Friday, January 6, 2012

Faces of Hope

Rabbi Abie – A beginning and an end

Two important touchstones of my life collided today. With one I bid farewell, with another I celebrated a new beginning.
Last night after two days of power outages I received news of the passing of a dear friend, Jerzy Kluger of Rome. Jerzy, as now many millions know, was the lifelong Jewish friend of Pope John Paul II. While I first met the Holy Father in 1999, I did not meet Jerzy until 2004. But my relationship with him over these last seven years had been so intense I had committed to his wife Irene that I would be an officiant at his funeral when the time came. I missed his passing and I missed his funeral. I was in a remote mountain village in Guatemala watching the birth of new lifelong relationships between our pre-med students and health care in the third world. I had tears in my eyes in the morning as we stood in the triage area when I shared snippets of how Jerzy and the Pope changed the world our students were born into. I had tears again in my eyes in the evening when our students shared some of their difficult moments in encountering where medicine could not fix everything. And I had tears again later in the night when we each shared the nexus of our experiences in Guatemala and our spiritual journeys. Each student and staffer spoke words from the heart that touched everyone.
Today I missed the funeral of a dear friend. That ship has come back safely into the harbor. It was a grand journey but it has come to an honored end. Today I watched as 12 youthful ships sailed out from the safe harbor into turbulent waters for their life voyages. I pray their journeys, too, will be grand and honored. Godspeed Jerzy. Godspeed David, Micayla, Christian, Lia, Jenn, Megan, Mouhamed, Mary, Anna, Mike, Annie and J.D.

Mary Erwin – The answer is faith.

Mary is a junior Nursing major from Westerville, Ohio.

This whole trip so far has been amazing. I have seen God in every patient I have encountered in Panajachel, Guatemala. Each patient and family greets our medical team with a smile and is so grateful for the care we provide. We have a special room for patients and families to give them an opportunity to offer prayers up to God if they choose. Almost 100% of the patients have chosen to pray after their visits with the doctor. Today, I took a mother and child into the prayer room and must have sat with them for at least five minutes while the mother said prayer after prayer. Although my Spanish is very poor, I could somewhat figure out what she was saying. I picked up the words "Ave Maria" and "Madre de Dio" which indicated she was praying The Hail Mary. She also said many prayers of thanks for blessings in her life including thanking the doctors, nurses, and students of medicine here at the Heart to Heart clinic. I was in awe of how reverent and gracious she was. Even her son stood with his hands together in a prayerful gesture and remained quiet and obedient. Another patient I want to mention was a male in his 20s on a tight schedule. When I took him into the prayer room, he said he was late and had to get going - instead of staying to pray, he apologized and asked if I would please, please pray for him. Of course I said I would and he was very grateful. Overall, working the prayer room was a moving experience for me. It was neat to watch these people pray aloud and to see how important their faith is for them. How could people in such a poor community who have so little be so incredibly content? The answer is Faith.

Another neat experience I had today was shadowing Dr. Richard. It was amazing to see how much he can multi-task. Somehow he managed to examine patient after patient, fill out paperwork, decide prescriptions, and teach me all at the same time while never taking a break even just to sit down. If I had questions at any time he would answer them. He engaged us in the examining process by allowing us to listen to heart sounds, lung sounds, bowel sounds, etc. He also explained risk factors of several medical conditions and how to prevent them. He also showed me the importance of taking a medical history because this can be the best way to discover the root of a problem. I really enjoyed listening to his past medical stories --many were interesting or funny, but some were really eye-opening and helped me learn important advice that I will take with me to utilize in the future.

Anna Walsworth – Life lessons

Anna is a biology major and Spanish and chemistry minor from Geneva, IL.

Saludos de Guatemala! With only two full days left, it's hard to believe our week together is almost over. On the other hand, it's hard to believe a group of people can grow so close so quickly and experience what we have experienced. I couldn't have imagined better mentors or peers to share this trip with, all of who have become great friends.
I can't do justice to the wonderful people we have seen in the clinic. I think I speak for all of us when I say we've all considered bringing home one of the Guatemalan children - they are too cute. This morning I worked in triage, did some toothbrushing with the kids, and worked in our makeshift eyeglasses shop. Of the many people I fitted for glasses today, my favorite was a 65-year-old woman who walked in with no shoes and apologizing for her unwashed hair. She was blind in one eye and had horrible vision in the other. Rabbi Abie and I worked with her, handing her pair after pair of glasses until we found a pair that allowed her to see significantly better! The look on her face was rewarding enough, but she gave us hugs and kisses while thanking us repeatedly. I feel like I should be thanking these beautiful people in Patanatic for teaching me life lessons and giving me an experience I will never forget.

Thursday, January 5, 2012

Rabbi Abie, Nurse Bonnie and a patient with new glasses

Rabbi Abie – Blessed and truly ready

After four months of preparation for our Guatemala mission I am proud to say we have opened. The student participants have come together as a loving, supportive and able community. The medical team is first class and has bonded beautifully with our students. The clinic in Patanatic, just a dream last year, has opened and while there is still no plumbing (yes, we flush with a bucket of water drawn from a large plastic garbage can) and the electricity is yards of extension cords - our workplace is palatial compared to last year.
Our students were given a dry run with home visits on the mountain slopes of Patanatic. Every home visit was a walking challenge with the hillsides, barbed wire and raw sewage. But in four groups we fanned out into the four sectors and saw tens of home bound patients. We examined infants of just a few weeks to elderly in their 70s and 80s. In the home of our group's last visit to Sector 1, an elderly lady was convinced to come up to our clinic tomorrow so Dr. Richard could examine her more thoroughly. When we bid her farewell she pronounced to us that our visit was a gift sent to her by a gracious God.
Now that we have been thusly blessed - we truly are ready.

Bonnie Herscher – A well-deserved break

Bonnie is a nurse from Los Angeles.
After a long and moving day in our clinic seeing a 13-month-old diagnosed by Dr. Lauri with cerebral palsy and fitting glasses on children who had to drop out of school because they couldn't see, we treated ourselves to pizza and Gallo and sundaes. A day we won't forget and an evening that made us laugh!!!!

Wednesday, January 4, 2012

Dr. Lauri - Cerebral Palsy in Guatemala

Not much time but wanted to blog about a 13-month-old I saw today.
Brought in by her mom, she is the youngest of 7 children. Mom was concerned because her baby is not walking, sitting or talking, and gags and chokes on anything other than breast milk. The baby was all wrapped up being worn by her mom during the history taking, but I knew before I saw her that she likely had cerebral palsy. On the exam table it was evident - hypertonic, scissor legs, back arching, clenched fists, contracted elbows. She is also microcephalic.
With the terrific help of my phenomenal interpreter, Diana, I was able to tell the mother the child’s diagnosis and prognosis. We talked through all kinds of things, like her risk for aspiration pneumonias, etc. I am doubtful she will ever walk, talk, feed herself, etc. Mom already knew there was something wrong; I just gave it a name. She was listening to each word.
I started the child on vitamins and an antibiotic to treat aspiration pneumonia. In the United States, she would also get physical therapy, occupational therapy, speech therapy, developmental therapy, eventually be fitted for a walker or wheelchair, and a feeding tube, but not here. One of the Xavier Occupational Therapy students got to see the exam. She could not have had a better patient from whom to learn.
The clinic was slower volume this morning. I only saw 9 patients compared to 19 yesterday morning. But that one patient was like 100 to me. I will carry memories of her forever.

Annie's photo with friends

Dr. Lauri's photo of the pharmacy

Jennifer Ledonne – Rainbows above the volcanoes

Jennifer is a junior majoring in biology with a minor in chemistry. She is from Cincinnati.
This is amazing. Today we woke up to no electric and no water due to a storm last night. However, we were all still very excited to go to the clinic. When we arrived there was a rainbow over the three volcanoes that surround the lake, which also happens to be the view from our clinic windows. Our first patients were running a little late but eventually the clinic was in full swing. The people here are all so thankful and loving. They walk so far through very mountainous paths to reach the clinic. People of every age make the trek and wait patiently and gratefully for hours to be seen by the doctors. The most rewarding part of the day was providing people who could not see even the largest line of an eye chart with eyeglasses. They walked out of the clinic able to see more clearly for the first time. The people, the culture, the landscape...everything about this country is beautiful and I could not be more thankful to be here. Each of us is learning so much from every person we encounter, even Marghareta, the woman outside our hotel who tries to sell us blankets. Leaving the clinic today, we were lucky to see a sunset over the volcanoes.

Yesterday, we set up the clinic in the morning which was a lot of work, but fun. In the afternoon we split into four groups and made house calls. It was eye-opening to see how the people live day to day. All of the families live in very close vicinity to one another. The family that most stood out to me had a beautiful and healthy three-week-old. The parents, grandparents and entire family were glowing with pride of their new addition. Micayla and I were trying to say “handsome” but weren’t certain if the correct Spanish was “guapo” or “gordo.” It turns out “gordo” means “fat!” After trying to figure it out, the family caught on to our bad Spanish and it became a joke among all of us. Though there is a bit of a language barrier, but the miscommunications often lead to laughter, and our respect is apparent.

I could not be happier to be here. Since I first turned in my application, I have felt I was meant to be on this trip. Tonight at dinner I shared that with Cesar, the principal at the local school, who really initiated the clinic. He was so sweet and appreciative of all of us leaving our homes behind to come here but he didn’t realize how grateful we are to be here. We get to learn so much from this community and its people, which makes us grow as people. I am looking forward to the rest of the week and do NOT want this trip to end!!

Mouhamed Ndoye – Senegal to Guatemala

Mouhamed is a sophomore from Sidney, OH majoring in Information Systems and Spanish at Xavier.
Words can't express how the last day of 2011 was spent, but I will make an attempt. Waking up early in the morning to begin my first journey to a Central American country, I learned that one can begin the day at 3:00 am! At CVG airport TG-13 (Team Guatemala) applauded every member who received their ticket and met the 50-pound luggage maximum as though we were professional athletes being introduced before a game. After the wait in CVG and the layover in Atlanta, we landed in Guatemala City. Now that I think about it, the airport reminded me of Senegal, where I call home (besides the US). It was really heart-warming to see that people were happy. At this point, I have been in Guatemala for four days and every second of it has been amazing. God bless the doctors that came along on the trip and the organizers, Rabbi Abie and Carmen, because they are sent from God. Words cannot express my respect for all the members of Team Guatemala. JD, Jen, Annie, Anna, Lia, David, Mike, Mary, Micayla, Rabbi Abie, Carmen, Christian, Megan, Doc Lauri, Doc Richard, Bonnie, Jorge and Cathy are the best argument for the existence of God.

JD Burleson – Bloggin’ Bebe

JD is a senior Xavier student from West Carrollton, OH majoring in biology.

December 31, 2011 was my first experience with the beautiful country of Guatemala. The hotel in Antigua was amazing and I have one of the best roommates in David. The camaraderie has been great and we have gotten extremely close. I have also gotten to know the ladies of the group better and, as a whole, we have just become much closer. I am loving every minute of it. Bringing in the New Year with the new family I just gained in the beautiful city of Antigua was a special experience. I love Mouhamed, Christian, David, Mike, Lia, Annie, Anna, Micayla, Meagan, Mary, Jenn, Carmen and Rabbi.
January 2nd, 2012 was our first in the field exploring Patanatic and performing many different tasks. One of our first joys on this busy day was bringing all of our medicines into the clinic and setting up the pharmacy. I helped Dr. Lauri and the medical staff organize and move medicines that will improve the lives of so many people. From there, we set up a prayer room, which was amazing and essential to me, complete with the many rosaries donated to our mission. Prayer can bring the world together if people allow faith to reign and appreciate the similarities and the love that come through when we show honest Godly love to everyone. Our next step was to organize the donated eyeglasses according to their prescription strengths. I completely agree with Rabbi that changing the eyesight of a person - even just a bit – may allow them to see and work and support their families and enhance their happiness. Thomas Jefferson spoke of life, liberty, and the pursuit of happiness. That pursuit is much easier when you can see and interact with the world around you. I am really looking forward to the teeth-brushing station that we set up and will use tomorrow at the clinic. It will help improve dental care for children who will be given a toothbrush and toothpaste to take home. We will give each personal instruction so they can take care of their own teeth themselves.
During our break, we went up the hill from the clinic and met people around the town, including a man who wanted to take a picture “solamente con” [with only] a pretty girl in our group. We all joked that they were getting married (lol). The next part of our day after lunch was to go on house calls throughout the village with Nurse Cathy from LA, and follow up on patients who were seen by this group last year. We met an older midwife who was fatigued and felt weak. Her blood pressure was normal but her blood sugar level was very high and she was diabetic. There was no way she could get down the mountain in her condition because it is incredibly steep, but we took note. Later on that day, Dr. Richard and Nurse Cathy went back up to her home and tended to her needs. I was very happy because she reminded me of my grandmother and I didn’t want her to be stuck in her home alone or sick without any help. I was also very happy to learn she has family all over and friends who will help her. It means the world to the elderly for people to take time and care for them in respect of their place in society. We also visited a home where I had a very interesting conversation with an older gentleman while I took his vital signs. His blood pressure was normal as he asked me in Spanish if he was well or strong. At first, I was confused - he was making boxing motions with his fists, which made me thing he was a boxer. The translator told me he was asking if he was strong and after laughing at myself, I assured him he is indeed very strong and healthy, with blood pressure rivaling my own.

Tuesday, January 3, 2012

Lauri Pramuk, MD - Help out of the Moat

Lauri is a pediatrician with Group Health Associates in Cincinnati’s Kenwood location.

Today was another day full of grace in Guatemala. Having spent the week here last March, I had some idea of what to expect, but still found myself filled with awe many times. Today was our first day to travel to Patanatic, the community where we do the clinic, and our main event of the week. Last year the clinic was not even built. Today, just 9 months later, we were overjoyed to find a real clinic - exam rooms, pharmacy, lab, even a dental room! The floors are installed and the walls are up. The building doesn't yet have electricity, so extension cords are run throughout to give light here and there. It also has 2 bathrooms, but unfortunately neither has working plumbing yet. It will be an interesting week of clinic with no toilet, but it could be worse.

We spent the morning organizing our supplies. We brought thousands of dollars of mostly donated medications and some 300 pairs of donated eyeglasses. The students looked like squirrels preparing for winter getting the clinic set for open of business tomorrow.

The afternoon, however, was the real highlight. We divided into four groups, each led by one of the medical professionals. Each group went to a different sector of Patanatic and made house calls - in-home medical visits to community elders and those who had recently been on prescription medications. Prior to this adventure I was intimidated by the fact that, as a pediatrician, I haven't taken care of adult patients since I was in training 14 years ago. Assuming the home-bound patients would be mostly elderly, I brushed up on some adult medicine from colleague Dr. Richard (who is the best and most humble physician I have ever met). My team of Lia, Christian and Annie, led by our guide, Maricella, trekked up the steep mountain of Patanatic to the highest sector. When we arrived at the top of the mountain (completely winded from the steep grade), you can only imagine my delight to find our first home visit patient to be a 17-month-old boy! Right up my power alley! He needed follow-up for a recent throat infection and had developed diarrhea from the antibiotics. He was doing fine, but I discovered he was infested with head lice - probably our first case of many this week. We have plenty of permethrin to treat him, thanks to our phenomenally-stocked pharmacy. Our next visit had me donning the internal medicine hat for a beautiful 79-year-old woman who turned out to be completely healthy. She even out-walked us on our way back down the mountain a few hours later!

The groups returned from the house calls full of energy and amazing stories. They have now been in the families' homes, talked with them, shared stories, and seen how they cook in primitive stoves. The homes are made of cement, cinder block, and tin. The students saw how chickens, dogs, and cats live inside the homes as much as they do outside. In fact, as my team was walking down the mountain, I stepped over a grate in the road and heard a tiny peep. Looking down, I found a tiny chick stuck in the moat of the grate. We lifted off the rebar and I jumped into the moat, chasing the little chick until I caught it. We placed it back on solid ground and continued on our way. That little chick needs to grow up and make eggs to feed one of these families, which she can't do stuck in a moat. Sometimes we all need a little help out of the moat. This week in clinic, we get to help the people of Patanatic find a path to better health - find their way out of the moat.

Monday, January 2, 2012

Jan 2 Annie Regan Amazing Opportunity in an Amazing Land

Annie is a senior nursing major from Whitefish Bay, WI
Mucho amor de Guatemala!
We made it here safe and sound on New Year’s Eve. Little did we know what an exciting first night it would be!
Every time I have the opportunity to travel, I am reminded of the same feeling of overwhelming amazement and curiosity. The beauty of the mountains as we fly in, the excitement to meet up with our medical team from Los Angeles, the beautiful Guatemalan children strapped to their mothers' backs, the crowd-packed streets on New Year’s Eve, listening to a New Year’s Day Mass in Spanish, and bonding with the group on the rooftop garden of our hotel. This is just a taste of our first day... Everything hit at once and it was incredible! Being able to celebrate such an exciting holiday in a new place was awesome and I was amazed to see the incredible mix of people on the streets, celebrating together. Seeing strangers embracing to come together and celebrate the start of a new year was very cool and it was a perfect beginning to jumpstart our medical mission here in Guatemala! After celebrating and bonding with the group and getting more familiar in this new country, we start the work of our mission trip in Patanatic!
After tonight’s preparation meeting for the clinic and getting to know the streets of Panajachel, I am filled with a new kind of excitement and apprehension. Getting off of the plane in Guatemala, one of the flight attendants pulled me aside to say she was so grateful for our group and how cool it was for us as students to be able to learn in a community that could benefit so much from our actions. I know that as helpful as our aid in the community will be, we will benefit so much more from the experience. In this unique setting we are going to learn so much more from our interactions with the Guatemalan people, our amazing medical team, and one other as a group. Starting off the week I am so excited and grateful for the opportunity to put my practical nursing skills into action, form new relationships with a great group of people, and learn by doing. I hope our group will be able to bring the excitement and unity of our New Year’s Eve celebrations into the clinic as we start our adventures tomorrow!

January 1, 2012 Rabbi Abie's first impressions

January 1, 2012
Rabbi Abie Ingber
Antigua was superb. We arrived on New Year’s Eve just before dinner. The city was the ancient capital seat of Guatemala and arguably Central America but earthquakes and volcano eruptions eventually moved the capital to Guatemala City. People refused to abandon the 450-year-old town and eventually some reconstruction took place. Now, 34,000 people live there, but it is such a tourist draw that I would not be surprised if a quarter million were here for New Year’s. It was wall-to-wall people on the basalt cobblestone streets. Fireworks were everywhere, as were friendly folks and colorful costumes. There was a Times Square atmosphere in the entire city. While the students settled in a rested, we adults went sightseeing and ended up seated up front at a salsa restaurant with amazing salsa dancers. At midnight, we got a glass of complimentary champagne. Everyone hugged and celebrated. It was a great experience.
The students are really bonding. Today (with the help of a guide book) I gave them all a tour of the streets and churches and earthquake ruins. We have now arrived in Panajachel - our hotel village. It feels like home. Tomorrow, we set up our clinic and do 3 hours of home visits to diabetics, elderly residents, etc. Lots of climbing!
Tonight after dinner, we get our medical orientation.
Buenas noches!