gracias por sus rezos

i'm home safe.

another successful mission to guatemala.

another life-changing experience.

on february 11th, just before midnight, i boarded a continental 737 for my destination of el paraiso, guatemala. included on board the plane were 20+ others in our mission group -- doctors, nurses, dentists, nutritionists, pastors, techs, assistants, people looking to help. some, like the doctors and dentists, have specialized training. others, like me, a pa (plain-assed) firefighter, just want to help in some way.

after a change of planes in houston and a long layover, we landed in guatemala city and easily made our way through customs. all our meds, equipment, and handouts had been packed in large plastic crates and were labeled with their contents. guatemala customs barely took notice of what we were bringing in. i think they are pretty used to having mission groups visiting -- and there are always other groups on our plane heading to different locations.

a bus was waiting for us, along with our guatemala hosts, susy and helmer, and we were on our way to antigua for a day and a half of sightseeing and aclimating to the time and cultural differences.

antigua is a beautiful city. guatemala's ancient capital. it is surrounded by volcanoes, one of which is active. there are numerous schools teaching spanish for the traveler and is the recommended jumping off point for guatemala visitors. guatemala city is large, dirty, and sometimes dangerous. antigua is small, clean, and set up for the tourist trade.

but antigua has changed a lot since i first visited in 2001. gone are the masses of street peddlers and beggars. now the streets are cleaner and the peddlers fewer and more polite -- not harassing you, but still applying just enough pressure to make the bartering fun. but gone too are the students from all over the world. i remember walking down the streets hearing german, dutch, english, japanese, and many languages i didn't recognise, along with the spanish of the citizens. i hope this is only a temporary thing, maybe due to the poor global economy. if you ever get a chance to visit guatemala, antigua is a must-see -- especially during easter week.

i made my self-required visit to frida's, a local hangout for ex-pats and travelers. i have never seen any locals in here, unless they were accompanied by visitors. the food, drinks, and atmosphere are great, and i brought along gary (our mcgiver) and joel (one of the dentists). we were soon accompanied by more of the group. they know just where to find me.

that evening i had dinner with claritza and her family. claritza is my spanish teacher from my 2001 and 2002 visits to antigua. she teaches through a spanish school called probigua and also on-line through skype. i'd give her a plug here but i can't find her business card.

i must digress ... i need to thank those who make my trips possible. first, my wonderful and loving wife, for not only allowing me the time away from home and duties, but also for her encouragement in me searching out new adventures. my employer and fellow chiefs, for rearranging their time to cover my shifts, which gives me the extra time off needed. my family, my two daughters -- both health care professionals -- for their love. and my friends, for your prayers. thank you.

after dinner that night, a good sleep, my last hot shower for a week, and the next day sightseeing and souvenir shopping, we'll be heading to el paraiso on a 10-hour bus ride into the jungle.

the bus ride isn't all that bad. although the roads here are mostly dirt, full of chuckholes, and the drive is long, the countryside is beautiful, and my fellow missionaries (funny, i don't think of myself as a missionary), pass the time talking, sightseeing, and sleeping (along with some vertigo just to keep it exciting). we stop for lunch at a mall (mall? it seems so out of place), and continue on our way, finally arriving in el paraiso late afternoon after changing buses in the town of fray.

our clinic will be set up sunday in the village's nazarene church, after services. we will move the pews around, forming areas for greeting, vitals, nutrition, exams, dental, and pharmacy. it will take us all sunday afternoon. we also unpack all the crates and set up the equipment.

it's sunday morning, sunday school for the kids at 0800 and then full services at 0930. church here is a bit different, especially because it's in quiche, the local language, but also because: the women and children sit together, the men all sit to one side, and kids are allowed to roam freely -- and the men are very passionate during prayers, crying and sobbing.

a translator is supplied so that we can understand what is being said, and he invites us to the front so that we can sing a song and be introduced. cindy, doctor mark's wife, plays the electric piano and we sing along. i know nobody here understands what we are singing, but they probably recognize the tune. it's a good thing i have a booklet with the words in it because i don't know the hymn. i think we sound pretty good and everyone claps for us.

after services we break for lunch. we bring in our own cook, food, and bottled water and we are fed very well all week. meat, potatoes, rice, tortillas, beans, lasagna, cereal (with soy milk), eggs, ham, spam (i love spam), and the regular foods we eat at home. we've brought a propane stove and this time a refrigerator. three squares a day.

setting up the clinic goes pretty smooth -- after we've broken open the cases and figured out where everything is supposed to go. about half the people on this mission are new, but they seem to have a sense of what needs to be done and we all work well together. putting together the pharmacy always takes the longest. we put the meds in alphabetical order -- mostly -- but group items like the pediatric meds, cough suppresants, and lotions.

while everybody is setting up their areas, the locals watch through the windows and doors. pretty soon there's a group of kids in the church and someone has blown up balloons and exam gloves for them to play with. everyone's excited, both us and the villagers, to get the clinic going monday morning. we're finally done around 1900 hours, tired, dirty and ready for dinner.

this is our third year in el paraiso. the first year we had pit toilets and bucket showers from rain water collected in cisterns, taken behind black plastic curtains. before we arrived our second year we were told they had a surprise for us and when we arrived last year we found flush toilets and real showers. the village had devised a method to pump water into overhead cisterns and use gravity and head pressure to supply the water for the toilets and showers. two real toilets with real seats to sit on. two real shower heads (although the water was cold), to stand under. pretty close to heaven! we do have to sleep in tents inside the area of the church that is the school rooms. this part of guatemala has scorpions, tarantulas, malaria mosquitoes, and lots of other big and nasty bugs. we found two scorpions in the sleeping areas, and one in the kitchen. one tarantula was captured in the clinic and are almost always found in the bathrooms.

clinic starts first thing after breakfast monday morning. we're all set to go. this year i'm assigned as half a doc -- i do patient histories and chief complaints, after which i pass them on to doctor mark for physical exams. in the past i worked taking vitals and in pharmacy. it's all fun and hard work too. when taking vitals you get to meet all the patients. pharmacy is taxing in making sure you're filling the right prescription. patient histories and complaints is triage. doctor mark asks me what i think is wrong with the patient and what i would prescribe. by the last day, and with doctor mark's help, i'm getting pretty good at figuring what is wrong with the patient and what they should be prescribed. it's similar to what i do as an emt, but here i get to carry through and diagnose and prescribe, which i don't do as an emt. one year one of the docs had me suture, which was cool.

our patients run in age from babies to the elderly. almost all of the children and adults complain of headaches and muscle pain -- from working all day in the fields in hot weather -- plugged ears and stomach complaints. the babies have fevers, measles, scabies, giardia, and chronic diarrhea. many are constantly tired and i prescribe iron to boost their energy.

i must use an interpreter because of the quiche language. some speak of bit of spanish, and i also speak a bit of spanish. so we're able to practice together. it's fun, but sometimes heartbreaking. i always ask about their diet, what they are eating, and if they have a good appetite. it wasn't until the third day that i realized that what was being interpreted to me as "poor appetite" actually meant that they weren't able to eat because they had no money for food. when i visited guatemala in 2001, with rita, my spanish teacher from shoreline cc (and the best teacher anyone could every have -- thank you rita), it was the first time i was exposed to a third world country and true poverty. here were people living in mud shacks, dirt floors, with thatched roofs. no fresh water. no fresh food. everything they owned, which wasn't much, was within their reach. some had farm land to work. some goats or chickens. everyone bartered and everyone, at times, went hungry. no health care. no education. no security. i've seen poor conditions here at home, but nothing like this. and this is why i return.

between the medical and dental clinics we saw 1010 patients. most with the normal illnesses you and i put up with day to day and simply go to the grocery store and buy over the counter medicine. i can't tell you how many teeth the dentists pulled, but it was a lot. we also saw patients who had strokes and cardiac issues, who probably wouldn't make it until our visit next year; one fractured forearm on a boy from falling during a soccer game; a machete wound on a foot; a hernia; many lymphomas; ob/gyn issues; breathing problems; pretty much a little bit of everything else that comes through a busy er.

i think the best thing we give these people is an education in nutrition and hygiene. maureen and her crew do an excellent job at this. it seems to me that each year the people are a bit less sick than the previous year, which means they are eating a broader diet, washing their hands, and not drinking water unless it's been boiled. it wouldn't do much good to keep coming back year after year without the education.

this post has become way too long, and maybe too boring, so i'll finish here. but i do want to plug two websites. the first is kiva.org. at kiva you can make a difference by donating money for mini-grants to people and groups in third world countries. and when you get boared and need diversion, instead of playing solitaire, go to freerice.com. at freerice you can learn a language, or math, or another topic, and in so doing make donations of rice to feed a hungry world.

thanks for staying until the end.