One glorious week

We're close to the end of a glorious week of eye surgeries at the Hospital Nacional de Santiago de Maria.  For the first time ever, in my experience, we've had more than 50 potential patients show up (50 being the maximum our surgeons and our materials will stretch to).  Several patients were not qualified for surgery - because the risk would be too high or because there were serious complications - so our ophthalmologists completed 50 surgeries, right on the number possible.

Usually our problem has been patients who don't show up because they're afraid or uncertain about the surgery.  This time, thanks to the amazing work of Marvin Hernandez, our coordinator in Estanzuelas - where our patients live - just about everybody came.  And the problem we had to solve was lack of some of the materials needed to complete our 50 surgeries - in midweek, we had to find more Viscoelastic, a fill used during surgery, and sutures.  But with a lot of cooperation and even more driving - both Darren and Hernan, our motorist, had to travel an hour to San Miguel on Thursday - we purchased just enough to get through.

What's been most beautiful, as always, is our patients, and the delight and gratitude they express when the bandage comes off the morning after surgery and they can see more clearly.  Lots of hugging and thanking and blessing happens then - it's the very best reward for us.  Here are a few of them ready to go home with new vision:

Tomorrow we'll check the patients from Friday, pack up and take off for San Salvador.  And there are two very special patients, our very last patients, whom everyone will be waiting to see.  One, Marta Elena, wasn't on our original list, but came in for three days with the group from Estanzuelas, hoping that we might find a space for her.  And on the last day, we did.  One of her eyes was blind, the other had a cataract so dense she could see nothing: the doctors expect that tomorrow she'll see for the first time in years.  The second, Calixto, heard about our mission because he sells papers in the hospital.  No one can quite figure out how he saw to sell papers or get around, but he did.  And he came to us and asked if we could look at his eyes.  He, too, is blind in one eye and the other had the largest, blackest cataract Dr. Tony Pisacano has ever seen.  We had just enough materials left for Calixto's surgery and we will all be waiting tomorrow as he wakes up to a very new and brighter day.

Mission in progress

Our eye surgery mission is off to a great start.  First of all, everyone arrived (though the plane was an hour late) and our franquicia (customs permission) also arrived in good time, so we moved through the immigration and customs process reasonably quickly.

And then we were off to Alegría, a very, very long 2.5 hours from the airport - in the dark, so we couldn't see anything, and with a group who'd mostly been up and travelling since the early hours of the day.  We tumbled into the Casa de Retiros (retreat center) about 12:30 AM, and most people were up and moving again when the sun came up at 6:00 AM (not me, I turned over and went back to sleep until 8:00).

Still, it was easy to see what a great team we have - no one grumping, no one complaining about the cold water or the lack of sleep, everyone eager to get on with the mission.  It's a big group this time.  We have father and daughter ophthalmologists, Tony and Kristin Pisacano; our optometrist, Terry Clark; two scrub techs, Rosy Melara and Jennifer Woodland; two circulators, Silvia Pleitez and Sarita Angulo; interpreter Gloria Campuzano; nurse Dawn Fisher; patient coordinator Rosa Aguiar; photo-journalist and keeper of the autoclave, Mitch Costin; our beloved driver, Hernan Merino; and Darren Streff, Kathy Garcia and me.

Sunday we enjoyed lunch at an Alegría restaurant, looking out over a valley full of mist, and went to Santiago de Maria - the next town to the east, about 15 minutes away - to set up our surgery at the small National Hospital there.  As always, our first surgery was practiced on some of the machinery - here's a photo of Darren, Terry and Mitch Costin working on our slit lamp, used to calculate the power of the interocular lens:

Unfortunately, the frozen knob resisted all efforts to free it, but Terry figured out a work-around that involves raising and lowering the patients, rather than turning the knob in the machine.  A nice Salvadoran solution, that!

Today, in our first day of surgeries, we saw 11 surgery patients, which is just about unprecedented - the fruit of Marvin Hernandez' hard work in the Estanzuelas community.  Often before we've had days with four to six patients, so this felt wonderful to all of us, and our surgical team kept fully occupied.  And in the afternoon Terry, Dawn, Darren and Gloria gave eye exams and reading glasses when needed to about 75 hospital employees. 

A fine first day all round!

Ready to go

Hard to believe, but this is the last time I'm going to be responsible for one of our PazSalud missions.  I hope to be part of many more, but I'm passing the responsibility, very joyfully, to Darren Streff.  Today's the day our team arrives at the airport (at 7:45 pm) and I'm feeling like everything really is ready:

• We have our franquicia, the most important piece of paper, that allows us to bring in the medications and supplies without paying customs.  We also had an extra bit of drama - which almost seems inevitable - when we discovered at the end of our first time through the process that the group we were working with didn't have the right kind of license to support a franquicia.  Thankfully, our friends at the Archdiocese came to the rescue, and our amazing customs manager, José Manuel Gonzalez, got the papers through their second round in record time.
• We have piles of tubs, a tower of water bottles, boxes of heavy instruments, snack food, fans, wood tables made by Mitch Costin for our optometric equipment, plastic shelving, etcetera ready to be loaded on the truck in a few minutes.
• And I have washed and ironed the necessary shirts and pants, showered, packed my bag.  As soon as this is posted, I'll put the computer in its travelling bag.
• But more important than any of this, we have a great group of patients waiting for their surgeries, and a great team coming to offer them.  

May it be a week of good work, good health, new friendships and great joy!

A grand week

Our mission team loved their long, hot, busy, happy and productive week of medical and eye clinics in Estanzuelas.  We saw 1467 Estanzuelans, most for two or more clinics.  Our providers prescribed for those who needed medications - and everyone went away with vitamins and a toothbrush, at minimum.  We referred many patients for specialty treatment or diagnosis within the National Health System.  We signed up our full list for cataract or pterygium surgeries in April in the Hospital Nacional at Santiago de Maria.  More than 100 families are being invited to our capacitation session for receiving a water filter. 

But most of all, we carried away with us bright memories of faces and voices, people who touched our hearts, smiling or howling children, beautiful seniors, hardworking men and women.  

Here are a few images from the week, bright memories:

Sister Beth and interpreter Lea worked at getting just the right glasses for this patient.

Schellie was kept very busy with ear cleanings; a speech therapist, she's had expert training in ear lavage, and we used her skill to the full.

Interpreter Rita, Dr. Gulrukh and nurse Julie focused on this beautiful woman.

Dra. Jakellyne Jimenez, Director of the Estanzuelas Unidad de Salud (medical clinic) was our gracious hostess.

Marvin Hernandez (standing, center) coordinated all the local volunteers and kept everything running smoothly.  He's a superb organizer and a great leader - it was a delight to work with him.

Fatima and Wendy, two of the scholarship students who were our local volunteers, brought their intelligence and cheerfulness to every task.

Rosa and Hernan, two Salvadoran members of our team.  Rosa explains the eye surgery process to prospective patients, and Hernan drives us safely wherever we need to go.

And finally, here's the new Health Mission leadership team - Kathy Garcia and Darren Streff.  I am so happy to be turning over the work of in-country coordination to Darren, though I plan to continue to be involved.  Can't imagine better guides for this work! 

Day One of the Estanzuelas Clinics

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Our first full clinic day in Estanzuelas, and all is very well. 

Yesterday I exchanged congratulations with Marvin Hernandez, our amazing chief organizer for the Estanzuelas community.  I was relieved that we’d come through the airport arrival and the customs process with no problems and in record time.  He was relieved that all the organizational pieces – the invitations to patients, the welcome at a local school with dancers and lunch for 120, the rental of tables and chairs and canopies, the organization of volunteers for the week had gone without a hitch.

And now we’re off and running, working our way through the opening day questions and glitches (there are always a few of these).  Medics have paired up with interpreters, we’ve figured out how to write up the references for patients who need further tests or specialist care, and every clinic is full of Estanzuelans telling their stories, talking about their needs and anxieties, being fitted with new glasses and being heard with attention and respect.

Especially on Monday, it always feels like a river overflowing: local volunteers, PazSalud providers, interpreters and patients: we’re all trying to figure out the flow. By Friday we'll have everything clear - and then we have to leave!

(Photos, top to bottom: Brian checks a young patient's heart rate; Carol helps a woman choose glasses; Darren listens to a story; Lorna and Moises give patients their medications.)

A Circle of Wise Women

Last week, while Sister Eleanor Gilmore (founder of PazSalud) and Kathy Garcia were both here in El Salvador, we called together some of the people who've been our partners on our health missions to gather their ideas on how we can stretch and improve our collaboration with the people of El Salvador.  It's probably not entirely a coincidence that they are all women, though we've also had some amazing men working with us.  Here we are at lunch after the serious discussions: on the bottom row, left to right, Dora Alicia Alas (also known as Iris), a CIS organizer and our coordinator in San Rafael Cedros; me; Kathy; and Dina Dubon, a social worker with Caritas El Salvador and our coordinator in San Juan Opico.  Top row, Leslie Schuld, Director of CIS (Centro de Intercambio y Solidaridad); Rosy Melara, from Hospital San Rafael, who volunteers as our surgery nurse; Rosa Aguiar, of the Alcaldia de Comasagua, who volunteers in our Eyes clinic; and Sister Eleanor.

We talked about the possibility of working with a circuit of municipalities instead of going to a different one each year; we talked about how we can incorporate workshops and perhaps clinics from Salvadoran specialists on subjects like family planning or diabetes prevention and nutrition into our offerings.  We looked at stressing the importance of getting a pap smear in our women's clinic, and the necessity for followup on positives.  We talked about how to break through the fears that keep many seniors from getting the cataract surgery that they're qualified for.  We talked about cooperating more closely with the local government health clinic, the Unidad de Salud.  We talked about how our water filter program can begin to educate the whole community on the importance of clean water.

We came away from this circle of wise women with great ideas for the future, especially for the ways we can partner with Salvadoran organizations to have a long-term positive effect on the health of the communities we work with.  Gracias for the wisdom!

Preparation

Members of our mission teams often ask Kathy and me what we do when we're not in the middle of one of our mission weeks.  I've always found that a hard question to answer because there are so many different parts to the work, but I know that I always seem to have more work than time, and I know the same is true for Kathy (and will likely be true for Darren next year). 

This week it would be easy to answer the question, because this week I've been focused on getting ready for our February mission.  On Tuesday Darren and I (and my cousin Margaret) went out to Estanzuelas to meet with Marvin, our Estanzuelas coordinator, and the cooks who will be making lunch for the mission team and our local volunteers in February.  My job was to explain to Sonia, the group leader, and to the other women the precautions they'd need to take to make sure that all the gringos stay healthy.  We asked them to use bottled or filtered water to wash fruits and vegetables, to wash hands and knives and pots carefully, to avoid some foods that are hard to keep free of bacteria, like lettuce and strawberries (a suspected culprit for several illnesses last year).  We figured out the menus for each day - typical Salvadoran foods - and agreed on a price, $4 per plate per day, that will allow them to include plenty of fruits with each lunch.  We talked about being sure to include enough non-meat items so our vegetarians won't starve.  We said how much our team members enjoy Salvadoran food and how much we'll all look forward to great lunches.

Then we drove over to Alegria, had a great lunch with Marvin at a restaurant with a stunning view over the valley below, and went through the same discussion with Mélida and Berto who are going to organize breakfasts and suppers for us at the retreat house.  Padre Juan José was, as always, a very gracious host - here he is, from Margaret's iPhone photo:

Tomorrow I head for Estanzuelas again, this time to brief our local volunteers and the health promoters who will be in charge of inviting participants to come to our clinics.  In between, I got briefing papers ready (in Spanish, with help from Maria del Carmen) and copied the invitations that the local volunteers will give to our patients and wrote to Dr. Melendez, our helpful contact with the Ministry of Health and even caught up on e-mail.  A few very satisfying days - it always feels good to have the preparations well in hand before everything shuts down in mid-December. 

Introductions and New Possibilities

This long and informative blog post somehow got deleted, probably by me...  So I am trying to recreate what I vaguely remember saying a couple of weeks ago.

It's about Darren Streff, the Maryknoll Lay Missioner who has appeared in a few of my posts.  Darren began his Maryknoll mission in El Salvador with three months of Spanish study at the CIS, and while he was there - by beautiful serendipity, or as I prefer to think by grace of the Holy Spirit - he learned about our El Salvador Health Mission from Marilyn.  Marilyn, who was also studying at the CIS, met me when she was visiting in Suchitoto.  She's an adventurous Canadian, traveling on her own at the age of 80 (a great role model!), and we had connected over lunch at my favorite Suchi restaurant.  I had given Marilyn my e-mail address which she passed on to Darren.

He e-mailed to say that our mission sounded exactly like the kind of work he wanted to do in El Salvador, and could we get together?  We connected when all the Maryknoll Lay Missioners were making a retreat at the Centro Arte para la Paz, and began to talk.   Kathy Garcia and I invited Darren to come to a day of our eye surgery mission in April, and he loved every minute.  We could see how good he was with the patients and how much he enjoyed working with them, and we learned as we continued to work together that he's also reliable, creative, energetic and super-organized.  Here's a photo of Darren from that day.

Darren's background, with years of professional work in health care planning, administration and advocacy, was a great fit with PeaceHealth, the Sisters of St. Joseph of Peace and the El Salvador Health Mission.  Kathy and I had been talking about a succession plan, as my asthma has been slowing me down and making me realize that it's about time for a quieter life.   We saw a few possibilities, but once Darren showed up, we knew that he would be a ideal person to be our new in-country coordinator. 

Happily, PeaceHealth Board President Sister Andrea Nenzel and PeaceHealth CEO and Chief Mission Officer Alan Yordy agreed that Darren will be a great person to carry on the mission that Sister Eleanor Gilmore began 12 years ago.   We were able to introduce Darren to PeaceHealth and the Sisters of St. Joseph of Peace in October and November, in a rapid series of meetings that we all enjoyed.  Darren will be working with me until May, and then will get to take over the car and the bank account and the family support and scholarship programs and the many, many tubs of stored mission materials (his San Salvador house will be bulging!).  I'll continue to be involved with the mission in many ways - helping with fund development, updating the website, and - most important of all - participating in all our missions. 

It's a very happy development, and I'm grateful for Darren, one of the better gifts of the Holy Spirit.  May his work with the El Salvador Health Mission be full of joy and peace.

Checking in

I've been too long away from the blog, not because there's nothing to report, but because so much has been going on.  Last week Kathy Garcia was here and she and Darren and I did a lot of visiting, preparing and talking.  The preparations included a good visit to Estanzuelas, where we'll have our 2013 general medical mission, and then a visit to the hospital at Santiago de Maria, where we hope to have our eye surgery mission.  At the hospital, we all put on scrubs and booties to get a tour of the surgery suite - which looks great for our work.  As we got ready to leave, I stuffed my scrubs in my bag and picked up another set, which I assumed were Darren's.  The next day I pulled them out and discovered to my horror that I'd run off with someone else's scrubs, and furthermore that there was $3 in the pocket - someone's lunch money.  I imagine this poor soul cursing the gringos!  So this week I had to make the long trip back to Santiago de Maria (it's more than 2 hours from Suchitoto) to hand in the scrubs and confess.  It was the nun who did it!

Among the pleasures of Kathy's week here were visits with two scholarship students who were outstanding volunteers in earlier missions: Walther from Panchimalco, now in the 4th year of his engineering program:

and Alex from Comasagua, who's in his first year, studying psychology at the Pedagogical University:

They are both great guys, very deserving of the opportunity.

Lookin' good

One of the joys last week was visiting with all our eye surgery patients as they came to Dra. Ana Vilma de Burgos' office for their final post-surgery checkups.  Most of them were doing beautifully and were delighted to let me take their photo in their new reading glasses:

A few patients had to go through more processes: one woman had an eye infection that had developed after the first post-op and needed surgical cleaning; one man's interocular lens had moved and had to be replaced; three needed minor laser treatments.  A couple of others will have to continue using glaucoma medications.  Eyes are complicated!  And to be seeing clearly once more - what a gift, thanks to our talented ophthalmologists, all our dedicated team, and Dra. de Burgos.

Looking ahead

A couple of weeks ago, after we put all our surgery mission folk on the plane home, Kathy Garcia and I hopped in the new CIS pickup with Leslie Schuld to take a long drive to Estanzuelas, the town Leslie proposes for our 2013 mission.  And since our first question is always "and just where can we put the 28 people on our team?" we stopped first in the beautiful hill town of Alegría (the name means "happiness") to visit the Casa de Retiros (retreat house) run by the Pauline Missionaries.  It's a simple, spacious and beautiful retreat house that borders a finca, a coffee plantation, that's also owned by the padres. The town perches among steep hills, was the home of El Salvador's most famous philosopher, Alberto Masferrer, and has many beautiful moments like this shrine to Our Lady of Guadalupe.  

We were sold even before we got to Estanzuelas, where we were generously welcomed by Marvin Hernandez, who guides the CIS scholarship program there, and Dra. Jakellyne Jimenez, Director of the Estanzuelas Unidad de Salud (the government health clinic).  Dra. Jimenez invited us to use a portion of the clinic for our medical mission and we accepted most happily. Below, left to right, are Leslie, Dra. Jimenez, Marvin and Kathy. 

Buckets upon buckets

On Sunday it was time to give out water filters and buckets to the San José Villanueva families who'd fulfilled all the requirements (getting someone in the family tested for parasites and bringing $5 to cover half the cost of the water buckets).  I traveled out to the community with Iris Chacon (from San Rafael Cedros) who does an expert job of explaining the importance of clean water and how to use the water filters.  Darren Streff, a new Maryknoll lay missioner with a background in health care, also joined us - and got landed with the somewhat challenging job of hand-drilling the hole in the bucket (the water filter packets from Sawyer contain a small hand drill which works beautifully - but not quickly).  Here's Darren at work:

And here's Iris, teaching - my favorite of her stories was about a woman who said her filter was a bust, didn't work, couldn't get any water through it.  When Iris when to take a look, she found the woman had forgotten about cleaning the filter by back-flushing it and the filter was completely packed with mud.  Once cleaned, it worked like a charm.  Our participants - mostly mothers, many with several generations living at home - paid close attention.

The buckets, in the background, had all been previously used - mostly for Tang or some quite similar product from the smell - but will be washed out and converted into the bucket that receives water from the tap or the well.  The water is gravity-fed through the filter into a clean-water bucket that has a tap for drinking water.

All that talk about water - of course the inevitable happened, the clouds opened and water came pouring down from the skies, almost like a solid wall.  It rained buckets.  It rained cats and dogs.  And yes, we said, you can filter rainwater with the Sawyer system.  And then we put our papers and bags in one of the buckets and ran for the car.  Much of a good thing!

Surgery week

Our eye surgery week always brings us into the company of miracles.  It's good hard scientific medical work as our surgeons (Judith Newman and Tony Pisacano), scrub nurses (Sally Nelson and Rosy Melara) and circulator (Sarita Angulo) follow the protocols of any good surgery, maintaining the sterility of the surgical field, having all needed materials on hand and identified, creating an orderly pattern from first incision to closing.  There they are above, hard at work, gowned and gloved, standing over invisible patients.

But we know there's more to it when the patients come in the next day for their first post-op exam and are full of joy and gratitude at the gift of sight.  One woman said to Judith, "You have beautiful hands.  Thank you for using them to let me see again."  It's a joyful moment when the bandages come off.

In this photo one of our patients is testing her new vision while Selene Richardson, Tony, and Steve Scruggs delight in the moment.  There are few privileges greater than participating in a miracle like this one.

At work, at play

Two days into our eye surgery mission and we are at work and at play - with such a fine team it's sometimes blessedly hard to tell the difference. As is often the case, we lament the patients who were too afraid to show up, and rejoice in giving new sight to those who come to the hospital at 6 AM in the parish bus, driven by Padre Mario. Eye surgery is the focus of this mission, but we also found time to give vision checks (and reading glasses for those who need them) to staff at Hospital San Raphael. This afternoon nurses and janitors and cooks and x-ray techs lined up until we had to cut the line at 35 people. Those 35 waited with Salvadoran patience, laughing and joking and approving the new glasses of each one who emerged from the consulting room. It was a little fiesta. And we came back from the hospital to talk and laugh and play cards and share stories and eat mangoes and have our own fiesta here at the Centro Loyola. And now it's time to head for bed, to sleep until the little green parrots come flying and calling in the morning sky - and then back to work.

This week

In so many ways, I'm in the usual "day before" state - slacks and shirts ironed, customs permissions and paperwork in hand, the to-do list and the to-bring list checked over.  I'm just about ready to go meet our eye surgery mission group at the airport tomorrow night.

And at the same time I'm feeling - along with a lot of U.S Catholic Sisters - like I've been punched in the stomach (to paraphrase the elegant words of Simone Campbell, SSS, poet and director of NETWORK, the Catholic Social Justice Lobby).  The Leadership Conference of Women Religious (LCWR), to which my Sisters of St. Joseph of Peace belongs,  has been ordered to reform its statutes and is being put under the direction of Archbishop Peter Sartain for five years. 

It's personal to me because I was a member of LCWR when I was on the Leadership Team of what was then our Province.  And it's even more personal because Pat Farrell, OSF, the current President of LCWR, lived here in Suchitoto for many years, and is a friend to Peggy, Margaret Jane and me.  I've been going about the daily work and the extra work of getting ready for a mission, and I've been feeling kicked in the gut and I've been praying for peace, a prayer that feels necessary right now. 

I'm glad to have a week ahead that will keep me running all day, glad I have a mission to do and work that will help some people to see more clearly.  And I pray to see clearly myself, and to be peace-filled.

Feliz Dia de Amistad

Feliz Dia de Amistad, or Happy Valentine's Day...  I'm more than happy as I look back on our week in San José Villanueva and on the good work of our team.  We saw 1650 patients, most for two or three consults, gave out vitamins and toothbrushes to all, and gave medications and glasses to those who needed them.  We helped five patients in serious conditions, including one pregnant woman in the 9th month who hadn't received any prenatal care, to get to the hospital, and we must have given references for specialized care or further testing to at least 100 others. 

We had a wonderful time together, too - it's amazing that each time our group becomes a living team in about a day, and works together in complete harmony throughout the week.  Of course, as Kathy and I say, it's only the best people who choose to give up a week of their time to work with strangers in a hot and unfamiliar country.  Those strangers - well, long before the end of the week, they felt like friends and family. 

Here are two photos that tell the story of what this week was all about: above a little boy happily wraps himself around a big box of nutritional supplement.  Knowing that malnutrition among children was a major problem in Villanueva, we brought lots and lots of infant formula and supplements.   Below, our volunteer Leann makes friends with a Villanueva family.

Those are great moments to remember on this day celebrating love and friendship.

Villanueva, Tuesday

I'd love to give you some of those worth-1000-words pictures, but Í'm using Ayagualo's computer, and can't get to my photos.  Yesterday and today have been full and overflowing - we´ve seen some 650 patients so far, with lots and lots of them needing special attention or a reference into the national health care system.  Our hearts are overflowing with the stories we´ve heard and shared.  And then there´ve been a few cases of just overflowing, as some Salvadoran bacteria tangled with our gringo systems.  It´s been very hot in Villanueva, which makes the return to Ayagualo (not until 7:30 tonight) and the cooler breezes on this hilltop a great joy. 

For another view of our mission week, go to http://wwwpeacehealthorgpaz-salud.blogspot.com/ to read about the experience from the point of view of Barbara, our photo-journalist.

In San José Villanueva

Our mission team arrived right on schedule Saturday night, at 9 pm, and our only problem in Customs was that one of our tubs had gone missing (it arrived today after spending the night in Houston).  We were on our way to the beautiful Salesian retreat house, Ayagualo, by 11 pm, and arrived at about midnight, still with a little energy available for getting to know each other and talking about the week ahead.
Today we've been getting to know Villanueva and the church/school at the center of the town where we'll be working all week.  Many of us went to Mass and discovered that our host, Padre Mario Adin, is a wonderful homilist and a man deeply committed to the life of his community.  All day there were masses, meetings, study groups, catechism sessions, literacy training taking place in all the corners of the complex.
Our major tasks were setting up the various clinics and the pharmacy, counting out vitamins and bagging them (everyone who comes to our clinics gets a month's supply of vitamins), and having some training sessions with our team and with the local volunteers.
We know from plentiful experience that tomorrow will be a little crazy as everyone tries to figure out her or his job and as the patients flock in to see us.  We also know we're blessed to be here, that we'll be well fed, both at the retreat house (we had pupusas tonight!) and at the parish, where we had a grand lunch today, and that we'll get to return to the beautiful grounds and comfortable rooms (and hot showers) at Ayagualo each night to restock for the work of tomorrow. 
And now it's time for me to catch up on sleep after two very short nights!

Ready

That time of year again...

Our medical mission team arrives tomorrow, and at the last possible minute today (4:50 pm, to be exact) I got our franquicia (permission to import our medications and supplies without paying customs duties).  The franquicia is always a nail-biter, the essential part of our process that's pretty much out of our control once the papers have been handed over.  And I have to say that, like the good gringa I am, I really hate having to depend on something that's out of my control.  Illuminating, that.  As if my life or anyone else's was in my control!  But I do love the illusion.

And now, at last, the franquicia is in my hands, I've ironed the necessary shirts and slacks, I've checked my way through the long to-do list, I'm ready to meet the team at the airport tomorrow, and to introduce them to San José Villanueva on Sunday.

Meanwhile I'm enjoying the company of Margaret Gaffney, an Associate of the Sisters of St. Joseph of Peace, who's going to be part of the mission team.  Margie's been brushing up her medical Spanish in Guatemala for a few weeks, in preparation for helping with interpretation and came here on Thursday to help with the packing.  I've heard from Pat Clausen, who'll join us tomorrow at our retreat house lodgings and from Silvia Pleitez, who'll meet us at the airport, and from Hernan, our beloved motorist, who will be driving his new beige microbus to the airport tomorrow.

We're ready.

Getting to Know You

This Sunday and last Sunday I traveled to San José Villanueva, the site of our February Medical Mission, to meet with the volunteers who will be inviting patients to our mission.  Sunday turns out to be the best meeting time, after the early morning mass.  Today there were about 30 people gathered in a big classroom, lots of questions about the mission and about who should be invited.  If only we could see everyone in the community!  But our limit, we've found out over the years, is about 325 people per day, many of them going to two or more clinics.

Today they did the hard work of deciding which communities would come to the clinic on each day.  This is always the point where it begins to seem real and possible to me, so I rejoiced to watch these community leaders at work.  Already we have enough volunteers signed up to work with us throughout the week, which is amazing at this early point.

We're going to be using one wing of the parish school, which includes the meeting room shown in the photo.  It's great space, with a covered area when patients can wait, separate rooms for each clinic, a good pharmacy space and even a break room.  For all the great space, our work will not be easy; this week a report from the World Food Program shows San José Villanueva as having one of the highest levels of malnutrition in the country among children under five years - an estimated 38% of the youngest children in this rural town are small for their age.  What we can do to help in a week of clinics is really limited; our vitamins will do some good, but don't change the poverty that leads to such hunger among children.  And yet, we will be there as witnesses, and witnessing has value.