Saturday, January 5, 2013

Many years of heaven await

Hola amores!

I am sending a hello from heaven. With the way I feel right now and the view from where I am currently, that must be where I am. Guatemala is filled with the most beautiful sights and the most beautiful people.
I am so excited that I put off blogging until today because today was hands-down the most incredible experience I have had thus far. This morning our team rolled out of bed before the sun was even up (5:30 am) to make our last-minute trip to San Marcos. The village was hit by a 7.5 magnitude earthquake just a few short weeks ago. Although the four hour car trip to San Marcos from Patanatic was long, with multiple restroom breaks, a lot of speed bumps, some nausea, and a little confusion, I am positive there is not one member of our team who would not be willing to do it all over again for the experience we had in San Marcos.
No one could predict what we would see today. A few other medical teams had been to visit this community since the earthquake, but we had no idea what condition the city would be in after the destruction. As we drove around looking for our destination we found a city in recovery. While most of the buildings were still intact, evidence of destruction and the beginnings of restoration were apparent.
We knew we had our work cut out for us the moment we pulled up. Swarms of people had been waiting for an hour for our medical team to arrive. The “clinic” where we worked was actually a makeshift tin structure which had been housing 16 families who had lost their homes in the earthquake.
As we stepped out of the vans, there was some uncertainty as to where to even begin. How could we best serve these people who were clearly in such need when we only had a few short hours and limited supplies? How could we work in the conditions set before us? But our uncertainty was quickly replaced with focus and determination when we were welcomed by an older woman. She spoke for the group as a whole when she expressed the needs of her people and the gratitude that they felt towards us for coming to help.
We set to work. Lauri and Richard set up their examination rooms within the tin structure, using beds as examination tables. Triage was set up outside of the door and our pharmacy, held in suitcases, was set on a blanket in the street (and almost got run over, says Malia!). I was assigned to triage, testing blood glucose levels of the patients.
I set to work immediately and was completely immersed in my work. It was the same with all the other team members. Our work was hectic. After three hours, I realized I had forgotten to use the restroom (which I had desperately been needing to do since getting off the bus), had not eaten anything, and was still wearing a black jacket in the scorching sun. I worked with Tess and Ian in the midst of swarms of curious children, wandering dogs, crying babies, and long line of people. The area was cramped, the wind blew dirt over everything, and the sun was beating down on us. But I have never felt more satisfied with my work. Working with Ian and Tess was wonderful. After just a few minutes of adjustments, we had a great system going. We barely talked to each other, but just knew how to help each other. Tess was great with getting blood pressures despite the noise and Ian kept the line moving efficiently.
But all of the credit cannot be given solely to the three of us. We had an incredible little helper working with us. As we worked, a little girl stood by watching. As I am proud of the few Spanish phrases that I know, I asked her, “Como se llama?” (What is your name?) From that point on she became my assistant. She took out all my materials as a patient sat down, took away the garbage, and kept the papers from blowing away. She is just one example of the generosity and kindness we have seen in the Guatemalan people. I only hope that somehow our work has helped this girl who is clearly so full of intelligence and possibility.
Though I am far from being ready to work in the medical world, I am amazed by how much I have learned in just these few short days. Working in triage today allowed me to see this progress. The first day I had to take vitals, I was just collecting numbers. Today, I knew what I was looking at. I know what is abnormal and I know what to expect from the patients. It is a great feeling to know that I am steps closer to my achieving my goals. But it is an even better feeling to know that I was using my learning process to help others.
Because of the efficiency of our triage dream team, we had the wonderful opportunity of playing with the kids of San Marcos. I am constantly amazed by the children I have seen here. Three adorable girls got Tess, Ian, and I involved in a game that consisted of holding hands in a circle, hopping on one foot, and “eating” each other. The children are so patient and kind. We had kids ranging from toddlers to probably 10 or so all playing together harmoniously. Every child was welcome to play. No one became frustrated with the toddler who held up the flow of the circle, or the one who just kept wandering into the center. It was just simple unadulterated happiness, filled with lots and lots of laughter.
As I write this long post, I am riding in a van full of sleeping people back to Panajachel. The only way to describe how I feel is complete contentment. I am absolutely exhausted, a little sunburnt, and covered from head to toe in dirt, but I could not feel more satisfied. I am surrounded by breath-taking views of the clouds covering the mountains, finally relaxing after a day of doing what I love with 20 great friends. What more could I possibly ask for?
I must admit that there is some sadness in my about the impending conclusion of this amazing experience. Someone said this in reflection and it is my consolation about leaving Guatemala. The thing that I have love the most about this trip has been working in the clinic. While this may be the end of my trip, it is only the beginning of my medical journey. I love what I am doing here, and lucky for me, I will hopefully be able to do it for the rest of my life. My work has just begun! So it looks like I have many years of heaven awaiting me.
I send my love to my family. Love you guys! I can’t wait to share all of my stories with you.
Shoutout to the Center family from their wonderful daughter Adrian!
Grace Lambert

Thank you to everyone who has made this trip possible

Hola familia y amigos!

Today is already our seventh day in Guatemala. I can't even begin to describe to you all the experiences that all of the other students, our medical professionals and I have been through. I will try to show you a piece of what we've been through. I will start with our first day in the clinic...
Since I was in middle school, I've always known I want to be a pediatric dentist. So you can imagine I was a little bummed when I found out that I wasn't going to be at the dental station until Thursday. Instead, I started in pharmacy. What I expected to be just a day learning about different drugs and filling bottles with pills turned out to be one of the best days. For the first time I am reconsidering a future in dentistry. In the pharmacy, I got to spend the whole day with Cathy. She is an amazing human being. She let me do all of the work, while shared different facts about the drugs or stories about her experiences in many years in the ER. What makes her so different is that she doesn't just worry about my learning everything there is to know about every drug; she also takes the time to get to know me better and let me learn all about her. I appreciated every single story she told me, even those about how she met Richard! Cathy is such a great person, caring for each of us and making sure we are all having a great time. While in the pharmacy, filling the prescriptions and interacting with the patients about how to take their medicines made me so happy. Words cannot describe how much I enjoyed the job - it didn't even feel like I was working!
Monday and Tuesday were spent in Antigua. We toured the city and learned about the architecture and the history. On Monday night, Lauri told us the story of the process she and her husband went through when they adopted two of the most beautiful kids from Haiti. There was not a dry eye in the room. Hearing how she just knew those kids were hers and seeing the joy and love in her face makes me hope that I can be a mother like that one day. She really has influenced me into further considering adoption, along with having my own children, in the future.
We celebrated an amazing New Year together as a group. All 12 of us, plus Katie, left the hotel together, and we all stayed together. Ringing in 2013 with such a group of friends proves to me that this year will be a great one with great friends. Experiencing New Year's Eve somewhere completely different than the USA with my parents was very interesting. We all were in the middle of the city in the square. There were two huge lighted signs, one that said “2012” and another, not yet lit, that said “2013.” We had no idea what to expect because there was no "ball" to drop. We thought there might be a countdown, but no! At about 11:55 fireworks started shooting off. The next thing we knew, Tess said, "Guys, it's already 12:03!" We completely missed midnight! At about 12:10 the 2012 sign went dark and the 2013 sign lit up. It was OFFICIALLY 2013...only ten minutes late! Oh, and according to Rabbi, CJ and Sara got married while we were there. When we returned from Antigua Tuesday afternoon, we did some shopping before dinner. I mention this because we had quite an experience watching Adrian shop. Many people walk through the streets selling their handmade goods, like scarves, bracelets, and headbands, and come up to us asking us to buy. Adrian just couldn't say, “No.” She thought they were so cute. It started out with just a few headbands and eventually turned into scarves and more. It is the running joke whenever we go out shopping!
On Wednesday, we were back in our clinic! For the morning shift, I was in charge of taking the patient's blood pressure, heart rate, respiratory rate, oxygen level, and temperature. At first it was hard to communicate with the patients because I am not the best at Spanish. But, I quickly realized it wasn't that important. A smile is a smile in every language. When I would give a patient a smile, I could see the patient relax just a little bit more. When a smile would creep across the patient’s lips, I knew I was doing something right. All of my knowledge from Mrs. Phillips’ healthcare class was paying off! The best part of this job was taking vitals on the babies. Even though it was a challenge at times, the infants seemed so innocent. I got to hold a few children for their mothers - a miracle on its own. In the afternoon, I was in the exam room with Lauri. She is my role model. I'm pretty sure she could convince me that eating dirt was good for me. The amount of knowledge Lauri has is amazing, and the way she can calm a child and still assess him amazes me even more. As she would examine a child, she would walk Tom and me through her thinking and diagnostic process. What amazed me the most was how much she knows about every part of the body. She is a dentist, optometrist, and pediatrician all in one. She can look at a child's eye with a light and know immediately if glasses were needed. She even taught Tom and me how to look into the eyes and see the retina, which she didn't have to take the time to do at all. She can look inside a mouth and immediately see cavities, decay, and where teeth were extracted. While Tom scribed for her, I got to write all of the prescriptions out, since she knew how much I enjoyed being in pharmacy. While I was shadowing Lauri, a two-month-old baby came in with his mother and older brother. His older brother had a cold and the mother thought the baby was also sick. Lauri could have easily treated everyone with cold medicine, but instead decided to give the infant a closer look and fully determine what was wrong. Cathy took a rectal temperature for better results. This baby had a 102.5-degree fever. In the U.S., he would immediately be hospitalized for multiple tests. Lauri didn't know if the baby just had a bad cold or if it were something worse. The big problem... we aren't in the U.S. where we can get the infant to the hospital with no problem. Lauri had to make a quick medical decision. If she let this baby go with cold medicine, his condition could worsen and he could possibly die. Being the great person she is, Lauri got the people she needed and eventually figured out how to get this baby to a hospital. Whether this baby only has a cold or something worse wrong with him, Lauri made the correct decision. The next day, we got word that the baby was going to stay in the hospital for another few days. If this was only a cold or virus, the hospital would not keep him there. Lauri's medical decision may have saved this baby's life. Later that night, I got a chance to get to know some of my teammates a little better. Lauri, Adrian, Julia, and I were in a group. By looking at each of our pasts, we found similarities in our lives that led us to be the people we are now and why we are so passionate about what career we all want to pursue. This bonding continued after the reflection when Tess, Grace, CJ, Ashley, Stephanie, and I sat in the room for hours and just talked about our lives. This really brought our friendships to a whole new level instead of just a friendship that will only last for this mission trip. I have gained so much respect for the people on this trip who share their stories of struggle with me. By sharing my own, I learn so much more about myself.
Thursday we were in the clinic again! This time I was with Richard in the morning. We have decided that Richard is like Winnie the Pooh. He is one of the most kind-hearted people I have ever met. He has a desire to help people that not many doctors show these days. One of the most important things I learned from Richard is the importance of accuracy and getting all of the needed information to properly diagnose a patient instead of giving up and going with an option that you guess is right at first glance. For example, a woman who had a history of high blood pressure and high glucose came into the exam room. Richard showed us her past charts that said about a year ago she was placed on medicines to lower her blood pressure and lower her glucose. When her vitals were taken prior to coming into the exam room, both levels were normal. As she is on medicines that would seem right...or so we thought. Richard asked her about what medications she was on, and she admitted she had stopped her just last week. She said that she had had diarrhea for the past year, but it stopped about a week ago. Ok, so maybe the medicine is causing the diarrhea. Richard could have just put her back on the medicines since they seemed to help last time, but instead he took a step back and reassessed the situation. If she was off the drugs shouldn't her blood pressure and heart rate be back up? If they stay at a normal number without medication, we shouldn't put her on any drugs that are unnecessary. Richard told her to come back to the clinic in a few weeks and have her vitals taken again to see if they change. If they went back up, they would put her on a lower dosage of the drugs to hopefully avoid the diarrhea. Richard didn't take the easy way out by just looking at her history and refilling a prescription just to get to the next patient. He may have wanted to get to see all the patients waiting for him, but he taught me speed is not what medicine is about. If you miss something and give the wrong drug to a patient, they might get sicker, or in the worst case, die. The need for patience and detective-like skills, as Richard says, is so important in the medical field.
In the afternoon, I was in dental and I couldn't have been more excited. I brought children into the extra bathroom and let them pick out a toothbrush and then put toothpaste on the brush for them. I expected they all would brush their own teeth, with maybe a little assistance from me. The first patient did it all herself as I told her to make circular motions and to make sure to get the back teeth and the tongue. However, as I went to hand the toothbrush to the next little boy, he left his arms by his side and opened his mouth, showing me all of his teeth. Brushing his teeth, while telling him what I was doing, was such a great time! I have never actually brushed someone's teeth for them, but as weird as this sounds, I loved it! I love working with children's teeth because most of them do not have as much decay, they are baby teeth so they are in the process of losing them, and you can work on prevention with them. This solidified even more the fact that I want to go into pediatric dentistry.
As I type, I am sitting next to Cathy on our packed van on our way back from San Marcos. We left this morning at 7 am and took the four-hour journey to the city that experienced a 7.5 earthquake just a few weeks ago. The second we got there, we all went full force into helping the people of this community. Within minutes, the pharmacy was set up and I found myself working with Cathy, Julia, and Malia. What a great team! Julia would get the prescription and record it, I would make the suspension or count the pills, and Malia would make the labels and give them to the patients. Cathy's nursing skills were needed all over the clinic, so she was in and out. Tess, Ian, and Grace took vitals and were on a roll! I walked over at one point and they all looked the professionals! And the smiles on their faces as they helped these people were so inspiring to look at. Especially Tess. I watched her as she took blood pressures, and her body language communicated her passion for what she was doing. CJ and Sara worked with eyeglasses, and the rest of the students were with Lauri and Richard. Lauri and Richard did such an amazing job today. In three hours we got through more than 40 patients - amazing. At the very end of our time there, we handed teddy bears to all of the children. This was such an exciting experience to be able to give something that is so common in our lives to children who probably don't have stuffed animals to play with and sleep with every night. Last night we did a reflection where one person pretended to be a child from Guatemala and another person was themselves. In this part of the reflection I had to be myself. We were asked what our favorite possession was. Right away, I answered, “Fluffard.” Fluffard is my stuffed dog that I have had since I was born. He is at college with me and Tess even talked me into bringing him here with me, so he is currently in my hotel room! As I handed the teddy bear to the children, I just knew that this would be a favorite possession to at least one of those children.
Enjoying dentistry so much and having it be my passion for the past 8 or so years and loving working in the pharmacy has me so confused right now. I never thought that something would ever make me think about another career, but for some reason working in the pharmacy is so enjoyable. Maybe it is also because I am a chemistry nerd and the pharmacy deals with so much chemistry. I can just imagine my mom at her computer reading this, her elbow on the table, her hand in a fist under her chin, shaking her head with a smile on her face. She's probably thinking to herself, "Really, Kiersten? After taking the DAT and preparing to apply to dental school this summer, you’re just now rethinking this decision?" Haha, we'll talk about this when I get home, mom!
As for sicknesses, only a few of us have gotten a little sick. We all pretty much recovered in about 24 hours, which is great! We all are enjoying this trip so much and learning so much about Guatemala, the people of Guatemala, and ourselves. We realize how fortunate we are and how we need to help those not as fortunate as we are. Thank you to everyone who has made this trip possible!

Shout outs:
Malia says, "I love you all so much and I miss you."
Lauri says hello to all her familia!
Rabbi says, "The opportunity to serve to people impacted by the earthquake in San Marcos was one I will treasure forever. As one of our students Sara said: this puts a face to the word earthquake."
Ian says that he loves his parents, he's having a great time and he will call you when he gets home because he needs his stuff! He got his brother's email and he will still not see the Great Gatsby with him.
Julia says hello and how's it going!
Katie says hello to her awesome roommates and the best family ever!!
Fieger fam - Sara talks about you a lot! She misses you!!
Steph says Mom, Dad, and Anthony hello!!
Richard and Cathy say hello to Josh, Erica, Michael, Lily, and Nicole!
The perfect child says hello to her family and Tony!
Tess says to tell her mom that she cannot wait to tell her all about her experience!!
Mom and dad- I want to go out to eat when I get home to tell you everything! Love you mom, dad, Ty, and my amazing friends!!
-Kiersten Mossburg

Friday, January 4, 2013

All for One and One for All

Jewish and Muslim traditions both have explicit teachings that when one saves a single life it is as if that person had saved an entire world. Christian tradition similarly celebrates the saving and sanctification of every single life.

Our work in Guatemala brings these teachings together in a beautiful way with the Mayan teachings of a person's obligation to the earth, God and humanity.

Our students are incredible - from the first professional welcome in triage to the last stop in our teeth brushing dental area (one of two sometimes functioning bathrooms) our students elevate each patient and do what they have come to do - heal our broken world one person at a time.

But Wednesday brought a challenge to our team that was unexpected. A two-month-old boy was brought to the clinic with a 103-degree fever and a respiratory infection already one week old. Dr. Lauri and her team of student shadows assessed the infant as best they could, given the absence of X-rays and certain hospital tests. Dr. Lauri was faced with a dilemma. If the infection was viral, a normal course of antibiotics would suffice. But if it was bacteriological, the baby could die in a matter of days or hours. She knew what her practice and her medical insight would do in the U.S. The child would immediately be taken to the hospital for tests and special evaluations to determine the microbial cause of the fever and illness. But our little mountain village was two towns away from a hospital.

We knew what needed to be done. Katie, our student fellow, called our driver Pedro and our van was at the clinic in minutes. The mother and child, a local clinic worker and I jumped into the van for a very fast mountain ride to the hospital. Every few minutes I turned to the mother and smiled as if to say, "I know this is scary, but we have to do this and everything will be OK." It was easier to smile that expression than to try it in my very broken Spanish.

When we got to the hospital my green scrub shirt with the Xavier logo gave our van access to the emergency room gated entrance. We rushed the child into the emergency room and a nurse immediately put us on a hospital cart. Dirty curtains separated us from the next patients. The hospital cart was covered in a torn striped sheet with stains of many previous visitors. An armpit thermometer check confirmed how sick our baby was and we heard a call over a speaker for a pediatrician to come to the ER. We were relieved by the speed of the attention. Fifteen minutes later we were told the pediatrician would be delayed because of the shift change. Every minute was an eternity. My heart beat with the labored breathing of the baby boy. My eyes wandered to the dried old blood on the floor and the absence of a clean environment at the table which served as the ER nurses' station. The mother nursed only long enough to quiet her child - she too was anxious. After about a half hour the curtains opened and a blue scrub-uniformed man came into our curtained area. I did not understand him at first. Then I realized he thought I was a doctor and was in the ER looking for a doctor to help him! We need some help ourselves," I thought.

A half hour later a well-dressed pediatrician pulled aside the curtain and immediately took over. I was dismissed with the clinic volunteer leaving only the mother and baby with him. I reiterated what was written in Dr. Lauri's prescription for medical services and tests. I walked out of the ER and boarded the van for our quiet ride back to our clinic in Patanatic. We all went to sleep that night not knowing what had become of the baby.

This afternoon we received word from the family that the baby would be hospitalized for 3 - 7 days for intravenous medicine and testing. In all likelihood that course of treatment is reflective of a very severe life-threatening infection.

Every one of our students, every one of our professional medical team, everyone who had donated to our mission sent us to save a world which we did in the life of a two-month-old baby boy. In the village of Patanatic and in the hospital of Solola, we did not disappoint.

Gracias a Dios.

Rabbi Abie

Pato, Pato, Ganza

Hola familia y amigos!

I apologize for the delayed post. I was supposed to blog yesterday, but a pizza craving pulled 6 of us away from internet access for the night as we sought to fulfill our stomachs’ desire. While those reading may not understand the choice of pizza over media, the 12 medical mission students would surely go for a Big Mac, fries or an American pizza after 5 days of meals consisting solely of rice, veggies, and chicken.

Recalling yesterday’s events the team enjoyed the second full day in the clinic. I spent my morning with Dr. Lauri in pediatrics enjoying the precious little ones, snotty faces and all. My time with Lauri was an incredible learning experience. She taught me so much through what we saw and heard from the patients. I learned what an “excellent” (as Lauri calls them) ear infection looks like, saw possible HPV warts, and experienced the joy of calming a mother’s continued concern for her child. We also were able to treat several children with stomach bugs/parasites. As Lauri proceeded with checkups, it was hysterical to watch the children laugh at one another as their reflexes were checked. No matter how many children went through the process, the children watching always chuckled at the results.

In the afternoon I got to experience more child laughter as I was positioned in triage. Here, with help from Ian, I managed blood pressures, heart rates, etc. We were a bit shaky at first with the squirmy kids, but we quickly got into the flow of it. Triage was pretty quiet in the afternoon, so Sara, Malia, C.J., and I enjoyed playing with the kids. We spent hours playing Pato Pato Ganza (aka Duck Duck Goose) where Malia became a quick fan favorite amongst the kids and I naturally claimed the little toddler. While my afternoon was filled with games and laughter, this cannot be said for all the children at the clinic. One 2-month old was rushed to the hospital due to a 103-degree fever. Our thoughts and prayers are with the worried mother and ill child as they continue treatment today.

Dinner and reflection follow an exciting day at the clinic. Yet another night of chicken and rice, but a wonderful reflection helped fill the soul. We were divided into groups of four to discuss why and how each of us sought interest in the medical field and this medical mission. Kiersten, Adrian, Lauri and I were grouped together. It was incredible to hear everyone’s stories and find such similarities as to how we found a passion for medicine. My heart ached as Adrian shared a piece of her story of her past year in Haiti, but the group’s different life struggles brought us closer together in our common dream to serve and improve the health of others.

Julia Miles

Thursday, January 3, 2013

Duck, Duck, Goose

Today was our second day at the clinic, and the first day that I rotated out of triage into the back rooms. We had a really early morning today. Breakfast was at 7:30 and we were in the bus winding our way up the mountain by 8:30. After a couple minutes of chaos while everyone tried to get situated in their new stations, Grace and I settled and began to wait for the first prescription to fill. And wait. And wait. And wait. We started at 9:00 and it was easily 11:00 or 11:30 before we got our first prescription.

But that wasn't an issue at all, because Kathy kept the two of us so entertained with her war stories from the ER. I would have been more than happy to just sit there all day and listen to her stories. I learned so much about the things that can happen to people and the ways that we can work to heal them. Also, I learned where stones are the most painful, how to know if you have them, and what the biggest risk of high blood pressure is - all things I never knew. We also touched on the health condition of a certain head of the state department. It was so much fun and so incredibly informative. It made me look forward that much more to when I work with Dr. Lauri and Dr. Richard at some time over the next four days.

My lunch was provided by a local Guatemalan family - and it was fantastic. It occurred to me about half way through that meal that maybe the meal wasn't all that sanitary, but nonetheless, it was some really good chicken and rice.

After lunch, I was scheduled to go back out into triage and take the blood pressure, heart rate, respiratory rate, etc.... of all the patients. At first, I was a little bit bummed about that, because I did triage all Sunday, but once I got out there I really enjoyed it. The actual taking of the vitals was quite straightforward and sort of boring (although it's always interesting to take the vitals of the babies when they come in), but during my down time all of us in triage played with the small children whose parents were waiting to see Dr. Richard in the clinic. And that was quite an experience. If I was able to upload pictures and videos from my camera to this blog I would. Playing Duck, Duck, Goose with the little children was so much fun. They absolutely loved it. And as much as they loved it, I can guarantee that we enjoyed it much more. I've heard so many people say that they just want to take a Guatemalan child home with them - and today, for the first time, I really appreciated the sentiment. They are just adorable.

Ian Bentley

Wednesday, January 2, 2013

CJ's pictures


Dear grandma,

I'm alive. I'm sure you have been worried. Please see previous blog posts to catch up on our experiences thus far.
Yesterday morning, we began our long drive through the mountains to Antigua for our New Year's celebration. After eating relatively rustic food for the first days of the mission, it was a relief to finally eat at a modern cafe. We had delicious sandwiches before walking down the cobblestone streets to the famous archway at the end of the street leading from the city square. After stopping frequently to take pictures at every angle, we finally reached a building known as the Yellow Church. Covered in statues of saints and painted a golden yellow, the church was a beautiful piece of architecture contrasting with the deep blue sky. We had time to explore the streets where vendors sold artisanal goods and textile products. Walking back under the archway, we came across an elderly native woman selling hand-painted oil paintings. Being the compulsive shopper that I am, I had to have one featuring the beautiful archway that we happened to be standing under. (Side note: I have proven to be the expert at haggling vendors into getting souvenirs for cheap prices.) After finishing our shopping, we made our way back to our hotel. The hotel has open atriums covered in bright orange and purple flowers surrounding a stone fountain. We all decided to make our way to the rooftop where we experienced quite possibly the most stunning views of the trip so far. With the weather being in the high seventies, we basked in the sun on the roof listening to music before getting showered and ready for the evening ahead of us. After dinner, we went downtown to celebrate in the square with thousands of Guatemalans, Americans, and other world travelers. After a long night of fun, we woke up this morning and took a walking tour of the city where we saw ruins of cathedrals and several exciting other churches. After the tour, it was time to check out of our gorgeous hotel and head back to the city of Panajachel where we had a nice dinner and got gelato (ice cream) for dessert. We closed the evening having a group pillow talk session for team bonding.

So far, I have already experienced so much and discovered and learned so many lessons about the world and myself. I sit and think about the life that I have been blessed with living in the United States and compare it to the limited means that the people that I have come in contact with here have. Experiencing their community in person really puts life into perspective for me. One of the most amazing sights to see is small children, even toddlers, wave at cars passing by as they stand on the side of a winding road on an incredibly large mountain. Something particularly notable happened today once we arrived back in Panajachel. We had all been craving ice cream on the long trip home and we decided to search for it when we got back. After looking on the main street for quite some time, we found a store that sold some to our liking. Grace paid for her ice cream when a small native boy confronted her asking for her to buy him one. Instead of buying another, she graciously gave him her own. Acts like these make this trip a life changing experience. I've realized how much that I take for granted every day at home and it has really opened my eyes. I knew that I was signing up for a life changing experience, but I did not expect it to happen within 48 hours. I could not be more grateful for the chance that I have here to study and learn about something I have a true passion for by some of the most distinguished doctors and compassionate human beings I have ever met. I also cannot imagine being here with anyone else than my fellow Xavier students. We have grown so close this past semester and we all have connected on such an awesome level. This trip is turning out to be everything I had hoped and so much more. I hope to carry these friendships and connections that I have made for the rest of my life.

-CJ Oleksy

Luisa in 2013 - see the miracle

Luisa in 2012 - note the rigidity

Disability in the developing world

One year ago, in Guatemala I met a beautiful baby named Luisa. Her family had just celebrated her first birthday. She was the youngest of seven children. Her mother brought her to the clinic wrapped up in a sling, nursing, like most mothers here in Guatemala. While taking her medical history from the mother it was evident before I could even see her that she had some pretty profound medical issues. Her mom wanted to know why she could not sit, crawl, walk, talk like her other children had by this age. She also could not get her to take anything in her mouth other than breast milk. The little girl would block anything from her mouth and gag. When I put Luisa on the exam table we saw a beautiful little girl with severe cerebral palsy. She was microcephalic (small head circumference), and she could not hold her head up at all. Her legs were held in a tight scissor lock, her wrists flexed, fists balled up. Her mom and I had a long talk that day about cerebral palsy and her prognosis. CP in the U.S. is difficult, here it is devastating. Her main obstacles facing her were aspiration risk, most of these kids die of pneumonia since their muscles don't work properly to protect their airway. Luisa had it last year when I saw her that we treated. Her other main risk was malnutrition. The family needed to keep trying to get her to accept something in her mouth other than her mother's breast. We talked about working with Luisa's muscles so they don't contract - get stuck in one place.

Well, beautiful Luisa and her strong mother came to see me our first clinic day this year. Her mom was smiling this year. Once again, Luisa was wrapped up in her sling nursing as I asked her mother my litany of questions about her developmental progression, her diet, what kinds of illnesses she has had in the past year. She just turned two last week. I have to be honest as a part of me was not sure she would even still be alive this year. Her mother was happy to report that she can now roll over and control her neck, holding her head up, and she is taking some soft foods and allowing herself to be spoon-fed to some degree. When I asked her if she had any words, she smiled at me and said, "Yes, she says mama". Rabbi Abie says that is the only word she really needs. She smiles and laughs. She has not had a pneumonia since I saw her last year. When I examined her I was shocked by her muscle tone. She was no longer contracted, but was very loose. Her hypertonicity was replaced with hypotonicity. Fingers were not balled up, wrists not flexed. Her mom had been working with her muscles, doing her own occupational therapy. She can hold her head up well. She is in much better shape than I had imagined. She still faces a long road. I doubt she will ever walk. She clearly brings so much joy to her mother, and to me.

After her exam her mother wrapped her back up in the sling and sat down so we could talk about what things to watch for with her, Luisa clearly wanted to start nursing again. Her mother had her laying across her lap but did not have her shirt up so Luisa could get to her. The mother was keyed into everything I was saying but I just kept getting distracted by Luisa. With her little hand she was trying with all of her might to get her mom's shirt up so she could nurse. She was fighting for life. She is a survivor because of that fight.

Dr. Lauri Pramuk

Jan. 1 Downs and Ups

Hello to all back home! I hope your New Year’s celebration was fun and filled with family and friends, as ours was spent with people I don't hesitate to call my friends.

After spending the day driving to and exploring Guatemala, we had dinner and went into reflection. Rabbi asked us that we state our greatest happiness from 2012 and our wish for 2013. I thought long and hard about 2012. It was full of adventure, sadness, new friendships, and great memories, but I knew what my greatest happiness was. 2012 marked 10 years cancer-free for my Grandma. I said my greatest happiness was the continued health of my family, and I hoped 2013 brought my family the same good graces.

Rabbi talked about ups and downs and he changed the phrase. Downs and ups he said. You go from the downs towards the ups. I thought the phrase was so great. Thinking of just the downs in the preparation for the trip and then the ups we achieved.

Lauri told the wonderful story of the adoption of her two children from Haiti. It had us all in tears, happy and sad. A perfect example of downs to ups.

NYE was great, full of fun experiences with people from all over the world. It felt like the place to be! At midnight (well 12:10 because they were running late) the celebration of the ball drop occurred. Fireworks and lanterns filled the sky. We were talking to a British man named Indy, and the joke was that I was convinced that he looked like Zayn from One Direction. Of course I saw the Mediterranean skin and British accent and just pictured Zayn for the entire conversation. Mom and Josh - he is a Manchester United fan, continued street credit given from out premier league love.

We went through Antigua today, seeing the old churches, and buildings. It was fun and of course beautiful. We drove back to Pana and did our shopping. It was so fun to see us all bargaining with the locals!

We ended with reflection but really it was just laughing for all of us, one of the great abilities about this team. Remind your kids to tell you about the disease, dogged jaw.

Pillow talk last night with the team was fun and full of laughter, however, I admit I was falling asleep. As I am now. Back to the clinic!

Much love,

Sara Fieger

Tuesday, January 1, 2013

Jan 1 - Sara Fieger's photos from Jesuit Residence

Dec. 31 I Love You

This place is amazing and more beautiful than can be described. I have heard many people say, “I want to move and live here forever!” I’ve taken so many pictures and have learned so much already. The connection I have made with the people here has made this country even more beautiful to me. I miss my family very much and cannot wait to tell them about my trip and all the things I’ve learned. Tell my family I love them,
Malia Paige Smolenski

Monday, December 31, 2012

Tom's photos of the first day

The vans arrive

Dec 30 More than the physical

Words cannot describe my day. It started this morning when I woke bright and early at 8:30. After a delicious breakfast, we were on our way. After a 15-minute drive up the steep mountainside, we arrived at our destination. The scenery was gorgeous. We could see all of the terrace farms, the lake in the distance, and plenty of natives climbing the steep mountain trail. When we got there I didn't even realize we were at the hospital. From the front, it looks just like a meeting center. Once we went around back you could tell that we were in for a special surprise. As you enter, on the left is triage, including height, weight, growth curves, blood pressure for adults, heart rate, respiratory rate, gluco stats, and an eye exam. As I continue down the hallway, to the right through a big set of doors are two bathrooms. In one of them is a big dentistry kit with a giant inflatable toothbrush and many small dental hygiene products. In the other is a bunch of cleaning supplies and a bucket to bring water from the well to flush toilets. Down the hallway is a soon-to-be X-ray room, a pharmacy, 3 clinic rooms, a laboratory being set up, an optometry/dentistry room, and a back room for us to eat in. To begin our day, we sorted 2,040 pairs of eyeglasses. Most of the team sorted glasses into light, medium or heavy, also known to our patients as suave, medio, or fuerte. We also have a random stack of sunglasses and bifocals but haven't really used the bifocals and have only given out a few sunglasses. After doing that for 45 minutes we prepared for setup. The pharmacy has been set up by Dr. Lauri, Dr. Richard and nurse Cathy. We put as many of the glasses onto the shelf as we could and were divided into our positions for the rest of the day. I was assigned to triage with Stephanie, Ian, and Grace. Kirsten was in charge of the pharmacy, Tess and Sarah were with Dr. Lauri, Maliah and C.J. were with Dr. Richard, Ashley was in optometry and Julia was in dentistry. Thankfully for us, David and Katie floated around to help with our (ahem) beautiful Spanish as well as our two lovely local translators, Michel and Diana.

After a quick crash course in triage, our first patients arrived. Soon, my first patients came to get their eyes examined and their glucose checked. I will be honest and say I was very scared. Not only was I doing something relatively new, I was fighting a barrier with a language I had not used in years. However, with some Spanish holophrases and much pointing, I was able to get my point across. Even though my role was important for everyone downstream, I did not feel that I was truly connecting with the patients and their families. I would have to go out on a limb and really attempt to use my Spanish. This only became more and more evident as the day progressed as I really felt like I was missing something. I’m not quite sure how, but as everyone became more proficient at communicating in their own way, communication became - dare I say it - acceptable. It was then that I really started to connect with the patients. I asked several of the kids what they liked to do for fun, what living was like in Guatemala, what the adults did for work and for fun and I realized how much I had to learn. The best part was that as I became more communicative I could be more receptive. The gratitude on the patients’ and the parents’ faces when I took the time to explain to their child how we might be able to help their vision or that their glucose levels were okay, was something to see. As the day has progressed, I have increasingly begun to realize something inside my head is changing about how I view medicine. I cannot put it into words at this point, but my grip on what I thought medicine should be is loosening. On reflection now, I believe that the communication barrier was serving particularly well. By the look on the Guatemalans' faces I could tell they trusted absolutely without a doubt what the doctor had told them. At first glance this should seem like a no-brainer as I thought science is a universal language. However, when I heard stories of the problems these patients were running into in local clinics, I realized there is far, far more to medicine than just the science of treating symptoms. I always "knew" a doctor treats another human being, but I never really thought about what that entails. A person is more than the sum of parts and medicine should respond to all of a patient. What may work in one culture with a patient of certain values could be disastrous in another. Medicine must take into account the spiritual aspect of healing as one is usually not just getting rid of a bacterial infection. A medical professional is bringing joy, healing, hope and a new chance in a family to be closer. Medical professionals are in the unique circumstance of altering far more than a patient's physical health. They give hope. The only way to learn this is by realizing what one can take from another in healing. As Dr. Richard succinctly put it, "One thing you will realize is that when you leave a place like Guatemala is that you will not even realize what sort of ‘good’ you did or help you gave. You will only leave thinking of what you have gained as a medical professional and most importantly, what part of you has been enriched by your time here." And I believe that will be the heart of this trip.

Tom Gerbus

December 30 – The First Day

Today was the first day at the clinic. We traveled about 15 minutes up the mountain on very narrow roads, while navigating around the sharpest curves. At some points, I thought we were going over the edge. The clinic is very nice and has different rooms for exams, pharmacy, eyes, and check-in. Because it is near the top of the mountain, we can see the lake and the volcano in the distance. It is the most beautiful view and neither words nor pictures can do it justice.

After arriving, we started to unpack the medicines and glasses. Most of us were outside in the beautiful weather sorting through the glasses, deciding whether they were weak, medium, strong, or bifocals. A few of us estimated that there are about 2,450 pairs of glasses donated! Each team member was assigned to a station. I was the eye doctor for today. This consists of having the patient read from the chart and then deciding from that what strength glasses are needed. This was especially challenging for me. I know absolutely no Spanish and this job required a lot of talking with the patient. I had a crash course on simple words that would pertain to my job, such as better, worse, same. The first two patients were very rough. I don’t think they understood what I was saying at all and probably thought I was crazy because I was just saying one word to them but that was all I knew. However, after the first few, I learned what to say and it ended up being very successful. I used a lot of gestures and facial expressions to communicate with them and they responded very well to that.

The first patient I saw was a 19-year old boy who ended up not needing glasses but I had him chose a pair of sunglasses and he thought he looked like a rock star! The next patient had terrible vision; it was about 20-200 which meant that she could not see the top line which has the largest pictures. I went straight to the strongest pair of glasses I could find. She was so excited when her vision improved. I could tell from her facial expressions that she was amazed at how well the glasses worked. It took a lot of trial and error to find the best pair for her, but we found a pair that took her to about 20-30 which is nearly perfect! Another patient was an older gentleman who had about 20-50 and he was ecstatic to be able to see. It was amazing being able to help even though I know nothing about being an eye doctor. By the end of the day I was a pro at helping them find the correct eyeglasses and loved seeing their reaction when they could finally read the chart.

-Ashley Luffred

Sunday, December 30, 2012

Pharmacy donated and purchased for the trip

Drs. Lauri and Richard and the interpreters

Redefining wealth – Dr. Lauri Pramuk

I find it ironic to be leaving the United States on the eve of the fiscal cliff en route to humble Guatemala. This is my third year as medical director and pediatrician for the trip. Each year it seems to serve as a reset button for me, reminding me of what life is really about and why it is that I choose to practice medicine for my vocation. This morning I find myself already full and reset and I have not even seen one patient.

After a full day of travel yesterday leaving snowy Cincinnati and arriving in 80 degree Guatemala, the medical team finished our night by sitting down in the restaurant run by our interpreters' father. Our two wonderful interpreters for these last three years are two beautiful sisters in their early 20's, Diana and Michel. Richard, our internal medicine doctor and I joked with each other after our first day of clinic the first year that Diana and Michel are smarter than most medical students we have ever worked with in the states. The girls easily move between three languages: Spanish, English and Katchichel (the Mayan dialect in the village we serve). They very easily memorized every question Richard and I ask in our histories. They are little knowledge sponges. After they finish working with us all day they spend the evenings playing in a fantastic traditional Mayan marimba band in their father's restaurant.

So the trip feels real for us when we get to see Diana and Michel with their father, Miguel. Miguel has had a very difficult last year of his life. He shared with us last night how it was his community, both here in Guatemala, and people he knows around the world of all different faiths who prayed for him and lifted him through this difficult time, including our group and Rabbi Abie. He spoke in metaphors like a poet about needing to send love to your enemies. Now that he is through some of his hardship of the past year he is looking to the next way to help his village where he was born. He said he knows he is not a wealthy man, but the love of his community and his family make him more wealthy than the stars. Miguel understands real wealth. Thank God for Guatemala. Thanks for the reset button, now only if the rest of the United States could have been sitting at that table last night, the fiscal cliff would not be so domineering.

Dec 30 - Hello family and friends!

After a few bumps along the way, we have finally made it to the beautiful country of Guatemala! This morning, Tess, CJ, Adrian, and I woke up at 4:00 a.m. in my house to quite a few inches of snow. I mentioned to the others that I have never driven in snow, but they hesitantly jumped into the car with me...or so I thought. CJ hadn't quite made it into the car by the time I started backing up. After a flurry of screams (and some laughs), I stopped the car and CJ climbed in. Don't worry Mrs. Olesky, your son is perfectly fine! After sliding into a parking spot on campus, we loaded our bags and were on our way to the airport!

I sat on the plane next to CJ and Tess. As we were preparing for our naps, one of the pilots came over the speaker system and told the passengers that a group on the plane from Xavier University was going to Guatemala for a medical mission trip. He explained all that we will do while in Guatemala, and a passenger in the front of the plane started clapping. Before we could even register that this announcement was about us, the entire plane erupted in applause. Tess, CJ, and I looked at each other, stunned at what just happened. We did not come on this trip for applause or praise; we came to help others in need, others less fortunate than us. However, this applause...for us...made it all become so real.

At 9:00, we arrived in Atlanta with only a few minutes to spare before our flight to Guatemala. We must have been a hoot to watch running through the airport! We got to our gate in just the nick of time. We boarded, and then we were off on a three-hour flight to Guatemala City! I sat next to two of the nicest gentleman on the plane. One lives in Philadelphia but is from Guatemala. During the flight, some of us were practicing our Spanish, and he would kindly interrupt and tell us the correct way to pronounce a word or would help us translate English words to Spanish. Eventually, he put in his headphones, which were playing his music incredibly too loud. And before I knew it, he started to sing out loud! He continued for pretty much the rest of the flight. I couldn't help but smile at this man's carefree ways. He consoled me when I started to cry while watching The Odd Life of Timothy Green. As we landed, he turned to me with a smile from ear to ear, and exclaimed, "Welcome to my home country!" I couldn't have asked for a better welcome. These men on our flight gave me a glimpse of just how kindhearted the people of Guatemala can be.

We breezed through customs, and finally walked out of the airport onto the soil of Guatemala. As we walked out, we saw hundreds, and I am not exaggerating, of people waiting to meet their loved ones. They were hooting and hollering, jumping up and down, and waving their arms. They seemed so happy. As a frequent flier to and from home in Atlanta, I often see people waiting for their loved ones when I leave the airport. Only I never really notice if they are happy or not. They usually have straight faces. Here, however, I became happy just seeing the pure joy on these faces.

We met our two vans and split up into two groups. Our driver climbed on top of the van and took each of our suitcases and strapped them on top of the van. We each had at least two suitcases, so this was a sight to see! We stopped to get food, and then took off on the three hour (or so) drive to our hotel. Our whole van fell asleep for most of the ride. We were so tired! However, when we were awake, the sights were AMAZING. If I could post all of the pictures we took just from today, I would, but I can't! Sorry!

Around 6:30 we arrived at our hotel. Right away, Sara was bombarded with lovely women trying to sell her a scarf. Sara just did not want one though, so the lady moved on to Tom, who bought two. We went to our rooms. The three boys are in one room, Malia, Adrain, and Grace are in a room, Katie, Sara, and Julia are in a room, Tess and Steph are in a room, and Ashley and I are in a room. The rooms are so much greater than what we expected. We each get our own bed, and the bathrooms are phenomenal, but we won't be spending much time in our rooms.

After dinner, we had our first reflection that I thought went very well. We went out to walk through the streets and learn about where we are staying. Rabbi told us where the greatest places to shop were and where the most expensive merchandise is. While out, we got to meet our two translators. These girls are in their early teens and are the cutest and so sweet. As we were meeting them, they just stood there and smiled. We cannot believe that these young girls are working in the world at such a young age. I am looking forward to getting to know them so much better throughout the week. After a small tour, and a small explanation on where not to go, we all decided it was time to hit the hay. After all, we did travel for quite a few hours today!

As I sit here typing, Adrian just came down to inform us she just flooded her room because she forgot to unplug the shower cap...this is going to be an entertaining week! ha!

As you can see, we are having a BLAST. I hope you enjoy our blog and love all the pictures! I am sending love from each person in our group. Malia says hello to all her younger siblings! And I miss you Mom, Dad, and Ty! Love you all!

Kiersten Mossburg

Dec 30 - Bienvenidos a Guatemala

These three words we have heard scattered throughout our day. They barely begin to describe the hospitality of the Guatemalan people. Most important: these three words officiate the beginning of our stay in Guatemala.

Before I get too ahead of myself, I’ll start back to this morning, when we woke up to the snow-filled streets of Cincinnati at 4 am. We somehow made it to the campus police station on time, but also almost backed over our beloved CJ when leaving Kiersten’s house. But not to worry, we all made it to the airport in one piece. Our welcome on our flight to Atlanta was when the pilot made a special announcement for our group, which elicited applause from the entire plane. That was a special and humbling moment for all of us, and I was surprised by the gratitude our fellow passengers showed us.

What those passengers may not have not known, however, is that although we will be helping the citizens of Guatemala medically, they will help us in ways we cannot yet imagine or put into words. My last trip to Guatemala has shaped me into the person I am today in innumerable ways, and I cannot begin to envision what this next week has in store for each one of us. The happiness I feel engaging with this culture is absolutely indescribable. The sights, smells, and sounds that filled the streets as we walked tonight were exhilarating, and we are all anxiously awaiting what tomorrow will bring. Our group grows closer with each minute we spend together, and I know that by the end of the week we will have bonds and memories that will last us a lifetime.

My group requested that I send a “Hi Mom!” from each student, and assure parents WE ARE SAFE AND ABSOLUTELY ECSTATIC. So really, Moms, no worrying. Malia sends a shout-out to her siblings to say, “I miss and love you!”and Sara sends a special message to her grandma to say, “Miss you!”.

Sending love back to Los Estados Unidos,

Tess Petrozzi