Friday, March 16, 2018

The sun was intense, but I absorbed it all in.

The sun was intense, but I absorbed it all in.

Today we departed from Cincinnati to go to Guatemala. I strived to be on this journey for the past three years, and it was finally here. After applying to the trip three years in a row, this year was finally the year that I was able to apply the knowledge I have learned about health care, Guatemalan culture, and how to be an effective teammate.

As the plane landed in Guatemala, all I could see were mountains, colorful buildings, and a new landscape that I had been unfamiliar with. Everyone on the plane began to squeal with excitement, and the Guatemala team began to get restless to start the journey. Once getting off the plane and gathering the luggage, we stepped outside into the airport pick up. My first sight of Guatemala was of the hot sun overhead; next, I saw dogs lying in the sun near the terminal, children and their parents in beautiful colorful garments sitting on the sidewalk, and children playing soccer in and around the cars passing by. As the team packed up the luggage on the top of the bus and in the back of a truck, the sun was beating down and we were sweating, but it was almost like Guatemala was welcoming us with its warm presence and loving touch. I admired the people around me, and the excited, smiling faces.

After packing all the luggage, we drove away from the airport toward Guatemala City. The sun was still shining through the bus windows, and I smiled. The loving touch of Guatemala never ceased to be present, and I knew that this week was going to be amazing.

Thursday, March 15, 2018

Lost for Words...

This entire trip managed to encapsulate God/love for me. What else could be the very reason why I am so lost for words? “God is love; whoever abides in God, and God in him(1 John 4:16)” God to me is love. She is everything and nothing simultaneously. She is ultimate and unconditional love, joy, and happiness. She is peace.

I’ve seen a lot of love in the form of understanding, patience, and determination here in Guatemala. Every single person here has taught me something about life. Jose Roland taught me the importance of walking and talking in your purpose, and the “Je ne sais quoi” of following through. Dr. Eric taught me how far radiant and abundant energy can go; even in times of stress. Nurse Stephanie taught me how to let your fire burn: sagely and with grace. Lastly the people of Guatemala taught me resiliency, the power of collective work, and determination. In Guatemala my eyes have been opened and awakened to beauty in all forms, and seeing this here has allowed for me to be much more thankful for my life. It’s hard to be good person, especially when life itself consistently pulls you to be the opposite and everyone here somehow manages to try. Wow. Everytime I see God I am filled with such immense joy. So thank you Guatemala for showing me God/love in many different ways. Bless this beautiful country, that I am so honored to have stepped foot on.

Amber Minefee

Patience and Gratitude

I spent today with Rabbi Abie in Glasses. I was so very delighted to watch in amazement as most of the patients that we took in for glasses were capable of having their vision improved dramatically. Some patients we improved from being able to read no lines on the chart, to having perfect 20/20 vision. The patients who showed their appreciation eyes sparkled with joy with new glasses and usually began to speed up in reciting the lines. As I watched the patients show their childlike glee, my heart quenched with fullness because we could make people smile again. Sadly towards the end of the day, we began to run out of prescription glasses for the patients. I began to become frustrated because I wanted every patient to experience the joy of improved vision. Thankfully Rabbi Abie was by my side, and scavenged through boxes to make sure that every single patient possible could see after walking out of our clinic. We couldn’t help everyone, and I think the lesson that I learned today was the importance of patience when having a high need to control. If you’re anything like me you want to do the best that you can at all times, and when you can’t you feel as though that you’ve failed. Today I learned that it doesn’t matter what happens as long as you’ve tried your best. One of the biggest indicators of this is that to my surprise, even the patients that we didn’t help still left the clinic with a smile on their faces and grateful for our efforts. To the patients today, thank you for your patience and gratitude. I’m honored to have learned from you.

Amber Minefee

Another Day of Clinic!

Today I started my clinic experience outside, working at the dental station. As I started working, it was really cold outside, since the sun didn’t reach me yet. However, children began coming into the clinic with their families, and I called the children over to play and color with me. Little girls came running over with smiling faces, and little boys were talking to me in Spanish. Immediately, the chilliness from the air disappeared and I felt warm from the hugs and smiles I was receiving from my little ‘amigas' and ‘amigos.' The morning was so fun, and I strengthened my Spanish speaking skills by talking to Guatemalan families, and teaching them how to brush their teeth. In the afternoon, I spent time with the internal medicine doctor, Dr. Richard, and learned about how to examine patients and give them the best care. He gave each patient his full attention, and then spent time to teach each of us students about the diagnoses he was making. He taught me the importance of patience and active listening while seeing each patient, and I will most definitely take that into my medical practice in the future.

Back at the hotel, we were packing our lunches for the next day when suddenly, a hotel staff member told all the men on the medical team to leave the room; only the women could stay. From behind her back, she pulled out a big, beautiful bouquet of red roses with little tags on them which read, “Feliz Día de Mujeres!” (Happy International Women’s Day!), which would be the next day. There were many tears and hugs as each woman on the team embraced the woman passing out the roses. Each of us felt more empowered as women to take on anything we set our minds to, and the bond between us became closer. The men on the team were finally allowed in the room, and they got roses to, but without the tag :)

Today was a beautiful day.

Rachel Krevh

Tuesday, March 13, 2018

The Fruit of Months of Hard Work

My eyes slowly adjusted to the light coming from the plane’s window and what was unbearable whiteness dimmed and the details of the land below took shape like a freshly printed Polaroid picture. As I looked over Maddie’ shoulder trying to see as much as possible I caught a teary eye and she said “ugh my eyes are all watery, I’m so lame.” She was right in that there wasn’t any particularly eye-watering beauty in the random collections of houses and the occasional cement road winding around the mountainous terrain below. But it wasn’t the sight that brought my friend to tears, it was what it all represented: The fruit of months of hard work.

An hour or two later I got to meet two more members of our Guatemala family for the first time, Dr. Richard also known as the most agreeable man alive and José Roland who from first glance you know you’ve found someone as dependable as the sunrise.
We go on what must have been the best bumpy bus ride of my life. We finally reached our destination, and no matter how many times Nurse Stephanie tells you that the clinic is small nothing will prepare you for the improvised waiting rooms, or the parsimony of that Triage room or for the kids with their smiles looking at you like they’ve known you for years. We unpack everything and leave.

I have no idea of what is to come nor do I want to expect anything. I am by no means an empty canvas, engrained in me are countless scribbles that attempt to make sense, but I cannot wait to be painted nook to nook…hasta lunes!!

Growing in Ways I Did Not Know I Could Grow

This trip has changed my life in so many ways. Each person made an impact on my life. I have learned so much about Guatemala, medicine, and life. There are not enough words in the world to describe how thankful I am for this trip. Throughout the week the team has become my family. I love each and every one of them. We have shared so many different things, including laughs and tears.

As for our medical team, I learned so much from them. Dr. Lauri taught me about pediatrics and how much education is really involved in that. I never really considered going into pediatrics but now I would really like to work with kids. My favorite moment with Dr. Lauri was when she was talking about how the best thing is to reassure the mom that she is doing well. Dr. Lauri showed a mom of this little boy his growth chart and explained through Diana (one of our translators) that the boy was growing at a healthy, steady pace. The mom was overjoyed and the smile on her face was priceless. Dr. Lauri truly showed each patient compassion, which is what I hope to do with my patients.

Dr. Richard taught me to be a detective. Each of his patients seemed to have more than one health issue. He was able to put the pieces together. While spending time with him, I realized how much we take certain tests for granted. For example; in our Guatemalan Clinic, we did not have the luxury of a simple blood test or urine test can take an hour or two to process, as we do in the US. Instead, we had to go by what the patient was telling us and past medical diagnoses. One of the Dr. Richard’s patients who stuck out to me was a patient who had a glucose level of 638 (Normal is 70-100). We figured out that the patient was not taking her medication so Dr. Richard had to make sure the patient understood how serious it was to take her medication. He was able to stress to the patient’s mother that she had to care for her daughter and make sure her medication was taken each day. Dr. Richard helped me to realize that I enjoy being a detective to try to figure out how I can best help the patient.

Kristen and Stephanie are amazing nurses. I learned so many different things from them. I hope to be able to critically think on my feet like they can. They were able to be creative with the materials we had to be able to help the patients as much as possible. Being in triage with them made me realize how much nurses are able to do without the doctor. Dr. Richard said, “Nurses save more lives than doctors do.” This trip has showed me that. One of our patients collapsed on us and before any doctor got there Kristen and Stephanie had him awake and were taking to him. That just amazed me. I was able to use all of my nursing skills and it really confirmed why I want to be a nurse.

Dr. Eric taught me so many things about medications. I learned how to write scripts and the different dosages. I asked him so many questions. I asked him at least one question about every bottle of medication. He is so intelligent. I was able to be exposed to different medications and understand why doctors would prescribe one medication over another if they do the same thing.

Rabbi Abie taught me about life. There is so much in this world to know, you just cannot know it all. He taught me how to listen more than you speak. Every single person has a story and there is so much to be gained from all of those stories. My favorite quote of his is “The two most important days in your life are the day you were born and the day you find out why.” I found out on this trip that I am meant to care for people and love people. The little things are often the most important things.

Thank you everyone who played a role in helping me grow this week in ways that I did not know I could grow. Thank you for experiences and memories that will last a lifetime. Thank you for your kindness, wisdom, and compassion.

Just People Helping People

We’ve completed our time in the clinic as of Thursday, and it kind of breaks my heart a little bit; we’ve all fallen in love with the beautiful people of Guatemala. While I choked up as we pulled out of the clinic the very last time, the beautiful, kindhearted, hilarious, and brilliant people surrounding me kept me from shedding more than just a couple of tears. I’d like to share a few of the incredible moments I experienced both in and outside of the clinic.

I’ll start with our very first morning in the clinic. Both Adonis and I were assigned to shadow Dr. Richard. It is hard to express the plethora of information we absorbed in the five hours we had that morning. I will share three things I learned that morning that I will never forget. First, never do anything if you’re not going to do it right. Second, listen. Simply sit down and take the time to listen. Third, a bit more scientifically related, gout is a product of elevated Uric Acid levels most often determined by genetics. Shadowing Dr. Richard refreshingly redefined what it meant to shadow; it was the first time I ever felt involved in the diagnosis process or even understood the complexities of many common diagnoses.

Another incredible moment in the clinic occurred towards the end of the week while I was working in the glasses rotation. It is here where I felt the difficulties of participating in a medical service trip. After distributing dozens of glasses each day, we were running out of certain glasses that could help each patient because our supplies were limited. It was very difficult for me to tell the patient the best glasses we had for her weren’t going to perfectly improve her vision; I wanted to be able to provide the best to her because she deserved nothing less than the standard anywhere else. It is at this moment that the woman stood up and grabbed both of my hands in hers, looked me in the eye and thanked us for being here and doing what we were doing.

Even though I still wish we had a better glasses prescription for her, this woman demonstrated the understanding, gratefulness, patience, and humility of the Guatemalans we met throughout the week. José Rolando, our contact in Guatemala and an incredible community leader, said it best during our last reflection, “What you came and did wasn’t a mission trip; it wasn’t even a service trip. You were just people helping people this week.”

Monday, March 12, 2018

Last Day at the Clinic

If only this trip were two weeks long instead of one! What an incredible experience I've been given here in Guatemala. Learning from our amazing staff of nurses and doctors, interacting with and providing medical care to the Guatemalans, and spending quality time with my amazing team of peers, was more than I could have ever asked for. I got so much out of this trip medically, spiritually, and emotionally. I discovered that I prefer a fast-paced, intense, and ever changing environment that requires flexibility and critical thinking. I discovered that I can't ever and will never be satisfied with my knowledge base, but constantly searching and asking and striving to improve myself as first, a person, and second, a medical professional.

One day this week, when we had some free time, Shannon and I were discussing what gives human beings purpose to live. This wasn't an unusual topic, as most of our team often found ourselves engaging in deep and meaningful theological and philosophical conversations. After some discussion and reflection, I came up with the answer to what keeps humans living as human connection. Later in the week as I was reflecting, I realized that through the course of this trip I had developed a newfound understanding of the meaning of human connection. Yes, the main purpose of this trip was medical service, and With this I was able to practice my skills and further develop my medical knowledge base. But, that was not my main take away. Rather, I discovered human beings' capacity to engage in and formulate boundless spiritual and emotional connection that is beyond linguistic description. In regards to my team members and the medical staff, I was able to create a cherished and unique relationship with every individual person. Even greater, we created a culture amongst ourselves- one with so much strength and passion that you really felt that together, you could do anything. In regards to the Guatemalans at the clinic, despite a language barrier, despite the differing backgrounds and ways of living, and despite only having short interactions, connections were made with each and every patient who went through our clinic. To give a specific example, I had a special bond with a little girl named Natalie that I met on the first day of clinic. I only had a brief conversation with her, but every day after that she would greet me with a big smile saying "Maddie! Maddie!" each time she spotted me. The last day at clinic, on March 8, she presented Maggie, Rachel, and I with individual hand made cards wishing us a happy International Women's Day and saying how happy she was to have met us. Tears were shed when we had to say our goodbyes.

In other words, I was deeply moved by the ease and swiftness that the Guatemalans gave away their smiles, appreciation, and spirits to us Americans who have limited knowledge of who they really are and what they go through. I think this human connection that I have noticed and received in a new way so profoundly and deeply this week is, in fact, love. In the next couple weeks, as I enter a new stage of my life and begin a career as a nurse, I am encouraged by this unique aspect and ability of health care providers to connect with those they serve. I hope I am able to portray and engage in this skill even half as effectively as the Guatemalans and the medical staff that I have interacted with this week have. I am incredibly thankful for their example and teachings of how to love whole heartily and without fear or hesitation. I leave this trip feeling inspired, but nostalgic, encouraged but not shaken, and without a piece of my heart, which I left in Guatemala.

Madelyn Hayes

Sunday, March 11, 2018

To Capture the Rainbow

Where does one begin when so much has happened. I am faced with the same difficulty a painter faces when attempting to capture the full beauty of the rainbow. He is afforded all the colors necessary for such endeavor and a white, inviting canvas, but how? How can I mimic the shattering of light into an infinite number of colors? How will I explain to you, the mountains arrested in big brown eyes? How will I detail the smiles of cracked lips sweeter than a Guatemalan bread pudding? Where in the world of words will I find a phrase to describe the feeling in my heart so filled with wonderful humans. I cannot, but more importantly I refuse to reduce this experience to mere words. What I can do however is tell you of a girl named Natalie. A little girl in a red and white dress with a hair band, fearlessly walked up to Xavier students most of which do not speak the only language known to her, Spanish. But she who wore her heart not on her sleeve - oh no - but in every gesture, movement and glance - she who did so did not need words. She talked tirelessly, and when she was met, at times, with blank stares from us she did not stop but seemed to pick up speed and confidence. She wrote some of us a letter and kept others company while they waited in the twilight hours for the clinic to fully close up shop. She ran up and down the steep hill with us, she got in on our inside jokes and she joined us in our silly squad cheer. Most significantly however, is what she represented, for me at least. In a trip with lioness hearts like Mishel and Diana, in the presence of the ever-present Dr. Richard; in the reassuring proximity of our beloved Nurse Stephanie; and with many many other named and unnamed idols of this trip, a little kid in a red and white dress stands head and shoulders above all to teach us what love can be, what a word of kindness can do, and how to seize the world in tender palms so that the beauty of the rainbow may not be disturbed...

Adonis Hawari


After landing at the airport, many emotions, ideas, people, and phrases have resonated with me. The first being the phrase, "Bienvenidos!" This phrase, meaning “Welcome!” was one I was unfamiliar with prior to arriving in Guatemala. I saw it on a billboard as I peered out of the bus window on the way to set up the clinic and asked some of the more fluent Spanish speaking teammates the meaning and pronunciation. It took me a long time to master the pronunciation, but, at that moment, the term could not more accurately describe my emotions. I felt warmed, not only by the sun, but from the beautiful people surrounding me; both those part of the team and those we were meeting in this new incredible place. The people of Guatemala embody a welcoming atmosphere full of an infectious joy.

Looking past the initial welcomes towards the medical service for the week, I recognize and am  intimidated by the immense tasks before us: providing medical care to people who may never had access to such care in the past, educating young children about proper dental care, filling prescriptions, and we are also striving to provide more than physical care. We will be holding hands with each other and our patients in prayer, solidarity, and love. In addition, we hope to instill a type of power that does not diminish, but empowers the people of this country. Together in partnership with the people of Guatemala we can try to repair the world and humanity a little bit and hopefully learn from each other along the way. I think that is one of things I am most excited about for the rest of the trip; building those relationships, connections, partnerships, and meaningful interactions with our patients because that is what will last when we leave. Hopefully, one day those connections and partnerships built together result in a prosperous, empowered, and self-sustaining community.

Shannon Cunningham

Coming to a Close

This week has been a whirlwind of emotions for me and everyone on this trip. I’ve laughed and cried harder than ever. Strangers touched my heart more than ever. Not only was my heart touched, but I was able to grow as a person. My hardest moment was when I realized that sometimes we don’t know what happens when our patients leave, and sometimes we cannot solve the problems we’ve had. This was really hard for me to process.

Juan is a patient that will always hold a special place in my heart due to the fact that he was the one who forced me to realize this. I had spent most of the day talking with him while I played with his granddaughter. Despite the language barrier he had a genuine interest in my life back home. Later that day he fainted in the middle of triage and was sent to the hospital. This hit home for me because he was fine the whole day. The next day, he came back to the clinic. When he saw me walk through the door he called me over and greeted me with open arms. He embraced me with a hug and told me he just needed someone to tell him that he was going to be okay. The hospital would not admit him without him doing lab test that would take days. This frustrates me, because he had already passed out 5 times in less than a week, and was having symptoms of a heart attack. I almost broke down in tears because we could not do anything to help him at the clinic with the materials that were available to us. I couldn’t stop thinking about what would happen when he left the clinic. Such a good man did not deserve to not have answers. Medicine sometimes fails us and that’s okay, but it’s something that we must realize. 

With this lingering in the back of my mind leaving the clinic on the last day was very emotional for me. I know that I would not be back in a week to check on his status. Facts like this make me never want to leave. Because of people like Juan and my team I have found my second home in Guatemala.

Lauryn Watson

Saturday, March 10, 2018

Touching Ground

Yesterday was insane. Landing in GUA was so much different than I ever could have imagined. Every five minutes I would look out of the plane in amazement. The terrain is so beautiful. Life seems so simple here. I watched children play on the street with a bottle on a string; while their parents pedal trinkets. The people are so welcoming here. Everywhere we go we are welcomed with open arms and smiles. This morning (Sunday morning) we went to the holocaust museum. It’s important to GUA Because history repeated itself in countries across the world. We also went to the square. It a was nice to see all the families feeding pigeons and the kids running around having fun. Next we went to the cemetery, which was really interesting. Many of the tombs were broken into. In fact we saw a femur on the side of path. José said it was likely the result of gang activity. It was really interesting to see the intentional separation between the rich and the poor in the cemetery. However since the contrary had become so over crowded over the years he rich and the poor lived together.

During this tour José taught us 4 very important lessons.
  1. We are always trying to separate our self from the other but we have to live with the other. 
  2. Don’t be greatful for what you have but for what they are. 
  3. Don’t work for the other work with the other. 
  4. Call the other by their name not the other.

Lauryn Watson

Moving Beyond the "Other"

"Be grateful for not what we have, but for what they are" - Jose Roland

We're standing in a cemetery looking out into the valley referred to as "the dump", where workers sift through the trash from the city to sell. As we look out, we are taken back by the immense growth of the trash in a mere 4 years, starting as a valley and quickly filling up to be even with the top where we stand. We are also distracted by the sun burning our skin and causing us to sweat. It is initially easy to feel pity on the garbage scavengers, living a life amongst the heat and garbage just to make it another day. One may also think, "Wow, I'm so glad I have been blessed with air conditioning and security in nutrition and finances". But, as we reflected, Jose Roland challenged this type of thinking. Rather than looking at these garbage scavengers as the "garbage scavengers", or the "poor" or the "others" that have lesser, resulting in us appreciating what we've been blessed with- what if we approached it a different way. What if, as we watched them work, we think about their past life that lead them to this lifestyle, and their present, of working day after day under the sun's burning rays amongst the people's unwanted leftovers. How amazing are they. Trekking on in the worst of conditions while being suppressed by the social and economic structure that prevents them from change their lifestyle, resulting in a seeming lack of hope. Yet, they wake up day after day, doing what they need to do to feed themselves and families. So much will and strength and dedication and love.

These reflections we had as a team lead me to my own reflections that challenge the motive for this trip. We didn't just come here to help the "others" who have less resources than we do. In fact, as we also discussed, the word "others" is problematic in itself, encouraging a further distance between ourself and those we serve. Rather, we came here to learn how to be incredible. We came here to learn how to grow and love and be thankful and have an incredible spirit for life, all without the materialistic things and resources that we've grown up with. We came here to learn how to be grateful for who they are. And let me tell you, they have so much to offer and we have so much to learn.

I feel excited and grateful and humbled to be in this beautiful country with its loving people. As we begin clinic tomorrow, I pray that with the short time I have with each patient, I can make even a portion of difference in the patient's life, of what this country and their people have already made on mine. Thank you to Jose Roland, the staff, and my team for keeping me centered and my motives in check as I begin the week in clinic.

Madelyn Hayes

An Opportunity to Grow

"Just because you don't know doesn't mean you aren't good enough, it means you have an opportunity to grow," said Stephanie Ibemere as we ended our first medical debrief. We have spent about 5 months preparing for this trip. We practiced medical skills, Spanish skills, learned about the Guatemalan culture, and developed as a team. As a team we have gotten so much closer and our friendships will last a lifetime. Today was the first day of clinic and I was ready.

I learned so much today. I began my morning in glasses with Rabbi Abie. really feeling like I still have my spanish skills because I got to use them because rabbi can’t really speak Spanish. My favorite patient was a woman who I did all by myself. Her eyes lit up and I don’t even know how to describe her thankfulness. I had no idea what I was getting into with glasses. I have never had glasses or contacts so I learned the different prescriptions.

In the afternoon, I was in triage. I loved it. As a nursing major, we are able to do these skills in clinicals in the US but here it is so different. Our patients are so thankful. One of our patients passed out as Maddie took his blood sugar. His eyes rolled in the back of the head and passed out. They had a pulse but he was having PVCs and so they think he had a heart attack. Kristen and Stephanie were amazing. Anyway, no one had aspirin until Osie ran down hill to get some. He got some aspirin and the ambulance was called. 

Kristen and Stephanie were able to critically think and I am striving to be that. I have the best teachers in the world. I have learned so much in clinic and it has only been one day. I just want to thank the medical team for all they do. I am ready to grow emotionally, spiritually, and in knowledge.

Margaret Sullivan

Muchísimas Gracias Guatemala

Be thankful not for what we have but for what they are. These wise words along with many others came from our incredible Jose Roland, the one who knows the people of Guatemala better than anyone. On Sunday we looked over a massive trash dump a few yards from a cemetery in Guatemala City and saw some of the most extreme poverty of the country. The scene looked like something from a sci-fi movie - dozens of vultures circling around in the air, smoke drifting upwards and an abyss of trash that extended deep into the valley. People were scavenging for hours under the intense sun through the depths of garbage hoping to find some treasures that they could eventually sell and earn some money from. This was their means of income. I had never seen anything like it and my instant reaction- like many others was to feel pity for them and be thankful for what I had- that I would never have to search through a dump in order to put food on the table. But Jose made me think differently.

He called me to appreciate and find the beauty in these hardworking and hopeful people who were doing what it took to support themselves. They had dignity and they had strength. Throughout my time in Guatemala I’ve looked for the beauty in what others may find ugly. Though the roads here may not be as well kept as in the United States and people live more simply- there is so much beauty in the spirit of the people of Guatemala. I have been blown away time and time again by the way they live their lives- with positivity, patience and generosity. During our days in the clinic I had the incredible opportunity to get a sense of the community that lives in the mountains of San Lucas. Each and every person I encountered, no matter how sick they were, greeted me with a warm hello and a smile. Their love of life was infectious beyond compare. Some patients would wait in the clinic all day to be seen by the doctor if it was busy. I’d lead them to the waiting area and even if they were there for hours, they would be so calm and content with waiting for their turn- they never complained and they never got upset with us. They were happy just to be there and it didn’t matter how long it took. Some would even hangout after they had been seen because the clinic like a watering hole for the community. Finally, the amount of generosity was overwhelming. It was so powerful to see people who have little give so much; they gave small gifts but beyond that they gave their time and their prayers. They were gracious and excited to help in anyway they could.

Our patients may have learned from our medical team; but they taught me so much more about the type of person I want to be. I hope upon returning to the US I am able to emanate this unparalleled, beautiful spirit of the people of Guatemala. Muchísimas gracias Guatemala, ojalá que nos veamos pronto.

Prasun Shah

Agua es Vida

As I am riding a bus along the base of Volcano Agua outside of Antigua I finally have some time to reflect on this year’s trip. Agua, water, water, water. It is easy to take for granted in our comfortable lives back in the United States how easy it is to get clean water. You can drink water safely out of the tap almost anywhere in the USA. Unfortunately the same is not true in places like Guatemala, and much of the rest of the world.

I met a little baby named Levi here a year ago. He was 6-months-old and had failure to thrive. With the help of my amazing interpreter, Diana, we talked mom through why his growth curve was worrisome and discussed practical ways she could get him to grow better. The family drank water out of the tap and all the kids suffered from chronic diarrhea. We talked about how they could get a water filter from Ecofiltro at a subsidized price and cautioned against Levi being given unclean water with his at-risk growth. I put Levi on my list of kids that I knew needed close follow-up. This year I had the pleasure of seeing him again. He is now a beautiful toddler and is thankfully back on the curve on the lower percentiles.

At least he is growing marginally better. But he wasn’t well. Mom brought two of her other 6 kids with her this year to see me. They all have chronic diarrhea, distended abdomens; the older ones often complain of headaches and dizziness. The family never got the filter, they still drink water out of the tap. Diana and I careful explained that all of her children are suffering from not drinking clean water. You can treat them all for parasites, amebas, the GI pathogens ubiquitous in unclean water, but as soon as they drink from the tap again they will once again get sick. I think she understood this year. It helped so much to have the few plots on the growth curve (a birth weight, last year’s weight, this year’s weight). I think when families see that plotted out and explained it helps to put it in context for them. I was not surprised she didn’t get a filter after last year’s visit. These families have lived off of unclean water for generations, they don’t change overnight.

Today we just took the Xavier team to tour Ecofiltro, the factory where the filters are made. I have been here once before. A year ago in January Rabbi, Abie, Eric, our pharmacist and I came down to Guatemala for a scout trip. We were looking to plug into a new community to try to help them become more self sustaining with their own health over a period of years. When we toured the clinic in the town where Levi lives I asked the community health worker if the families drank clean, filtered water. She told me no and I knew at that point we had our work cut out for us. I told our Guatemalan host, Jose Roland that we can do very little good in a place like this without providing a way for them to get clean water. The next thing we knew we were touring a factory outside Antigua called Ecofiltro. They make water filters using clay, sawdust and silver - all materials harvested in Guatemala and manufactured in an environmentally sustainable way, organically using the sun and wind. The employees are not even allowed to bring junk food or soda to work. I love Ecofiltro. It gives me hope, hope for the lives of people in places like Guatemala. The technology Ecofiltro developed is used in 38 countries around the world.

The company agreed last year to help us in our work here. They come to our clinic and families can purchase a filter at a subsidized price - basically for the equivalent of buying bottled water over three months they will pay for the filter. The filter will last for two years. Needless to say, Diana and I asked every family last year and this if they drank filtered water. Last year none did, this year 5 families had filters. We made a dent. This year Diana and her super saleswoman skills was able to convince all of the families that we saw who didn’t have a filter to let her put their names on a list of families interested in getting a filter. Now Ecofiltro will meet with those families for further education about the filters and hopefully will sell some. We can change the trajectory of a community little by little (poco y poco). It is work, a lot of work, but it is worth it. It is life.

Here is the website link to Ecofiltro for more information:

Lauri Pramuk, MD

Saturday, March 25, 2017

A Week's Difference

One week ago, I wrote about arriving in Guatemala and beginning our journey. Today we are heading home, with healed hearts, after being broken numerous times, and renewed hope. As I reflect on what this week has meant to me, I am in awe and I am still not quite sure how to put it in words. Before this trip, my hope for a better world was incredibly dim. I did not see much of love, or of God. Now I see God everywhere and I hear God in every waking moment.

The difference this week has made in my life is unforgettable. I see love everywhere now. I see God everywhere. I see God in my peers, who wore their hearts on their sleeves and fully threw themselves into this experience. I see God in the medical team, who are fully committed to their patients and taught us what it means to heal and be healed through serving others. I see love and God in the Guatemalan people, who do not let the inequality they witness everyday harden their hearts. These are God's people, who always end their conversations with "Vaya con Dios" (Go forth with God). They are rooted in their faith and have taught me what it means to be completely reliant on God and trust him. They have taught me to love abundantly, without hesitation or resentment. They have taught me to readily forgive. They give without expecting anything in return, and in that way, they have taught me to be more generous.

I am grateful that I was given the opportunity to be a part of this trip, of this journey. We have all said that our hearts broke a thousand times throughout the week, but it was put back together much stronger and much more capable of genuine love. I am grateful because I met some incredible people who are now like family to me and I could not have asked for a better team to with whom to have this experience. I know this week touched my soul because when I woke this morning, my first thought was, "I want to stay home". I've found a new home in the Guatemalan people.

Aichetou Waiga 

Tears and Joy

Our final day at Choacorral yesterday was met with both tears and joy. It was sad to say goodbye to all the patients, children, and community members, but we were all excited to reach out and help the community of Chapernas the following day.

After an hour long ride to Chapernas, I step off the bus and experienced a huge amount of culture shock. There were no paved roads, very few buildings, and a thin layer of dust covered everything. The school building that we were calling the clinic had no air conditioning, few lights, and a barely functioning bathroom. When I first walked into the clinic I could not belief the number of people that had showed up. The entire room was lined with men women and children, all trying to see a doctor.

I spent the morning with Dr. Lauri in pediatrics. It is so inspiring to watch how Dr. Lauri works. She always has a tremendous amount patience with the kids and easily diagnose patient after patient with confidence. Near the middle of the day I was running a script to the pharmacy when Brad pulled me into his room. Brad was a trained nurse who volunteer at this school made clinic twice every weeks, and he just happened to be from Ohio. The reason he pulled me into his room was to show me a very interesting case. When I walked into the room I saw a frail old woman sitting in a chair. As I moved further into the room I immediately realized why she came to the clinic. The woman, who was an astounding eighty-nine years old, was completely missing half of her nose. The skin and cartilage that should have been covering her nasal cavity was gone. Brad explained to me that the woman had small spec of skin cancer on the tip of her nose that went untreated and eventually resulted in her losing half of her nose. Now she comes in twice a week to get the area cleaned and bandaged.

What was heart breaking to me was the fact that had this woman lived in a more developed country that cancer spot could have easily been removed. While this woman may have lost part of her nose, she never lost her pride and determination. She held her head up high and managed to live ten years with the open sore. This woman showed me that when life deals you bad cards you can either complain and give up, or you can accept it and face it with a smiling positive attitude which she did.

Joseph Kavanagh

Where I Feel Called

Friday was undoubtably the most tiring and mentally and physically challenging day of clinic for me. Chapernas is a small village about 30 minutes from the coast in western Guatemala. As we drove into Chapernas we knew it would be different from Choacorral. The dirt roads, open air houses, and the type of illnesses varied vastly from Choacorral. Walking off the bus into 90 degree weather was not only a physical shock but when looking around i was shaken to the core. The two large buildings were basically just huge rooms that we took over and set up our stations at. We walked in the main building and it was packed with people waiting to be seen by our medical staff. However, when we turned the corner God blessed us with another pair of intelligent hands and a caring heart. Nurse Brad came into our lives as a surprise. He is an American nurse that does mission medical work in Guatemala and visits this site twice a week. He was just as surprised to see us as we were to see him. We worked seamlessly together to serve this huge population of people who needed medical care. I worked in triage all day. Hearing people's stories, investigating their health issues, and using nursing skills is my favorite part of triage. The fast paced atmosphere was especially difficult in this clinic. The heat paired with the amount of people and the acuity of the patients made the day especially hard. Working with Maddie and Xye was incredible. Our Spanish skills and nursing backgrounds prevailed and we were essentially done triaging by lunch time. However the most difficult things to witness was nurse Stephanie having to turn away patients. There were just so many people and not enough time or resources to see all of them. This was devastating but it shows how much continued efforts are needed.

My time in Guatemala has taught me more than I could have hoped. On Friday I learned, or perhaps rencountered, the fact that I, as one person, have the ability to change the world. If I changed or positively effected one persons life in the little town of Chapernus I did good. My last patient of the day was a old woman who had diabetes and was leaking, for lack of a better term, from her legs because of all of the edema and fluid retention. She had extremely low blood pressure but her blood sugar was only 175 without taking her medicine for her sugar for a number of days. This was not a problem of diabetes this was congestive heart failure. However, what I learned from this woman was not about her diagnoses, it was about the smile she had on her face when strangers were talking a foreign language surrounding her. It was about how her family advocated for her needs and care. It was about how her daughter was doing the best she could with what she had and was full of gratitude for our being there. My time in Guatemala was not about saving the people. These people do not need to be saved. They are strong, compassionate, loving , hospitable, grateful, and rich in life and love. They are different from the people I am normally familiar with, but that doesn't make them any less worthy of love and care. They need to be walked with not changed. Guatemala has officially broken and ruined me in the best way possible. This beautiful country and its people have changed the way I view health care and have possibly changed where I feel called in this world. They have taught me to love and wear my heart on my sleeve, that it is okay to ask for help, that vulnerability is not a weakness, and that it is more important to be rich in faith, hope, love, and community than in anything else. I am so grateful.

Melinda Birky

Wednesday, March 15, 2017

There Are No Secondary Causes

We all have special people who come into our lives and leave lasting impressions.  Father Vince O'Flaherty was one of those people for me.  I lived with Father Vince, a Jesuit priest, in my senior year of college at Regis University in an intentional faith community in a low-income Latino barrio in Northwest Denver called Romero House.  At age 70, Father Vince was our leader, living amongst 20-something year old college students, learning to cook for the very first time in his life, leading us by his example of selflessness.  One of the things he would always say was, "There are no secondary causes."  The gentle hand of God was present in all things for Fr. Vince.  This is a very Jesuit concept and I am grateful I learned this from him.

This week in Guatemala I have been reminded of that sentiment over and over again.  This is our seventh year on this trip.  The community we first encountered 6 years ago went from having never had a physician in their village to having a fully functional, independent clinic in that time span.  This year that community has 17 groups coming to volunteer this year.  And in a little over a year one of their young men, whom we met as a community health worker 6 years ago, will graduate from medical school in Guatemala and come back home to serve that clinic year-round.  So we made the difficult decision last summer that when we were planning for this year's trip we would probably be of better service to move on from our old village and start anew with a community who did not have so much help.  It was difficult to think of not seeing our wonderful families of Patanatic again, but they had many helpers at this point.

In a random act of God's gentle hand last summer Rabbi Abie met a phenomenal couple named Jose Roland and Lisa Monterroso.  Lisa is a Xavier graduate of the OT program and had met Jose Roland when she traveled with a Xavier OT trip to Guatemala several years ago.  The two fell in love and are now living and raising their two young boys in Jose Roland's native Guatemala.  When Lisa and Jose Roland were visiting Lisa's alma matter of Xavier last summer they met Rabbi Abie and the conversations about the medical service trip to Guatemala began.  Jose Roland - also known as Roland, then became our Guatemalan contact.  He started the work of identifying two new communities in Guatemala who needed services.  We could not have met a more generous and loving human being.  He identified two communities for us to start a relationship with, in hopes of giving them a gentle lift up in the next few years so that they can in the mean time identify people in their communities who can train as health workers to sustain their own communities.  Our hope is that over the next 10 years or so these two new communities can, with some help from our trip, become self-sufficient in their own health promotion.

In January, Rabbi Abie, Eric Bertelsen (our pharmacist) and I traveled to Guatemala for 3 days to meet with Roland and community leaders in these two new villages to see how we may best serve them.  Our first community is in San Lucas and has a government medical clinic but there is little to no staff for it.  When we toured the clinic I became aware that this community has no access to economical, clean, filtered water.  Without clean water it doesn't really matter what we could do down here - it would be like putting our fingers in the holes of a dike.  Water filtration has to become universal.  I told Roland that we needed to see how to bring clean water to these people.  The next thing I knew, a few hours later we were touring the factory of a globally known and respected manufacturer of home water filters called Ecofiltro.  Roland knew the factory owner, had called him up and asked him if we could come meet him.  We learned all about Ecofiltro and he learned all about our trip ideals of building capacity in communities so that they may become self sufficient in taking care of themselves.  The next thing we knew, Ecofiltro was donating water filters to our two new clinic sites and their schools.  And Ecofiltro agreed to come into the new villages and sell water filters to all the families for a very affordable, subsidized price.  So, probably over the course of 2-3 years those homes will all have free filtered water in their homes.  Even if we do nothing else in those two villages that will dramatically change the trajectory of their health.

Each time we have presented Roland with a new problem, he works at it and solves it.  He knows pretty much everyone in Guatemala and has a heart for helping - especially for helping people feel empowered to help themselves.  We were waiting in the bus at a bank one afternoon after clinic so the Xavier students could exchange some of their money.  I saw Roland warmly greeting two beautiful adolescent Guatemalan girls in their pristine school uniforms, who were clearly delighted to see him.  When he joined us on the bus I asked him who they were and he told me he had known them since they were toddlers.  They were HIV orphans and he knew them from the group home in which they live.  So, literally we go from him knowing the CEO of a major international water filtration company to these two HIV orphans.

Roland and Lisa walking into Rabbi Abie's office that day this summer was definitely the work of the gentle hand of God.  There are no secondary causes.

Lauri Pramuk, MD

A Kite Rises Highest Against the Wind, Not With It

Winston Churchill said, "A kite rises highest against the wind, not with it." That saying has often come to the fore in my life as adversity has entered. The great statesman was referring not only to a country, but to a community and to the individual person.

Nowhere is that more evident than in our Guatemalan community - with the beautiful Mayan people who line up outside the entrances to their clinic and to our Xavier medical family in each and every exhausting hour.

In the fall of 2016, a friend and colleague, Dr. Carol Scheerer, head of the Occupational Therapy Department, came to my office at Xavier. She wanted to introduce me to Jose Rolando Monterroso and his wife. Lisa Monterroso was an OT graduate of Xavier, who had met her now- husband on an OT trip to Guatemala. Jose Roland and Lisa were visiting Cincinnati with their two young sons, Lucas and Jacob.

Carol thought it would be nice for real Guatemalans to meet me, an honorary Guatemalan. Little did Carol know we were ready to move on from having accomplished our long term medical mission in Patanatik. In that Western highlands community we had totally transformed the community's capacity to take care of its own health care. It took six years, incredible Xavier students, medical colleagues and an inspired and dedicated community to achieve that goal. It was time for a new community and a new local inspired soul to handle our logistics and create a lasting bond with the local population.

Jose Roland was that man - thoughtful, capable, inspired and with a heart that could span from Guatemala to Ohio.

We entered into our relationship slowly, letting the gentle hand of God sew the disparate fabrics together. A mid-January preliminary visit only served to confirm that all of Guatemala was in his pocket. We had entered into his heart, as he had into ours.

The interfaith medical service week has now come and gone. All the planning, all the fundraising, all the medical education came together in a way that can only be described as magical. The 19 member team, supported by the  prayers and donations of hundreds, brilliantly executed our service trip. Hundreds of patients were seen and cared for, hundreds of pairs of glasses changed lives, but over and above it all, the twelve Xavier students were forever changed. They saw hundreds of community members, in native dress and Western attire, young and old, desperately sick or just needing an affirmation of relative good health, pass in front of them and enter into their hearts. These special descendants of a great, inspired Mayan tradition, taught them resolve and faith. It is a hard life in our two impoverished communities. It is a difficult daily grind to navigate the hillsides and the heat, the poverty and the bureaucracy. But every person they met flew their kite so high against the adversities they encountered. Not one patient noticed the slight hesitation in their blood glucose finger prick. Not one patient complained about the wait to see doctors or our pharmacist. Not one patient expressed concern as they tried on tens of used eye glasses to find their own 20/20 on our eye chart. Not one patient was frustrated with some of our team members' broken Spanish. Not one. Despite the daily adversities, caring for children and family took priority and found quiet resolution. Despite the adversity not one patient was bowed. Their faith, their love of family, their pride in their Guatemalan heritage lifted our spirits and brought joy to each team member. At the end of each and every day our exhausted team members found the strength for medical debrief and reflections. Tears of joy, compassion and growth lifted our spirits.

We will be back. The beautiful people of San Lucas and Chapernas have partnered resolutely with us. They want to help themselves. They want to sail their kites high. Our beautiful young people will hold the kite strings with them. God will provide the wind.

Rabbi Abie Ingber

Sunday, March 12, 2017

A Sunrise in Every Soul

For as long as I can remember, I think that I have known a few truths about the world, and the only people I can thank for this knowledge is my parents. When my sisters and I were little, we were fortunate enough that our Amma and Baba took us on adventures around the world, and these experiences in countries other than my own taught me more than I realized at the time. I had seen the reality of most of the world on trips to Pakistan ever since I was a few months old, and I had also seen the beauty of the world.

During the months leading up to our trip and our meetings, we learned about the realities we would see: the people we were preparing to serve lived lives much different than our own. As the type of human whose heart bent when she saw even a too skinny dog walking around outside the clinic in San Lucas, I knew this would be immensely difficult for me to see and experience in a more direct way than ever before. For this reason, I knew that I would have to seek the beauty of the world during my time in Guatemala.

Every morning since we landed in Guatemala City, I would wake up earlier than I should have. Partly because of the roosters that would would signal a too-early start to the day at 3 am but mostly to see the sunrise. The first day in San Lucas, I realized only after the world was suddenly full of light that I was facing the wrong direction and missed it. The next morning, I tried again but the mountains were blocking my view. On Wednesday, I woke up my lovely roommate Xye so we could find the sunrise together but our view was less than ideal. The same dilemma was the case on Thursday and Friday, but I did not want to give up.

This morning in Antigua, I woke up early again with Xye determined to finally accomplish my goal with my last chance. As we climbed onto the roof of the hotel to find the best view possible, we realized that the only thing we would see would be the light appearing behind a fluffy and almost impenetrable layer of clouds. As I began to feel a little disappointed that I still had not seen a Guatemalan sunrise in its beautiful entirety, I understood that this realization was completely wrong.

I saw the sunrise every day in our clinic in San Lucas playing futbol with the kids who  filled my heart with hope: they smiled no matter what words I strung together to say a sentence in Spanish and covered me with stickers of princess from head to toe. Though they did not have much, they were joyful and hopeful.

I saw the sunrise working in the glasses room in Chapernas: the light that illuminated each face after someone put on glasses and could finally see the world.

I saw the sunrise in every single soul I encountered that belongs to Guatemala.

I saw the sunrise through the amazing Dr. Lauri and amazing Dr. Richard, who showed me what selflessness looks like and taught me the most important thing about medicine: the people. And through Dr. Eric and his never-waning excitement and happiness. I saw the sunrise through Nurse Stephanie, who amazed me in more ways than I can could ever count and stopped to teach me the importance of believing in myself and who I am in the middle of a chaotic triage. Through Stephanie Renny, who handled every obstacle with grace and always made sure that we were all getting enough water. Through Roland, who instilled a desire to stay hopeful and to aim to make a difference with what I do. Through Diana and Mishell who never stopped smiling and talked to me about the importance of hope. And through Rabbi Abie, who allowed us to experience a Shabbat dinner together. My fellow students gave me the sunrise every day as we worked together and every evening during our group reflections, teaching me through their eyes.

If one of my goals of this trip was to see the sunrise, I think I saw it more times than I could have hoped. Because I learned that no matter how much darkness the world may see, the sun will always rise and fill it with light and hope.

Zenab Saeed

God's Good Works

Today was our last day in our clinic in Choacorral, and it didn't hit me how fast this trip has gone until I started saying goodbye to all of my patients. The experiences I have had these past few days will forever be ingrained into my heart. I have grown more as a person and learned so much more in this week in Guatemala than I have in the two years I've lived here. That's how impactful this trip has been for me.

Today was special because patients I had met earlier on in the week returned again and again and I began to see familiar faces. Specifically with one family, in which I developed a relationship with. I sat down with this family and learned who they were and what their story was. It was two sisters, their mother, and all of their children. In the thirty minutes I talked with them I found out that they walked over an hour and a half to get to the clinic, both sisters married young, at 15 years, and both sisters had kids at a very young age. I was astonished at the stark differences we had in that sense, I mean I'm 21 and barely am able to take care of myself, how could I ever take care of children, especially when I'm still a child myself?

It definitely left me pondering the whole day, but it also showed me how wonderful these women are and how strong they are to take care of not only themselves, but their families as well. The fact that they walked over an hour and a half just so their kids could be vaccinated is just astonishing, and by luck they were able to come on a day when we were here. However, I wouldn't call it luck, things happen for a reason in life. There was a purpose and reason for why I met that family and developed a relationship with them. In a way, it was God's way of showing himself to me, of demonstrating his good works. It was his way of showing that even in the toughest times and I don't think He's there, He really is, in moments like these.

So where do we go from here? That's the question we're always left pondering because we're only here for a limited amount of time. How will we know if the patients we attended to will be able to continue on without us? How will we know if they're able to buy their medication again after they've run out of what we've given them? Will it be too expensive? These questions have been circling in my head this week, and now that our journey is soon coming to an end, they've become more pertinent. Even though we offer care and medical attention to these people, I wish we could give more. I wish I could give more of myself to them, but in reality I can't, as much as I would like to.

Moreover, it breaks my heart that I won't be able to come back next year to see these wonderful people. It truly saddens me because it's through these people that I was able to see what I have to offer and what my calling is in life. As much as I've done for them, they have done way more for me, more than I could have ever imagined. I hope to see this relationship of our medical team with this town develop more profoundly, in a way in which the livelihood of the people are changed for the better; in a way that builds up the community to the extent that in future they will be sustainable and be able to thrive on their own, much like at our old clinic in Patanatic. I can only imagine the wondrous strides this town and this clinic will do for the people of the community, I can't wait to see what's to come in the near future for them.

Angela Ellis