Wednesday, June 29, 2022

Keepin' On

Orquids love the rainy cloudy weather!

Rainy season is in full force around here. In general we love this time of year for its cool, cloudy days and rainy nights. It's a real blessing knowing folks up North are suffering 100+ degree days and fires.  However, things are getting pretty soggy around here lately.  Thankfully in our area we haven't had any serious issues, but the two main highway systems from the Capital city to the Highlands and to the Coastal areas are plagued with mudslides and a huge sink hole. That makes travel to the Capital a real headache. Be praying for the government to have wisdom and resources to adequately address this. 

Arial view of the mudslide on the highlands highway. They have it back open now and under observation. (Photo Prensa Libre Carlos H. Ovalle)

Major sink hole in the Coastal highway. Still not passable. (Photo Prensa Libre Roberto Lopez)

Clinics are going well and people are grateful as always for the care they receive from our staff. I had a patient come in with diabetes symptoms ("Doctora, my urine is like pure honey!") accurately diagnosed by his wife for about a year, but he wasn't having any of that! We gently but firmly pointed out his high blood sugar result, 30 lb weight loss, and all of his symptoms and started his diabetic education. Hopefully he will accept the diagnosis and medication and begin some lifestyle changes. His wife who has been a diabetic for 15 years was well controlled and very thankful for her medications and asked about nurse Sheri. 

Mobile clinic in Rio Bravo

Covid cases are picking up again, but so far no hospital overflow like last year, which is reassuring. Schools are still in a hybrid state as they are waiting to get kids vaccinated before going full time. Not sure when that will come to pass, so we just wait and pray for families to figure it out the best they can. A study came out this week showing that 70% of Guatemalan students failed to reach minimum academic standards during the last 2 years. We have a long way to go. 

Moms and kids from Las Trampas.

Our hospital licensure is still an issue at Clinica Ezell, preventing us from hosting surgery teams. But we are on the right path and jumping through the hoops necessary to get government approval of our site. Our local health department is starting to be more reassuring about our future approval. We talked to a dentist friend who said lots of private clinics are struggling with the same issues regarding their environmental and sanitation licensing and large fines for practicing without proper permits in hand. So, we are trying to be diligent and patient and praying for progress. Please continue to pray for us to advance in this area. 

One of the ongoing requirements to maintain the environmental license is planting native species plants and trees on the property. Our staff reached out to the government agriculture agency and we were able to score some free saplings (including mahogany) and education on how to start our own nursery. The program provides the trees, and we invite people from the community to come help work, and the government pays the people with food packages per day of labor. 

One of the ladies (Dolores) helping prep seedling bags.

Our onsite tree nursery.

Thankfully we are still able to host mobile medical/dental clinics this year. We've enjoyed spring break teams and wheelchair clinics, and in May we hosted a team from Oklahoma Christian University to wrap up our well-child check-ups for the ABC sponsorship kids. They are a great group and always come prepared.

Dr. Neil Roberts showing off his pediatric skills

Diane and AnaLuna running the library area.

Everyone is growing well thankfully!

This year we were even treated to a smoked turkey Thanksgiving meal for the whole staff and team, courtesy of Eric Phelps! He brought down his own smoker and left it for us to use now and for next year!
Eric Phelps the champion turkey smoker, sharing his know how with our team.

This was a great group. Thanks, OCC!

Tuesday, March 22, 2022

Spring Break with Harding University and Abilene Christian University

These last two weeks in Chichicastenango we hosted  teams from  the Harding University Physician Assistant and Nurse Practitioner programs led by Gary Hill, P.A., Greg Brooks, D.N.P  and Carolyn Nunnally. and Abilene Christian University led by Autumn Sutherlin and Amber Brokaw. It was great to see them  again and work side by side doing well-child checkups, attending our normal clinics, offering physical therapy and teaching exam skills. We had visiting physician Stan Sizemore and dentists John Case, Tim Hacker and Kristin Goodwin and Andrea Lux and physical therapist Ann Lee Bradford which was great! 

Getting out in communities with everyone was refreshing. So many of the kids were hard to recognize after two years of growth under their belts! Our last teams to visit in 2020 just before the borders closed for the pandemic were these groups, so it was encouraging to get together again in better times. By law we still have to use masks everywhere, and we were proud of everyone for complying. We were a little worried about pre-return testing for Covid as Guatemala is just now coming down from peak cases, but everyone was negative and able to return on time. We are thankful to God for allowing  these teams to come experience the work we do,  and we pray that he will guide us as we work on our licensing to be able to have surgical teams as well. Please be in prayer of thanksgiving for the way God has helped us so far and for continued guidance and wisdom.

The Health Talents Delegation arrives in Mactzul 6to.

Dr. John Case stamping out dental disease.

Investigating the cause of headache.

Great views from the auditorium.

Showing mom where dental cleaning is needed.

Greg Brooks teaching exam skills

Great team from Harding!

Labor of love-- Ashley washing dental instruments!

Chilly Chichicastenango morning with the Harding team.

ACU team meets with the Xepocol youth for worship and supper around the bonfire.

Waiting room activities in Paxot 3
Worship with Xepocol

Future engineers
A crazy game of "El Rey Pide..." Lightening fast team scavenger hunt game.

Brushing folks up on vital sign skills before going out.

Local gourmet food served up at lunch in Paxot 3

Tamalitos in corn leaves--a luxury during dry season.

Autumn's fan club.

Iglesia de Cristo en Paxot 3.

Mobile dental suite.

We had dental, medical, dental education, mental health screening and physical therapy all in this building and patio areas. Whew!

The ACU team enjoying their hand processed chocolate after a long week!

Sunday, January 23, 2022

Faith Healing

Working in healthcare we put a lot of trust in science and medicine and evidence. These are things that have been studied, and observed and generally give reproducible results. The field of medicine is a beautiful body of knowledge and resources available to us through the study and observation and work of generations of healers, scientists, and physicians who have dedicated their lives to relieve pain and disease. And given by God.

So how do we incorporate the idea of prayer and faith and petition to God into our medicine cabinets and doctor bags? This is a question that keeps coming up in my mind. As a Christian physician, I wrestle with the two worlds of medicine and faith. Am I giving my patients the best of both worlds? Am I relying too heavily on one over the other? Are they really two worlds?

This week a patient of mine came in for follow-up of her diabetes. She's a strong Christian woman who has a lot on her plate. She is widowed and cares for her only child--a grown daughter who has several disabilities. She came in last August with a severe foot infection after stepping on a nail. We referred her to the hospital for care and never heard back from her. She said she went for another opinion and the doctor told her the same thing. But she never went to the hospital because she didn't have anyone to look after her daughter. She prayed and pleaded for God to heal her. 

And he did. 

Her foot looked great and only had a slightly darkened area where the abscess had been. She was very matter-of-fact, like she had seen this before. I was pretty surprised. We talked about her blood sugar control and she asked for a refill of her meds. We prayed and thanked God for his healing and for the medications. She said she would be back next month. 

I'm not advocating shunning medicine, nor any of the other advances in civilization like vehicles or plastics or commercially made clothing. But we can't put all of our faith in science and technology alone. Working with people who don't have a lot of financial resources has taught me that evidence-based medicine is a luxury a lot of times. And God works fluidly inside and outside the limits of science and limited means. 

Like this patient, I want to learn to use all of the tools given to us by the Creator. He is the one who gives us life, oxygen, water, plants and animals for food and medicine, our intelligence to figure things out, antibiotics, diabetic medications, our surgical skills, etc.  He is the one who cares for us and knows what our earthly bodies need. He is the creator of all things in this world, is all-knowing and all-powerful. He has given us evidence of his existence in his creation. So why not consult God in our treatment plan?

In what other areas should we be consulting God? Are we trusting him to provide? Are we living our lives seeking the Kingdom of God? Are we remembering that he already knows what we need?

You made all the delicate, inner parts of my body
and knit me together in my mother’s womb.
Thank you for making me so wonderfully complex!
Your workmanship is marvelous—how well I know it. Psalm 139:13-14

…but your heavenly Father already knows all of your needs. Seek the Kingdom of God above all else, and live righteously, and he will give you everything you need. Matthew 6:32-33

Jesus looked at them intently and said, “Humanly speaking, it is impossible. But not with God. Everything is possible with God.” Mark 10:27

Thursday, October 7, 2021

Something New

Although we have had many changes to the work we do here in Guatemala, we can't say that its been all bad. Here's an update of our goings on.

Surgery Teams

We have agonized over not being able to have surgical teams and are working diligently to get our hospital licensing where it needs to be to go forward. The pace is terribly slow, but we see progress and are trusting God to lead us in this. There are updates and new construction and new requirements and newly enforced details that have made things difficult for us. We hope to be able to get through these hoops and start bringing our surgical teams back to work with us!

Mobile Medical and Dental Teams

ABC kids from the Chijtinimit church.

Because of continued high numbers of Covid cases in the country, we have limited our U.S. teams to maintenance crews and dental care for our ABC sponsorship kids. This allows us to schedule patients in the communities and limit the number of people hanging out together before and after appointments. It has gone well, and we have been able to attend the majority of our ABC kids focusing on restorative care (fillings, sealants) and preventive work, rather than just extracting teeth. We feel blessed to have been able to attend so many of the kids already. 

Making progress on the dental front!

Our maintenance team came from our home congregation of Eastside Church of Christ and really knocked out some hospital honey-do's! One of the industrial security requirements for our hospital license involves placement of smoke alarms, emergency lighting, large fire extinguishers and safety signage. 

Emergency lighting and smoke alarms--30 each around the hospital.

One of the 300 "What to do and not do" signs.

One of the 30 fire extinguishers mounted.

Having small teams also gave us a chance to test run the Covid protocols that we have in place for visitors. One of the things that gives us pause is what to do with a team member that tests positive (or gets sick) during their stay here--causing them to have to stay and isolate and retest negative a before being allowed to board a plane back to the U.S.A. We have had one team member in this situation and thankfully, other than having to stay over longer, not being able to check into a hotel or Airbnb in Guatemala City, and the cost of double checking his Covid test and retesting at the end of his isolation, he didn't have any significant complications. This allowed us to re-evaluate our protocols and prepare for future incidents.

Outpatient clinics

Some of our staff visiting our sister Antonia as she mourned the death of both of her parents.

Our Guatemalan staff continue to work full time in our primary care clinics in the Highlands and the Coastal area. We have our central clinics Ezell and Caris open daily and have been able to incorporate several communities into our mobile clinic rounds. 

Mobile clinic team in Chuchipaca.

Patients are grateful and see the importance of prompt care and careful management of chronic disease to avoid complications and preventable hospitalizations when hospital space is at a premium around the country. They appreciate the prayer time in their times of grief and loss and the encouragement from staff and evangelists to keep on keeping on.
Women's Health Training seminar with Faith in Practice.

We even hosted a Women's Health Training week at Clinica Ezell for our doctors and nurses, providing free cervical cancer screening to over 250 women in the immediate area. The conference and was led by our friends at Faith in Practice--Dra. Patty Baiza and Dr. Jorge Mendez. They allowed us to pick their brains and review the principles of cervical cancer and precancerous lesion detection. It was a great blessing to our staff and patients. 

Covid--The Collateral Damage

A familiar sight around here lately--funeral procession.

We continue to have very high numbers of cases and hospitalizations, causing our national hospitals to collapse. We have so many patients waiting to have elective surgery, and the national hospitals will not take non-emergent cases. We get calls from cancer or trauma patients needing additional services but can't get admitted or transferred to higher level centers due to lack of bed space. It is getting hard to purchase common medications due to importation issues, supply/demand, price increases. 

ABC kids from the Las Trampas church.

Kids have been doing virtual schooling the entire time. Most of our rural kids have very little access to internet, so homework lessons are assigned once a week or via messaging, and parents take the work up to school for grading. There will be no senior level testing to close out their high school education and no graduations allowed. Just endless holding...and worrying about the future.

Something New

It's really hard to see the good that can come of difficult situations, trials, and persecutions.
When we are in the moment all we can comprehend is the crisis, the pain and potential consequences to come. We are all living in difficult times right now, be it the pandemic, job insecurity, economic downturn, intercultural strife, political turmoil, struggling marriages, health crises, etc. What good could possibly come from the trials we have, the failures and delays and disappointments?

If we look at Isaiah 43, God works in all of these situations. He makes a way in impossible situations; he sees solutions that we can't fathom; he uses our weaknesses and failures and enemies to achieve his good end. This year has been hard because of continued limitations from the pandemic, the changes in governmental regulations and constant illness and death around us, but God in in it with us. He sees what we don't see and has plans for our future. Let's trust him and be ready to join in.

6I am the one who cut a path

through the mighty ocean.

17I sent an army to chase you

with chariots and horses;

now they lie dead,

unable to move.

They are like an oil lamp

with the flame snuffed out.

The LORD said:

18Forget what happened long ago!

Don't think about the past.

19I am creating something new.

There it is! Do you see it?

I have put roads in deserts,

streams in thirsty lands.

Sunday, August 1, 2021

Dusting Off

Our poor blog has been in abandonment for a couple of months. Not that we aren't busy, but rather it's hard to report on the things that seem routine to us. This week we threw some excitement into the mix!

For the first time since the pandemic started, we hosted a U.S. team. We had a small mobile dental team come to the Quiche area to help us address some of the needs of our ABC sponsorship kids. 

The dream team!

We set up in the Paxot II church all week and had surrounding churches/families bring in their kids by appointment to avoid crowding. We were able to attend 71 kids from 3 churches, offering long overdue fillings, sealants and cleanings. This was in addition  to the regular dental patients that we were able to continue serving because of the help of the team. 

Dra. Silvia Albizures joined us, covering Dra. Aura's normal clinic to free her up to go mobile. 

Holly working hard on dental hygiene. And some interesting spectators!

Julie helping Dra. Aura. 

Glamorous personal protection equipment. Bode felt left out!  

Gary helping Dr. Mark.

Not-too-bad attempt at social distancing.

Waiting room fun

Thankfully our team's pre-travel Covid tests were negative and they made it back without glitches. We hope to continue to bring in medical and dental teams to help with the work here!

Our Covid numbers here in Guatemala are still sky high. But the number of  percent of  tests positive has started coming back down (we reached about 31% positive and are down to 23% now). Unfortunately, the already stressed hospitals are just now getting hit from that peak (Imagine full wards and ICUs and newly admitted patients lined up in chairs in  hallways connected to oxygen tanks, waiting for a bed. Imagine all ventilators occupied and staff ventilating intubated patients by hand until a machine opens up. Imagine a national shortage of sedatives so intubated patients are awake on the ventilators. So keep praying for the overworked and under-supplied medical teams working in the hospitals and the patients who are struggling. 

    "Forget the former things; do not dwell on the past.
See, I am doing a new thing!
    Now it springs up; do you not perceive it?
I am making a way in the wilderness
    and streams in the wasteland. Isaiah 43:18-19