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

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