SUMMER 2003
GUATEMALA MEDICAL AND CONSTRUCTION
MISSION REPORT
JULY 14 – 23, 2003

This year’s medical/construction mission to the Western part of Guatemala was indeed an experience that could be sub-titled “Murphy’s Law”.  If it could go wrong, it did.   

This report is a day by day diary of events that highlights the essence of “above and beyond” commitment.  This team enabled a successful eighteenth medical and construction mission to the highlands of Guatemala.  Again, for the seventh year, we sent a 10-member clinic team to the central highlands to work with the priest and doctor, Padre Roberto Armas, in the local churches. This team stayed four days with the Padre in Quatzaltenango, sleeping and eating in his church.  His parishioners provided the cooking and the local police department provided the transportation to clinic sites.  Padre Roberto and his wife Cynthia, occasionally work with the winter team in the eastern section around Lake Isabel.  

First, our medical clinic efforts were frustrated by the Customs Clearing Facility.  We were not able to get our medicines cleared until the afternoon of July 19th, leaving us just Saturday morning to hold clinics where the medicines were most critical.

In spite of all the roadblocks, lack of cooperation from officials, and late arrival of medicines, the love of God showed through this team.  They were able to see and treat nearly 3900 people in 21 clinics over the four and one half days they were able to work.  

The high cost of U.S. pharmaceuticals necessitates the purchase of the majority of our medicines from Holland sources.  These medicines must be shipped to the country in which they will be used.  Therefore it is prudent to send an advance team to prepared the packaging and labeling of these medicines for the clinic pharmacies.

The U.S. medicines are delivered locally and are prepared and labeled for each clinic.  That work was accomplished with local team members, meeting for at least two Saturdays to complete this task.  These teams are also responsible for the huge task of packing all these medicines and supplies into duffel bags which are then tagged and labeled as to the contents. Each team member on the trip is assigned a duffel bag as his/her additional check-in piece of luggage. These medicines will be combined with the medicines from the advance team and worked into individual clinic kits.  After each clinic, each pharmacy will be re-supplied from the general “pharmacy” at base camp.  This is a tremendous logistic endeavor. 

During the days when the critical medicines were still in Customs, the team members showed God’s presence in charity and mercy by contributing a total of $275.00 to purchase some of these medicines from the local pharmacies.  In addition, this team also contributed a total of  $1,700.00 of their own monies to support four surgeries.  This has not been done before in the mission’s twelve-year history.  Local physician and hospitals were employed to assist four patients who were originally seen in the clinic.  Through the efforts of Melinda Hamilton and Sara Crenshaw these four people are back in good health. The Guatemalan physician and surgeon agreed that treatment was necessary for the health and welfare of the patients. I must say that this physician and young surgeon in a private hospital in Guatemala City did these four operations on a Sunday morning. The operations were: (1) hysterectomy; (2) remove a large growth from a young boy’s ear; 
(3) repairing a hernia on another boy; (4) and resetting a broken arm so a young boy could bend his arm.

During one of the clinics, a 13-year girl had a grand mal seizure. “She had been on medication that they no longer could afford to buy ” the mother said. Money was donated to buy her medicine for 50 days. Dr. Jerre White, the team’s doctor plans to send her enough medications for a year.   

The Mission 2003

Wednesday, July 9th
	The advance party departed Pensacola airport at 12:20 p.m. for a non-eventful flight to Guatemala, C.A. with a stop in Atlanta. This stop enabled the team to enjoy some of their favorite foods before departure.
	Arrival at the Guatemala airport was going as usual until we came to the custom area. For the first time in many years the custom officers wanted to inspect the medical supplies which we carry in duffel bags. Within the first couple of layers of the first bag, an agent discovered some medicines that had expired one month earlier. After two hours in customs, going through all six duffel bags and the agents taking a large trash bag of  “expired” medicines away, we were waved through. This experience gave this advance team, after much discussion, a new procedure for labeling and packaging medicine for future missions. 
	The team arrived at La Villa Motel in El Tejar at 10:30PM.  Every one received their assigned room keys, went to their rooms, and enjoyed a most deserved nights sleep. To our surprise, the cool evening turned unusually cold. The next morning all asked for additional blankets for their beds. 

Thursday, July 10th:
	This day started with Morning Prayer, with our coats on, and then a good breakfast. The team had to set up tables in the hotel driveway, as the Salon (meeting room) usually given to us, was booked for a conference the next three days. The hotel management was kind enough to provide us with two adjoining rooms for our work, at no cost to us. We started checking our six duffel bags, the many bags and boxed that were left in storage from the last winter medical trip, and previous missions before that. We checked each bag, and read every label and discarding any medicines that were expired. We counted, re-labeled and re-packaged all the medicines in our possession.  These were then divided into four “kits”, one for each team. 
	Initially, we expected to receive all the Holland medicine in country by July 8th. Our next correspondence stated the medicine would arrive July 10th. .  The next information stated that the shipment would be in two parts and would be delivered to our hotel sometime on July 14th or early on July 15th.  None of this happened. 
While most of us were working on the medicines, Geary Gaston, leader of the construction team was taking an inventory of all the construction tools that have been left in storage since last summer.  Much to his dismay he discovered that most of the tools and other supplies were missing.  Since all the tools had to be removed from the Cathedral last January and stored in another facility in Antigua, we assumed the other tools were overlooked at the Cathedral. Since I would be going to the City, I volunteered to look for the missing equipment.  We learned a long time ago that we need to remain flexible; “best laid plans…” 
	The checking, counting and packaging of medicines continued through the day, with a lunch break in between.

Friday, July 11th:
	The day started with Morning Prayer at poolside, now with just sweaters, then a good breakfast. The construction team leader left with Timotao Pasturer, the Engineer of the Cathedral, to pick up materials for the summer mission project.  Their plan was to build a playground for the children at the Episcopal Church schools in Villa Nueva. This project was to include two sets of swings, basketball court, and volleyball set up. 
	I also departed for a meeting with Bishop Guerra in the city, which never was able to take place. Bishop Guerra was stuck on the highway during a demonstration of construction workers that had blocked the highway with their equipment.  This blockade had to be cleared by the Police.  This incident happened on the road that the construction team would travel the next four days. 
On searching through the storage room of the Cathedral, I did find the two duffel bags and a large plastic box that was used for tool storage. I brought these back to the motel for the Construction team leader who also returned by noon. All of us joined in to continue checking, counting, and packaging of medicines. When all of the construction tools had been assembled and inventoried, it was discovered that the plastic box had been broken into and all the “hand” tools were missing. Some of these tools were vital for the construction project.  A list of missing equipment was given to me and I called the Bishop and mentioned the problem. He asked for the list, and he promised he would try to recoup the loss from the local contractor who they had been using them to construct a building on the Cathedral property. The team worked until dark, then  packed everything away into the motel rooms, and called it a day. 

Saturday, July 12th:
	Again the day started with Morning Prayer at poolside.  The weather was still cool but beginning to warm some.  I had called home to ask that a sweater be sent to me with the team that was coming down on Monday. Another good breakfast, this morning with Pancakes, scrambled eggs and bacon.  	
	Word was received that the medicines were at last in country, but we would not be able to receive them from the custom agent until “probably Monday July 14th”. Fortunately the advance team was able to set up four complete team kits and two duffel bags for each team to work with when the clinics would start on Tuesday.
	All medicines have been counted, bagged, and packed. The Construction leader had returned, our work area was cleaned, and no clinic to go to.  Our morale was low.  I made the decision to call a vehicle and take a trip to Antigua for lunch and a walk around the city a bit. I had already made arrangements with Gustavo Somaya and his wife Judy to have the evening meal with us. We had the meal at an excellent restaurant “NU-FI, NU-FA”.  We enjoyed good food and fellowship with our brothers and sisters in Christ.
	I must explain that Gustavo has a travel/tour agency in Antigua, who has, along with his busy business schedule, for the last six or seven years done a Herculean job for both the summer and winter teams. Gustavo works to get our medicines out of customs makes transportation arrangements; sets up hotel reservations for the team, for nothing more than our thanks and what Gustavo and Judy call their Christian duty.
	A van ride back to La Villa, El Tejar and a much needed rest, as this team has worked very very hard to get everything ready for the main team to arrive on Monday July 14th.   The break lifted our spirits.

Sunday, July 13th:
	We had an early breakfast for an early departure from La Villa to the Cathedral of St. James in Guatemala City.  The English service was officiated by Bishop Guerra.
	After the service the congregation of St. James had a reception for the team.  Back at La Villa, some of the team members jumped in and finished the task of dividing and counting medicines, moved the team kits, duffel bags, and miscellaneous materials to the second story Salon.  This is the place where the teams come to restock their medical supplies. After work was completed, we relaxed, looking forward to the medicines and teams arriving the next day.

Monday, July 14th:
	The day started with heavy rain. I departed La Villa at 4:30am for the city to pick up 3 team members arriving on early flights. One was from California and two from Illinois. These three were given their rooms and they departed immediately for bed, as they had been flying all night.  The advanced team continued making arrangements for the arriving evening team.  Their job was to make sure rooms were made ready, keys made available, and any other needs they might have.  At 5:00pm I again departed for the city to pick up the team members coming in from Florida, Alabama, Ohio, Georgia and North Dakota, which were all to arrive within 20 minutes of each other. Due to bad weather, all the flights were delayed for approximately two hours. The first group arrived an hour late, but the North Dakota group was not to arrive until much later. The bus with the first groups departed and a van was to wait for the North Dakota group. The first people arrived back at La Villa at 11:30pm. All the duffel bags were deposited in the Salon, people received their room assignments and keys and all departed for a good night’s sleep. The North Dakota people finally arrive at 12:30am. They were treated to the same hospitality and they departed for a good night’s rest. These teams had no trouble with customs at the airport, maybe due to the late hours.   That is another example of how circumstances can change from minute to minuet.  “Best laid plans…”.    
	Unfortunately, it was noted that some of the bags did not make it on the same plane as the Pensacola group.  The bags were due to arrive the next evening, which means another trip back to the City tomorrow evening. 
	We still have not received the medicines that have been sitting in Customs since July 8th. New regulations have caused this delay in which Bishop Guerra could not expedite. 

Tuesday, July 15th:
	Another cool morning started with Holy Eucharist and a short meeting then we went to breakfast. The Xela team departed for their clinics in the area around Quatezaltenanco. I kept back the pharmacists’ assistants and one person from each team to count and pack the medicines that were brought down in the duffel bags the team members carried.  After inventory, the medicine was distributed into kit locations for the next days clinics.  By noon all the medicines, toys, soap, toothbrushes, and toothpaste had been divided among the four teams. I then called for a vehicle to take these people to one of the clinics so they so they could begin to experience the work they had come to do. Unfortunately the driver was unable to find the locations of the clinics, even after receiving additional directions. After driving around an hour or so they returned to La Villa. 
	I placed a telephone call to our diocese and spoke to Canon Dunnam.  I explained our frustration about our medicine shipment being held in customs.  I requested Bishop Duncan send a fax to Bishop Guerra explaining our situation and how we would appreciate any help we could get in releasing the medicines. At present, it is a “new” regulation that limits “not for profit” organizations to only two medical shipments in one year. We were at two shipments over the limit, and without a registered import agent we were not to get our shipment. Bishop Guerra could not be our registered agent.  He is concerned that it might change the status of the Cathedral.  I do not understand, however it is probably more complicated than I know.  We will find an agent somewhere.  These  medicines are needed by the people in Guatemala.  We came here to help them and we are very limited without the needed drugs.
	At 4:00pm I again called the Delta baggage supervisor to check on our “lost” luggage. But it was no where to be located. I was also informed that a claim for lost luggage must be in writing before a passenger leaves the airport.  I was told to call back after 8:00pm to see if it got on tonight’s plane from Atlanta.  One piece of luggage that was thought to be lost was found back at La Villa. 
	Our efforts to retrieve the medicine ends again as the Custom house closes at 5:00pm.
	All the teams returned to La Villa by 5:30pm after a full day’s work. Team reports were given after the evening meal.  Everyone seemed to have a good day despite the lack of some medicines. The Mission Team ended the day with Compline, and turned in for the night. 

Wednesday, July 16th:
	The day started with Holy Eucharist, a good breakfast, and teams were on the road by 8:00am. Jim Smith and I left for the City to visit the airport and personally check on the baggage, as well as stopping by the Customs agent to check on the status of our medicines. In talking with the airline agent, we ran into “another” problem. Since the missing bags were not claimed on Monday evening, there was no way they could be traced. According to the agent, “since 911” all bags left unclaimed for more than 24 hours would be taken away.  Since this seemed unrealistic to us, we convinced the Delta agent to let us file a claim for all15 bags. Hopefully, using all of the identification numbers we might find the four missing bags. I called Gustavo in Antigua to see if all the customs’ paper work had been completed and maybe we could get the medicines. All of the paper work from us was complete, money paid and we were close by, we thought we could just swing by and get our meds.  I was informed that the Custom agent had told Gustavo, that IF the Bishop would submit a “few” papers, we could have a one time temporary permit to pick up the medicines. The Bishop did consent this time and Jim and I dropped by the diocesan office picked up these papers and deliver them back to the custom house. Bad timing for us, the Custom House closed at 5:00pm. We went to Antigua and gave the papers to Gustavo who would have our “temporary agent” arrive early in the morning at the Custom House to pick up the medicines. The man sat in the long, long line from 10:30am until 4:00pm before he was close enough to have the door close on him.   
	All the teams returned to base by 6:00pm. Team reports were given after the evening meal. All participated in Compline then turned in for the evening. 

Thursday, July 17th:
	The day started with Melinda Hamilton’s team leaving early in the morning, eating breakfast on the road, for a long 2 hour ride to the clinic site. The remaining personnel had Holy Eucharist and breakfast then on the road again, departing for their designated clinics sites by 8:00am.
	I called the Delta representative, wasting 20 minutes on my phone card sitting on “hold”, I finally talked with the baggage agent who reported that they had still no knowledge as to the whereabouts of our bags. I then spent 30 minutes between the Delta agents’ office and the baggage supervisor, and was told to call back in four hours. I did call back in four hours, and was told that I had to call an 800 number to get the real deal on where our bags were. On calling the 800 number I was told I would have to call the baggage agent in Guatemala, as they could not help me. On questing why she could not help me, I was informed that she was in San Palo, Chili. 
	Hope yesterday of obtaining the medicines has hit a blank wall again. The custom agent said he would release the medicines, but now the tax agent refused to release without “one more paper to be signed.”  Bishop Guerra informed me, “I have signed all the papers I am going to.”  Gustavo talked with the diocesan engineer, Timotao Pasturor who, back in the early days of our medical missions did all this work for us. Timotao said, “I just had to walk around and knock on doors” and that was a lot of work. But the old adage of “do not make a women mad” paid off for us. Gustavo found a secretary that was a little upset at her bosses and he was able to get the papers through without the additional signature, due to a “computer glitch?” That, unfortunately, is the way things are usually done. Now we could receive the medicines, but it was 5:00pm and the Custom Office was closed. 
	Again we wait – Medicines that we do have are rapidly being depleted.  Team members are purchasing medicines at the local “Farmacias” to enable them to continue with the clinics.
	All teams were back at La Villa by 6:00pm. Evening meal at 7:30pm, after which team reports, Compline and then to the beds. 

Friday, July 18th:
	A good night’s sleep was had by all the very tired team members.  With the morning Eucharist and a typical Guatemalan breakfast under their belts, all teams left for the heather-lands by 8:00am. 
	The Construction team, having completed their project at the Canterbury School in San Jose Villa Neuva, were given a small party from the children, with each member receiving a certificate of gratitude from the school children, for their new play ground. 
	I made “another” trip to the Guatemalan airport to check on the lost bags. Not taking “they are not here” for an answer, I requested to see the baggage supervisor.  After a short discussion, the storage room was opened and I saw for myself that NO team bags were there. I did receive additional information about the bags.  They had all been loaded on the plane in Atlanta. Enough of the bag situation. Maybe someone needed the medicines more than we did. After a through investigation of digging through trash bags and matching up bag tags, I surmised that “IF” we did loose any bags it was only one.
	Gustavo’s driver called at 4:30pm and reported that he had the medicines out of customs and we could come and pick them up. Dan Krueger and I were in Gustavo’s office picked them up from the driver and delivered them to La Villa at 7:30pm.
	All the teams were back by 6:00pm and were eager to get the medicines that had just arrived into their team kits and be ready for the morning.  All of this was done before supper, leaving all the rest of the medicines we did not use still in their boxes.  This made counting and inventory much easier on Saturday evening. This was done to enable us to give the winter team an accurate count on what they had to operate with and also what they had to order for themselves.  We also placed quite a few medicines in a large bag to send back Xela with the driver.  This was to re-supply Padre Roberto with worm medicines and other medicines that our team had borrowed from him so they could work and keep the clinics open. 
	The evening meal was a quite a bit happier that it had been all week long. Team reports were given, then Compline, and then to bed.  Tomorrow we still have clinics to visit in the morning.

Saturday, July 19th”
	 This day started again with morning Eucharist and another great breakfast with the especial of La Villa, Paenkick’s, sliced fruit, mashed black beans, and scrambled eggs.  Only two teams departed for clinics, with the third staying back in La Villa to hold a walk in clinic in the Salon for motel employees, their families, and anyone else who came by.
	The other two teams returned to La Villa around 1:00pm broke down their team kit and bags, placing all the medicines in containers ready to make the inventory easier.  This was in preparation for on Sunday afternoon departure. 
	The Xela team was very late in arriving back. I was getting worried, so I tried to contact them via telephone, but Padre Roberto said they had only left and hour or so ago. At 7:30pm after staying four and one half days at the 9,000ft altitude, they were glad to get back down to 5,000 ft.  We held off supper for awhile to give them time to put their gear in their rooms and wash up a bit. After dinner we had the Xela team give us a day by day report on the week’s events, which were very interesting as they had some great after clinic experiences. 
	A great evening meal was had by all, with Bishop Guerra and wife Norma, Padre Lucas Choc and wife Irma as guests. Gustavo and Judy were unable to attend. Note of interest – Padre Lucas with family never missed a meal, especially the evening meal.  The La Villa management presented the team with two delicious well decorated cakes. In addition, a letter was read from Dona Rasquel Mendes, the owner, thanking us for staying in her establishment. She was ill, and could not come personally as she had always done in previous years.  The team had all chipped in money, which is a team tradition, to give all the help at the motel a tip.  This included the ground keepers, house keepers, cooks, waiters and office personnel.
	The team stayed up a little later than usual this evening to celebrate our success and to enjoy the Marimba band.

Sunday, July 20th:
	The team slept in a bit, and had breakfast little later than usual since we were going into Chimaltenango to have our church service at Padre Luca’s “Cathedral.”  This is the church that the summer teams have been putting money into and working on for the last four years. They still have a long way to go before it is completed. The summer construction team is committed in 2004 to another project, which is to build a storage building for our left over supplies between missions.
	The service was in Spanish, as expected, but Chan West and Stephen Baird did their best to help out with the translations for the Gringos. 
	I received, for the team, a beautiful weaving from the Iglesia Espiritu Santo, San Andrus Itzapa, one of the clinic sites. This was hand woven for us and it reads: “Gracias Jornada Medica 2003, Iglesia Episcopal Santo San Andres Itzapa.”  Their gratitude was very touching. 
	After church the team returned to La Villa, picked up luggage, got on a bus and two vans, and departed for a two day R & R in Antigua, C.A. This departure makes the medical mission officially over and everyone is now a tourist.  This is where I loose control over them as a team, as if I ever had any in the first place.   

	As team “Chief”, I cannot give enough praise to this group of committed Christians for the hardship they endured, long walks up and down hills, their ingenuity, resources and their own money in keeping the clinics running.  As team leader for eight of the twelve years that this Diocese has been sending our medical teams to Guatemala, I can say that this team was with out reservation somewhere way above and beyond the norm. 
	In twelve years we have learned to cope with minor irritant problems, but Murphy’s Law rained supreme this year. If it was going to happen --- It did. 
1.	Medicines supposed to be out by July 8th were not received until July 19th, one day before the mission ended.
2.	Drivers could not find two of the designated clinic sites.
3.	One clinic site was scheduled in a “gated community” where there was no need of charitable medicines or medical attention. 
4.	The problems in getting the missing duffel bags
5.	Doing the paper work properly through the correct channels which led to further delays and frustration.  The “old way” prevailed.  This list could go on and on. 

Things that will have to be different:
1.	We are presently working to obtain an organization that will be our in country agents who will receive our medicines ahead of time and have them ready for us to pick up.  We are in conversation with an agent at present.  This will probably cost us a donation.
2.	In ordering medicines, we will have the winter team order for the summer team and vice versa, so the medicines arrive in country at a minimum of two months in advance. An accurate and detailed inventory must be kept in order for this to be successful. 
3.	Investigate a way in which we can include in our mission budget, a way to provide transportation for patients to the charitable hospital in Antigua when surgery or special procedures are needed. We have obtained a list of volunteer surgeons that visit the hospital during the year.  In our absence, the local priest can help schedule patients. 
4.	This list also can go on and on.

TEAM ROSTER
Mission Coordinator, Summer 2003:    Duane Leifur
Doctors: 	Dale Gauvin, Alan Turnham, Jerre White, John Baird
Providers: 	*Sara Majors, *Melinda Hamilton, *Pam Pranke, Angela Shinabery, Linda Fontenot, Claire Nieubahr, Susan Caulfeild-James
Nurses:	Lorrraine Gahagan, Alyce Heer, Conne Heer, Jane Berglund,
		Esther Lofton,  
Med Students: Noelle Blue Arm, Rebekah Berg, Jolene Dunn
RN Students: 	Carrie Wright, Emily Miller
Pharmacy: 	Donna Chipps, Diane Engels, *Florence Crawford, Mary Syfrett,
		Donna Corneliusen, Anne Syfrett, Cynthia Ault, Jessica Ault. 
Linguists:	Kevin Connell, Chan West, Mariah Groome, Abigail Anderson, 
		Sara Crenshaw, Megan Little, Stephen Baird.
Lay/movers:	Jenny Turnham, Jim Smith, Isobel Fisher, Jim Andrews, 
		Jeffery Caulfeild-James
Construction:	*Geary Gaston, John Gahagan, Gene Omasta, Dan Krueger, 
		Franklin Little, Greg Huebner, Tim Shoultz, Curt Kennington.
Clergy:		The Rev. Denis Baum, Pastor Ben Shinabery

*Team leaders

Clinics sites visited:  Saragoza, Santa Cruz Balanya, Chupol, El Tejar, Chuguexa,
	Chumanzana, Chimaltenango, Chucalibal, Chichicastenango, Cerro Alto,
	Los Aposentos, San Jacinto, San Andres Iztapa, Patzicia, La Villa, 
Quetzaltenango, El Cedro, Chantal, Zunil and La Esperanza.

The Advance Team:
Katie Bell, Mary Blair, (who left us on 7/14 to continue their vacation), Esther Lofton,
Jim Smith, Geary Gaston, Gene Omasta and Duane Leifur

The Guatemala Medical Mission is God’s work with a great group of Faithful Witnesses to Christ.

Duane Leifur, Mission Coordinator,
 AKA, Big Daddy or Papa Grande
850-434-0628
leifurd@bellsouth.net