Peace and Presence

Reentry back into the States always feels like more of a crash landing, but it is nice to spend some time reflecting on our experience in Cobán this year.

Our days were jam packed from sun up to sun down, but the beauty of this is that it allowed me a chance to be more present and remove the daily distractions that often plague us. When you take a minute to slow down, when you look up from your screen, you’re forced to face the humanity in front of you. That’s exactly what occurred this week as I interacted with our team of medical professionals and students, our partners at Ciudad de la Esperanza, and our beautiful patients that traveled from near and far to be seen in the clinic. 

It’s always such a blessing working with a group of people committed to improving the healthcare for our brothers and sisters in Cobán. We arrived very late on our first day of clinic due to some unforeseen traffic, but without fail, we unpacked over 30 suitcases filled to the brim with supplies for the year in record time. It was amazing to watch in action as everyone moved in lock step to get everything organized so we could begin seeing patients as soon as possible. So we began another great week in clinic. Throughout the week, so many miracles happened because of these efforts and the skills and talents of every member on our team. Many patients were gifted the ability to see better thanks to our Global Vision 2020 eye glasses kits. Our incomparable engineer, Matt, was able to 3D print a prosthetic prototype for a little girl with no legs and create walkers. Perhaps the biggest miracle for me; a 4 year old girl who was excited to see the dentist! The list is endless. 

It was also so special to talk to and get to know our incredible group of students who grew so much as individuals and future healthcare providers. I could see them progress throughout the week as they grew their clinical skills and the courage to speak more Spanish! They were able to see what collaborative healthcare looks like and witness the incredible soul and resilience of Cobán as they made every effort to connect with our patients. 

We shared many tears and laughs in our nightly debriefs as we discussed some of the patient cases that had come in that day and wrestled with the reality and challenges that many of our patients faced. There were so many examples we heard of about how this community supported one another. Neighbors checking in on elderly in their community. A child taken in by a family that was not his own. A family doing everything they could to find resources for their youngest boy with CP. 

This week taught me many things but most importantly, it taught me the importance to slow down and to be present. To witness the humanity around me and see the God in others. 

Christian Alegria, DMD

Growth and Deep Solidarity

Growth on growth on growth. That’s the phrase that echoed through my head this past week as I spent time with this incredible team and community. It’s not every day that you get to relive an experience you had six years ago as a junior undergraduate nursing student and then return as a 27-year-old nurse in grad school serving as part of the medical team. I still can’t fully express how surreal that felt.

Seeing how much the clinic has flourished and expanded its capacity was incredible. The last time I was there, it was one room spearheaded by the incredible nurse Esmerelda. Now, it has grown into a guiding haven for the community with full-time medical staff. Being able to come back and speak to everyone with a little bit more Spanish under my belt also felt immensely rewarding. No longer was I passing my phone back and forth on google translate with my friend Mateo, our photographer, but instead could catch his sarcastic jokes in real time. I also got to re-experience the camaraderie of the medical team, but this time as peers instead of role models. However, what I could never have predicted was how meaningful it was to offer the same mentorship that I cherished when I was a student to this year’s new student team.

I was surprised by how invigorated I felt teaching and guiding students through an experience I knew so well. I loved helping ease worries about triage while also challenging students to practice their Spanish, which I originally had struggled so deeply with as a student. I loved refocusing our energy on building capacity and thinking critically about how we can take what we learn from this community and apply it to protecting the rights of vulnerable communities struggling back in the United States.

Monse and I were given the opportunity to lead the final closing debrief, and in that space, it felt like I was speaking directly to a younger version of myself, sharing what I would want her to take away from this experience knowing what I now understand about our systems. After our initial debrief, I ended with this statement:

“Now that we recognize how we can show up for our communities, I want to read a short passage from the book I am currently reading, See No Stranger. It is written by the Sikh activist Valarie Kaur, who reflects on growing up in the aftermath of 9/11 and trying to create radical love amidst an environment of hate-motivated attacks directed at her and her community. She talks about the idea of ‘ancestral solidarity.’

‘People of color survived oppression throughout our history through acts of solidarity. Shallow solidarity was based on the logic of exchange—you show up for me, and I will show up for you. But deep solidarity was rooted in recognition—I show up for you because I see you as a part of me. Your liberation is bound up in my own. We needed to show up for communities who were subject to state violence, AND for the people in the countries our government was about to bomb, AND for the soldiers about to be sent into battlefields that did not need to exist.’

— Valarie Kaur, See No Stranger

As we reflect on that passage, the concept of fighting for systemic justice just makes sense. If we build better healthcare access for those in Guatemala, then we are building a better global healthcare system for all of us. And that is the point.

Don’t we want a world where we don’t need to travel to another country to remind ourselves of the love and community that can exist within healthcare? A world where communities are not dependent on us to provide resources, but instead have access to greater economic opportunity and the ability to remain within the loving communities they’ve created?

We want everyone to have access to resources, love, and community. If this trip impacted you, I hope you continue to advocate for equity and justice within our healthcare system, especially as it faces incredibly detrimental policy shifts that will affect you, your families, and our community in Guatemala.

-Kateri Dir Munoz 

What the Heck Just Happened?! The Clinic Gets a New Name

A very emotional morning unfolded at La Ciudad de la Esperanza on the second day of clinic last Wednesday, as the community formally unveiled the clinic’s new name: La Doctora Laurel Pramuk Clinica de Atencion Integral en Salud. After some beautiful words of welcome in Spanish from Dr. Ricardo and Doña Rosario, Lauri and I were asked to come forward, step onto a small step ladder, and, as everyone counted down from three, remove the clips that held up a sheet covering a sign on the wall. The sheet fell away and the name was revealed. Lauri was caught completely off guard and so was I. Tears flowed as everyone burst into applause.

When she was finally able to speak, Lauri managed just a few words. “If I wanted any place to have my name on it, it would certainly be this place. Thank you.” For my part, trying to absorb this unexpected honor, Dr. Ricardo’s words about the work of the medical team held even greater significance. “Sister Ann Manganaro,” he said, “would be very proud.”  

On their Facebook page the next day, La Ciudad announced the naming of the clinic “after Dr. Laurel Pramuk, American pediatrician who has dedicated fifteen years of her life to helping the Guatemalan community in their healthcare needs, seven years of which have been on behalf of the population of Cobán, Alta Verapaz. Dr. Pramuk leads the project with students from Regis University in Denver, Colorado, an effort that translates into caring for more than 2,500 patients per year in our clinic. Accompanied by her husband, Regis professor Dr. Chris Pramuk, the name that will accompany us on this road to help the most in need was revealed in a moment of surprise. We are so grateful, Dr. Lauri, for your dedication to the people of Guatemala!”   

Others have shared beautifully on this blog about their experiences in the clinic over the course of the week: the beautiful children, the courage of families, the medical challenges faced with expertise and creativity, patience and love. For me, the naming is an additional gift beyond all words to know that the people of this community will hold Lauri in their hearts as dearly as she will always hold them. The sense of wonder and gratitude for what she and the medical team have built over the last 7 or 8 years, on both sides of the border, is truly overwhelming. After a lot of hugs and tears, all that remained after the naming ceremony was to get back to work!

Lastly, one of the things that has moved me so much about experiencing the clinic at La Ciudad firsthand is the intergenerational learning and partnership it embodies. Like an electrical force field flashing from heart to heart, mind to mind, the care of the medical team for every student in each patient encounter  – teaching and questioning, challenging and encouraging – leading with curiosity and genuine care for the (whole) person is really beautiful to behold. Young and old, experienced and inexperienced, confident and tentative, all walking together side by side, seeds planted and watered in the lives of everyone involved. Education as whole person formation, the best of what a Jesuit education can provide. 

I’m so deeply grateful to the La Ciudad community, to Regis University, and to the medical team and students who welcomed me as one of their own, alongside my beloved wife Doctora Lauri, an experience I will never forget.     

Chris Pramuk, PhD

Padre Sergio expressing his thanks to Regis University, to Dra. Lauri, and to the medical team and Regis students for their partnership with La Ciudad de la Esperanza and the people of Guatemala.

Unconditional Love

My week in Guatemala was a surreal experience. No amount of knowledge prior to the trip could have prepared me for what I was going to experience. It felt like the necessary pause I needed before returning back into my everyday life. It was as if I was reflecting on different aspects of my identity within the activities of this trip. For this reason, I separated this trip into three different aspects of my life: my clinical life, my personal life, and my life within a community.

My clinical experience at Guatemala, opened my eyes to how generous my life is at home. On my first day at the clinic during my rotation in pediatrician with Dr. Lauri, I witnessed firsthand a number of patients who had a severe delays or illnesses due to not being diagnosed on time. Although I would feel distraught for these children, I couldn’t help but admire them and their parents for their resilience. Throughout all our visits, I consistently felt the unconditional love these parents have for their kids, and their desire to seek help for them — even if it means that they have to walk since the crack of dawn to get to the clinic. I also couldn’t help but see my family within this Guatemalan community. Though it was a good motivator, it would leave me frustrated at times because there was only so much I could do for these patients. Going back to my everyday clinical life, I hope to keep viewing my patients as an extension of my family so that I may be able to give them my all.

During our debriefs after every clinical day, I was able to reflect on my personal life and the kind of woman I want to be. I didn’t realize how good my life was until I was aiding a community that had so much less than me. It opened my eyes to all the things that I should be thankful for. I will never stop being mesmerized by the way so many of our patients are willing to walk for hours just so that they can meet with a doctor and then share a prayer before they go back on their walk. Now that I go back home, I aim to practice graceful meditations so that I aim able to truly see what life has to offer.

During my time on the bus and in Antigua, I was able to reflect on my life within a community. I cannot help but admire how beautiful each and every member on this trip was so passionate about helping others. It’s not everyday that you are given the opportunity to be surrounded with people who genuinely enjoy helping others. This grew a desire within me to make sure that I have a strong community at home that motivates me to help the most vulnerable.

Over all, my time in Guatemala was a life-changing experience. There are no words that can describe the way I feel. Truly, a part of me is still wondering how I will be able to explain my experience to my friends and family. It feels as though I have a reawakened a longing to love others without expecting nothing in return. Moving forward, I hope to spread this unconditional love in every aspect of my life so that I may be able to see the smiles I saw in Guatemala back at home.  

-Sandra Rodriguez 

Agape

 If you were to force me to describe this project in one word it would be,

agape.

Unconditional love, without condition, care for the other, despite it being difficult, despite cultural, religious, or language barriers. The idea that all persons are deserving and are worth the effort. 

This past week in Coban, in Antigua, and especially in clinic at Ciudad de Esparanza, I have been exposed to what I believe is this idea of unconditional love directly in action. I witnessed medical providers go above and beyond in their responsibilites, to ensure that patients are given the resources they deserve. I have seen students pour their hearts out to the children of Coban, playing football, tag, and creating a community that welcomes togetherness and family. 

Though I was only able to experience this project for a week, I have seen the ripple effect that hope and commitment has on both the community of Guatemala, but also the medical staff and the students.

This experience has allowed me to reflect not only on the culture of a foreign country but also has opened my eyes to the privledge and the emotional poverty that is rampant in my own country and the world today.

There are many, many days in my life where I feel a sense of despair, worthlessness, as if hope is lost. The belief that as the world evolves more and more, less and less people will be willing to speak up, create change, fight the social norms, create that ripple that motivates and influences difference, embody agape. 

That belief I now know is incorrect.

Despite how gloomy the world may seen today, there are numbers of communities and people across the globe that I can’t see or possibly even imagine who are at a constant battle pouring their heart and themselves in order to create a more just and true world. 

It only takes one person to come up with an idea, but it is with a community of individuals where change is made.

Words are nowhere enough for me to describe that I feel that there are truly no boundaries and obstacles that can not be overcome with the action of love. There are of course times of doubt, times where it seems easier to quit. But, despite the doubt and hate, this journey has taught me to turn those emotions into kindness, into an idea, and then into action. Because hate and love are what I believe to be, two sides of the same coin.

Because love is truly a gift that can create real miracles in the world today, I have seen it for myself, and it is something that is especially needed now as the world continues to change.

If there is anything substantial to take from this blog and this experience, 

I ask you.

Love thy brother, love thy sister, and especially, love thyself.

-Vincent Nguyen 

A Letter To My Mom

Dear mom,

I don’t think I fully understood what this trip would mean to me until I was in the middle of Coban, Guatemala helping out at the clinic. Everyday in clinic, I was reminded of the strength and compassion you have. Today at the glasses station, I saw mothers light up when they found the right prescription, then immediately brought up their children to experience the same thing. I also saw the strength and selflessness of a mother in the waiting room, watching mothers comfort their children, reassuring them with gentle words and quiet patience despite their worries and exhaustion.  

What struck me the most was the look of adoration after watching their children do the smallest to biggest actions. I saw it in the way they celebrated when their child having the strength to sit themselves up in physical therapy. I saw it in the way they brushed hair out of their children’s faces while waiting for treatment, trying to ease fear with nothing more than a smile or a hand to hold. I smiled, laughed, cried, and mourned with the mothers I met this week. A mother’s love was felt in every place in the clinic. 

I noticed the humility the mothers had during my experience, not taking any credit for their child’s progress. The progress happened because of the constant love and support of the mothers. Sharing these moments with the mothers reminded me so much of you and all the ways you have supported me, often without asking for recognition in return. 

Through the endless sheets of coloring books, they stayed and admired. Through the illnesses and uncertainty, they stayed and guided. Through the challenges of becoming a single parent, they stayed and nurtured. Through all the obstacles, they stayed and loved. There is no strength greater than the one of a mother. The resiliency and selflessness of a mother is nothing short of remarkable. 

Words cannot fully describe how much I appreciate your impact I felt during this week. You truly are incredible, mom. Thank you for being the person who guided me through this experience. I am who I am because of your kindness, love, and patience. I can’t wait to share this experience with you. I love you. 

With love,

Val

¿Quieres probar?

 Fun, laughter, and lasting memories were anxiously waiting for the young boy's answer. With his full toothy grin on display, Omar smiled widely at the small blue bottle of bubbles I offered him. 

¿Quieres probar? I asked.

It wasn't long before Omar nabbed the bottle from my hands, venturing outside the clinic into the blistering heat. Omar introduced me to his friends--with immense linguistic difficulty on my part--and we all happily blew and chomped on bubbles. Omar's smile shined brighter than the sun, and his laughter continuously echoed in my ears. For a moment, the troubles I faced earlier this week were far from my mind.

Kristine's eloquent description of him as a sponge perfectly sums up the essence of the ever-wise Dr. Richard. The entirety of my first day in clinic was spent soaking up the endless knowledge Dr. Richard had to offer--and boy did I soak. I was in awe of the power he held and the magic he worked, carefully explaining each step he was making to evaluate the issue and come to a solution. The day was productive and mentally stimulating, but that night during debrief, a tsunami of emotions washed over me. 

With shaky hands and a heavy heart, I shared with the team how much guilt had silently built up throughout the day. It was like a hole burrowed deep into my heart. In thinking of the patients we saw, I was apologizing, and then I felt even more guilt about making my reflection about myself. That day, I witnessed the boundless strength and fortitude this community has. No fall from working construction or unexplainable pain could shake the resolve of these individuals. And even more, all of the patients were so grateful. I was confused why they were thanking me when I hadn't done anything for them. It felt undeserved. 

Near the end of debrief, I sat with sweaty palms and furrowed brows, drowning in sorrow, silently realizing the scope of what had occurred today. I couldn't explain how I felt. After we finished, I hastily got up to leave and head to bed when I was approached by the medical team, specifically Monse and Dr. Richard. It was like lifeguards had tossed a life jacket to bring me back to shore. Their words of comfort and wisdom helped enlighten the deeper meaning behind today: having confidence. But this is not confidence in yourself, rather, the patients.

As I lay in bed thinking about the entirety of today, I realized capacity building goes hand in hand with building confidence in your patients. And that process starts with you. I've heard people say you can't pour from an empty cup, and I believe that saying applied to me today. I was deathly afraid of triage and butchering Spanish, but it only took a couple of practice tries to get into the groove. And then, triage was amazing. (Shoutout to my Triage Ladies--including you, Monse.)

Don't let fear stop you from sharing your unconditional love with others. Like Omar, an entire world of warmth and joy could be unleashed by simply saying yes. It only takes that first step to build a path of confidence others can walk upon. Be the Trailblazer that leads others towards health and happiness.

So now, my question to you is:

¿Quieres probar?

-Ryan Cao

In a Place Full of Color - Finding Humanity in Service

When I first signed up for this trip back in August, I knew it would be meaningful. We spent months fundraising, preparing, and learning about Guatemalan culture in anticipation of our time at Ciudad de la Esperanza in Cobán, Guatemala. But no amount of preparation could have fully prepared me for the impact this experience would have on me, not only as a future nurse, but as a person.

Over the course of this trip, I had the opportunity to rotate through several specialties including internal medicine, pediatrics, dentistry, physical therapy, pharmacy, and triage. Although we were technically shadowing, we were also very involved in patient care. In triage, we took vitals and helped prepare patients for their appointments. At the glasses station, we fitted both children and adults for readers and prescription glasses. Every rotation taught me something different and gave me a new perspective on healthcare, communication, and service.

One of the most impactful parts of this experience was the community surrounding the clinic and school. The school itself was overflowing with color, energy, and life. Children ran through the halls laughing, yelling, and playing freely. There was such a strong sense of joy and community that felt so genuine and alive. It made me realize how different life and connection can look in different parts of the world. Despite having far fewer resources than we are used to in the United States, there was an overwhelming sense of warmth, hospitality, and kindness everywhere we went.

What stood out to me most was the mutual respect shared between everyone. Patients, providers, students, teachers, and community members all treated one another with so much dignity and compassion. People welcomed us into their community with open arms, and I do not think I will ever fully be able to express how grateful I am for that.

At the same time, this experience challenged me in ways I did not expect. In the United States, we often rely heavily on testing, technology, and immediate access to resources. In Guatemala, I saw firsthand what it means to work with limited supplies and limited access to care. Things we might consider simple or routine in the U.S. are not always possible there. It forced all of us to think differently and focus on what we could do for each patient with the resources available. There was something incredibly powerful about seeing healthcare approached with so much creativity, adaptability, and compassion.

As difficult as it is to explain, I genuinely feel like I am leaving Guatemala as a different person than the one who arrived. This trip gave me a new perspective on life, one filled with greater curiosity for other cultures, deeper gratitude, and a stronger passion to serve others. It reminded me that healthcare is not just about medicine or procedures. It is about human connection, empathy, dignity, and meeting people where they are.

As a Bahá’í, service is something I really value, and this experience made that feel more real than ever before. I saw what it looks like when people from different backgrounds come together with the shared goal of caring for others. I saw how compassion can transcend language barriers, cultural differences, and circumstance.

I do not know what I did to deserve an opportunity like this, but I know it is one that will stay with me forever. The people I met, the lessons I learned, and the perspective I gained will continue shaping the kind of nurse, and the kind of person, I hope to become.

Thank you, Guatemala, for your kindness, your beauty, and your humanity. A part of me will always remain here.

- Nadija Rutar