At Hospitalito we see many patients who, at a relatively young age (40 years old), have Chronic Obstructive Pulmonary Disease (COPD).
In the US it is mostly due to smoking, but here in Santiago Atitlán it is caused by years of cooking over an open fire in an enclosed space.
The lady who makes tortillas for our neighborhood is about 45 years old. Brent delivered one of her grandchildren recently. We buy tortillas from her several times a week. We have also seen her in the hospital at times for her COPD. After visiting her one day and noticing her coughing with her child and grandchild in the same enclosed smoke-filled space, we wondered if there was something we could do.
We spoke with our social worker at the hospital and found that there is a program to get clean cook stoves into the houses of the local population. In Santiago Atitlán it is estimated that half of the households cook over an open fire, while 47% use an inefficient masonry stove with varying degrees of ventilation. It is also estimated that cooking over an open fire accounts for up to 30% of the families' expenses. Clean cook stoves are up to 60 -70 percent more efficient.
We were able to purchase and install a stove for about $50. The stove actually costs more, but is subsidized by a doctor who worked here in the past. The smoke is ventilated through the metal pipe so it is much less smokey. Since the stove is much more efficient, it uses less wood which means less expenditure for the family on wood and better for the environment.
You never know how anyone will react to changing the way they have done something for their whole life. In this case, the transition seems to be fine. The tortillas look and taste the same (Brent thinks better) and it is much better for their health and the environment.
Brent had performed the Cesarean section on Daniel's mother, Petronila, in March and Jennifer had taken care of mother and Daniel after wards. 
We celebrated Christopher's birthday recently with a party. He invited the children from the local orphanage, neighborhood kids, and a few friends from school, in all about 30 children. We had a great time with lunch, a treasure hunt, piñata, and cake. Elmo (the piñata) was the only one who had a rough day!
We were able to purchase and install a stove for about $50. The stove actually costs more, but is subsidized by a doctor who worked here in the past. The smoke is ventilated through the metal pipe so it is much less smokey. Since the stove is much more efficient, it uses less wood which means less expenditure for the family on wood and better for the environment. 
As we have mentioned, in an earlier blog, we have found a number of organizations in Santiago Atitlan doing good things.
However, we were really surprised when the priest announced that there were going to be 23 marriages during Mass. This was not a Las Vegas style group wedding. Each couple took their vows individually, exchanged rings, and had their blessing and applause. Needless to say, Mass was a little long that day (more than 3 hours!), but the kids did very well, despite not being able to see much. The brides all wear their traditional dress and then a white veil. 