Sustainability

I just returned from Guatemala and this year’s Interfaith Medical Service Project. This was my second year joining this group of amazing individuals, and my first year where we could bring students along with us. 

As I reflect back on our week in clinic I want to talk about one of the underlying concepts of this project. One of the biggest draws for me to this group of professionals is their faithfulness to the concept of sustainability.

Prior to going on this trip Dr. Stephanie talked to the group about sustainability and building capacity. She is a passionate and awesome speaker, but seeing is believing. You have to live it to know it. 

During our time in Guatemala this year I was able to educate the students on how we manifest our emotions and our worries, our stress in our physical bodies. I was able to show them how we, as healthcare providers, can help a person release those things in order to help improve their quality of life. I had the opportunity to work with Lisa to provide a child with some equipment that will help improve his ability to participate in activities with his family and at school. I worked with, and on, our team of professionals to provide the best care we could. With the help of Lisa, our OT, we started a relationship with an orthotist in Guatemala that will, hopefully, help to provide more needed equipment to the children in this community. I witnessed the profound love and pride a mother shows to her blind child, and encouraged her that her love and perseverance will make all the difference in his future. I witnessed as Dr. Lauri, Dr. Stephanie, and Dr. Chris facilitated a collaborative relationship with the University to support the community of Ciudad de Esperanza. 

But, perhaps most importantly, I spent hours teaching Esmé, the nurse who lives in Cobán and works throughout the year at the clinic. Esmé wanted to learn how she could better help her patients after we have gone back home. She spent precious time with me, learning how to feel for trigger points in the muscles and how to relieve them with pressure, how to listen to the response of the body and how to educate the patient. She practiced her technique and asked thoughtful questions.  

For me, this is the purpose of our time at Ciudad de la Esperanza. To educate, to collaborate, to foster relationships and build new ones. 

I hope the students are able to take in all that they observed and learned during this week into their futures and become better, more compassionate, holistic people - no matter what path they find themselves on. 

Deb Bauer, PT, DPT

Ojalà

It takes me a little while to process what happened over our week in clinic with the students. There are so many events and emotions to take in and digest and then choose the topic to write about and share with you.  I hope you have enjoyed reading the previous blogs from the medical team and the students.  We have experienced a lot this week. This is my seventh year as a member of the medical team. Side note: thank you very much Lauri Pramuk for inviting for a cup of coffee to sit and discuss this wonderful program those years ago – I’m glad I said yes to going and thank you for your friendship and the friendships that have been built along the way!!  As the pharmacist on the team, I am responsible for filling prescriptions and counseling our patients with their medications. I do this in my daily work as a community pharmacist. This year was different. I had the added responsibility to oversee the Prayer component of our daily clinic schedule. Once the prescriptions were filled and patient counseling was completed, the two students working in the pharmacy with me invited our patients to take a moment with us for quiet reflection or prayer before leaving clinic for the day.  

We had our prayers written out in our clinic handbooks and had practiced reciting them during our weekly preparation meetings. I am not a native Spanish speaker as many of the students are not.  So correct pronunciation and accent placement on certain words was a bit trying at times.  Our students and I did our best and our patients were more than kind accepting our foibles with speaking Spanish. I found the students felt more comfortable reciting the same prayer each time they led our prayer circle with a different patient.   It was always a treat for me to hear one of our native Spanish speaking students recite the prayers – using the correct pronunciation and accent placement.  One of our prayers (the Catholic Prayer) repeats the word ojalà several times in this prayer. As I was listening to our student, Wendy, recite this prayer and the word ojalà was repeated, I was drawn to how beautiful that word sounded with the correct pronunciation and the accent in the correct place.  After the ‘Amen’ and we thanked and hugged our patient good-bye, I shared with our prayer group how beautiful that word sounded. Wendy shared with us ojalà means hopeful or having hope.  Webster’s dictionary defines it as meaning “hopefully” or “let’s hope so”. This word comes from the Arabic phrase “inshallah” which means “God-willing” and is also used to reflect the hope that something will happen. 

So, this is where my thoughts are with my blog. Where is my “ojalà”?  What is my “ojalà”?  I am ever hopeful for the beautiful people of Guatemala. The work that is being done by our beautiful friends and colleagues at La Ciudad de la Esperanza is truly remarkable and I am hopeful it continues. I am hopeful that our week in clinic was beneficialto the people of Coban. I am hopeful that this experience played an important role for our students on their journey to their medical careers. I am hopeful the students will look back on this experience often and rekindle the fire that I saw in them this week.  I am hopeful our service project will continue to grow and build sustainability for Coban and its surrounding communities.  I am hopeful for our medical team that we continue to be good stewards of knowledge, kindness, generosity, peace, and above all, love. Ojalà is a beautiful word – and I am hopeful you can experience its beauty. 
Dr. Eric Bertelsen 

 

We Are All La Ciudad

I have finally been able to set aside some time to reflect upon our project in Guatemala this year. This week, I have been asked many times by those following along, “How was your trip?!”. My default response has been “it was good,” or “it was a great trip,” or “we had so much fun” because it is difficult for me to find the words to adequately express our experience. For me, a big part of our time in Cobán was just observing and listening to the patients that came from near or far to see us. As many of the group have already shared, we heard some tremendous stories from our patients about their human experience.

It was the words of Dr. Felipe one night in discussion that I continue to go back to. After about the first or second day, he shared that many of the patients he had seen in clinic reported aches and pains, but what he found after listening to them is that many times the symptoms started after a tragedy or other significant event in their life. He made a poignant observation that oftentimes la tristeza (sadness, but I feel it has so much more meaning in Spanish) can manifest itself in physical ailments. He shared this can be difficult in medicine, because there are no exact medications or instructions to give for a hurting spirit. 

Dr. Felipe was right, but the more I sat with these words and thoughts, the more I felt that there was maybe one solace to this pain– community. I think it is hard for everyone to accept that we cannot go through our lived experience alone, and inevitably tragedy or disaster will strike (looking at you, Covid) but we have to find comfort in one another. We have to be in community. By taking a new group of students to Cobán, we grew the community just a little bit bigger. It was comforting to see the students interacting with the patients at Ciudad, maybe in broken Spanish, but always with a smile and a hug or a hand shake. As our team worked through the week, we became assimilated with the team at Ciudad and by the end of it, we were all sharing a meal as one. Throughout the week, we listened to the students reflect on their experience and the stories they heard in the clinic, and I could sense that it touched them in a special way. Our time in Cobán was short, but as we lived in community and cared for our people, my hope is that we helped lighten their spirits just a little.

I write these words, mostly to myself, so that the next time someone asks me about my time at Ciudad de la Esperanza, I can come up with more than three or four words so that those stories continue to be shared and the support for our community in Cobán continues to grow to help the hurting spirits.

Dr. Christian Alegria

Patient care in La Ciudad de Esperanza (ACE)

When we think about healthcare and patient care, we think about doctors being able to diagnose us and refer us to treatments or further procedures in a streamlined process. Diagnosis can happen quite mechanically and doesn’t always require providers to go beyond medical history and relevant information. Our medical team, however, will always want to know every patient at ACE personally. Even then, diagnosis doesn’t always happen and treatments aren’t always readily available. With a lack of resources and equipment in this clinic, our team’s providers can only offer so much or are only able to alleviate their pain, all within the short period of one week.

 

Our clinic’s patients, like any patients in the US, came with questions about their health and expected resolutions. However, the science aspect of healthcare is not a standalone and is the least emphasized in patient care. Guatemala’s healthcare system is limited, but our medical team maintains strong dedication to our patients. They are deeply attentive to the complex lives of this marginalized population, whose hardships vary between each person and greatly contribute to their health. This could be seen in the exam room of Dr. Felipe who often said, after most appointments, that more could have been done for the patients had they been in the US. He understood how much burdence his patients shouldered from traumas and hardships of poverty and how this reflected in their physical pain. This was especially true for the women that came to our clinic. In the Latin machismo culture, they faced criticism over their children’s welfare and were blamed for their children’s health issues. While she was helping a patient, Dr. Deb noted how the patient carried the pain of losing her child in her shoulders, hence creating extreme tension in her muscles there. In another case, Dr. Lauri caused a mother to burst into tears when she remarked how her son made up for his blindness with a vibrant personality.   

 

Is our little clinic doing enough for this community? The answer may not be clear to some. However, the Hippocratic Oath calls for our providers to “benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.” They uphold this value in its truest sense by allowing the patients to acknowledge their pain and experience, by giving visibility to the patients who might just be at the bottom of the social hierarchy. By coming to the clinic, these patients are able to make sense of their suffering, are reminded to continue taking care of themselves, to keep listening to their own body, the soundness of their mind, and their heart. The clinic of ACE may be lacking in technology to make diagnosis. But our medical team sustains quality patient care in the midst of challenges, in anticipation that our healthcare would one day be completed with resources, and that we will soon reach full capacity. 

 

Lastly, I would like to personally thank…

Dr. Eric for showing us your passion for patient care during consultation

Dr. Deb for teaching us about the connection between spirituality and physical wellbeing in PT

Dr. Christian for showing how art and dentistry are combined in healthcare

Dr. Felipe for your sincere dedication and consolation for every patient 

Dr. Stephanie & Nurse KK for your patience during triage and your firm but compassionate reminder of “patient first”

Ricky & Mary for keeping the team afloat and working so hard behind the scenes

Dr. Lauri for showing us your bird trick that brought the brightest smiles and amusement to the pediatric patients

And my fellow students and everyone in our team that made this trip happen!

A Hurricane of Emotions

It’s a bittersweet feeling sitting on the bus leaving Coban. It seems like 4 days of clinic is not nearly enough. Reflecting back on this week I have experienced a hurricane of emotions some I have never felt before. I will continue to process this experience for quite some time. I could talk about how in awe I am of our medical teams compassionate holistic patient care and strong leadership or my admiration for the vulnerability of my peers, however I would like to focus on two patient encounters that have had a profound impact on me. 

This first was on the second day of clinic in the morning while I was shadowing Dr Lauri. The day started out slow but, I was excited and eager to meet with patients. We were seeing patient after patient listening to their stories and it was as our third set of patients walked through the door that I instantly knew they were different from the other patients that we had been seeing. The first one to enter the room was this very small wrinkled man with a bright red baseball cap on a button up shirt and jeans, following him were two young brothers wearing muddy clothes torn shoes and stained face masks. We quickly learned that this man was in no way related to these two boys as he was even too old to be their grandparent. He told us that he had taken in the two boys because their parents abandoned them and their adult siblings could no longer care for them. I have seen poverty here in Coban like no where else before, but these patients you could tell were some of the poorest in this village. I cannot even describe in words how I felt hearing that even though this 76 year old man barely had enough to care for himself he still took in two young boys that had no relation to him what so ever. What touched me the most was when the man said as long as he had life he would do all in his power to care for these boys. You could tell that the brothers were loved and witnessing this kind of love is something I will always carry with me. Even though all we could do was give them a basic check up and a water filter this man and these two boys were so gracious. It hurts my heart there wasn’t more we could do for them, but even so this man hugged each of us in this room on his departure and thanked us over and over for what seemed like very little. Things that I view as a universal human right like healthcare and clean drinking water this family never had.

The last day of clinic I was with Dr. Deb in the PT room and even though her schedule was empty for the day it quickly filled up. Our first official patient was little Fernando an extremely intelligent boy who is nearly completely blind. As soon as he entered the room it seemed like he took control immediately taking stalk of everything, everyone, and where it all was in space. He was confident and more than anything he was a normal little boy, he was playing and using his imagination the entire time he was with us, regardless of not being able to see. This little boy was amazing to be around, but even more so was his mom. As soon as she walked in you could tell she was carrying lots of emotions with her. She began to cry as she told us her and her sons story, how desperate she was to do all she could for her baby as soon as she was told he was going to be blind. She explained that she knew many other women who’s children were blind or disabled who just completely gave up on them and how she had hope and continued to help him be independent and confident in himself. There wasn’t much from a medical stand point we could do for Fernando and his mom in the PT room. So what we did was listen and reassure his mom that she was doing a phenomenal job with Fernando and that he was miles further ahead of other children his age, let alone other blind children his age. I was in awe of this woman, she was such a loving and caring mother who was doing everything in her power to help her son regardless of the unimaginable obstacles. I will forever carry their story with me and aspire to advocate for the people in my life including my patients the way that this mom did for her son.

Although I am sad that our time in Coban has come to an end and it feels like there is so much more to be done, I am grateful for the time that we did have. Many of my patients thanked me while in the clinic, but I also thanked them and I wish I could find the words to express how truly thankful I am for them coming to us and sharing pieces of the stories. My time in the clinic has truly solidified my calling to nursing and while sitting on the bus today reflecting on all that took place I find myself extremely lucky and somewhat unworthy to be in a field where I have the privilege to be the one who patients tell their stories to.

Kara Rodeheaver 

A Dose of the Guatemala Blues

“Ma’am, MA'AM!! Please step back. Step back. Ok I got 1, 2, 3 open. Sir! (waving hands to cal attention), SIR! Ma’am you need to put this in another bin. It has to be as flat as possible. (Person puts bag in bin and believes it is as flat as possible) MA'AM, you need to come back and put this bag as flat as possible. Turn it around!  Ok I got 1, 2, 3 (pointing to the next people in line to indicate where to step next)."

My turn . . . "Take all your electronics and make sure they aren’t overlapping." (Me: Ma'am do the electronics need to go in another bin?) "Take out all electronics and make sure they aren’t overlapping." (Me: Places things in bin as best as I can but fast as we are rushed through security after customs) "MA'AM! Put ya shoes over here!" (Me: I sorrowfully move my shoes to the other bin where my carry on is and step back as dictated to do). 

Preparing myself for be inevitable “random” screening, like hope on hope, the line for regular TSA precheck type screening opens. I called to Dr. Christian, grabbed Nurse Kristen (aka KK) and we sauntered, through with melancholy and one last squeeze I could give Nurse Kristen, through the X-ray machine. As we make it to the other side, Dr. Christian and I must quickly grab our bags, see if eating is possible, and hustle to our gate. I look up and Nurse Kristen’s bag has been stopped for screening. With no minutes to spare, I too yell out, “KK, we are going.” Choking tears, moving away from what is and will continue to be a spiritual experience. This was our welcome back to the US. It is always like this - every single year. Harsh. Cold. Jarring. Culture shock. A stark contrast to the “Bienvenidos a Guatemala” delivered with a smile upon our arrival last Sunday in Guatemala City. I noticed this year when we arrived, there was a TSA agent at every corner of the ramp we took to enter La Aurora Intl Airport in Guate city. Each one of them welcoming us with the cariño I’ve come to deeply respect and appreciate. 

You may read our blogs and read that we call the Guatemalan people a caring, kind, welcoming, and generous people. This is easily noted in our first and last experiences traveling together as a team. The sense of humanity, human sensitivity, the human condition, and the respect for one another seems to be etched into the fabric that is Guatemala. El tejido de amor/cariño/amistad puedo decir. This tejido feels like it is woven into my own neural networks while in Guatemala and somehow calms my mind, spirit, and unpredictable body. Upon return, it feels I am lined up, like a cattle on its way to the rainbow bridge, to have the tejido ripped from my neural pathways. But as tears well up, I fight against the surgeons that would like to desensitize me to what I have experienced in Guatemala so that I might return quickly to the status quo. I fight, as we ask our students to fight, not to turn away from the tension of walking in solidarity with others, but to lean into it, marinate in it, struggle in it. It was incredible to be back in Cobán, with my friends and colleagues, moving our collaborative effort forward after missing last year (thanks to COVID). I 
truly missed Juan Pablo, Esmeralda, Rosario, Padre Sergio and the incredible group of human beings that make Esperanza live up to its name. I had the great pleasure of finally meeting Dr. Ricardo in person after a year of zoom and whats app video calls. It felt like we already knew each other. This group is like the real life Avengers and remain incredible examples of what it means to live your life with purposeful action and carry a welcoming spirit with you every day. 

We are blessed to have this relationship with the Ciudad de la Esperanza team. As I reflect on this year’s experience diving face first into the clinic’s new electronic medical record, meeting the nursing and medical students completing their rotations from local Guatemalan universities, and all the inside jokes we have developed “entre jefes,” I am left with a glimmer of light which inspires me to continue making good trouble. It was amazing to finish clinic and review the patients requiring follow up and be able to sit with Dr. Ricardo and Nurse Esmeralda and simply schedule the follow up visits right then and there. The dream of collaborating to develop sustainable health care solutions for this community feels so much closer than ever before. Dare I say, it feels as though we will realize this dream and exceed it as we have been planning bigger collaborations in the area. I struggle every year to leave and it seems as I get older and gain clarity on the world I’d like to live in, leaving only becomes harder. Apparently, my wish to stay in Guatemala is also clear to others as I was told today that “I looked so sad” while in a meeting. It’s true, I have the Guatemala blues. I find myself missing the friendship . . . The personhood we experience there. I miss working with my incredible Guatemalan and US colleagues. I miss the feeling of a community caring about each other. I miss the feeling of true respect, kindness, and compassion. So yes, I’ll look sad for a few more days and eventually I will normalize. For now, I must navigate the culture shock of re-entry by writing, texting my people repeatedly, and remembering the importance of our partnership with La Ciudad de la Esperanza. 

The hope of better health will always outshine the blues of returning, always! 

Saludos,

Dr. Stephanie Ibemere

We Don’t Need Eyes to See

We Don’t Need Eyes to See

Our last day of clinic this week began with a very special 5 year old.  Fernando is a bright, articulate, innovative, fearless young man, who told nurse Kristen in triage that he was going to be a doctor when he grows up. He also happens to be blind.  Fernando was born prematurely and the oxygen that he needed after birth to keep him alive severely damaged his eyes.  I had Mila in the peds room with me that morning.  Her mom is a NICU nurse.  I told Mila that her mother would know all about retinopathy of prematurity.  Oxygen damages the fragile retina in babies.  It is a well-known risk for premies, and with appropriate, early intervention with pediatric ophthalmologist usually vision can be spared.  But Fernando wasn’t offered any intervention until it was far too late.  His mother shared with us through tears her early journey of becoming a mother to a young boy who will never see.  She is a remarkable advocate for him.  She takes the 5 hour journey to Guatemala City once a month to see specialists and has found a school for the blind in the city that he attends virtually.  The burden of his disability weighs heavily on her.  But it really doesn’t seem to weigh at all on Fernando.  Kids who have such a major deficit from birth or a young age often compensate very well.  When Fernando entered the pediatric room he immediately went about exploring the room with his hands.  He was knocking things off the table and bumping up against the people in the room.  He had no problems climbing up on to the exam table and was a shining star for his exam.  He really, really loved hearing the birds in his ears - “pajaritos!”

As we were wrapping up with his visit and walking him over to see Dr Deb in PT so she could work with him and his mom on some therapy skills visually impaired people need, I found myself thinking of Stevie Wonder and my husband.  Chris has been a lifelong admirer of Stevie Wonder, he can still tell you about his memory of his older brother Johnny bringing home the album “Songs in the Key of Life.” Chris has written extensively on Stevie’s music and actually has an entire chapter of his book The Artist Alive on Stevie in the context of theology.  Stevie’s early life story is not unlike Fernando’s. He was born prematurely with underdeveloped optic nerves and also got retinopathy of prematurity from oxygen in the NICU.  His mom took him to doctors and faith healers as a young boy, determined to find a way to preserve his vision.  Stevie remembers with disdain many episodes of strangers digging around in his eyes.  Finally he told his mom, “Maybe God doesn’t mean for me to see.  Maybe God meant for me to do, to be something else.”

By the time Stevie was 12 he had burst onto the music scene and he took Motown by storm.  His last name was changed to Wonder because veteran musicians who saw him called him the 8th Wonder of the World.  

If you are unfamiliar with the album “Songs in the Key of Life” you probably will recognize some song titles - “Isn’t She Lovely,” “Sir Duke,” and “Joy Inside My Tears.”

He is an incredible song writer.  Perhaps the most poignant song on the album, and honestly one so pertinent to a community that is built on a landfill, is “Village Ghetto Land.” Chris has written extensively about this song. In one article, titled “‘The Street is for Celebration’: Racial Consciousness and the Eclipse of Childhood in America’s Cities,”Chris writes about how the song “Village Ghetto Land,” juxtaposes disturbing images of “life the way it is” in the city over the serene instrumentation of a chamber quartet:

    Would you like to go with me/Down my dead end street

    Would you like to come with me/To Village Ghetto Land?…

    Children play with rusted cars/Sores cover their hands

    Politicians laugh and drink/Drunk to all demands

Having briefly visited the landfill just before clinic the same morning we all met Fernando, this song takes on real world significance. 

In my experience with children who are born with a major disability or who have one thrust upon them at a young age, they often adjust - sometimes they adjust even better than their parents.  Kids tend to figure things out.  Fernando was one of those kids.  His mom, understandably, is still trying to figure things out. She knows what he is missing, and what challenges lie ahead for him.  He really doesn’t.  Young Stevie Wonder didn’t either. Both of their mothers were in a time of mourning a loss their children felt in such a different way.  I look forward to following along in Fernando’s life to see what God meant for him to be.  He clearly did not need eyes to see that day in clinic. 

Lauri Pramuk, MD

 

First Day

While riding on the bus through the rolling hills of Guatemala yesterday, I kept wondering what I had signed up for. I was so eager and thrilled for this incredible opportunity, but also anxious and doubted my abilities. These nerves were immediately alleviated upon arriving in La Ciudad De La Esperanza this morning. The community was so welcoming and grateful, and the team instantly bonded and worked together to provide the best care possible.

I was in awe of the heart for medicine and the crafted skills in all the healthcare providers. I shadowed in dentistry and physical therapy today. From watching Dr. Christian's care and tenacity completing extractions for patients in a comfortable manner, to experiencing Dr. Deb's and Dr. Lisa's ability to connect with patients and alleviate pain, I feel so inspired to be the kind of conscientious, loving, and thorough healthcare provider they are.

The incredible patients I met today also had a profound impact on me. I am so humbled to be able to help and contribute to a longitudinal, sustainable mission. It is heartbreaking and difficult to watch children experience hardship and chronic illness, and not be able to take away their pain. I was struck by the sheer joy and happiness in the pediatric patients, despite their hardships. 

Watching the joy on not only patient's, but also their family's faces when receiving an orthopedic foot piece to help them walk was something I will never forget. Being able to share memories, laughter, and provide support to patients was a true blessing. I am eager to experience more incredible moments like this in the next few days!

Sarah Sullivan 

The Warmth of Guatemala

A big reason as to why I felt the need to go on this trip was because of my adoration for my grandma. She dedicated a significant portion of her life to service work as a surgery nurse. Traveling on the SS Hope, she defeated the English to Bahasa Indonesia language barrier and worked to bring healthcare to many living in Southeast Asia. But most importantly, she showed me solely love, warmth, and comfort when I visited her as an eight-year old.

Today, I finally got to work in triage! As I was standing and waiting for patients to be checked in, a familiar face walked in through the door. She had come yesterday, when I worked in dentistry with Dr. Christian. We found she had very advanced periodontal disease, and she only had a handful of bottom teeth remaining. Dr. Christian had asked us to feel her thin jawbone, and it scared me as to how fragile it felt. I couldn’t imagine as to how much she struggled to eat, and maintain a good diet without dentures.

Today, she was wearing the same black and white floral traditional dress that I saw in dentistry. Immediately, I waved and greeted her, and her face lit up as she returned the greeting. When Nurse Kristen passed me her blue clinic passport, I ushered her back to get her vital signs. She started asking me about my day and talking to me in Spanish. It got to a point when I couldn’t understand what she was saying and I told her, “Lo siento. No puedo hablar español muy bien.” She laughed and said, “¡Yo tambien! Yo hablo Quetzche.” Immediately, I felt welcomed back into the conversation. 

Then, it was time to take her blood sugar. I poked her with a lancet and a drop of blood formed on her left ring finger. I wiped it away with gauze, and massaged her arm for another drop of blood to form. But nothing was coming out! I kept nervously massaging, and she laughed it off saying, “¡No tengo sangre!” I felt relieved and asked, “¿Usted muerto??” She chuckled and offered her right ring finger, which worked wonderfully. 

Although we didn’t talk too deeply about ourselves, we were able to connect, regardless of the language barrier. She was so warm and welcoming. 

I shared at the debrief tonight about this older woman, and came to the conclusion that in her, I found the same warmth, love, and comfort that my grandma showed me. I saw my grandma in her, and I was reminded today, of the reason I came on this trip — to carry on this legacy of unconditional love that my grandma planted in me.

Naomi Lumban-Gaol

Thinking about Camus

In 1947, shortly after WWII, Albert Camus published a very important and influential novel, THE PLAGUE. His book has been in the news lately — for perhaps obvious reasons! — and now that I and others in our group are having “a personal relationship with the pandemic,” thinking about Camus seems especially apposite.

I’ve been having wonderful text talks with family members and friends. Amazing how important our relationships are: none of us can do this human journey alone. 

So this morning my sister-in-law (a physician) sent a text that read said, in part, I “read an article on Camus on Vox today. He is my new hero!🙃” I just finished it. It touches something profound for all of us and I wanted to share it.

https://www.vox.com/platform/amp/features/22989761/vox-conversations-albert-camus-the-philosophers

p.s. a colleague in Regis college’s peace and justice studies program, Eric Fretz, has asked me to co-teach part of his course this fall in which THE PLAGUE is the text under discussion. I really hope I can do it.

Fr. Kevin Burke, S.J.

Laugh, Pray, and Play

My time so far in La Ciudad de la Esperanza has been amazing in so many ways and nothing I say will really capture it, but I’m going to try anyway! 

First I want to talk about what I have been doing in clinic. I have been able to shadow and assist with so many different doctors and I have already learned so much. I especially loved my time in the dental room with Dr. Christian on Tuesday! As a pre-dental student I have shadowed many times and seen lots of teeth but this experience was unique. For one I actually got to assist which just reaffirmed my desire to be a dentist. Second, it was really eye opening to see the oral health of these patients and how they were managing with the pain and issues. Today I was in the pharmacy with Dr. Eric and I thought it was really meaningful talking and praying with the patients. Even though we didn’t speak the same language we could have a space and time to be grateful and reflect. Also I was in the pediatric room with Dr. Lauri today too. I learned a lot about development and got to see same cute babies. Honestly today was my favorite day so far!

The second thing I want to talk about is the joyful, gracious, and playful environment that surrounds the clinic and school. Everyone that I have met has been so full of life and accepting of my not so good Spanish skills. It is a big change from normal for everyone to be so welcoming and warm. Additionally, I have really enjoyed playing with the children in Cobán. Whether it is bubbles or a ball or random objects in the peds room, the children love to play and are so excited to do so. Again, even though we don’t speak the same language we can still laugh, pray, and play together.

Molly Schmanke 

Thank you

To better understand the needs of the community in Coban, we’re conducting a community needs assessment (CNA). The purpose of the CNA is to broadly evaluate the basic needs within the community such as health, safety, housing, food, water, education, and employment. Students and several health professionals who reside in the community interviewed patients at the clinic. These students and health professionals are from the disciplines of social work, psychology, and nursing. Our hope is to better understand and meet the needs of the community by gathering these data. Further, we plan to apply for grant funding and these data will enable us to share quantitative assessment data with prospective funders. 

A thank you to our Regis University students...

~ thank you for caring deeply about the Guatemalan people

~ thank you for thinking seriously about inequities for indigenous people

~ thank you for engaging fully with every single patient you met 

~ thank you for opening your hearts, minds, and souls 

~ thank you for serving as positive role models for my daughter 

~ thank you for wanting to make this world a better place one person at a time

~ thank you for embracing differences and finding similarities in our humanness 

~ thank you for joining me as we learn and grow together 

~ thank you for providing culturally competent care

~ thank you for showing empathy and compassion in your actions and words

Go...set the world on fire! 

St. Ignatius of Loyola 
Dr.Tristen Amador 

The Shared Dreams in Coban

It’s the second to last day of clinic. I knew from the start that this group was going to have to work as a team, but what I didn’t realize was that each of us, and each shift that we have been partaking in was a missing piece of what will one day become a complete puzzle. A patient comes in with their child and the triage group paints their faces in their heads before they take their vitals. Next the patient awaits for her appointment with Dr. Lauri so her child can be examined but in the meantime we send her to get a vision test or a fluoride cleaning. Once we finish we give them bags of bath and mouth hygiene kits that are filled with toothpaste, toothbrushes, shampoo, and more for their household. Dr. Lauri then takes them in, and during her appointment she prescribes meds for the child as well as recommends a visit with our physical therapist. The mom then schedules an appointment with Dr. Deb the next day which is convenient because she has to come back for a general checkup anyways. The patient then leaves with her child, meds, and hygiene kits, and returns the next day. Many of our patients went through this cycle of seeing everyone by working on their muscles, their teeth, getting checked up, etc. We each contributed to their wellbeing and what one group witnessed was simply another story told to the rest of the group that witnessed other pieces. These pieces are completing the puzzle that will one day allow Cobán to reach a point where healthcare is a top priority. Our patients get to pass down their new education, new management methods, exercises, their experiences with getting help, and more to the rest of the community and one day it’ll be so stable that a new group of people in a new place will be ready for a team like ours, and for a change like the one in Cobán. 

This week has generally been amazing, but also emotional. It surprises me how patient the patients have been, and how grateful they are when they leave. These people genuinely care and want to improve their lives regardless of whether or not they’re afraid of being sick. Many people have traveled a few hours just to see us and It says a lot not only about the work we are doing but about their willingness to want to get better. This trip has solidified what it is I want to do with my life. I cannot wait to be there for others as a whole and improve their lives through innovative care the way we are doing so right now. 

Ximena González 

THE SMELL OF IMPOVERISHMENT

Fr. Kevin Burke, S.J.

Of all our senses, smell seems at times the least important. A friend of mine, a religious sister in California, has no sense of smell and she jokes about what an advantage it is for living in community. (Perhaps that is why she chose a Beagle for her pet and companion.)

But when we reflect on the connection between smell and memory, we realize that certain smells can trigger

memories more urgently than any other sense. Not so much specific, discrete memories, but the whole world of “a time past” can be powerfully evoked by the smell of a cigar, or coffee in the morning, or a sheep barn, a lilac bush, or a particular brand of floor wax. I find myself considering that smell might be our most primitive of our senses and, thus, the one most capable of breaking through superficial constructions of reality. The sense of smell can bring us to the heart of the real.

Jon Sobrino, the brilliant Salvadoran theologian who survived the 1989 massacre at the UCA because he was in Thailand at the time, once told me “we don’t really know poverty, know the plight of the poor, until we smell it.” The smell of poverty leaks from the borderlands of death.

This morning, Drs. Lauri and Stephanie stopped our bus just before entering the ACE compound (“La Communidad de La Esperanza”) at the site of the large municipal dump. It was here, nearly 20 years ago, where ACE was born. It was here that Pardre Sergio brought “una olla de arroz y frijoles” and a soccer ball to the edge of the wasteland and began to play with the children of the garbage pickers…

The smell was terrible. 

The bus was silent as we finished the drive (a very short distance) to the clinic.

We couldn’t get the sticky dump-mud from the soles of our shoes. 

We felt the violence of odor. 

The smell of impoverishment pocks the airways and lungs. The terror of a thousand lashes on the pristine bodies of children. The ineluctable weight pressing against the souls of helpless mothers and fathers. The dump reeks the odor of guilt, of that which should not be. 

Our sense of the beauty of Guatemala, of these people, these children, has been deepened. Rendered more complex. Our passions for justice have awakened in the presence of a pervasive smell. We did not wrinkle our noses and then turn away (glad that the dump is a gated community surrounded by barbed wire.) We looked down, we looked up. We looked ahead to the work of the day awaiting us. But if we ponder it, we notice that have been changed. A little.

A Gift

I read this poem in our debriefing session this evening (Wednesday 6/1). We wanted to share it with our readers and one another.

The poet is Denise Levertov (1923-1997), a great great human being and a brilliant poet.
Fr. Kevin Burke, S.J.

A Gift

 

 

Just when you seem to yourself
nothing but a flimsy web
of questions, you are given
the questions of others to hold
in the emptiness of your hands,
songbird eggs that can still hatch
if you keep them warm,
butterflies opening and closing themselves
in your cupped palms, trusting you not to injure
their scintillant fur, their dust.
You are given the questions of others
as if they were answers
to all you ask. Yes, perhaps
this gift is your answer.