Not Dr. Cody

It has been many months since I even attempted to write a blog. The block has been on full effect as I have lacked inspiration and enthusiasm for the written word. Reading is still fun, but the writing is being neglected and actively ignored. During this temporary period of benign neglect, the water project has grown rapidly. Filters are being constructed daily and installed on a cycle of every two weeks as the concrete hardens. We have now installed 70 filters in San Juan community, with 40 of those installations happening in the past month. Your financial support and the assistance from the ERM grant has enabled us to expand building and installations without inhibitions.
We collaborated with two other NGO’s to compile a list of the 30 poorest families in SJ and they were the first families to receive filters last month. The next 10 were those who merely asked for the better water source. And moving forward, especially as Wuqu’ Kawoq begins a malnutrition project in the area, we want to ensure the poorest and most malnourished children have access to better water. The Biosand filter guarantees 10 years of pure drinking water for a family, and those who are most vulnerable and sick should have this guarantee sooner rather than later. We will analyze the level of stunting and malnutrition among certain families and ensure that they are the next families on our list.
We are constructing the filters now at a cost of about $18 per filter, which averages out to $1.80 per year over 10 years for pure water. The cost is minimal and the effect is tremendous. With continued financial support, from both private donors and public institutions, we should be financially capable of building well into 2013. The current budget will continue to be expanded as we branch into other communities and begin building in other highland towns of Guatemala. One of WK’s most malnourished communities is where we start at the beginning of April. Following completion of the two currently planned towns, we will construct in another WK community.
The laborers are working 6 days a week right now as they build filters two-three days a week then perform follow-up education for previous installations and install new filters. We have also made the process completely electronic as the input all their work hours, data, family information and education components into an online document. The workers are completely independent without Omar and I around and the project has become a self-propelling tool for healthier water. A newly constructed filter requires two weeks for the concrete to cure and another two weeks for the biological filter layer to grow. But little did we know, your donations and the workers efforts is guaranteeing that the concrete box cures and heals for much beyond the initial two weeks. If you would like to donate during this 3 month donor cycle, just go to the link providedThank you for your support of Wuqu’ Kawoq and the water project.

pineapple upside down mold cake

pushing paper and chatting under the canopy of flowers

my next move wasn't to break the stick over my leg...nor to point to a mathematical diagram of flow rate. I was merely entertained by the walking stick

Graham made sure I was included in every photo, not necessary. Pedro and Erwin are the focal points as Pedro (blue hat) does most of the manual labor and Erwin is our go-to administrator in town if we need any extra connections

a thorough examination is necessary for all things big and small

I am posting another blog because an announcement did not go out with the first blog posting of all the pictures. I felt that everyone should know that pictures were being shared…enjoy

It is close to December 25th and I’ve been getting soft. Maybe even lazy, spending my evenings laying around playing on the computer, talking to family and inputting patient information into the medical record system. Sometimes I’ve even been so lazy as to sleep on occasion when my circadian rhythm allows My softness has kept me from writing for over a month and it is unacceptable. I’ve written emails and letters, but telling the stories of life here is much more interesting. It has been a busy month of many patients and very complicated medical issues with the plentiful mixture of allergic coughs and shoulder pain also arriving at the clinic. I even spent a few days in Chattanooga over the past month exploring the cozy city of southeast Tennessee.

First, the ambulance man is doing better and better. They still haven’t operated on him, which is still very necessary. He can’t eat any fat and every time I visit him he asks, “Can I eat meat? Fish? Some egg or avocado?” And I tell him they are all risky and I wouldn’t recommend it. The despair in his acceptance of avoiding his favorite foods for another few weeks is almost comical. It is like telling your child for the hundredth time that Superman still isn’t coming to his birthday this year. It is that forlorn, “oookkkkaayyy, I guess I can always hope he will show up next year,” sort of acceptance from this patient each time I tell him to stick to fat-free foods. The patient’s strength is building and he is venturing outside quite a bit. Last week I hiked down into his corn field to chat and check in with him because he was stretching his muscly body for a change. He is happy, but hungry.

The woman with the mass in her breast who we discovered at the end of one of our visits will be undergoing treatment for breast cancer. The child who once had 6 toes, now has a perfect matching set of 5 toes on each foot. The twins we found with the faint crying and severe malnutrition are much better and their ribs have vanished beneath the additive effects of fatty vitamins. And sadly, we lost one patient whose chronic disease was not being managed correctly by a kidney specialist. It was the tough realization that we can’t save everyone no matter how much work is done and connections made to ensure people receive the best care possible from trained specialists. The death pounded my mental strength as it was a very premature loss and one due to the cumulative effect of missed opportunities. WK created every chance for good care, but we were barricaded by the missteps of the unfolding destiny of the patient.

Briefly I will share the most interesting clinical story that comes to mind. An 18 year old girl arrived at the clinic for a standard pregnancy check at 8 months of gestation. Urine, blood pressure, fetal heart beat, fundal height will all be checked, but before the exam can start she examples her unusual symptoms. She has been itchy all over for weeks and had some peculiar upper abdominal pain that isn’t correlated with food, contractions or body position. Her exam reveals no rash, but she still complains of a persistent itch. I probably would have dismissed this a year ago, but thankfully a willing obstetrician educated me back in January that any pregnant woman with an itch and no rash needs a thorough workup of her liver, gallbladder and bile acid salts. I sent the patient for blood tests and an ultrasound of the liver, gallbladder and pancreas. We diagnosed her with intrahepatic cholestasis of pregnancy and told her to be very vigilant about fetal kick counts and hourly movements. At 18 she doesn’t understand why this is a high risk pregnancy or that counting the movement of her baby means checking that the child is alive, but we did our best to educate her thoroughly and instill enough information and caution that she will be careful. I see her again in 3 days, we will see.

I am home in less than two weeks as Christmas is quickly approaching our present moment. I am taking the weekend to buy a few gifts for a few of the people I love deeply and after the shopping I will visit the water project to pay our employees. Things are running smoothly as the interest in the filters continues to grow and the town is receiving an influx of cash due to the coffee harvest. Things should be busy starting January. But as it is December, it is once again the 3rd month of the rotation and we are asking people to donate again. The next rotation will not occur until March, another three months of course. I also have many photos to post and will be loading those in a day or two when I get the cord to connect the camera to the computer. We shall have a photo blog soon!

Omar and I initially dreamed this project up with the assistance of WK last February and we were so ecstatic to see it begin in June. We also submitted a request for funds from the Environmental Resources Management grant foundation this past July in hopes of providing sustaining money for the long term. Three weeks and a day ago, Omar and I and Wuqu’ Kawoq found out that we were awarded the sum of money we asked to continue building water filters in Guatemala. Fantastic news and a big boost to our production capacity. The money has significant strings attached and must be used over the next year for filter construction. We hope to build between 250-400 filters with the money depending on how the process of construction and installation is completed. We are beginning early 2012 in a new town with plenty of need and over 200 families ready for pure water. From there we will ensure that San Juan is still thriving and maybe even adventure into another town before 2012 ends. This is a project that must be completed by the end of 2012 according to the budget and requests of the grant. We will be working with intent over the next 12 months to ensure each penny is optimized and clean water is disseminated to as many people as possible. And even though we have this outside money for the next year, we still need your support to ensure the success of the project and that people continue to receive high quality water where the Guatemalan water system fails to provide safe and potable water. Follow the link on the blog to wuqukawoq.org and you can donate there.

Much love to everyone, sorry I’ve been neglecting my writing, but I shall post pictures this week…I PROMISE! And more posts will be shared soon. Wishing for fissure fun doing a jig at a wedding.

The man from the ambulance ride is alive and well. He is in the hospital and will stay there for the next month as his gallbladder returns to normal and his body recovers. Surgery will occur when he is strong enough to handle the trauma of cutting out an organ. His gallbladder is rather inflamed (physiologically, due to the infection) but a select few of the WK team are connecting the inflammation to the haymaker I gave the patient’s stomach. Using his stomach as a brace when the ambulance hit the brakes apparently is not advisable. We are calling it the hand of God.
And that gallbladder was the size of a grapefruit before I got clumsy on it
More to come, I will get to shooting pictures soon, promise.