A Note From Jamie

Hola!! For those of you who don't know, I am sitting in a hostel winding down the last day of a week long mission trip to Guatemala. The past week has been refreshing, uplifting and devastating all at the same time. My team included myself, one of our ER docs, 4 nurses and 4 ER techs. We came down to run a clinic at an orphanage just outside of Chimaltenango Guatemala. Over the course of the week we treated over 300 people from the small village where the orphanage is located (the orphans have a doctor that they can see 4 days a week so they didn't really need any of our services) There was also a dentist that came and he was very busy. Anyway, the very first day, a patient of mine came with her two small girls and all three were to be seen. When it was her turn, she revealed that she was pregnant, due in 4 days and that she was having cramping in her stomach and low back and thought her water broke that morning. (and now it's after 2pm). She said she wanted to be checked to see if she was ready b/c if she went to the hospital and wasn't ready they would send her home. So contractions are 20 minutes apart. and, knowing the hospital is over 1 hour away and this is her third pregnancy.......and after I did my bimanual exam and jammed my fingers on a little skull, we were having a baby!! So we scrounged up most of the necessary supplies and actually had a fetal heart monitor and 1 1/2 hours later, little Marco was born!!! We gave momma and baby a ride home after the delivery, which I felt very weird about taking an hour old baby home but anyway, and she had walked at least one mile uphill in labor, to get to the clinic! It was really amazing. then, on Tuesday, a woman came in with 2.5cm mass hanging from her right earlobe and she was so relieved when she was told we could remove it for her. I thought it looked pretty good after it was all done!! We treated several little ones for intestinal parasites that often cause poor appetite and stomach aches. Wednesday was mama Carmen day, we went into Guatemala City to another orphanage where an elderly lady (not really sure how old but guessing late 70s) takes care of over 80 orphans. We set up an assembly line and did basic exams and found a few scabies and lice infestations but the rest were overall healthy. mama Carmen also feeds the homeless that live around the orphanage. She gets no funding from the government so I'm not really sure how she keeps the place running other than donations. The next day was business as usual. We did have an old lady who again came back to the clinic for the third time, I think she had a little dementia, and had the same complaints but denied having been there before. She was in her 80s. Very cute. Friday, we worked a half day at the clinic and had a celebration for the orphans. The founder of the orphanage, Ivan, gave a testimony of why each of the orphans had been placed at the orphanage, most sexually abused by there parents, others sold as sex workers when they were as young as 5. Very disturbing. But, this orphanage is amazing. They have several teams that come throughout the year to work and apparently, from the group that was here last year, they have gotten quite a bit finished. They currently house approximately 50-60 kids I think and will soon be opening four more "dorms" and will be able to house 100 more. Statistics I've heard are that there are approximately 150,000 orphans in Guatemala. There was a few other groups that were here with us. a group from South Dakota came down and they built a house for a widow and her three daughters. The "house" is a one room cement block building that is 10x14 feet. To get to this house, you have to climb an extremely steep dirt hill and once at the top this little room sits next to her mothers house. There are chickens and dogs running throughout the area and they work in the fields surrounding the house. When the team presented the house, one bed just larger than a twin and a blanket for each of them, these women sang a song, bowed their heads, joined their hands and prayed and wept. They apologized to them for not being able to pay them for their hard work. I went to help take pictures of the group and video tape the presentation of the house not having seen it. When I finally got to the top of the hill and saw the tiny home and how happy these people were. I thought to myself, this "house" could fit into my bedroom two times over. I felt pretty selfish as I stood there and watched these women weep and offer us chips and drinks in thanks. So, knowing that there are a lot more people that we know, or don't know who are struggling at home or in far away lands, lets work a little harder to "pay it forward". This is not an attempt to guilt anybody in to adopt a hundred orphans or anything but this trip really did make me understand that no matter how little we had when I was growing up, I might not have had all the things the other kids did but I didn't have to live on the streets or eat out of a dumpster. I always had food, a roof over my head, a warm bed to sleep in and a family that loved me. Ok, back to the not so somber stuff! So to wind down the trip, we opted to stay an extra day and today, we rode to the top of a volcano on horseback!! The view was amazing. (I'll send everyone a website of all the photos when everyone gets them downloaded). I mean, I felt like I was on top of the world. And, there was some real lava flowing down!!! Ok, I guess we didn't go all the way to the top but pretty close. Then, we went into the city of Antigua, which is one of the oldest cities in Guatemala and our taxi driver told us he had to go. So on the way home, we rode in these little tuktuks, that are way smaller than a mini cooper and only fit three small people in the back. Well, it was an interesting adventure and after several near death experiences on the way home we made it back alive!!! It was a perfect ending to a pretty amazing trip. I plan on coming back next year and if anyone is interested, let me know. Even if you don't come here, do something else; volunteer, build a habitat house, give a little bit back, it's worth it, good for the heart!! Hope all is well with everyone!!!!

~ j

Bo's Final Journal Entry

Sunday
After our climatic Saturday, a dull Sunday was welcome. The morning was not as rushed as usual and my knees were given the morning off after their abuse coming down the volcano the day before. Since our van would not be leaving until 9:30 for the airport, we had a leisurely breakfast: one last cup of coffee, a final glass of fresh squeezed OJ, and bean spackle. I packed up, paid Lidia and climbed into the van.
Our driver proudly informed us that as a result of the tip we had given him for safely delivering us each morning and afternoon this past week, he was able to purchase the laptop his daughter needed for school. That final bit of gratitude just put an extra smile on our faces and cemented the sense of accomplishment we felt in making this trip. Reflecting on the week, I don’t think anyone was disappointed in our mission and return home with the knowledge that their efforts created positive changes in some really appreciative people.
Once at the airport we were again greeted with a long line to check in. We didn’t suffer any economic set backs on baggage weight (good thing they didn’t weigh me!) or number of bags this time. Passing through security without any problems, we had plenty of time to shop for last minute souvenirs (Matt finally found something for his girlfriend) and enter the land of duty-free. Evidently accustomed to gastronomically adventurous Americans, a McDonalds was there for those in hamburger withdrawal. A moment of angst as no one had seen Randy since check-in and the boarding time neared. A search party was dispatched, soon successfully locating our errant friend, who, I think, had struck up a conversation with a new friend, Montezuma.
Finally boarding after a half hour delay, we went through a bag search prior to being allowed on the plane. Gary had brought two small volcanic rocks from our adventure the previous day, carrying them in his backpack. Assuming he was trying to steal Guatemala, these were confiscated and our nefarious smuggler was allowed to join us. We felt bad for him, as we had packed our rocks in our checked luggage, which passed through customs without incident. I guess I understand their position. If every tourist took two small rocks, in two million years they would be left with a volcano the size of an ant hill, clearly detrimental to continued sphincter testing tours.
Airborne, Continental had, no doubt, always wanting to please, consulted with Casa Angelina to discover our gustatory preferences – yes one last meal of chicken. Dinner and a movie at 35,000 ft. Thankfully, the flight was uneventful and we arrived on US soil in Houston.
Gary’s heinous reputation preceded him and once in Houston, US Customs detained him for two hours, grilling him for not declaring his two cartons of duty-free cigarettes. I think they were convinced that the recent US economic downturn was caused by duty-free shops and it was their duty to correct this oversight. His interrogation allowed him to miss his connecting flight, giving him time to write his thank-you note to Homeland Security for keeping him safe. Fortunately, there are many Houston-Chicago flights daily. I heard later that he made it in OK. After all he had been through, I’m glad I gave him the extra volcano rock I had carried in my pocket so he would at least have proof he had been there.
And so ended our travels. I took a flight to St. Louis, having said my good-byes in Houston. We vowed to have a debriefing party soon, and in Kelly’s honor, everyone will be bringing a chicken dish.
I hope those that have read this journal have enjoyed it as much as I have had writing it. All barbs were delivered with a kind heart and no malice was intended. Many references probably made no sense unless one was a member of the group, as the journal was primarily written for the group’s entertainment, as well as a way to jostle memories in the future. Good luck to all in the coming year. A special thanks to Randy and Dennis for keeping us on track, making all the arrangements and communications with Casa Angelina, and to Dennis for his pictorial recordings of the week. Keep in mind that this effort was totally on the part of the individuals who went this year and last. We received no support, financial or otherwise, from any institution. So, on behalf of the orphans and patients we saw in Guatemala, I would like to offer a special thank-you to those who did contribute both money and time. You have truly helped make one small part of this world better and helped project an image of Americans as helpful, kind and generous.

A Note From Dennis

A FEW WORDS FROM THE DOUBLE D.
Ok, a few notes of a more somber nature on our trip this year. Thanks for the humor, Bo, but I feel I would be remiss if I didn’t add a few notes of my own as well. :o)
As you all know, this was a very healing trip for me last year, as I hope it continues to be for anyone that chooses to join us. One cannot experience the culture and the poverty of these people, and the deep, sincere gratitude for the smallest of acts, and not be affected and encouraged to keep on doing this. As I said during our dinner that Friday night, thank you Jeremy and Melisa for planting the seed in Peggy’s heart several years ago which grew into us making the trip last year, and the continuing mission to return as often as we can.
As you’ve already read, this year contained several more “firsts” for us, not the least of which was the birth of baby Marco. I must make a few comments on this event. When Randy and I were going through the supplies at St. John’s Mission outreach center, a month before the trip, we each grabbed several things, just on a whim, that caught our eye. One was a bulb syringe, another was a neonatal stethoscope, and then there were the bags with the “hygiene kits”, including towels and washcloths. As we prepared for the impending birth of Marco, I took a number of these hygiene kits to obtain clean towels and washcloths for his first bath and to help soften his new “bed”. I got the bulb syringe that Randy had grabbed, and lo and behold, there was the neonatal stethoscope among the supplies! We could have done it without these and other items, but I thought it was pretty neat that we had grabbed them somewhat fortuitously.
I cannot help but marvel at the miracle of birth, as it has happened for eons without the modern technology we have all become so accustomed to. It really drives the point home when you are witness to such a birth in a small clinic in a remote little village in Guatemala. We all have our own beliefs, but I truly believe God was watching out for Marco and his mom that day. So many things could have gone wrong! First, her water had broken that morning, in a very un-sanitary environment, as is common in this part of the world. She had progressed in her labor throughout the day, and then walked nearly a mile or better uphill most of the way, to come to our clinic, knowing that a medical team happened to be visiting from the United States. She sat there while Jamie examined her two daughters, and only then did she happen to mention, oh by the way, that she was in labor and could we check and see if she had time to get to the hospital! She didn’t want to go too early because they would turn her away if she was not ready yet, and it was nearly an hour away by car.
Her labor progressed quite normally, and quite gracefully, I might add. We barely heard a peep out of her, even in hard labor. We were able to get hold of her husband and he arrived literally just minutes before the birth. I was grateful for the one piece of technology that we did have in the room—a fetal Doppler! I was able to monitor the HR during contractions to make sure there weren’t any decels. Thank God, there were none. Everything was progressing smoothly and normally. We continued to try and prepare for any complications. We started an IV with fluids we just happen to bring—since last year we had to use 10cc flushes to save a baby from dehydration. We got a dental syringe with lidocaine, the only thing available, (and this was because the dental team was there that week as well), in case an episiotomy was needed.
Had the baby been breech or any myriad of other complications, the outcome could have been very different. But after about 2 hours, baby Marco arrived about as text-book as one could hope for. All without the fancy monitors and sterile instrument packs of a modern delivery room. We placed him in our “receiving table”, a large Tupperware tub lined with clean blankets donated by another group, proceeded to get him cleaned up and dried and stimulated enough to get his circulation going well. The cheers that went up in the hallway when he made those first cries was incredible! I will never forget that sound. It was like scoring the winning touchdown in the super bowl. The word had spread quickly and many from the other groups, and even Ivan, were all gathered waiting for the first news. I could feel the excitement in the hallway and the power of their prayers for all concerned. And yes, I was bawling!
It was so touching watching as mom and dad became acquainted with Marco, and the love that was evident as his dad gave him his first bath. I am told that this is not a common thing in this culture for the father to be so involved. Some are, but many are not. It was an experience I will never forget. Then we had to get back on the bus, and only an hour later, Jamie and Jen, and I think was it LA??, took them home. I was like—wow! You’d never see that happen in the states! As much as some insurance companies would love to see it, I had to pray for them that nothing would go wrong in those first hours with baby or with mom. But as I say, this is the way it happens in so much of the world—not in a high-tech sterile delivery room with millions of dollars in technology and equipment, and most do just fine.
I can’t help but think about what would have happened had we not been there that day. Would she have gotten someone to drive her the hour to Chimaltenango in time? Would she have ended up having the baby at home? There would be no one at the clinic at that time of day other than Jen. So many things could have gone wrong, but everything went right in this instance.
The daily volume was such this time, (I’m sure a result of having some regular care 4-5 days a week), that it allowed Randy and I and others to check out some of the other activities of the week. Randy got to help with the widow’s house one day, LA, Randy and I, and Jodi from South Dakota, got to go into the village, wander the streets and pass out toys to the kids, (and believe me the word spread FAST!), and we checked out the widow’s house, got to meet them, and visited the widow from last year, who is still doing well. It was very humbling to see the conditions these people live in. the shacks they live in, and yes for the most part they are just shacks, are little more than spare lumber and corrugated tin. Yet they are all so happy and gracious to us visitors. I sometimes feel guilty when I think of all the material things I have, and these people and millions around the world, have barely enough to eat or cover their heads at night.
Some of us were also privileged to witness the dedication of the widow’s house this year. This was another experience I will never forget. The widow and her daughter were so pleased to greet us all and offer us soda and crackers. God only knows how long they had to work to obtain several bottles of soda and packages of crackers! But they eagerly went around offering these as a small token as we “toured’ their new home. A nice new cinder block house, no bigger than most of our kitchens, and it was probably one of the nicer homes on the block now! Attached to it was her mother’s house, and the small wooden shack of a kitchen with the only ventilation for the smoke from the stone hearth being the cracks in the walls between the lumber. We met the rest of the extended family, and then the South Dakota group posed for pictures in front of the house, along with the widow and her family. They had also given them gifts of blankets for all of the family, and then a prayer was said and benediction was sung. I was again moved to tears as the widow continued to pray for several minutes afterwards, eyes closed and continuing on in her soft voice, crying herself at times. There literally was nary a “dry eye in the house”, or outside it I should say. Such a difference was made in her life and the lives of her family that week! WOW!!! I was humbled to be witness to this and be a part of it.

I can’t begin to describe what a feeling it is to be able to make such a difference in someone’s life. Yeah, we make a difference in people’s lives every day in this job we do. But to have the privilege to be able to help these people of this tiny village, and do the things we did in the medical clinic and Mama Carmen’s for the week, was by far some of the most rewarding times of my life. Thanks to the fundraising and donations, we were also able to present Jen with $2100 in cash for the clinic for supplies and meds, and $1100 to Mama Carmen. I later found out that this will be especially helpful to her, as the local government has decreed that unless she adds another story to her house, they will take some of the orphans from her. The South Dakota group, on hearing this, decided to forgo their “last night out” at Santa Domingo with us, and instead gave the money they save and then some, to give Mama Carmen a little over $1000 themselves! What a blessing to her! This woman is truly a saint in human form. She takes in all these kids, feeds the homeless in the area, goes to the garbage dumps by herself at night to take the kids there some food and offer them a little compassion, (which is no safe area at night for an elderly woman alone by far!). The “bad guys” seem to appreciate what she’s doing though and leave her alone. If I could only have the faith to do the things she does. What an incredible lady!
In closing, I have to say it was a pretty amazing trip again this year, not to mention the wonderful hospitality of our hostess Lidia at Dona Isabel, the wonderful food each day, the fantastic dinner at Santa Domingo, and the spectacular view from the top of Volcan Pacaya. And we survived the Tuk-Tuks!!!! That was an added bonus!!
All I can say is this—if you ever get a chance to take a trip such as this, don’t think twice! Yeah, it cost us airfare and hotel, but how many pay much more than this every year for our own vacations! To have a chance to truly help those who have no resources at all is one of the most rewarding experiences of my life. Don’t pass it up!! :o)

PS: ER Abroad will once again be planning to return to Guatemala. Possibly a trip in Oct., and definitely again in Feb. next year. We appreciate any support of supplies or donations so we can continue to bless the clinic and Mama Carmen, and possibly other orphanages in the future.

A Note From Gary

Anyone entering the medical profession is frequently asked, “Why do you want to do this?” Most will tell you, “to help others”, which is true. The Emergency Room is a whole other world, and it takes a certain type of person to work in that world day in and day out.
I work in and Emergency room that is a Level 1 Trauma Center every other year, in Springfield, IL. We saw over 69,000 pt’s last year. I like it because it is fast paced and you keep busy every minute of the day, (and night). You see everything in the ER from minor things like stubbed toes, bruises and cuts, to shortness of breath, heart attacks, and any kind of accident imaginable—and a few you couldn’t imagine.
I’m not very comfortable with pediatric cases. What I really like are the heart attacks and any kind of trauma. If someone comes in with a heart attack, we can quickly stabilize that person and have them in the cath lab, usually in under an hour, often times much less. And in traumas, we can stabilize the pt and get them to surgery if that is needed, or to some other dept. or to the floors quickly to get the care they need to be healed. There is “instant gratification” in being part of a team such as this.
One day, a typical day in the ER, there were pt’s in the hallways, the usual mix—some with chest pain, short of breath, psych pt’s, broken bones and drunks. I was helping a pt in the hallway with shortness of breath when I was called to go to Trauma 2. When I arrived there, I was told there was a full arrest coming in. Within 2 minutes, the pt was there, everything was hooked up, and I relieved the paramedics doing CPR. As they were giving us report, they noted that they had just found out the pt had been down for nearly an hour. In medicine, an hour is an eternity. The doctor had me stop CPR to check the pt, and finally pronounced him dead. I began to help get the pt cleaned up and ready for the family to see him. I was then called away to help in the department again. I never did see the family of the pt who had died. It was just another typical day.
About 2 months later, I came to work one day and went into our break room. . I saw a note on our bulletin board, and recognized the name on the note. It was from the family of the man who had died that day. His wife wanted to thank us for being with her husband at the last moments of his life, and told us she knew we did all we could. I was moved to tears, and had to step into the bathroom for 5 minutes to compose myself. I was so moved that the family was so grateful, and I was glad to be a part of the great team that we are. I was truly humbled. I am not a very religious man, but I do have my beliefs, and that note touched my soul that morning.
After that, I stepped out into the dept. and saw my first patient of the day. I asked if there was anything I could do for him. He got within 6 inches of my face and yelled—“I need pain medicine—I have a toothache!” I smiled and told him I would check with the doctor and the nurse and see what they could do. Just your typical day in the ER.
When Dennis told me of his trip to Guatemala, where every person and every family are so grateful for everything you do for them, I knew I had to be a part of the next team. I needed another memory of someone who really appreciates what we do. Dennis was right! It was more than I ever imagined.
I think the best day of the trip for me was when we visited Mama Carmen’s. But remember, pediatrics is not my thing. Within minutes I was surrounded by 15-20 orphans. They spotted my stethoscope, and within minutes, they all wanted to listen to their own heartbeat. What they didn’t know was they really touched my heart. They were all so eager and loving. With what they had been through in their short lives, they were all so starved for attention…and they got a lot of it that day from everyone there.
So if anyone asks me, “Why do you do what you do?”-- that’s why.

Bo's Journal--Saturday

Saturday
The 6:45 volcanic belch was on time, apparently it’s not just a M-F phenomenon, as Saturday’s eructation was not only timely but bigger than any prior. Breakfast alfresco as always (we’ve had good weather) featured not only bean paste, but also beans-n-weenies, a bunker buster combo, or dirty bomb, we couldn’t decide which, both lethal especially considering the minibus we would be crammed into this morning. Before wedging into the vehicle, we said our good-bye’s to Kelly who was returning to the US today. Had she known what lay in store for the rest of us, I’m not sure she would have rather stayed.
We had, the previous evening, decided to go to Volcan Pacaya, rather than the volcanic lake, as we had learned of road construction that would have turned the lake trip into a four hour enduro each way. Arriving at the park entrance without Jamie being car sick, we paid our fee, then played tour guide lottery. Four or five candidates eagerly jostled for selection, all broadcasting their English speaking abilities, but Pedro won, being the only one who actually could speak English. Back into the van with an added Sardine, we wound our way up the mountain, all eyes forward; feeling that to actually look to the side, on this gravel and dirt road without a guard rail would propel us off the side. The one person who actually did look, Nolan, of course, said, “Wow, that’s almost straight down!” Maybe the evening devotionals this week had helped, as we arrived safely to the area where we would unstrap the van and get on horses for the rest of the way up (who thought this through?). So far all sphincters had held, but soon were to be tested again. The SD group had taken the trip the week before and had advised us to take the horses to the top, rather than hike. Proud of our negotiation abilities, we procured a rate of 200Q (about 27USD) for up and down vs. the SD group who paid 20USD each way. The fiends, however, never mentioned what awaited. Mounting up provided for a moment of hilarity as the horses were not much bigger than large dogs – OK, maybe the size of donkeys. I think I outweighed mine. Randy, Tony and I didn’t have to mount up, rather just let the horse walk under us and sit down. I think I heard Dennis’ horse curse. The tack was on par with what we expected in a third world country – wooden saddle with a very, very thin pad, which prompted Randy to later exclaim, in a much higher voice, that the saddles were like a cheap hotel – no ballroom.
My equestrian experience is rather limited in my lifetime and very few of us were avid horsemen or women, so it was fortunate that each horse was accompanied by a Guatemalan handler. Some were also equipped with a small boy who would hold onto the horse’s tail and whip it on the ass to encourage the horse to advance up through some of the near vertical sections of the trail. The SD had thoughtful left certain details out in their retelling of their adventure, this one of them. From the trail head to the top included nearly 2,000 feet of vertical climb. While having the horses do the climbing certainly helped save our lungs and legs, we all agreed that the ride could be included on Fear Factor. To say it was thrilling would be masochistic, unless you include in your definition of thrilling being on a slipping, sliding horse on a narrow path frequently bordered by steep slopes (we call them cliffs). To help keep help keep the horses on the trail, the Park service had included sections with two strands of barb wire (a real safety net) which Gary’s horse let him test for sharpness. By the time we reached the lava fields at the top, Dennis’ horse was bug eyed, mine was wheezing and Matt’s had fallen once. Of course, Nolan was having a grand time. Stopping for a few minutes to allow us to reset our sphincter tone, we traversed the final 1,000 yards across the lava field with an initial 200 yard descent (steep of course), then an 800 yard more gradual ascent through both loose sand like pumice and sharp, boulder-sized lava rocks. Matt’s horse said enough, dropped to his knees and Matt rolled off the front onto his back. Fortunately, it was the sand-like area and he was unhurt. However, he vowed to walk back down when we finished at the top. I agreed to join him, as I had run out of adrenaline and had not brought a change of underwear.
Dismounting at the top, we reacquainted our knees to gravity and walked about like a support group for thrombosed hemorrhoids. In the middle of the lava field, the view was spectacular, Dennis limiting himself to 500 photos, and one could follow the lava flow all the way down into the valley below. From our vantage point, we could also see the three other volcanoes that ringed the lake we had originally plan to visit. The trail’s end was still approx 1,000 vertical feet from the top of the volcano, but visitors were not allowed at the top, as there was still active lava flow (which we could get a glimpse of when it spilled over the edge). We did climb a little farther up, the others to experience the effort of climbing a lava field (kinda like trying to walk up a steep snow covered slope), me to look for a private place to pee, accommodations over-looked by the otherwise comprehensive park service. We were freaked out a bit when our guide, utilizing a walking stick (thoughtfully provided for $1 by the ever enterprising youth of Guatemala), jammed it into the sand-like area next to the recent flow boulder field (where we had just been climbing) and revealed a bright orange glow beneath.
Regrouped, we headed down, both my horse and I relieved by my decision to walk. Jamie, her adrenaline depleted as well, and Dennis had joined Matt and me. After climbing the final 200 yards of the lava field of loose pumice, Dennis arrived on terra firma with an Apgar of 4. With no AED in sight, he decided to climb back onto his horse, much to its dismay. Jamie picked that moment to declare that her micturation urges could no longer wait, picked an appropriate potty bush and new hallowed ground was anointed where she joined the Guatemalan outdoor team. All the appropriate comments made, we continued our descent back to civilization. With aching knees, but clean shorts, the trail end was reached. Refreshed by two Gallos and proper facilities, we paid our guide and boarded our van for the trip back to Antigua; Nolan properly restrained and gagged to prevent further commentary to our proximity to the hereafter.
Off the volcano without further incident, we asked the driver to find us a typical Guatemalan place for lunch. He chose Guatemalan Denny’s. Hamburger cravings satisfied, we climbed back in, experienced the only rain of the week and were dropped off at the Mercado in the center of Antigua, his work with us completed at 5pm.
A delightful hour was spent negotiating for trinkets, souvenirs and cigars at the open air market place. A sea of people, we were not hard to spot as Gary was a head and shoulders taller than the crowd. Successful in our effort to stimulate the local economy, we gathered at a previous agreed meeting spot for our return to Dona Isabela. Guatemalan Elmer showed up to engage us in debate, bummed a cigarette from Tony, and tried to conn us out of a contribution to his spiritual wellbeing. He even proudly showed us his driver’s license, but when asked about his car, he said he didn’t have one, thank God! Several truths emerged from our discussion. First, no 10 person cabs or vans were to be had; second, none of the cabbies knew where Dona Isabela was. Complicating this further was the fact that none of our group had brought the phone number or address of the hostal with them, nor the numbers for Jeremy, Jennifer or any other native who could give them directions. From a standpoint of sport and the desire for one final adventure, we decided to rent Tuk-tuks for the return to the hostal, having found a driver who thought he knew where it was.
I should first explain what a tuk-tuk is. A tuk-tuk is a three wheeled vehicle with a front seat behind motorcycle like handle bars to guide and control it, a bench seat behind, that could seat 7 Guatemalans or 2 – 3 average Americans. This is all enclosed in canvas covered frame and powered by a 50cc engine that might produce 30 horsepower.
We hired four of them, proud again of our negotiation skills. Each driver, after receiving general directions to Dona Isabela in precise Spanish, was grinning in anticipation of the upcoming competition. Revving their engines, the last of our group barely into his/her seat and we were off!! In a scene reminiscent of the original Pink Panther, neck and neck, we careened through the narrow cobblestone streets of Antigua, accompanied by a high pitched carnival scream we recognized as Jamie. At the next intersection, the tuk-tuks broke formation, each off in a different direction. Matt and I looked at each other, bewildered as we stormed through the intersection maintaining our course, our drivers hand firmly on the horn. Two blocks later, now in a very quiet, dark section of town, a tuk-tuk we were sure contained Leighanne and Jamie, based on the Doppler affected screams, passed through the intersection ahead. We surged straight through. About 5 blocks and two turns later, suddenly all tuk-tuks converged for the last 100 yards, screeching to a halt in front of Hotel Isabela – a place no one in our group had seen all week. A stunned silence ensued as our predicament slowly dawned on us.
Praising AT&T for their world domination and useable signal, we called Memorial ER, spoke to Angie and got Peggy’s number, who was able to google Dona Isabela and get us directions. To avoid further miscommunications, we spoke louder and added an “O” to each word. Realizing that the new location laid considerably in the other direction, the drivers demanded a renegotiation of their fee. Coming to agreement and anxious to get back to somewhere familiar, not wanting to be tomorrow’s headline – 10 AMERICANS MISSING IN CENTRAL AMERICA, PRESUMED KIDNAPPED – we caved, giving up all gains from previous battering. Back in the tuk-tuks with our soon-to-be-affluent drivers, we swarmed like bees through the back roads of Antigua, buzzing along in a cloud of dust. The rear wheel of the tuk-tuk ahead got at least 1 ft of air on one occasion, but righted itself quickly on one bounce. Back on the highway for the last two miles, Gale and Tony had their life flash before their eyes as a pick up tuck overtaking our little train almost side-swiped them at 50mph (our top speed). Like fighter pilots in formation, we peeled off into the entrance and through the gate of the residential area that contained Dona Isabela, stopping in front of the correct place this time. Jamie sprang out, throwing money at her driver for delivering her alive. Matt & mine missed out on his bonus, earned had he won the race.
Nearly an hour late for dinner, we were dirty, grimy and sweaty, but thankful that we were still among the living. Bless Lidia, as dinner had been held and we quickly cleaned up for our final dinner at Dona Isabela – chicken. Randy commented that the only thing more dangerous, to complete a trifecta of fear, given the day’s events, he would have had to have unprotected sex with a Guatemalan hooker. Later, I thought I heard Dennis on the phone, “Hello? Mamacita?” Just kidding.
And so the last day, closed with a glass of wine and an authentic Guatemalan cigar. Not bad.

Bo's Journal--Friday

Friday
I started the day with a good run and our volcano offered its now customary plume. We speculated on whether there are Guatemalans stationed at the top of the volcanoes, sending each other smoke signals (Bingo tonight at Santa Lupe Community Hall, same time as usual, bring chips) or if that’s where they dump left over bean paste. We didn’t buy into that one, as no one has reported a plume in their bathroom. Breakfast was rushed because the South Dakota group wanted to get to the orphanage a half hour earlier, to provide a little extra time to complete their projects. Chad, the defacto leader of the SD group was roundly cursed (at least by our group) the night before when he mandated the departure time. So we boarded even less alert than usual, but not disappointed that only one more bus ride to endure after this one awaited.
The morning at Clinica Misericordia passed quickly as morning devotions had been pushed to the afternoon and we quickly had 62 patients registered. With three rooms seeing patients, we finished around noon. I had started teaching Jennifer how to suture the day before. The pig’s foot we were using had been put in the freezer instead of the refrigerator. So, needless to say, it was quite solid. Using the oven to thaw it a bit so we could resume her lessons, it was inadvertently left in a few extra minutes. Suturing a medium rare, warm pig’s foot just wasn’t quite the same, but Jennifer gamely persisted and developed a good grasp on the basics. Meanwhile, the rest consumed their last chicken lunch for some time, Kelly had pasta.
The afternoon began with the insufficiently delayed devotions consisting of more unknown spiritual melodies, sung in Spanish this time, by the orphans, ensuring a complete loss of meaning for us. Accustomed to our ignorance, we had, however, learned when we needed to applaud. Ivan then introduced us to some of the orphans and shared their stories. Someone must have complained, because the auto-biographies were not as graphic as last year. Nevertheless, it was obvious that the children had made great progress. The oldest orphan had finished high school since our last visit, graduating valedictorian of her class and was continuing her studies to pursue her goal of becoming a pediatrician. Gary, with his new found fondness of children, was surrounded by several orphans, obviously enjoying the attention as much as they his.
Next, several of us walked to the village where the SD group had this past week build a home for one of the widows. Home, in this case, is very basic: cinder block walls, one window, a door, no running water or electricity – all on a 12 x 16 slab of concrete. It contained a bed, twin sized, and a stove constructed out of half of a 55 gal oil drum, with an innovation not common in this village, a flue on the stove to exhaust the smoke through the roof. Primitive as this sounds, the widow now had one of the nicer places in town. Not, sure how different the place would have been if built for a widower - put in a pool table maybe, fridge for beer - but that’s outside of the scope of their mission. At any rate, it was a great thing they did, all in 5 days. I know most of these writings have focused on the “medical mission”, but an acknowledgement is deserving of the selfless bone breaking work the SD group has done this past week. In addition to finishing the widow’s house, they and another group from Pennsylvania finished two more dorms so that another 50 orphans can be rescued. Sounds like there will be a little more work for us next year. One last bus ride, in some ways bittersweet, as we said goodbye to new, good friends.
A quick change at Dona Isabela, the 11 of us strapped on a minivan for a short drive into Antigua and a life changing meal at Santa Domingo. We arrived at the monastery, on a street like every other, dusty, narrow and cobblestone. Entry was through a plain wooden door in a tall, stone wall. Oh, but the transformation once through it. A walkway under a trellis stretched before us, a manicure garden along side, real candles on both sides. Soft chanting from hidden speakers completed the atmosphere. One could almost sense the presence of the monks before, shuffling through in their friar robes in sandals. After a “oh my God this is so good!” margarita at the bar, we were dazzled by a meal whose presentation was surpassed only by its taste. Now I have been privileged to eat in some spectacular restaurants from San Francisco to New York, Paris to Vienna, and this meal was on par with any experienced there. The price-fix meal Matt and Jaime chose had them oohing and ahhing through each of their 8 courses. Jennifer, Max and their new son Caleb, Jeremy, Melissa and their daughter joined us for our unexpected gastronomical treat that was the topper for the week. Surrendering our taste buds for two and half hours of dining, on level never expected in this part of the world, we returned to Dona Isabela still giddy from the culinary celebration just experienced. Bravo!
And that, my friends, is a civilized way to end the week.

Bo's Journal--Thursday

Thursday
Dun-te-de-dum te-de-dum-te-de-dum, Dum-te-de-dum te-de-dum-te-de-dum, Tum-tum, tum-tum. Yup, made it all the way around the neighborhood without stopping, did the Rocky-on-the-steps of liberty plaza scene, then limped into the hostal for breakfast. Didn’t wake the girls before 6:45 as Kelly had promised me a second circumcism if I did, so, diplomatically, I waited until 6:46 to deliver candy grams.
Breakfast here has been alfresco all week; the weather in Guatemala allows it. One of the drawbacks, however, is that this wonderful coffee we are served, cools very quickly in the chilled cups. Every day, in addition to the egg-du-jour, we have fresh papaya, watermelon, cantaloupe and pineapple, plus, of course, bean paste. I’ve come to the conclusion, that bean paste is really spackle for the colon. Very effective, it gives you a delivery like a ride down a water slide. Today, a new item on the breakfast menu was brought out; Kelly was speechless, chicken tamale!
Into our routine now, we boarded the bus, glazed, waiting for the caffeine to kick in. I don’t think it woke anyone up, but its diuretic effect was undiminished and we eagerly anticipated our arrival. Word had gotten out of our presence, or the presents we gave the children advertised our largess, at any rate we were busy. I think we saw 50 patients in the am. We broke for lunch, headed for the pavilion for our standard ground fowl fare. The Mongrel Dog Troop, evidently had a successful recruiting drive as their number had increased, all apparently well in-serviced as none appeared to have any difficulty chewing the bones. Another 20-30 patients came in the afternoon, most of whom arrived after 4pm, which again endeared us to the other teams anxious to leave on time. No Miracles today, a well-baby check on the baby born here Monday – mother and child still doing well. The biggest case was the I & D of a lateral thigh abscess. Tony was given the chance to play surgeon and soon pus was running. I don’t know what it is about abscesses, but some people really love them. I guess it’s the cause & effect: pain-cut-drain-relief.
Heading back we darted and twisted through traffic, waved to the Mamacitas who seemed to recognize us (which one said “Hello Dennis!”?). Our appetites were ready and supper did not disappoint: Bar-B-Q chicken. No sweat, Kelly is a confirmed vegan now. A special treat awaited tonight, as Lidia had put in a sauna and massage area. The girls indulged themselves as Matt and I praised God with a Chilean Cabernet. Dennis informed me, the South Dakota group is concerned. Jeremy and Melissa visited after dinner, what special people they are, took our coffee order and promised to join us for dinner tomorrow. Up a little later than normal, we finally called it a night. I had noticed the mattress label in the morning, some firm named Redi-Mix, but, no big deal, my devotions for the evening were adequate and I fell asleep quickly.

More Pics!

VIEWER DISCRETION ADVISED!!!!!!!

After a few comments regarding Bo's journal post, I need to remind everyone........HELLO, it's BO!!!!! Bo is being Bo and it is not my place to censor him. There are many inside jokes and innuendo meant for the original members who could not return this year that some readers may not understand. Please bear this in mind and read at your own risk!! :-)

Thanks for the laughs Bo!

Peg