Inauguration

INAUGURATED!!

We finally reached our long awaited dream of inaugurating and opening the Casa for service. On November 10th, we had a beautiful ceremony and people from near and far who have been an integral part of the Casa came to celebrate this beautiful day. Our general director Dr Erica came from the US along with her sister Monica who is our financial director. Pastor Immer and Shirley (director of missions) came as the representatives from Christ Wesleyan Church, our church sponsor in the US. My parents also came as a huge surprise to me!! They were here for my birthday as well as the inauguration, and it was so fun to show them around San Juan. It was so beautiful for me to see so many people come and to have those who came such a long way from the US here to celebrate this day that we worked so hard to achieve. 

THE FIRST WEEKS

We have begun our prenatal clinic services at the Casa and are receiving new patients each day. Although we are still attending actual births in-home, we are excited that beginning 2017 we will be able to start attending births at the Casa. Lesbia and I work with our three birthing assistants (Joel,  Wendy, Johana) who come on a rotating basis. We are getting down a smooth system as we work out all the details with administration, documentation, etcetera. We are so fortunate to have Merlyn as a wonderful and very detail-oriented director of administration. 

It has been wonderful to also have Kennet in town these days helping with on-going projects such as the website creation, the kitchen plans and the outdoor lighting plans we have for the Casa, to name a few. 

Johana and I are learning how to use the ultrasound machine with Dr. Jes which is a huge blessing for us. We had a wonderful ultrasound donated to us and we are very thankful for this opportunity to be able to learn this skill and provide our patients with the highest quality of care. Normally the cost of an ultrasound in this area is too expensive for the average family to pay. We are now able to better detect problems which need referral to a specialist earlier in pregnancy, thus decreasing the risks of having complicated deliveries. 

EMERGENCIES IN CHILDBIRTH COURSE

Last year, Lesbia and Wendy received a wonderful class on emergencies in childbirth and helping babies breathe from a midwife from the US who volunteers with Faith In Practice. This organization travels all over Guatemala doing these trainings, since this country has one of the highest infant and maternal mortality rates. This year, they returned to our area and Joel, Johana, myself, and Kennet were all fortune to receive this class. Upon completion we received and entire birthing kit, complete with an Ambu. Praise God for His faithfulness in bringing wonderful people who are collaborating with us and helping us provide the best services possible! 

Every so often Dr Jes hosts a teaching about perinatal care. This last class we had she taught on gestational diabetes

MY CASA

My little casa is coming along nicely. The grass in my yard is growing as well as the flowers (and weeds…). My kitchen is almost complete now and I am able to cook almost anything! Although I do not have a full-sized fridge, nor do I have measuring spoons, measuring cups, nor baking dishes, I somehow was able to cook a Thanksgiving dinner for the Casa staff and their families (18 people!). I made roast chicken, sweet potatoes, homemade mac n cheese, and baked green beans. I made chocolate chips cookies, and although the absolute easiest thing to make, they were definitely the favorite food among the guests! This year although I missed my family, I am extremely thankful to have spent my first Thanksgiving with Kennet, for this opportunity to work with such wonderful people. I can truly say there’s no place I’d rather be. 

One evening after church recently, one of the youth leaders approached Kennet and I and asked if we would come to a young adults gathering and share our testimonies and how we are serving God here in San Juan. I was able to share a little bit of my story and what I am doing now, and Kennet also shared about himself and taught about using our gifts and talents to honor God. One of my favorite things is to listen to Kennet teach the Bible, and we are both thankful that the youth leaders want us to be more involved in their activities. 

Prayer Requests 

-Collaboration. We have potential for collaboration with other health care facilities in San Juan, so I am praying for smooth collaboration efforts and agreement as we navigate how and and in what ways we will work together to serve each other and reach more people.

-Reaching the aldeas (remote villages of San Juan). One of our dreams is to reach the remote places that have no healthcare access. Many of the families that live here have many children and their parents cannot provide enough food and clothing for all of them. They cannot afford medicine or any type of healthcare even if it were available to them, which it is no. Although we are taking steps to reach these people now with education and bringing them to our clinic monthly, we first need a van as a means of transport. Our dream for the future is to have a Casa in aldeas. For now we keep praying and moving forward one step at a time.

-Spiritual Ministry. I am praying for our spiritual ministry to grow at the Casa. From my own experience with my friends here and with patients, unfaithfulness among spouses, domestic violence, alcoholism, and drug abuse  

Update from San Juan!

Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up. As we have opportunity, let us do good to all people, especially to those who belong to the family of believers. 

-Galatians 6:9-10

Be steadfast, immovable, always abounding in the work of the Lord, knowing that your toil is not in vain in the Lord.

-1 Corinthians 15:58 

Ministry 

I now been back in Guatemala for about a month and am settling in for the long haul! July and August were filled with great progress with the Casa, and after spending a few weeks in September back in the US and Honduras with family and friends, I am now back and have moved into a beautiful little house which I am renting from a friend. 

We are preparing for our inauguration of the Casa on November 10th! Just 12 days away. We have been working this month preparing for the ceremony and inviting over 100 guests. I am so thankful for the continued collaboration with Saving Mothers and the Guatemalan Ministry of Health as we prepare for the opening of the Casa. 

As we prepare for the inauguration, we are putting the things together which are necessary before the opening. I have continued to meet with Jes from Saving Mothers, with the Ministry of Health, and the municipality of San Juan as we work to have everything prepared from a legal standpoint. We have also been getting last minute equipment set up and I am happy to say that we nearly have all that we need from a clinical standpoint. We have also been preparing the outside of the Casa, cleaning out the garden, leveling the driveway/parking area, and painting the the outside of the building. While we painted the trim a sky blue, we hired a local painter to do our logo.

It feels like a slow and long process, but I am so grateful to work with a great team of people for such a worthwhile cause and that we are near to providing perinatal care and education to those who are in need!

New paint job for the Casa! We are thankful for our new friend Bernardo who did a wonderful job with the logo. 

Working on the parking area and gardens.  

Saving Mothers/ Casa staff meeting. 

While our patients will pay a fee to help cover the costs of their healthcare, additional funding for the Casa is critical at this time for the continued functioning of the Casa. If you are interested in financially supporting the work of the Casa and/or receiving my fundraising newsletter, please do email me at annaghaas@gmail.com. 

I am so grateful to each one of you who take the time to read about my life in Guatemala, who pray for me, and encourage me from near or far. I could not do it without you!

Personal

My tiny house is surrounded by coffee and avocado trees, as is the Casa (about 7 minutes walking distance from my house). Everyday I collect fallen avocados, and have eaten them with corn tortillas for 1 or 2 meals per day for about a month now. I didn’t think I would ever get tired of avocados, and being that they are so expensive in the US I rarely ate them. But let me just say, if you are in need of an avocado fix, please come visit me- I have plenty that I’d love to give away!

For the first time in my life I enjoy drinking coffee black. The local coffee is so fresh and has no bitter taste. Guatemala is one of the top countries for producing coffee, and this region produces especially quality coffee.

My house is slowly coming together. I am also very thankful that Kennet found me a vehicle for a great price! A 1987 Toyoto pickup that is perfect for my needs right now (namely moving my life from Honduras to here :)) Kennet helped me plant grass and flowers which a growing slowly (but surely.. I think). I have a bed and a closet that Kennet made from his own imagination (having never made one before) so I am very proud of him for that! I have a make-shift kitchen with a tiny fridge, a rice cooker, an electric skillet, a magic bullet blender, and very importantly (and yes, the first kitchen appliance I bought)- a Swirlio. I am hand-washing and line drying for the time being as I am buying all of my home appliances in Honduras for cost effectiveness, so once a month Kennet with bring me some appliances until I have everything. I will never again take for granted these beautiful things that I once thought basic necessities. No, they are something that most people in the world will never use and I am so grateful to have them and to be able to bless others with them.

         Dogs. I have been missing my dog Acey a lot these days (he passed away shortly before moving here). San Juan is overrun with stray dogs and I would love to euthanize all of them and clean this town (and all of Central America) of these poor skin and bone sick dogs, but there are a few dogs here that are filling my need for a dog while I wait for my own, including the three newborn pups of my neighbors' (one of which I almost adopted when she got lost and ended up at my house). For the time being I've befriended Dolly and Tyson which I kind of consider my own anyway since they belong to my "San Juan family."

L-R clockwise: Tyson, Dolly, and the three new pups (bottom L I almost took as my own)

     I have workout routine that Kennet and I created which I try to do about 4-5 days a week, running from here to San Pedro (the next town over), and then doing sprints, pushups, lunges, squats, carrying Kennet on my back, etc, on the road entering the San Pedro which I have duly named “The Hill of Death.” It is a horribly steep hill that the tuk tuk taxis even struggle to climb. When I feel like I am close to death, which usually only takes a few minutes, I then run back home. I basically have a love/hate relationship with that hill. 

     I have been attending Bethel church here in San Juan. The pastor is very kind and I learn a lot from his teachings. Being that Kennet (when he's in town) and I are the only ones there who regularly attend who are not local San Juaneros, it didn’t take long for the pastor to know us. One weekday evening we helped out with an evening service outside. Even in the rain they did not cancel! They are faithful to share God's word.  

     One of my favorite parts about when I lived in Honduras was meeting missionaries and learning about their work and collaborating with them. I have already met a couple from San Pablo and a lady in San Pedro and I look forward to how our churches and ministries can work together. 

     On the weekends it's very fun to explore new places around the lake. A couple weeks ago we went to a beautiful place called Jaibalito with Jes and some new friends who are temporarily living in the area! Jes has been a great help to me not only with the Casa but also in great places to have fun! This is the view from the hotel/ restaurant. 

     Kennet joined a San Juan soccer team and every weekend I enjoy watching the team play. The majority of the team consists of the family of Merlyn and Lesbia, my two co-workers who I consider my family here being that Lesbia houses me for the first 3 months of my life here. We've won 5 of 6 most recent games! 

And on a last note, I'm glad they do not celebrate Halloween here. One, because I don't want to say that I hate Halloween, but I strongly dislike it. And living in a place alone where many times at night (like tonight!) there is no electricity and I venture by the light of my iPhone, I am glad there is no mischief night/ Halloween presence here!

    As always, I would love to hear from you, and stay tuned for more updates!

Steps in a New Direction

In their hearts humans plan their course, but the LORD establishes their steps.

Proverbs 16:9

The LORD makes firm the steps of the one who delights in Him.

Psalm 37:23

The last week of August held much change and excitement for me. Not only did I get engaged (story to come!) but my plans to move to Honduras changed into plans to live in Guatemala, to stay in this tiny, beautiful village of San Juan La Laguna, to continue this wonderful work at the Casa that I have been blessed to be a part of from the beginning stages.  

While I was finishing what needed to be done in San Juan before I came back to the US for two weeks (before my anticipated move to Honduras), my boss called me and told me that they are actively looking for someone to fulfill my position as a full-time paid position. It came as a surprise, even though I knew that the job I was doing wasn’t only necessary for the beginning preparation of the Casa, but also necessary once the Casa would be open and functioning. Because I had my plans to be in Honduras, I didn’t consider staying at this time, although I did daydream about coming back in the future and playing a role in nursing and maternal/child health education once I held a midwifery degree. 

Kennet had come to visit and help with the Casa when I first arrived in the beginning of July and as we rode the lancha (boat taxi) one day from San Juan across the lake to Panajachel, we took in the beautiful scenery, the uniqueness of each village, the massive volcanos and the tiny fishing boats, the immense height of the mountains and the depths of the lake that we floated upon, having an average depth of 720 feet and a max depth of one 1,120 feet. We talked about how fun it would be to live here one day if the opportunity ever would arise. It was exciting to think about but I didn’t let myself dwell there; in my mind I had many opportunities in San Pedro Sula and connections with many people throughout the country of Honduras. I have close friends there who are like family to me, Kennet and his family are there, there are churches there that I love and have have been looking forward to reconnecting with. 

Fast forward two months to when my boss called me, and I was in a conundrum. I so badly wanted to stay and continue what I was doing here in San Juan and have this amazing learning experience in this field of work that I’m so passionate about, but it was completely out of line with my plans and I felt in that moment totally under qualified (how God uses us so profoundly in our inadequacies). In talking with Kennet about all of this, he encouraged me to make my decision not based on selfish reasons but to think about where I would be of most service and gain the most experience with the skills that I am building and the anointing that I have been given. 

After a very short time, much shorter than I anticipated, it became clear that I should stay. After I told my boss, I felt a sense of peace and joyful anticipation for the year to come. I don’t know how long God will have me there in San Juan (maybe one day we’ll have a Casa in Honduras or another beautiful country!). This experience for me has been a reminder to remain open daily and to listen to God’s spirit within me, not remain stuck in my own ways of thinking.

It officially begins the first week of October, and I will have a mix of responsibilities at the Casa, including working with Lesbia as a nurse and birthing assistant, the liaison between our team in San Juan and the US, the overseer of daily operations, and fundraising/ donor relations. 

I thank you, dear friends, for taking time to be a part of my story from wherever you are. Your prayers are powerful in my life, and thank you for what you are doing to support what God is doing in me and the Casa Materna.

I do have a few prayer requests at this time of transition:

- God's hand would be upon every person that comes into the Casa and that we would have ever-growing wisdom in every decision and action we make 

- As I make my home in San Juan and continue my long-distance relationship with Kennet that we grow in our relationship with God and each other

- A conference I will be attending in Naples, Florida, this weekend where I will be able to reconnect with old friends and share about what I am doing in Guatemala

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)