Love the Washington Coast!

We spent a fun-filled week at the beach with the rest of our clan.  What a fun trip!

 Resting in my homemade lounge chair at the end of a long day.

 The family that reads together stays together!

Flying the kite

 Happy birthday, Grandma!

 

Happy birthday, Uncle Joe!  Check out the high number on the cake!

Red Sox Nation in the PNW

The Red Sox are in town so of course we were there to see them.  We got to the game early enough to get a place right by the bullpen so we could watch the pitchers warm up.  Evan and Nathan even got balls from the catchers after they were finished warming up!  Dad will be at the game again tonight.

Day 19 - Home!

My day started with a 3 1/2 hour drive to Guatemala City and ended at home.  Filipe, he man who drove me to Guatemala City is the H.I.M. in-country coordinator's cousin and does not speak English.  I no longer remember enough Spanish to carry on a 3 1/2 hour conversation so there was time to reflect on my trip.  However, we did our best and it was really good practice.  What is the universal language?  Soccer?  No, baseball!  I asked him if he had ever visited the U.S. and he said no, but he wanted to because he loves baseball and wants to watch a major league game.  We talked baseball for the rest of the trip.  Filipe knows the sport inside and out.  He plays for a team and coaches a group of high school-aged boys.  He showed me pictures, videos, and even took me to their fields in Guatemala City.  When I told him my husband is a Red Sox fan, we discussed Big Papi's year and speculated on whether he will actually retire after a year like this.  It was a lot of fun.  I invited him to go to a Mariners game if he ever visits Washington. 

What an amazing experience - one that I hope I repeat multiple times in the coming years and for much longer periods of time in my retirement, but this is where I belong.

Day 18 - Guatemala

Another good day.  We started our morning at Maria's daycare.  Maria is a woman who was taken to the United States for a necessary surgery when she was a child and lived with the founder of H.I.M. for a year while she underwent rehab.  She returned to Guatemala, grew up, and began working for H.I.M.  She saw a need in her village.  Young children under the age of 4 were staying at home without any adult supervision all day while their parents worked.  Many older children were not attending school because they were caring for their younger siblings.  They also were not getting enough to eat.  Maria started a daycare for these children so they would have proper supervision and their siblings could attend school.  They start off each day with a bath and fresh clothes and a meal.  The kids put on a little program for us and showed off the English words Maria has taught them (a lot!).  The 13 children seemed very happy and were obviously well-cared for.  It was 45 minutes well-spent seeing the difference that one act can make.  Without the surgery, one act, Maria would have had a severe disability and would not have been able to work.  In fact, she may have starved.  Instead, that act allowed her to grow into a woman who saw a need, and in one act - founding the daycare - has changed countless children's lives.

I spent the day at the H.I.M. House physical therapy clinic supervising PT and OT students and assisting with care for over 20 patients.  The other 2/3 of our group set up a mobile clinic in another village. 

Before dinner, a group of us went up to a waterfall that is about 3 miles from where we are staying and went for a swim.

Tomorrow I travel home.  It is time to hug my boys tight.  And shower.  And burn my shoes and a few of my clothes. :)

From the roof of the H.I.M. House

Day 17 - Guatemala

Lovely day in Guatemala.  A small group of us traveled through a mountainous and lush region to Mulan, where H.I.M. has a complex consisting of a nutrition center, which currently feeds and houses 13 children, an orphanage, which currently houses 9 children, a senior center, which hosts seniors one day a week and the intent is to soon make it an adult day care center, and a physical therapy clinic.  We evaluated and treated about 20 patients and saw a wide range of diagnoses: recent stroke, chronic stroke, Friedrich's ataxia, s/p ankle dislocation, tunneling pressure ulcer (in a little boy with an AFO that didn't fit well), venous ulcer, neck and shoulder tightness from a huge benign tumor in the neck, acute MCL tear, and many others, including a few children with cerebral palsy and one with severe bilateral club foot.  The larger group traveled to a village to set up a mobile clinic.  They saw a wide range of patients, too, including a man with a bilateral above-knee amputation with a scorpion bite on his elbow.  He was very worried that he would lose his arm, which is essential for his mobility.  They also saw a family with three non-ambulatory boys ages 14, 12, and 9.  The parents carried them to the clinic.  The boys had undiagnosed Duchenne Muscular Dystrophy.  Remember the life expectancy I mentioned yesterday?  About 14.  The two PTs at the clinic had to tell the parents their children's diagnosis and arranged for them to be evaluated at the nearest city hospital.  What a tragic day for this family.

The clinic was busy, and was short translators for the first hour until a woman walked in and asked if she could help translate.  She is a professor of Kinesiology in San Diego and was visiting her family in the village and heard that there were Americans providing a free clinic.  She helped translate all morning.  God knows all of our needs! 

The orphanage



 

 

My view for lunch

 

Members of 'Music in Motion' practicing.  Local children only attend school in the morning, and are often lightly (or not) supervised in the afternoons while their parents work.  This ministry of H.I.M. invites them to learn to play an instrument in the afternoons.  They have a building and practice right next to the PT clinic.  Unfortunately, I will miss the concert they are giving on Thursday.

 

Day 16 - Guatemala

There are not words to describe my morning.  We made bean tortas and rice milk and visited a village that is located in a garbage dump.  A dump.  I've read about people who live and scavenge in dumps, but never thought I'd see it.  It is beyond heartbreaking and was extremely difficult to see. 

It is a very organized system.  We could see people's work areas where they sorted their garbage, and we were told that there is a strong honor system and people do not take one another's findings.

We worked with a high school youth group who had collected clothing and shoes to distribute.  We served over 100 people. 

While a piece of clothing will not change someone's life and a sandwich will not sustain a child for a week, it is a way for H.I.M. to build relationships with the people in the village so that they can then bring mobile medical clinics to them.  In fact, while we were there, a woman brought her son to us to ask for advice as he had sustained a femur fracture and was still having pain.

The PT group opened a mobile physical therapy clinic in Pueblo Modelo from 11:00 - 3:00.  The people there are actually as impoverished as the people who live at the dump.  They just got running water this year.  Houses are constructed of a combination of clay bricks, corrugated metal, boxes, and blankets or sheets.  There were no floors.  I was able to enter a home to borrow a bench.  The woman there was cooking over a clay oven with an open fire.  We treated about 30 patients and saw everything from kids with mild to severe cerebral palsy to ankle sprains to a woman with an upper extremity prosthesis to a man with knee pain from muscle weakness following a femur fracture to a man with rib pain following a fall from a roof to a woman with nerve damage from a machete wound.  Quite a range!  The OT group gave a half-day course on working with autistic children to parents and educators in another town.
 

Making sandwiches

 

Serving sandwiches

 

Some of the PT students playing soccer with kids.  Note the girl with bare feet.  Imagine what she could step on in the trash.

This is Eduardo.  He is 8 years old.  Evan's age.  He is smaller than Nathan.  I cannot write more about him without tears.  It is not fair.

This picture is courtesy one of the students.

Most of the houses were at the edge of the dump.  If you look closely on the right of this picture, you will see two houses that were actually right in the middle of the dump.  There were others, too.

 

Women scavenging for anything that they can sell (metal, glass, etc.)

 

 This is someone's work space.

A home in Pueblo Modelo.  Note how one wall is made from hanging material.

Betio is an 8 year old boy with Duchenne Muscular Dystrophy, a neurological disorder characterized by progressive muscular degeneration and weakness.  He was able to walk until he fell from a roof into a fire.  He has massive scars from the burns and subsequent skin grafts.  His wheelchair does not have a cushion and is too big for him and has no foot rests so he couldn't put his feet over the edge.  He has severe hip and knee flexion contractures from sitting in the wheelchair like he is in this picture.

My students worked on decreasing some of the contractures.

Then they rigged his wheelchair so that he could get his legs over the side and have a foot rest.  It's not perfect, but will hopefully prevent further contractions, which would make it very difficult for his family to care for him.  Betio has an older brother with Duchenne Muscular Dystrophy.  Life expectancy for a boy in a developing country (without cardiac and respiratory care) is around 14.  So much pain for one family.  The high school youth group that is down here is working on a house that H.I.M. is building for the family.  Betio came to the clinic with his friends because his parents were helping build the house.

Leah, an occupational therapist, and I talking to a little girl at the autism course.