We're Home

Buenos dias, amigos y amigas! Ya hemos estado aqui por casi un mes, pero solamente ahora estoy escribiendo. Disculpame, por favor. Nuestro viaje era excelente!!!

Hey everyone. Our apologies for not writing earlier. Lindasy and I have been back about a month now, and we are back to the grind. Lindsay is down in Charlotte this month on her pediatrics ICU rotation, and I am in Chapel Hill taking a dermatology elective. Fortunately, the remainder of the year will be together. Anyhow, we wanted to let everyone know that we made it back safely, and that we had a fabulous trip. Thank you all for your support and prayers as we ventured out into the unknown. We will write more later about our experience now that we've had some time to really think about it, and we will also add more pictures to the blog entries for your viewing pleasure.

Again, thank you to all of you for keeping up with us and for supporting us. It was a huge source of comfort to know that we had friends and family at home who were joining with us on aregular basis. Take care and many blessings to you all!

Centro Cristiano Para Sordos

Our time in Bolivia is rapidly coming to an end. It has been an incredible opportunity, and we have been blessed to see many different facets of God´s work here in an among the people; and we have thoroughly enjoyed experiencing the culture and getting a small glimpse of the beautiful country. We leave Bolivia on Thursday to meet up with Rory and Brett Sallach, as well as Chuck and Angela Barrier (friends from med school), and Anne P. Johnson (Lindsay´s former Sunday school teacher). However, before signing off for a while, we would like to tell you about an organization that we were fortunte enough to go and visit today. It is called the Centro Cristiano para Sordos - The Christian Center for the Deaf.

Centro Cristiano para Sordos is a Christian boarding school for deaf children, serving children from all over Bolivia, and offering schooling up until the 5th grade. It was founded by two missioneries in the late 1970s, who had been serving in Bolivia since the mid 1950s. The school has grown since that time, and is currently serving approximately 30 students, as well as deaf faculty, groundkeepers, and crew. The current director of the school is the daughter of the original founders , and she is here with her Bolivian daughters, (one of whom is Lidia, who offered us Spanish lessons while here with HOH), as well as her mother (the original founder).

There is a large deaf population here in Bolivia, but there are no other boarding schools available for these children, where the children can be prepared to integrate into society. The Centro provides not only room and board and school education, but also incorporates Christian teaching, church services, and Christian counseling for the children as well. It is truly an amazing work that has been undertaken, and the rewards are evident as the children grow, learn, and mature.

We were able to play with the kids today during their extended recess break, and we also toured the grounds and viewed the new projects that are underway (new boys and girls dormitories, etc.). The school is almost self-sustainable with crops, a private well, and room for livestock. This provides great opportunity not only for reducing the costs, but for developing a strong work-ethic and responsibility within the children as well.

While the majority of the children have families that they visit on holidays, at least five of the children are orphans, and have been "adopted" full-time by the Centro. The love that the faculty and staff have for the children is self-evidnet, and it is a great encouragement to see their good work. If you would like more information about Centro Cristiano para Sordos, they are in the process of developing a website, but their email address is as follows: ctrsrdos@albatros.cnb.net.
Thank you for reading along with us, and thank you for your prayers and support. We will try to update again over the next two weeks, but we might be without good computer/internet access until we return home on the 5th of June. Blessings to you all!

El Hogar Jenuam

During our afternoons, we have been blessed with the opportunity to work at a local orphanage about 2.5 miles up the road towards the mountains. An elderly Quechuan woman cares for the eight children at the home, and the father-figure at the orphanage is a Bolivian police officer who helps with the children when off-duty. We have been trying to visit the children a few times a week, and have been able to provide them not only with companionship, toys, and toiletry supplies (toothpaste, toothbrushes, shampoo, soap, and lotions - thanks to Josh and his friends at Curves!), but at our last visit we also provided medical consults and arranged for follow-up with the Bolvian pediatrian at the hospital for those that needed further medical attention. Sadly, the majority of the children have lice and parasites, but we were able to help purchase meds for them.

The eight children are beautiful, and they serve as a constant reminder of God´s rich blessings. Despite what they lack, these children are easily the most well-behaved, receptive, and appreciative children we have ever met. They greet each volunteer with shouts of "Tio" and "Tia" (Uncle and Aunt), and they are quick to hug and be hugged. They are always eager to talk, to play, or to simply sit and read, and they are always appreciative of our time. They have an incredible knowledge of the Bible and are eager to share their faith. They are truly God´s children, and despite their hard circumstances, they are being raised in His light and are blessed.

¡Bolivia!

Lindsay and I arrived into Bolivia around 11:30 pm on Saturday, April 21, after a wild scramble to find a flight - our original flights with Lloyd Aereo Boliviano (LAB) were cancelled, and the airline did not bother to advise any of the passengers of the change. However, God is good - and apparently wanted us here - because He opened doors for us that had previously been shut and made for a safe and "uneventful" trip into Cochabamba, Bolivia - including a late departure from San Jose, a 25-minute layover in Lima Peru in which we had to rush through customs and go to another terminal to catch our already-boarding flight, and an enjoyable night in the La Paz airport awaiting our next flight that was scheduled to leave at 8:00 am. In all honesty, none of the trip should have worked, but God-willing, we made all of our connections, flights were available from La Paz to Cochabamba (despite the huge demand and lack of supply since LAB went under), and miraculously, our bags made the 25 minute transition in Lima, Peru!



Hospitals of Hope is a beautiful hospital located in the town of Vinto, a suburb of Cochabamba, Bolivia. We are living in a guesthouse about 150 meters from the hospital with three other volunteers.






Our good friend, Josh Watson - who is graduating from UNC SOM and moving to Ohio where he will begin his med-peds residency at Ohio State - also came down for a week to join us in our adventure. It was a true blessing to have him here, and it afforded ample time to discuss future plans for further mission trips when we are all fully-certified physicians! It will be exciting to see where God takes us all in the future.






Bolivia is a beautiful country with majestic mountain ranges and wide, rolling valleys. There are close to 40 indigenous tribes that live in Bolivia, the most prominent near Cochabamba being the Quechuan. They speak a tribal dialect, but many of them also speak Spanish. Culturally, Bolivia is a completely different world from Honduras - the people are much less dramatic in their speech, and seemingly more reserved in general. However, the people are lovely, and we are enjoying our time among them.

HOH, is essentially an American hospital in Bolivia, although it is staffed and operated by Bolivian-trained physicians - which allows for continuity of care when volunteers are not present. American doctors come down on trips to teach and instruct and improve the level of medical care offered; but generally speaking, this hospital is by far and away the most impressive medical facility we have seen during our time in Central and South America. We have already taken part in multiple laparoscopic surgical procedures (lap choecystectomy, lap Nissen, etc), and other fairly advanced procedures are performed here on a routine basis.

That being said, we have less to offer here than at the other clinics where we served. As such, our time in the hospital has been spent learning from the physicians, occassionally serving as translators for other volunteers that do not speak Spanish, and attending lectures and labs (IV placement, ABGs, ambulance services/paramedics, etc). However, there are ample opportunities to get involved with the local people and to provide a service - of which we will discuss more in the next blog entry!

On a quick note, Lindsay and I are both quite sick with sinusitis; and I also have some GI bug which has kept me bed-ridden for the past three days with nausea, vomiting, and fatigue. However, God is good, and we have started the appropriate treatments and are slowly improving. Please keep Lindsay and me in your prayers, and pray for a continued godly medical ministry through HOH.

Costa Rica Vacation

We were blessed to have family and friends join us in Costa Rica for a mid-way respite, before continuing on to Bolivia. They definitely achieved the goal of fattening us up (as JR has lost about 15 pounds since coming to Central America), and it was such a treat to see familiar faces and spend quality time with loved ones. We wanted to share a couple of the pictures from our Costa Rica adventure. Tomorrow we continue south towards Cochabamba, Bolivia!

Good Friday in Honduras

We spent Semana Santa (Holy Week) in the town of Comayagua, Honduras, while off on another medical brigade, this time with three chaps from England, including two fourth-year dental students and a physical therapist/accupuncturist. It was a great trip, and a wonderful opportunity to provide medical and dental care; and it afforded an incredible opportunity to meet our new companions. However, what was possibly the most interesting part of the week in Comayagua, was the town's annual celebration of Good Friday.

Every year, local families and businesses gather together on Thursday night around 11pm to decorate the main streets through the city center with carpets that are hand-made from about 11pm until 8am the following morning. These carpets are vibrant and beautiful... and are made entirely from colored saw-dust, rice, grains, and other natural elements found in the city. Comayagua is the only town in Honduras that holds this tradition, and it draws people from around the country and elsewhere to view the marvelous works of art. Hopefully our pictures will give you a small taste of the artistry. It was truly amazing!

Goodbye Mountain Movers Clinic

We are finishing up our last week of clinic. Actually tomorrow is our last day before we head out on another brigade, this time in association with a couple dentists from England. We thought we would upload some more clinic pictures before we leave. We have had an incredible experience and have learned a lot! We are now conducting consults and counseling patients completely in Spanish! We have seen a broad range of tropical medicine, and have had some amazing patients. We have definitely fallen in love with the children of Honduras! The one in Lindsay's arms is one of the few "chunky" kids here! Don't you just want to squeeze him? He is sending you an "hola" from Honduras!

Danli, Honduras

Danli is a town of about 10,000 people. As you can see from the pictures, the mountainous views are beautiful. The weather has also been wonderful, 75-80 degrees with a breeze. The people are very friendly and love to practice their English "hello" and "goodbye" with the Americans. Here I am handing out some of the toys that the Texas group brought in. Linda, you will be happy to know that the girls loved your gifts, especially the sunglasses!


The markets are filled with all the fruits that you could imagine. Vegetables are also sold by street-side vendors, but are more expensive and thus a luxury for most families. Most of the patients that we saw in the clinic ate only rice, beans, and tortillas. Meat and vegetables were a rare addition.




We included a picture from a hike up to "La Piedra" (the stone). It was an intense 4 hour hike which was really a mixture of rock climbing, butt sliding, and branch swinging. After only minor injuries we reached the top. The view was definitely worth the hike, "vale la pena!"

We also captured a picture of a rainbow over the clinic one day after a rain. God was definitely smiling down! And finally, the view from the rooftop of our house of a nearby steeple. I hope that our pictures do this beautiful country justice.

Sadly, we are leaving Honduras on Saturday. However, we are very ready to see family, and are looking forward to spending Easter and the following week with JR's parents and Rod, Mary, and Bret Runestad in Costa Rica! From there we will continue south to Bolivia, where we will be working in a mission hospital in Cochabamba. We will keep you posted as internet allows! Blessings to each of you!

El Torsalo (the bot fly)

WARNING! THIS POST IS NOT FOR THE FAINT OF HEART (ie – Rory S. and Bret R., do not read, and definitely do not look at the pictures)

Clinic here in Danli tends to be very busy on Mondays and Fridays, while the middle of the week can be fairly quiet. Many of the patients travel a full-day (if not more) to reach the clinic, and therefore, attending the clinic in the middle of the week simply isn’t feasible as it would require missing two days of work. This past Friday was particularly busy… and full of some excellent cases. We had a gentleman with chronic prostatitis (first case of the day), a young kid with fungal infections and superimposed cellulitis and impetigo, as well as a nail extraction for an ingrown toe nail, among many others. However, the case of the day – and possibly the case of the month – was our first case of myiasis – more commonly known as bot fly; or here in Honduras, “el torsalo.” Myiasis is actually an animal or human disease caused by parasitic dipterous fly larvae that feed on the host's necrotic or living tissues. The fly larvae burrown into human flesh, takes up residence, and builds a nice little home. The burrow forms a hard nodule with a soft, fluctuant center through which the larva is able to breath. As such, common mechanisms of removing the larva include covering the opening with raw bacon or Vaseline and waiting for the larva to emerge from its den in an attempt to breath. However, if this fails, there is always the option of using a subcutaneous anesthetic injection and manually removing the larvae from its home.

We had a mid-40 year old female present to the clinic today with a nodule on her back, which had been bothering her for some months now. The nodule was hard and indurated, but the center was soft and fluctuant. She thought she had an infected pimple (espinilla), but she was unsure. Whatever the crater on her back was, we needed to incise it and drain it as it wasn’t going to heal without removing the contents. Without further ado, Dan and I began to prep the lady’s back (of course using sterile technique) in preparation for our excavation. We were suspicious that the nodule might contain a bot fly, but we were not sure. Lo and behold, once I broke skin and opened up the soft center of the crater, the little monster’s head popped out. I quickly grabbed it with my forceps (which was a mistake), because as soon as the larva was out, a rocket of pus shot out of the large abscess on her back. Needless to say, we quickly drained the abscess, packed it, and bandaged the patient up. We were able to provide her with antibiotics to cover the underlying bacterial infection that was brewing, as well as pain medications, and she has returned twice for repacking and dressing changes.

It is incredible that this sort of infection is really not a big deal to the folks living here – it is simply part of life. She was calm and collected the whole time, even when she realized that indeed, a fly larva had made its home in her back and was feeding on her. When we finished the procedure, she thanked us and told us she would be back to have the dressing changed. Not once did she question the diagnosis, nor give indication that she was disturbed by her infection. She was truly a trooper. This again serves as an incredible reminder to just how blessed we are. These are the cases that you hear about in medical school, but are told you will never see because they just don’t occur. Life here is different, and all of those things we shouldn’t see, we are seeing. Hopefully as the country continues to develop, health care will continue to improve, and tropical diseases such as these will become much less common. In the meantime, hand me a scalpel and I'll manually extract the critters!

Danli - the Carbonera

Danli, although not one of the larger cities in Honduras, has the unfortunate claim to a large population of families that have been economically forced to make their homes around the city dump. There are hundreds of families living in homes constructed of adobe, scrap metal, and plastic waste; living with hungry vultures, an immense number of flies and other insects, and the smell of burning trash. Sanitation is essentially non-existent and the living conditions are dismal, and the people who live at the dump are a good reminder of the harsh realities of poverty here in Honduras. However, these people are resilient and proud as they greeted us with smiles. We ran across this sign as evidence of their courage: "Seamos buenos por dentro, pero sin dejar de mostrarlo por fuera" ~ "Let's be good on the inside, even if it doesn't show on the outside."

Danli - The Clinic and the Brigades

We arrived in Danli about a week ago, and after the first night alone in the dorm with one other fellow (Dan - a recent college grad who is currently applying to medical school), we were joined by a group of 10 medical students from the University of Texas Health Science Center in San Antonio (UTHSCSA), and one of their internal medicine attendings, Dr. Lapey. This was a very welcomed surprise, as the clinic is normally managed by only two "physicians," and it allowed for a much easier transition into our work. Lindsay and I have been functioning as full-fledged physicians, but have had the benefit of Dr. Lapey on whom to bounce questions. The first and second year med students from UTHSCSA have been fantastic, and have truly made a huge impact in helping to interview, examine, and diagnose the patients. It has been a team effort for sure, and it has also forced us to refresh ourselves on our medical knowledge so that we can try to help teach them as well. We will be sad to see them leave on Monday :o(

However, that being said, it has been an amazing week with them here. We worked in the clinic on Monday; but on Tuesday, Wednesday, and Thursday, we split the group in half and alternated days working in the clinic and driving to a small surrounding aldea where we set up a medical brigade in the local school building and served the very needy population for three days. Many of the patients would otherwise be unable to access health care, and it was a tremendous opportunity to serve. The Hondurans are beautiful people, and it was a pleasure to serve them in this way.

While the trip has been both eye-opening and rewarding, it has not been free of "flaws." Much like La Ceiba, and Copan before it, we have already had our share of no running water, and we are scheduled to be without electricity most of tomorrow. However, we can take each day as it comes, and it always works out in the end!

The next three weeks will be very different without the other students and Dr. Lapey here to talk with, and to bounce questions off of. However, we are excited about the challenge of serving these people as best we may. It has truly been a God send, however, to have them here this first week to get us acclimated to the project. Praise God for his faithfulness and perfect provision! Our time spent in Copan and La Ceiba learning the language has also really paid off thus far. Thank you again for your support and prayers. We will write more later as things continue to progress.

40 Days and 40 Nights

Well, actually, it was only three days and nights of torrential downpours... but boy was it intense! We live in one of the communities bordering the Cangrejal River, and our neighborhood was essentially floating! Unfortunately, we were unable to take pictures until a day or so after the storm, so the water level had already dropped, but even so, it is impressive. The drainage system here leaves much to be desired. This first picture is the backyard of a bilingual school, and the second shows the fairway of the 18th hole at the local golf course, although it appears to be a lake! Four days post-storm, the waters are down, and everything is back up and running.

Roatan - the Bay Islands

Our time in La Ceiba is quickly coming to an end - we leave tomorrow morning for Danli, where we will spend the next month working at a medical mission clinic. However, we wanted to add one more post before we head off, as we do not know how accessible the internet will be in Danli.

During one of our weekends here, we were able to visit the island of Roatan (largest of the three islands comprising the Bay Islands, known worldwide for excellent scuba diving and snorkeling, and also reported to be the landing place of Christopher Columbus on his fourth and last voyage to the Indies), where we enjoyed a leisurely stay at he beach with snorkeling, kayaking, reading, and relaxing. Fortunately, or perhaps unfortunately, the island people all speak English, so this turned out to be a complete break from our studies! However, that being said, it was a much needed weekend to recharge and get ready for what lies ahead!

Hola otra vez de La Ceiba

Classes are plugging along - but the days are flying by! In the afternoons we are volunteering at the public hospital, which has been very eye-opening. JR spent last week in the E.R. and I was in the labor and delivery ward. Things are very different here as supplies and medicines are very limited. In L & D they are delivering the babies with only gloves as they have no sterile gowns, masks, etc. C-sections are vertical in most cases (depending on the doctor - not on the situation). And anesthetics - forget it - these women are delivering without any pain meds; although lacerations and episiotomies are repaired with local lidocaine.

The E.R. was an incredible experience for JR. Last week he saw an older gentleman with tetanus, a severe hand vs. machete injury resulting in 3 severed tendons, and an accidental electrocution. The poor boy with the hand injury walked three hours to get to the local clinic (Centro de Salud), which fortunately had a visiting American medical mission team with IV supplies. They started an IV before beginning the 3 hour journey in the back of a pick-up truck to the closest hospital (La Ceiba). He was treated that night by the in-house orthopaedist, but it is doubtful that he will regain complete function of his hand. The doctors here are incredibly talented, but unfortunately they are limited by their supplies.

One more week in La Ceiba and then we are off to Danli, a city south of the capital, Tegucigalpa. We hope all is well with you all.
Blessings,
Lindsay and JR

Flashback to Copan - Kim y Miguel Miller

In Copan we had the opportunity to meet Kim y Miguel Miller, a young couple from Florida with huge hearts for children and the Lord. They have recently begin a six-year committment here in Honduras to design, build, and operate a children's orphanage for children who are otherwise homeless or neglected. Mike's background is in construction (as well as dairy farming, outdoor adventures, you name it!), and Kim worked as a physical therapist before they moved to Honduras in August. They were finishing their fifth month of language schooling at Ixbalanque (the school where we were studying), and we were blessed to cross paths with them.

The couple spent time in Tegucigalpa (the capital city) working with an orphanage, where they clearly felt called to commit their lives to full-time ministry, before beginning this project with the Anglican church (Episcopalian diocese here in Honduras). We were fortunate to be invited to join them on a survey of the land where the orphange will be built - the aldea of Chasnigua. So, we took a weekend during our month in Copan to travel to San Pedro Sula (where Kim's uncle lives) and go and meet the people of Chasnigua and the land where the orphanage will be built. The land is beautiful, encompassing large rolling hills, forest, and a creek - a paradise for adventurous kids (and Miguel); and sufficient land to farm and raise livestock in addition to building the orphanage.

It was very exciting to talk with them about their plans and how they have been called into this ministry. Miguel (Mike) has an incredible gift with kids, as seen by his interactions with the locals in Copan, and the two of them have an immense knowledge-base which will help to serve the people. They are striving to live with the people, and to interact with them in a life-on-life manner, building personal relationships with them. Unfortunately, the ¨house¨that they were planning to live in is infested with bats, rodents, and all sorts of insects... As such, it seems that they will have to build a new roof and fumigate the entire building before moving in. However, they took it all in stride, knowing that the Lord will provide!

Kim has a passion for providing medical care to the children at the orphanage as well as the local population, and is hoping to organize a clinic at the site, with a full-time doctor. We would love the opportunity to return once we have started (or finished) our residencies to help with this endeavor. She has a medical background, having been trained as a physical therapist, but wants to become more comfortable and knowledgeable in tropical/wilderness medicine. If you have any thoughts or know of any such courses in the States, please let us know!

If you have interest in following along with their program, please contact us, and we can direct you towards their mailing list. They are an incredible couple, and it will be exciting to see how the Lord uses them to serve this very needy population here in Honduras.

¡Bienvenidos a La Ceiba!

We are now in Ceiba – a quaint port “town” (that also claims the title of 3rd largest city in Honduras) with beaches along the northern coast. Once again we are living with a fantastic family. We don’t have innumerable Honduran children running around the house as we did in Copan, but Don Carlos, Dona Lidia, and their 22 year old daughter Karla – who speaks excellent English – are incredibly warm and welcoming. We live in a small barrio on the southwest portion of Ceiba named “El Sauce,” and at a quick glance you might think you were back home in middle America – the larger cities of Honduras are much more industrialized and offer small suburbs near the city centers, similar to those in the States, but on a smaller scale.

We were hoping to visit the beaches this weekend before we begin working at one of the local public hospitals on Monday, but after 48 hours of rain with no respite in sight, we might just stay home and enjoy the day indoors.

Speaking of hospitals, from what we understand, there are four hospitals in La Ceiba (one public and the rest are private), and there is access to care at all times of the day. We will keep you posted about our time in the hospitals as it progresses. From what we know now, we will be spending a week of nights in the ER and a week of nights in OBGYN.

Thank you for following along with us and for your continued support. Much love to all of you!

Los Mayas

Copan – a small town on the western border of Honduras within 20 miles of Guatemala – boasts one of the most impressive and widely acclaimed archeological finds of the Mayan civilization. While the actual Mayan city is smaller than many others in Guatemala and Mexico, Las Ruinas de Copan is the only city with an intact “campo de pelota” on which the Mayans played their ritualistic ball game- from which the winner was eventually sacrificed; and more importantly contains the hieroglyphic staircase more of the historical lineage of the Mayan dynaste which has allowed archeologists unlock the Mayan language and learny in Copan.

While in Copan, we visited the Ruins with our Honduran family. It was a beautiful adventure and a nice change of pace. A few photos are attached.

¡Pobrecita!

It was Friday of our 3rd week in Copan, a day much like any other, as we walked into the Centro de Salud. One of the doctors was out for the day, so Lindsay and I had both joined in with Dra. Karla. As expected, children with colds and sore throats, the occasional case of scabies, and a handful of routine pregnancy checks came through the door to be seen, when all of a sudden there was an urgent knock at the door! In rushed another volunteer, a Swiss lady who was manning the vitals station. In her wake followed two middle-aged women and an adolescent boy carrying what appeared to be perhaps a newborn wrapped in dirty clothes. The Swiss lady quickly explained in Spanish that the child needed to be seen immediately…as the situation did not look good. With a hesitant rush the young boy placed the babe in his arms up on the examining table, eager to get help, but seemingly afraid to let his baby sister out of his care. As Dra Karla unwrapped the swaddling, the sight that met our eyes left us chilled and empty – a one-month baby girl who weighed no more than 5 pounds: her eyes were sunken, her fontanelle a crater on the top of her head. She was more skeleton than body. As we hurriedly examined the child, more and more of the family crept into the room, until there were close to fifteen persons crowded close to see what could be done.

There was no help to be found in Copan; the Centro de Salud had minimal IV supplies, and that only for adults, and we could find no vein large enough to stick. Dra Karla told the mother that there was a chance, but it meant a four-five hour journey to Santa Rosa. The look of shock and defeat that swept across the mother’s face was too much to bare – the impossibility of paying for the trip and her fear of traveling even farther from home left her frozen, speechless. With a fierce determination in her eyes and a warm gentle touch, the Swiss lady picked up the babe and lovingly held her close. “How do I get to Santa Rosa, and is there anything to be done now?”

With that, Lindsay and the Swiss lady ran to the nearest pharmacy to purchase some Pedialyte to try to stave off death for the young child. Dra. Karla and I continued to question the family and examine the babe, and when Lindsay and the Swiss returned, we all emptied our pockets to pay for transportation to Jarral, from where they could get an ambulance the rest of the way to Santa Rosa.

The circumstances surrounding this poor child are unfortunately all too common. The family is poor, has more than seven children, and is uneducated. Sadly, the mother also suffers from epilepsy and was unable to effectively feed her child for fear of dropping her. As such, the child was being intermittently fed cow’s milk and water. The severe malnutrition and dehydration had left the child in the throes of death. Not until a neighbor saw the child was the family convinced to make the journey into town to seek help.

Death in the aldeas of Honduras is a way of life, not an end. Children die during the night because of limited healthcare access, families wait too long to seek help for lack of money as well as acceptance of the child’s fate. Unlike our society, the true mother-child bonding does not seem to occur until months later, when the mother is more sure of the child’s survival. Death is a way of life.

The following Monday, we again saw our Swiss friend. The child survived the ride to Jarral and from there was transferred to Santa Rosa. God willing, she survived.

Vacunas, Consultas, y Las Aldeas

This past week the doctors from Centro de Salud invited us to join them on a trip to surrounding towns in the mountains (aldeas) to offer medical consults (consultas), prescription medications, and vaccinations (vacunas) to those in need. Four teams departed around 8:00 AM, seated in the back of pick-ups, equipped with coolers filled with vaccinations, boxes of antibiotics and anti-parasite meds, as well as stethoscopes, blood pressure cuffs, and oto/ophthalmoscpoes. Lindsay and I joined two of the teams and headed south to the small towns of Chilar and Boca de Monte, where our teams saw greater than 100 patients during the morning with only two physicians. The majority of the patients had parasites, and almost every child had scabies, and there were plenty of patients with "gripe" (common cold). A few of the children also had congenital deformities.

The trip was an invaluable opportunity to partner with the lcoal physicians and to learn from them more about the characteristic physical exam findings associated with the bread-and-butter diseases prevalent here. Chagas disease, which is endemic to many parts of Central America, is transmitted by parasites that live in the excrement of a small beetle - the reduvid - that lives in thatch roofs. Sadly, there is no cure for the disease, and there are towns nearby in which the entire populace in infected. However, we also saw how foreign countries have donated supplies to help a government-run program to replace all thatch roofs in Honduras with metal roofing. This program is by no means complete, but it is encouraging to see the global effort that is underway to prevent the spread of this disease. I actually spotted four reduvids that dropped on me during our consults, and as a result, the physicians are organizing a team to return to Boca de Monte to speciate the reduvids to see of they are the same ones that transmit Chagas.
Overall, it was an incredible experience. We learned a great deal from both the patients and the physicians, and our Spanish continues to improve.

Our time in Copan is quickly coming to and end. We leave Saturday for La Ceiba - a costal town in the north of Honduras. There we plan to focus more on medical vocabulary and hope to volunteer with the Honduran Red Cross.

La Clinica

We have been fortunate to find a niche where we can help and learn about the healthcare of Honduras. So far our information has been only from our teachers and Honduran parents, but now we are lucky to have the opportunity to experience it first hand.

Over the last week we have been spending our mornings working with the doctors of Copan in the "Centro de Salud," a government-run clinic. People from most of the surrounding pueblos come to Copan for healthcare. They start lining up around 7am and the two doctors see about 40 patients each, before 1:00pm. It is first come, first serve and the doctors are only paid for 6 hrs so everyone must be seen before 1-2pm. Fortunately, this consult is affordable for most everyone - 5 Lempiras or $0.25 - but then they must buy the medicine at the local pharmacies which doesn't seem to be discounted.

We help the nurse triage the patients early in the morning by taking vitals, and as the line dwindles, we move back to join the doctors for the consults. It has been incredibly interesting and informative to be included in these consults. Furthermore, it has been invaluable for us to observe the most common ailments, to see how they are being addressed, and to hear our new medical vocabulary in action. We hope that we will be able to absorb enough to do this on our own in just 2 months.

We have only been in the clinic for one week but from what we have seen, the most common illnesses are diarrhea/GI, upper respiratory infections, reactive airways disease, and pharyngitis. But one of the biggest initiatives of the clinic is family planning. There are many families with 10+ children and they are often the poorest families who come from the mountain communities by foot to be seen. Often times they have grandchildren who are the same age as their younger children. Mothers who live far away from the clinic birth their babies at home and don't bring them in to a clinic until their first severe illness - meaning that many children can go several months to years without vaccinations.

It is encouraging to see these doctors who are motivated to improve the quality of life for these people, and it is encouraging to see that the government is providing affordable healthcare. But there are still large challenges that these clinics face. We have not yet found soap in the clinic - the "foam in, foam out" policy definitely does not exist. They do, however, have new sterile needles for immunizations and injections, but they continue to be limited by lack of supplies.

Despite the lack of supplies and differences in standards of care, these physicians are providing a much needed service for the people of Copan. They are diligent in what they do, and they have a heart to help the people. We have truly been blessed with this opportunity to observe, learn, and in a small way, help the people of Copan. We look forward to continuing at the clinic, and we hope that it effectively prepares us for further, more independent work with the locals in the coming weeks and months.

Somewhat Surreal

It has been another beautiful day in Copan. Classes are going smoothly, and we are slowly but surely improving in our Spanish skills. It struck me while sitting here in the internet cafe, the large disparity between what we consider the "good life" in the US as compared to here in Copan, Honduras. I have never met a nicer, more agreeable family than the hosts we are currently living with, yet they have very little. Conversation often revolves around family members, and you can be sure that they always have glowing things to say about their kin and community. We are constantly invited to return - or to stay - and truly the kindness and genuineness of the people here is unsurpassed. However, in stark contrast to this beautiful face of the people, the reality of poverty is ever-present. There is no medical care for the people other than a local clinic that closes its doors at 5 o'clock, and is very expensive. The nearest specialist (or pediatrician) is greater than three hours away by bus; and secondary to poor transportation and the closed doors, death during the night has become commonplace. These short-comings are accepted as commonplace, and people suffer every day as a result.

There are often relief groups here in Copan offering their services, and we are beginning to make contacts with people through whom we might get involved and help. We will keep you posted as things develop.

On a lighter note - our language school has excursions every week and today was horseback riding!! One problem - the people of Copan are very small and so are their horses!

Hasta pronto,

JR and Lindsay

Round 2

Hello! Well, we'll try this again...

We left RDU at 6:30 am on Sunday, after the fabulous wedding of our dear friends, Chuck and Angela. By 7:30, we were in Atlanta, awaiting our 11:30 flight to San Pedro Sula, Honduras. Once in San Pedro, we caught a bus to Copan (about three hours), which turned out to be one of the highlights of the day. What beautiful scenery - rolling hills, tree-covered mountains, lush, tropical flora... think Jurrasic Park! We also met other foreigners who were coming to study at the two schools here in Copan, two of which are an older couple here to learn Spanish and serve as medical volunteers!

Copan is a quaint village with quite a few foreigners - the Mayan ruins about 1 kilometer outside the town proper, and the language schools are supposed to be second-to-none (hopefully they can work wonders with us). We have yet to see the ruins, but we have plans to visit them in the coming weeks.

Classes began yesterday, and we are already immersed in a completely Spanish world. Our personal conversations are a bit broken; however, there is a steep learning curve, and our family as well as our teachers are intent on making us profcient as rapidly as possible! Speaking of our family, it is a large extended family comprised of parents, children, nieces, nephews, and cousins - we love having all the kids around - they speak at a level much closer to our understanding! We have also toured the barrio with our family, visiting the local market, the central park, as well as other highlights. We'll try to get more pictures of the town uploaded soon. It is beautiful, and the people are generous and kind.

Once we are a little more proficient, we hope to find the local clinics where we can volunteer. We will keep you posted!

Well, we would love to give you some details, but the directions are all in German, and the last post we attempted got deleted in the process of posting it. That being said, we will write more soon. We got here safely, and it is wonderful. Much love, Linds & JR.

The Itinerary

Central and South America Excursion

Copan, Honduras (Ixbalanque) – [Jan 14 – Feb 9] Medical Spanish immersion program. We will be living with a local host family, attending Spanish language classes in the mornings, and working with Christian medical relief organizations in the afternoons.
La Ceiba, Honduras (Centro Internacional de Idiomas) – [Feb 12 – Mar 9] Medical Spanish immersion program. Again we will be studying Spanish in the mornings, living with a local host family, and this time volunteering with the Honduran Red Cross in the afternoons.
Danli, Honduras (Mountain Mover’s Mission International) – [Mar 12 – Apr 6] Non-denominational Christian medical mission clinic. Here we will join local doctors working in clinics during the days with occasional trips to outlying villages to provide medical care. We will also have night-shift work opportunities at the local hospital.
Costa Rica – [Apr 7 – Apr 21] Chloe and Mark Young; Rod, Mary, and Bret Runestad are joining us for two weeks in Costa Rica for a quick break and sightseeing.
Cochabamba, Bolivia (Hospitals of Hope) – [Apr 22 – May 18] Christian mission hospital and clinic. Working alongside local and foreign physicians in hospital and clinic settings, we will be serving one of the poorest populations in South America. We also are looking forward to weekly Bible studies, church services (both English and Spanish), and other outreach opportunities.
Ecuador and Peru – [May 20 – Jun 4] Rory and Brett Sallach; Anne Johnson; Angela and Chuck Barrier will be joining us as we explore Galapagos and Machu Picchu.
June 4, 2006: Returning home!

Our first post - the packing process!!!

Less than 2 weeks until we leave! The packing process has proven to be quite difficult. You never know what you will need over the next five months. Hopefully we won't forget anything too important :o)

Thank you for all of your support and prayers as our journey has begun to take form. We will try to update this blog as frequently as possible. We are uncertain when we will have internet access, but if you check periodocally, we will try to keep you updated and to post some pictures. Thanks again. Blessings!