Firefighting Instructors Get Hot in Guatemala

Retalhuleu, Guatemala – The polar vortex wreaks frigid havoc across the United States. Meanwhile, AMEDICAusa firefighting instructors Gary Allcox and Neale Brown work in heat stroke conditions in the pacific lowlands of Guatemala.

Today’s class is the second stop of a ten day, four city mission, involving nine different fire departments. The participants are the Bomberos Voluntarios of Retalhuleu, and the new Bomberos Municipales of San Felipe.

Unfortunately, fire engines do not come with instruction manuals

– Neale Brown, President, AMEDICAusa

These training missions are an important part of AMEDICAusa’s programs to support and aid the first responders of Guatemala. “We never donate equipment without providing the training to use it safely and effectively.” Said Neale Brown, AMEDICAusa’s president and CEO.

“In this case, we are assisting the city of San Felipe, Retalhuleu, start their first fire department. ” said Brown. “We are sending them a donated fire engine soon, and we want to make sure that they are ready to respond on Day One. By pairing them with their more experienced neighbors, they can train together and learn to work more effectively.”

The classes are structured to teach and practice basic skills for firefighters and fire engine operators. Pump operations, rapid fire attack, hose loads and SCBA practice are the order of the day. The importance of mutual aid is also stressed by involving members from the two neighboring companies to work together.

In Guatemala We Just Call it Friday.

AMEDICAusa delivers relief supplies to the victims of Volcán Fuego in Guatemala

Guatemala, Central America – Friday, October 12, 2018 – Heavy rains and storms are causing flooding and evacuations across five departments (states). Volcán Fuego erupts, and a lahar descends along its slopes prompting more evacuations. Major roads are cutoff by landslides. A magnitude 5.8 earthquake shakes the Department of Escuintla. Volcán Pacaya, only nineteen miles from the nation’s capitol, erupts sending a cascade of lava down it’s sides.

In the United States, were this to happen all in one day and all in an area the size of Tennessee, we would call it a major disaster. In Guatemala, it’s called “Friday”. – Neale Brown, AMEDICAusa

This is just one day’s news from the country in which we work. This is why we spend so much of our time and effort assisting with the training and equipping the firefighters and other emergency services here in Central America.

There is no major airlift of technicians and relief supplies, no giant, multinational effort to assist. It’s up to the local firefighters, underpaid, under equipped, and stretched very thinly, to provide what rescue and relief they can. With second hand gear, often of 1980’s vintage…aging and often unsound vehicles, tools that are several generations outdated and little in the way of personal protection, the Bomberos are Guatemala’s only line of defense.

Getting to a Disaster before it happens

While most disaster relief organizations rely on their warehouses of supplies, large “relief” funds and on-call response teams, we believe that there is a better, more effective way to provide the relief. For large scale disasters, the reality is that it takes a minimum of three to seven days to get foreign teams on the ground. Once on the ground, it takes several more days to get organized. Only then do they begin to make an impact. This is helpful to the survivors, but no real rescues are made. For smaller incidents, unless it is particularly noteworthy, there is little, if any, international relief at all.

The sad fact is, those persons injured, lost or entrapped in a disaster need to be reached within the first few hours after the event. The local first responders, the firefighters and paramedics in the disaster zone, are the folks who truly save lives.

By pro-actively concentrating our efforts on training and equipping these men and women, AMEDICAusa, our partners and our donors, make a more effective use of our dollars. We have a much longer reach, and effect more lives then just showing up after the fact. And that kind of relief aid can save lives every day, on the incidents that do not make the international news.

Even on Friday.

Volcán Fuego

Flooding in San Marcos

Earthquake in Escuintla

Highway blocked by tree.

Volcán Pacaya

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Your donation to AMEDICAusa, of whatever amount, helps save lives in Central America

AMEDICAusa, Inc. is a 501(c)(3) Tax Exempt Public Charity.IRS # 81-0842688 Donations to AMEDICAusa, Inc. are tax deductible under IRC section 170.

Fire-Rescue Instructors Get “Schooled” in Guatemala

AMEDICAusa and REDS Team Fire-Rescue Instructors deliver school supplies in Retalhuleu, Guatemala

Annual Fire-Rescue School Takes a Break

Retalhuleu, Guatemala- It is a tough job. It’s hot, humid and the days are long. The logistics are difficult, the equipment minimal. So, it takes some tough, experienced people to train fire and rescue personnel in Guatemala.

Our annual Fire-Rescue school in Guatemala is a joint project of the REDS Team, of Garner, North Carolina and AMEDICAusa. Twenty-seven fire departments, the Guatemalan army’s humanitarian rescue team (UHR) and the Red Cross attended this year for classes including Water Rescue and Fireground operations.

After several grueling days spent in the water and on the training grounds, the instructors and the Army were given a little break. This morning, we loaded up the military truck with supplies and headed off to visit two local elementary schools.

When Programs Collide

Life for a child in rural Guatemala can be rough. Most parents work as subsistence farmers or campesinos on larger farms. Money is scarce, most living on about $1.75 a day. Clothes, books and even meals are difficult to come by. The grim statistics are that in Guatemala there are tens of thousands of school age children who are not in school. Simply because they can not afford the supplies.

AMEDICAusa provides a supply program to elementary schools in rural areas in Guatemala. Placing the basic education supplies directly into the hands of the students ensures that at least one worry is taken care of. Each packet contains enough supplies for about three months of school.

This is the first such supply trip that our instructors have experienced. But the crossover between our programs is not at all unusual. Because we work closely with the local fire departments, and the firefighters know EVERYBODY, we get many referrals of schools in need from them. Local firefighters also frequently serve as volunteers on our missions.

“Tough Guy” Hearts Melt, and it Isn’t the Heat

Our previous Fire-Rescue schools have always been at the Air Force base in Guatemala City. Logistically this was easier, and the City’s altitude provides a more temperate climate. But Guatemala City has no river, and water rescue classes require, obviously, water.

Moving to the pacific lowlands, where there are rivers, but also extreme heat and humidity, presented some challenges. However, it also gave our instructors the opportunity to see a great deal more of rural Guatemala, and to meet people outside of the fire service and military.

A classroom wall built of egg cartons. You use what you have in Guatemala.

An escuelita in rural Central America bears little resemblance to a typical elementary school in the U.S.. Construction is generally primitive. Dirt floors are common, many have bamboo walls, and electricity and running water are often only a dream. Fans or air-conditioning are unknown, even in the heat of the lowlands. The Ministry of Education provides a teacher’s salary, such as it is (around $300 usd a month), and not much else. It is one thing to know about the poverty of the Guatemalan people, it is quite another to experience it first hand. No where is it more evident than in a rural escuelita.

Our instructors are both shocked and amazed. Seeing how little these kids have, and how grateful they are for a little help is a humbling experience. Several are so moved that they offer to come back simply to help with more school missions. We will be glad to have them.

Practicing AMEDICAusa Goggles with the kids (photo: The REDS Team)

Time to get to work.

The kids are a little shy at first. We are far from the Guatemala City or the tourist towns of Antigua and Lake Atitlán, so the children have had little or no interaction with “Gringos” before. Breaking the ice isn’t difficult, teaching the kids how to put on our our “AMEDICAusa Goggles” does the trick, along with taking their pictures and simply asking their names and speaking with them in broken Spanish.

A lollipop break with the kids

Each child is given his or her own package containing notebooks, pens, pencils, erasers and, as a small bonus, a lollipop. Everyone gets into the act, exchanging a smile, a brief word or a fist bump as the kids get their packet. The time is too brief. While all of us could easily spend the entire day here, but we have another school to supply, and classes to instruct this afternoon.

Teaching students and soldiers to put on AMEDICAusa goggles

Fire Instructor Captain Allen Jenkins distributes school supplies and smiles in equal measure

Firefighter & Water Rescue instructor David Thompson exchanges a fist bump with a schoolboy.

Water Rescue instructor Kirsten Steele, herself a teacher, with Guatemalan school kids.

UHR soldiers distribute school supplies with AMEDICAusa

AMEDICAusa president Neale Brown during school supplies mission in Retalhuleu

Teniente (Lt.) Angela Werner of the Guatemalan Army UHR

Water Rescue Instructors Kirsten Steele and Emily Harrison with some new friends

San Miguel los Lotes – Guatemala’s New Pompeii

Dinning Table where a family was just sitting down for lunch in San Miguel los Lotes, Guatemala (photo: AMEDICAusa)

Nothing was Unusual in San Miguel los Lotes

Zona Cero, Guatemala – A quiet, sunny, Sunday afternoon in the small Guatemalan town. The only day off for most of the villagers who commonly work sunrise to sunset six days a week, toiling in the fields of nearby fincas or tending one of the myriad Tiendas (tiny convenience stores) that dot the towns of the country. Some are just home from church, some are sleeping off Saturday’s ritual night out. Kids are playing inside and out. Dogs roam the streets. Mothers and grandmothers are setting lunch, Sunday’s main meal, on tables outside. Dominating the skyline above is Guatemala’s most active volcano, Volcán Fuego, emitting a pretty normal plume of ash and steam…

https://www.amedicausa.org/wp-content/uploads/2018/08/Volcan-Fuego-Eruption.mp4

Volcán Fuego Eruption – June 3, 2018, San Miguel los Lotes (Caution: Strong images)

Gray. Just Gray.

An overwhelming monochrome moonscape strikes you as soon as you arrive. As if someone has filtered out all the color from the world and left only the slight variations of tone found in old photographs. What little color remains is muted, dusty and somehow sadder for its rarity. A child’s shoe here, a discarded plastic cup there… but not nearly enough to brighten the landscape. What few leaves remain on the scorched and dying trees are dull, drooping and grey/tan. A sudden and very hot winter has come to the land of eternal spring. At first, you see what appears to be a scattering of small houses, dusty, dirty, and empty. It is only when you look closer that you realize that you are looking at the second story, the single story residences having been completely buried.

This is, in fact, one of the chief dangers of San Miguel los Lotes now.

A Dangerous Path

There is the Volcano, of course. It remains active and new eruptions are not only possible, but likely. We have posted a lookout just in case there is any activity during our survey. We are five miles from the main vent, close enough that there is some danger. Lahars are a threat as well, but less so, since there haven’t been heavy rains in the last two or three days. Dust is less of a problem since the rains have compacted much of the finer ash that would pose a heath risk. Still, we are careful not to scuff our feet or raise more dust than we absolutely have to.

Partially excavated for access, the main street of San Miguel los Lotes (photo: AMEDICAusa)

No, the most serious risk we face at the moment is the buried, unmarked houses. Most have laminate roofs, either metal or fiberglass, not very well supported in the best of times, now carrying the load of many tons of ash and rock. Some have already collapsed, leaving sandy, crater-like depressions in the earth, adding to the feeling you are on the moon.

It would take just a little more weight, say your footstep, to collapse a roof, drop you into the void and bury you in the ash that followed.

San Miguel los Lotes Before & After Eruption (photos: DigitalGlobe)

Learning from Disaster

AMEDICAusa had, of course, been active in the disaster recovery from the day of the eruption. Messages from our friends and firefighter colleagues in Guatemala started pouring in within minutes of the event. Clearly it was much worse than the initial news reports. It became quickly evident that there was severe shortages of even the most simple of rescue and emergency medical supplies. That became our priority. Our staff and volunteers were engaged in the effort to get supplies to the shelters, hospitals and first responders for the first two weeks after the disaster.But identifying needs, arranging donations and distribution of supplies from the States is not the same as being on the ground.

To learn what was done and what wasn’t, what worked and what didn’t, I needed to go to Zona Cero.

When in Doubt, Call the Fire Department

My first call was to my long time friend, Comandante Vinicio Calderon, Chief of 32 Compañía, Bomberos Voluntarios, in Patulul. In addition to his duties as Chief of Department, Calderon serves as commander of an entire regional division of Guatemalan’s Fire Service, some 16 cities, including the area near Volcán del Fuego. Calderon was part of the command team, and intimately involved in the emergency response to the eruption.

Zona Cero is a restricted area, for many reasons, but primarily because of the dangers involved in just being there. No one is allowed in without legitimate need. CONRED (Guatemala’s version of FEMA) keeps a tight reign on access. Even with prior arrangement, it took several hours and a lot of paperwork to obtain my unrestricted pass from CONRED. (I was asked for next of kin information and to which hospital I wished to be transported as well as my normal travel documents… an ominous touch.) They do not allow media access and the press has congregated in a small, semi-permanent knot around the zone’s roadblock.

Neale Brown and Comandante Vinicio Calderon at San Miguel los Lotes (photo: 32 Cia. Bomberos Voluntarios)

On The Road

The military counts people in and out, as even with an official pass, only so many are permitted in the zone at a time. We were held at the military guard station for over an hour and were allowed in only when enough workers had exited to counter our entrance.

The first half mile of the journey into the zone from the checkpoint is eerie. There is a fine coating of ash over everything, but for the most part it looks undamaged, but deserted. Houses, stores, even cars stand ready for use, but remain empty. Occasional stray dogs wander alongside the road. I wonder who, if anyone, takes care of them. A low, gray, rocky hill in the middle of the highway marks our entry into the true Zona Cero. Beyond this point the pavement ends, covered in hundreds of thousands of tons of volcanic ash and rock. A highway crew is parked next to the buried village. They are working feverishly to reopen Ruta 14, the main highway linking western Guatemala to Antigua.

A Walk on the Moon

Accompanied by Comandante Calderon and three of his firefighters who were here during the initial response to the eruption, we climbed the ash hill into the ruins of the village. There is a smell. At first, just a faint whiff of sulfur, then the strong smell of corruption and decay. It waxes and wanes as we walk, but it is always there. An awful reminder that this is now officially a cemetery, with a great many bodies still unrecovered. The Fire Chief relates how difficult it was to abandon the recovery effort.

We walked through some of the buildings that were still accessible. A neighborhood restaurant and bar, the chairs and tables scattered and overturned. The small kitchen of a home. The shrine to Virgen de Guadalupe that somehow survived the destruction of the rest of its building. The firefighters pointed out where they were able to affect rescues, and the more numerous places where they recovered the dead. Search markings left by the responders remain on the walls of those structures above the ash. A paint mark meaning three dead found here, or more commonly, no entry, no survivors. Over there, they say, is where we recovered the children, indicating a breached cement block wall where five children were found clutching each other on a bed. I’ve seen the photograph. I won’t reproduce it here.

Firefighters deal with their burning boots at San Miguel los Lotes

Firefighters faced increasing injuries, damage to equipment, and were finally chased out of the zone, at a dead run, in an emergency evacuation due to a lahar. Command ordered all rescue and recovery efforts to cease. Difficult as it was, the risk to the responders outweighed the bleak prospects for any remaining rescues. It was unpopular. Families wanted their loved ones recovered. Firefighters wanted to keep working.

It was, however, the correct decision.

Lessons learned and What is Needed Now?

Despite the danger, and the difficulty of the task, both mentally and physically, the firefighters didn’t want to give up. Hiking boots fell apart, the glue melting and the stitching charred by the latent heat of the debris. Gloves wore out in hours, abraded by the glass-like volcanic ash. Eyes grew red and irritated by the dust, leaking around cheap construction goggles. Coughing and sneezing from that which penetrated the masks.

Questions remain about the initial circumstances surrounding the government’s response to the disaster. The authorities were apparently meeting about whether or not to evacuate the area at the time of the eruption. This has raised something of a political firestorm, but is not related to the emergency response to the disaster after the eruption itself. By all accounts, while there were some difficulties, the fire service performed well, even heroically, in the response. There are some training issues, but the biggest problems involved equipment, or rather, the lack thereof. Boots and gloves for the responders were used up at a prodigious rate. Not designed for intense heat nor the abrasive volcanic materials what few they had were soon gone. Simple masks and goggles capable of filtering out the fine volcanic dust were in short supply.

The end of the pyroclastic flow at the furthest edge of the village. (photo: AMEDICAusa)

The Scope of the Disaster

The official toll stands at 169 fatalities, though they are only counting those victims whom they have identified. Firefighters Juan Bajxac and Antonio Castillo were killed in the eruption. Both were members of 55 Compañía CVB, Alotenango. CONRED official Juan Francisco Galindo and Police Officer Donaldo Chután Enríquez also gave their lives.

Juan Bajxac and Antonio Castillo of 55 Compañía, CVB, Alotenango, Guatemala, evacuating people from a bridge moments before their death.

Unofficially, authorities in the Guatemalan government and rescuers within Zona Cero have told us the the actual numbers are closer to 3,000 dead. Several small villages, not mapped or named, are not included. Hundreds more sustained injuries, including life threatening burns.

3,379 people remain in twelve official shelters. Thousands more being sheltered privately with family and friends.

San Miguel los Lotes has been declared a National Cemetery.

Relief Efforts Continue

The shelters for the survivors are exhausting many of their relief supplies. One shelter, the Finca de Industria in Esquintla, told me that they will run out of food on or about October 1st. They are also short of personal sanitation supplies and cleaning products. Fortunately, one of our partner organizations, Sociedad Cívico Cultural Guatemala of Chicago, Illinois, is delivering more than a truckload of supplies to the shelters this week to help ease the shortages. (Though many of the canned and dried foodstuffs they shipped have been held at the border, “until it can be determined if they are expired”. They aren’t – I helped pack a lot of them.) A lot more will be needed before the survivors can be resettled.

Plans for that are moving with glacial rapidity.

Want to help? The survivors and the first responders of the eruption of Volcán Fuego need a helping hand. You can make a donation to AMEDICAusa easily and securely here.

Canalitos: How We Made a Fire Chief Cry in Guatemala

AMEDICAusa – Delivering the goods in Canalitos, Guatemala

Canalitos: Welcome to the “Red Zone”

The cantón of Canalitos, known in Guatemala City as Zona 24, is one of the poorest and most dangerous parts of a city already infamous for gang violence and extreme poverty. You venture there with some trepidation, and only with good reason. It is designated a “Red Zone“. Once denoting areas controlled by the insurgents during the civil war, Red Zone is now the term for particularly dangerous, crime ridden areas.

Canalitos Firefighters on scene with a 17 year old girl, victim of a gang shooting.

Emergency Services in Zona 24 are provided by the Bomberos de Canalitos. A small, very young Fire Department, their Facebook page is littered with posts of shooting victims to which they have responded. Since they have no fire engine, they run primarily out of a small “Ambulance”, a worn out Toyota mini-van. Formally the private vehicle of the Fire Chief, it is showing its age. Bucket brigades are used to control any fires. Independent of the two national Guatemalan fire organizations, they struggle for support. Asking a Quetzal (13¢ U.S.) a month, what few funds they have come in small donations from local residents.

Building a Fire Company in Canalitos

We do not do much work in Guatemala City. We have a relationship, of course, with the Bomberos Voluntarios and Bomberos Municipales, and both have their national headquarters in the capitol. But, by and large, the capitol’s fire companies, while underfunded, have more equipment and training than their rural counterparts. They protect, after all, the homes and workplaces of the country’s congress, bureaucrats and most of the nation’s wealthy.

Canalitos is different. Annexed into the city almost as an afterthought – Guatemala’s major watersource of is here – few of the city’s services are available to residents. Neither national firefighting group is really interested in investing in such a poor area. Of course, very little tax revenue comes out of the barrio, so it remains largely ignored by the government.

Enter Pablo Muralles and Angelica Garrido‎. Veterans of Guatemala’s Bomberos Municipales, they created a new fire department where none had existed. With the grandiose name “Asociación de Emergencias Medicas Bomberos de Canalitos” (ASEMBOC) they took on a small, run-down commercial building for their station While building the department, they recruited at-risk youth to form the core of their firefighting force. Creating an alternative to the gangs and violence is important to them.

AMEDICAusa meeting in Guatemala City with (L-R) Pablo Muralles, Angelica Garrido, and Marisol Martinez of ASEMBOC

AMEDICAusa Gets Involved

Guatemalans are a close people, even when far removed from home. Carlos Luna, a Canalitos native now living in Chicago, brought the fire department to our attention. Luna runs a large Guatemalan community group in the windy city, as well as “Marimba Luna Maya” an international youth music group. He also holds down an everyday job. Carlos is a busy guy. But he still has time to try and help out his native barrio. He contacted AMEDICAusa after hearing how we help the Guatemalan fire services, and put us in touch with Comandante Muralles. A meeting was arranged in Guatemala (to which the firefighters brought Rellenitos, one of my favorite Guatemalan foods) where we got to know the department and it’s challenges.

A Long Journey for Fire Equipment

Of the things Bomberos de Canalitos lacks, perhaps none are so important as protective gear for the firefighters. Helmets, coats, jackets, gloves and boots are difficult to find, and very expensive in Guatemala. Even more difficult is to find them in matching colors and styles to outfit an entire fire company.It is not at all unusual to find firefighters in 1960’s era fiberglass helmets, canvas jackets and gardening gloves. ASEMBOC had some, courtesy of Carlos and the Chicago Fire department, but not nearly enough. Could AMEDICAusa help them out?

We had received a great donation of black turnout coats and pants from Waldwick Volunteer Fire Department in New Jersey. An equal number of fire helmets, nearly new, came from the Huntington Volunteer First Aid Squad in Long Island, New York. Boots from Pennsylvania, gloves from North Carolina. Yeah, we can do it! But how do we get it to Guatemala?

It really Does take a Whole Village

About this time, Volcán Fuego erupted in Guatemala, and AMEDICAusa was involved in the relief effort. The aftermath of the eruption brought the chapín community in Chicago together in a relief drive for the folks back home. Donations of clothes, medical supplies, food and money were being raised, and a Guatemalan-American shipping company, ServiExpress, had even donated the shipping. Carlos Luna asked if I would be interested in coming to Chicago to speak and help out at their relief event. (He also promised me the best Rellenitos north of Tikal if I would do it.) Space could be found for some fire gear he told me.

Not wanting to show up empty handed, I managed to stuff enough sets of turnout gear, helmets, gloves and boots to outfit Canalitos into my little car and set out for Chicago.

Chief Angelica Garrido sheds a tear while receiving an AMEDICAusa equipment donation

“I may have caused

a Fire Chief or two

to cry during my career,

but never before in happiness”

– Neale Brown, AMEDICAusa

Fortunately the Guatemalan community of Chicago were spared the agony of my public speaking, but we loaded A LOT of boxes that night. Enough to fill a couple of tractor trailers with donated goods. Included in that haul were our firefighting equipment, soon to be on its way to Guatemala.

So, two emergency service agencies, one Chicago community organization, one shipping company, one Maryland based non-profit, several dozen volunteers, and several thousands of miles later, the firefighters of Canalitos are a little bit safer tonight. It makes me want to cry a little too.

Next we have to find them a better Ambulance…. anybody got one to donate?

No,really…I’m Serious. Call me.

Hard to say who should be towing who…

BLACK FRIDAY SALE! 50% MORE KINDNESS WITH YOUR DONATIONS!

Double Your Caring and Kindness with your Gift to AMEDICAusa.

140,000 Children in Guatemala Can’t Go to School in Guatemala due to Poverty. Every $2 you give allows us to reach one more child.

Its that season again, and we’re all absorbed in the question of what gifts to give. I invite you to consider a gift that lasts a lifetime…give a child in rural Guatemala a chance at an education.

Our program is designed to get elementary age students into school, and keep them there, by delivering the basic school supplies that they would not otherwise be able to afford. While this may seem a relatively low-tech program, it is actually a simple solution to a very large problem in Guatemala. At least 140,000 school age Guatemalan children are not enrolled in school. The principal reason: an inability of the families to afford the simple school supplies needed for their children. Most of these kids are in the rural and indigenous sections of the country where we are most active.

AMEDICAusa school supply mission in Champerico, Guatemala

AMEDICAusa volunteers, usually led led by Silvana Ayuso, our Vice President in Guatemala, deliver the supplies directly into the hands of the children. Based on the UNICEF “School in a Box” concept, we have modified it to suit the needs of Guatemala. Pencils, pens, notebooks, erasers…you get the idea. Even a small toy and a treat are included. Simple things, but a great boon to those who often make less than a dollar a day.

Rather than just send a box of supplies to a school, we have individualized the packets to ensure that the supplies actually reach the children for whom they were intended, and broken it up into amounts suitable for approximately 3-4 months. This helps insure that the items get used by the students, not sold or ruined in the often-challenging climate. We try and reach each school we supply three times during the school year.

We use our funds frugally. AMEDICAusa buys all of our supplies from wholesalers in Guatemala. This is not only vastly less expensive than in the U.S., but also saves us shipping costs (often more than the supplies themselves), and gives a little boost to the local economy.

Guatemalan firefighters delivering school supplies – AMEDICAusa

Besides the obvious educational benefits, this program also often serves as our gateway into the rural communities. It is the rare visit where we are not called upon to see, treat and/or transport a sick or injured child. This allows us to introduce our medical programs. Many of our volunteers are from the local fire departments with whom we work closely in our disaster aid and training programs. They aid us in delivering the supplies and help introduce us to the local population. It also the best introduction to Guatemala for our U.S. volunteers who are invited to participate in the school supply delivery missions.

We are in the midst of our annual fund-raising drive for next year’s programs. We are also soliciting partner agencies to help support the missions. If you, someone you know, or a group would be interested in helping, please feel free to contact me any time. Browse our website and let us know if you have any questions, and please…Give generously.

Thank you for your kind consideration,

Neale

Neale S. Brown

President, AMEDICAusa, Inc.

Giving the Gift of Education

.A Simple Gift That Makes a World of Difference.

AMEDICAusa school supply mission in Champerico, Guatemala

Guatemalan firefighters delivering school supplies – AMEDICAusa

Thank you for your kind consideration,

Neale

Neale S. Brown

President, AMEDICAusa, Inc.

Feed These Hungry Firefighters – Help A Brother Out!

The Firefighters of Guatemala Need Your Help.

Every year AMEDICAusa and our partners, The REDS Team, conduct a week long Fire and Rescue school for the firefighters of Guatemala.

FEED US! Crews take a break between drills, Guatemala Fire School, 2016

Because the various Fire Departments in Guatemala can not afford to send their firefighters for training, we provide the school free of charge, including room and board. (The average firefighter in Guatemala makes only about $300 a month). All of our U.S. instructors volunteer their time and skills, and arrange for their own travel. However, we do have expenses involved in the care and feeding of the Guatemalan Bomberos.

That is where you come in. We are in need of donations to cover the costs of feeding these first responders. Each six dollars we raise covers the costs of feeding and housing a fire fighter at the school for one day. Our goal is to raise just $4,000 over the next month to cover the costs for the entire class of firefighters. With your help, we know we can do it.

“Our goal is to raise just $4,000 over the next month to cover the costs for the entire class of 100 firefighters.”

Firefighter Safety Briefing Before extrication class, Guatemala Fire school 2016

This year’s school is focusing both on water rescue and engine company fire ground operations. 100 firefighters representing 50 fire departments from all over country will be invited back to the school. When they return home, they then become the trainers for their own department. By using the train-the-trainer approach we multiply our efforts (and your donations) many times over.

Please help us help our brother and sisters in Guatemala with your donation of any size.

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AMEDICAusa, Inc. is a 501(c)(3) Tax Exempt Public Charity.IRS # 81-0842688 Donations to AMEDICAusa, Inc. are tax deductible under IRC section 170.

Hurricanes, Floods, Wildfires, Earthquakes and Volcanoes

Guatemalan Firefighters practice a Mass Casualty Incident, Fire School 2016

These are just some of the challenges these firefighters face. Guatemala is home to frequent natural disasters and the Fire Service is the first line of protection for it’s people. Despite their often old and outdated equipment, they work and train hard. While we write this, Guatemalan fire crews are busy surveying their towns and cities for damage after this morning’s 8.1 earthquake.

The Firefighters Of Guatemala Salute You!

Guatemala Hospital Saves Lives Despite Critical Shortages

**Babies, Sand and Machetes…*AMEDICAusa interns at the National Hospital of Retalhuleu***

A child clings to life in the Pediatric Emergency Room

There can be no observers here.
I am “bagging” a three month old baby girl. She has been brought into the hospital limp, pale and unconscious and with a obviously swollen belly. She hasn’t nursed for two days and was fussy and inconsolable yesterday. This morning her mother couldn’t wake her and rushed her into the emergency room tied to her back on a motorbike. Now she is no longer making an effort to breathe on her own.

She is in septic shock, likely the result of an intusseception, a rare intestinal condition that can kill part of the intestine and cause life threatening complications. Her life is dependent on a small tube inserted into her throat and continuing to squeeze the attached bag to inflate her lungs every few seconds. I took over the job of breathing for the baby when the nurse’s hands began to cramp.

The doctor and a nurse struggle to get an I.V. into the child. This is always difficult in a baby, much harder when they are in shock. I offer to start an inter-osseous line, a procedure we would commonly use in the States in this situation, but the hospital doesn’t have the necessary needles, and a regular catheter would likely break before penetrating the bone. I continue to breath for the baby. Finally they manage to place a very small IV. It will have to do. We’ll continue this until the infant goes into surgery and other staff will continue to manually breathe for her through the surgery and over the next two days. There is no mechanical ventilator available to take over.

Welcome to the Hero Hospital

The Weather Worn Sign of the Hospital Nacional, Retalhuleu, Guatemala

The first thing you notice here is the heat. Unsurprisingly, the western Guatemalan lowlands are hot in the summer. The daily afternoon thunderstorms raise the humidity to truly oppressive levels. A coastal breeze helps a little when outdoors, but it doesn’t reach into the hallways or exam rooms to provide even a little relief. Other than in the operating room, the air-conditioning doesn’t work.

Fanning with a notebook, Doctor Lorena Yancor. and student attempt to keep cool in the ER

The commercial fans installed to compensate are victims of overuse and age and have long given up the ghost. Doctors and staff have brought in a few personal fans here and there, but they are small, and ineffective beyond a couple of feet. The patients, family and staff, crowded in to cramped spaces, provide an additional source of heat…and without ventilation, a source of smells that are best left undescribed.

The Hospital Nacional of Retalhuleu is the primary source of medical care for the poorest of the poor in this part of Guatemala. Part of the country’s two-tier national healthcare system, it serves those who don’t have a regular paycheck: the campesinos (farm workers), the indigenous, and the unemployed. Like it’s sign, it is worn around the edges. Nicked and dented by uncountable stretchers, the paint could use another coat. But it is clean and kept so by a squad of mopping janitors, who make endless rounds of it’s floors. The hospital is chronically short of medicines, equipment and even routine maintenance supplies.

Reading x-rays by window light

There is one, elderly, x-ray machine to service the entire hospital and the waiting times are long. The films themselves are read through an open window…as the light-boxes generally don’t work. The lab, though reasonably well equipped, is dark…because they don’t have the florescent tubes to replace those burnt out. CT scans, MRIs, and the other modern diagnostic tools are a wishful dream.

The tools available here are primarily the hands, eyes and ears of the medical staff, and they are surprisingly good. Many of the senior staff have been here since the Hospital opened some thirty years ago. Eschewing the more lucrative practices they could have in Guatemala City (some 90% of all of Guatemala’s doctors reside in the capitol city), they continue to practice here where their talents can be put to the best use. All have become excellent diagnosticians and instructors for the medical students that often rotate through the hospital as part of their training.

AMEDICAusa is a supporter of the hospital, donating medicines and equipment in support of their efforts to treat the poor. (Among other things, AMEDICAusa donated most of the equipment for their gynecology clinic, where they had previously been forced to to exams on an office desk.) This time we brought several crates of pediatric medicines…and two talented students from the United States to serve a volunteer internship in the hospital.

The Pink Sand

Four kids come into the pediatric emergency room with their father. They range in age from 4-10. All have makeshift bandages, dishtowels, t-shirts, scraps of cloth, around their hands and feet. Dad is limping a little. A medical student unwraps one child’s hand and guesses she has a nasty skin infection of some sort. I look at the family. All the kids have the same infection and only on their hands and feet? Something isn’t right. I have another of the kids unwrap his hands. Under the dirty towel, and under the pink layer of calamine lotion that Guatemalans put on any type of skin disorder, his palms are shredded and blistered. Chemical burns?

A Child’s Chemical Burn in the Pediatric Emergency Room.

Dad is dressed in the unofficial uniform of a Guatemalan campesino, a farm worker. Worn, dirty jeans, a second hand t-shirt and a beat-up cowboy hat. A machete scabbard is on his belt. I ask if he lives in el campo. Yes, he says. He works in the fields. Do they use chemicals there? Yes, sometimes. Whats wrong with your leg? He points to the kids hands… el mismo..the same, he says. I call the chief pediatrician over and explain what I think this is. I ask the kids what they have been doing over the past couple of days. Playing in the new arena rosa… the pink sand…that they dumped near our house.

It is an industrial, urea based, fertilizer. Apparently, no one thought to tell the farm workers it was dangerous. The kids have been building sandcastles with it, and walking barefoot through the spillage. Dad has the same burns on his leg from repeated contact as he shoveled it into wheelbarrows.

Organized Chaos

The only formal waiting room in the hospital is in the outpatient clinic. All the other patients, for the emergency rooms, labor and delivery, OB/GYN and so forth, must wait patiently in the hallways, or under what little cover is available outside. Lines form in the hallways for each service, a mixture of patients and their families. All chat quietly while they wait. Well kids scurry about, playing improvised games underfoot. Mothers quietly nurse their babies while exchanging news with friends. None seem disturbed by the wait, even when the occasional fire department ambulance patient is rushed in ahead of them. They know the drill.

Dr. Gilberto Morales

Overseeing the operations is Dr. Gilberto Morales. A dapper man, he manages to appear calm and cool while nattily dressed in always-pressed shirt, tie and lab coat, despite the heat. It would be easy to rage in frustration at the job he is required to do, taking care of thousands of patients without sufficient resources, but he remains unruffled. He orchestrates the staff, building, equipment and patients with admirable restraint and aplomb. He has set up a rotation for our interns – Emergency, Pediatric Emergency, OB/GYN clinic, Labor and Delivery, and Surgery – where they will both learn the most, and be most helpful. After a brief tour of the hospital, the interns are handed off to the respective department chiefs.

Rites of Passage
In Los Campos, the communities of the farm workers, young boys at the age of 12 or 13 are given their first machete. This universal tool, kept honed to razor sharpness and carried in decorated sheaths, requires some practice to use efficiently and effectively. Like a baseball player with a bat, there are a lot of errant swings before mastering the hand-eye coordination necessary to hit consistently. The emergency room often sees those who have swung and missed.

AMEDICAusa volunteer Efim Oykhman repairs a machete wound

“Mario” is a thirteen year old boy who walked in to the ER with an embarrassed grin and his dirty, and now bloodstained, t-shirt wrapped around his right wrist. No longer attending school, he has joined his father in the fields of a local finca. He was chopping weeds out of a sugar cane field when an errant left handed swing hit his wrist, rather than the noxious plant he was aiming at. His is the third machete injury we have seen today.

It will be the first that our intern, Efim Oykhman, closes himself. He has assisted and observed in several previous procedures, and now is ready to do it himself. Under the watchful eye of the surgeon (called in to rule out any tendon injuries), he closes the wound with eight deft sutures, a little antibacterial ointment and a dressing. Mario goes home a little wiser, and Efim has successfully performed his first surgery. Both are happy…and a little relieved.

Treat ’em and Street ’em

Pediatrician Dr. Carlos René Jaime González, a native mexicano, very patiently explains to the parents of his tenth patient of the day that the pediatric emergency room is not where minor routine illnesses belong. First they should go to the local Clínica de Salud (Health Clinic) in their area. Second, for more serious problems, to the outpatient clinic. Only the really sick or injured are supposed to come to the pediatric emergency room. The lines to the emergency rooms are full of patients that really should be in the outpatient clinic on the other side of the hospital, but that area is full and the wait times are longer. Many of the patients have “self triaged” to the emergency room, and there is no staff to prevent that. The doctors are resigned to this, though it takes up valuable time. It also means that some very sick people are waiting outside, while less seriously ill manage to be seen first. Dr. Gonzales frequently checks the hallways to make sure a seriously sick or injured child isn’t waiting.

Dr Carlos René Jaime González and AMEDICAusa Volunteer Daria Smoliarchuk Discuss a Patient

The doctor’s at the Hospital Nacional don’t have the time to get to know their patients well. There simply isn’t enough time in a day to take detailed family histories nor fill out many forms. In Dr. Gonzales’ pediatric admitting room, the patients come in, get a quick once over and basic history, a rapid but thorough exam, then either medication samples off the shelves (yes, drug salesmen come even to Guatemalan ER’s) or a prescription for medicine from the hospital pharmacy (free) or their local farmacia if the hospital is out of medicines. Total elapsed time…maybe five to ten minutes for the average patient.

Few make it beyond the anteroom and into the three treatment beds in the pediatric ER. Those are reserved for those truly in need of emergency care. A asthmatic child working on his fourth nebulizer, a ten year old with a fractured arm, and our 3 month old with sepsis.

Our “Countess Dracula” Gets Her First Case

AMEDICAusa Volunteer intern holds retraction during surgery at Hospital Nacional Retalhuleu

Back in emergency a young woman comes in with severe abdominal pain, nausea, vomiting and fever. She has been suffering symptoms for two days. Dr. Lorena Yancor, Chief of Emergency services, checks in on the patient demonstrating techniques for abdominal assessment for our interns, while I translate and explain what she is looking for and why. This is why our interns are here, to learn to examine patients without the diagnostic tools available in the States. The patient has all the classic signs of appendicitis . A surgeon is called and he demonstrates again the same skills, as well as a couple of advanced techniques to confirm the diagnosis. Off to surgery she goes for an emergency appendectomy. The surgeon asks our intern if she would like to assist. Daria, drawn to blood like a moth to flame, and who appears magically when ever a patient comes in with an open wound, readily agrees. As it turns out, the surgery was just in time, and was more complicated than first thought. As the surgeon opens the patient, her appendix ruptures.

Twin Problems for Hospital Births

Prenatal care is still a rarity for most women in Guatemala, particularly in the poor and indigenous communities. Often a woman will go through her entire pregnancy and delivery without any medical care at all. Health and sex education is lacking, brought here only by NGO’s like AMEDICAusa and it’s partners.

Birthing in Guatemala is often attended by midwives, comadronas, who are largely untrained in modern medical techniques. They often rely solely on traditional indigenous practices and beliefs. Some are very good, and have received additional training from NGO’s and limited government programs. As a consequence, many of the births done in the hospital are complicated, referred here by midwives skilled enough to recognize problem pregnancies.

During our intern’s rotations in the OB/GYN clinic, labor and delivery, and surgery, fully half of the births were cesarean and most of these births were performed on an emergency basis. Prematurity, age of the mother (both very young and very old) and undiagnosed maternal medical problems are common issues.

“Maria” is a 19 year old woman who came in to the OB/GYN clinic with painless vaginal bleeding in what appears to be her third trimester of pregnancy. She doesn’t know exactly when her last period started, but she thinks it was last November or December, either eight or nine months ago, and she has had no prenatal care.

Healthy twins delivered by emergency C-Section at Hospital Nacional Retalhuleu

This is her second pregnancy – she had a healthy baby girl two years ago. Maria has been “spotting” off and on for a couple of days, but has more bleeding today and is having some irregular contractions. Her external abdominal exam reveals TWO fetal heads and possibly two sets of heart sounds. She is sent for an ultrasound, which reveals not only twins at about 36 weeks gestation, but also Placenta Previa, a condition that threatens both her life and those of her babies. An emergency c-section is called for and our interns are there to assist.

Medicine in a Disaster Zone

Once delivered, our twins are moved to the neonatal ward. Like all the other wards, the patients here are grouped together in large rooms without walls or curtains to separate the beds. The neonatal ward is a stark reminder of the disasters that are often visited on Guatemala. A large fissure has appeared, running vertically down a structural wall. The crack is the result of a 6.6 earthquake that occurred in June and effected the stability of the structure. The epicenter of the quake was 35 miles from the hospital. One man was killed, crushed by a wall collapse about a kilometer from the emergency room. The entire neonatal unit is going to have to be moved for safety until repairs can be made.

Earthquake damage in wall (L) of the neonatal unit of Hospital Nacional Retalhuleu

Outside the hospital, ash and steam clouds can occasionally be seen rising from explosive Volcan Santiaguito some 15 miles to the northeast. The hallways in the hospital have discrete triage system markings denoting catchment areas for patients in case of mass casualties.

They are as prepared as they can be, but shortages of supplies and equipment are worrisome.

Did you know?

AMEDICAusa provides support and equipment to the Hospital Nacional of Retalhuleu and other medical facilities for the poor and indigenous peoples of Guatemala. We can’t do it alone. Your donations are what make our programs possible. Please give generously.

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6.9 Earthquake strikes Southwest Guatemala

Victim is rescued from Church collapse after Guatemalan earthquake.

Early Morning Earthquake claims at least one life.

Retalhuleu, Guatemala- A violent earthquake collapsed a portion of the Catholic Church in San Sebastian, Retalhuleu, Guatemala early this morning. 30 year old Juan Francisco Esteban Javier was sleeping inside the church. Though rescued alive from the rubble by firefighters of Retalhuleu’s 11 Compañía CBV, Javier later died of his injuries at the local hospital. Sadly, the first confirmed fatality in this morning’s severe quake. An elderly woman has reportedly perished of a heart attack resulting from the temblor in nearby Malacatán, San Marcos, Guatemala.

Landslides and Damage to Buildings widespread.

Retalhuleu’s Fire Chief, Salvador Matheu, said that the older Spanish colonial buildings were the worst affected. Firefighters and city officials have been surveying the damage throughout the city.

“There is damage to the Old Cathedral and the Governor’s Palace in the historic Central Square.” said Matheu. “and even some to the Fire Station. Newer buildings haven’t been damaged as much.”

Firefighters prepare to move leaking tank of chlorine gas after earthquake.

A chlorine gas leak at the city’s water treatment plant became the most immediate problem after the rescue. The earthquake had fractured a supply line from the supply tank to the plant causing an uncontrolled release of the deadly gas.

“We don’t have hazardous materials suits, so the best we could do was move the tank as far as we could from the houses nearby, while wearing our firefighting gear.” said the chief.

In the nearby town of Santa Cruz Muluá, a portion of the old Catholic Church collapsed and the municipal building was damaged. Maydi Aguilar, an official of the municipality said “We have reports of houses damaged and collapsed both town and in the villages but, thank god, no injuries reported yet.”

The main highway linking Retalhuleu with Quetzaltenango, two of Guatemala’s largest cities, has been blocked by multiple landslides and a possible tunnel collapse.

Officials Breathe a sigh of relief after earthquake.

Reports of serious damage are coming in from firefighters and officials all around the area of the earthquake. However, most of our reports have said one thing in common. It could have been much worse. San Cristóbal, Totonicopán reported damage to buildings, but no known injuries. Quetzaltenango, Guatemala’s second largest city reported extensive damage, but few injuries. Even towns closer to the epicenter, San Marcos, Malacatán and San Pablo, report few injuries, though the power is out in those areas. The epicenter of today’s earthquake was deep and in a relatively sparsely populated region of the country. This is thought to have limited the human toll. For comparison, the 1976 Guatemala Earthquake killed 23,000 and injured 76,000 more.

Experts say aftershocks are possible over the next few weeks and maybe as strong or stronger than the original quake. Residents of the region are being urged to take precautions.

Update: 9:32 pm EST: The Institute of Seismology, Volcanology, Meteorology and Hydrology (Insivumeh) said that in 15 hours, they had recorded 39 aftershocks with magnitudes between 3.3 and 4.6 . Prensa Libre is now reporting five (5) deaths in total. The three additional deaths are said to be cardiac related. In addition, they report seven additional traumatic injuries. Fifty (50) known landslides have blocked roads and highways in the area.

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