The Night the Lights Went Out in Guatemala!

Today was a totally different day than we had been experiencing over the past week.  We actually had some downtime aside from Dr. Elry and Chris providing care to some of his patients that come during his normal business hours as today is a normal day for him.  Ernie and Joyce had seen a handful of kids as they all had come during the week during our clinics.  It was definitely a quieter day which we were able to enjoy because the sun was out and breeze was warm!  Today was also the day when 8 of our teammates head back to the states as their mission time was up.  We want to thank them for all of the passion, care, expertise, and teamwork that they had demonstrated while they were here with us.  We will absolutely miss them!!!

After we had lunch, we took a short trip to the "waterpark" to go for a boat ride on the lake.  When we entered this park, it was absolutely astonishing that something this beautiful could be surrounded by so much poverty.  The grass was green and the palm trees were blowing in the breeze, and the peacock was calling.  You could hear the laughter of the children that were swimming in one of two pools that they might not get to go to often as it costs 20 Quetzals to enter.  This park is owned by the government but is maintained by funding from several companies in the area.  As we walked through the park, it made us feel like we were in the states again. 

We arrived to the dock to take out boat ride around the lake and waited in line for this experience.  There weren't many people waiting so we were able to get on right away.  Upon boarding the boat, we didn't know what to expect but could see that the it was a little choppy.  We departed from the dock and didn't think that it was so bad.  We made our way to the other side of the lake where we saw a monastery, a castle, and a painting on the cliff side dedicated to 'baby Jesus".  We then began to round about and see some of the "lake homes" that are around.  Some of these homes appeared to be in good shape but then would be next to a home that is run down and looks dilapidated.  Such inconsistencies! We began to head back to the dock but as the driver began to pick up speed, we were being "showered" with lake water.  As we were being drenched with water, we began laughing as this was not to be expected.  We arrived back at the dock and continued laughing as we were drenched.  What an amazing time this boat ride was and appreciate the time that Elry, Liz, and Samuel took to give us this opportunity.

We returned to the clinic just in time for the weekly "kid's club" where Elry and his brother play music, sing songs, and dance.  The kids love it and at the end of the session, the kids got a snack, and were able to make puzzles brought by Joy.  After this, we were having fun time with them by jumping rope and swinging them around in circles, as well as limbo.  What a great afternoon it was to be able to just have fun with many of the kids that we had been seeing all week in clinic. 

As the sun went down, we sat around the porch and had some time to just talk and be together.  But shortly after sundown, we had realized that "the lights went out in Guatemala".  According to Dr.Elry, this happens on occasion and then they comeback on.  We had received some information that part of Guatemala City also has no power and we are unsure as to when they will come back on.  Liz and Norma found some candles so that we were able to eat dinner.  Dinner by candlelight was a wonderful way to finish out the stay at Holy Cross Clinic in El Salitre.  We had just finished dinner and no more than 2 minutes later, the lights finally came back on.  Once this happened, you could hear the hooting and hollering from all around the neighborhood. 

Again, it is time to hit the hay as we have to get up early for breakfast as we have to head to Guatemala City to pick up Kayci, Phil, and John (pharmacy students) to come to Zacapa with us for our next three days of clinic.  We are ready to go, all meds are packed, and hope that we have enough on hand to care for the patients of Zacapa.  We will do the best that we can with what we have and as always, appreciate the support from all of our family and friends.

Good Night to All and Sleep Tight!

 

Clinic Day - Take 5! Even More Amazing Interactions!

What an amazing day we had with even more amazing interactions and experiences from the team members experiences.  This was the perfect way to complete the work with the team for week 1.  Followed are the experiences from the individuals team members eyes.

1.  Joyce - The most fun thing that I did today was with a boy named Ivan.  He colored a picture and I said that I would take his "Photo" and so I did.  Again, he colored another picture and I said that I would take a "Photo" and so I did.  For the third time, he colored another picture, approached me and said "Photo".  I had to laugh at that.  It was a great day to be able to provide care to the children and families in a new way versus from the nursing perspective all the time.  It was a great day and relaxing to be able to just play with the kids.

2. Joy - The highlight of my day was when the white dog with black spots returned.  He came to me and put his paws on my chest.  That made me happy and gave me a feeling of satisfaction as there are many domesticated pets that are wandering around the village.  I really realized the difference of the behavior of the children today and they seemed to be more behaved for some reason.  It is hard to say why this behavior changed but I really enjoyed the change in environment.

 3.  Bev - I was in triage today and completing the blood sugar tests.  This one gentleman came to get his blood sugar tested.  He happened to notice on the history sheet that his name looked like Maria.  At this moment, he stood up and began singing because of the misunderstanding that he had.  His name was actually Mario.  After his performance and picking on Juanita, our intake assistant, for her handwriting, he was insistent on me speaking in English to him so that he could practice.  With this appreciation, he gave me the biggest hug that made me really appreciate no matter how little the gesture or interaction, they are very appreciative of what can do for them.

4.  Gail - This was my first chance to see Dr. Musil in her role as a Diabetic Educator.  She provided the education and care for them that we would normally do in three days.  This was an incredible influence on me to see him come to acceptance of his disease.  It is so hard to explain the feeling that I had experienced with this but it was amazing.

5. Chris - The relationship with Juanita today really blossomed.  Over the past couple days, we have been working together and understanding how each of us work despite our language barrier.  Our way of communication was a modified sign language so to speak.  I was excited of the influence that I was able to have on her by changing her practice of wearing gloves and hand sanitizer when providing patient care or obtaining a blood sugar.  It was amazing that something as simple as this could change a persons practice in order to improve the patient experience.

6. Melodie -  The food continues to be delicious!  I enjoyed learning more of the hands-on skills and experiences that will make me a more well rounded and educated pharmacist.

7. Michelle - I appreciated the decreased volume of patients today because I was able to spend more time with them.  This gave me the opportunity to really connect and "listen" to them despite the language barrier.

8. Beth - I had an awesome experience today doing something that is part of my everyday experience at the clinic at home; it is a profound experience to see what gratitude looks like at the same time that you are feeling it in your heart.   We forget the simple things that are the most important sometimes as we get wrapped up in what "we know".  Diabetes is prevalent all over the world, but what we are missing most of the time is the fact that controlling it is impossible without simple human connection.  A good reminder.  A wonderful feeling to be reminded. Although I spent the day teaching, I think I learned things that cannot be taught.

9.  Ernie - (random thoughts:) Today during the examination of children, I gave Melodie and Michelle half of the answers to the pediatric elective exam, which I expect they will ACE next week.  This is the first night that the whole team has been together, although we have been working together during the day.  Now that we have used all of our medications during this first week, we are looking forward to visiting the local pharmacies for supplies in week 2.  I can't wait for the 4 hour scenic bus ride across Guatemala to our next destination!

10.  Dawn - I so enjoyed doing something totally different than my normal work flow.  I was able to participate in the pharmacy and learned some things from Alex.  I was way out of my comfort zone and being challenged in a way that I had not been experienced before.  I was able to counsel patients on medications and in a language that is totally "foreign" to me.  It was  a really great day!

11. Jeremy -  Today was an amazing day.  First, waking up to the same view of Lake Atitlan for the 5th consecutive day.  Followed by another amazing meal by Liz and then preparing for clinic.  Today we saw approximately 70 patients with three providers and a Diabetic Educator, Beth.  A memorable patient that I saw today with Jiyoung was a 12 year old boy.  He came in with congestion, parasites, and cough; as most of the kids did.  When we went to assess him, I noticed that his heart sounds were abnormal as I heard them loudest on the right side of his chest, had clubbed fingers, and cyanosis to nail beds and lips.  I went and asked Ernie to come and take a look at this patient.  In addition to Ernie, I had Dr. Elry come to the room as I knew that we were going to need his expertise as well.  While Ernie and Dr. Elry were in the room with the pharmacy students to see the patient, I asked Dawn if we could use the pulse oximetry that she had brought along because I knew that it would be important to see what his oxygen level would be.  Upon arrival to the room with the equipment and placed it, we found that his oxygen saturation was well below normal, 80% (normal is >90%).  With the expertise of Ernie and Dr. Elry, it was determined that this kid had a significant VSD with potential pulmonary hypertension.  WOW!  This is very rare occurrence here and amazing that was not detected until 12 years later.  Dr. Elry made a referral for this child to see a Cardiologist in Guatemala City for a future repair.  This experience has made me very thankful that I am able to work with a highly qualified and experienced team in order to provide the best patient care here in Guatemala.

It is time to say Goodnight!  and God Bless! 
And by the way... it was sunny and 80 here today!

Clinic Day - Take 4! What A Day!!!

And day 4 . . .this is how it went:


We started off the morning with a walk to the local school where we provided toothbrushes and toothpaste to the preschool children as well as antiparasitic medications to the 6th grade students. The preschool children received the toothbrushes with excitement and were educated on proper use and technique of brushing teeth. Unfortunately, the 6th grade students were not as thrilled to chew their not-so-tasty albendozol. The team had to carefully check to make sure that the students actually took their medications, as a few of them tried to be sly and slip them in their pocket!

After our visit to the school, the team was welcomed at the clinic by a line of patients eager to be seen. It was going to be a busy but productive day! There were three providers for the day: Jeremy, Dawn, and Ernie.  Together all 3 providers saw 90+ patients. We, the pharmacy students, were blessed to have the opportunity to spend a portion of our day with the providers and help assess patients. It was an amazing learning experience and included many firsts! Melodie and Michelle got to experience giving a nebulizer treatment to a few young children, suctioning infants with bronchiolitis, and an older adult. Michelle and I (Kristel) saw a case of head lice on a young girl from a broken family. The team knew that without follow up treatment and a supportive family this would only be a temporary fix, but we were glad to treat her to allow her some relief, if only for a short time. One of the most impacting patients of the day, was a 2 month old infant who weighed less than 7 pounds. This infant was malnourished due to the mother being unable to supply proper nutrition for the baby. The mother clearly loved her child, but due to her own poor nutrition it resulted in poor quality and quantity of breast milk. Hopefully the vitamins, education and counseling on proper nutrition along with God's grace will provide this child the chance to thrive.

After reflecting with some of the other students and team, I can truly say that our experience today really opened our minds and hearts to the reality of how poverty can affect a patient's health. It is easy to sit in class and hear a professor discuss different disease states and their manifestations, but to be a part of an experience with these illnesses firsthand allows you to gain an understanding that cannot be acquired in the classroom setting. We feel incredibly blessed to be able to help in the care and treatment of patients at Dr. Elry's clinic and look forward to the remainder of our mission this week!