Creating Ripples …

 

This year's experience at La Ciudad de la Esperanza has been difficult for me to put into words. As with each year, things seem to just fall into place and the worry leading up to the trip melts away as we walk into Clinic on the first day. The greetings and smiles we receive and return to the Esparanza team and community patiently waiting for us to set up fill my heart with joy. 

This year we met even more remarkable people who showed me what it means to be family and community. Mothers, Fathers and Aunties brought in babies for guidance and help to address their physical, medical and emotional needs. Patients we have seen before came in and we marveled at their progress and growth since last year. We provided a safe space for women to express their needs and emotions. Sometimes we provide medicine, or exercises, or tools to help, but often we just listen, hold hands and pray. 

As a physical therapist, a mother, a teacher, a friend, I want to “fix” things. In the States, a patient comes to me and I obtain things - wheelchairs, gait trainers, crutches, standers - to provide the opportunity for these children to engage in their environment and community. In Cobán these items are not only out of reach, but they are unnecessary. Instead of buying equipment I find myself asking “ How can I best support you? What are you struggling with?” And the answer is always “Thank you for coming. Thank you for caring.” I listen, I educate, I support and I hope that this is enough until next year, when I will bring more items and more knowledge to help. 

This year I had the opportunity to go down the hill from the clinic and tour EDECRI, a school for children with special needs. This school, unknown to me until this year and hesitant to have outside people come in, is amazing. In the morning it is a school for children of all ages to come and learn. In the afternoon it is a program for people to come learn a trade - cooking, car detailing, agriculture, computer science. They told me they are the first, and perhaps only, school for children with special needs in Guatemala that is recognized by the Ministry of Education. They have physical therapy, speech therapy, and child psychology.  We began the first steps of collaboration. They will follow a sweet 5 day old baby that came to the clinic with a severe cleft palate and Down Syndrome through at least the next year. I was able to provide a walking stick and instruction to a young adult who is blind and one of their physical therapists to increase independence. We discussed a potential surgical intervention for a teenager with Cerebral Palsy.  I hope our two communities will continue to collaborate in the years to come. A set of twins with Cerebral Palsy came Into the clinic this year, they are severely motorically impacted, but they are very communicative and have much to share. Knowing this school exists gives me great hope. I hope they will have an opportunity to work with the speech therapist and learn additional communication skills to engage with their world. 

I am eternally grateful to be a part of this amazing team and thank each and every person who helps to make this project possible. Gracias a dios. Que la esperanza y la luz los guíen  

-Deborah Bauer, PT DPT

Medical Team Physical Therapist 

SOMOS FAMILIA

 So, it happened again. This is my ninth year with the medical team. Like previous years of writing on this blog, I think I’m the last member of the team to write my thoughts about my experience in Coban, Guatemala. Some would say I’m a procrastinator, I don’t think I am. There is just so much to digest and think through about this experience, what parts do I share and how do I put it down in words.  Do I start at the beginning with the interviews and putting the team of students together? Is there one particular moment of the week in Coban that stands out? Is there something I want to share about a particular patient? While thinking over these questions, one phrase stands out to me. The phrase, just two simple yet important words, that were shared at one of the earlier evening debrief sessions with the team by one our newest members of the team, Antonio.  He shared, very simply, Somos Familia. Two simple yet important,words. 

We expanded our family with new members by choosing eleven beautiful students of Regis University. These students met every week for two semesters learning about Guatemala: its culture, its people, its government, etc. We also welcomed Antonio and Rabbi Spike this year – thank you Dr. Richard for the introduction. All the while building relationships with one another as a team and joining in the family of medical professionals: Lauri, Richard, Stephanie, Kristen, Christian, Deb, Ricky, Monse, Mary and me.  Somos familia. 

The team arrived in Coban on Monday, May 6th. Our first day of clinic on Tuesday was the beginning of a wonderful family reunion of sorts. We were greeted by many familiar faces: Juan Pablo, Dr. Ricardo, Rosario, even Spike the dog.  Other familiar faces started showing up as we saw patients in the clinic. Patients I had seen on previous trips. It was wonderful to see all of their faces again – Danny, Anaih, Irma, Benedicto, Sebastian, and Etty.  These are just a few of the 104 patients we saw in clinic over the week. Filling prescriptions is the primary focus when the students work with me in the pharmacy. When we dispense their medications at the end of the clinic visit, we also off a time for reflection and prayer with each patient. This is a special time for us. Praying with and for one another is a beautiful family tradition. Each team member and each patient came to clinic as a member of a nuclear family, but we all came together as members of a larger family who shares, supports, prays for, and loves one another. As families do.  Somos familia. 

We are now back at home. Life continues. Graduation for one of our students, summer break for others, back to work, back to our routines. Our Guatemalan family is back to their routines as well. We may not see our family members as often as we would like, but we can all look back fondly on our weeklong family reunion in Coban. Somos familia.

-Eric Bertelsen, RPH Pharmacist

Medical Team Pharmacist 

If You Listen

It always takes me a bit of sorting through emotions to be *somewhat* ready to talk after returning home from Guatemala. A few days of marinating in uncomfortable and raw and always unexpected feelings before I can even imagine being able to share what is a seemingly indescribable experience. It’s no secret I wear my heart on my sleeve (thus why I literally have a tattoo of Guatemala on my arm), and I’m notorious for being incapable of encapsulating big emotions and explaining meaningful events in a brief summary, so if you’re still here, thank you for sticking around, and I’ll try to keep the rest of this short. But I think this is important, and honestly what I’d want to say to anyone who asks me how my trip was. 

Guatemala has been a part of my life for 10 years. I don’t remember who I was before that. I can’t imagine what kind of provider I’d be without this instrumental piece of my world, of myself. The people in rural Guatemala have so much to communicate - so much beauty, strength, pain, knowledge, resilience, gratitude, faith. But you can’t hear it, you can’t see it, you can’t even begin to understand it if you don’t really listen. We are taught as healthcare professionals to auscultate breath sounds and heart sounds and how to differentiate normal from abnormal on a physical examination of a patient. It’s that other part, though, that can’t really be taught. The part where you make a conscious decision to really care, really empathize, really treat every person with dignity and respect and compassion. You choose to be your best self for that person and walk in solidarity with them because you wholeheartedly believe that decency and sharing in the human experience is vital to anyone’s health and survival. But how do you know who you’re fighting for, who you’re treating, and WHY you’re doing what you’re doing if you don’t actually remove your stethoscope, or your blinders, or your prejudices and preconceptions and listen? Truly be WITH them. I try to come back to these thoughts to ground myself when some days feel really tough and listening with just a stethoscope seems easier. I remember that I don’t want to be the reason someone continues to suffer. Because the thing is, our organs can’t really tell us who we are as humans. We have to want to know more about our brothers and sisters (who are not as different as we may have believed), or we’ll miss the point entirely. 

So if you think about Guatemala, or any person who you share space with from day to day, know this: people have so much beauty, strength, pain, knowledge, resilience, gratitude, faith. But you’ll only learn that if you’re willing to listen. 

Kristen Kellogg, APRN-CNP

Medical Team Triage Nurse

Won’t You Be My Neighbor?

Often times I find it difficult to put into words what this week of experience brings to me working with the medical team and students. Our lives are disrupted for a week traveling to a distant destination. Working in uncomfortable conditions. Trying to provide the best care we can with what we have. 

This was a very special year that brought many memorable moments to reflect upon. Year after year, I witness an overwhelming sense of community that pushes through a society of divisive rhetoric.

Don Manuel. Nonagenarian brought to clinic by his neighbor. He had a large tumor encompassing his right eye and was in pain every day. I was able to listen to his story with Dr. Richard and he has limited vision out of his left eye. His wife, however, can no longer see at all and so Manuel is left to care for her. Prior to seeing us, he said he was only taking one pill a day for pain. I can’t imagine the daily challenges he faces. Thankfully, he has a community that is looking after him. We were only able to offer medications for pain, but a listening ear can sometimes be equally therapeutic. 

School fluoride applications. We were able to meet Dr. Betzy a dentist helping part time at the clinic. Together,with her help we provided fluoride varnishes for all of the school kids. I commend them for bravely facing the unknown. I would assume that their past experience with dentists is less than favorable judging by the worried faces when she was explaining that we would be working on their teeth. One group at a time, they patiently sat in the chairs and allowed us to paint on the varnishes. After a few groups went through and they realized it was bubblegum flavored and that there was a nice Rabbi offering prizes after they were finished, their fear turned to excitement. What touched me the most was the children holding hands as they closed their eyes, opened their mouths, and accepted their fate. A small gesture of solidarity. A reminder to grab your neighbors hand when facing the unknown. 

Lastly, an incredible medical team and group of students that came together to make healthcare happen. A group of selfless individuals that were willing to put their lives on pause for a week to help our Guatemalan brothers and sisters. I certainly can’t leave out all of the donors and volunteers that supported and continue to support our project and make this all possible. To all, I am eternally grateful. 

Dr. Christian

Where to begin . . . Guatemala is the Grounding Wire/Dónde empezar . . . Guatemala es el cable a tierra

 This blog post is available in both English and Spanish 

In English

I spend a lot of time on planes because of the way life is for me right now, thus, two weeks before we took off for Guatemala, I was in Nigeria for work. I was in my country. May 5th came and my heart leapt for joy realizing I would soon go to my other home - Guatemala - how blessed am I. Where do I begin? How do I explain what our eyes have seen and our hearts experienced? Flying so much lately has meant I don’t spend much time with my feet on the ground. Where do I begin? I begin by sharing, Guatemala invites you . . . quietly pushes you to put your feet firmly on the ground and listen. 

This year, I was honored to watch two students from our first student team from Regis take on the many hats I have worn in the past and do so with great poise and grace. Their leadership allowed the opportunity to look at our collaboration, analyze our opportunities for growth, and connect with my brothers and sisters at Esperanza on another level. I got to put my feet on the ground and “Casper” less. Thank you Ricky and Monse. Thank you Juan Pa, Ricardo, Josue, and Rosario.

There are many things that occur in this wonderful (read with full British level sarcasm) body I have been given which often leave me feeling like I am floating and suffering through a rather lonely and scary battle. Somehow though, this feeling immediately flees when I am in Guatemala with my medicine friends. At least, that’s what I call us - the real Avengers who get their superpowers from immunosuppressive medications. I know that reads oddly, however, if you met my medicine friends, you would know what I mean. They are valiant, courageous, strong, resourceful, gritty, humble, incredible, and beautiful despite the body they have been given to walk this Earth. The solitude of being different and therefore treated as fragile melts away when I see my medicine friends. Though we may need to rest more than others, with our feet up to help with circulation, this time, one of my medicine friends got to put her feet on the ground and walk into clinic. I will never forget seeing that ever in my life. It was my reminder to never stop, no matter how impossible this special kind of life seems to be - just keep reaching your feet to the ground. This special group of brothers and sisters carry a special piece of my heart - we understand each other on a different level. 

This year’s team was part of getting the feet of Project CURE on the ground to complete a community needs assessment so we could support the shipment of requested (not random) medical equipment and resources to the clinic at Esperanza and in the surrounding communities. For the work of their hands and now their feet, I and the medical team are grateful to our student team. We are also very grateful for the partnership with Project CURE as their mission and vision centers on the critical skill of listening to support healthcare capacity building. 

It remains difficult to explain what happens to me, us, in Guatemala. I will try to explain by sharing what happens to me once we experience the Mayan Ceremony. I do my best to enter the ceremony every year with an open heart so as to receive the message Victoria has for me and all of us each year. For the first time ever, we held the ceremony in a home. Interestingly, we were required to remove our shoes . . . When we walked in, we were met with swirls of incense and were mesmerized by the continuum which made up this incredibly constructed home. I was quietly pushed to slow down, look, listen, and inhale. Then I opened my eyes and saw her, Victoria. I quickly moved to greet her before the ceremony began and she asked me to recall my Nahual (Nawal) . . . I couldn’t but there was my brother Mateo to save me - bring me back down from floating in my own frustration for not remembering nor having a note to which to refer. For the record, I am 12 Ajpu and Victoria reminded me what this means - I will never forget again. Standing at the top of the circle which was home to a beautiful sand garden, Victoria encouraged me in response to my heart’s petition and wishes. I floated to her to be honest, however, when I left, I felt every bone in my feet as I walked from her back to my seat with my Ajpu sistren. This ceremony is always incredibly overwhelming. I remember leaving and feeling like someone came and took off all the backpacks of rocks I had been carrying for the last year as if to give me one night to take a break before I picked them back up again - so I could feel the ground and listen for a moment instead of vibrating chaotically through each minute. 

That is what Guatemala does to me . . . to us all. It is an opportunity to re-connect to what we really are. It reminds us to stop floating and stand ten toes to the ground. Guatemala is my grounding wire. We came to give out from our own hearts which can often be extremely draining, yet, the beauty of the collaboration we have with Esperanza, we often leave with more than we came with. So, I thank Guatemala for the recharge so that now I can think about where to begin for this next year of accompanying our brothers and sisters in Cobán. 

Dr. Stephanie 

En Español

Paso mucho tiempo en aviones porque es mi vida ahora mismo, por eso, dos semanas antes de despegar hacia Guatemala, estaba en Nigeria por trabajo. Estaba en mi país. Llegó el 5 de mayo y mi corazón saltó de alegría al darme cuenta de que pronto iría a mi otro hogar - Guatemala - qué bendecida soy. ¿Por dónde empiezo? ¿Cómo explico lo que nuestros ojos han visto y nuestros corazones han experimentado? Volar tanto significa que no paso mucho tiempo con los pies en la tierra. ¿Dónde empiezo? Empiezo compartiendo, Guatemala los invita. . . Nos empuja (en silencio) a poner los pies firmes en la tierra y escuchar.

Este año, tuve el honor de ver a dos estudiantes de nuestro primer equipo estudiantil de Regis asumir los muchos roles que he hecho en el pasado y hacerlo con gran aplomo y gracia. Su liderazgo me brindó la oportunidad de observar nuestra colaboración, analizar nuestras oportunidades de crecimiento y conectarme con mis hermanos y hermanas de Esperanza en otro nivel. Llegué a poner los pies en la tierra y hacer el trabajo de “Casper” menos. Gracias Ricky y Monse. Gracias Juan Pa, Ricardo, Josue y Rosario.

Hay muchas cosas que suceden en este maravilloso cuerpo (léase con total sarcasmo británico) que me han dado y que a menudo me dejan con la sensación de que estoy flotando y sufriendo una batalla bastante solitaria y aterradora. Sin embargo, de alguna manera, este sentimiento desaparece inmediatamente cuando estoy en Guatemala con “mis compañeros de autoinmunidad”. Al menos así es como yo nos llamo: los verdaderos Vengadores que obtienen sus superpoderes de los medicamentos inmunosupresores. Sé que suena extraño, sin embargo, si conocieras a mis compañeros de autoinmunidad, sabrías a qué me refiero. Son valientes, valientes, fuertes, ingeniosos, valientes, humildes, increíbles y hermosos a pesar del cuerpo que se les ha dado para caminar por esta Tierra. La soledad de ser diferente y por tanto tratado como frágil se desvanece cuando veo a mis compañeros de autoinmunidad. Aunque es posible que necesitemos descansar más que otros, con los pies en alto para ayudar con la circulación, esta vez una de mis compañeros de autoinmunidad puso los pies en el suelo y entró a la clínica. Nunca olvidaré haber visto eso en mi vida. Fue mi recordatorio de que nunca debes detenerte, no importa cuán imposible parezca este tipo especial de vida: simplemente sigue con los pies en el suelo. Este grupo especial de hermanos y hermanas lleva una parte especial de mi corazón: nos entendemos a un nivel diferente.

El equipo de este año formó parte de la tarea de poner en marcha el Proyecto CURE para completar una evaluación de las necesidades de la comunidad para que pudiéramos apoyar el envío de recursos y equipos médicos solicitados (no al azar) a la clínica de Esperanza y a las comunidades circundantes. Por el trabajo de sus manos y ahora de sus pies, el equipo médico y yo agradecemos a nuestro equipo de estudiantes. También estamos muy agradecidos por la asociación con Project CURE, ya que su misión y visión se centran en la habilidad crítica de escuchar para apoyar el desarrollo de capacidades en atención médica.

Sigue siendo difícil explicar lo que me pasa a mí, a nosotros, en Guatemala. Intentaré explicar compartiendo lo que me pasa una vez que experimentamos la Ceremonia Maya. Hago lo mejor que puedo para entrar a la ceremonia cada año con el corazón abierto para recibir el mensaje que Victoria tiene para mí y para todos nosotros cada año. Por primera vez realizamos la ceremonia en una casa. Curiosamente, nos pidieron que nos quitáramos los zapatos. . . Cuando entramos, nos encontramos con remolinos de incienso y quedamos hipnotizados por el continuo que constituía esta casa increíblemente construida. Me empujaron silenciosamente a reducir la velocidad, mirar, escuchar e inhalar. Entonces abrí los ojos y la vi, Victoria. Rápidamente me moví para saludarla antes de que comenzara la ceremonia y ella me pidió que recordara mi Nahual (Nawal). . . No podía, pero estaba mi hermano Mateo para salvarme, hacerme volver a flotar en mi propia frustración por no recordar ni tener una nota a la que referirme. Para que conste, soy 12 Ajpu, y Victoria me recordó lo que esto significa: nunca lo volveré a olvidar. De pie en lo alto del círculo que albergaba un hermoso jardín de arena, Victoria me animó en respuesta a las peticiones y deseos de mi corazón. Para ser honesto, floté hacia ella, sin embargo, cuando me fui, sentí cada hueso de mis pies mientras caminaba hasta mi asiento con mis hermanas de Ajpu. Esta ceremonia es siempre increíblemente abrumadora. Recuerdo haberme ido y sentir como si alguien viniera y me quitara todas las mochilas de piedras que había estado cargando durante el último año como para darme una noche para tomar un descanso antes de volver a recogerlas, para poder sentir el suelo y escuche por un momento en lugar de vibrar caóticamente a través de cada minuto.

Eso es lo que me hace Guatemala. . . a todos nosotros. Es una oportunidad para reconectarnos con lo que realmente somos. Nos recuerda que debemos dejar de flotar y ponernos a diez dedos del suelo. Guatemala es mi cable a tierra. Vinimos a dar desde nuestro propio corazón, lo que a menudo puede ser extremadamente agotador; sin embargo, la belleza de la colaboración que tenemos con Esperanza es que a menudo nos vamos con más de lo que trajimos. Entonces, agradezco Guatemala por la recarga para que ahora pueda pensar por dónde empezar para este próximo año de acompañamiento a nuestros hermanos y hermanas en Cobán.

Dr. Stephanie

Have I not told you that if you believe you will see the glory of God?

 ¿No te he dicho que si crees veras la gloria de Dios?

 

Durante la semana que muchos esperan por todo un año para poder volver a la clínica para saludar a doctor Richard, doctora laury, para saludar a sthefania y Kristen, para poder hacer una cita con Cristian, recibir su medicina por Erick y su gran carisma y poder saludar a monse y rehabilitarse con Deb. Y que todos los estudiantes se interesen y ayuden a los pacientes. 

 

Cada llegada es una esperanza para las familias guatemaltecas, como dije a los estudiantes no ayudan solo a la persona enferma a estar mejor, ayudan a sus padres, a sus hermanos, a sus vecinos y toda la comunidad.

 

Me siento agradecida por poder estar ayudando a mis hermanos.

 

A veces sentimos que Dios no nos contesta nuestra oración directamente pero el tiene sus misterios para darles solución como es el caso de doña Gladys que trabajo tanto para que su hija marcelita pudiera tener una vida digna sinembargo el decidió recogerla y tenerla con el. También el caso de don Manuel que a tenido una vida de carencias pero a través del amor de Dios sus vecinos lo atienden y Ramiro un joven con muchas ganas de volver a trabajar siembargo la artritis  ya no le permite, que llegue un año mas y decir con una sonrisa enorme mire ya puedo mover los dedos es como podemos ver las respuestas a nuestras oraciones.

 

Siempre es una experiencia impactante año tras año los casos de los pacientes y se crea un vínculo con ellos, cada vez que llego a Ciudad Esperanza puedo ver la paciencia, la nobleza y el amor al prójimo que tiene doctor Richard a sus pacientes que sin saber su idioma puede saber sus malestares. 

 

Solo puedo decir que si puedes ayudar a tu 

 

hermano de una u otra manera hazlo, no sabes las necesidades y cargas que lleva cada persona. 

 

Termino agradeciendo y recordando un versículo que siento es necesario en nuestros días y para nuestros pacientes.

 

Clama a mi y te responderé, y te daré a conocer cosas grandes y ocultas que tu no sabes. Jeremías 33:3

Mishel Tzul, interpretor for Dr Richard for 13 years

Translated to English

Have I not told you that if you believe you will see the glory of
God?

During the week that many wait for everything
a year to be able to return to the clinic to say hello
to doctor Richard, doctor laury, to say hello to
sthefania and Kristen, to make an appointment
with Cristian, receive his medicine from Erick and his
great charisma and being able to greet Monse and
rehabilitate with Deb. And that all
students become interested and help
patients.

Each arrival is a hope for families
Guatemalans, as I told the students, no
They only help the sick person to be better,
They help their parents, their siblings, their
neighbors and the entire community.

I feel grateful to be able to help
To my brothers.

Sometimes we feel that God does not answer us
our prayer directly but he has his
mysteries to solve them as is the case
from Doña Gladys who worked so hard for her
Marcelita's daughter could have a decent life
However, he decided to pick her up and have her with him.
Also the case of Don Manuel who has had a
life of lack but through the love of God
His neighbors take care of him and Ramiro, a young man with
I really want to go back to work, however
arthritis no longer allows him to arrive for another year and
say with a huge smile, look, I can now
moving our fingers is how we can see the
answers to our prayers.

It is always a shocking experience year after year.
patient cases yearly and a
bond with them, every time I arrive in the City
Hope I can see the patience, the nobility and the
love of neighbor that Dr. Richard has at his disposal
patients who, without knowing their language, can know
their discomforts.

I can only say that if you can help your

brother one way or another do it, you don't know
the needs and burdens that each person carries
person.

I end by thanking and remembering a verse
which I feel is necessary in our days and for
our patients.

Call to me and I will answer you, and I will make you known
big and hidden things that you don't know.
Jeremiah 33:3

Breathe, breathe, breathe

Toddler with hemiplegia we see every year, making great progress thanks to his adoptive mom’s loving care

Dr Richard, always young at heart wearing a vest that was given to him by the man with schizophrenia. Richard had to complete the look with Ricky’s cowboy hat

Finishing the full newborn exam on the new baby with cleft lip/palate and trisomy 21

Dr Ricardo on the right, who is at the clinic year-round half days, thanks to our amazing benefactors. He will follow this little 5 day old as she gets her cleft lip and palate repaired

Our little dynamo who is blind instructing Thomas. Of course he is learning how to use the stethoscope because he wants to be a doctor when he grows up. He will probably be better with heart murmurs than me - when kids lose one sense often the other senses are more fully developed. He has excellent hearing!

Was a normal 16 year old until an autoimmune disease tried to steel her life 4 years ago. Thanks to benefactors we will finance her medications this year. They are making it possible for her to see us this year without being in her wheelchair!

Victoria and her 14 yr old son after the Mayan ceremony

My place of peace this trip. Breathe, breathe, breathe

Breathe, breathe, breathe.  I don’t even really know where to start in processing this year’s work in Guatemala.  Usually during the week I will have one or two patient encounters that bubbles to the top and I have an overwhelming need to write about them.  That is so helpful for me as a way to process the experience.  This year, however, there are just countless encounters.  Every year there are many moments of feeling such an intense presence of the divine when we are there, but this trip I just cannot pick one to land on to write about and process.  So, I am going to write out a little one-liner about many things.  First up is our continuity patients.  These are patients we have come to know over the years. They come each year to have an annual visit with us.  Needless to say these relationships are deeply powerful to all of us.  We care so much for these beautiful people and really just want to give them a little hand along their way.  If we can ease their burden just a little, it eases ours.

Continuity patients

• 20 year old with dermatomyositis probably induced by COVID in January 2020, who we are able, through lots of caring donors, to supply her autoimmune medicine for the next year (these cost her several thousand dollars annually in Guatemala) - without them she is confined to a wheelchair

• Dynamo almost 7 year old with visual impairment that captures everyone's hearts now for the last 3 trips.  I have immense respect for his phenomenal mother. He had to have a tooth extracted this year by Dr Christian our dentist.  During his fear and panic over the prospect of having the tooth pulled he shouted that he was going to “destroy Christian!” but his mom sent a very sweet voice recording of him forgiving Christian the next day.  The little boy has worked hard the last year to learn some English to great us with when we come to Guatemala..  The voice recording is : GOOD MORNING CHRISTIAN THANK YOU por sacarme los dientes - half English and half Spanish.  Listening to the voice recording  over and over again has sustained me through hard things already!

• Family with 2 young children with skeletal dysplasia that Deb has been able to prevent joint contractures from worsening; their third baby had her second physical this trip - no skeletal dysplasia for her except her sternum, so I am hopeful she will grow up without such mobility challenges

• Elderly gentleman who has schizophrenia and sees Dr Richard yearly.  We are now able to pay for his medication refills. He credits Richard for saving his life on the first visit even though we had no meds to offer him, but Richard listened to him share his story.  That was enough to sustain him for a full year until the next trip.

• Last October a sweet child lost her battle with aplastic anemia and I was able to see her mom and share a hug and tears remembering how wonderful her daughter was.  We tried unsuccessfully to get her enrolled in a research trial at St Jude’s for several years.  She needed a bone marrow transplant to survive.

• 3 year old with hemiplegic cerebral palsy from a failed abortion attempt by his biological mom, doing great with the loving care of his adoptive mom, Daisy.

• Older gentleman with rheumatoid arthritis who couldn’t lift his arms above his head when we met him 3 years ago, we bring his medication.  He travels 5 hours one way to clinic and now shows off his much improved mobility

• Several adult patients with hypertension and diabetes that join us annually

Really just seeing any one of those patients in a week would be enough teaching opportunities for the Regis students and would make us as providers work hard to help address their problems in whatever way we could.  But in addition to all of those, we met several new, equally complex patients this trip.

New patients with significant medical problems

• 8 yr old twins with severe cerebral palsy, who lost their dad 15 days prior, so widowed mother is left to take care of 7 children, two of whom are completely immobile and in diapers,  They also have ambiguous genitalia, so remarkable learning case for the students - and me

• 13 year old with untreated congenital hypothyroidism leading to severe brain damage.  Family traveled 5 hours one way to clinic.  We were able to get her thyroid labs done for her and refill her thyroid medication - based on her current dose she needed 274 pills for a 1 year supply, we had 273 for her.  I have never seen a patient with untreated congenital hypothyroidism since it is screened for at birth in the US and immediately treated to spare the immense brain damage. What made us have the exact right number of pills to give her this year? It is that whole providence whispering thing and us answering the call.  I truly am amazed how every year some miracle happens like this.  She also had a tumor resected from her left eye 3 years ago, she was scheduled with me as a post-op appointment for that problem - that is the least of her concerns, really.

• 5 day old with cleft lip and palate and trisomy 21 - she got started on a program the TESS foundation does thru the clinic where she will get the specialized bottle nipples cleft kids need since they cannot form an adequate suck from a human breast.  She will get weighed monthly at the clinic and get 8 cans of formula each month to ensure she grows well enough so she can start getting surgical repair after 6 months of age.  TESS foundation identified our clinic as a hub clinic for the whole area since we are able to support Dr RIcardo’s stipend to be there year-round and provide pharmaceutical help.

• Young toddler with syndactyly - fused fingers - and tight achilles tendon who got started in PT, both Dr Deb and I stressing to the parents to not treat her as if she is dis-abled but just differently-abled.  They have been reluctant to let her try to use her hand and legs because she is different.  She is already figuring out how to use them despite their reluctance. 

Even though this seems like a long list, I am 100% sure I am missing many more.  I came home coughing on the plane back to Denver and a few hours later I tested positive for COVID.  And the brain fog is real.  So for now this is the best I can do for this list.  But look at the remarkable list of people we have had the honor to meet this week and try to accompany them on their journey.  It is hard to walk it alone, especially when resources are so scarce.  Each one of them will motivate us to work harder this next year and raise more funds to continue this project.   

Our week ended with our visit with Victoria, the Mayan priestess who does a ceremony with us each year.  This year we had the ceremony in a peaceful private home that is built into the hillside overlooking Antigua.  For me it was an hour of letting go of anxiety and just being in the present moment.  It was a chance to breathe, breathe, breathe.  And for every second of it I am grateful.

Dr Lauri