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.

How time flies... over half way done in Honduras

Our whole volunteer group together at the goodbye party before saying goodbye to four.

Sharing the Ranch with my family.

Relaxing on the beautiful beaches of Cayos Cochinos, Bay Islands, Honduras.

Exploring Guatemala and Honduras with friends Linnea, Erik, and Beth.

In front of our sand-floor hut on and island called "Peanut"

Parker made fast friends with the girls in my Hogar.

Rafting the Rio Cangrejal in the northern jungle of Honduras.

Proud to be an American... in Honduras.

June ended with me completing 24 years of life and celebrating my first Honduran birthday.  I would like to add that the birthday song they sing here is the longest I have ever encountered. And all my hogar girls screeched with great pleasure as they cracked 5 eggs over my head (Honduran tradition). They decided to take it a step further and dumped milk and mud-water mixture on me as well. Whose birthday were we supposed to be celebrating anyway? A week later I also celebrated my first USA Independence Day out of the country. The volunteers had a big bonfire in the center garden of our house where we roasted bargain Honduran hotdogs and ate a delicious American flag cake. I was also told “Congratulations” by several Honduran employees, which made me giggle.

On July 15^th I started a week-long vacation and headed to Guatemala to meet up with some FLBC camp friends, Beth (who is in the Peace Corps there) and Erik and Linnea Johnson. After getting delayed at the border because I forgot my residency card and my passport looked like I had been illegally in the country for 4 months, I finally made it across the border and reunited with my friends a day later. We traveled through Antigua, Panajachel, down to the giant Lake Atitlan, and stayed the night at a beautiful hotel overlooking the lake and several volcanoes. We spent the next four days traveling though Honduras seeing Mayan ruins and enjoying the beaches on the northern coast, before retuning back to the Ranch to spend the weekend here. It was such a blast to spend time with friends from back home and explore new parts of Central America.

The day they left marked the start of a surgical/medical brigade of 68 doctors, nurses, auxiliary personnel and families, here on the Ranch. The first day of the brigade I spent assisting and translating for a Dermatologist who came and treated hundreds of children and their skin problems. The most common issues being foot funguses or “athlete’s foot,” warts, and skin rashes. The other days of the brigade I worked in the surgery center in the admissions room helping to prep all the patients for surgery. It is always hard work and long days starting at 5:30am and working until evening, but really rewarding. Two of my hogar girls had surgery during this week, and it was a pleasure to be able to follow them through the whole pre-op, inter-op, and post-operative process, and even get to observe their surgeries. Many of the patients that receive orthopedic or general surgery when the brigade comes are patients that at some point have passed through the external clinic, where I work. For many of these people who come to the external clinic in need of surgery, we can only offer basic pain medication and write their name down in the “Brigade Book” to contact in 3-6 months when the next medical brigade comes. It is very rewarding to see patients walking out of the surgery center (even though it might be on crutches) with a big smile on their faces, finally relieved of a disability or illness that they may have lived with for years, when they never thought surgery would be an affordable option.

We get two groups of new volunteers each year and they overlap by one month with the outgoing volunteers to better facilitate training and orientation into their new jobs. While no new nurses came in this group, we had 5 fabulous ladies arrive the first week in July to start their 13 months of service. Therefore, the day after the medical brigade ended, it was time for four of our volunteers to close their service and we celebrated our last night together with a big goodbye party in Tegucigalpa. It was sad to say goodbye to these volunteers whom I have lived and worked with for the last 7 months, and weird to realize that the next Goodbye party will be my own. The next morning I got on a bus and headed north 5 hours to meet my mom, dad, brother, and sister who flew in to embark on 10 days of traveling all over Honduras. They were great sports through a variety of conditions, including sleeping in a sand-floor, grass-roofed hut on a small island and a lot of riding in the back of pick-up trucks. Visiting Copan Ruinas and my host family where I first attended language school, white-water rafting in the jungle, and hiking and relaxing at a cozy Bed & Breakfast in the cloud forest were definitely highlights. We spent a weekend on the Ranch just relaxing and hanging out with the kids. For my dad and brother, it was their first time seeing where I have lived and worked for the past 7 months. My brother was definitely a big hit with the 11-15 year old girls in my hogar. One, without a shy bone in her body, just sat right down right next to him and didn’t leave his side for the rest of the afternoon. Another stared up at him from her seat when he walked into the room and just uttered one word… “Beautiful!” I also loved it when my dad just sat right down at a table and started coloring with the girls and then exchanged drawings at the end with one of the girls, Yulissa. On Wednesday I said goodbye to my family with a few tears, but it was such a wonderful experience to be together as a family seeing some new parts and sharing my favorite places of Honduras with them.

So now I have just been adjusting back to the work routine and enjoying the new volunteer group. It is also nice to be back in Hogar with the girls. This upcoming week will be a big week for me, as I am helping in both the internal and external clinics and coordinating the activities of 4 visiting nurses. But if there is anything I have learned over these past 7 months, it is how fast time flies by regardless of how much you try to slow it down, so you might as well just carry on and try to love every minute of it.

What a life.

The biggest focus of my work outside the clinic over this past month has been implementing a de-parasite campaign throughout the ranch. This is something that happens every six months, but instead of just passing out pills to everyone, we decided that it would be much more useful and better preventative healthcare if education on parasites was included along with the medication dispensing. So, on most afternoons lately, I can be found walking around the ranch toting my “Parasites” poster and a box full of medications. It has turned out to be a bigger project than initially anticipated since we have been understaffed in the clinic for the past few weeks, and I am sometimes on my own to cover the 20-something sections of kids on the Ranch, all with different schedule. But it has been fun as well to go into each hogar, especially since I am rarely over on the boys’ side of the Ranch. When I give my talk, or ‘charla,’ I mostly educate on how intestinal parasites are passed (Fecal-Oral route) and how to prevent the passing of them = good hand hygiene, only drink potable water (even that is sometimes questionable here, given that ours has been brown for some weeks now), and wash raw fruits and vegetables well before eating. Then all the kids line up and take their first parasite medication and I leave the second batch of medications with the caregiver, doing my best to ensure that everything is clear to reach optimal compliance.

I am continually amazed by some of the skills that the children develop here; maybe because they are skills that not many people acquire in the US or at least until they are much older. One of those would be machete-ing. We don’t even have a verb for it in the English language, but in Spanish, Machetear = to machete chop. This is an ever more frequent weekend work task during the rainy season to keep the grass on the Ranch short, which I am told, in turn decreases the number of mosquitoes. Lawn mowers don’t exist here. I am quite awful at this chore, and it only took me a measly three minutes to get a nice big blister on my knuckle. Despite the extensive efforts of my girls to teach me the proper technique with a machete and a lot of giggles, I think they have finally just given up, and have accepted that it is not a skill that the Gringa is going to acquire.

Last night I had a one-night experience of being a new mother and the lack of sleep that you get with a newborn. We have a new family that just arrived to the ranch, including a pair of 3 month old twins, who really like to cry and wake up in the night about every 2 hours to eat. Good thing they are pretty darn cute, or spending my Friday night in the clinic with them wouldn’t have been as much fun. When they are finally placed into the baby house this next week it will be a big change for the staffing and routines to have the addition of two such young members to the NPH family.

One of the highlights of this month was taking my first real vacation last week (as in traveling for more than a weekend since getting to Honduras 6 months ago). It was wonderful and restful. I went with my good friend from University, Katie Bray, who is just about to finish up her year of service at the NPH Children’s Home in Guatemala. We met up in the northern part of the Honduras and headed up to the coast to enjoy the sun and beaches for a few days. I found out that my sunscreen doesn’t work very well. I slept more than I have since getting to Honduras. And our last day in town, on a Monday, we practically had the whole beach to ourselves. Then I brought Katie back to the Ranch and we spent a few days here comparing the many similarities and differences between the two NPH homes. It was really great to see her since it had been over a year since our last meeting.

 The view from our hostel of the city of Tela, looking toward the ocean.

 Comida tipica... a typical (fancy) Honduran breakfast: eggs, ham or sausage, cheese, cream, avocado, beans, and plantains.

 Exploring the bambo forest at the botanical gardens outside of Tela.

 Enjoying dinner with my friend Katie Bray.

 What is the beach without sunset pictures.

We put Katie to work in the clinic for a morning.

May Madness

I can’t believe May is almost over and along with it, my 5 month mark here in Honduras. I mostly just look back in awe of how fast this time has gone by. The month of May in particular for me was filled with a variety of emotions stretching from fun, joy, sadness, and frustration. The first weekend of May was spent on a much anticipated trip with 4 other volunteers to the National Park La Tigra located a few hours outside of Tegucigalpa. It was a perfectly relaxing, pampering weekend where we spent two nights at a beautiful bed and breakfast, ate some really good non-Honduran food, and explored the cloud forest on a 5 hour hike to a waterfall (lacking a little water after the dry season, although pretty), and just enjoying a little time away from the Ranch.

My last couple weekends as ‘Nurse on-call’ I was stretched emotionally and tested in my ability to function well in new environments and on lack of sleep. The first weekend began on a Friday afternoon taking one of our littlest toddlers into the hospital, and I stayed the evening worrying in the emergency room with her and her caregiver. I got a little bit of sleep staying the night at the NPH University girls’ house. Then next morning I walked to the public city hospital that was just a few blocks away to stay the day with another little NPH girl who had been admitted a few days earlier. After managing to get her finally discharged around mid-day, I made it back to the Ranch just in-time to attend mass. I got to spend a few minutes with my kids in Hogar before I got a phone call that one of the elderly members of NPH living in the Grandparents’ house was sick. Low and behold, I ended up doing back to the hospital for a third time within a day. I stayed the night there with him (still in my church clothes) and sleeping in the ever so comfy emergency room chair. I returned home late morning Sunday emotionally and physically exhausted from spending almost all of the last 48 hours bouncing from one hospital to the next.

This past weekend was almost a repeat, but this time instead of spending the night in a private hospital, I was with one of our boys in the Children’s medical unit of the city, public hospital. This hospital is the teaching hospital and has many specialties, but operates with very little resources. If your family member needs any medical supplies such as a bag of IV fluid or some sort of dressing, you physically have to go across the street to the pharmacy and buy it for them. You also must bring your own towel, toilet paper, soap, water, carry your own labs to the laboratory, etc. You have to work hard to find out any sort of information about any plan of care, otherwise it is very easy to just get lost in the system and be there for days without much being done. Although flawed, it leaves me with much more appreciation for our American healthcare system. So there we were, in a room with 6 beds and each bed had a small chair beside it for the mother (or me as the stand-in for the night). There was quite a social community feeling in the room where the mother’s had made friends with each other, everyone was generously sharing food, stories, and cell phone calls. I read some stories to my patient and the little toddler in the bed next to him, and we even managed to get a group Uno game together. When it was time to sleep, some of the mothers who didn’t prefer their hard plastic sitting chair to sleep in pulled out plastic bags or pieces of cardboard and laid them down on the floor to sleep.  Torn between the better of my three options of squeezing onto the cot with my patient, utilizing his wheelchair, or just settling for the floor, I eventually ended up joining the other mother’s on the floor. To say the least, I didn’t sleep a ton that night, as I would occasionally wake up to the sounds of children vomiting or crying in pain, or the Nurse coming in to give medications. But on the positive side, my little patient did sleep well and stayed in a positive mood through most of the ordeal.

The weekend prior was our Volunteer retreat which was a nice weekend away with the whole staff, which rarely happens because half of us work opposite weekends. We stayed just outside a little touristy town in the mountains called Valle de Angeles. I helped plan the weekend with two other volunteers to include a mixture of reflection time, group discussions, and team building activities. It was a really positive time to get to reflect a little bit about volunteerism and our own personal volunteer experiences, highlights, and struggles, and also to bond together as a group. In just over a month, the July group of new volunteers will come and those who have been here for a year will prepare to leave.

As part of being in the clinic, we receive all the new children who come to the Ranch. Usually they come as a group of siblings and they stay in the clinic for 1 week to be assessed and make sure they are healthy before being placed into their Hogars. It is always interesting to see in what state they come, and their stories are often heartbreaking. Sometimes the children seem a little shell-shocked as they assimilate to the community and culture here on the Ranch, especially if they have come from extreme poverty, to now receiving their own clothes, having their own bed to sleep in, indoor bathrooms, electricity, drinking water, and more. I imagine it is also overwhelming for them to be put into a house with a group of 20 other children roughly their age. As the weeks go on, the kids make friends and learn their way around and the routines here on the ranch and generally do pretty well.

In March, we received a new family to NPH that really touched me and many others. It included 6 children, ages 1 to 12 years old, and their 34 year old mother who was dying of cervical cancer that would have once been operable and treatable, but the family did not have the resources for her to receive treatment. As a result, Juana and her family were brought here so that she could pass away knowing that her children will always be kept together as a family and will be safe and well provided for. The children were all placed in various Hogars, based on their age level, but they came daily to spend time with their mother. The oldest boy, who I admire a lot, sometimes spent the night in the clinic to be near her. He is only 12 and I believe was caring for family before coming here. This was the first time in my life that I had watched somebody actively dying where there was nothing to be done but hospice care. During Jauna’s two months here with us, the clinic staff did their best to pamper her and make her last few days as peaceful and comfortable as possible. Sometimes when I see one of the 6 children I feel sorry for all that they had to go through watching their mother die, but then that quickly melts away when the 7 year old, Marta (who I like to call Martita because she is so tiny), comes running down the sidewalk with her arms wide open and a huge grin on her face, as she careens into me and I give her a great big hug and know that she is in a great place and will grow up to do good things.

 Our view from the Bed & Breakfast that we stayed at in La Tigra.

 The group of volunteers that I spent my weekend in La Tigra with.

 Caro and I embarking on our hike in the cloud forest.

 Admiring the canopy above.

My amazing roommate and emotional lifesaver, Caro.

Welcome the Rainy season and daily afternoon showers (or rather down-pours).

 Preparing the baby shower cake for our Ranch doctor.

 Baby shower festivities with most of the clinic staff.