Hope and Plaster

I first met Samantha* during a Saturday clinic in Canillá. She was two weeks old then, the smaller of two twins born recently at government hospital which is two hours away driving.  At times, this trip is impossible to make during the rainy season.  Her father held her tenderly as her mother lifted her traditional Mayan dress to reveal her left foot, which was turned so far inward that the sole of her foot nearly touched the inside of her shin.

Samantha had been seen at a government hospital for her clubbed foot, but was turned away.  It may have been because of her dark skin, or maybe the surgeon was not interested in a client without the resources to pay for the procedure.  At any rate, she was told to come back in a few years.  This would have been disastrous.  

Thankfully, we learned to manage clubbed feet in fellowship training.  Taking Samantha's little foot in my big hands, I carefully wrapped her leg in plaster cast material until her foot became straight, the angle of the knee was just so.  I worked with one of our new nurses to form the cast until it hardened.  Her father looked satisfied, hopeful that his daughter would walk and play with the other children some day.   

We continued this process week after week, each time with more progress.  Samantha will see a surgeon this week. This time, the needed surgery will be quick, easy and will produce a lasting result that will benefit Samantha for a lifetime.  It is a blessing to be able to touch lives like Samantha's.  God spoke life into Samantha, he speaks all life into motion and for Him this is not hard to do. Nothing is difficult for Him.  

"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future."

Jeremiah 29:11

*Patient's name has been changed.  Photos taken with parents permission.

One foot in front of the other

Well sometimes when you serve on the mission field, or really at any and all stages of life, you get a real hodge-podge of "stuff".

We have been reminded many times lately of Proverbs 19:21 "Many are the plans in a person's heart, but it is the Lord's purpose that prevails." Amen to that and our God is good!  And it is a daily reminder that every goal and purpose we have is only to bring HIM Glory.  Our daily to-do lists sometimes are different than that of the Lord's.  When we keep our eyes set on knowing and serving Jesus, everything else that needs to fall into place does. 

We have had more sickness in our family in the last month than we've had in a long time.  Don't worry, we're shaping up fine and I'll spare you the pretty details.  We spend most of our time raising kids, working in clinics, and doing various and sundry tasks that have to be done in order to get the hospital in working condition (there are lots of these).  In Guatemala, you can't just call the car guy or the roadwork guy when the power steering goes out or the road washes out from in front of the clinic, for instance.  So, lots of hours get nibbled up doing these odds and ends.  

We're thankful to have met lots of really great people down here. The kids are doing well and have made great friends.  April and I have spent quite a bit of time in clinic.  When we're not in clinic, we are usually homeschooling the kids.  I think Abbi has hit her stride finally with that and the boys are getting the hang of phonics.  I've been doing some teaching sessions with the nurses at the hospital. They are young but have excellent potential and are bright, kind people (they are very patient with my broken Spanish).  Getting to know them better has been a highlight of our time here.  We've been covering riveting topics such as IV fluids and Diabetes.  More to come!

                               A precious child eating corn on her mom's back.                            

                                                                                                   

Casting a newborn with clubbed foot.  We are very grateful for the funds from the EV Free Church in Charles City, IA which purchased a cast saw and was in God's perfect timing for this little one.

Dr. Luís and our team helping to fix the road in front of the Chiminisijuan Clinic.  We provide an outreach clinic weekly here, and in the rainy season the roads become very difficult to travel.  A couple weeks ago, during a downpour we actually were stuck (the truck was literally stuck in the mud) and we had to wait out the rains and for our "rescue" vehicle to be able to arrive.

Abbi playing chess with friends!

A rare family photo (with not so rare funny faces) - will we ever have a normal family photo, I'm beginning to have my doubts.... what is 'normal' anyways!!!

Abbi and I making Chicken Tikka Masala and home made naan - delicious!

Peter and I doing wound care on a patient with chronic wounds from a disease called Scleroderma.  The deformity and necrotic digits are a complication from this disease called Sclerodactyly.  We happened to be visiting when April was seeing Pediatric patients and were able to help out.  Shorts and flip flops are not our usual clinic attire!

There are many items that have been provided for the hospital to serve and care for the patients.  This walking boot and crutches are just one example of these blessings!

The nurses have become big fans of James (Santiago or "Santi" for short!)

The kids are enjoying learning Spanish and working on crafts with our friend María.

We are blessed to have an above ground pool on the compound.  The kids really enjoy getting cooled off on a hot day.  Look out swim team, here they come!  We loved getting to know a sweet couple, Martha and Tom, from Texas during their stay here.  They come every couple of years to service and certify the airplanes.  Their passion for the Lord and stories were so encouraging!  And it was nice to have some "Grandma and Grandpa" love for the kids :-)  We do miss our family greatly and are always thankful for the 'family' God gives us while here.

"We also pray that you will be strengthened with all his glorious power so you will have all the endurance and patience you need.  May you be filled with joy, always thanking the Father.  He has enabled you to share in the inheritance that belongs to his people, who live in the light.  For he has rescued us from the kingdom of darkness and transferred us into the Kingdom of his dear Son, who purchased our freedom and forgave our sins."

Colossians 1:11-14

A Little Bit of Everything (our life in photos)...

In the last few weeks since our previous update, a lot has gone on.  We had the great pleasure of hosting some dear friends from Iowa.  We ran eye clinics here in Canillá as well as San Andres.  You can see some of the happy recipients of glasses in the photos below.  A LOT of glasses were given out.  The most remarkable were those (both young and old) who had seen so poorly for so long that they really lit up when looking through a new pair of glasses.  It really was heart warming.

Abbi and her friend Keziah had a nice time with us at the clinic in San Andres, handing out coloring pages and crayons to the other kiddos waiting to be seen in clinic.  They also got a chance to go hang out with the kids at the local orphanage.  I think they enjoyed showing off their nail painting skills as much as the kids enjoyed getting their nails painted.

James is happy 99% of the time.  He turns 1 year old this month - where has the time gone???!!

I would be the big white guy.  I'm usually at least 2 feet taller than the patients.  Hide-and-seek is difficult here.

Our optometrist friend Riley fitting a little girl with glasses.  Not only was the team able to run many eye clinics while here, but he also held an afternoon of training the nurses at the hospital.  They learned how to use the auto-refractor and find which glasses a patient might need.  This is one of our goals of working in the hospital here in Guatemala, not only to provide medical care but to train nurses and eventually medical students.

We found a huge frog in the backyard.  The boys had a good time with it.  Abbi was a little less excited.

 The local market - Fridays and Saturdays.  Our shopping list usually consists of mangos, bananas, papaya, pineapple, tomatoes, onions, lettuce, carrots, broccoli, watermelon, cantaloup, avocado, limes, green beans, potatoes, oranges, apples, strawberries, cilantro, jalapeños.... the list goes on.  

The hospital continues to come together...

 John 10:10 "I have come that they may have life, and have it to the full."

Colossians 1:11 "And my God will meet all your needs according to his glorious riches in Christ Jesus."

Ephesians 3:20 "Now to him who is able to do immeasurably more than all we ask or imagine according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever, Amen!" 

We spent a day at Mariposita - a local facility that cares for special needs children - doing a whirlwind eye clinic.  James (also known as Santiago here locally - or Santi for short) made friends with a few of the workers there.  He especially tends to make friends wherever we go.

We are blessed with wonderful nurses and staff and lots of precious pediatric patients.  The children are enjoying these knit hats, which were lovingly made by one of the teachers at our kids' school back in Iowa.  Thank you Mrs. Ovel!

April and one of our patients hamming it up for a selfie :-)  We try to take turns at the clinics when the kid's schedules allow....

There's no better way to beat the heat than fresh squeezed orange juice and a hammock!

Well, that pretty much sums things up.  We'll keep you updated as time goes on!

A Tale of Two Babies: New Life

As I write, my healthy, happy children are playing in the family room (OK, maybe Peter just hit James - but you get the point).  We just wolfed down a breakfast of fried plantains and pancakes, complete with coffee and real cream.  From the cow.  Down the street.

It's been an interesting week(end) here in Canillá.  Our buddy Ryan was kind enough to take me on a rescue run up the mountain on Thursday.  The bone dry mountainside has been burning only a few miles from our house for the last week - don't worry, we're fine down in the valley.  We heard through the grapevine that a family was trapped in their home far up the mountain.  After a quick ascent up smoke-filled switch backs, we drove up into the area of the blaze on four wheelers.  We found the family alive and well at the top amidst a previously burned area of the forest fire. Praise God!  Fairly anticlimactic, but it was a good adventure all in all, and we are very grateful that all were safe.

Thankfully, we've had the first rains of the rainy season since that trip.  Crops will begin to thrive soon and the fires have died down.

We did have two very different deliveries over the last couple of days.  In the early days of beginning an OB program, there's a pretty steep learning curve.  We found this to be true when we re-opened our OB department back in Iowa seven years ago.  We've had some bumps along the way there, but have awesome nurses and (I think) happy patients.  It has definitely been a privilege to get to serve, laugh with, and pray with some really great ladies in that time span.

We feel the same growing pains here.  On Friday around supper time, I was called to the hospital to evaluate a woman who had given (normal) birth 7 times before.  These are supposed to be the easy ones.  They are supposed to go off without a hitch.  A Neonatologist friend happened to be visiting from Guatemala City at the time.  Our OB unit is just opening, so myself and friends stayed by her side throughout the night, praying for guidance each step of the way.

The mosquitos were ravenous and despite our medicines, the woman just wouldn't kick into labor.
So in the wee hours of the morning, we decided it would be best to transfer the patient to the government hospital in Quiché.  This merely involves loading the woman, her husband,  and huge bundles of patient "luggage" into our suburban, taking her to the airstrip, putting all of the above in a four person airplane, getting a taxi in Quiché and dropping her off.  No problem.  Except during the very bumpy trip in a truck without shocks on the dirt, rocked filled road, she began contracting.  A lot. You don't have to be an OB expert to know that the odds of this very experienced cervix dilating quickly and shooting that baby out at 1000 feet above ground in a four person plane was growing more likely by the minute.  I got about 2 blocks from the hospital before I whipped the truck back around through a herd of cattle on the road.

Once back in the labor room, her contractions continued to pick up.  She delivered shortly thereafter, but the baby had immediate respiratory problems.

Thankfully, our neonatology friend was waiting for hand off.   After half an hour, it was clear that this child would need a neonatal ICU for at least a few days.  He was having severe breathing issues and would probably would not have survived a home birth.  And here we found ourselves on the question of transfers again.   I was amazed as our exhausted team coordinated with the government hospital in Quiché, got the plane ready, and worked like crazy to get somebody to pick us up from the airport on arrival.  All the while, seeing and trusting the Hand of God's protection and plan over this little life.

After downing more than several cups of coffee, I cradled our little patient in my left arm, my right arm holding the neopuff (air pressure device), an IV bag, and a pulse oximeter.  Others loaded the portable oxygen tank into the back of our suburban.  Somebody drove us to the airport.  My eyes were fixed on the sat monitor and my hands on keeping the tubing functioning and neopuff positioned correctly.  The whole journey was one long prayer.  I slid awkwardly with all gear into the back of the airplane.  We jostled along to Quiché, stopping in the middle of an empty airstrip, greeted by armed military guards.  We then walked on to a main road nearby, where we hitched a ride in the back of a pickup truck - winding through Easter parades - to the government hospital.  That was a first for me.

Dropping the child off at the government hospital was bittersweet.  I was spent.

We continue to push forward daily to serve the "least of these" in the most excellent possible way in Jesus' name.  We embrace life here.  We fight for life here.

Situations like this leave one feeling a little bit run-over.  The sheer expenditure of resources of human capitol in the incident was draining and left us with many questions.

However, situations like this also point to the reality of...
God is in control and we are not.
God's faithfulness to us as we serve him in our inadequacies.
God's provision for and goodness to that child - a neonatologist just happened by that day.  We are grateful for the help.

In our fatigue, we got a call again on Sunday that another woman had been brought in by a midwife (these are untrained village midwives).  She was completely dilated and "stuck."  She'd been pushing for hours. Despite all this, April and I got to do our first delivery together in a long time.  It was smooth, easy, and beautiful.  The baby was given the middle name "Pablo."  He's the bright one to the right.  I don't think I have ever been anybody's namesake before.  After praying with the her, the mom got up and walked out with her kiddo like nothing had ever happened in the span of a few hours.  I think God knew we needed a easy one.  We all went home grateful, with our spirits lifted.  I took a nap.

"But you, Lord, are a compassionate and gracious God,  slow to anger, abounding in love and faithfulness"

Psalm 86:15

Praying with Don Pablo and mom of Don Pablo

"He will also send you rain for the seed you sow in the ground, and the food that comes from the land will be rich and plentiful.  In that day your cattle will graze in broad meadows,

Isaiah 30:23

Watching God move mountains

We've been in country for a week now.  Thanks to a lot of help from some very good friends, we were able to get to the airport in Des Moines with all four kids, a stroller, a car seat, seven 50 (and a half) pound bags plus carry ons.  Our house, grass, garden, and mail are all teed up to be cared for by some special people- you know who you are and we thank you.

So far we've gotten settled in to the guest house here in Canillá, which will be our home for the next couple of months.   The long term missionary community here is great and we found ourselves settling in more quickly than we have at the beginning of previous trips.   The kids don't sleep too much, but that's nothing new.  They are great.  They just don't sleep.  We are both tired and blessed.

The longer I've been involved in missions, the more obvious it becomes that God has a different set of priorities than I do.  His inherent completeness and profound love for people result in Kingdom of Heaven social and economic policy that would leave both mainstream economists and time management gurus scratching their heads.   One of the really beautiful things about being involved with organizations that provide care for "the least of these" in the name of Jesus is seeing the impossible (or, OK, the exceedingly improbable) happen to the benefit of those who, in the opinion of the world, don't really amount to much and probably don't deserve it.

God's love is like that.  Time after time, God shows up and makes impossible things happen.  I've never actually seen a mountain get thrown into the sea, but I think you get the point.  These things do happen every day. It's just that sometimes we are so distracted or preoccupied that it's hard for us to see them.

I'd like to tell you about Sarah *, a sweet 28 year old mother, whom I first met in our outreach clinic in San Andres (a 20 minute drive from the hospital).  Sarah smiled as she lay on the ultrasound table, her triplets wiggling wildly within her. She and her husband locked eyes, beaming as we watched one of the babies suck her thumb.  We have been planning for Sarah- already high risk with triplets- for the last few weeks.  She is now 28 weeks along (37 weeks is full term). As I carefully measured her various parts on the ultrasound and checked her baby's fluid levels, all seemed to be well.  

Before completing her prenatal visit, our nursing staff checked a blood pressure, which produced an alarmingly high result.  We then checked a urine study, which confirmed that, despite a lack of symptoms, Sarah was in the early stages of a dangerous pregnancy related condition called preeclampsia.  Thankfully, we were able to bring Sarah back to the hospital for further evaluation.  

Preeclampsia is a condition defined by high blood pressure and protein in the urine which can progress in severity to eclampsia, which is a life-threatening emergency for both mother and baby(s).

Because of the Hospital staff, laboratory equipment, and nurses we were able to provide proper diagnosis and treatment for Sarah.  Without these resources, we would not have been able to identify abnormalities of Sarah's liver enzymes as well as her blood sugars.  This liver problem allowed us to categorize Sarah as very high risk which led us to give her medicine to prevent life threatening problems and protect her babies.  Because of the extremely high risk nature of her pregnancy, we flew Sarah and her premature babies to a larger facility in the capital city where appropriate neonatal care will be available after delivery, which will occur in the very near future.  Without the hospital facility and laboratory capability that we now have, this disease progression would have been impossible to detect in a timely fashion and results would have been catastrophic for Sarah and her family.  

The history of this Hospital is long and winding.  So many different people and resources have come together in the most unlikely of ways to bring us this particular point in our history. It has been said that it's like somebody took a box of puzzle pieces, dumped them out on a table, and had all the pieces just fell together and completed the picture.   

The construction of the hospital itself has been expensive, exhausting, and challenging for many involved.  But also a beautiful and inspiring thing and is surely a picture of God's goodness, greatness, and his love for those we serve.

I'm convinced that God brought this hospital into existence to bless many, but would have done so even if Sarah was the only one to benefit.  His love for her is like that.  God often shows up in impossible situations against overwhelming odds in order to confirm his love for individuals.  He still moves mountains.