A little R&R&R&R

We arrived in Antigua, Guatemala Friday afternoon.

A beautiful city to the north of Zacapa, it was once the capital of Guatemala before the capital moved to Guatemala city.  Originally called "Antigua Guatemala", literally meaning "old Guatemala", you can see the mixture of centuries worth of architecture. Ruins of buildings stand next to small houses along the same street.

 

Founded by the Spanish in 1523, the indigenous Mayan people of the region were enslaved.  However, they rebelled against the conquistador Pedro de Alvarado and forced him to find a safer place to live.  His wife Beatriz took over the city but was killed, along with many other citizens of the city, in a mudslide in 1541. The third time the Spanish rebuilt the city, a series of earthquakes destroyed a lot of it in 1773.  This event was the final push to move the capital to Guatemala City.  As the capital grew, the indigenous people and citizens of Guatemala returned to Antigua to rebuild.  It still prospers as a major tourist destination today.

The city is overseen by three volcanoes.  They are called Agua (water), Fuego (fire) and Acetanango, an indigenous Mayan name.  The largest of the three is Agua, seen below from the Cerro de la Cruz, Cruz of the Hill.

Antigua is a beautiful combination of old and new.  Preparing for Semana Santa, or the Easter festivities, purple banners hang from many buildings.  Semana Santa is an important holiday in Latin American countries.  An old building in downtown Antigua houses religious figurines ready to line the streets.  Men will actually carry a real life crucifix through the streets as an honor as well.

Hearts in Motion brings its students here for what I like to think is a little R&R&R&R.  Students get some relaxation, exploring the city, shopping, eating and spending time together.  Other students indulged in a little recreation, either choosing to go ziplining, hiking or on a tour.  For a lot of people this is a time of recuperation.  Either with stomach issues or serious bug bites, it is good to have so many medical personnel surrounding us.

However, the final R, and the most important I feel, is that it is a time of reflection.  It is easy to go through the motions and just experience what happened in Zacapa and to move on.  But for a lot of people, including myself, I believe that this is not a trip that will stay in Central America.  Some people have started considering changing their majors to a medical profession or have already started planning on returning.  Others' hearts have changed so much and have been humbled by their experiences that their heart is permanently in motion.

Tomorrow we return to the United States.  No matter the original reason that a person joined Hearts in Motion, I know for myself personally, and for a lot of people I spent this time with, we will not return the same.

The Power of a Heart in Motion

For our last stop in Zacapa, we visited the Hearts in Motion nutrition center.

Complete with a nursery, therapy clinics and dining hall, the center was built to fight malnutrition in children.   Before and after pictures hang on the walls showing children with skeletal bodies as infants and now with smiling faces and chubby cheeks.  Children pushed all around us, smiling, laughing, squirting us with water guns and requesting photo after photo.

One boy was immediately recognized as Juanito, who had been screened for surgery but had developed bronchitis.  Pushing past the bronchitis, he is now a healthy boy with a repaired lip, and he will return next year to repair the palate.

Another child who received surgery today was Judith, the nine-year-old girl from Esquipulas who was diagnosed with a cleft palette after approaching the speech therapists with a hypernasal voice.  Both surgeons worked on her case today, and successfully repaired her palate. 



     Así es la vida.

 Tomorrow we leave Zacapa.  I'm leaving here covered in bug bites, sunburns, dirt and sweat.  But more importantly, the people I have met and the places I have seen have set my heart in motion.

I was listening to one of my favorites songs, "Timshel" by Mumford and Sons.  Even though I have listened to this song a thousand times, this time the lyrics took on a whole new meaning.  I smiled as I listened to the words: "Death is at your doorstep, and it will steal your innocence, but it will not steal your substance."

Whether it was the dump, orphanage, medical clinic, hospital, or one of the other various locations Hearts in Motion reached, the people of Zacapa are the kindest people I have met.  The group from Hearts in Motion was met everywhere with masses of smiling faces.  Many of the people live without electricity, without hygiene, and with an encyclopedia's worth of ailments and illnesses.  Death stands at their doorstep, and there is little time for innocence.  Nurses have seen mothers as young as 14 years old walk into the clinics with one child in hand, another on the way.  But despite all of this, every doctor,  nurse, therapist, volunteer and even the wandering journalist have been showered in laughs, hugs, and smiles.

The next part of the Mumford and Sons lyrics illustrate what I personally feel is the core of Hearts in Motion:  "You are not alone in this, as brothers we will stand and we'll hold your hand."

Hearts in Motion hears the unheard and treats the untreated.  If it weren't for Hearts in Motion, these people may have never seen medical treatment or received health education.  Their only care would have been the resources around them and their family members.  Bringing people from across the United States through Hearts in Motion, a wealth of talent, experience and expertise comes together to help the people of Zacapa.

Personally for Karen, the founder of Hearts in Motion, the most exciting thing is the future they are building for the people.  In the 30 years she has spent in Guatemala, she has had the opportunity to witness patients grow and advance in society.  Hearts in Motion doesn't just build houses, centers, and new palates, but it also builds lives.  One boy lost his arms and legs when a flagpole he was holding fell into a power line.  Karen has watched him recover and grow, and he is now a French and English teacher.  Another boy was hit by a semi-truck and lost his left arm and leg.  After Hearts in Motion, he is now an assistant to the mayor of his community and has changed how his local government views the disabled.  María, the local daycare teacher and first patient of Hearts in Motion, never thought she would walk again when she was growing up with polio.  She is now the leader of her community.  Carlos, the man paralyzed in a motocross accident, has now opened a therapy center and is working with Hearts in Motion to change the lives of the disabled people in his hometown.

But it is not only Guatemalan lives that Hearts in Motion changes.  Every night when volunteers gather for dinner, they share stories of their day, stories of the patients who touched them personally.  It is easy to understand now why many of the doctors are on their seventh or eighth trip with Hearts in Motion.

One sharing her story--a girl named Eva--said something that really hit home with me personally.  She spoke about how she came here with the mindset that she could change the world this week but realized the work will never stop, it was just a matter of doing the little she could each day.  Karen called this job security for Hearts in Motion.  The country will always need help and there will always be people to serve.

H.I.M. truly sets hearts in motion.  I came on this trip to observe and report back what I have seen here in Guatemala and in the process have had my eyes and heart opened. 

Tomorrow, vamos a Antigua.

Vamos a El Palmar

Así es la vida of El Palmar.

Set high up in the mountains, El Palmar is a small town with a population of just under 1,500.  As of a census just taken last month, nearly 79% of the town's population is under the age of 40 and 47% of the population in El Palmar is under the age of 14.

Climbing the mountains in two vans and a small bus, we arrived at the Health Center for El Palmar.  Even though the town was humble, it was clear that the center kept good care of its people with the resources it had.  A map hung from the wall that showed every house in the town, schools, soccer fields, the pregnant women at the time, and the newborn babies.  Posters hung throughout the center explaining malnutrition, depression and various other ailments that could affect the people.

Like they did in Esquipulas, the volunteers with Hearts in Motion set up three stations in the center.  One station was for ear cleaning, another for general medicine and the last for dentistry.  A great group of people were already waiting to be a seen and a line wrapped around the building.  I played soccer with a young group of boys on the side of the building, trying to keep the children entertained while they waited in the heat to see the dentist.

Once the kids started to run circles around me in my old age, I headed inside.  However, once I stepped inside, the circles that had ran around me outside, continued.  Dentists, assistants, nurses and students hurried throughout the center, trying to treat as many people as they could.  I quickly learned the necessary Spanish to help translate in the dentistry clinic and asked people which teeth were bothering them.  Many people pointed out three or four teeth with severe cavities.  Others only had pieces of teeth still remaining.  I would warn the patient of the lidocaine injection before sending them to the dentist to inevitably get their teeth pulled.  Several people had seven or eight teeth pulled in one sitting.

In total, the dental clinic alone saw 93 patients.  Of those 93 patients, 224 teeth were pulled.  Obviously dental hygiene isn't prevalent in El Palmar.  Three of us went outside to hand out toothbrushes and teach children to brush in circles from all sides.  They also won prizes if they proved to us that they knew the proper technique.

 

Looking around El Palmar, and the people that had gathered, again I saw the impact that Hearts in Motion has on this region.  Not only in El Palmar, but in Esquipulas, the hospital and other clinics scattered throughout various villages, masses gather waiting for the arrival of the medical staff, as you can see below in the picture showing the people walking to the clinic.  Starting as a small operation sending certain patients to the States for surgery, it has become a staple of the region. Most of the time it is the only health care that the people can afford.  The gratitude from patients continues to overwhelm and touch all of us, and it is clear that the vision is growing and will continue to grow.

For example, as we left El Palmar after a long day at the clinic, we stopped by a humble house on the side of the road.  Karen, the founder of Hearts in Motion, had recently met this family and was touched by their story.  The mother has two mentally challenged children and makes rope to support the household.  She showed us how she makes rope and quickly wove together the picture you see below.  What was more beautiful than the rope was the pride on the woman's face as we admired her work.

Hearts in Motion has its hand in every thing it can.  I have stood alongside therapists, surgeons, nurses, teachers, caregivers, prosthetic technicians and now dentists throughout this trip.  Other students have also helped at construction sites that H.I.M. is funding as well.  For me, Hearts in Motion takes the saying "See a need, fill a need" to an entirely new level. 

A Day as a Doctor

Así es la vida of the Hearts in Motion doctors.

Today, I stepped in the shoes of the medical personnel with Hearts in Motion.  First, it's important to understand the working environment Hearts in Motion has.   A half an hour outside the hotel in the actual city of Zacapa lies the Regional Hospital of Zacapa.  It is the only hospital serving the nearly 200,000 people that live in the region of Zacapa, one of the 22 regions that make up the country of Guatemala.

A hospital in this condition would scare the majority of the United States.  Patients have zero privacy and the majority of the rooms have five beds.  The most common thing to see is just a room full of beds, each one holding a man or woman in poor condition with just an IV drip.  None of the patients had heart monitors or equipment at their bedside and only two or three nurses watched over the thirty patients in the ward.

Hearts in Motion has added their own additions to the hospital grounds.  The speech and hearing group operates out of a beautiful therapy center nearby.  Right next door to the therapy center is a prosthetic lab led by man named Luis.  He explained to me the process of baking the mold for the plastic form, and showed me the form for a forty-year old man named Arturo that had lost his leg to diabetes.

For surgery, the wards used by Hearts in Motion are the men's ward, women's ward, pediatrics ward, and the operating room.  The doctors shared the four operating rooms with the Guatemalan surgeons in the hospital.  Patients went in and out of the room all day long from a boy who fell out of a mango tree to a patient of Hearts in Motion who had a tumor on the side of his neck.

From all sides of the surgical and medical process, Hearts in Motion has brought only the best of the best to serve the people of Zacapa.

Así es la vida of Dr. Amy Meredith.

Dr. Meredith is a speech pathologist from WSU Spokane.  She is the leader of the small group of students in past blogs that administer the speech and hearing testing.  This is her third trip to Guatemala with Hearts in Motion.  Adopting two children with cleft palates herself, she has a personal connection with the mission of the trip.  Her son, Alisher, was adopted from Kazakhstan with a bilateral cleft palate.  Bringing him to the States, he received the necessary surgeries to correct his condition. Her daughter, Jasmine, was adopted from China and had a unilateral cleft palate that has also been corrected.  Dr. Meredith's wisdom from her experience before, during and after cleft palate revision adds a new level to her ability to help her clients.  She also understands the difficulties of babies with cleft palettes and has brought special bottles to feed newborn infants with cleft.  Tomorrow she will be giving a lecture to the nurses in the Regional Hospital of Zacapa to teach more about the bottles and cleft in newborn babies.

Así es la vida of Dr. Ken Stein.

A plastic surgeon from Chicago, he had four surgeries today.  They included a tumor on the side of a man's face, a cleft palate revision and a reconstruction of a woman's lips.  On his feet from early morning to his last surgery at four in the afternoon, his stamina is remarkable.  On his eighth trip with Hearts in Motion, he is a frequent flyer to Guatemala.  I asked him about his most interesting case in all that time and he laughed remembering the case of a 13-year-old girl on a past trip.  He told me how she had come to Hearts in Motion because a dresser her fallen on her face when she was little and had crushed her cheek bone and killed the facial nerves that controlled her right eyelid.  She lost sight in her eye and there was nothing Dr. Stein could do for the most part but the thing he noticed the most was the smell that came off the girl.   He asked the family about the smell and they told him she had had it for ten years.  After anesthesia was administered, he searched for the source.  He ultimately found a bean in her left nostril that she had stuck into her nose as a three-year-old.  Sitting in her nose for ten years, it was no wonder she smelled.

The process I was closest to- and that I actually became a part of- was within the post-operative wards.

Así es la vida of Priscilla.  She basically runs the entire
 post-operative process for Hearts in Motion.  I became her right hand today as we checked up on patients, filled their needs, filled prescriptions of Tylenol with codeine, ibuprofen, and antibiotics, and communicated with the Guatemalan nurses the needs of the Hearts in Motion patients.  Priscilla is impressive, to say the least.  Her experience is in NICU or the newborn infant ICU at Sacred Heart Hospital.  She now works at Mount Carmel Hospital in Coeur D'Alene.  With only a small table in the back of the pediatrics ward, she wrote out all of the post-op instructions for each patient in Spanish.  I helped translate as we attended to each patient that had gone through surgery the day before.  Some kids had had parts of their hip bone used as bone grafts for their palette and were already walking around.  There was also a baby that had spilled hot water on itself and had bad burns on its chest and face.  Working nonstop throughout the day, Priscilla is honestly wonder woman.  I had to work hard to keep up with her.



Walking in the shoes of the medical staff of Hearts in Motion, they are truly big shoes to fill.  Working long days in humid weather and poor conditions, the medical and surgical staff are truly incredible people who are fueled by their love for their work, the people they serve and the mission of Hearts in Motion.

People of All Ages

Así es la vida of the Usumatlán senior center.

After spending the last two days with children, I accompanied the speech and hearing students to the local senior center to administer hearing exams on the elderly people in Usumatlán.

The students from WSU Spokane set up the audiometer, a small machine that sends different decibel levels to a set of headphones.  The patient places the headphones over their ears to test for their hearing threshold and basic hearing abilities.  Like I mentioned in a previous blog, you may have received the same test when you were younger, raising your hand and signalling when you heard a beep.

The majority of the people that passed through just had a bad case of earwax and hearing loss due to old age.  Dr. Amy Meredith quickly led a class on how to properly clean your ears, showing patients that Q-Tips actually impact the earwax more, and worsens the ability to hear.  It is better to pour a small amount of hydrogen peroxide in the ear, something I will start applying to my own hygiene.







           Así es la vida of Manuel.








The only thing bigger than Manuel's ears is his love for God.  I had the opportunity to sit with him and hear his story as he described to me his humble childhood.  He had five brothers and sisters, three of whom died young.  Another sister was born after him but she died at age three.  He began talking about his people and the immigrants to Guatemala, and the tears began to roll.  This is when he told me of how he turned to religion as his guide and as the foundation of his life.  He then told me of how when his father died, his last request was for Manuel to sing.  And I can't describe Manuel's ability to sing.  I am attaching a video below to show you that he has the voice of an angel despite his advanced age.  He found his first guitar when he was 18 years old, and taught himself to play by sight and sound.  Life could have easily forced Manuel to shut down but instead he turned his story, and most importantly his music, into a way to reach and touch people.

It took us a while to leave the center.  Every person in the center gave us a hug and a kiss on the cheek, showering us in thanks and prayers.  A woman stopped us to tell us that our visits are so important, not necessarily for the exam results, because the majority of the people already knew they were hard of hearing and all the exam could tell them was how much hearing they had lost, but she told us the most meaningful thing to the people in the senior center was that we were there.  Our presence alone was the highlight of their day, something that stuck with me personally thinking of my grandmother in a senior center back home.

I know I keep writing this, but I continue to walk away with a new appreciation for the Guatemalan people.  In my past posts I wrote of how the children continue to smile despite the hard lifestyle they are forced to survive.  It was once again eye-opening to see people who had lived their lives and still maintained the same amount of love and heart we received from the children who had just started.  The motion of the hearts in the people of Zacapa is perseverance.

Our trip to Esquipulas

Así es la vida of Esquipulas.

Two and a half hours outside of Zacapa lies Esquipulas.  A group of us traveled by bus to a new rehabilitation center nestled into the cobblestone streets of the city.

Hearts in Motion recently put its hand into the community of Esquipulas and so this expansion of H.I.M.'s work was new and exciting.  The bus towed dentists, speech therapists, nurses and student volunteers over the mountains to reach the people.

Así es la vida of Carlos Enrique Olmedo Ceron.  Carlos was not always disabled.  It wasn't until a motorcycle accident that put him into a wheelchair.  His disability opened his eyes to his community and the needs of the people and, therefore, he sold his car and other belongings to buy physical therapy equipment and opened the rehabilitation center.  Karen met Carlos only last year so his relationship with Hearts in Motion is young and full of potential.

Needless to say, what he has done on his own is already heartwarming and impressive.  By the time the bus arrived, a large group of people sat waiting for H.I.M.'s arrival, hoping for answers and treatment they wouldn't normally be able to afford.


We split into three rooms, the first was for speech therapy and
 hearing exams, the second general medicine and the third dentistry.  Bringing their own sterile equipment, dentists for the most part pulled teeth.  In fact, the majority of the people were looking to have a tooth pulled by the 4 or 5 dentists that came.  Translators stood by to tell people that the dentist was about to administer an injection and that it would pinch.  The dentist chair is naturally and intimidating and frightening place and you could see the ease on the people's face as the process was explained to them in their own language.  WSU foreign language professor and associate dean of the College of Arts and Sciences, Ana-María Rodriguez Vivaldi, walked around calling people "generals" for their bravery in the dentist chair.

My own personal perspective of today was shaped by the speech therapy group.  Signed on as a stand-in translator for them, I got a unique look into their specialty and how they help people.  One station took the patient through a hearing test, the same one you may have experienced in elementary school, raising your hand when you heard the beep.  Another station had the patient repeat simple words to test how they pronounce the normal trouble sounds like "r", "s", "k" and "g".

The patient I had the most experience with was this beautiful girl
 named Marileny.  Her grandmother brought her to the clinic explaining she could understand, read and associate words but could not say them.  We sat down and began various exams testing structural movements like moving her jaw from side to side and touching her tongue to a popsicle stick on all sides of her mouth.  It was immediately apparent that she had trouble getting her tongue to the stick, especially at the sides of her mouth.  Dr. Amy Meredith of WSU Spokane had me explain to the grandmother that Marileny is trying her hardest with the muscles she has, meaning that her muscles are so stiff it is hard for her to relax and she lacks complete control of her motor skills.  Dr. Meredith and the students diagnosed it as cerebral palsy and had me explain to the grandmother that Marileny is trying very hard and she just needs practice.  As we sounded out words like "gato", "sol", "hola" and so forth, she improved as she mimicked the movements of our mouths.  It was obvious that she would only get better with practice and time.

Another girl, Judith, had quite a different story.  Sitting down with the students, they immediately noticed she had a hypernasal voice, or seemed to speak through her nose.  They checked the inside of her mouth and found a cleft palate.  A van returned for her and brought her to Zacapa and she now sits in our hotel waiting to be put on the surgery list.

Having no experience with medicine myself, it was incredibly eye-opening to watch my colleagues in action.  They took small voice abnormalities and diagnosed them to greater causes.  Judith's family had no idea that her palette was split until today.

After the rehabilitation center we quickly visited the local orphanage that various patients had walked from that day.  As soon as we walked through the grounds, children ran to us with hugs and smiles, and it was once again hard to believe the hardships they had already experienced at such a young age. One nun held a small baby, Rafael Antonio, that had been turned into the orphanage after being found in a cardboard box behind a bus station.  The nun of the orphanage also told us their greatest need was personal toiletries like soap, shampoo and toothpaste, explaining that they use the money they receive for food.


The people here inside and outside of Hearts in Motion continue to amaze me.  Their lives, stories, experiences and talent open your eyes to just what people are capable of.  I have met various children throughout this trip, living in garbage, not able to speak, and abandoned, but the most powerful and humbling thing is that no matter what, they smile.