You Just Have to Experience It

Before leaving for Guatemala friends told me that they couldn't tell me much about the trip – that I just had to experience everything for myself. They were right. The first two days in the clinic were full of guessing and problem solving as we started learning the system, were struggling with Spanish, and felt overwhelmed with the joy of all we are learning. Although I felt confused and in the dark at first, it has been rewarding to gain confidence with filling prescriptions, working with Dr. Lauri and Richard during exams, and fitting people for eyeglasses (even with little to no Spanish). It is hard to write about all that has happened and how it has made me feel – especially because I haven’t had much time to journal or think with how busy we have been. I want to take advantage of every moment we have here.

The first day in the clinic I loved getting to hold a 3 month old baby and making him laugh while Dr. Richard treated his mother. Yesterday I got to learn about filling prescriptions with Nurse Cathy and Stephanie. I really enjoyed counting pills and filling the scripts. That afternoon I shadowed Dr. Lauri with Brittany. We got to hear a heart murmur and see a tympanic membrane that was scarred from multiple earn infections. Yesterday I was able to help a woman with leg deformities be fit for canes to help her walk. It was really awesome to see all that I am learning as an Occupational Therapy student come into good use, especially because earlier in the year I was questioning my decision to be an occupational therapy major. Much of my questioning has been due to my frustration that as a senior, I have hardly had much contact with patients and not a lot of hands on experience. I have been reminded of this frustration on the trip because a lot of the younger students who are studying nursing have a lot of knowledge and experience. However, I have also been reminded of how much I want to learn and how important it is to me to be a health care provider. It has given me new motivation for when we get back to Cincinnati, even if I am frustrated with not having much hands on experience. I also have this motivation because I can easily see how what we are doing in the clinic relates to occupational therapy. We are restoring bits of health to people, so that they may more meaningfully participate in the things that they need to, have to and want to do. What we are doing does not and cannot change the state of poverty or the entire health care system of Guatemala; however, I see the value in helping just a few lead more fulfilling and meaningful lives.

What happened this morning in eyeglasses was a perfect example of just that. We had a few older women come in that had very bad eyesight. The first woman couldn't read our chart standing just a foot away from it. Our team worked hard to get her a pair of glasses so that she could see almost every line on the chart from 5 feet away. I honestly didn't think it was possible. It was a very special and powerful moment for all of us in the room and I am so glad that I got to share it with Rabi Abbie and Kathy. Like my friends told me, you just have to experience it.

I am writing this blog from the clinic this afternoon. I have to say that the time has flown by. There is so much to take it. We have amazing doctors and nurses who want to provide the best care to patients while teaching us as much as they can. They give us insights that wouldn't be learned in the classroom, making the week an invaluable experience. The clinic has also allowed us to learn more about the people of Guatemala, just as living in the area for the week has. The street that our hotel is on is full of life and culture for us to learn from. I have loved walking up and down the street with other students, discussing what we see and learning about each other. This may be the part of the trip that I have treasured the most – personal relationship and connection with the team, the patients, and the people in the community – even if for just a second or a few minutes. I can’t wait to see where the journey will lead us in the next few days. I hope to take some more time to reflect on the meaning of all that has happened and how that relates to my faith and life in Cincinnati, as there is no way that this trip could become an isolated event.

Thank you to all of you that are reading and that have supported us along the way. I wish each and every one of you could be here to experience it yourself. Thank you also to the team for being a part of the journey – you all inspire me to learn more and be more.

Rachel Snodgrass

March 4, 2014

A Beautiful Way to Wake Up

It is amazing to think that a few short months ago, I received the phone call saying that I would be one of the twelve students that would be travelling to Guatemala over Spring Break. This was really exciting news as this is something that I have wanted to do and experience. 

Over the next few months, we all met, fundraised, and bonded. I could not have asked for a better and more loving group as we all go on this wonderful journey together. During the months leading up to the trip, we heard from several different students that were once in our shoes and about their amazing time here in Guatemala. This only added to the excitement as we prepared for this adventure. 

When we arrive to the clinic on Sunday afternoon, it was not at all how I pictured it to be. After seeing pictures and hearing stories from the past, I created this picture in my mind of the clinic. The vans all dropped us off at the bottom of this steep mountainside where we would then walk up a little bit to reach the clinic. The view from the clinic was the first thing that caught my eye as it was absolutely breathtaking. You stood at the entrance of the clinic and to the left, in the distance, you could see the lake and one the right was beautiful mountain sides full of hard working Guatemalan families working on their terrace farms. It is amazing to think that in America, this piece of land with such a beautiful landscape would cost millions. 

After setting up the clinic, it was time for our first patients. On Sunday afternoon, I was in the glasses clinic, where I was able help individuals be fitted for a new pair of glasses. It was amazing to be in the glasses clinic as one woman I help started with 20/70 vision, barely able to see anything. After fitting her with glasses, we was then able to see 20/20 and her face lit up with a smile. It was really unique to have the experience with her and it is one that I will never forget. On Monday, at the clinic, I first started off in the prayer room. At first I was really nervous as my Spanish is minimal and I was supposed to read a prayer with the patients in Spanish. However, after some practice, I was able to improve my Spanish enough that it could be understood. It was amazing to be able to pray with the patients and to hear their own prayers afterward. Even though, I started off really nervous, it ended up to be a wonderful morning.

In the afternoon, I was in triage, which I was excited about since I was familiar with taking blood pressures and graphing children on growth curves. I really enjoyed my time in triage as we were slow and therefore able to really get to know each patient. I also had the opportunity to play soccer with some of the children in our free time, which we all enjoyed. There was one girl in particular, that never left my side and so we often sat and colored. Even though I could not communicate with her in full sentences, I was able to still get to know her and had a lot of fun with her.

As it was five o’clock, it was time to pack up the clinic for the day and this gave us some time before dinner to explore the town we have been living in for the past few days in the daytime. It was really interesting to walk around the street and see all of the Guatemala clothes, purses, book bags, etc. However, I quickly learned that you cannot wander around and just look at an item. As soon as you showed some interest, the owner would then grab everything that was similar for you to look at and would not stop until you bought something. Fortunately, I had Stephanie who has been a huge help in translating, I don’t think that I could survive this week without her.

Last night was a great night to relax a little bit and take in the true beauty that surrounded me. As today was the third day at the clinic, the days keep getting better and better. I started off the morning in prayer again, but was able to shadow and observe Dr. Lauri and she worked with the children. When we get back to Cincinnati, I will be starting my Pediatric rotation, so it was really exciting for me to learn all about the population and some little tricks that help when doing assessments on children. She is a wonderful doctor and really enjoys working with the children which really shows in her actions and her personality. In the afternoon, I was in the pharmacy, helping to count and dispense medications for the patients.

Overall, it has been a great learning experience and I cannot wait for tomorrow when we head across the lake to San Pedro for some more visits. I have quickly discovered that there is not a more beautiful way to wake up than to wake up in Guatemala knowing that you are going to meet and help some amazing people. I am so grateful for my experience so far and I don’t want to leave this wonderful place where everyone is some kind and wonderful.

Becka Hartman

March 4, 2014

The Art of Medicine

Where do I even begin? We arrived in the beautiful country of Guatemala a few days ago, but already my life has been changed. On our first day, we arrived in Guatemala City late so we spent the night in a hotel there. When we woke up in the morning, from our hotel room we could see a volcano billowing smoke. It was a wonderful surprise since we didn't even know it was there! That day we had a long car ride to our village. All of us were wide-eyed and excited to see Guatemala City and the country. We drove around mountain after mountain after mountain. The sights we saw were absolutely breathtaking. We arrived at our hotel which was in the middle of a marketplace. I was so surprised to see cars, motorcycles, tuk tuks (cute little glorified golf carts), stray dogs, and people all sharing one tiny cobblestone street.

After dropping our personal belongings off at the hotel, we ventured fourth to the clinic. More winding up steep roads brought us up to our workplace for the next week. I’m not sure how the clinic doesn't slide off the mountain. It’s perched upon the steepest hill I've ever seen. I don’t know how the vans made it. The view is absolutely gorgeous though! Our backdrop everyday is a massive volcano sitting behind the shining lake. The countless pictures I've taken don’t even begin to capture the essence of this place! After picking up our jaws from the ground, we began setting up for the day. My first shift was in pharmacy so I helped Nurse Cathy set up and organize all of the medications we brought. I learned to read scripts, fill prescriptions, and mix antibiotics from suspensions. It was incredibly exciting and Nurse Cathy’s stories from the Emergency Room made the day even better.

On Monday I worked with Dr. Lauri, who treated all of the kids, and Dr. Richard, who treated everyone else. Dr. Lauri was very much surprised when an entire first grade class came with their teacher. The kids were all very cute and generally healthy, but I learned the importance of having a documented medical history. Dr. Lauri did the best she could to treat whatever problems they reported, and we gave deworming medicine to all of them, but since the teacher was the only information we had, the physicals weren't as thorough as we would have liked. Knowing that I want to go into optometry, Dr. Lauri also showed me all of the tests she does on a child to detect eye complications. I was incredibly grateful for that and I could never get sick of watching her examine a child’s eyes. Lunch was prepared by women from the village and consisted of some sort of beef, tortillas (which are at every meal), guacamole, and salsa. I have to say, the salsa was the most delicious salsa I've ever tasted, and it was nice to have a homemade Guatemalan meal.

After lunch I worked with Dr. Richard (Nurse Cathy’s husband). I was very lucky to get to be with both doctors on one day! Dr. Richard was extremely thorough in explaining everything to us. I learned the proper way to write scripts and he taught us all about the importance of taking a correct blood pressure (and was very patient with teaching me as I’d never done it before!). We saw a few infections and gave a pregnancy test which were exciting! Richard also knew I wanted to go into optometry so during down time so he showed a group of us how to use an opthalmoscope and how to examine an optic nerve. I've shadowed optometrists before so I've done all of that, but that didn't stop me from shaking with excitement! Everything that I learn makes me that much more passionate about my future career.

My overall experience so far has been absolutely amazing! Everyone here is very willing to teach us and I've learned more than I ever could in a classroom. The most valuable thing I've taken away so far is the art of medicine. As Richard told me, it can be easy to take the easy way out and assume something about a patient, but doctors have to be incredibly thorough, caring, and even creative to treat a patient correctly. You have to be willing to go to a lot of lengths to look after the well-being of a patient. It’s so beautiful seeing the passion they have for medicine and for serving the people of Guatemala. It’s been a wonderfully irreplaceable experience and I feel so blessed to be part of it.

Kathy Kathmann

March 4, 2014

An Amazing Journey

This has been an amazing journey so far. I can't really believe that we are in Guatemala right now. This last couple of days I've woken up thinking that I am maybe at home in Texas because of the weather but then I step outside and realize, no Stephanie, you are in Guatemala!!!

So far we have had a day and half of clinic time and it has been incredibly busy. I think I imagined a completely different type of clinic. I am not sure what exactly I was expecting but I can already see myself wanting to do more work with these people.

Tomorrow is bringing another full day of work. Today we saw an entire first grade class of children that were probably the most beautiful children I might have ever seen. Tomorrow we will be seeing more children and some adults. I have been learnig so much about how to apply everything I've learned so far in the MIDAS program.

One thing that I have taken away from all of this in these few days is the amount of kindness each person in Guatemala has shown us. They have a respect that is not seen in the United States. I think we stand to learn something greater than our abilities by working in this community.

Stephanie Ibemere

March 3, 2014

A Snapshot of Day One

Click READ MORE to view more photos.

A Culture Beyond Rich

Yesterday was a very long day but none the less rewarding.

I was privileged to start my experience shadowing Dr. Lauri in pediatrics where we saw 17 patients in a course of four hours. There was a small language barrier that slowed us down but overall the clinic went by very smoothly. I was able to see very many healthy babies and I could NOT believe how well behaved they all were. We dealt with no screaming or crying babies, they were all patient, well behaved and genuinely happy to be here.

This difference between American babies and Guatemalan babies just show how the culture here is so gracious and thankful for healthcare. It truly touches my heart to see this because I feel like in America, healthcare is something we definitely take advantage of. Dr. Lauri was telling us about how in her practice back home she spends the majority of her day trying to convince parents to vaccinate their children. Whereas here in Guatemala they will walk to the city of Solald (not sure if I spelled that right) and wait all day for vaccination for their children.

The different dynamic of culture really makes me really realize all of the luxuries we have in America that we do not even realize.

As someone who has traveled often, I have realized how spoiled we are as a country but never through the eyes of other people. I have never been able to immerse myself in a culture as well as I have been here (and I have only been here for one day).

I feel like I could go on and go about the children I met yesterday and about how adorable, loving and grateful they were. The children were SO polite, patient and all around well behaved. At one point Dr. Lauri was preforming a check up on a little boy and I began to play with his infant brother. As soon as I reached out to play with him the father handed me the baby. As someone that has not had much experience with infants in my mind I was like ‘’ohhhh god, what do I do with this little guy?” I was wiggling him around trying to get him comfortable and eventually I had him (Daniel) settled on my hip, and before I knew it he was looking at me with the cutest grin on his face. I really feel like I will not be able to forget that little boys smile and how warm I felt while holding him. The fact that Daniel’s fathers handed me him without me even asking, really shows how much they respect they have for us here. He trusted me with his child with absolutely no hesitation. Something like this is really hard to accomplish in our culture and touches my heart that I am able to attain it here.

If you cannot tell I’m absolutely in love with this culture. I have been here for one day and I’m already thinking of how I will be able to come back.

There is no doubt in my mind that this trip is going to change my life. Just from writing this blog I have teared up twice. I cannot express how truly happy I am that out of the 90-some applicants I was chosen for this experience. This just gives me more of an initative to make the most out of my trip. It helps me realize that I am here for a reason and this is a part of my life I am supposed to have to mold me into the person that I am meant to be in the future. I am here with an open mind and an open heart, and because of that I know I will be able to transform myself for the better.

As Dr. Richard was telling us last night; we have to learn to listen to what others have to samy, see through others eyes and live through the experiences that they share with us. That is exactly what I plan to do and cannot wait to see what the next week has in store for me.

The people here are AMAZING, the children are perfect, and the culture is beyond rich.

Thank you for your time,

Kelsey Minix

March 3, 2014

Breaking My Heart Wide Open

This place and these people are breaking my heart wide open.

Each little smile that I encounter, each hand that I hold, and each adult that I manage to actually communicate with yanks the chasm that cracked open when I stepped out of the airport apart even wider.

I’m overwhelmed by the beauty of the volcanoes when we turn the corners of the crowded little streets. I’m overwhelmed by cold showers which wake me up faster than the crazy delicious cups of coffee. I’m overwhelmed by the temperate weather that has yet to fall short of what I consider an absolutely perfect spring day in Cincinnati.

But mostly, I’m overwhelmed by the humility. By the endless patience. By the gratitude and excitement that leaps from the hearts of these people, even when all that I’ve done is hand them shampoo or placed a sticker on their little shirts.

Equally amazing is the exuberance that has shined from each of those on the medical team as we’ve run through hallways, brushed teeth, pricked fingers, and struggled to understand sentences. They renew me endlessly and have brought so many tears to my eyes as they’ve shared stories and danced with babies. We all keep saying over and over again, “Is this real life?” I think that’s the best way to envelope the feelings we’re all experiencing so far because TRULY it doesn’t feel real. It feels too beautiful and too blessed to be real.

So yeah, my heart is broken in the very best way because now it’s so open and so full and so happy that I can’t wait to see what else this week has to pour into it.

Morgan Alexander

March 3, 2014

Medical Education Videos

In two short days Team Guatemala becomes Team Xavier as 12 Xavier pre-med, nursing, and OT students embark on Xavier's fifth Interfaith Community Engagement's medical service trip. For the last four years I have served as the medical director and team pediatrician as we have gone to the beautiful community of Patanatic, Guatemala. My husband, Chris Pramuk is a theology professor at Xavier, which is how I connected into the trip. Rabbi Abie Ingber is a close friend to both Chris and I, and as you know he is our trip leader. The rest of the medical team these past four years joins us from Los Angeles. They are: Richard Walter, and extraordinarily kind, compassionate, internal medicine physician; Cathy Walter, his wife, and phenomenal trauma nurse; and Bonnie Herscher, animal-lover, and also phenomenal trauma nurse. I can say of all of them that their friendship these past four years, through our time in Guatemala, I count among the most important in my life.

In years past we have asked the Xavier students to work in groups and create an educational poster in Spanish that we can hang on the walls in the clinic. We have had some fine posters in years past. But this year we decided to delve further into technology and take advantage of the TV that is in the waiting room in the clinic in Patanatic. In the fall the students chose from one of four educational topics: dental hygiene, prevention of infectious disease, pediatric nutrition and adult diabetes. I introduced the students to two wonderful, Spanish-fluent doctors here in Cincinnati, Dr Marie Callen, a pediatric dentist, and Dr Mayra Frias, an internal medicine physician. We also used the help of a friend of mine, Laura Bell, to help interpret. What the students did is make four phenomenal, brief educational videos in Spanish that will play in the waiting room in Patanatic. They will also be used to train community health workers who live in nearby communities.

These videos have the ability to empower the people in Guatemala through education. It will be through learning about disease and prevention that this community will thrive and rise above the poverty of their lives. This gift, given humbly by these twelve pre-healthcare students is their own legacy to the people in Guatemala that we are going to serve. We have not even left yet, but I am so proud to be able to work with these fine Xavier students. As they start their medical careers through this foundation of service to those who are marginalized in our world, they are truly being men and women for others. Ignatius would be proud too.

- Lauri Pramuk

It's hard to believe that five months ago 12 students were calling their families and friends to announce the exciting news that we had been selected to be a part of Xavier's Interfaith Medical Mission Trip to Guatemala. It's even harder to believe that today was our last day in the clinic.

As usual we were divided into stations: dental, vision, vitals, pharmacy, or shadowing. Each student quickly taught one of his/her peers how to work the assigned station as patients lined up for a consult. By the end of our week in the clinic we found a system to get people through every station in the most efficient way possible. I think that this is, in part, due to the strong relationships that our Xavier group has formed with one another but I also think it is because of how kind and patient the people of Guatemala are, allowing us to develop that system.

I am so grateful to this community for not only providing us with the medical experience of a lifetime but also for welcoming us into their community and into their lives. As people left the clinic they said "Gracias" to us as we said "Gracias" to them. I'm sure they assumed that our response was due to our limited knowledge of the Spanish language but in reality, they gave us far more than we could ever give them and we will be forever thankful. Although communication was difficult at times, smiles and hugs are universal.

Stephanie Jantzen

The 2012 Interfaith Medical Mission Trip has ended. The team is en route from Guatemala City to the U.S. this morning. The lives of many people have been changed.  The students and medical personnel cared for their villagers in Patanatic and were asked to also travel to San Marcos, which suffered an earthquake a few weeks ago.
Ask the participants to share their experiences with you. Again, they are:
Kiersten Mossburg of Fayetteville, GA - junior chemical science, minors in biochemistry, English.
Tess Petrozzi of Powell, OH - sophomore nursing major.
Ashley Luffred of Avon, OH - junior liberal arts, minor in psychology.
Grace Lambert of North Royalton, OH - sophomore natural sciences, minor in theology.
Adrian Center of Mason, OH - first-year biology.
Malia Smolenski of Loveland, OH - junior applied physics, minors Spanish, international studies.
Stephanie Jantzen of Cincinnati - senior biology major.
Ian Bentley of Cincinnati - senior biology, minors in chemistry and theology.
Sara Fieger of Cincinnati - sophomore natural sciences major.
Tom Gerbus of Cincinnati - junior biology, minors in chemistry and theology.
C.J. Oleksy of Martinsville, IN - sophomore business, minor in natural sciences.
Julia Miles of Indianapolis - junior biology major.
Katie Scheidler of Muncie, IN - program assistant and trip coordinator. A senior biology major, minors in chemistry and peace studies.
Rabbi Abie Inger, executive director of the Center for Interfaith Community Engagement at Xavier.
Dr. Richard Walter of Los Angeles, physician
Cathy Walter of Los Angeles, LPN
Dr. Lauri Pramuk of Cincinnati, pediatrician
Thank you to all who contributed and supported the team.

A gift of love

Clinic in San Marcos

Post Quake San Marcos

Kiersten's glasses show someone a new world

Kiersten in her old glasses

A new view of the world

I just wrote a blog yesterday. However, I witnessed a miracle today at the clinic and must share it with you. My apologies for making you read two incredibly long blog posts!

In the morning, I was in vision. This means I fit patients into eyeglasses. Before any patients arrived, Tom, Rabbi, and I were sorting thought the 2,000 glasses in the suitcases and organizing them by strength. As I was sorting, I came across my glasses from the third grade! What are the chances? It was our last day in the clinic, so I was one of the last rotations, and there were two others sorting through the glasses with me. I turned to Rabbi with wide eyes and said, "These are my glasses!!" He took me into the vision room and took my picture with them on. We decided to put them up and see if they would fit one of today’s patients. He said, "God, if by some chance you are bored today and have just a millisecond, it would be great if you could send a patient in that needs Kiersten's glasses. It's not a huge priority and not that important, but if you have a second and you're bored, this would be nice." We got back to work and finally, a patient came in. We fit her with glasses within a few minutes. Then, a second patient came in. I did a quick vision test and realized she needed a pair of the weaker eyeglasses. We worked with her to find two pairs that could work that she loved. Then Rabbi turned to me and said, "Let’s just try your glasses. I don't know if they will work, but it's worth a try." My hands were shaking. What if they actually did work? I placed them on her face and, when she looked up at the vision chart, her face lit up and she started looking at everything in the room. Her eyes were huge and she looked at Rabbi and me, exclaiming, "Perfecto!" I turned to Rabbi and said, "I'm about to cry!!" Rabbi ran out of the room to get a translator to explain to the patient why I was crying and what was going on. As we told her, I continued to cry, and she seemed so happy to know that her new glasses used to be mine. This experience truly was a miracle that not everybody can experience.
-Kiersten Mossburg

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 medications...one 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

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

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

CJ's pictures

Lessons

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

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

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

Pharmacy donated and purchased for the trip

Drs. Lauri and Richard and the interpreters