In the past few weeks since returning home from Guatemala I have thought back on my experiences and wondered how I can adequately describe the sights, sounds, smells, and most of all the spirit of the people in that great country. In truth, words are inadequate. I can understand a bit how Moroni felt when he was writing; I feel an inability to express in words what I am feeling inside and a frustration with my own “weakness in writing” (Ether 12:23). But, since this is, in a sense, a part of my record to my children, I will try my best. I am hoping that the pictures will help show the love and gratitude I have for the people of Guatemala. Going there over the past twelve years has changed my perspective on life. It has changed the way that I look at the world around me. It has changed me.

I love the Guatemalan people for their strength, for their courage, for their generosity, but mostly I love them for their humility and their joy in so little. Many live in such very simple circumstances.

According to World Bank, approximately 75 percent of the population is estimated to live below the poverty line, which is defined as an income that is insufficient to purchase a basic basket of goods and services. Each and every time I travel through that country I am reminded of how much I have. As I visit with the people I am often struck by how different my life is from theirs. My struggles are as foreign to them as theirs are to me. And yet, each time I am reminded of this simple truth: we have a Father in Heaven who loves us all equally. We are all here for the same purpose and we all must learn to be faithful, to have hope, and humility, and to learn charity (Alma 7). Interestingly, we are able to learn these things through very different life experiences.

Each trip we get on a bus and drive through the country to our destination city. Every year I am reminded again of the circumstances in which many of the people live. I am reminded of the poverty of so many. As we drive we see children playing in the dirt next to busy roadways while their mothers make tortillas or sell goods at little stands.

It is so unlike the world as I know it. In the United States we are consumed with having everything we want instantly. We get caught up in facebook, pinterest, email, and texting. Many of the patients I see don’t even own a refrigerator, let alone a personal computer. We get upset if we have to wait 20 or 30 minutes past a scheduled appointment time at a doctors office. In Guatemala they arrive early in the morning and wait patiently for hours to see a doctor. At home I feel frustrated by my lack of closet space. I spoke to a woman a few weeks ago who only had one change of clothes. Very simply, they make do with less. Sometimes when I talk to the people and they tell me their story, I fight back the tears. Other times the tears come before I can stop them. And sometimes we cry together.

Marcario had some of the most loving and attentive parents I have ever met. He hardly ever cried post op despite having a painful cleft palate repair.

Nadia before and after surgery ( a little bloody and swollen). She traveled many hours for surgery (Walking 8 hours, a bus for 4 hours to Guatemala City, then an additional 4 hour bus ride with us to get to Retalhuleu.

This is Elisabeth. Her mother is 22 and single. When I asked her where the father was, she replied, “he lives with his other family.” When she was born the doctors would not let her mother see her for several hours because they were sure that she would not want to keep the baby once she saw her cleft lip. “She is my child, I love her no matter what she looks like.” her mother told me.

Kevin before and after surgery.

To me, they are beautiful before surgery:

Randy

William 12 hours old
William was born last night at the hospital. One of the nurses signaled to me to come take a look at him right after he was born. He was born with a cleft lip, cleft palate, extra digits on his hands, his toes were not separated, among other problems. When I left the room, the mother was lying on a stretcher in the hallway by herself. I took her hand and told her she had a beautiful baby. When I walked by a few minutes later, the doctor was relating her sons problems to her, I was so thankful I had not said more.

The following morning I went looking for her and found her in a room full of women nursing their newborn babies. She was the only woman without a baby with her. I wanted to get her information so that we could keep in touch with her and hopefully help her the next time we are in the country. I also wanted to let her know we were able to remove the extra digits on the baby’s hands (they had no bone so we were able to tie them off so they would eventually fall off in a few weeks). When I visited with her she told me she this was her third child; she had a 2 year-old and a one year-old at home. She also told me she had not even seen her baby yet. I went to the area where they were keeping the baby and took pictures so she could see him. I taught her how to tape his ears so they would form properly and also taught her how to tape his lip to help minimize how wide the cleft would grow. I hugged her and prayed we would be able to help her next year. I have thought of her often the past few weeks and wondered how she is doing at home with her three young children.

This young man is 15 years old. I suspect that my 5 year old weighs more than he does. He had been in the hospital for a month, he has tuberculosis and severe malnutrition. His little brother was in the pediatric ward suffering from the same illnesses. They would not let him go to the pediatric ward because he was too old. He would wait by this window for his mother to come sit in the courtyard and visit him for a few minutes each day and then return to a ward full of grown men.

Preciosa.

Preciosa with her single, 15 year old mother.

Preciosa post-op. She was pretty bruised and swollen, but she looked beautiful.

Manuel had to be one of the happiest, most fun-loving patients we cared for. He literally skipped out of the hospital.

This baby, Jostin, was being cared for by his grandmother. His mother was 15 and off “playing.” At one point we planned to cancel his surgery because of a slight upper respiratory infection. The grandmother was determined that he have the surgery and asked us to reconsider. Finally, we started him on antibiotics and moved him to a time later in the week for surgery. When we handed her the baby after surgery she sobbed. A friend later told us she was using all of her resources to care for the baby, even going without food to be sure he had what he needed first.

This was a seventeen year old mother with her one year old son. They had been at the hospital for over a month as they were both suffering from malnutrition. She told me they lived on the streets and she tried her best to care for her baby, but had no family or financial support.
One of the most inspiring patients for me was Walter, a handsome twelve year old boy. Walter had to drop out of school in second grade because he had a cleft palate and no one, including his parents, could understand him when he talked. We fixed Walter’s cleft palate on Wednesday in the late afternoon. On Thursday morning when we went back to the hospital, his parents, with tears in their eyes, thanked us. They could finally understand their son when he spoke to them. Walter has plans to start third grade next year.

Just this morning Anna asked me if she could have a “play date” after school. Then she said, “but Mom, I don’t want it to be at our house because it is not as nice as some of my friends houses.” I was surprised, but I was also thankful for the opportunity to teach an important principle. I shared with Anna some of my experiences in Guatemala. We talked about the things that matter most in our lives. We discussed how our home is not fancy, but it is clean, and comfortable, and it meets our needs. We talked about the importance of making do with less. I worried a bit that I had burdened her with too much information and my point would not be clear. When she invited a friend to our home this afternoon, however, I knew she was listening.

After we completed our work, we organized the equipment and supplies into bags and storage containers.  It took about four hours to do this, much more than I had expected.  It was time well spent.  Everything is well organized for retrieval on our next visit.  They are safely stored in the office of Alejandro Corti for a future trip in early 2010.

Brief summary of the trip:

Dr. Dean visited Quezaltenango, Guatemala in August 2008 and again in February 2009.  With the help of Dra. Silvya Rodas, he made contact with five orphanages and one special needs school.  The Aldea Infantil orphanage seemed to be the best organized.  It was a place where we felt we could work, teach prevention and have an impact.  Francisco Barreno Castillo who is the director of the Aldea Infantil was very accomodating.  The Aldea was stable and organized.  There was a place to put a small temporary dental clinic.  There were plenty of children with dental needs.  Francisco was also willing to share our efforts with other needy groups, utilizing his space.  That included an offer to store or equipment for us.

There is another orphanage that is underfunded and in need.  There is a home for teenage girls and a school for special needs children that we can help also.  Again Francisco has offered the use of his facilities to take care of the others in the future.

The first group brought down about four suitcases of humanitarian supplies which were donated by the Grand Junction Colorado West Stake primary.  Some of these supplies were given to children as rewards for good behavior during dental visits but the remainder was given to directors of the Aldea and Escuela Oficial Urbana Mixta de Educacion Especial “Xelaju”–the special needs school to distribute as needed.  We also gave some items to Hogar Del Nino Minusvalido, Hermano Perdro orphanage.  Hermano Pedro is an orphanage run by the Catholic Church which has children and adults with special needs.

The first group visited the dental clinic in Guatemala City that has been built in a state run orphanage.  The dental clinic is funded by the Church of Jesus Christ of Latter-Day Saints and should be staffed by the BYU Academy of LDS dentists.  The five chair clinic is far from finished.  When finished it should be a help in meeting the needs of orphans in Guatemala City.  A missionary couple is directing the construction.  A dentist has been called on a mission to work in the clinic.  It is my understanding that it will serve future missionaries and current missionaries of the Church of Jesus Christ of Latter-day Saints.

Both groups visited the old hospital in Santiago de Atitlan that was destroyed by a mud slide.  We also visited the new hospital that is being built in a safer place in Santiago de Atitlan.  The new hospital is well underway and should be functional in about a year.  The community hopes to be seeing patients by the first of 2010 but Dr. Dean doesn’t think it will be functional until about a year from now.  There will be a two chair dental clinic in that hospital.  The space has already been designated.  Dr. Dean met with the architect and will continue to serve as an advisor.  The hospital will serve about 43,000 Tztujil Mayans and some Cachikel Mayans.  The directors calculate that they will serve about 100,000 Mayans.  You can read more about it by going to http://hospitalitoatitlan.org and http://www.amigosha.org. There is a video that is rather interesting.

In the hospital there will be two general anesthesia surgical suites.  I already have commitments from two anesthesiologists in Grand Junction to go with me to Guatemala when the hospital is done.  I hope they will follow through on their commitments.  I have also talked to a Guatemalan anesthesiologist in Quezaltenango who is will to perform general anesthesia on any child who is in need.  I personally don’t have any experience with in-office anesthesiology so am a little concerned about it.  I have lots of experience with hospital dentistry and feel comfortable in that venue.

Dr. Dean also visited the Hospital in Solola.  Solola is one of the poorest regions in Guatemala.  There is a real need for dental care.  Currently, they are the only hospital with general anesthesia operating rooms.  The hospitalito in Santiago de Atitlan will be a real help in relieving the burden when completed.  They also have a dentist that works two half days a week.  I haven’t been able to see the inside of the office but from the outside, it is well below standards.  I have meet with the hospital director and feel that a working relationship could be reached.

It was wonderful to have trained dental assistants.  I wish that there were some that were Spanish speaking but we were able to use the LDS missionaries to help us translate.  You can’t translate caring and love.  My assistants can communicate that in any language.  A smile, a tender touch, a soothing tone of voice is all any child needs to understand.  My wonderful assistants have all of that and more.  We worked as a team.  It was great.

I would like to add a general dentist to my team.  I really would rather treat the children and leave the adult dentistry to a general dentist.  We already have five volunteers general dentists and hope with continued public relations to have more.  One is scheduled to go with me in the early part of 2010.  It will require that I buy another portable chair and dental unit.

I plan to pursue help from the dental students in Quezaltenango.  Not only can they help in the clinic but they can be a constant source of dental education in the community year round.  The students are willing and anxious to do something.  We just need to give them direction.  Dr. Dean has been approached about teaching some classes to the dental students next year on pediatric dentistry.  That will be a language challenge but one that he is considering.  One of the Spanish teachers at Mesa State College in Grand Junction has offered to help me to translate my power point presentation into Spanish.

I am pondering some way to train Guatemalan dental assistants.  There must be some way to do it.  There also should be some way to boost the production of the Guatemalan dentists.  I have a Spanish speaking hygienist who I hope will come with us next time and go from house to house at the SOS orphanage instructing children but more importantly the mothers.  I would like her to train some of the dental students at the same time.

I can’t think of many negative aspects.  The trip was great.  It went better than I expected.  I look forward to making some improvements but I can’t complain or be critical of what we did this time.

Antonio Salguero made the trip wonderful.  My staff doesn’t want to go without him, ever.

On the day of Josue’s birth, his mother anxiously awaited his arrival.  This would be her first child.  As the doctor handed her baby boy to her, she was terrified by what she saw.  Josue was born with a bilateral cleft lip and palate.  Mr. and Mrs. Pop had never seen anything like this.  The doctor informed Mrs. Pop that this was her child and that she should kiss him.  His mom said, “The first thought that went through my head was, ‘How will my child eat?’

She knew that she loved her child, but she wanted to disappear.  She was mad at God and blamed him for her first born child’s deformity.  She asked him why He would do this to her child and why it had to happen to her.

Josue’s grandmother offered comfort to her daughter by saying that Josue was a creature of God and that only He knew why Josue was sent this way.  She continued by saying that Josue needed a mother and that Mrs. Pop could not leave him.  If she left, he would wonder later in life why his mother had left him.

Josue’s mom was promised while in the hospital that this type of deformity could be fixed with surgery.  She returned to the local hospital to inquire about the surgery, but was turned away because the doctors were on strike.  Losing hope, Mrs. Pop decided to speak with a social worker who referred her to the Pediatric Foundation.   She was informed that a group by the name of Hirsche Smiles Foundation (HSF) would be coming to Guatemala City and they would be able to fix her child’s facial deformity.  In 2007, when Josue was four months old, Dr. Siddiqi, a surgeon with the HSF team performed the surgery that changed the lives of both Josue and his family. Now, he is a happy little kid with a beautiful smile.

Nadesha Cos Lopez, 15 months

When Mrs. Cos saw Nadesha for the first time her heart broke.  She became very sad.  Nadesha had been born with a unilateral cleft lip and palate.  She went to her mother for comfort.  Her mom told her that Nadesha was born that way because she had done something wrong.  “You must have not wanted the baby, that is why she was born that way,” or “You probably were drinking when you were pregnant,” she was told.  Mrs. Cos felt hopeless to hear her mother speak this way.  Mr. Lopez, Mrs. Cos’s husbsand comforted her by saying that God would find a way for their child to be helped.  They started by making appointment after appointment with the doctors at the hospital but every time they arrived they were told that the doctor was not available to see them or that he was not there.  Then they were referred by Naomi and Hugo, friends of theirs to see if the Pediatric Foundation could help them.  In May of 2009, Nadesha was seen in a clinic by the Hirsche Smile Foundation and a few days later she was in surgery having her lip repaired.  When she was handed to her mom after surgery, her mom was surprised about the change that had just taken place.  “It was as if from one day to the next my child was a different child!” she excitedly expressed.  Nadesha just completed her cleft palate repair this year with HSF for which her mother is very grateful.  It has changed her life.  It has changed her family’s life.  Nadesha’s grandmother now understands that this condition was not caused by her mother’s decisions but rather by some unknown cause.