The long and winding road

I often joke that where we live is in the middle of nowhere. The hospital sits alongside a dirt road with small villages on either side of it. We are situated one and a half hours from the nearest bank, supermarket, and pharmacy (other than what we stock at the hospital). However we are like a big city to some patients who come to visit us from along the coast and up in the mountains.

About two weeks ago I (Alisa) saw a sweet older couple, Bernarda and Julio, for a check up of their chronic conditions. During a visit I like to ask where a patient is from and what they do where they live. Imagine my surprise when they said that they lived in the small mountain community of Buenos Aires. They are both in their 80’s, but had walked over four hours to get to the hospital for their appointment!

Bernarda and Julio with Pastor Denis (center) getting prayed over after their appointment.

They woke in the pre-dawn hours to slowly make their way down the mountain- Bernarda assured me that they walked very slowly in order to avoid injury. Thankfully Julio, who was getting treatment for a gastric ulcer, was feeling much better and seemed to be recovering quickly. For this couple, our hospital is one of the few options that they have for any kind of health care. I prayed for their journey home and was reminded of the verse in Psalm 18:36: “You gave a wide place for my steps under me, and my feet did not slip.”

In the same week during one of Andrew’s call days a nurse radioed at 9pm. She said that there was a young man that just arrived with a bullet wound to his leg that needed urgent attention. It had happened at 11am that morning, but they were so far up the mountains that it had taken him 10 hours to descend and arrive at the hospital! He had tripped and fallen during a hunting trip, causing his gun to fire and it hit his left calf. Friends and family carried him for the first three hours out of the jungle, then he made the rest of the way slowly across trails, rivers, and dirt roads, to arrive after nightfall at Loma de Luz. The next morning he was brought to the operating room to repair his calf which had great results (before and after pictures available per request via Andrew. We realize that there may be some folks out there that don’t want to see a gun shot wound as a part of their Wednesday afternoon). He was discharged two days later.

Loma de Luz is situated in a rural area to serve such patients as these. Please join me in praying for them and future people that we serve that just like in Exodus 13 that their travels would be watched over by The One on High. “By day the Lord went ahead of them in a pillar of cloud to guide them on their way and by night in a pillar of fire to give them light, so they could travel by day or night.”

Alena with a favorite “baby doll,” the hospital CPR infant mannequin. She has great positioning for a good jaw lift and chest compressions here.

Traveling in a pandemic

Traveling during a pandemic? Most people would wisely shy away from the endeavor. However, we are not most people.

I must say, that there are some definite positives of choosing to travel during a pandemic. You can cut your drive time to the airport in half because there won’t be any traffic. Afraid of battling through the crowds when you arrive at the airport? Not to worry, yours is the only flight all day! The place will be almost vacant looking. Don’t have time to clean up or shower before you go? Well, you’ll be sprayed with bleach spray and sanitized at least once along the way.  That actually may bring me to some of the peculiarities of traveling during a pandemic.

After a spectacular time in Florida with our families, we began the process of returning to Honduras in early July.  Upon arrival in Honduras we were given temperature checks, screened for COVID symptoms, and asked if we had any COVID positive contacts. Then we were sprayed with some kind of supposed COVID killing solution from head to toe- front and back, by a man in a hazmat suit as soon as we stepped off the airplane. Even little Alena did not escape the suspicious spray, she too was doused in it. After waiting several hours in customs we had to sign documents that stated we would be in a strict quarantine at our home for 14 days. If we broke the quarantine we could get up to 6 years of jail time. No fine listed for this misdemeanor- we’d go straight to the big house. And it also mentioned that if somehow we had COVID and gave it to someone else and they died, we would be charged in the court system as committing homocide.

After being thoroughly scared about the prospect of Honduran prison, we finally escaped customs to claim our baggage- which was also doused in COVID-killing spray. Thankfully we were able to quickly be on our way after this initial gauntlet with a special salvoconducto- a paper that gives us permission to be traveling in Honduras which had to be requested and approved several days before our planned travel. Bathroom stops for the 5 hour drive were limited, because it was not our official day to be in public (every person is assigned a number in which they are able to circulate- the last digit on their ID card). Needless to say, when we finally arrived to our house on the top of the hill Friday night we deemed it a great victory!

Contrast this to our arrival some weeks earlier in Ft. Lauderdale where we stepped off the plane and through customs to get our luggage as if everything was normal. No temperature checks, no COVID screenings, no bleach spray, and no requests or demands to quarantine. Perhaps there is some middle ground between the two experiences that would benefit all?

Back to the jungle, we were finally cleared from our quarantine and have started working again in the Hospital. Andrew saw his first COVID positive patient. Below is the concerning chest x-ray the morning after her arrival. Thankfully she recovered well and is now at home in quarantine.

The x-ray of a COVID (left) vs normal (right) patient. You want to see a good amount of black (air) in the lungs. The left x-ray (COVID positive) has significant infiltration (white) and thus limited air movement leading to low oxygen saturation (she initially required 8 liters of oxygen to keep her oxygen saturation level above 95%).

Thankfully our COVID patients have remained in the minority of the wide range of medical problems we diagnosis and treat on a daily basis.  I (Alisa) saw a young man who fell off his horse and broke his collarbone. Thankfully an arm sling and several weeks of rest is all that he will need.

Clavicle x-ray

There was also the case of mystery eye lesion (thought to be a keratocanthoma), but upon biopsy, ended up being positive for leishmaniasis (a parasitic lesion from the bite of the sand fly). Special medication had to be ordered from the health department to eradicate this parasite.

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We are thankful for the opportunity to keep working along side our Honduran neighbors during the pandemic and are amazed at the resilience of the people here even in discouraging economic times. Thank you for your prayers and partnership!

One.

One.

Loma de Luz has seen one case of COVID-19 since the global pandemic started earlier this year. The elderly woman with symptoms of shortness of breath and cough was quickly moved to a government hospital closer to her home where many cases are being treated.

I must admit I had expected to see our hospital overrun with patients, not having enough beds, oxygen, or supplies to treat the illness. And perhaps this may still come to pass in our future. However, since our quarantine lockdowns began I have seen much more suffering economically. I have written about it before, but most of the local economy consists of farming, construction, and fishing. Construction has been lowered significantly, with the quarantine there is no public transportation to get out of the area to start other jobs, and fishing is suffering as several boats that travel to Columbia can’t leave as the borders are closed. The local (and national) economy much like in the U.S. has been suffering deeply.

In this time of crisis the money that many of you have donated towards food for these families have been essential. It has kept several from the brink of starvation and given them hope. One family was forced to start selling their chickens (which are helpful for their egg production and raising chicks) for 100 lempira or $4 per chicken, as there wasn’t any money to buy other basics such as beans and flour. Another family with three adults and six children had been forced to only eat once daily, and sometimes only have coffee for their ‘food’ for the day. When they received the food donation they were so excited, and said they could now eat at least twice daily with significant portions.

This week the hospital was able to create and is distributing more than 100 bags of food that can feed a family for about two weeks. Thank you for your contributions towards this effort. It is making a huge difference where we live!

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Food bought in bulk before sorting.

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The sorting and weighing process.

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Finished product waiting for distribution!

We hope as things begin to open back up in Honduras slowly that the local economy will show signs of recovery as well.

I am writing this now from Orlando, Florida! The timing of our clinic schedule worked out that we were able to take a break during the month of June, and we got one of the last few flights out of the country on Friday. We are looking forward to celebrating Alena’s first birthday with family and some relaxation time before heading back to Honduras in July before a few other physicians start to take their furlough time.  We are thankful for this unexpected time to get much needed rest. Praise Jesus for a mostly uneventful travel day and good health.

 

Telemed

Since the inception of Hospital Loma de Luz, God has enabled partnerships with many skilled and caring medical providers who lend their expertise to us for the good of our patients.  While most visiting medical providers are only able to physically come to Honduras for about a week or so, they all graciously make themselves available to us via email, phone or video chat throughout the year, aka telemedicine.

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While some Hospitals can do remote surgeries through robots, we still have to do surgery the good old fashioned way

All of those years of building relationships and exchanging medical knowledge and resources has enabled our general practitioners to provide on the ground specialized care every day of the year.  For example, about two months ago, Alisa had a patient with an unusual lesion near their eye that several providers were puzzled over. After a photo and quick email to a visiting ophthalmologist, who at the time was in Florida; she was able to create a treatment plan that everyone was pleased with. 

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Unusual lesion near the eye  diagnosed via email consult

Through partnerships with other ministries and medical providers in Honduras, we have been able to use telemedicine to share the knowledge and resources God has faithfully provided to us to bless the lives of people ALL over Honduras.  Our Hospital has been in partnership with a medical ministry on Roatan called Clinica Esperanza for many years now.  Usually when there are patients who need care beyond the scope of Clinica Esperanza, they refer those patients to us and after an hour and a half ferry ride and another hour taxi ride they end up at our Hospital.  One of the biggest areas in which Roatan is lacking in specialty care is with Orthopedics.

Since about Mid March, Roatan has been on lock down with no one able to come or go from the island.  This has left many patients in a bind, especially those with orthopedic injuries as there is currently no Orthopedic doctor on Roatan.  However, through the use of Telemedicine, we have been able to guide the general medical doctors at Clinica Esperanza through the care of different types of orthopedic injuries which if left without timely care would result in the need for more complex surgical intervention in the future and even permanent dysfunction.  

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An example of permanent dysfunction from an untreated club foot.

One such patient was a 6 year old who fell while playing which resulted in a displaced both bone forearm fracture.  After exchanging multiple messages and even putting together an instructional video, the staff at Clinica Esperanza was able to get a better reduction of the fracture.

Another patient was a 38 year old who fractured his right 2nd metacarpal.  We were able to send info on reducing and splinting the fracture and the staff at Clinica Esperanza took it from there.

Thankfully these two patients had orthopedic problems that could be stabilized and treated without surgery.  Other patients are not so fortunate, like a 43 year old who recently had a motorcycle fall on his foot.  To properly treat these fractures they need to be relocated and pinned in place in the operating room before the deformity becomes permanent.  With a lot of prayer and coordination the patient was able to make it over to Loma for surgery this past Friday which went very well.  These few cases are just a small glimpse of how God has continued to provide for the medical needs of the vulnerable in the midst of travel restrictions and other obstacles that this global pandemic has caused.

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Before Surgery

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Surgery required the placement of 8 pins to stabilize all of the fractures in the patient’s foot.

Thanks to the generosity of many, there are funds to make over 220 food packets for needy families in our area! These packets have included some “luxurious items” such as coffee, toothpaste, cheese, and cookies in addition to rice, beans, flour, etc. We have heard countless stories about how these food donations have saved families from selling off their livestock and ultimately, destitution. We will continue to distribute more food in the coming weeks as food dwindles down again.  Thank you for continuing to support our family and our community here in Honduras through encouraging words, finances and prayer!

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All hands on deck to help create the family food packs

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Families from El Torro, a rural mountain village, gather to get food.

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Some excited friends able to bring back food to their families in a town called Nueva Armenia.

Corona quarantine

Hello everyone,

I hope everyone is safe during this unprecedented time. Just like many of you, during the quarantine, we thought it would be a great time to have a new pet addition to our family!

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This is Otis, a white-faced or capuchin monkey (along with Gina, our Honduran mentee). Just kidding! He is a pet of one of our neighbors. We aren’t that brave to have a baby and a monkey. Let’s be honest, there isn’t too much difference between the two. Here is our actual new pet:

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Yeah, no. That one didn’t last very long either. Thanks to our fearless gardener, Don Pablo, this snake didn’t make the family cut after all. I guess we will remain pet-less for the time being. But, I am enjoying all of the very cute puppy pictures that everyone is posting.

In all seriousness, Honduras is in full coronavirus prevention here. There is strict quarantine from 6pm to 6am, and you can only go out to town once per week depending on the last number on your ID card. Before you can leave the county, your car gets sprayed with bleach, you must pass through multiple checkpoints to verify your ID number is correct, and only two people are allowed to travel in a vehicle at a time. The lines to enter stores can be very long as well.

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The line to enter Walmart last week.

While there are about 450 coronavirus cases in Honduras, there are none present at our hospital.  We continue to prepare and wait during this unusual time. The Lord has used the crisis to create stronger bonds with our local health department, the local mayor, and the current government. With their cooperation and great assistance, a Harvest Aviation flight with a large amount of personal protective gear and needed medications was able to land in San Pedro Sula last week. We had enough masks/gowns/etc to share with our partner physicians at the local Honduran health department.

Please pray for the poor of Honduras, as this crisis has affected them the most. Most live day to day and with the quarantine few have been able to work. Many now don’t have enough money to buy food and have been foraging in the mountains to find anything (iguanas, large rodents, etc) to eat. The hospital, in partnership with two local churches, has been making food packets to distribute to our local community. So far they have been able to make about 280 packets of rice, beans, flour, coffee, butter, spaghetti, spaghetti sauce, soap, salt, and soup mix. Each packet costs $25 and can feed a family for two weeks. During delivery last week one family was so thankful- they admitted they had eaten their pet lizard the night before because they had nothing else for their family and children to eat.

Unfortunately there are over 500 families that need help during this time. If you would like to donate specifically for food, click here: Online giving option. Please send us a note for other giving options if you are interested.

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Making food packets for the community.

 

I will leave you with a Psalm that I have found encouraging during this time: “Be still, and know that I am God! I will be honored by every nation. I will be honored throughout the world. The Lord of Heaven’s Armies is here among us; the God of Israel is our fortress.” (Psalm 46:10-11).  I am praying that you all would feel the Lord of Heaven’s Armies protection over you this week and that God would continue to be glorified throughout the pandemic crisis.

Coronavirus and Honduras

Greetings to everyone!

We are in the thick of our coronavirus response here, along with the rest of the world. As I see friends and family around the world dealing with social isolation, Honduras is also following suit. The country acted very quickly last week, even with only approximately 6 confirmed cases at that time, to encourage everyone to stay home by closing schools and non essential stores. Soon after, they closed their borders to anyone coming or going with only 4 hours notice! Everyone is under curfew and police are stopping people to make sure that it is necessary for them to be out. Currently our borders are still closed (land, sea, and air) to everything except food, medicine, or other needed supplies.

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Social distancing- “Don’t sit here. Maintain your distance”

Our hospital team has been working hard to prepare the staff and facility to take coronavirus patients. This has included gathering all protective gear, forming a treatment algorithm for sick patients, creating a different triage space to separate potential coronavirus patients from other ill patients, and preparing an isolation ward. The maintenance staff has installed several new hand washing stations all over the hospital compound as well.

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Hand washing station “Tippy-tap” outside of the hospital.

We are also educating staff on how to protect themselves, their families, and patients.

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Hospital corona virus educational in-service.

As of last night the number of confirmed cases was 24. We aren’t sure what to expect in the coming months, but are praying that the Lord will give us wisdom, energy, and guidance as we combat the coronavirus in Honduras.  Our team is working around the clock to prepare for the worst while trusting God to provide for all of our needs.

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Doing a walk through of our newly outfitted (over the course of just a few days) isolation rooms/area for suspected Corona Virus patients.

Please pray that Honduras would be able to effectively combat the virus with public health measures such as social distancing and curfews. Please also pray for energy and wisdom for treating potential or suspected cases we may encounter in the future as well as the health of all of our hospital employees. Know that we are praying for you and your safety as well during these unprecedented times.

Amputation Averted

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Our on-site prosthetics lab.

Hospital Loma de Luz has developed the reputation of helping to heal or cure medical problems that others have said could not be healed or cured.  One way we see the effects of this reputation is through patients who come to us seeking another opinion after being told that the only treatment option for them is a limb amputation.  We do not deny that there is a time and place for doing an amputation (like if there is a deep infection that is continuing to grow despite adequate treatment) but we also believe that if the patient is wanting to fight for their limb then we are willing to join them in that battle.  In my (Andrew) time at Loma I have only been involved in the care of a handful of patients who have come to us actually seeking an amputation from the start. While we are here to serve our patients and ultimately do as they wish, we never go into such a life changing operation, like an amputation, without thorough investigation and counseling.

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Prosthetic feet that we use for our patients

One of those rare patients was a 34 year old male named Henry.  I first encountered Henry one Saturday while I was on call for the Emergency Room.  He had come all the way from San Pedro Sula (the second largest city in Honduras, about 5 hours away from our hospital) requesting an above the knee amputation for his left leg which was deformed and grossly shortened from trauma many years ago.  Subsequent attempts at treatment elsewhere had failed to provide pain relief or a functioning left leg. He had spent so much time and effort to find help yet everywhere he went the answer was the same, either undergo an above the knee amputation or live with a non functioning leg the rest of his life. 

After an initial evaluation, it was found that his left knee was chronically inflamed by a deformed knee cap which caused him debilitating pain and made his leg all but useless.  Thankfully, our team at Loma determined that we could offer more than an amputation. After much deliberation he decided to have his knee cap removed to try to improve his pain and knee function. The surgery went well and he was able to regain pain free knee movement but a large leg length discrepancy remained.  His left leg was about 6 inches (or half a foot) shorter than his right leg, making it impossible for Henry to put his left foot flat on the ground to walk. For his leg length issue we turned to our prosthetics department in hopes that they could fashion something for him to be able to walk again without crutches.

When James, our prosthetist, evaluated Henry for the first time he said that given the magnitude of Henry’s leg length difference (close to 6 inches) there was only one potential prosthetic option but not only had we never made the type of prosthesis Henry required at Loma, we did not even know if it would work with the equipment we had.  After talking through the risks and benefits and seeing that Henry was completely on board to try the prosthesis, we decided to give it a go. One of the issues we faced was that the amount of plastic that needed to be heated for this particular prosthesis was too much for the oven we have in the prosthetics lab; so James had to come up with a process to heat one half of the plastic and then quickly turn and heat the other end of the plastic before the end that was just heated cooled.  By God’s grace the first attempt went well and the prosthetic was able to be made. Now the only thing left was to have Henry try it out.

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When Henry saw the brace he could not stop smiling and when asked how he was feeling, his response was, “I am so Happy!”  After trying on the brace and making a few minor adjustments, Henry was off cruising the hospital halls without the use of crutches and under the power of his own leg for the first time in several years.  Myself and Henry could have never imagined that almost 1 year after we initially met, Henry would be walking around with a prosthesis AND his very own, still intact, leg. God is so faithful. He obviously had this plan in mind the whole time.  Looking back at Henry’s journey gives me hope and encouragement for each patient I have the privilege to care for. While we do not always have answers to all the problems we face each day, we press on and do the best we can with the knowledge that God has already prepared the good works for us to walk in (Ephesians 2:10).

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The ‘What’ of Suffering

 

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Off the coast from Loma de Luz looking west toward Pico Bonito

Working at a tertiary care hospital in Honduras means that we are all too familiar with suffering in this world.  While we do have specialists who visit from time to time, our full time staff (an extraordinary group of medical providers) are constantly having to rise to new challenges both dealing with difficult cases (even for hospitals in the US) and navigating limited resources.  While God has done many miracles to either cure or save our patients’ lives, there are also many instances when our patients do not improve, despite our best efforts.

This past weekend, after overcoming so many obstacles and receiving around the clock intensive level care, a twin recently born at our hospital with gastroschisis passed away.  While watching the grief of not only the family but also the providers who gave their all to try to save this little ones life, I was reminded of an incident that occurred not long after we began serving at Loma de Luz.  What follows was initially written well over a year ago as I tried to process the suffering and grief I was not only seeing but was also having to enter into and deal with.  Thankfully, as I hope you will see, God walked with me through the hard questions that suffering brings and gave me, and if I may be so bold to include you as well, a purpose in suffering.

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Aerial view of hospital. The dirt road to the far left in the picture is the main road.

Every Sunday the hospital provides the opportunity for an “English” church to be held for the missionary community here as well as for visitors.  One Sunday last year was a bit different as we had a visiting Ophthalmologist who is also a Christian Apologist.  He gave a sermon on suffering. In his message he said that the most common thing to do when experiencing or seeing suffering is to ask, ‘why’. As an apologist he gave some possible responses to the question of ‘why suffering’ based on the bible. One possible response is that we suffer because of the consequences of sin, either our own or the sins of others.  The bible is full of examples of this including the death of King David’s son whom he had through an adulterous relationship with Bathsheba (2 Samuel 12:13-14).  

Another possible response, and had it not been said by Jesus it would have been an almost unthinkable response, is that we suffer to display God’s glory.  The context in which we find this radical perspective is with Jesus’s encounter of a man who was blind from birth (John 9). Jesus’s disciples, thinking in the context of the death of King David’s infant son, asked a logical question, “…Rabbi, who sinned, this man or his parents, that he was born blind?” (John 9:2).   Jesus immediately provides a whole new lens to view suffering through by replying, “Neither this man nor his parents sinned…but this happened so that the works of God might be displayed in him.” (John 9:3).  He then went on to heal the man’s blindness and sought him out a second time to offer him salvation, thus displaying the gracious and merciful works of our God.

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Aerial view of the hospital compound looking toward the coast.

The point of sharing some of these possible responses to the question of ‘why do we suffer’ is that the ‘why’ behind the suffering is not always evident or able to be known by us.  This message was especially timely as the night before we had a code blue at the hospital in which we were unable to resuscitate a 2 year old boy who we think went into shock from an infection.  I have no idea why this 2 year old boy was taken from his loving and caring mother that night or why more recently, despite initial miracles and intensive care, the twin passed away. I can wrestle with the question of ‘why’ for the rest of my life but God wants us to get beyond the question of ‘why are we suffering’ to the question of ‘what am I going to do with suffering’ or more specifically, ‘what am I going to do about the suffering that I see’?

It is in the question of ‘what’ that we have a responsibility.  Are we going to believe what God says about suffering and persevere through it or are we going to let it consume and overcome us?  My natural response is to shy away from suffering and not dwell on it or if I do, to get angry asking the ‘why’ questions. Jesus said in John 16:33,“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.”.  Over a year ago I had a front row seat to the great tragedy of the loss of a young life but I also experienced the hope to which God has called us as I watched my wife be the hands and feet of Jesus as she mourned alongside the grief stricken mother of the two year old. Then again, more recently, I saw the tender and loving care that our medical team provided and continues to provide to the family of the deceased twin.

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We are not here in Honduras to end all suffering, if we were, we would have burnt out long ago.  We are here to love others as Christ has loved us which includes loving others in the midst of suffering and pointing them toward the God who promises to walk with us, even through suffering (Matthew 28:20), and will one day wipe every tear from our eyes (Revelation 21:4). We can not do this in our own strength which is why your prayers are such a vital part of our ministry.  I hope and pray that you also are being the hands and feet of Jesus to those around you as you live out the ‘what’ of suffering in this New Year.

Feliz Navidad

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Christmas time in Honduras has been very eventful so far (mostly in a good way)!  There was a Christmas light display in the town square of Balfate (small town that is close to our hospital) including a visit from Santa.  Then the Children’s center affiliated with the hospital had its own Christmas party with another appearance from Santa and an epic “snow ball” fight (soft and cushy white balls where used).  We also have had alot of rain in a short amount of time which has caused the local rivers to flood, making them impassable to cars (good thing Santa has flying reindeer or, in our case, wooden canoes for crossing rivers).

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Photo op with Honduran Santa

One of the privileges of serving in Honduras, especially during the holidays, is having a front row seat to seeing transformed lives through God at work.  This past week I got to stand in awe of God’s work which he did through the people I am privileged to call co-laborers.

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Santa’s Little Helper

The first is a 37 y/o female who has neurofibromatosis type 1.  You may remember the picture of her foot from our past blog post in April 2019 (click here for a refresher).  Neurofibromatosis type 1 is a genetic condition characterized by the growth of multiple, usually benign, tumors along the nerves of the body.  Our patient had been living with two prominent tumors (one near her elbow and the other near her ankle) for most of her life and they were continuing to grow.  Our patient had been unable to find help for her infirmity until she came to our hospital and had an initial operation last year to remove a tumor near her elbow (which was the smaller of her two main tumors). The operation went extremely well and after much planning and preparation, she underwent another operation this past October with our visiting othopedic surgeon who happens to also be a foot and ankle specialist.

On her most recent follow up the patient was healing very well and was able to walk normally for the first time in many years.  We also did biopsies on both tumors as sometimes they can be cancerous and we are pleased to report that both were benign.

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AP and Lateral x-rays of 11 y/o boy when he first came to our hospital.

The second patient is an 11 year old boy who came to us with severe club foot of his left foot.  Usually children who have club foot are treated early on with bracing and if need be surgery (especially if they are not corrected by the age of 5).  One of the local churches in his area put him in contact with our hospital and this past October he received surgery to correct his foot deformity.  This past week he was finally able to begin bearing weight on his leg, walking with his foot flat on the ground for the first time in his life.  To say he was excited was an understatement as he and his mom could not stop expressing their gratitude, both to us and to God.

Both these patients received early Christmas presents through a small mission hospital on the northern coast of Honduras with limited staff who work hard and rely on God for all of our needs.  He has not failed us yet.  Great is His Faithfulness!

We wish you and your family a Merry Christmas and a Blessed New Year!

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Family Photo with Santa and our Honduran mentee (photo blurred for privacy).

What I never wanted to know about getting older

What I never wanted to know about getting older… as a woman.

About half of the Christian population in Honduras are catholic.  In our rural area, a practicing catholic family usually means that you have a big family. It is not uncommon for some of my (Alisa’s) patients to have 8-10 children! Unfortunately, many years down the road after having so many children there are some big changes that can happen in a women’s body (can I get an amen from my female readers who have experienced some form of these changes already?).

One change that I knew- like in a textbook sense- could happen in this population is called pelvic organ prolapse. It is exactly what it sounds like it.  It is when a woman’s pelvic organs (uterus, bladder, and/or rectum) prolapse, or extend out. Usually symptoms are related to a mild prolapse where the uterus is just kind of sagging a little. However, many women that I have come into contact with have severe prolapse.

Imagine my surprise when I first began seeing patients that explained that there was “something coming out below” and during physical exam I found not just a little sagging, but that a large part of their uterus (or entire bladder) was extending out from their body! These women have a hard time walking, completing their household chores and cooking, and doing much of any activity due to pelvic organ prolapse. After 8-10 pregnancies their pelvic floor muscles are just kind of worn out and can’t hold everything in anymore. Their organs are truly spilling out of their body.

prolapse-types
All you never wanted to know about women’s pelvic organs! We will spare you from the actual photos.

Thankfully there are a few treatments that we can offer our patients. There is a device called a pessary that lifts the uterus and bladder back up and a special surgical repair. Over the past two weeks in clinic I have had my schedule full of these women coming back for follow up (word got out that we can give some relief and all their friends started coming too).

One woman told me she can now hold and pick up her grandchild without discomfort. Another said she can clean her house normally for the first time in several years. And another is able to clap and sway in church. While this is kind of a weird topic for a newsletter, and isn’t as flashy as say a person regaining the ability to walk, it is another example of Gods mercies to alleviate some of the “light and momentary troubles” we face in this world.

And here is a picture of Alena to finish us off, because no one wants to see more pictures of uteruses. We hope you all have an excellent Thanksgiving and holiday season!