got back at 6:30--not terribly late in the grand scheme of things, but too late for two of our promoters to find a ride back to their town. So we had to help them pay for a private vehicle to take them back (about two days' pay).

This weekend we are in the Capital meeting with Rick Harper our director to go over plans for the coming year, budget and other items.  It was such a relief to get out of Chichi for a few days and enjoy the concrete world of Guatemala City!  We love our quiet town of Chichicastenango, but have had it up to here with the sink hole, rain, drainage issues, new bus terminal behind our house, loading and unloading zone in front of our house, traffic jams, getting stuck in the mud, backing up-uphill-in the-mud-to-help-oversized-trucks-pass, government officials visiting and promising large sums of money to do a half-baked repair on a serious problem, and the looming dread of looking for another house to rent in the future. 

So we are grateful for the weekend escape, even if it is for work. It's good to be able to work without coming home in muddy shoes and pant-legs everyday.  If Guatemala City seems beautiful, just think what heaven will be like!

¹⁵ The angel who talked with me had a measuring rod of gold to measure the city, its gates and its walls. ¹⁶ The city was laid out like a square, as long as it was wide. He measured the city with the rod and found it to be 12,000 stadia^[c] in length, and as wide and high as it is long. ¹⁷ The angel measured the wall using human measurement, and it was 144 cubits^[d] thick.^{[e] 18} The wall was made of jasper, and the city of pure gold, as pure as glass. ¹⁹ The foundations of the city walls were decorated with every kind of precious stone. The first foundation was jasper, the second sapphire, the third agate, the fourth emerald, ²⁰ the fifth onyx, the sixth ruby, the seventh chrysolite, the eighth beryl, the ninth topaz, the tenth turquoise, the eleventh jacinth, and the twelfth amethyst.^{[f] 21} The twelve gates were twelve pearls, each gate made of a single pearl. The great street of the city was of gold, as pure as transparent glass.   Revelation 21:15-21

Wake up surprise - That was not an Earthquake - It was a mudslide

This morning we woke up to what we thought was an earthquake but did not quite feel like an earthquake but more like a tremble when a tank or large heavy truck passes by

 

It turns out it was not an earthquake but rather a series of mudslides happening off the highway less than 100 meters from our house, falling at least 200 meters.

 

Interesting enough, exactly one year ago today we took pictures of the first mudslide in this area and posted a blog around that time.  The 2 pictures below are of the first mudslide and you can see that only a part of the asphalted highway had fallen (to the right of the man or the trucks).

From Sep 11, 2012

From Sept 11, 2012



Here are pictures from today Sept 11, 2013.  The area where the trucks were has now also fallen away to a depth of 200 - 300 meters resulting that the earth below the new highway is now also unstable.  The earth is extremely saturated due to all of the rain and with trucks and buses driving over the area over and over and over, the vibrations of the earth just keep making it all fall off.

 

Unfortunately, 3 people lost their lives yesterday from this mudslide but now the local emergency workers have the highway shut down and no one is allowed to drive over the area.  This presents some problems for everyone and also us as we must find ways to get to clinics that are on the other side, including Clinica Caris.  This means taking the long way around which is about 1 hour or leaving trucks on both sides and having everyone walk from one side of the road closure to the other.  They have set a walking area about 50 meters from the hole which is good.

 Not sure I would want to stand that close!

 

Should make the news somewhere... 

 

Trucks, cars, buses, people piling up to see what happened, walk around to find a ride or wait to see what they will do about the highway. 

 

 Catching rides back to Chichi and on to the other destinations.

 

Walking behind our house - for those that have been here you will notice the warehouse where I want to put the indoor pool!  No such luck now, will probably become highway....

Changing of the Guard (water guard)- Tiva Water Filters

On Wednesday of this week Manuel, Tomas, Enrique (Quique), Cesar and I (Kemmel) travelled to Xejox and Chuchuca about 2.5 hours from Chichi to change out some water filters for families in the ABC program.  About half of the families needed a replacement filter cartridge so we took advantage to switch the families to a new water filter.  In the past we have been using the HELPS water filter systems which is a ceramic, activated charcoal filter which works great.  We asked the families how they liked the current HELPS filter and the response was an overwhelming "Utz!" which means good or awesome.  We also asked if they have seen a decrease in gastrointestinal problems in the children and the response was the same - "Utz!"

So we are not changing filters due to not working well, but rather for longevity and convenience.  The TIVA water filter has been donated to TSI by some generous donors and has a lifespan of at least 5 years, so we have no revolving cost of changing out the water filter cartridges.  The TIVA water filter is a super-fine sand based water filter system.  Before placing anything in the field we try it ourselves first, so Enrique and the Dunham's have been trying and the results have been positive (or you could say negative as no new GI issues).  The TIVA Filter was Enrique's first filter and his family is more than happy with the outcome.  It is exciting to see him explain how well it works and he is no pushover.  He is a an army veteran who likes things in order and working well!

Manuel giving the first explanation of the filter

During the demonstation



Atentive crowd - 53 families! 53 water filters

Showing people the superfine sand - seeing is believing

More seeing is believing

Tomas answering questions

And the sand is added to the first filter!

Prepping 53 filters

The common stoic look...

Each family turned in the old so we can save for future use.  Many had changed from white to a light tan which is a result of the smoke from the kitchens impregnating the plastic.  Many still use open fires for cooking in this area, so unfortunately it gives us a reality check to understand what their lungs look like and why women have Chronic Pulmonary Disease as the get older and also why pneumonia continues to be the #1 reason for death in the area.

Checking the list to ensure we do not miss anyone..

We had each of the fathers or mothers (if they were able) put their own filters together in groups of 5 families to each of us.  Then many of the men stepped up and helped the rest.  Community in action!

Cesar in action

Local men taking over the job.


We also met with the parents and the ABC children regarding oral hygiene and talked about the importance of following the techniques given by the dentists to ensure long lasting teeth.  Even many of the parents asked when we would come back for dental cleanings as they wanted their name on the list. 

As talking is not enough, we also took action and had each child brush their teeth and then we gave them a couple drops of dye to see how they did.  Many had to go back and brush some more to get rid of food still remaining on the teeth, but overall they did well and some did very well the first time.  Most everyone cam back the second time with clean teeth with no dye, so we used the example to show the parents that it may be a good idea to send the children back to brush a second time at least one time per day.

Unfortunately, no photos of the dental practice - we get involved and forget about it.

All in a all a good day.

New Territory

We had clinic out in the town of Chicua II today.  Our new brother in Christ, Manuel is on the town counsel and has wanted us to come out and use the clinic/hospital facility that they have in their town, which has been sitting empty for several years.  After several dry runs due to competing activities we finally had a decent showing of patients.  We suspect there will be more in the future as there was a school meeting today and continued murmurings of unrest regarding the sacking of the mayor in Chichi.  Apparently people are leery of walking around town when manifestations are forming for fear of being forced into joining the crowd of protesters.  But we did have a nice group of patients including one of my regulars from Clinica Caris who lives out there.

 

We are praying for this clinic to grow and for our presence to be well accepted so that we will have more opportunities to visit and share the gospel with folks in the area. 

Lisa and Kemmel with long time Caris patient, Maria.  We are now in her town - nice..

Sandra and Maria setting up dental extraction area

Marcos and Martina ready for cleanings and dental restoration

Sheri in one of the equipped clinic rooms

Manuel, Ceci and Cesar prepping for vitals, lab and pharmacy.  Cesar was our radio announcement writer today..

Manuel, new brother in Christ and community leader.  We were also hosted by 2 ladies from the women's committee.  Very helpful and great hosts and extremely interested in what can happen in the future.

 

We are down at Clinica Ezell in the Montellano. Normally is is hot and humid, but it's been just humid thanks to a storm system. We are excited to be here to see old friends and meet some new ones like Cary and Rita Sills. They recently sold everything and moved to Guatemala and are busy learning language in Antigua.  This week we are taking advantage of Cary's programing skills to work on building a database system for the ABC program. Now that we have over 700 kids in the program, we are feeling the urgent need to manage data better and be able to update files both here at the different work sites and for the ABC staff in the States. Technology does have it's blessings!

Cary and Rita Sills--wild adventurers.  Just ask them where all they have visited on their motor scooter!

Cary looks skeptical as Kemmel describes what we would like to do with the data.

 

Meeting of the ABC minds.  Cary, Luis, Julie, Carolina, Violeta, Alex and Kemmel