Thanksgiving

We were blessed this Thanksgiving with the presence of Dan's parents, Mark and Jenny, and his sister, Allie. They were able to get the whole Thanksgiving week off and come for 9 days. It was a really fun week and we stayed pretty busy - we even put Mark to work doing some physical therapy in some of the rural communities!



We also found time to do some coffee picking, visit Leticia, a woman in town who weaves, visit Cristantos, a friend of ours who does carving, go hiking, have some really fun meals with friends, and of course play with Clara a whole bunch. The kitchen ladies made us a really wonderful Thanksgiving lunch with turkey, stuffing, and mashed potatos, which we ate after celebrating a really nice Mass with Fr. John Francis.


Jenny learning to weave with Leticia.


Picking coffee! The 6 of us picked about 40 pounds in 2 hours. A pound of coffee berries yields about 2 cups of actual coffee. The coffee harvest was just beginning, so there were still a lot of green berries to pick around. Our guide Martin has been working on the Parish farm projects for 35 years. He was a great source of history and perspective for our many questions.


Hiking up one of the mountains on the East side of San Lucas. The volcano in the background is Mt. Atitlan.


We went to the hospital party in the back of the ambulance! We were celebrating the successful completion of the surgical jornada from the month before. It was a night of music, games, and really, really good food.


Playing with Clara Maria

If Thanksgiving is a time for gratitude, I don't think we could think of anything we were more thankful for than to spend time with family, sharing our lives and hearing their stories. Some of our favorite memories of San Lucas will be of the things we did this week. It was really hard to say goodbye on Saturday morning, especially since it was at 5am! But we were glad to have had the time together, to have Clara see the faces that go with the voices she is so used to hearing over the phone.

Backlog

Hello!

Sorry we've been so out of touch lately - we're going to try and post all of our backlogged stories that we haven't had the time to put up. Thanks everyone for your patience!



Clara drifted off to sleep after spending nearly all of Christmas morning playing with her new favorite toy - wrapping paper!

Merry Christmas!

Toys!

Clara is starting to interact with toys - grabbing for them, holding them, putting them in her mouth, etc. She also has figured out how to hold her hands together in front of her - makes her look very prim and proper! She still thinks her dad is the most entertaining, though.

Dan and Clara

Clara thinks her dad is pretty funny!

Bouncer Talks

Frog Kicks

Clara whaps her feet down so loudly you can hear it across the house!

Hiccups and Cooing

Heads Up!

The Magic Bar of Soap

The above pictured soap bar is unique in that instead of getting smaller with use, it appears to be growing. Yes, it is indeed larger now than when we first bought it nearly TWO months ago! Regardless of how many hand-washings it goes through each day...this soap bar is unending. We have various theories to explain this phenomenon, including it soaking up the water in the soap dish or the oatmeal in it expanding from the moisture...but in the end, it is a mystery.

Making Our Own Facebook

Greetings!

Clara Maria has requested that everyone please send a close up of their face, somewhat like this one:

She has started focusing really well on faces and would like to get to know you all. Please send your photo to either: fult0059@umn.edu, or loiseoldham@yahoo.com.

Clara (and we) thank you.

A Week of Surgery

We were blessed last week to have a group of surgeons and nurses visit from Michigan. This was their second time in San Lucas and since last year folks have been pretty excited for their return trip. I was told that last year the group was able to do about 42 surgeries in total. This year the staff at the hospital knew better what bumps in the road to expect, knew how to effectively schedule patients so they would be ready to go on their scheduled day, and to get things rolling earlier so the surgeons had enough time to get everything done.

In the months leading up to the surgical "jornada" we had been slowly seeing patients and referring them for surgery, as well as all of their laboratory work-up, heart studies if needed, and of course paperwork and consent forms. The surgical team told us to aim for 60-100 patients, we did our best and in all we scheduled 95. They were really surprised to hear that number, saying that they really had meant 60, and they weren't sure they would be able to do all 95 in 5 days. This is where the staff at the hospital really made things happen through all the organizational work they had done ahead of time - so we hit the ground running and went to work.

The above picture shows our operating room. We actually set up two tables in the same room so two surgeries could go at once. It was really exciting to see the room in use because most of the year it sits empty, or is used as a storage area. The post-op area was full of patients getting ready to go in, or still sleepy from their anesthesia.

In the end, the final count of surgeries performed was 85. And we finished by Friday lunch. The plastic surgeon wasn't able to make it, so we had to cancel about 10 specialized surgeries, but otherwise everyone showed up, and everyone made it through. The surgeons tell us that they've never seen a group so organized as the Parish Hospital, both in preparation or the business of the week. But it wasn't about the numbers, it was about the stories of people who helped and were helped. The farmer with a huge hernia for 7 years who can go back to work and support his family, the mother with gall stones who can now live without pain, the 5 year old with a cleft lip who can start eating normally, and not be made fun of. The medical student who had an IV put in so he could keep working despite being sick. Dr. Tun spending all day, every day in the OR, giving the patients confidence with his presence and translating when needed. The team of carriers who lifted over 60 patients on a thin stretcher down the hall, down the winding stairs, down another hall, and to their bed, without a single fall. The translators who worked long hours to make sure we all knew what was going on. The nurses who took extra shifts voluntarily and saw a record number of patients fill their beds without a single major complication. The picture above is at the closing ceremony while Dr. Tun is thanking everyone, Guatemalan and American for their help and care. In the end there were lots of tears as the surgical team had to leave - people together who only shared the common language of care.

Here's our team. Guatemalan, American, Human. The operating room now again stands empty, a reminder that we still depend on volunteers to make surgery happen here in San Lucas. The post-op area is eerily quiet with 10 empty beds. We sat there afterwards reflecting with Dr. Tun, catching our breath, and looking forward to next year.

Clara and her dad

Clara is approaching the two month mark and doing great. She is a happy baby that sleeps well, eats well, and is more fun every day as she gets stronger and moves more.

I took a few pictures of Dan and Clara together lately that turned out pretty well - and just looking at them makes me get a little emotional! Dan is an amazing dad and Clara is beginning to smile back at his grins and giggle at the tickle of his beard.

Clara's New Tricks

In honor of the Halloween tradition of "trick or treating," Clara has been treating us to some new tricks in the last few days. She gets more fun all the time.

Showing off her smile.

And her laugh.

Holding her head up!

Watching Cy.

Hail Mary

"Hail Mary full of grace, the Lord is with thee

Blessed are you among women

And blessed is the fruit of thy womb, Jesus

Holy Mary, Mother of God,

Pray for us sinners

Now and at the hour of our death

Amen."

Only moments before we had thought that we would be a little spontaneous and jump on the biggest ferris wheel in San Lucas. But once it started moving we both spontaneousely broke into the "Hail Mary" out of abject terror as we whipped around and around. Apparently in San Lucas, where there are no roller coasters, they use the ferris wheel to attain that feeling of stomaching dropping fun. We were expecting a calm, relaxing ride with a good view of the lake and of town but we were in for a surprise.

It was the feria last week. The closest equivalent we can think of is like a county fair. Lots of cheap games, food, local music and dancing, and of course lots of cheap rides. The celebration of the feria is on the feast day of St. Luke, the patron saint of town. All the towns around the lake are named after saints and they hold their ferias on their saints' feast day.

What we thought would be a ten minute ferris wheel ride actually turned into an hour long adventure. Immediately after we got on, the ferris wheel turned 180 degrees so that we were all the way at the very top. We were stuck there for about 15 minutes while the operators waited for the next people to get on. We must have just been (un)lucky in our timing. We eventually got over our terror and enjoyed an amazing view and had fun looking down at people when knew. We both wonder now if perhaps we were trying to recapture some of the spontaneity of our pre-Clara days. Our Newton House community member Cassie was visiting us during the feria and she was babysitting for "just 15 minutes" while we ran an errand. When we found ourselves sitting 60 feet up in the air we called her to let her know it might be awhile. When our feet finally touched the ground again we agreed that we were ready to leave ferris wheel adventures behind for a different kind of adventure, who is currently napping under our billowing flower print curtains. Maybe someday we can even take her on a ferris wheel - but I think we've both decided it will definitely not be here in San Lucas. More likely, we'll have to grit our teeth as we watch her jump aboard with her friends and remember the days when we did the same.

Clara Maria Fulton Fulton

We registered Clara with the Guatemalan government this week, officially making her a Guatemalan citizen....with the official name of Clara Maria Fulton Fulton. (All for the low price of 4 Quetzales - about 60 cents. To get her a US passport we'll have to pay $65.)

Why Fulton twice, you ask? Because traditionally, people here have two last names - one from each parent. So say we were Lois Smith Jones and Dan Johnson Fulton. When we married, Lois would drop the Jones and take the first last name of Dan, becoming Lois Smith Johnson. Clara would take the first last name of each parent, becoming Clara Smith Johnson, also. The computer program for registration of new babies automatically fills in the blanks, and the workers didn't know how to override it; thus, Clara received a last name from each of us.

There has been some confusion of late, because the national government is trying to begin a centralized registration process. Previously, newborns were registered by the town in which they were born. San Lucas was one of 77 towns that initially refused (related to taxes - the municipality used to collect the money for registration, but now that money goes directly to the central government). By the time we registered Clara, though, the national program had been in use in San Lucas for a couple weeks.

One Month Old!

Yesterday we celebrated Clara being a month old. She has already grown and changed so much! At birth, she weighed 7.5lbs; now she weighs a full 2lbs more. Her head control and vision improve daily. She follows us with her eyes and seems to be aware of the locations in the house of her favorite things to stare at: a small stuffed Cy (ISU mascot), a red paper crane, Dan’s Twins hat, the curtains.

We also marked the occasion by taking the first steps towards obtaining Guatemalan citizenship for Clara. One requirement for registering her is proof of certain vaccinations, and Clara received her first one yesterday. She handled it like a champ but we really struggled with both the decision to do it and the physical holding her down for the injection. The vaccine we gave her is for tuberculosis; it is no longer done in the US and leaves a circular scar on the shoulder where the injection is given. We initially had hoped to avoid it, both because of the scarring and also because she will always test positive on Mantoux tests for TB (plus she’s just not at much of a risk). So we tried to get an exception so that she could still have citizenship without the vaccine, and were passed around until finally the physician at the state facility where vaccines are administered gave us a mini-lecture on skirting the law.

I was surprised at how guilty I felt, holding her arm in place for what felt like an eternity while the nurse gave her the shot. Clara hardly cried, but Dan noted an expression on her face of surprise and fear that she’d never made before. Fortunately, she doesn’t seem to be bothered by it today.

Squirming

Our Growing Girl

Clara has been growing by leaps and bounds. She's stretching out - so much so that she already outgrew her drawer-bed and we've had to transition to a real crib. She sleeps so much better now that she's not too cramped.

Our little athlete

Documenting her cute footprints

Fast asleep

The many faces of Clara

Our little one is already beginning to express her personality...through a wide variety of facial expressions!

Hmmm...

Mischevious

Asleep and Angelic

ANGRY!

Just plain beautiful.


Love from San Lucas, Dan, Lois and Clarita

More Pictures of Clara

Family Photo
Clara gets plenty of "tummy time" when she is awake and is able to turn her head from one side to the other.

Ummm...not sure why this photo is upside-down...but I'm not awake enough to figure out how to rotate it. Clara loves sleeping in her touchdown pose in her little drawer-bed. (She, like her parents, supports the Cyclones even when they lose a lot.) You can see her mosquito net pushed off to the side.

Hospital Band - "Soy Idiota"

Hospital Staff Picnic

We had a blast a few weeks ago at the hospital picnic. It was the first ever staff picnic in celebration of September 4th, the "Day of the Healthcare Provider" here in Guatemala. We drove half an hour to a park/chalet to celebrate. There was a big outdoor pavilion with a built in rock oven to grill all the meat. We spent the first part of the afternoon playing relay games, like passing an orange to the next person in line with only your chin, or carrying spoons in our mouth to fill a glass of water, or the classic spin your head on a soccer ball and then try to run back after you are dizzy. We finished with a great game of soccer.

After the games the hospital band grabbed their instruments and serenaded us with a variety of popular songs, including an adapted one called "El hospital" set to the music of a different song but with lyrics written by the band to make fun of all the staff at the hospital. Later we ate an amazing dinner or chicken, beef, intestines, liver, and kidney. I wasn't brave enough to try the kidney, but everything was amazing. We also had Guacamole, refried beans, sodas, and wine. The night ended with speeches of thanks and excitement for the coming year at the hospital. We are so grateful for our co-workers, their fun attitudes, and their patience with us as we learn and fuddle about. It was an amazing night.

Pictures!

Clara Maria

It is will great pleasure that we announce the birth of Clara Maria Fulton. She was born September 14th at 9:45 on a rainy Sunday evening. She weighed 7lbs 8ozs and was 19.5inches long. She is beautiful and most people have said she looks like her mother.

Lois actually had told me 20 hours earlier that she had just had a contraction that was somewhat uncomfortable. She had been having painless contractions for weeks, but at 2AM on Sunday she had her first "real" one. By 6AM they were coming every 3 minutes or so, but what we didn't realize was that we had a long way to go and they were to get much much stronger. We called Dr. Tun at home and he met us at the hospital at 7AM. He told us to come back at noon. We spent the morning breathing through the contractions, applying counter pressure, and walking. We even played some cribbage! At noon he told us to come back at 4PM. We were a little disappointed that more progress hadn't been made. Lois also seemed to be experiencing a strange phenomenon that when she laid down her contractions stop, so we spent the rest of the day sitting or standing. By 4 the contractions were incredibly strong and long. When we went back to the hospital again, this time Dr. Tun told us to stay. By 7pm Lois started to feel like pushing, and a very intense 3 hours later little Clara made her grand entrance to the world. We were so excited she was out that we forgot to check if she was a little boy or girl for several minutes!

My major feeling on the day, other than unspeakable exhiliration and joy was the strength and courage Lois had throughout her labor. I don't think I will ever really understand what it feels like or means to go through labor, but I do know that Lois is amazing and now that its over, we have both agreed we wouldn't trade it for anything.

There are too many details from the day to recount, but just a few more: After Clara was born I got up from behind Lois to go meet her. She immediately pooped all over my shirt. "Nice to meet you too!" The hospital administrator Pablo Benedicto had come that night when he heard Clara was on her way. He had a clean Guatemalan National Team soccer jersey which he gave me to wear instead of messy shirt. When I tried to return the jersey a few days later he said, "Please keep it as a gift to remember the birth of your daughter in Guatemala." Another story, after we had gotten cleaned up a bit after the birth, Emi Tun, Dr. Tun's wife, had also come. She brought with her some piping hot chocolate, a Guatemalan tradition, for us all to toast the birth of Clara.

My final feeling on the day is the overwhelming sense that God was present and supporting us through it all. Whether it was through the energy he gave Lois to sustain through so many contractions, or through the calm presence of Lois' Mom, or through the perfectly timed and rejuvinating arrival of Flori our favorite nurse who for some unknown reason had decided to call the clinic that night to see if we were there. When she found out that we were she came immediately and arrived just as Lois felt she had no energy left to begin the final 3 hours of pushing. Or in the patient presence of Steve, another volunteer, who did all our driving for the day, and refused to leave even when there was nothing left to do but wait for hours and hours. Or the prayers and encouraging phone calls with family so far away. Or perhaps in the many calming and reassuring Church songs we would sing to regain our composure between contractions. And while I think whatever might have happened would have been exactly as God would have wanted, we can only give our deepest thanks that here in this place, without technology or advanced medical care, where we needed everything to go normally without complications, it did. Now I look across the room at Lois rocking Clara to sleep and realize this is only the beginning. We know God's love and support will continue through the hands, prayers, and love of family and friends. Thank you to everyone for your help along the way. We couldn't have done it without you.

Much love,

Dan, Lois, and Clara

No baby yet!

Just in case anyone has been waiting and watching for an update as anxiously as we have been waiting for our little one to arrive, there's no baby here yet. However, Lois' mom is here, which is exciting. She arrived on Saturday and has been a great sport about orienting to San Lucas and helping us get ready for having a newborn in the house. Hopefully we will have an announcement soon!!!

A Work Day

Life here overall is really good. Fr. Greg has developed an organization that is run by Guatemalans and then American volunteers can come down and fit in where they can, but the main focus is on learning as opposed to "helping". There really isn't much Americans can do that the Guatemalans can't do better, faster, and with fewer resources. Their hospitality to us has been amazing and we are grateful to be here. A typical day for us is to wake up around 6 and get ready for the day. At 7 we head down to the Parish for coffee and breakfast. By 8:30 we are up at the clinic getting ready to start the day. I see inpatients with Dr. Tun while Lois starts seeing physical therapy patients. After inpatients, we visit the new babies and new moms, then to the ER to see if there's anything big going on there, and then to the consult clinic where Dr. Tun sees 10-15 patients and I see 5-10 patients in the morning. We give numbers to the first 15 folks who show up - then after we finish with them, its kind of first come first serve. The reason for that is that if you get a number, the price is discounted. It provides an avenue for poorer folks to come early, get more complete care, plus the discount. People with a number pay roughly 50 cents for the visit, and then buy their medicines at cost. People without a number pay around 7 US dollars, and buy their medicines at a little bit higher price. People can also choose not to wait at all and go straight to the ER (much like the US) but the price there ranged from 10-15 US dollars. People who show up early get a number and as a result get their chart from chart room with all their other records. They also get their vitals taken before they see us. People that just wait without a number show up without any charts and no vitals so its a little more challenging to understand the full story. People can also choose to go to one of the private clinics in town, but ours is the only facility that is open 24 hours a day and weekends. Our most busy days are Mondays and Fridays because of the weekend, and then Tuesdays, because it is a market day. Wednesdays and Thursdays are a little quieter, so we spend more time working on development projects. Some of these projects are: preparation materials for medical groups, medical presentations for promoters or hospital staff, and medicine storage organization.

We are enjoying the people and the work as well as learning more every day about the culture, language, and just medicine in general. We hope in the coming days we'll get to keep learning and fitting in where we can.

***The picture is of Dr. Tun. He has been the hospital physician for about 10 years and it is clear he is well respected in the community. He has been a really supportive mentor for us both.***

Preparing for a baby, San Luqueño style

When people in town hear that we are not returning to the States for the birth of our baby, they almost invariably comment that it will be “Luqueño” in addition to American. It’s interesting that they attach belonging to being of San Lucas, but no one has ever said anything about the baby being “Guatemalteco” or Guatemalan.

Regardless, we have been fortunate to receive lots of assistance and advice in preparing for the baby’s arrival from the parish and from local moms. We have a huge stack of baby clothes, a crib from the parish cook, and have heard lots of labor and delivery recommendations. Almost everyone has an opinion on the baby’s gender…more guess boy than girl, but I think that may be more related to the greater desirability of a firstborn being a boy in this culture than to any characteristics on which they may be basing their opinion.

This week I had a lesson from a local mom on diapering, bathing, and general care of newborns. Diapers are complicated! First, there is the “umbliguero,” a small triangle of fabric folded and tied around the waist to cover the umbilical cord until it falls off, so that the diaper doesn’t irritate it. Next comes the diaper cloth itself, folded and tied on with a “fahuello,” a piece of fabric with ties on either side. Cover it all with plastic pants, and you’re good to go….until the baby goes, then it’s on to the laundry lesson. J

I was grateful to have a chance to ask questions about some of the local customs, as well as the logistics of baby care here. Bit by bit, we are feeling more settled and anxiously awaiting the arrival of our new little one. Stay tuned! We’ll be sure to put up an announcement when the time comes.

Vulnerable

We got soaked on our ride home from San Gregorio today. Like most of the Guatemalans, we travel in the back of pickups. Sometimes we are blessed with a canvas tarp to keep us dry, but today the rain pelted us as we climbed back up the mountain from the small community we had visited. Our raincoats worked for awhile, but eventually they soaked through and the water found its way into our pockets and shoes. I got to thinking how we were pretty vulnerable out there today, which got me thinking about many of the patients we’ve met. Vulnerable to illness because of malnutrition and poverty. The difference between my vulnerability and theirs is that I chose to be here, to ride in the back of a pickup and do this work. Most of the people that are forced to visit traveling medical doctors who don’t speak their language don’t have a choice. Would you go to a physician who had only marginal understanding of your second language if you could choose to go to someone, anyone, else? I try to remember that while I explain the cause of an illness, or how to use a medication – I have chosen to be here, she has not. The power differential is palpable and the medicine and advice I gave aren’t that unlike a raincoat in the back of a pickup – it works for awhile, but eventually you may still get soaked.

I think we will spend our entire year here learning about vulnerability. I think we will learn that there are lots of causes of, lots of explanations for, and lots of plans to fix poverty. In the meantime we keep trying to reexamine the way we live, and try to see the connections between the choices we have the privilege to make and the vulnerability of our patients here.

Follow Your Feet

I wouldn't call myself a Lord of the Rings fanatic, but I do find wisdom in Tolkien's words, especially in the reflections of the Hobbits. They are simple folk, in love with the land and earth, and not much for technology or industry - certainly not computers. But Bilbo Baggins, the fictional author of "The Hobbit", did find it important to have an account of his adventures, a record of where he went, what he saw, and how he was changed. He wrote his story "There and Back Again" as a diary and also as a window into his adventures, because he knew not everyone could be so privileged to just pack up and go.

I think this is what I hope for in this blog. An accounting of sorts, a space for reflection, and also an acknowledgement that we could not and can not do this alone, but only with the thoughts, prayers, and support of all of you, our family and friends.

As we begin to enter a time of preparation for departure we thought it fitting to begin this story. I don't think either of us know exactly where or how it will end, but that is what makes an adventure, an adventure. We go to serve, to listen, to learn, to grow, and to be changed. But in the meantime, we're packing our literal and metaphorical bags and reflecting on the advice of Bilbo Baggins:

"Stepping out on the road is a dangerous business. You have to keep you feet under you, or before you know it you'll be swept off to who knows where!"

So let's step onto the road - whether it be to distant lands or to local neighborhoods - and follow our feet.