Thursday, Jan 27
First time ever this morning that Ismael was 20 minutes late. Hmmm….is he getting like me or did something happen?
As always, I am always blindsided with issues that I didn’t see coming. When we started our high school sponsorship program, I didn’t see this potential problem.
Turns out that a small group of teens on “motos” (small motorcycles) were on their way to to high school yesterday (not our group) and they were stopped by 3 men with guns. By the grace of God our group in the bus had passed just a little earlier. However, the news quickly got out and the parents of our group were of course alarmed. Once again, Ismael sprung into action to immediately address the issue. First, he typed up 2 notarized letters to be sent to the local police and another to the school. He immediately called the police chief to arrange for security on that road.
In the letter to the school, he explained to the principal the concerns of the parents and that SewHope was in complete agreement with any wishes that the parents might have to decide not to send their children until we have had a chance to develop a plan. He then contacted the community leaders to arrange for a meeting with the parents today. He had done all this since we left him at 9PM last night and still made it at 7:20 AM to pick us up!! In all my life, I have never met anyone so humble and yet so incredibly responsible, capable and unceasing in his determination to correct injustice. And in all this, he and Orfe get up every morning at 5AM to pray for an hour and again every evening before dinner. The more I see here, the more I realize that he and Orfe are working day and night for us at a salary that would not be close to minimum wage in the states.
More on the parents meeting later……
So off we drove in our usual manner for an hour and a half, talking, planning, struggling with Spanish, laughing and sometimes almost crying.
On the way, we stopped on a busy road to pick up some of our patients who would be treated for their cervical dysplasia! They had arrived on this part of the road at 6AM since that’s the only time the bus comes. By now, it was 8AM. They happily laughed and were so delighted that we really did come as promised. They had actually also come 2 days before when we hadn’t figured out how to have the treatment available. But no problem! They just waited for the next bus which wouldn’t arrive for 5 more hours and happily come back 2 days later!! And they were each holding a small toddler !! Can you imagine???? I think of my patients In Maumee who sometimes swear at my nurses if they have to wait 30 minutes!
So they joined us on the bus and sat quietly in the back with their babies who never made a sound for the next hour. As we pulled into Pueblo Nuevo, we saw that great preparations had been made for the great celebration! Today was going to be the “Dedication of the Classroom”!!! The school was completely decorated with flowers, beautiful palm branches and ribbons. The 2 Ministers of Education had promised they would be there but since they hadn’t arrived at the designated time, the community decided to wait for them and we went ahead and started our clinic. I saw a few patients and then by 11, when they still hadn’t come, the leaders decided to go ahead. Orfe had even spoken with these 2 Ministers the evening before and they told her how excited they were to come. It’s always the same – everywhere here. Again, when I read books and go on organizational websites, the constant theme is that you need to involve the local officials. Well, we always try and they always say all the right things and make all the right promises and they NEVER follow their end of the bargain. And this is really why the poor are poor. Yet, knowing what I do about what the United States has done to greatly contribute to the devastation of this country, I can hardly blame the local “Guatemalteca” officials for the corruption that exists now.
So, on for the celebration! Once we arrived, one of the leaders came running up to me with this little plastic sizzors (the really cheap kind you buy at WalMart!) and asked if we’d cut the ribbon to the classroom for the event! And the party began! First, the Guatemalan national music resounding on the speakers! The school director began the announcements on the microphone welcoming us and calling for all to recognize this great achievement. We were ushered up to the open porch in front of the school and asked to sit in the special chairs put out just for us. Of course the only seats available were the ones that the kindergartners use!! Can you imagine Randy and I sitting there on these tiny seats looking like Prince Charles and Princess Diana surround by hundred of children and all the people of the community! This is surely the closest I will ever come to royalty! The speeches began and then the official cutting of the white ribbon!! The paparazzi were there – oh if only I was wearing something a little fancier than my usual Athleta skirt and white T-shirt!!
Then it becomes ever grander!! Hands on heart, everyone starts the singing of the Guatemala National Anthem which is about 5 times as long as hours. But everyone knows the words as if they have this great allegiance to this government that has abandoned them. Then the procession!! This is a picture Randy and I have in our minds forever! 3 of the community leaders (2 men and one woman) come solemnly processing in carrying the official banner of the community looking very stern and very, very official. They carefully climb the stairs and make a careful turn as they face the croud. Massive applause!!!
And then the speeches begin and go on and on and on. Massive thanks to SewHope!! Many speeches about this is a day they will never forget! Great hope for their children! Great promises that the teachers are now going to show up and the children will also show up!! After over an hour of speeches, I was asked to speak. Realizing that at this point, the children were totally not listening, I spoke only to them and yes, I kept it brief. “I have 4 questions for you. Who knows the date?” They all looked puzzedly at each other and a couple of the smart ones came up with the answer. “When do you finish school this year?” Now that was a tough one…..great debate on even the month they finish but they finally made a decision….”OK, Randy and I are going to be here on the last day of your classes this year!” And now…..”Who wants to advance to the next grade next year?”””” WOW…..all the hands zoomed into the air! “And who wants the Pueblo Nuevo school to be the best in Guatemala??” WOW……great shouts! We do!!! And how will you get there? “READ” STUDY” WRITE”, they shouted.”We will start coming to school every day!!
OK, you all get the idea! Then the feast began….the community had paid for a meal of chicken and race for all and one of the pastors had done all the cooking! Could it get any better????
But it only took a few minutes for the sense of exhilaration to be brought back to reality. I began to talk to one of the teachers (the biggest liar I’ve ever met in my life). He hadn’t shared any of the books that we had sent last year with the students. During the celebration, he had taken 2 of each of them and put them into the children’s bookbags pretending that they had been reading them all month. Since they obviously didn’t look used, it only took me a minute to find out from the kids that they had never seen them. Randy, Ismael, Orfe and met spent another hour talking with the teachers…..by the end of it we all agreed that we need some plan to have some control over these teachers. They are completely worthless and even worse, their level of pathologic lying is sad. But that’s for another day…
So then, the meeting with the parents of the high schoolers. It was awesome! They came in looking sad and a little hopeless. They clearly have great respect for us but I think it was the first time in their lives that they had a meeting with “officials” (i.e. people with money!) that actually listened to them. We allowed them to talk at length and we completed acknowledged their fears and their right to take the children out of the program. But they eagerly chatted and finally came up with a plan for varying the roads that the busdriver would travel. They talked about the great sadness that they lived in a country where people couldn’t even help them. They discussed the great need for education and their tremendous gratitude for this opportunity. There was some debate about how to go forward but everyone left satisfied and empowered. Hugs all around!
Then back to the clinic. I then had to use the new electrocautery machine for the women with the advanced dysplasia. This is something I only do at the hospital at home and of course I have all the right equipment and right supplies, etc. I was definitely nervous!! But with my trusty penlight, my lidocaine, the generator and the grace of God, everything went perfectly. Yes, it took about an hour to do each procedure that normally takes 5 minutes but everyone went home happy and hopefully cured. Since it was so late and dark when we finished, we drove them all home to various parts of the Peten which took another 2 hours!!
OK....then Randy and I once again got to enjoy a beautiful dinner at 9PM where we had to chance to “digest” the day and discuss hopes for the future. And this is life in Guatemala….
We spent the early part of the morning on the phone trying to figure out how to get the nitrous oxide tank here for treatment for the women with the cervical dysplasia. For 2 weeks, I’ve been back and forth with this company. As with everything else, nothing is available in the Peten and it requires sending it on an 8 hour ride from Guatemala City. And of course, the only have the “large” size which looks like a missile! We can’t get a straight answer about cost and the terms change with each phone call. Finally, Randy asked me if there wasn’t any easier way to treat these women; he’s always so good at looking at problems in different ways. Bing! The bulb went off in my head – we could use the cautery machine that we sent down here last here. So off we went to the storage facility where we keep the KAH food and found it. Later in the afternoon, we got it all hooked up and no, it wouldn’t work. I almost cried. Seems like EVERYTHING here is such an effort. So, I called the OR at Toledo Hospital and spoke to one of the nurses. She gave me a couple of ideas which didn’t work; I felt so defeated. But we didn’t give up and after a long series of button pushing, success! There was a lot of high-five-ing going on and we made a smiley face in a mango with the cautery! It’s kind of amazing what gives you joy down here! So tomorrow the little ladies from all the villages will hopefully be treated and maybe in some small way, we’ve prevented them from being the victims of cervical cancer.
As we drove along the bumpy dirt road this morning, a young woman came running out of her house waving us down. Ismael pulled over and she frantically starting telling us that her daughter fell and hit a wall and “died” last night. As my heart skipped several beats, I then Irealized that she actually meant that the girl lost consciousness for a while. “Dying” is actually the term they use down here when someone faints. While my Spanish continues to improve, some of these “cultural” terms totally crack me up! The first time I heard this usage of the word “death”, I had asked a woman if she had any complications with her first delivery. “Yes”, she said “I died”!!! Long story but you can imagine my confusion!
Anyway….getting back to the woman on the road. She explained how her daughter had fallen and was “dead” for 8 minutes. When she “woke up”, she was completely confused for a long time. She vomited throughout the night and cried with a terrible headache. Now wouldn’t you bring your child to the hospital if this happened?? No, not here. By the morning she was able to walk, so they sent her off to school!! But the mother was clearly alarmed and wondered if we could make a house call on our way back from the clinic tonight. So at 7PM we pulled up and they eagerly welcomed us in to evaluate the girl. This home was in a village called “Mango”. Mango is a big step up from Pueblo Nuevo since they have electricity, a better school system and some minimal infrastructure. But in the home you felt the same sense of despair, filth, poverty. The girl way lying in the hammock above the dirt floor. Ten years old, she looked more like five. She shyly talked about the pain in her head but assured us that now she felt hungry and she could easily walk and talk. As we chatted, a small pig came over while a more massive one wasn’t able to get in the door! Seriously, can you imagine having a pig in your exam room!!! A cursory neurologic exam from the obstetrician showed that the girl was probably getting over a minor concussion. Now try to explain that in broken Spanish to people who have no concept of anatomy! After much grasping for words, Ismael, Orfe and I finally figured out that she had a “cuagulo” (basically a blood clot in her brain!). “Ahhh”, now it all made sense to them!
Knowing that the local hospital would never admit a child who could walk and talk, I gave them the warning signs to look for that should cause them to bring her there. Of course, the first question was “how much would it cost?” So many children die here that paying any significant amount for treatment is always weighed against how many meals they wouldn’t have.
As we drove back to the hotel, Orfe received a couple of phone calls from the local minister of health. They will be coming to meet us tomorrow as we all celebrate the new classroom that we just finished. And now the bad news…..the hopeless teacher who did almost nothing last year will be returning again. School started the first week in January and she hasn’t shown up yet. But she’s the girlfriend of the other teacher there who’s “politically” connected and so that’s that. The village families hate her and she really didn’t teach anything on the days she did show up. Randy, Ismael, Orfe and I looked at each other dumbfoundedly. Hmmmm…….OK we put money into a school structure, we give books and supplies and we send people who are happy to provide guidance. But how do you make any inroad when you’re faced with this nonsense? Sometimes it seems that there are nothing but blockades. Then we remind each other of the small but very meaningful steps that we see. For the first time, the leaders really are getting together to discuss the school situation. Knowing they have us behind them, they are finally speaking up and starting to believe that they are entitled to have a voice in what happens. There is a young man in the village named Mario who seems to be an answer to prayer. He’s been at all the meetings and is one of the few who genuinely cares. Along with Ismael, he supervised the construction of the classroom all for no payment. Apparently, he’s trained as a teacher and has an official certificate. Because he’s not in the “click”, he can’t get a job and has chosen to go back for another certificate so that he can be the teacher for the adult education classes that we are sponsoring. I didn’t even know we were sponsoring them!! Ismael and Orfe never stop astounding us with their efforts. With the small salary we are giving them, they work night and day for us!!
Apparently, Orfe herself was not permitted to have an education beyond 6th grade when she was young. Her father wouldn’t allow the girls to continue beyond that level. But she always dreamed of a real education and she completed her university degree in social work this year at the age of 37. There is an organization called CONALFA that helped her succeed and so she contacted them to see if we could start one of their programs in Pueblo Nuevo. She set it up so that Mario will be paid to teach the adults to read and she will be the other teacher though she won’t be paid. She is so passionate about this work. Her energy and faith and compassion always humble me. She told me yesterday that her life completely changed when she starting working with us 2 years ago. She said that before she used to be always tired and worried. With a huge smile and tears in her eyes, she said that now she has received the purpose in her life that she had prayed to have for years. She feels completely surrounded by God’s love and care and has boundless energy. She and I laugh constantly in the back of the car as Randy and Ismael sit in the front. She is so patient with my Spanish and sometimes we come to tears laughing about the things we hear in the clinic. Gynecologists really do get to hear things the rest of the world is protected from!! When the women want to tell me something about their “private parts”, they call it their “thing”!! Deena had told me this before but somehow I had forgotten so I was quite confused early in the week with all the references to “my thing”!! The other word that is so hilarious is their term for their period. Being the good little Spanish student that I am, I know at least 3 Spanish words for this. But oh no…..they call it the “infermidad”…..basically the “sickness”. So now when a pregnant woman comes in, I ask “Do you remember the first day of your last sickness?”
Randy had quite a day. Wait till you all see the photo of him climbing into the village water tank which is higher off the ground than I want to think about. Since he’s been quite the scientist this week and has proven to the people that their water is filthy by demonstrating the bacterial colony counts on his agar plates, he wanted to show them that the water from the tank is clean. Since he was worried that the pipes were contaminated, he wanted a sample directly from the tank. How to do that? Just climb up and get it!! He is truly in his element here. If anyone is going to stamp out intestinal worms here, he is!! We continue to be frustrated that the people don’t quite believe the necessity of using the latrines so it’s a constant battle to convince them. On the first day, I literally saw 3 moms bring the children to the back of the clinic to poop right in front of the window!! But after Randy showed the community leaders the results of the agar plates, I started hearing new pleas from help from the moms about ways to convince some of the villagers that they had to start paying for the diesel to run the water tank. The cost is really negligible and if they’d stop paying for the injectable vitamins that some idiot brings around here every month, they ‘d have the money.
I know I’m digressing but I hope all these things give you a sense of what it’s like here. Oh… one last visual…..early in the morning I saw a 70 year old Mayan woman. She was the epitome of the photos you see of these people. When she told me what village she was from, I asked how she got here. She left her home at 5AM, walked for an hour and then got on a horse and rode for another hour. When I asked if I could take a photo of her on her horse, she was joyous! After her visit, we went outside and she literally ran to one of the homes to grab her saddle and horse blankets. Within 2 minutes, she had the white horse saddled and up she popped. All the women waiting at the clinic were hysterical laughing and a couple came over to ask if I could photo them on their horses! Oh….what a difference to Maumee Ob/Gyn!!
As always, never enough time. So much to tell you all. This was supposed to be a trip for planning, organization, evaluation of projects, etc. Yet it’s so impossible to say no to the lines of desperate faces that await us at the clinic. As we drive in to Pueblo Nuevo each morning, it seems funny and tragic to see 8 month pregnant ladies literally running to the clinic with osteoporotic 70 year olds behind them!
The mornings begin and their stories unfold. My heart breaks with each story and my emotions undulate between also wanting to run and wanting to be here all the time. At times, the choices that the people make seem so incomprehensible and I almost become angry when they seem delighted with the announcement that yes, you are pregnant with your 12th child and yes, you have no money or food. Randy and Ismael went to each home yesterday to get an accurate “census” of how many children, what grade, if in school, etc. He described a home with 18 people in one small room; dirt floor, filth, children with runny noses jumping on the mattress that sleeps 5 under the hammocks that sleep the rest. How can I possibly expect them to reason like we reason? Their lives are so full of tragedy that it is senseless.
Yesterday, I saw “Katerina”. She’s the 7 month old (weighs 10 pounds) with the heart defect. We’ve been working with a pediatric cardiologist in Toledo and a group in Guatemala City to have her heart problem surgically corrected. We’ve been buying her formula, trying to build up her nutrition in anticipation of surgery. Turns out that her mother says that she prefers water with sugar so her mom drank the formula! As rage built inside me, I reminded myself that if this was easy, everyone would be doing it.
Sometimes we read about the problems of the world – poverty, starvation, injustice. Oh, if we would just share more, things would be better. But as we become more entrenched in these people’s lives, I see that the roots of despair are so deep that it will truly take an act of God to make it the world that it should be.
Yet, we see small but very significant changes. Randy and Ismael visited one home where the mom was very shy and didn’t interact with the community at all. She now has one of the gardens which is flourishing and she has gained more confidence and even smiles and interacts with the others.
I met with all the teens in our high school program yesterday. Their faces were the epitome of hope. We had given them a test the day before and the results were worrisome. Many of them are barely at a 3rd grade level. They will need much help to succeed. I begged them to tell us each step of the way what they need because our dream is that each one will benefit from this. 5 of them leave their homes at 5AM and walk through a jungle path for 90 minutes to board the bus at 6:30. AM. For the last 2 weeks, they have all been punctual, clean and motivated. That alone speaks volumes to me.
Have to run – more later. Keep us in your prayers.