Back in the states...

Final update:
Everyone has returned home safely. Thanks, again, everyone for your support and for following our daily comings/goings in Guatemala. Our trip was a great success and we look forward to going again next year at the same time (June 11-19, 2011). Please look for updates and trip details at the following website of Xavier University’s Department of Occupational Therapy: http://www.xavier.edu/ot/guatemala.

Gracias!

home sweet home

Krista and Lauren made it home safely, and actually early! We ended up catching the direct flight from dallas to Cincinnati! I hope everyone else has safe travels!

Volcano and city dump

Hola,

The XU OT Team had an awesome final day in Guatemala. Once again, we split into two groups; one went to Volcan De Pacaya (the volcano) and the other went to Rolando’s ministry at the Cemetery. The Volcano team will relive their amazing adventure first…

Team Volcano (Joan, Carol, Meridith, Hailey, Melissa, Rachel, Kaitlin, Katy, Krista, Lauren, Mabel, Steve, Josh, and Darvy) left at 7am to head towards Pacaya with food and water to give to those who are living on Pacaya when it erupted last month. The volcano has been closed to visitors since the eruption last month and the XU team was the first group of individuals to hike/tour the volcano since. We drove up at least an hour to a village (past San Francisco…no, not California) and handed out food, water, and milk. While it was an amazing experience, it was certainly overwhelming. Our van was quickly rushed with small children, men and women who were in great need due to lack of resources. As Steve explained to us, not only did the Volcano destroy their homes, but it took away their source of income, mainly crops and tourism as well as access to food. Afterwards, we continued on our quest to climb Pacaya and see lava. After driving around Pacaya for over 2 hours, we finally made it and the views made the entire trip worth while. We immediately climbed out of the vans and rushed the volcanic molten rock. Beautiful. Breathtaking. B’dazzling….just kidding on that last one…kinda. We even roasted marshmallows over the sulfur pockets. And let me tell you, nothing beats a sulfur-mallow. Yum! It was definitely an experience to remember for a lifetime.

After Pacaya, we drove, some more, and had a minor pit stop at a Texco gas station due to our van dying. Thankfully, an American driving Buick (with his car battery placed UNDER the back seats…wild, I know) came to our rescue. Finally, we made it to the cemetery which provided an overlook of the city dump. Many of us stood there speechless as we watched the trucks pile in, dump the trash, then people scavenge through the fresh load of garbage. The dump provides a job for many people. When the trucks come in, people hover around and search to find anything worth selling, or even worth eating. It is a lifestyle one doesn’t wish upon anyone, so, as you can imagine, it was difficult to watch.

Favorite quote:
“It’s already band-aided” –Meridith when replying to Lauren about her volcano badge of courage
“You mean bandaged?” –Lauren
“Oh” -Meridith

Fun story:
Lauren getting slapped in the face…by a horse’s tail. End of story.

Lauren (student) and Meridith (therapist)

Team Cemetery: Susan, Laura, Lisa, Kelly, Kate, Georganna, Danielle, and Stephanie went with Rolando, who is one of our drivers/translators to his ministry which is working with the young kids who work in one of the large the public graveyards in Guatemala City. It was fascinating. The public graveyard was packed with people who go every week to place flowers on the graves...which are actually crypts above ground...no in ground vaults but the driver could not tell us why. The crypts, are actually small mausoleums that the families build for all their family members to be entered into, and they are quite decorative, individualized and interesting. The children who live near there go to either clean grave markers or sell flowers or other odd jobs that someone will pay them a small hand of coins for...and Rolando goes there from 10:00-2:00 every Saturday along with three other young adult friends. They teach the children to sing songs about religion, have prayers, give them lunch and then play with them for awhile. They are also teaching the kids to do a dance routine that they are going to go to do at a competition somewhere near Guatemala City in August. It was adorable to be a part of this. The kids and their grandparents and parents embraced us with open arms.

Georganna and Susan also worked on a local pastor’s wheelchair while we were there as he had heard from our driver that some therapists were going to be there on Saturday. Stephanie, Kelly, Danielle and Laura played with the children (ie. colored, ran around like crazy women, cuddled and hugged them). Kate & Lisa worked with a young boy who has cerebral palsy...as again, they had heard there was going to be therapists in the cemetery. The grandmother of five of the children who were with us for the ministry approached Georganna and Susan to ask what to do about her pain in her wrists, which was obviously carpal tunnel. We told her what to do and not do and promised to send her a pair of wrist splints back with Rolando next Saturday...so on our way back to Antigua we had to stop at a WalMart to buy splints to send back to her next week. We all joined in a great game of soccer with all the kids after they had their lunch which was energizing, exhausting, exciting, and a great way to end the time with the children. Many of the therapists decided to show off their 'world cup' moves, which resulted in Susan (accidentally) taking out an 8year old, while scoring the solo goal for the girls team. GO TEAM MUJERES! As we were leaving, many of the children AND their grandparents or parents came up to hug us and wish us a safe journey home. It was a fantastic way to spend our last day here - and well ended up getting a tad (well for some a ton) sunkissed :)

We too went to the dump overlook. Talk about both a contrast of the beautiful flowers and ravine, surrounding the shocking scene of garbage mounds, trucks and people scrounging for their next source of survival. An amazing scene that is too much for words, and will never be seen anywhere in America. Talk about culture shock. Our afternoon ended with Rolando taking us to get 'the best ice cream' in Guatemala, and and afternoon free to roam around the beautiful town of Antigua for some last minute shopping, coffee and adventures. What an amazing place - we are sad to leave!

FYI-
For your viewing pleasure, please observe the video below - as Stephanie & Kelly attempted to master the dance (featuring some Michael Jackson tunes) that the children have been practicing since February for their August competition. Granted, an hour later they still couldnt pick up on some of the novice moves (taught by a professional dancer - seriously!) - they still had an absolute blast. Not so bad for beginners!

Georganna (faculty) & Stephanie (therapist)

Note from the trip leader:

It has been a great week. What a joy to serve and work with the children and their caretakers at the orphanages. What a pleasure on our excursion days to learn more about the country and its people. Our time here has been meaningful for us all - our hearts and minds have been touched and blessed many times over.

As our week ends, I want to thank the practitioners for donating their time and expertise. I want to thank the faculty and Dean Meyers for their support and assistance. I want to thank the students for making this trip possible as it is only with their enthusiasum, spirit, and, participation that such an experience was possible. And, I want to thank our in-country hosts for their gracious hospitality; especially, Steve, for his many connections and wealth of knowledge and experience that made all go smoothly. Lastly, I thank all of you at home as it was your caring, support, and donations that carried us through.

With kind regards,

Carol (faculty & trip leader)

Friday with the Airport Group

Technically, it might not have been a group but I did travel safely back to Cincinnati today. It only took 16 hours and a few flight delays, highlighted by 3 gate changes on one flight and an hour on the runway in Atlanta waiting to leave.

I also used my new found skills to help repair the brakes on a chair at the Atlanta airport. Proof that I did learn something from all the terrific professionals that I had the honor of traveling with this week. Thank you all!

Mark (Dean and aspiring OT)

Friday- last day in the orphanages

Today is our last day in the orphanages. We split into our two teams- the Sensory team and the Wheelchair team and went to our last two orphanages for the morning. The Sensory team went to Anini and spent time in Casa 1 and Casa 5 and worked with children with profound disabilities in a rural setting outside of Guatemala City. One child that we worked with, Rogelio, was brought to Anini in February when he was 2 years old and 10 months and weighed 8 pounds. He was one of 9 children that the parents were not able to care for and therefore fed them coffee for their only source of nutrition. Due to this, he has extreme malnutrition and also has the diagnosis of Down’s syndrome. He was fitted into a wheelchair/stroller on Thursday and then today we worked on feeding techniques and educating the “mamas” on his visual problems and what his behaviors indicate. For Hugo, another man we saw, we trained 4 of the "mamas" to do a specific therapy technique for which we think will be very helpful to diminish his frequent outbursts. We also worked with a little girl, Karen, who had significant autism who was self-stimulating herself by pushing too hard on her closed eyes to receive input from the optic nerve. By taking a flashlight and creating significant healthy visual input she, for the first time, stopped the negative behavior and was holding a therapist’s hand instead. Our quote of the day in reference to the children of Amor del Nino, our second stop, is “These children our beautiful.”

The wheelchair team went to Marina Girola within Guatemala City. A majority of the children there already had wheelchairs and just needed some adjustments for better function. We spent a lot of time adding footrests to one child’s wheelchair, moving the power switches to an accessible location for another, or tweaking the position of headrests, laterals, and footrests. We were lucky to have a PT on our team who provided some great intervention to a couple of children who never have an opportunity to stand by placing them on a tilt stable and allowing them that input through standing that left them smiling and giggling with delight. We also helped a little girl, Cecilia, who was serenaded by the team with a robust rendition of “Cecilia” by Simon and Garfunkel and was so moved to hear her name in a song that she gave Georganna a kiss in appreciation. We worked fast in a short amount of time because our afternoon was being reserved for a trip to Amor de Nino/Love the Child to play and assess some of the children there. Our quote of the day is “Cecilia, you’re breaking my heart, you’re shakin’ my confidence daily, Oh Cecilia, I’m down on my knees, I’m beggin’ you please to come home…”

Our teams joined forces at Steve and Shyrel’s home in San Lucas where they have 58 children in their home whom have been abandoned or removed from their homes by the courts and are waiting for the process to either place them with stable family members or give them an adoptable status. There were different areas depending on the age of the child- 0-6 months, 7-12 months, 1-2.5 years, and so on. We all had some cuddle time with the little ones and refrained from placing any in our luggage! We offered some advice on a few children with special needs for increasing focus, redirecting negative behaviors, and providing various forms of stimulation. One success story in our brief interventions was Tanya, a girl with autism, who received many forms of proprioceptive input and given a weighted lap pad and for the first time sat still and engaged in an educational exercise for more than 20 minutes. We also fed, dressed, changed, and played with so many children who were smiling and laughing and enjoying every minute of attention. Overall, it was a great finish of our tour of the orphanages of Guatemala and a great example to us of the hard and rewarding work that Steve and Shyrel complete here in country and that we’ve been learning about all week in our interactions with them. You can visit http://www.lovethechild.org/AmorDelNino/Love_The_Child-Amor_Del_Nino-A_Childrens_Home_in_Guatemala.html to learn more about their amazing home.

The Earth moved in the middle of the Night

Just to make sure Mark got to experience a full picture of Guatemala before he leaves, we did feel an earth tremor overnight, about 3:30 am. Everyone is fine and ready to start the day!

Joan (faculty)

Thursday with the Wheelchair Group

Hola followers-

Today, the wheelchair team went to Anini, an orphanage on the South side of Guatemala City. The ride there was an adventure all on its own! We experienced Guatemalan traffic for the first time! It is definitely a different experience from the states! We also were able to see some of the remnants of the volcano eruptions. The streets were lined with volcanic rock and ash, which was an exclusive experience, since we are highly unlikely to see that in the states. The views were also breathtaking as we came down the hill into Guatemala City!

When we arrived at Anini, the children were scattered around waiting for our arrival. We immediately took our tools and baggage into the cafeteria, and the children starting arriving. Each team, composed of a therapist and a student, worked diligently throughout the morning. The chairs today have been the most difficult yet. Each team only got through 2 chairs in the 5-6 hours we were there. They needed a lot of maintenance and the supplies just weren’t matching up today.

The highlight of the day was when Daniel, a boy who never had a chair, was fitted for one. After we completed maintenance to the chair to fit his needs, he began self propelling around the room! It was an amazing site to see! He had a grin from ear to ear and it was obvious he enjoyed his independence. We have all never felt so happy and proud. It gave us as students a glimpse of the excitement and joy we will bring future patients!

Tomorrow is already our last day in the orphanages. We will go to Marina Guirola and, from what we know, the children all have chairs already. Our main job and purpose will be to maintenance the chairs and make any needed additions or adjustments. We look forward to the next adventure in our Guatemalan journey!

Funny story: Us being fashionably late, as usual:

Georganna asking: What does vamanos mean?

Kate: Let’s go!

Georganna screaming: VAMANOS!!!

Buenas noches,

Lauren (student) and Krista(student)

Thursday with the Sensory Group

Hola Familas y amigo(a)s,

Today the Sensory team went to Marina Guirola, a small Catholic orphanage with 17 children in Guatemala City. Compared with our previous two sites, the children at this facility had much higher needs in terms of motor, feeding, and sensory needs/issues (almost all 17 children were in a wheelchair). While the size of the facility was small and the gyms had limited equipment, the caring staff and wonderful personalities of the children was evident, making this day one of our favorites in the clinics. The team split into 3 smaller groups once we arrived and each group saw 2-4 children. We also ate lunch with the children to address feeding concerns. One particular child needed assistance for positioning, jaw, and tongue exercises in order to promote more independence with feeding.

The highlight of the day was working with a 25 year old man named Gustavo, who has been living at the orphanage for several years. He has athetoid cerebral palsy, causing the majority of his movements to be uncoordinated and jerky. He is also non-verbal, but very intelligent and fully aware of his environment. He uses a power wheelchair and has a head-control system to maneuver it. Despite all of his obstacles, Gustavo is a delightful and charming young man who was full of personality. He was even blowing kisses to some of us as we left! Kelly (therapist) and Mabel (student) worked with him in the morning on adapting his head pointer for typing and made him hand grips to prevent skin breakdown in his palms. In the afternoon, Joan, Meridith, Kelly, Melissa, and Hailey all worked together to get Gustavo standing…and what a feat that was! Once his straps on the wheelchair were removed, Gusatvo’s movements became challenging (he us unable to control his extremities, which then often kick, hit, or flail), which is why 5 adults were needed to complete this task! Be sure to check out the pictures to see Gustavo’s wonderful smile and recognize why it was our favorite moment of the trip!

We ended the day by driving to the Guatemala City mall to eat dinner at Pollo Compenero, which as Steve calls it, the “McDonald’s of Guatemala and a must have” while here. It was quite delicious and even though I (Meridith) was denied access to play in the ball pit and ride the train in the mall, we would all recommend it.

Tomorrow will be our last day in the clinics. We will be heading to Anini (where the wheelchair team was today) and to Steve and Cheryl’s house (to work with some of the 50 children in their orphanage) for our final day clinics. We can’t wait to continue working and learning from the children, their caretakers, and families.

Fun Story:

The team ate poolside. No joke.

Adios chicos,

Meridith (terapista) and Mark (Dean)

Excursion Day #2: Berhorst

16 de junio 2010

Excursion Day #2: Berhorst

Today the entire group traveled to el campo (countryside) to visit an indigenous Mayan village with an organization called Berhorst. Rolando and Darvy, our esteemed drivers, gave us a 2 hour roller coaster tour of the winding mountainsides, mud roads, and cobblestone streets that led us to the village of Xetzitzl in the Patzun region of Chimaltenango where the children and others welcomed us at their school with speeches and applause. Through translation—at times from Catchiquel, to Spanish, to English--they expressed their gratitude and excitement for having us visit their isolated village. They also told us of the hopes they have of expanding an improving their school in an effort to meet the needs of every child in the village. Then, in order to see some of the improvements that have been made in the village already, the Berhorst staff took us on a tour of some of the homes.

This organization helps families in the campo improve their quality of life in four main areas. The first improvement we saw was a stove that reduces the amount of smoke that is released in the house and reduces the amount of wood needed to cook. This helps the environment by decreasing the amount of deforestation and helps improve quality of life by reducing the amount of time needed to carry firewood from one location to another. Then we saw a gray water purification system that cleans the drainage water so that grease and other contaminants do not destroy the ecosystem. Next, we learned about the improvements they made to the latrine system. By adding a pipe to exhaust the fumes from the hole-in-the-ground latrine, people are more apt to use it instead of contaminating other areas of the farmland. They also showed us the “green gardens” that the people of the village have learned to plant in order to supply their families with more nutritious food.

We were served lunch by the women of the village at their community center. In this building, women gather to learn about embroidering, providing nutritious meals for their children, and family planning. The meal consisted of Incaparina, an enriched formula drink, chicken, carrots, salsa, and homemade tortillas. We were very honored and grateful for this meal and hospitality, but struck with their eagerness to thank us for what seemed to us to be very minor donations. After lunch we got the chance to interact with some of the children from the village. Although very shy, the children enjoyed having their pictures taken and seeing themselves on our cameras. They showed us off with smiles, blowing kisses, and freshly picked flowers.

After our visit to el campo, we toured the Mayan ruins of Iximche which was once the capital city of the Catchiquel Mayans. We saw the remains of the plazas, temples, and a ball court which was the site of the first ever organized sport. In the very back of the ruins, candles were still burning from rituals performed by indigenous people earlier that day.

Our day concluded with a wonderful dinner out at a restaurant in Antigua called Epicure. We each had a delicious dinner and a fabulous dessert along with great company. Today we saw a slice of real life for the majority of Guatemalans. They are a beautiful, hospitable people and we are incredibly grateful to share a day with them.

--Haley (estudiante) and Joan (terapista)

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The Guatemala Gang 2010

Tuesday with the Wheelchair Team

Today the wheel chair team (Georganna, Susan, Laura, Kate, Lauren, Krista, Danielle and Kaitlin, also we borrowed Stephanie and Lisa from the sensory team) visited Misioneros del Camino (Missionaries of the Highway). This is the same outpatient clinid that the sensory team was at yesterday. We were fitting kids with wheelchairs which we laboriously carried from the United States. Today, we understand why we made such a challenging effort.

Not only were we able to give new wheelchairs to eight children, but we were also able to modify four other children’s wheelchairs in order to provide more comfort and function. Many of the children were entertained by our driver, Rolando, with nearly life size puppets with disabilities (crutches, walkers, leg braces). The most touching portion of our day was with two young sisters who have osteogenesis imperfecta (brittle bone disease). Both of the girls needed wheelchairs and serendipitously we had two chairs that fit the girls nearly perfectly. In addition we were able to provide the oldest with a walker as well in order to allow her to continue walking. The two girls were overjoyed with their new chairs. Upon leaving the clinic both the mom and dad thanked us graciously. While the mom was hugging Georganna, she began crying tears of joy led to everyone in the room crying as well.

It was almost a blessing in disguise that Stephanie joined our group today because one of the children she evaluated yesterday returned for a wheelchair evaluation. When evaluating him for a wheelchair, Stephanie saw an improvement in the child. The aunt of the child told Stephanie that she had worked on his exercises with him all night! (If only all our patients did their homework with such enthusiasm.)

The staff were so appreciative of our help they provided us with a delicious lunch of carne, rice, potatoes and amazing tortillas that we tried not to scarf down. In addition, we were given the most amazing caramel cake we have ever tasted. During lunch we talked with the staff about their one and a half hour journey they make daily to come to work, as well as their experience at Misioneros del Camino.

Even though we were able to give eight children wheelchairs, we were short on chair and unable to provide a little boy, Diego, with a much needed chair. However, we were able to teach his mom ways to improve core strength and reduce spasticity (muscle stiffness)

Fun Story:

Pulling into the Lutheran Center, the truck with all of our supplies was being unloaded by three students (Kaitlin, Krista, and Lauren) and Steve Osborne (our main contact in Guatemala and founder of Amor del Nino). Georganna instructs the driver (Rolando) to go slowly so we don’t have to help. Rolando then backs the van up slowly because we “forgot to check out the parking lot”. The last bag was being taken inside when we pulled up to the entrance.

Quote of the Day:

“The dog is being walked.”—Dr. Mark, Dean of the College of Social Science, Health, and Education.

Now this quote needs some explaining. The entire ride to and from the orphanage Georganna tried to find skinny dogs to feed. With no luck on the way home, after even circling Antigua, we finally see a dog. Georganna is so excited to have a dog to feed only to find out the dog was being walked by his owner.

Danielle (student) and Susan (therapist)

Tuesday with the Sensory Team

Tuesday: Sensory Team at Nuestros Pequeños Hermanos

Quote of the day:

No andes por el camino trazado, pues te conducir a únicamente hacia donde fueron los otros.

Don’t walk the way that has been walked because it will only take you where others have been.

-Alexander Graham Bell

The day began on a sad note with the news that our friend Chris had to go home early. He severely sprained his ankle and needed to have access to more advanced medical treatment than is readily available in this area. We will miss him greatly and wish him the best of luck and a speedy recovery!

The sensory team spent the day at Nuestros Pequenos Hermanos, the same location that the wheelchair team visited yesterday, to evaluate the children that the staff identified as needing the most attention for sensory issues such as feeding, sensory stimulation, and calming techniques. When we first arrived, we were very impressed with the size and quality of the facility that houses around 350 children, 24 of whom have special needs. Our team split into two groups, one for sensory work and another to work specifically on feeding issues. Two of the staff members, Daniella, an occupational therapist, and Ellen, a teacher, observed and worked with us all day to learn from our therapists, answer our questions, and educate the tías (caregivers) about new care techniques.

One of the most interesting and moving cases of the day was Fernanda, a fifteen year old girl who appeared to be around seven to us. She had only ever been fed using a bottle and had severe oral defensiveness, not allowing anything in her mouth. After working with her for a while, it was decided that, unfortunately, she needed to keep feeding with the bottle in order to receive some nutrition but in order to reduce defensiveness it would be beneficial to massage her gums every day. It was extremely hard to make a recommendation that balanced what our goals were for her and what would be most realistic and achievable for her and her caregivers.

On a lighter note, something that brought a little laughter into the day, was Melissa working with a little boy who was deaf and did not know sign language. We had already attempted American Sign Language and realized how futile it was since he didn’t know Sign Language. As she was trying to communicate with him, Melissa took it a step further and she was speaking to him in English as well before someone noticed and asked her what she was trying to accomplish by using two languages he didn’t know! We’ve spent a lot of time switching between languages and it tends to get pretty confusing at times.

As a whole, today was a continuation of what has been an extremely rewarding and eye-opening adventure. We saw and experienced things that we could never have anticipated both good and bad. Tomorrow, as we spend the day with the organization Behrhorst, which provides grey water systems, latrines, and stoves to rural areas, we hope to continue learning and seeing new and amazing things.

With love,

Mabel (student) & Carol (faculty)