Edgar

Edgar arrived to the Emergency room after a truck backed up and pinned him between the truck and a wall. He had severe chest pain, a thready pulse and oxygen saturation that was dropping rapidly.  On exam he was noted to have no breath sounds on the right side of his chest and you could feel the air bubbling under his skin. He was diagnosed with a pneumothorax and feared to be developing a tension pneumothorax.  

 

This is occurs when the lung is punctured (in Edgar's case by one of his many broken ribs.) Air, from the lung, enters the thoracic cavity and compresses the lung.  The increasing pressure causes the lung to collapse and if the pressure is not relieved can cause collapse of the venous return to the heart and death.  

The ER crew acted rapidly and placed IVs, started oxygen and prepared for a tube thoracostomy. This tube, placed into the chest wall, helps to relieve the pressure that is increasing in the patients chest.  

The tube was placed without difficulty and immediately Edgar was breathing easier and his oxygen saturations increased.  Edgar then was transported to Guatemala City where he spent 8 days in the hospital and ended up having part of his damaged lung removed.

On follow up he was all smiles and very thankful for the care he received. 

New Year

The new year has arrived and so an opportunity for reflection.

We have been here for nearly two years and will begin the third year of our three year commitment to Hospitalito and the diocese of Sololá-Chimaltenango.

We have been blessed in so many ways.  

At the Hospital we've been part of a remarkable trans location from the old "interim" hospital -- which was a backpackers hostel -- to the "new" Hospitalito, which should be called "Hospitalote" or grande, allowing plenty of room to grow in the future.  We've seen the Guatemalan doctor staff grow to 4 full time generalists, an obstetrician and now a pediatrician.  Hospitalito has become part of the country's education of pediatricians which places a final year pediatric resident at Hospitalito full time.

We have also seen our role change from primary caregivers to more educational and administrative roles.  In this regard, Brent was recently elected to the board of Hospitalito.

Our children have made friends, attend school locally, and continue to amaze us at how little it takes to make a child happy!

We are so grateful for the many ways our family and friends back home continue to support us -- thank you!

Step Along the Way

Jennifer and I first read this poem on Dr. Stoughton's blog during his time in Zimbabwe.  It was initially attributed to Archbishop Oscar Romero and more recently to Bishop Ken Untener of Saginaw.

Not only does it seem appropriate for us during our time here in Guatemala but I think it speaks volumes to all of us where ever we may be on our journey with God.
 
During this Christmas season, when new beginnings are celebrated in the birth of Jesus, may we all find our "step along the way"

Peace and Love
Brent, Jennifer, Christopher, Elizabeth, Julianne and Nicholas

A FUTURE NOT OUR OWN

It helps, now and then, to step back and take a long view.
The kingdom is not only beyond our efforts,
it is even beyond our vision.
We accomplish in our lifetime only a tiny fraction
of the magnificent enterprise that is God's work.
Nothing we do is complete, which is a way of saying
that the kingdom always lies beyond us.
No statement says all that could be said.
No prayer fully expresses our faith.
No confession brings perfection.
No pastoral visit brings wholeness.
No program accomplishes the church's mission.
No set of goals and objectives includes everything.
It may be incomplete,
but it is a beginning, a step along the way,
an opportunity for the Lord's grace to enter and do the rest.
We may never see the end results, but that is the difference
between the master builder and the worker.
We are workers, not master builders; ministers, not messiahs.
We are prophets of a future not our own.
This is what we are about.
We plant the seeds that one day will grow.
We water seeds already planted,
knowing that they hold future promise.
We lay foundations that will need further development.
We provide yeast that produces far beyond our capabilities.
We cannot do everything, and there is a sense of liberation
in realizing that. This enables us to do something,
and to do it very well.

Amen.

Mission Together

This is the half way mark of our three year commitment and the time has really gone fast. Like so many times in life, some days seem to last forever but when looking back the weeks seem to pass by without realizing where they have gone.  We are excited for the coming year to continue our work at Hopsitalito, school for the children and strengthening our relationships with the people we've come to know and call friends here in Santiago. 
We also want to take this opportunity to thank our family and friends who support our mission here in so many ways.  Through your prayers, kind words, emails, letters, and financial support, we are able to continue to answer this call to serve.  We realize that this is not the Burket-Thoene Family Mission, but really our mission together.

Thank you.

School

We came back to Santiago just in time for Christopher, Elizabeth and Julianne to take their final exams for the school year as their school year runs from mid-January to mid-October.  The kids did very well and all will advance to the next grade level in January.
 
The school had a very nice Kindergarten graduation ceremony for Julianne.  Much to their dismay, they are all homeschooling over the break.

We had thought that maybe the transition back to Guatemala might be difficult for the kids after being in the US, but the kids haven't said anything.  Since we've been back, we've heard them ask a couple of relatives on Skype what they had eaten that day.  They certainly enjoyed the wide variety of food while we were on vacation.

Home

We recently got back from a visit back home.  It was really nice to see family and friends and to catch up on everyone's lives.  Though Skype has been great, being home in the presence of loved ones is truly something special.  It was one of the best vacations we've had because we had more time to just be with people.

We thought that maybe the kids would be struck by things they saw in the US that were different from Guatemala, but we were surprised that they really didn't notice a lot. Christopher commented about a toy that we saw in a store, "Who would pay $300.00 for a toy?" Julianne wondered why there were so many cars.  Jennifer was struck by how good the infrastructure is in the US -- good roads, drains, sidewalks, fire hydrants.... things we take for granted in the US that just aren't present in other places.

It was interesting that when we were in the US and we would talk about Guatemala, we would say, "At home....," meaning "in Santiago" which means that we must now consider Santiago Atitlan home.

While we are very grateful for running water, an indoor toilet, and pretty reliable electricity in Santiago, upon our return we were reminded how much we miss hot running water, water pressure, and just how light everything is in the US.  However, after being back, we realize how good it feels to have the chance to use less resources just by the very fact that we are here.

Conception and Cecilia

Concepcion came to Hospitalito at 8:30 AM.  She had noticed onset of strong contractions at 4 AM but could not come to the hospital until she was able to get a ride from her village, Cerro de Oro (about 20 minutes from Hospitalito).  When she arrived, at 8:30 AM, she was dilated to 5 cm and the baby was in a breech position. Concepcion also had a history of a previous Cesarean section in 2003.  She was only 29 weeks pregnant and too early to deliver at Hospitalito.  

Preparations were started to transfer to Guatemala City where there is a neonatal intensive care unit.  She was given medicines to protect the babies brain, slow down the labor and help develop the babies lungs.  After one hour she was 7 cm and it was felt it would be too risky to try to transport her for a 3 - 4 hour journey as she might deliver in the ambulance.  

We then had to decide rather to proceed with a repeat cesarian or deliver vaginally. A cesarean would be the least traumatic to the baby but a 29 week newborn would probably not survive while a vaginal delivery would be the safest for mom.  After consulting with a number of volunteer doctors and even a call to a good friend/obstetrician in the USA it was decided to proceed with a repeat Cesarean.

Brent performed the cesarean section with a visiting Obstetrician, Wayne Weber assisting and his son Nathan (an anesthesiologist) providing the spinal anesthesia.  Baby Cecilia was delivered without difficulty with initial apgars of 3 and 6.  Two other visiting doctors from Ventura, California, Drs. Lepore and Noah, helped to resuscitate Cecilia.  Cecilia then began to have problems breathing and Dr. Nathan intubated and preparations were made to transfer to Guatemala City.  Dr. Noah accompanied Cecelia for the 3 hour trip.
 
Cecelia returned to Hospitalito after 6 weeks on a ventilator and 2 months total in the Neonatal Intensive care unit in Guatemala City. She has a long ways to go but she already has come so far. She is gaining weight and developing well.