Tour de La Casa Materna!

Amigos, aquí ustedes pueden ver este video del progreso que estamos haciendo!
Si quieren más información, pueden contactarme por correo electronico: annaghaas@gmail.com
 

Tour of the Casa Materna!

Friends, please check out the progress we are making!
Please contact me at annaghaas@gmail.com if you are interested in more information

The Casa Materna Continues to Move Forward

The past two weeks we have been quite busy doing a variety of work. We have been working on the protocols of the Casa and other necessary paperwork, participating in educational classes, making improvements to the Casa, and we also have spent ample time with the municipality working on the legality process. It is a slow process and last week we took some steps backwards with some complications with the Centro de Salud, the organization from Spain who funded the construction of the clinic, and the municipality, but thankfully everything has been worked out and we continue to take steps forward in preparing the Casa. We were informed that the Centro de Salud will no longer be coming to occupy the first level of the clinic, so we are hopeful that the space will be granted to us! 

Education 
Dr. Erika Close from Canada has been working in different parts of Guatemala over the past years teaching a program called Helping Babies Breathe, which is designed to help healthcare workers in low-resourse areas to help babies survive after birth. Upon finishing her classes, the healthcare workers receive an Ambu resuscitation mask. For Lesbia it has proven to save the lives of several babies so far. Dr. Erika has been and continues a huge support to the Casa with education and healthcare supplies. She came the first week of August and taught a three day class with us (our staff and those who are applying to be birthing assistants once we are open), teaching newborn resuscitation and care of the mother and baby postpartum.

Last week we had a class taught by Jes, the director of Saving Mothers Guatemala. We are so fortunate to have been able to join forces with them, so when we have classes her student midwives and our students and staff are able to join together and have a great learning experience. In this class we reviewed prenatal care and protocols in low-resource settings.

 Jes received a donation of beautiful scrubs for all of her students from the FIGS Scrubs with the Saving Mothers logo.

Curtains 

Last week our hand-made curtains were finally ready and they look beautiful! We are so thankful for our neighbor who worked so hard for weeks to make them so perfectly for us. Kennet spent hours getting covered in dust while drilling the whole and applying the hooks where our curtains now hang. 

Lights

Last week Kennet also replaced the fluorescent lights with LED lights which are 90% more energy efficient. They were shipped to us all the way from Hong-Kong, and they look beautiful!  

Before

After

Interviews 

Today with Jes, Lesbia, and Merlyn, we held interviews for the birth assistant position that we are looking for. We interviewed six people today with a variety of experiences and talents in different areas, and we are thankful that we found someone with a lot of experience in material child care and is a paramedic. We are hoping in the future as the Casa grows and we have the finances, we will be able to employ more of these people who have talents that can help us and are in need of work.

Prayer Requests

-Continued funding so that our program can continue to grow and we can reach and employ more people

-Timely progress so that we can open in the right timing (specifically with the legal documentation that we need)

-Cordial relationship with the Centro de Salud, the Ministry of Health, the Municipality, and others with whom we are working and making efforts to collaborate with on this project

-Mutual understanding and respect between educators, families, and student healthcare providers 

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!