Holidays in Honduras

December began with an NPH Soccer Tournament, which we, NPH Honduras, had the privilege of hosting. After months of preparations, including the children hauling bags of dirt and working to help construct a new soccer field, the big week finally came. A men’s and a women’s soccer team came from each of the corresponding NPH Central American homes in Nicaragua, Guatemala, El Salvador and Mexico to represent their countries, along with a few directors and support staff. Half of our kids moved out of their homes and into the hogars of the younger children for the week, sleeping on their cots on the floor to accommodate the several hundred extra people we had on the Ranch. After a big opening ceremony with the national anthems from each country represented and a running of the torch, the games began. Our days were very long. Games were played on two fields, men’s and women’s, from 8am until 5pm for four days. In the evenings, we had community dinners or special activities. One night each Country delegation shared their culture with the rest of us, by presenting their traditional homeland dance, with costume and all.

The Clinic staff set up a very well equipped first aid station contained inside our Micro-bus, converted ambulance, which luckily only had to make a few trips to the hospital for x-rays. Each morning our external clinic staff would hurry to get all our work done and finish with our patient consults so that we could catch as much of the games as possible. Our Honduras Boys team did very well and made it to the finals. After a very suspenseful game, they won in a shootout and after the final goal was scored, the field was immediately stormed with hundreds of children and adults. It was a very exhilarating experience as we all encircled the team and ran a victory lap around our home field. The week was concluded with an awards ceremony, fireworks, and a fiesta. Overall, the kids made fast friends with our visitors and apart from being excited to have their own space back, they were sad to see their friends go. I think it was a valuable experience for them to interact with kids just like themselves, but from other cultures and countries.

After the tournament, I had just one week to count down until a very brief but much anticipated visit home to the states. Since volunteers work every day for 2 ½ weeks straight during Christmas with the kids, we got 5 days off prior to assuming our positions as caregivers before their guardians left for vacation. I took advantage of this gifted break and added a few more vacation days on to be able to make a 6 day trip home to see my family in Utah. It was an interesting experience when I re-entered the Atlanta airport, almost exactly 1 year after I had left it, to hear English spoken all around me, and I was a little overwhelmed by all the vendors and hustle & bustle. On my first morning home I had an interview with the University of Minnesota, Doctorate of Nursing program, and after that I was able to begin my relax.

It was such a wonderful feeling to be able to curl up on the couch with a hot drink and Christmas music, and take in twinkling lights of the tree and the abundance of holiday decorations. My whole family was home together. We played board games, had a Welcome-Home Christmas party with our family friends and neighbors, went tubing in the snow, and celebrated an early Christmas, before I left on Tuesday December 20^th. I even got to see my brother in action working at Best Buy. It was a dream to sleep in a bed that I didn’t feel the boards through, and eat delicious home cooked meals and baked treats. I also was able to squeeze in a visit to Salt Lake City to visit all my friends and roommates from last year. As I knew they would, the days passed all too quickly and it was time to return again to my home in Honduras. But instead of wishing that I was staying or that I was coming home sooner, my visit home somehow reinforced my confidence that I made to right decision to stay here until May. I didn’t quite feel ready to begin life again in the States and still felt the call to be here in Honduras with the kids, tackling the work that is never finished.

Christmas with the kids so far has been a wonderful event. I’m not sure if it’s just the spirit of Christmas in the air, or that the caregivers are gone and it feels much more laid back because the university and high school kids are running things, or that I am not working much in the clinic and get to enjoy just being a volunteer and spending time with my girls. Christmas Eve is the big day of celebration here. After a short Christmas pageant video done by the kids, we went down to the field by the swimming pond to celebrate the evening. The maintenance crew had strung lights all in and around the trees, so that the whole place magically twinkled. Tables were set up on the patio so that we could all share a traditional Honduran Christmas Eve dinner of tamales together. There was a dangerously huge bonfire that could have kept you warm from 30 feet away, and fireworks flying all over the place. The kids each got a chocolate bar, apple, and grapes for their midnight snack. There was an outdoor movie set up, our only male volunteer dressed up as Santa Claus and handed out candy canes, and we had marshmallows for the kids to roast over some smaller fires. When the clock struck midnight, everyone ran around sharing a Christmas hug.

I spent Christmas Eve night with the girls so that I could play Santa in the morning. By the time we finally got back to Hogar after the Christmas party, it was 1:30am, then they all piled their cots on the floor and started a movie, as promised. They woke me up at 3:30am after it finished asking “Which one do we get to watch next?” And a little exasperated, I told them that Santa would not be coming for children who were up after 4am in the morning. When I woke them up in the morning to ‘Feliz Navidad’ playing on my laptop, and told them that Santa came, I have never seen children run so fast to the main room. It was my first year playing the role of parent and setting up for Christmas, making sure that all their stockings were hung with care. Thanks to my mom, Grandmother, and a few other visitors who had donated individual and community gifts, the girls were well taken care of on Christmas. After sharing presents, the girls got dressed and picked out clothing items and/or little toys to give away. The “Orphans” of NPH on Christmas morning divided into three different groups and walked miles to three neighboring impoverished villages, to give away belongings so that others could receive gifts on Christmas as well. If that isn’t a lesson on generosity and living as a child of God then I don’t know what is? After two and a half hours of walking round trip, we finally made it back and got ready for Christmas Mass. After mass, we volunteers indulged in our own Christmas dinner party enjoying some of our favorite dishes from home. Although this was my first Christmas not spent with my family, it was a very joyous experience for me where I learned to appreciate new traditions and look beyond the importance of gift giving to the true meaning of the season.

 Christmas Eve bonfire.

 One of our new little munchkins to the Ranch, Ricardo.

 Out to Christmas lunch with my two Year of Service assistants from the External Clinic, Maria and Coto.

 Mexico's presentation of their traditional dance on Cultural night during the soccer tournament.

 Looking across the main soccer field during the tournament at the NPH logo that my roommate Caro painted by hand.

"Posadas," a Christmas tradition where the caroling procession goes door-to-door by candlelight with Mary and Joseph to see if there is any room at the inn
.

 Stockings made by my mother and stuffed with lots of goodies for each girl in my Hogar.

 The girls waiting in the hallway on Christmas morning to enter the livingroom and see their gifts; still half-asleep.

 Hiking on Christmas morning to bring gifts to the neighboring village of Tamal&Queso.

 Despite being in Honduras, we volunteers were able to pull off a pretty realistic American Thanksgiving dinner.

I was on the pie baking committe for Thanksgiving... we had 10 pies in total for our 35 guests.

Graduation and Giving, Dresses and Dances.

The school year here in Honduras has now come to a close, and this week we celebrated the graduation of the 5^th/6^th grade and 9^th grade from the vocational school. Every student graduating got to choose a sponsor to spend the graduation evening with and escort them across the stage to receive their certificate. Four of my hogar girls graduated from the 5^th/6^th grade in the vocational school, which is an accelerated program to help older children who come to the ranch and are very behind academically or possibly have never been to school, catch up so that they can be main-streamed again. So next year they are looking forward to joining their peers in the normal 7^th grade class. Those who graduated from 9^th grade are now certified in a trade such as electricity, shoemaking, woodworking, metalworking or making clothes, and will leave the ranch today to go do a practicum for 1 month in Tegucigalpa. Ideally, if the student chooses to be finished with school and leave NPH, they are skilled in a trade and could support themselves on their own. Those who plan to continue on to high school will do one year of service, volunteering in various jobs on the Ranch in return for their schooling, and then continue their education in January 2013. We will celebrate the Montessori and 6^th grade graduations from the elementary school next week.

Instead of “The Sweet 16 Birthday” in the United States, the most anticipated birthday for most adolescents in Latin America is turning 15 years old, called Quinceañeros. In 2011, 30 NPH children turned 15 years old, and instead of celebrating each individually, the Ranch throws one big huge birthday bash for all the kids together. The oldest girl in my hogar was included in this bunch. Everyone gets very dressed up, the Quinceañero boys in a button-down collared shirt and tie, and the girls in a flowy, lacy dress; all outfits are matching and made by the kids in the sewing workshop. The girls were manicured, groomed, and painted up, looking like they were ready for prom. After a celebratory mass, we all ate dinner in our hogars while the Quinceañeros were served a special dinner and cake in the auditorium. Later the younger children rejoined the party and all the birthday kids were paraded in arm in arm with their escort, who was often a mentor or older sibling. Then they shared a waltz. After that, several of the kids performed a choreographed dance in the center of the auditorium. I must say, the kids here can dance impressively well, since they grow up dancing from a young age. The rest of the night was just a huge dance party, which I have to admit I had a blast dancing the night away with volunteers, employees, and kids to various types of hip-hop, reggeaton, and Latin music.

A few weekends ago I got to take a quick trip a few hours up north to a colonial city, Comayagua, which was the historic first capital of Honduras. My highlight of the trip was climbing up into the bell tower of the cathedral in the central park. The clock in the bell tower is the oldest in the Americas and the second oldest in the world. It was built in 1100 by the Moors for the palace of the Alhambra in Granada, and later donated to Comayagua, Honduras by King Phillip II of Spain. The view from the tower was beautiful looking down on all the colonial buildings, surrounded by the rolling hills. There were several other historic cathedrals and buildings to wander around as well. Although we only stayed for a night, I left feeling refreshed and with a new understanding for the history and culture of Honduras.

Every night before we turn off the light in hogar, one child will volunteer to say the prayer. Praying is no rare occurrence here on the ranch, and by a young age most of the children are able to confidently say a genuine prayer in front of their peers. In this season of thanksgiving, I have been continually amazed by the gratefulness of the children. While many of us would look at these kids and feel sorry for them for their circumstances, that they are orphans or were abandoned or abused by their parents, or that before coming to the ranch they lived in a shack with a dirt floor and ran around barefoot, or had to beg on the streets for food and money to support their younger siblings. And now they are safe and cared for, but still, all their worldly possessions fit inside one small locker, they share a 3 room house with 20 other children, live apart from their brothers and sisters, and have only a few caregivers amongst them. They do not feel sorry for themselves. Instead, they give thanks for what they do have, for their health and their family, for knowing that they will have three meals a day, and that they have loving caregivers to care for them.  And more, they pray for those who have less than what they do. They ask God to take care of the sick and the poor, for the children living under the bridge, and those that have no bed to sleep in at night. Even though the holiday is not celebrated here, these children truly embody the spirit of thanksgiving all year round.

Another value that I have seen greatly exhibited among the children is generosity. As we are nearing the Christmas season, Hondurans love to play “Amigo Secreto,” which is essentially what we would recognize as “Secret Santa.” The kids do it among their school classmates, in hogar, and we even have Amigo Secreto going among all the healthcare personnel. And they take it very seriously… not only do they do everything to prevent their ‘amigo secreto’ from discovering them, but they go to great lengths to keep it a secret from everyone involved. Although these children have very few clothing items and personal possessions, I have watched several of my kids pick out one of their best shirts to pass on to a friend. One of the little girls, Ana, somehow compiled 6 different gifts from her personal belongings to give to her ‘Amigo Secreto.’ I have come to the sad realization that it is often those who have less that somehow give more, and those that have more are less generous of their worldly possessions. I told my kids that many people in the US could learn a lot from them about generosity and the spirit of giving.

 The oldest clock in the Western hemisphere, made in 1100 by the Moors.

 The view looking out from the belltower of the Cathedral in Comayagua, Honduras.

 Weekend trips with Lydia and Irene.

 The main cathedral in Comayagua, Honduras' first historic capital.

 Wendy, Kelsi, Tia Dania, and Sonia on graduation night.

 The 30 Quinceaneros who turned 15 years old this year, all dressed up to celebrate their big birthday.

 At the party with Sonia, the oldest in my hogar and only Quinceanera.

 Some of the girls from my hogar, Estrellas de Belen.

 The Quinceaneros performing a choreographed dance, impressively starting with a waltz that transitioned into other types of dance.

 Getting all dressed up for the birthday Celebration.

Reflections on Life

I feel as though I have been transported back to Washington state as I sit on my bed and look out my window at our courtyard garden and watch the fine misty rain dance about in the air. Instead of the short bursts of down pours that the previous months held, it is now a little grayer, a little cooler, and the rain is a little more drawn out. Never the less, there is laughter and joyful voices of tiny children out my other window as they play on the squeaky swing-set equipment across the way, and I feel at home. This month I sat down to write a volunteer testimony for our Home Correspondent and the NPH website to help give donors and future volunteers a better idea of what the volunteer experience is all about. I would like to share some of the insights I came up with as I tried to reflect upon my 10 months in Honduras thus far.

I often forget how different my life is here compared to back home. A change that might be more noticeable returning back to the USA in a few months than it was originally coming to Honduras. But right now, it is just life. I walk almost a mile to and from work each day. This walk I often enjoy as a time to think and enjoy the beautiful 7am misty view of the fields and mountains around me. In the afternoon, the joy of the walk depends largely on the temperature of the day. As most of you know, prior to coming here to Honduras, I had a wonderful job at a fabulous Children’s Hospital. The clinic here is a stark contrast from the state-of-the-art hospital I previously worked in where I had all the newest technologies and best resources at my fingertips. I spend two hours each morning doing vital signs in a room that doesn’t have light (the light bulb only turns on when it wants to) apart from the daylight that enters through the windows. We have no drinking water and most days recently, no other running water either. Friday I had to take my instruments outback to the spicket to clean them with the brown water outside. Our roof leaks terribly, and every day before I leave I have to remember to cover up all the important desk supplies with a water-resistant cloth, and hide the important papers in the drawers. Occasionally we have a bat that likes to visit and hangout on the ceiling. But we make progress slowly, and benefit from the love and support of others. This month I received a wonderful donation of thermometers, stethoscopes, and glucometers from Dr. Tammy Chelsy who had visited and volunteered at our clinic for a week in July and gathered donations to meet some of our needs.

I have had to adapt to the lack of conveniences, and in many ways become much more resourceful. I have learned to do many things by hand, such as sterilize equipment, make cotton balls, and bag and label medications. Here my scope of practice is very wide and I wear many hats. I am not only a nurse, but also janitor, maintenance, secretary, administrator, supervisor, and pharmacist. I do everything from sweeping and mopping to filling medication prescriptions and educating patients about their health and wellness. Life is never dull here. I have helped deliver a baby in the back of a pick-up truck, twice, tended to many machete wounds, and careened down the windy road toward the Tegucigalpa hospital in the back of a minibus converted to ambulance. It’s great… I often wonder what it will be like for me to readjust back to an acute care hospital setting in the US where I am strictly a nurse with lots of rules, guidelines, protocols and policies to follow.

One of my highlights this month was getting the opportunity to visit the home of one of our volunteer surgeons who performs minor surgeries for some of our patients every couple weeks. He has a passion for chocolate and raises his own cocoa plants in the highlands north of here. His home however was just close enough to take a fun day trip, in which we helped us to make chocolate from scratch. We started with the fermented cocoa beans, roasted and shelled them. Ground them up until it looked like coffee grounds, and then put them into his special mixing machine with milk, butter, and passion fruit flavoring. In addition to the delicious chocolate that we got to eat, Dr. Cerna was an excellent host and we enjoyed a day of beautiful views and fresh air at his home set up in the mountains above Tegucigalpa.

Mid-October we had our second staff retreat of the year and headed south to an island called Amapala, off the pacific coast of Honduras. It is a lush, jungle island with a 783 meter inactive volcano peaking in the middle. The staff retreats are always a lot of fun, especially since half the volunteers work opposite weekends, so there is some staff that I never get to travel with otherwise. Unfortunately we timed our trip just a tropical storm was cruising its way up the pacific coast. It rained in spurts about every 10 minutes, and when we did finally make it to the beach, we went swimming in a torrential downpour. I guess we were wet anyway, and we had warm coffee waiting for us when we got out.

Lastly, a moment from Hogar. There is one girl in my hogar who is a year or two older than the rest, and as many of the older kids here go, it takes a while to earn their respect and trust. They see many visitors and staff come and go in their lives, especially the volunteers who are only here for a year. It seems like a long time to us who uproot our lives back home and leave our family and friends, but really to the kids we are present for just a small fraction of their lives on the Ranch. Anyway, when I first came into the hogar in February, we both definitely rubbed each other the wrong way, and she barely spoke to me for the first several months. Then, if I did get her attention long enough to say something, it was usually followed by a drawn out eye-rolling. Over the past several months I have finally been able to break down that barrier with a lot of the girls, and little by little, with this one in particular. Then last week, unexpectedly, she came up to me, wrapped her arms around my wait, looked up at me and said “Heder, I love you! When you leave I am going to cry a lot.” These genuine words were so unexpected and surprising coming from her mouth, that all I could do was smile and think about how much I will miss each one of my girls as well.

 Enjoying the view and fresh air from Dr. Cerna's patio, overlooking the mountains around Tegucigalpa.

 Cocao beans ready to be roasted and shelled.

 Lydia, Kate, Caroline, Micaela, and Gina hard at work shelling the freshly roasted cocao beans.

 Turning the chocolate grinder to break up the nibs into grounds, while sipping a fresh cup of hot chocolate.

 One of my favorite families on the Ranch over to our house to spend some quality family time together.

 Although hard to tell, this is actually the back of a school bus, jam-packed from floor to roof with produce and goods that locals were bringing from Tegucigalpa to the south coast.

 Waiting to cross from the mainland over to the island of Amapala with all the volunteers on our Staff Retreat.

 The whole volunteer group enjoying a rainy day at the beach.

 The city of Amapala at dusk.

Life Decisions

September was a month of very hard work and many big decisions in terms of planning for life after my time in Honduras ends. Starting with the first weekend in September, I began the process of applying to graduate schools to study a Doctor of Nursing Practice program with a pediatric specialty; ultimately become a Pediatric Nurse Practitioner. It was difficult for me to make the decision between Family Nurse Practitioner and Pediatric Nurse Practitioner, but my experience here has further made me realize that my passion is primarily working with children and I plan to continue to do so. Thus far, I have applied to 4 different programs across the country, and I’m thinking I will call that good for now. It was an exhausting process that consumed most of my free time the last month, and it is a huge relief to have hit the “submit button” on all those applications. It is funny to think that I will find myself back in a lecture hall in about a year. I am really excited and looking forward to returning to an academic setting, as it will have been three years since I graduated from University by the time I begin my Doctorate.

The second new development is that I have decided to stay here as a volunteer for NPH Honduras for a little bit longer. Instead of leaving in February, as originally planned, I will be here until mid-May. I am very excited about this opportunity because these extra three months will allow me to focus my work on some special health projects that are in need of more attention. This time frame of finishing up in May also allows me a few weeks to travel around Central America, and also return back to the States to enjoy the summer and much needed quality time with my family before moving off to Graduate school. So, if anyone has any interest in traveling around Central America with me during the end of May or early part of June, let me know.

A new volunteer nurse will come in January to take over my position supervising the External Clinic, and I will work with her until she is comfortable in her role. Then I will spend my time on projects such as helping with weekly surgeries with our visiting surgeon, increasing health education for the children in their Hogars or school, attempt to setup an ophthalmology clinic for our children with vision problems, and making sure our new electronic charting system that is in the plans to be promptly installed is working correctly. I have and continue to love my time in the community clinic, but I am also really looking forward to these last three months which will allow me the time to focus on enforcing or starting projects and programs that directly benefit the children here.

Time in hogar with my girls continues to be a joy. One of my favorite weekend activities with them is when we all go down to the little pond and they have the rare opportunity to be free, let loose, play, swim, roast hot dogs and just be kids. The girls are usually pretty persuasive and eventually get me into the water with them, in one way or another. Even though I have only been with this Hogar since February, I have been watching them mature from pre-teens to adolescents right before my eyes. Thank goodness most of them are still sweet and give me big hugs and love to scream “Heder” (my name in SpanishJ) when I come over in the evenings. On September 15, Honduras celebrated “Dia de la Bandera” which most closely resembles our 4^th of July. The entire Ranch went to the next town over for a big parade. Every child was involved in the parade whether they were on a float, representing an animal from Olympiadas, twirling a baton, dancing, or playing an instrument in the band. They were all dressed up in school uniform or some sort of costume. I sadly was not there to witness this all myself, as I was stuck in the Hospital with an adorable 5 year old girl, but from the pictures that I saw it seems to be one of the biggest NPH events of the year. I will include pictures below.

In clinic happenings… we had a visiting doctor come for a day and offer Osteoporosis testing for our patients. It was exciting to make this service available and we had 60 people show up just for the test, plus the regular group of patients to see our Ranch doctor for a consult, and patients for the general laboratory. All this resulted in a gloriously jam-packed clinic, so full that I had difficulty maneuvering myself through the hallways. Coming up in one week, we will begin offering Gynecological exams for our female patients, and testing for cervical cancer. Many patients had been asking if and when we can make this important preventative healthcare measure available, so it is really exciting that it will finally become a reality.

 Kelsey with our cat Matias (who is actually a girl) and has invited herself  to come live in our house despite much protest from the volunteers.

Celebrating the June/July birthdays with some girls from Estrellas de Belen (my Hogar)

Saying goodbye to our other volunteer nurse Tiffany before she returned to the US.

Tipical special Honduran dinner... meat, avacado, plantain, cheese,beans, and tortilla. Note: This was at a restaurant, not anything that we get to eat at the Ranch.

 Most of the clinic staff, taken at Tiffany's goodbye party.

 Two sweet girls showing off their traditional Honduran costume.

 Baton twirlers in the Dia de Bandera Parade.

Surviving the Olympics

At NPH Honduras, the biggest, most anticipated, most time consuming event we have all year is a little thing called Olympiadas (“Olympics”). I will do my best to explain to all of you what this entails, if you can bear in mind that my explanation will nowhere near do this occurrence justice. It begins in mid-July where every person on the entire ranch is assigned to one of 18 teams, a mixture of kids (preschool-age through college), volunteers, Tios and Tias, and all other ranch employees. Each team was assigned an animal corresponding with the theme this year, “Wild Animals,” and was responsible for having a giant flag, team T-shirts, a mural presenting their animal, a dance routine with costumes, and any other décor that they felt inclined to construct. For the first few weeks of practice, teams met every Tuesday and Thursday, and being the Honduran way, not a whole lot gets done. But as the big day draws near, the teams begin to get organized and start work on all the projects. I missed just about all the meetings up until the week before because of my vacations and week with the medical brigade, but we sure made up for it the last week. The week of Olympiadas is just madness, with practices every day from 2-4pm, which don’t actually start till 3pm and could go until 6pm or later. I was put in the group planning the dance, and was actually starting to get sore by the end of the week from dancing so much.

The actual event begins Friday, and all that day there is a feeling like Christmas or summer vacation is coming. The kids even get out of school at 10am so they can practice their dances and put all the finishing touches on their presentation components. When evening comes, all the teams gather together in their designated location around the perimeter of the auditorium, waving their giant flags, and cheering wildly for their team. Then begins the presentations and dance performances in front of about 600 people and a panel of judges. Each team had a different dance theme from salsa or meringue, to hip hop or disco. Our team’s was Rock and Roll, which was a blast and we danced to Little Richard’s “Keep-a-knocking.” We had 5 guy/girl pairs from ages 9 on up and we did a lot of twists, lifts, and swings. Our dance was pretty short compared to some but technical, and I felt like I was in the air for a lot of it. Did I mention that I got to wear a tiger-print mini-skirt and knee socks? The night was a blast to see people of so many different ages come together and put on incredible presentations.

The next day began the actual olympiadas part which is pretty much a giant field day with all types of games including a giant slip & slide, obstacle course, long-jump, NPH trivia, relay races, volleyball, hockey, and tug-of-war. It was an exhausting day, but the kids had a lot of fun. I spent the days prior setting up a first-aid station with everything I could think of from Band-Aids, ice packs, medicines, to emergency resuscitation materials (luckily we didn’t have to use those). Thankfully, the weekend auxiliary nurse and a university student offered to run the infirmary, so I was able to participate in most of the games with my team and just check in on the station every hour or so. We had a dislocated shoulder, cut open foot, and a few dehydrated kids, but nothing worse than that. We played the games until the afternoon rains came in and dumped. After much needed showers, we all re-gathered that night to hear the announcing of the winning teams. Sad to say, Team Tiger did not win, but it was a wonderful, fun, sometimes frustrating, exciting, and exhausting Olympiadas month.

Needless to say, I have truly also enjoyed the last two weeks of being in a somewhat ‘back-to-normal’ routine. The day after Olympiadas my friend Carl Pierce from PLU came for an 11 day visit to see what volunteering as a nurse in a developing country is all about. Having just finished nursing school to get his RN license, he was able to work with me in the external clinic, as well as help out with simple surgeries with our visiting surgeon, see the teaching seminar on HIV/AIDS that we put on for the children’s caregivers, and even visit the public hospital in Tegucigalpa a few times. During the weekend he was here, we took a trip with 4 other volunteers up to the largest lake in Honduras, called Lago de Yojoa. It was a quick weekend trip, but full of adventure. We stayed at an American owned micro-brewery, visited a giant waterfall called Pulapanzak. While there, we took a $5 well-spent tour to traverse over slippery rocks and forge the blinding spray and pools of water to cross behind the waterfall and climb into some caves. Later we rented row boats and went out onto the giant, picturesque lake that is bordered by green mountains and was shrouded with the clouds of the afternoon thunderstorm.

One of my proudest accomplishments in my work at the external clinic is starting up a Diabetes Club, to cater to the needs and better educate our 50-ish Diabetic patients that come to us for healthcare. This Friday was our second gathering. We have tried to schedule all these patients so that their doctor’s appointment is on the same day, once every two months, and we only attend to Diabetic patients on this day. We start the day at 6am doing vital signs and blood sugar tests. Then we provide them all with a light breakfast since they have all come from hours away and without having eaten anything so we can measure their fasting glucose levels. Then each meeting we have given talks on a variety of different topics to better educate these patients on their condition and how to live a healthier, longer life. It has been a bit of a learning experience for me because many of our patients do not read or write or do not have more than a primary school education, so you can’t just hand them an educational pamphlet and expect them to take it home and read it or understand it. I have learned it is best to try to explain things very simply, but in a practical and concrete manner. We still give handouts, usually with lots of pictures, and hoping a family member or neighbor can read it to them. Then the patients go on to receive their doctor’s consult and their medications. We try to recruit at least two doctors to be present on this day to cope with the large patient load. I am excited to have gotten this program up and going and it is something that I really hope will continue long after I am gone. I also would like to start a similar model to cater to our high blood pressure patients, and possibly other groups.  

 Part of my Olympiadas team with our team banner and dance costumes.

 Kids running around the auditorium with their team flags.

 Caro and I finally got a few walls of our room painted. It feels much more like home now.

 Taking patient vital signs during the Diabetes Club day.

 At the waterfall Pulapanzak.

Rowing away on Lago de Yojoa. With new volunteers Kate, Irene, Lydia, and Caroline, and PLU friend Carl.