Goodbye Roosevelt!

Today was Lisa's last day to walk out the door of the apartment to go to work at the Hospital Roosevelt here in Guatemala City. It appears that she has met her requirements and now we just wait on the final grade to be presented to the Director who will then pass on the approval to the medical board to finalize her license to practice medicine in Guatemala with the same legal rights as any Guatemalan physician. Here are a couple of pictures of the front of the hospital as Lisa enters for her last day. No more white pant scrubs either - these we will burn!

All in all we would not say it was a great experience, nor a terrible experience, but we have learned much more about the healthcare system in Guatemala and Lisa has learned new skills that she did not have as a US physician. She can now start any IV line, set arterial lines, perform respiratory therapy and her skills as a phlebotomist, transport aide and many other ancillary type functions have improved tremendously. Oh, and she can do a lumbar puncture with the best of them. One thing we can say about the physician education here is that they get a very good education on clinical diagnosis without the availability of high tech diagnosing procedures.

Here is another picture of some of the buildings at the Hospital. The large groups of people you see in the background are at the hospital for a consult for their children - could be a surgical or medical consult for patients with long term illness to surgical candidates such as spina bifida, hernias, hydrocephalus, etc. 2 weeks ago I went along with a family from Chichicastenango to help them through the maze to get a consult for their newborn baby who was born with probable spina bifida. It is a very confusing process, but in the end we received what we needed and they come back next week for another consult. We will be praying that all goes well. This helps us understand why families are very reserved about wanting to go through the process. It is not that people treat them bad, but the process is complicated and you must just keep trying until you are in the correct location for your consult. On any given day there are hundreds of people in lines going through the same process. This would not be the poster-board for an efficient government healthcare system, but it is the best they have and if you persevere you will probably eventually get the care you need.

For all of you transcriptionists out there my hat is off to you. I have spent the day translating letters from the ABC children to their sponsors and have learned that I would not be very good at this full-time. I am way to easily distracted and as you can tell, I am posting a blog instead of translating the letters right now. I am not even close to my goal of completing a good number of them. I started with 75 letters and still have a pretty good stack left! I would not be making very good productivity standards and these are the type standards which I helped develop in the past! I am glad there are people in this world that have this wonderful, God given skill as are many physicians and other professionals are as well! At one point in Lisa's practice she tried the voice recognition thing to quickly decide no thank you. So kudos to you!

Lisa and I want to thank each and every one of you for your prayer support and financial support during this year and of course for all of our time while in Guatemala. This by far has been the hardest year in a long time for us and probably much more for Lisa. We entered the year with a not so great attitude and much fear about what would happen and along the way doubted many times, but through your prayer support and the grace of God we have been able to finish the year and we look back at it with a much more humble attitude. We pray that God will continue to guide us and mold us as we attempt to serve Him - In our weakness, He has made us strong!

Tomorrow we are free of this responsibility and we can begin to look forward to many more opportunities. Next week we join a surgical team at Clinica Ezell in Montellano and the following week we are going to take a few days to go to the beach in Honduras (one of the benefits of living somewhat close to Roatan). Then we head back to Chichicastenango to meet up with our fellow team members for the rest of August. We will probably have some trips to the city to finish up paperwork provided the university is able to have what we need ready. If not we will finish that up in October. In September we head to the US to spend some time with family and get a little rest before starting with clinics in October. For me, I have probably had enough rest these last months, but Lisa is well deserving.

God bless and please continue to check in!

Almost Done! Friday is celebration day!

Lisa has 3 days left in her 6 months rotation at the Hospital Roosevelt. She has been in internal medicine for the last 2 months and she has one more call which is the last day of her rotations so that is a bummer as she has to work all night. However, that will be the end. She went to meet with the director yesterday and it appears she does not have to do a research paper as the other students will have to do, so we pray that is the case.

She found out today that she actually got the highest grade in the this 2 month rotation which made her feel good. she has been working very hard at her responsibilities.

On Sunday, I began to move things back to Chichi. We forget how nice it is there. It truly feels like home and we look forward to being able to go back together and continue to work with the teams in the area. We have many ideas and we pray that God will continue to lead us. We have made many friends in the area and we look forward to spending more time with them and jointly growing in our personal relationships and our relationship with God. The drive continues to get worse in some places and better in others, but once you are there it is very relaxing. The road is pretty stressful and tiresome, or maybe I am just getting older!

We are extremely grateful for all of the prayers that have been offered on our behalf and also humbled at the assistance we have received to help with the extra costs we have had of covering expenses in 2 locations. Thank you and we know the Lord will bless you greatly for your generosity.

Please pray for the economy here in Guatemala. The affects of increased gas prices, low economy in the US and many other factors including crime, politics, price increases are starting to be recognized in the daily lives of the people in Guatemala. It is very difficult to know where the answers are so we can only rely on the power of God to help transform this country.

We promise to blog more once we are back in Chichi - Home sweet Home!

For those of you who know Aura, Marcos' dental assistant, she passed her entrance exams to dental school! Congrats Aura!

God is good!

Update

Well it has been 2 weeks since I last posted a blog and we have had quite a bit happening. Lisa continues to finish out her last month and has actually had a couple of weekends free which we did not do much except allow her rest time and spend time together which has been nice. I was incorrect in saying that she was in men's ER as she has been assigned women's ER. They call this the "crazy ward". Most of the problems of the patients deal with depression or some type of family problems which results in stressful symptoms such as fainting and collapses. It is sad to see so much emotional and spiritual conflict but as everywhere it is a reality that people face in their lives. Lisa has had quite a bit if opportunity to pray with patients in attempts to provide them some peace in their lives. These are the times that we rejoice that we serve a loving God whom we can rely on to help us through our struggles.

She only has 16 days left in the month and 5 calls. Please continue to pray for her strength and endurance to finish the month and to pass all of the tests that are left. She has one final at the end of the month that covers the entire 6 months of rotations. This test is worth 20 points of the overall so at least it is not a high percentage of the total grade. The tests are what she worries about the most right now. Of course the work is also taxing and that is where the strength and endurance is needed.

Over the last 2 weekends we have not done much but rest and take some long walks on the weekends. This last weekend we took a short drive to just get out of the apartment and the city and we drove down the El Salvador highway which was a very beautiful drive and we passed an area that sells pineapples and were able to buy 3 for Q10 or about $1.50. Pretty awesome price for a pineapple.

Over the 4th of July a team came to work with our teams in Chichi and helped us in clinics for 3 days. During this time we started a new program with a couple of the schools in the area of the clinic. This program includes providing medical and dental checkups to the kids of the school and providing a report to the parents about the growth of the child and their overall health conditions. Some children were better than others but overall as compared to the growth charts in Guatemala, many children are doing well. For dental, it is a much different story as many of the children had very poor dental health. We will take the opportunity of what we learn to present solutions and education to the school children and parents on how to better the overall health of the child. We will do this through a variety of ways to teach health principles and are looking at a possibility of introducing a fluoride treatment program that will need to be managed by the local school and/or parents. So we will see how this works. If positive results we will duplicate this in other areas. Please pray for the parents and school to be receptive to ideas that we can help improve their situation. This becomes delicate as we do not want to pressure them with our ideas but rather help them view the need so they can take ownership of providing themselves ways to improve the overall health of their children. So, please pray for wisdom on our part as well to not offend and to be patient with the communities as we work together.
The positive news is that the schools and the parents have been very interested in this program.

The other day a friend of ours from Paxot 2 delivered a new baby with Spina Bifida. Sheri and 2 health promoters, Juan and Gaspar went to visit the family in the hospital and to provide them encouragement. Juan has taken an active role with the family and is trying to help them in any way that he can. It is great to see the staff take interest in this way - not that they would not have, but the fact that they visit and speak with the family daily is a great ministry to that family. They will be heading to Guatemala City tomorrow in an ambulance provided by the National Hospital which has been arranged by the social workers who work there, who are also arranging their accommodations and needs while in the city. This is also very encouraging. Please pray for this family - their names are Sebastian and Anastasia Sut and he is an elder in the church in Paxot 2.

We continue to look forward to the day we head back to Chichi so that we can feel more involved in the ministry. Please remember to review Sheri's blog at www.sheriinguate.blogspot.com for other news and pictures of clinics, etc. She is the master blogger, normally blogging every day!

God bless!

Another Difficult Month Finished

June has now passed and this is Lisa's last month in service at Hospital Roosevelt. Last month was a little better than surgery, but still a very difficult month with long days and difficult patients. This last month of July we were hoping for Lisa to be assigned to the hospital clinic but instead she was assigned to men's ER. This is not as good as the clinic but better than women's ER and some of the other options. The word is during this month you get off earlier - around 4:30pm so that will be a nice change for her.

For those that read the blog before 2pm today, please say a quick prayer for her as she has a midterm exam today. She was pretty nervous this morning as we were driving to the hospital.

On the Chichi front, this week we are expecting a group to come work in some mobile medical clinics. We are also beginning the trial phase of a school program we are starting for the schools that surround the clinic in Lemoa. In this program we will provide medical and dental exams for the children of the school and will also look for opportunities to provide education on health topics. The schools have been very open to the idea so hopefully we will also have good responses from the parents. We hope to encourage parents to seek treatment when needed and preventatively, especially for dental care.

The MET students are now back home after a great month living with families, experiencing culture and experiencing serving in medical missions. We hope and pray this month has helped each one develop an idea and desire to serve in the future.

Just one month left.........Praise God! A familiar term used here in Guatemala for this physician service is that the experience is "bonito" (would be translated as a good, special experience); however, we are still not convinced we would consider any of it "bonito". It has potential of being a very good program, but the killer is the demand on time which takes away any good experiences that could happen.

We are looking forward to August and even more so to September when we get to go back to the US and visit family and October when we will be back full-time in Chichi. Oh how we miss Chichi - home.

Thank you for all you prayers.

Update on Tomasa Chicoj and Julisa Lux

Here are some updated photos of Tomasa and Julisa, the 2 young cancer patients that we have been working with for some time now.

Tomasa came to us about 2 years ago with a recurrent retinoblastoma tumor. She underwent treatment of radiation and chemotherpay until August of 2007. Latest reports indicate she is doing extremely well. We have not received any prognosis but she appears to be doing great and has started to attend school and only comes for visits every few months.

Before picture

Picture from last week with father, Pedro, and brother, Manuel.

Julisa came to us almost 2 years ago as well with onset of lukemia. She too has been undergoing chemotherapy for quite a bit of time and is not down to once a month visits.

Before Picture - during her chemotherapy treatments.

Picture from Wednesday of this week. She came to the church in Pacaja Xesic to participate in a children's program.

Lisa - Prayer Answered!

Therefore put on the full armor of God, so that when the day of evil comes, you may be able to stand your ground, and after you have done everything, to stand.

-- Ephesians 6:13

We received this verse via a daily verse distribution over the last few days as well as many emails of encouragement from all over. This verse helps us place the correct perspective of who we should trust and the responses we received emphasized this calling for faith and perseverance in God. Your responses and expression of love for us has been overwhelming and we so greatly appreciate everyone who has been praying for us. We received our first answer to prayer on Friday afternoon when Lisa found out that the Saturday session may not obligatory. Then later that night more good news that there was no session on Sunday either! So Lisa was able to come off call on Saturday morning around 11am and rest the remainder of the day. We had a dinner with some visitors and friends Saturday night which offered her much more encouragement. Then yesterday, we were able to attend worship service and Lisa was able to spend some time studying and preparing for this coming week. This morning we started early, leaving the house about 4:30am so she could prepare for morning rounds, but she is a new person.

Thank you for your prayers, encouragement, support and faith! Just 6 weeks to go!

Humbled and thankful,
Kemmel and Lisa Dunham

Please pray for Lisa

We try not to post blogs that have a negative tone and we have always tried to keep a positive attitude towards this year of service Lisa is enduring. However, today was a bad day for Lisa. We would like to request prayers on her behalf to lift her up and provide her with a peace that only God can provide.

Lisa is struggling through these last 2 months of service. In May she was in a surgery rotation and had to work every day of the month, plus was on call every 3rd night (which means at the hospital for 36-40 hours with no sleep). This month was supposed to get better and she was going to have Sunday's off. Last Sunday we did have off and made the trip to Mexico to renew our visas so that was not very restful (although nice to just leave the city) and we still did not get to go to a worship service as when we returned on Sunday she had to go to the hospital to review her patients prior to Monday. Today she found out that they have some class session tonight for 2-3 hours and then also 2 4 hour class sessions on Saturday and Sunday. She was hoping to use the time tonight to prepare for a class she must present tomorrow on Coronary Syndromes. She tries to stay positive but she is at wits end with how crazy and disorganized and inconsiderate of a person’s time this service is. The time is much worse than anything she experienced in her process in the US. She is going on almost 2 months with not being able to attend a worship service which also takes its toll spiritually.

What pressures her the most if she does not pass these last 6 months, then all she has done is for not. This means not missing any days that she is requested to be present, passing all of the tests, being prepared for each rounds with the residents and attendings, being a good care giver, preparing all the classes she must teach, and as we like to say - staying under the radar.

This leaves me very sad as well as there is nothing I can do to assist her besides just try to provide some moral support and ensure that everything outside the hospital is smooth. We consider ourselves pretty tough people, flexible, by the grace of God, able to withstand many things, but this situation is really starting to affect us and mostly Lisa as I just have the ripple effect of feeling discouraged for her.

Thank you for all of your prayers, we need it. And we apologize for bearing our discouragement.