Update From San Juan

This week and the last have been busy!
 We have been finalizing the purchases and installations of our most needed equipment, organizing the last details, and meeting with the mayor and members of the municipality for the legality of the function of the Casa.

Google Hangout
While Google video chats are a a great way to have a meeting with people in three different places (Erica in USA, Jes in San Martín, and the rest of us in San Juan), poor internet connection and three different languages happening at once make a meeting last about three times longer than would otherwise need to last! But we are grateful. Grateful for partnerships with caring and equipped people and for this ability to communicate with people in scattered cities and countries.
Speaking of, I am greatly missing my family these days and am thankful for video chat so I can see my (rapidly growing) nieces and nephews and the rest of my family back in the US and Rwanda.

ATI... It doesn't go away! 
This is an inside joke to my nursing friends... ATI is a board exam preparation course that was pretty much the bane of our existence in nursing school and kicked our butts all the way through. It has proven, however, to be an effective way to help one pass the nursing board exam and it is a great reference post-graduation!
I have found myself reviewing the maternal-newborn textbook often for reminders on a variety of topics. Every week, Cristina and Wendy travel to the three villages of San Juan (an hour and half to two hours away), to give classes to the pregnant women in the communities. A big part of the Casa project is education and we want to equip these women and their babies to be as healthy as possible. We also want to build relationships with them so that they build trust with us and will be able to use the Casa for their births. Last week I went with Cristina to teach about nutrition during pregnancy. I once again referenced my ATI book to refresh on teaching points such as foods which contain folic acid and iron. It is very rewarding to work with these women who are very interested in learning and who express gratitude for the opening of the Casa. In these communities the women don't even have access to basic hygiene products that are necessary during and after their births.

"Can you draw? I can't draw even a stick figure"
None of us working on the Casa project are artistic, so I set about to find a painter who could paint the outside of the clinic for us "Casa Materna" with our logo, as well as our birth room, postpartum rooms, and prayer room with silhouettes of mothers with their babies and the following scriptures, respectively: Tu, Señor, creaste mis entrañas; me formaste en el vientre de mi madre. Te alabo porque soy uno creación admirable! (Salmos 139:13-14), Los hijos son un regalo del Señor, los frutos del vientre son una recompensa (Salmos 127:3), Muy de mañana me levanto a pedir ayuda; en tus palabras he puseto mi esperanza (Salmos 119:147). 
(All of these scriptures are from the Psalms so the English translation can easily be found).
Kennet and I came across a painting that we loved in an art shop in the tourist part of town. I semi made friends with the owner of the shop, Filipe, so I decided to go ask him if he knows anyone who paints what we were looking for for the Casa, and sure enough he did! I am so happy about this addition that we will have in the Casa (once we have legal documents we can get started with this), and for my new friend Filipe who not only paints beautiful art here in San Juan, but has also traveled to the US, even to my city of Philadelphia and has painted a mural there!

"That man who helped us hang the clothes line? I'm very worried. He's been to prison at least twice"
Last week there was a medical team from the US that was occupying the first floor of the clinic. There were many locals helping them with the clinic, so the whole place was buzzing with people. While we were upstairs hanging our still dampened sheets to dry on the roof of the Casa (see following section), two men came upstairs and upon seeing us struggle to hang the line, they offered to help us. They quickly and easily hung the line and I was grateful for the help as I began to hang damp sheets smelling fresh of laundry soap and bleach.
After the men went downstairs, Merlyn came over to me and proceeded to tell me that one of the men is known as a thief by the whole town. We were very puzzled by the fact that despite this he was still given the job to work with the visiting teams. Merlyn made sure to emphasize to him our new functioning security camera.

A trip to the beach... to do laundry!
Merlyn, Johana, Wendy, and myself took all of our sheets to the lake last week to be washed by hand. From 10:00 to 3:00 We washed and rinsed and hung them on the line. When we were finished, Merlyn said, "we've had these sheets for three years, and we are finally getting to use them." Wow, all the washing suddenly seemed liked such a reward and an excitement to be yet another baby step closer to opening the Casa. Upon all the sheets being dry, we folded and counted them for a total of ninety-two.


Let there be light.. and more water!
Finally we have electricity! It was installed last week (only took four years) and it makes such difference in the feeling of the Casa. If we need to test any equipment we can now easily do it without having to bring anything to the house. And in the evening hours, everything just feels so much.. brighter :) 
Although we've been getting daily and nightly rains that are turing our streets into small rivers, we are happy that we are getting yet another water source at the Casa! On the roof level we will have water access to be able to do washing of linens in meantime while we do not have a laundry area... now we just have to wait for a day without rain so it can be installed!

Lesbia's birthday!!
Last week was Lesbia's birthday and I'm so happy that I was here this year to celebrate her. I bought a cake from a local bakery and all of us (even Dolly!) enjoyed it for two days.
Lesbia may be the most humble and the most compassionate person that I know. Working with her has taught me many character quality traits in a new way: she is faithful (Proverbs 28:20), she never tires of doing good in helping others (Galatians 6:9) she is humble (James 4:6), she is compassionate and feels the suffering of others as if it were her own (and for one working in healthcare and midwifery in places of such low resources, this brings much suffering) (Galatians 6:2), she is determined and fights for justice even when there seems to be no progress (Isaiah 1:17, Psalm 82:3), and her unwavering faith and trust in God and belief that He is sovereign over all (Proverbs 31:30). I am forever grateful to her for teaching me such strong character and midwifery skills by her example.


In death, in life, we're confident and covered by the power of Your great love

Little boy born the last day of July

In the past two weeks we have rejoiced in the birth of another healthy baby, but we also grieve the loss of one. With such limited resources here for neonatal healthcare, we were not able to give this baby what she needed to save her. This was a traumatic experience for all of us involved, and prayers for the family going through this immense loss are deeply appreciated.
After all was said and done, through tears Lesbia lamented the great sufferings for lack of basic necessity and lack of support from authorities. We reminded each other of our thankfulness to God for the caring people working with us to help these communities and for all those making an effort to eliminate easily preventable suffering. We reminded each other that we have done and will continue to do all that we can do and we must trust God's sovereignty over all. May our sufferings motivate us to love all the more deeply and work all the more that we can.





Prayer Requests:
-Proper vehicle for the Casa
-Continued support from the municipality of San Juan
-Safety for the staff, patients, and equipment of the Casa
-Comfort and peace for those suffering
-Continued finances for the Casa
-Partnerships with other ministries that we potentially have


Therefore, my beloved brothers, be steadfast, immovable, always abounding in the work of the Lord, knowing that in the LORD your labor is not in vain (1 Corinthians 15:58)

Pay It Forward

During these weeks that I've been in Guatemala, I find myself often reflecting on my last year of nursing school and how grateful I am for the professors I had, the classmates/friends I had (and still have), and for my brother Andrew and his wife welcoming me to live with them. They showed me nothing but kindness. I had my study and sleep space, endless amounts of coffee, and study breaks were times filled with little nieces and nephews or going for runs while exploring new places with my brother. They did this out of the generosity of their hearts and did not ask for anything in return. Although Bear Creek feels more like my true PA home, they surely made Philly feel like home during my years in college, and I will always hold those memories in my heart.

Bear Creek is where I loved to spend weekends and holidays, experiencing the same hospitality from my sister Sarah and her husband. I enjoyed countless hours with them the great outdoors, watching The Office, making delicious food, and many days just sleeping and not doing much at all but enjoying the company of them.

In my memories of growing up, parents were always welcoming friends to stay with us. They have set a good example of hospitality for us, reminding us that it is more blessed to give than to receive (Acts 20:35), and to my siblings to whom I look up to so much, thank you for continuing that example.

The kindness of my family often reminds me of when I lived in Honduras. The medical director of the hospital and his wife took me in as their own and I became a part of their family during that year, and they remain dear friends of mine to this day.
One evening after dinner I thanked them for accepting me as family. Pauline told me that while in college and medical school, she and Jay had been shown the same hospitality, and they are just paying it forward to the next generation, and she told me that I have my own family I will do the same.  


When someone has shown you kindness, be sure to pay it forward. Be sure to always show kindness to others, because you never know when you'll be the one in need. 

Progress In The Casa Materna

Another week of adventure and making progress sometimes slowly, but definitely surely! This week hasn't been as adventurous as last week when Kennet was here; we took the opportunity to travel around the lake visiting other towns and hiking around the mountains (with my new Solar BakPak that he gave me!!)  and finding the places with the best food and coffee. Although he's now back home working in Honduras, he continues to be of help from afar with details such as finding the best pricing for lighting and curtains which he will bring to us next month.

 
Hiking the Cerro de la Cruz of San Juan and passing by the San Juan museum


Xela
This week I traveled with Merlyn and Lesbia about two hours away Xela where were were able to find a lot of supplies still needed. Although we are extremely fortunate to already have some big items in the casa such as hospital beds, cribs, and exam tables, there is a still a lot needed to complete our supply closet. We are almost completely ready now with just a few items needing to be bought in in the US for cost-effectiveness. A missionary team coming from Erica's church at the beginning of next month has been so kind to bring us these items.

Progress in the Casa
All of our areas have now been assigned and we are organizing each room. Right now the municipality is only giving us the upstairs of the clinic as they are claiming to use the first level as a new location for their Centro de Salud. We are still hoping that they will decide to give it to us in the future as their current location is sufficient for their needs and we could expand greatly our program and host teams that come to serve and educate the people of these communities. Upstairs we currently have the waiting area, bathrooms, a birthing room, a newborn exam room, the prenatal care room, the staff lounge, the administration office, the prayer room, the pharmacy, the storage room, and two postpartum rooms with three beds each. We are very thankful even for this space and the rooftop space that we have which we hope to utilize in the near future. As well we have beautiful gardens and as mentioned before, space for a kitchen and laundry area.

This week we were told that we would have electricity, but this has yet to happen. We have had a surveillance camera installed, and Kennet has helped us to purchase LED bulbs which are 90% more energy efficient than regular light bulbs, so once the electricity is actually working it will be pretty exciting.

We continue to work with the municipality to get approval regarding the legal aspect of the functioning of the Casa so that we can can work with the Ministerio de Salud to have everything in legal order.

Photos: Birthing room and the view from the windows- a small farm of cows and horses with avocado, coffee, and lime trees


















Jes
A new friend of mine and huge asset to the Casa project has been Jessica, a Physician's Assistant who works with Saving Mothers. Erica introduced me to her as she's been working here in Guatemala teaching birthing assistant classes to the comadronas ('midwives') here. The curriculum she developed is a several month long program and she has been working in different parts of rural Guatemala, San Juan being one of them. She is currently living near Xela teaching her new school, and has been a help to me with things such as where to find certain supplies, electronic records and patient documentation, contacts to many local people who can assist us, and much more including the best places to eat and fun places around the lake to visit on the weekends :) All of our casa staff have graduated from her school and the casa will be a place where new birthing assistants can come and gain experience.


Birth
This week we had a birth! Every time I attend a home birth with Lesbia (or in the Centro de Salud which unfortunately has near to no medical supplies) I am so thankful for the casa and its opening coming soon. Thankfully the mother and baby are both doing well now, but the birth was a little complicated. The first-time mother was having trouble getting her little one out despite the babe only being 6 pounds. Her heart rate began to drop dangerously low but we thankfully we were able to assist the mom to push her out just in time. She wasn't breathing upon birth but the Ambu bag came to the rescue and we were able to resuscitate her. Within a short time she was breathing and began to cry a little over the next hour.
The photo is with Lesbia shortly after baby was cleaned up and doing well.



Global Health Media 
In my last year of nursing school, my community health professor showed our class these amazing educational videos. They are available in many languages and free to download which is absolutely amazing!  I remember thinking to myself that day in class, one day when I'm a community nurse I'm going to educate the people with these. Now all this time later, I was talking with Jes in Xela this week, and she reminded be about the videos and that there are many available about pregnancy, birth, and newborn care. I am so excited about these and how they will serve the people here!


Prayer Requests! 
-Permission for us to use entire clinic for our birthing center
-Electricity
-Legal aspects (working with municipality and Ministerio de Salud)
-Safety of the mother's and babies in these communities
-An emergency vehicle for the Casa
- Alvarez- Cholotío Family: Lesbia and her husband Juan and their three daughters Elena, Oneida, and Cana (and new Pit Bull/Dalmatian pup Dolly) have welcomed into their family as their own. They have taught me about perseverance, servant-heartedness, and contentment in ways that I never imagined. My prayer is that God continues to bless them more than they can imagine for their hard work and service to their people.

Return To La Casa Materna

As many of you know, I spent the month of June 2015 (see posts from that date) in San Juan of Lake Atitlán, Guatemala, working on a birthing center project that was initiated by my friend Dr. Erica in partnership with her church, Christ Wesleyan, in Milton, PA. A year later we are now close to being able to open it. I am here for two months working again with Lesbia attending home births with her and working with her and her sister, Merlyn, who will be the administrative director of the Casa.

Right now we have two birthing assistants, Johana (Lesbia's daughter), and Wendy, who have been helping us immensely with the preparation and Cristina, a nurse from the Centro de Salud (local health center) who has helping us with some preparation as well.

Kennet has been here this first week and has been helping us with a lot. Among many things, he repaired half of our cribs which were broken, helped us purchase a computer, and repaired and rebuilt a storage closet (which we were told was unfixable and should be thrown out).
It's been so fun after being apart for 6 months to be able to work together and have fun exploring different places around the lake. The Atitlán region has so many beautiful places!

Return to the Casa after more than a year

Organizing the Casa with Kennet, Cristina, Johana, Merlyn, and Wendy

View from the casa which directly faces the Rostra Maya.
The tin shed is the future home of  our kitchen and laundry area.

Beautiful gardens surround the Casa. Some rose bushes are taller than me!

His Faithfulness Continues Through All Generations

The grass withers and the flowers fade, but the word of our God endures forever
-Isaiah 40:8

He who began a good work in you will carry it on to completion until the day of Christ Jesus
-Phil 1:6


    This month has been the month for which I have been waiting to come for the past four years. I have officially graduated Eastern University with my Bachelors of Science in Nursing. These have been four of the toughest years of my life, and they have also been the most beautiful and the most rewarding. I have seen God's faithfulness every step of the way throughout my life, many times retrospectively, but never so profoundly have I experienced His faithfulness moment by moment as I have during my time at EU, especially these past two years of intense clinical and nursing classes.
    Since spending a year working at a children's hospital in San Pedro Sula, Honduras, from 2011 to 2012, I knew that I wanted to be a nurse and work with undeserved populations. It was my dream since then to move back to Central America one day, and that dream is finally coming true. (Note: I have to thank CURE International [cure.org] for welcoming me to work with them for that year, because of them I fell in love with Honduras, and it is beautiful to see how God is working in the lives of thousands around the world through CURE).

    With the culmination of my undergraduate studies come many mixed emotions. I want more than anything to begin this next season that I have anticipated for more than four years now, to be a missionary and a nurse and fulfill the passion that God has put in my heart, and there is an inexplainable amount of more excitement on top of that because I know that my boyfriend Kennet is there waiting for me.
    At the same time, there is a loss to never again spending time as a nursing student with my nursing pals who have become like sisters to me. I will no longer live with my brother and sister-in-law and watch my little nieces and nephews grow up day to day. I won't be able to go to Bear Creek on the weekends to spend time with my sister and brother-in-law and their four kids, riding quads at the lake or jumping on the trampoline, or riding horses with my sister Mariah. My sister Emily and our best friend Lauren are both becoming moms this month, and to not be able to watch these little ones grow up is a loss to me; my nieces and nephews mean the world to me and it feels like an even greater loss than when I moved away from home after high school and my four younger siblings grew and changed so much, and I felt like I was missing a huge part of my life by missing their lives.

    With this biggest change in my life (thus far) happening now, I have been reminded that with the change of seasons there is loss, but there is always something better ahead. To the church in Philippi Paul wrote, "I press on to reach the end of the race and receive the heavenly prize for which God, through Christ Jesus, is calling us" (Phil 3:14). This is my greatest reminder of what life on earth is about- following God's leading to bring His kingdom to earth and living with eternity in mind. He will always lead us to greater places than we will leave behind. Following Him means to follow peace and no matter what mixed emotions I have with the changing of places I live, the changes of possessions I own- none of that matters. What matters is the fact through everything, God does not change. He is the constant, and throughout all of the change, I must keeping following the constant peace that only He can give us.

    In a very scattered and ever-changing world in which most of the time we have no control, feeling like a tiny boat being tossed about in a stormy sea, I want to encourage you to trust in God's faithfulness. Let Him be the anchor for your soul. Don't let the "potentials" or the "what if's" steal your peace from the unknowns of the future. God is our anchor here in this moment, giving us the grace for this moment, and He is faithful to do that in every moment.

Your faithfulness continues through all generations
-Psalm 119:90

my prayer these days

Where Is The Hope?

I recently experienced the most difficult of situations that I have had thus far in nursing school, and probably one of the most difficult in my whole life. Being a nurse means at times caring for people in the most sick and most vulnerable times of their lives and it is truly an honor, but it brings with it sadness and many times a sense of hopelessness. 

I had this experience very profoundly for the first time, where I truly felt hopeless and helpless. In this particular situation, the illness and complications that my patient had did not allow for any way of communication. This person could not speak nor use his hands to write. Although he was completely mentally capable, his current physical state prevented him from being able to communicate in any effective way. His primary nurse and other student nurses stood with me as we painstakingly tried to read his lips as he mouthed word by word what he was trying to communicate. In those moments I would have given anything to have a lip-reader come and save us. Among many feelings, this person was afraid, anxious, and frustrated as I stood there completely helpless, holding the hand of this beautiful soul. I could see the sweetness of his spirit as he always mouthed "thank you" with a smile every time I was able to understand and help him. The sadness of this situation was crushing me. I knew that his illness was terminal and I couldn't just hold his hand and tell him that he would be better soon.

At one point I was sitting at the computer and I began to cry. I usually can emotionally separate myself from my patients, but the realization of my lack of being able to provide for his needs profoundly affected me. I had never felt so helpless for a patient. I prayed in my heart that God would give this person peace, that he may know God's love and saving grace. For a brief moment I did feel peace, remembering that what I do is not by my might nor by my power, but by the Spirit of God (Zechariah 4:6). 
As beautiful as nursing is, it can be just as heartbreaking. Any field of work has it heartbreaks. To state the obvious, we are in a broken world, and who said life would be easy? No one. On the contrary, Jesus promised hardships and persecution and trials of many kinds, but He promised to never leave us. If there is one thing I want my patients to  know, it is that. And when I cannot communicate this, I remember that Jesus works through me on my behalf (Hebrews 7:25).
I can choose to live in hopelessness by what I see, or I can live in hope through faith in the One who is faithful from the beginning to the end of time (2 Cor. 5:7, Phil. 1:6).
More than anything physical healing, I want every person that I care for to have spiritual healing and know a hope that is greater than life or death.

I was able to care for this patient again the next week, and I was so happy to see his smile upon seeing me. He seemed more comfortable than the week before which was shortly after his admission and invasive procedures, and I was able to understand nearly every word he mouthed to me. I cried again upon seeing a sweet letter on his wall written to him by his daughter, but at the end of the day as he was getting ready to sleep, I was so thankful to have been able to spend time with him again. I knew that I had done all that I could have done and gave my best, and that, friends, is all that God asks of us. to walk in obedience to Him. He will take care of the rest.