Greetings, dear friends of Hospitalito Atitlán, I hope this letter finds you safe, healthy, and having an enjoyable summer. Here at the Hospitalito, we are working hard to treat the people despite the extra challenges that have been coming our way. Guatemala has been experiencing a variety of natural disasters. We have been very fortunate in Santiago Atitlán and have not had deaths in the community despite several mudslides. It has been a strenuous and stressful time due to the state of the roads, here and all over the country. No one knows when this will end, as rainy season has just started.

Transportation continues to be a serious problem, leaving us short in terms of supplies and staff. Medical volunteers have canceled due to these conditions. At the same time, because of impassable roads, patients are traveling from further distances, creating more demand for Hospitalito. While our staff is working extra hard to provide the excellent care this region needs, our board and administrative staff is working hard to find solutions.

HA recently hired a new, full-time physician, Dr. Juan José Daniel from Guatemala City. We would like to hire two more Guatemalan physicians and to offer scholarships to train a social worker, an ultrasound technician, and nurses. Scholarships pay for the cost of education and also allow us to cover their shifts while in classes.

While the devastations of nature and the stress of providing care with limited resources have been challenging, we are looking towards the future with much hope. We are also looking at the positive aspect of these developments. Hiring and training more staff will have many benefits, for individuals, families, Hospitalito, and the community. The idea to have a strong base of national physicians and nurses has always been the plan. So, we have much to be grateful for.

Please become part of the solution, and help pave the way for a brighter future. We urge you to consider donating towards medical services or towards a scholarship (read more on our website). We also highly encourage interested medical professionals to come and volunteer, as soon and as often as possible! HA needs your help to continue providing quality medical care to the underserved.

Many thanks to all whom have already contributed to these causes and helped alleviate our general need during these challenging times. Best wishes to all of our friends.

Sincerely,

Dr. Juan Manuel Chuc

We are thrilled to announce the re-initiation of our Maternal Infant Program. Now, for just $25 a month you can make a tremendous difference for an expecting mother and later for her child. The demand for this program has not stemmed from donors or volunteers, but from community members and staff.

This is a highly valued program that helps families most in need to give a new baby a healthy start to life. While Hospitalito Atitlán always offers excellent maternity and infant care, not all families in Santiago Atitlán participate in all we have to offer. Vicenta Chavajay, our social worker, frequently identifies families that could greatly benefit from extra help during a pregnancy or after a new birth.

The Maternal Infant Program is a sponsorship program where expecting mothers are enrolled to receive comprehensive maternal and infant care for free. This includes standard care such as regular prenatal visits, vitamins, delivery at the Hospitalito, post-partum visits, and regular infant/child visits. We also include a full battery of prenatal testing, which is not available anywhere else in the region. Equally important, the sponsorship program includes additional educational meetings, for anyone in the family that wishes to attend. Topics include prenatal nutrition, warning signs during pregnancy, breastfeeding and child nutrition, and family planning.

These are all vitally important services, as the high rates and tragic consequences of poor maternity care in this region are gruesome. One of Hospitalito's main goals is to reduce maternal and infant deaths in this community. While we have always provided this important care to as many families as possible, we usually charge small fees. Our maternity care has done remarkably well sustaining itself, and has helped to dramatically decrease maternal and infant death in Santiago Atitlán. We have helped prevent many tragedies in the last few years and there were no maternal deaths in 2008 or 2009. For families most in need, even small fees can create a barrier to receiving the critical preventative care that can make such a difference. This Sponsorship Program is designed to reach families that have the greatest need and the greatest risk, to provide them with not only free comprehensive care, but also with additional education and support, for the whole family.

When we receive a donation for the Maternal Infant Program we enroll one expectant mother, whom will then be paired with their sponsor for at least one year. The sponsor receives letters and photographs from the family. Once a family is enrolled, all members of the family are welcome to receive care, and this can be extended for up to five years after the infant is born. We encourage sponsors to stay involved with the family for as long as they are able. We also encourage both the sponsored family and the donor to write to each other as frequently as they'd like, as they are sharing is such a remarkable role; helping to give a new life a healthy start.

This has been a tremendously important and successful program in the past, and we are thrilled to be actively offering it again. For more information about the program and to become involved, look at the Hospitalito's website under Maternal Infant Program:

http://www.hospitalitoatitlan.org /sponsorship.html

We don't need Sherlock Holmes to figure out that Brent Burket and Jennifer Thoene don't event fit the description of your usual medical volunteer. The evidence is everywhere upon entering their home: two pairs of kids-sized rain boots, swirly blue and pink, a bookshelf of children's literature, tables loaded with crayons and coloring books, the movie choice of the day is Toy Story 2, and the final clue, a small voice saying, "mama, it's not fair".


So, why do two US physicians with four children under the age of eight, choose to move to highland Guatemala? And for three years, no less?!?

"We met in med school," explained Brent. "Both of us wanted to work in the developing world, that was the initial spark between us. We both have faith and want to serve the underserved population. We have that population in the US as well, but not to the same degree or at the same level as here. We also wanted for our kids to have a cross-cultural experience."

Jennifer opens her arms to incorporate the two bedroom house, comfortable by Santiago Atitlán standards with a refrigerator, gas stove, running water and washing machine. "We have to live like this. If you are sick, you cannot serve the people," Jennifer humbly excused herself. "It is very time consuming to do housework. Without the comforts you have to go to the market every day, cook food from scratch after you have gathered the firewood, do laundry by hand. Very little time and energy would be available to tend to the sick."

As far as the four children Christopher, 7 years, Elizabeth, 6 years, Julianne, 4 years, and Nicholas, 3 years, "they are doing great. Every day is an adventure; they have fun outside and discover anthills and such. Everyone here loves children and knows Nicholas, and greet him hola Aklaax. To have children is an excellent way to become integrated in the culture."

The two oldest children attend first grade at the Padre Aplaas Parroquial School in town. It is named after the Oklahoma priest who was murdered during the civil war. The two younger ones attend Puerta Abierta, a preschool and library.

Brent and Jennifer made their choice to volunteer in Santiago Atitlán and its Hospitalito based on several factors and special considerations for their children. Situated at 4,500 ft, the elevation is high enough to avoid tropical diseases such as malaria. There were many human reasons as well.

"With Misson Doctors, we could have gone to the Petén, Bolivia, Ecuador or Africa, but we were drawn to the Hospitalito," said Brent. "It has a unique relationship with the national and international community, and the board is a blend of Guatemalan and ex pats. It is important for us to work with Guatemalan doctors who are grounded in the culture."

He compares the experience to the one they had in Ghana 2000-2002. "We were six doctors, none of them national, to oversee a hospital of 170 beds. People died daily, even kids. Within two years we burned out."

Brent and Jennifer started their service at Hospitalito in May and will stay for three years, supported by the Los Angeles based organization Mission Doctors Association, where Brent has served on the board. Before departure, Mission Doctors gave several months of preparation courses, and once in Guatemala, they were required to take three months of Spanish classes. Now, to make time for the children, Jennifer and Brent divide the time at the hospital between them.

"We notice how important the language is, and it would also be helpful to speak some Tz' utujiil as the patients are so grateful when we listen to them. We hear their life-stories every day. It is very touching and humbling. In a US hospital you have a feeling to go, go, go all the time. It is a different pace here, which allows time to interact with the patient one-on-one, we have time to talk to them and to the staff. And in case of needing a specialist's opinion, I can contact them via internet, " said Brent.

I ask if it doesn't hurt to give up two good US wages for three years.

"Maybe in the future I will regret the money," said Brent, "but to give up family and friends is by far the hardest thing." Now, Guatemala City is a five-hour flight from Los Angeles, where Jennifer's family lives, and a little further from their previous base in Medford, Oregon, where Brent has family. "But you gain a simpler life by not using as many resources, we have no AC, no heating, no vehicle," Jennifer filled in. "We live on a lot less than we are used to, but we don't have to worry about the day-to-day expenses as they are covered by Mission Doctors Association and the hospital. And we don't receive all that junk mail!"
There are only two things besides family and friends that they go out of their way to attain: crunchy peanut butter and cheese.

By this time, Toy Story 2 has run its course and the children draw in on their parents. It is another day for stirring up anthills and chasing butterflies.

You can follow the Burket-Thoene family on their blog: burketthoenefamilymission.blogspot.com

Two months have passed since Doctor Fernando Leiva's early departure due to heart failure on May 22. All were shocked and saddened by his sudden passing at 58 years of age. As soon as the news arrived a memorial was built at Hospitalito for all to pause and remember this great man. Approximately 15 employees, volunteers and board members attended his funeral in Guatemala City, and contributed with touching speeches. Dr. Leiva was a great supporter of Hospitalito since its first days in Panabaj. After his internship there in the 1980s, he always kept it close to his heart. Since the surgery room re-opened in 2005, Dr. Leiva faithfully arrived every six weeks to perform surgery. He offered his services for free. Dr. Leiva was educated at Harvard and Oxford, where he trained with the very best. He served as a member on the Steering Committee of the Capital Campaign to raise funds for the new hospital building. He was also a member of Club Rotario Guatemala Oeste that has offered immense support to the hospital. We are now immensely grateful to his physician friends whom have come together to assist with his important roles. Dr. Cofino from Guatemala City and Dr. Luis Flores from Austin, TX, performed surgery at the Hosptial in his place, and more have promised to continue the work of Dr. Leiva at Hospitalito. To honor his legacy, both as an accomplished surgeon and a man of passion, the first surgical suite at the new hospital will be named after him. He will be forever missed and forever remembered and honored at Hospitalito.

After five children (ages 13, 11, 9, 7 and 5), Santos Reyes Mejía Jacinto, 43, and Angelina Cojtín Xiloj, 39, thought they knew everything about becoming parents. When Angelina Cojtín Xiloj's water broke at four in the morning on June 28, they went to the medical clinic in their hometown San Lucas Tolimán. There were still two surprises awaiting them: They were to become the parents of twins, and Angelina Cojtín Xiloj learned she suffered from pre- eclampsia. She was transferred to Hospitalito Atitlán right away.

"We were very anxious, but were immediately attended by the doctors at Hosptialito. I asked for a lot of strength from God," Angelina Cojtín Xiloj said. She was greeted by a whole medical team and started on magnesium sulfate to lessen the dangers of pre-eclampsia.

The twins were delivered by cesarean, and although they had been carried to full term, they were tiny at birth. The first, a girl, only weighed 1.7 kg (3.7 lbs). The second born, a boy, was slightly larger at 2.3 kg (5 lbs). Both babies had difficulty breathing, were running fevers and were not able to nurse. They were given dextrose solution by IV for strength and each had an incubator with bilirubin lights to treat their jaundice. On their fourth day, the pediatrician decided to feed formula nasogastrically in order for the babies to gain weight. And finally, on the fifth day, the little boy started to suckle. It took seven days of worry until the girl gained enough strength to start breastfeeding.

Doña Angelina stayed at the hospital with her babies during this time, caring for her twins and working on her milk supply, while healing from her own surgical wounds. On July 5th, eight days after admittance, mother and babies were considered strong enough to leave the hospital and return home.

"It is very difficult to be in this situation when you don't have enough economic resources and you are the only earner for the family," Santos Reyes Mejía Jacinto said. "With each day that passed we worried about the expenses. But the doctors and the social worker told us that the most important thing is to save the lives of the babies and not to worry about the cost. They encouraged us and thanks to this our babies received the necessary treatment."

The check-up one week later went very well. The physician was met by two healthy babies, a recuperated mother, and a grateful father. "Thanks to the many days we spent at Hospitalito, I realized how well the doctors and nurses were taking care of my wife and children. We are very happy and very grateful," Santos Reyes Mejía Jacinto said.

Doña Angelina said she has an eager 13-year old daughter at home, who helps her look after the twins. "We realize that it was a large expense, but thanks to the social department we can pay on a voluntary basis," said Angelina Cojtín Xiloj, who added that her childbearing days have come to an end.

Most American high-school students have a lot on their plate: classes, sports, music, jobs, clubs, college prep, and trying to find time to hang out with friends. Hospitalito Atitlán is fortunate enough to have a partner who has found a way to combine all of the above while raising funds to help build the hospital. Quite a remarkable feat!

You may remember reading about Eric Lyons, who was planning a fundraising ski event last February. Eric is a 16-year old junior at Weber High School in Ogden, Utah. Over the past year, he worked with energy and gusto that many of us may have forgotten exists to create two incredible events to raise funds for construction. His own efforts ranged from selling hot chocolate at his school, recruiting partners such as major health and skiing organizations, publishing articles and giving presentations.

The first event was a cross-country skiing race held over President's Day weekend. 70 determined people made it to the event and raced, despite near blizzard conditions. Skiers raced a course set at about 6500 feet, through woods, beaver ponds and fields, with nearly 10,000 foot peaks in the back-ground. Skiers ranged from a man in his 70s to children and several nationally ranked racers. Live trumpets played throughout and each participant was announced as they came through the finish gate to the applause of the spectators and other racers. After the race, warm refreshments were served as a raffle of professional gear was held. All made for a festive atmosphere, challenged only slightly by the driving snow. A general sense of excitement and unity could be felt throughout the day, as everyone had joined together to do what they loved in order to contribute to an important cause.

The second event was held on May 17th at Weber High school. This time, Eric had his school's Multicultural Club host a night dedicated to raising awareness and funds for Hospitalito. The school was decorated with large photos of Guatemala, Lake Atitlán, Santiago Atitlán and its people. Catered Latin American food was served to the sound of Guatemalan music. Eric presented a slideshow about the Hospitalito after dinner and then a silent auction was held. More than 100 people participated. Afterwards, the group went to the theater to view a performance of poetry and dance. Eric made all of this happen by recruiting participants, finding companies to donate prizes, sharing his knowledge about Guatemalan culture, and sharing his passion for the Hospitalito with his own community.

In the end, his two events raised over $15,000! This is in addition to separate donations that his friends, family, and partners have contributed. He also spread the word about Santiago Atitlán and Hospitalito.

How did one young person make all of this happen? Well, after Eric visited Santiago Atitlán last summer, he decided that he wanted to make a difference and help the community by helping to build the permanent hospital. It is quite remarkable what can be accomplished when an individual has passion, drive and energy! Here at the Hospitalito Atitlán, we feel very fortunate to count Eric Lyons as a friend. He has not only helped to contribute a significant amount of money, he has reminded us all what passion and hard-work can accomplish. Thank you Eric!

The construction site is bustling with change and visible progress every day. The entire roof has been poured (all by hand), and the new floor is looking beautiful! We are poised to open our doors for the patient care areas sometime around the end of this year. Stay tuned for an announcement with dates for the dedication and celebrations.