New Seeds in Shifting Soil

May 6, 2026 

It is the final days before we embark on another trip to Ciudad de la Esperanza in Cobán, Guatemala with 11 Regis pre-professional healthcare students, and our volunteer medical team of 11. We begin our preparations for this with an application and interview process for the Regis students every September. We meet weekly with the students throughout the academic year to prepare them for the week seeing patients in Guatemala. The students learn about Guatemalan history, culture, healthcare in Guatemala, ethics of medical service trips, how to take accurate vital signs, how to measure and plot children on growth curves, how to take blood sugars, how to interpret and fill prescriptions, as well as a little about primary care pediatrics, internal medicine, physical therapy and dentistry. They also work hard throughout the year to raise the funds to make this program happen every year. We’ve raised enough to bring the pharmacy to the community for the year, and since 2022 have raised enough to support the stipend for a Guatemalan physician to be at the clinic year-round part time, as well as a full time nurse. 

I have worked closely with Regis University Advancement for several years, trying to acquire grants to help us support the clinic. This year, with the help of Laurel Petralia, Senior Director of University Advancement, we landed a sizable grant from the Loyola Foundation. http://loyolafoundation.org/   Because of this grant, we are able to significantly advance the capability of the clinic at Ciudad de la Esperanza. We are planting some major seeds with this grant funding. Most impressively, we were able to purchase an electrolyte analyzer and hemoglobin machine for the lab. I have gotten to know a team of people at McKesson and Abbott Laboratories, who have been generous with their time and support to help us make these equipment purchases. Having easy access to these labs will be transformative for the community. The grant also purchased child and adult glasses with customizable lenses through Global Vision 2020. So we are excited to roll out this new endeavor next week. gv202.org The grant will also be used to purchase some room air-conditioners for the clinic. The effects of climate change are so very easy to see as we travel year-to-year to Cobán. Of course the global south will feel the earth’s warming before the north. When children are ill, excess heat leads to devastating consequences of dehydration quickly. 

Finally, the grant purchased a 3D printer that we spent the last month guiding through customs. Last May, Matt Muller, an engineer at National Renewable Energy Lab, joined us to install the solar panels he had donated for the roof of the clinic, helping make the clinic less dependent on the energy grid.

Matt’s skills were also utilized to build a gait trainer for an 8 year old with cerebral palsy. Matt has agreed to keep joining us on the student trip and we are thrilled to have his amazing engineering skills. We have 2 patients in the community who are amputees - one is a toddler who is a bilateral below the knee amputee from amniotic bands in utero (think protein strings in the womb that form tourniquets, cutting off blood supply to limbs, effecting normal limb formation); and the other is a man in his 30s who was trying to immigrate north to find work to feed his young children back in Guatemala. He fell from a truck in Mexico and ended up losing his right arm above the elbow. Matt, who is always looking for new engineering challenges, has expressed interest in trying his hand at creating 3D printed prosthetics. We are all anxious to see how this will all work out. 

click play to see this newly mobile young man in using his gait trainer

The other major news of this past year is our official launch of the endowment to build the capacity for further sustainability of the program. What we have learned over the years of doing this work is that foundations that offer grants tend to like tangible things to fund - see the previous discussion. It is harder to find long-term, sustainable funding to pay people a living wage. Without a Guatemalan physician, nurse, and social worker in the clinic, year-round, this clinic would not survive. In the few years since our partnership began with Ciudad de la Esperanza, the local medical school in Cobán has recognized this clinic as an excellent site to rotate students through. Because there is a physician and nurse there, Guatemalan student doctors, nurses, dentists, psychologists all rotate through the clinic throughout the year. The more capacity for these kinds of clinic experiences for future Guatemalan healthcare providers, the more likely they will stay in the area after their training instead of moving to Guatemala City, which most professional healthcare workers tend to do. 

So, for Regis Gives Day this April, we planted some more seeds. We officially launched the endowment. It is called AMIGA - Ann Manganaro Initiative for Guatemalan Accompaniment.

Ann Manganaro was a Sister of Loretto and pediatrician, who has been a long time hero of mine. She lived in El Salvador during their civil war in the 1980s (though she wanted to be stationed in Guatemala).

She died young of breast cancer, but there is a health center dedicated to her in Salvador that serves 50,000-60,000 Salvadorans. Accompaniment is one of my favorite words, thanks to another one of my heroes, Paul Farmer, MD, founder of Partners in Health. Accompaniment is the perfect word for the partnership that now exists between Regis University and Ciudad de la Esperanza. The idea is to build this endowment over the next several years to the point that the interest will sustain the stipend for the healthcare workers at the clinic in perpetuity. We made a nice dent with over $52,000 donated in April. I am still absolutely blown away by that figure. It is so gratifying to have such generous support from so many people who believe in the work we are doing. 

click play to see more about the endowment and Sister Ann Manganaro

I have never done any formal training in global health, but I feel like I have had a front row seat to global health through the work in Guatemala the last 15 years. These new seeds like grants and endowments are new to me. We can use these seeds of the grant-funded equipment and the endowment for future sustainability to help this program grow. But the soil of global health is shifting. With the dismantling of USAID in January of 2025, and the loss of over $2.4 billion dollars in NIH global grant funding in the last year, global health initiatives have never been at greater risk. What the Trump administration does not seem to understand is infectious diseases don’t respect borders, and climate change will only drive the immigration crisis further. The loss of these types of programs will have the most profound impact on children. I still have trouble getting my head around the defunding of PEPFAR (President’s Emergency Plan for AIDS Relief) that George W Bush (with guidance from Paul Farmer, MD) initiated in his presidency. It had helped contain HIV worldwide and made it no longer a death sentence. With those programs gone, we will now see HIV thrive again. Mother to infant transmission will resume and the virus will develop rapid resistance to our treatments. With the destruction of the CDC (Centers for Disease Control) and our fractured relationship with WHO (World Health Organization), the US now stands completely unprepared for the next pandemic. I am writing this as a human-to-human transmissible strain of Hantavirus has killed 2 people on a cruise ship that is docked off the coast of Cape Verde with 150 passengers still on board. I cannot even begin to discuss what misinformation has done in pouring gasoline on the anti-vaccine movement. The last year has been the hardest year of my career as a pediatrician due to misinformation from our current government about vaccines and other routine, evidence-based medical care of infants and children. All of these things are intimately tied together. Systems that helped global health progress have been severely damaged in the last year. The soil of global heath has become significantly harder to cultivate in the last year. 

Humanity is all interconnected. Once you see that, you cannot unsee it. Pope Leo understands this interconnectedness. When asked by a reporter about immigration, Pope Leo responded, “What is the Global North doing to help the Global South?” He knows that systems have to change. 

The students and medical team will be posting about their experiences through the week. You can follow along on our webpage rubuildingcapacity.com   Click on the menu top left to scroll to “archives” to read past posts and ones to come. 

Lauri Pramuk, MD 

Medical Director and Pediatrician Regis University Guatemala Interfaith Medical Service Program