2017 Team

2017 Team
Team with Dilcia's Family

Saturday, January 31, 2015

Final Report from Nueva Capital

30 Enero 2015
0530 hours

Mission Honduras LeMars Medical/Dental team followers.  This will be my final report on the progress of the team as the medical and dental elements were completed yesterday.  It was a very hectic day as usual.  The team continued to provide consults and treatment for approximately 400 children yesterday from Santa Teresa School.  The dental element was extremely busy as well.  Their numbers are included in the above number.  Sadly so many children needing dental care could not be seen and treated by the Dentists.  Each child received de-worming medicine, vitamins, antibiotics and various other medicines.

The team was surprised during the early afternoon by taking a few minutes from their busy day to listen to a young man play the organ.  This young man is blind.  He was first seen by the Heelan team during their first visit to Nueva Capital when they visited his home to take him various health items.  He truly is an amazing story and performs various concerts in the area.  He is well respected.

The team was also surprised when the school had a general assembly in the courtyard to recognize the efforts of the team.  You will see a photo of this in the blog.

After the final patients were seen all medicines and supplies had to be packed for transport to Cerro de Plata.  After all items were packed away the team gathered for a slide presentation by Father Patricio.  This was followed by a wonderful dinner and a general sing along which included all the staff members and young Honduran men working in various projects at the school.  It was incredible and the young men really enjoyed being part of this team.  I'm sure that the team members have various thoughts and emotions about this past week and know that they are leaving behind about 1800 men, women and children that have had their health status improved.  No, this was not rocket science, but the team members saw some incredible challenges both with the patients and the process.

Now a day of rest and then they return to the USA to continue to reflect on this past week.  I stay behind to begin the planning for the next brigade, Gehlen Catholic Mission Honduras.  They will be here in this same location in March where they will build 3 homes and perfom other missions.

Gracias Adios that all team members are healthy.  God bless and peace.

Mr. Francis






Friday, January 30, 2015

One Doctors Journal / Amazing



….........
1/28/15:

“My feet hurt. They burn.”
“How long?”
“6 months. Maybe more.”
“Do you have diabetes?”
“Si.”
“What do you take for your diabetes?”
“Metformin. Insulin.”
“How do you know how much insulin to take?”
“40.”
“Do you check your sugar?”
“How do I do that?”
OK, there wasn't much point to going there.
“How much Metformin do you take?”
“1 gram.”
“When did you last take it.”
“A long time. I can't buy it.”
Blood sugar was 441.
This was not a problem I was going to solve here.
Then I changed my thought.
Informed by another patient from another time, my question became:
What can I do with what I have.
We have Metformin. Just about a bucket full.
A trip to our dispensing pharmacy yielded a bag of Metformin.
He was so thrilled, he proclaimed at the gate to anyone who would listen:
“Look! I couldn't afford 30 days of Metformin. They gave me 6 months!”
I don't know that we made a real difference as measured by US standards, but, to him, someone cared.
And that's why we're here.

…......................

Once there was a boy.
All good stories start with “Once there was...”
Once there was a boy.
He was walking along the seashore, occasionally bending over then standing, tossing something.
An older, wiser man came along.
“What are you doing?”
“I'm tossing the starfish back in. The tide left them here. They will die here on the beach. So I am throwing them back.”
“Don't you know? There are a million starfish just on these few miles of beach. You're not making any difference!”
The boy, heedless, bent over and tossed another starfish back in.
“Well, to that starfish, it did!”
And that's why we're here.

…............................

I'll break habit for a few minutes.
The stories of patients we are seeing here are made possible by a self-organizing army.
That army is made of nurses.
Admittedly, it is trite and redundant to praise nurses.
Ever see a protest in favor of nuclear war?
The nurses have been manning the access point, the triage area.
There are some 300 “tickets” given per day.
Do the math.
If a physician sees every one of these and we have 4 physicians, at 15 minutes each we'd be done with the first day sometime next week.
So, with physician backing (not that it's needed, but it's good to have everyone on board communicating), the nurses have organized the intake process.
The basic concept is thus: If, in their collective experience,  what the patient needs is something they could do without a physician or can be handled by protocol order (antihelmenthic for weight), they just do it.
The idea is to drive decision making to the level closest to the decision.
This is a deceptively simple concept.
Command-and-control systems have never worked; this one does.
And it is due to people taking responsibility for their professional actions and executing the mission.
And how successful?
Over ½ of the people presenting for care are cared for primarily and only by the nurses.
The physicians make periodic visits to maintain appearances.
But frankly, given the acceptance of the populace and the excellence of the nurses' work, I think it's just vanity.
Which is ok; we have a lot to be vain about!

…................

72 years old.
She had this ache.
That ache.
Legs hurt.
Bowels were slow. Or fast.
Headache.
In the US, fibromyalgia; a group ripe to get hooked on narcotics.
And narcotizing pain might be ok as long as one can live with the consequences.
But she didn't want narcs and I didn't have any.
So we talked.
She lived at home; no nursing home or assisted living.
How long ago had her mother died?
She didn't; she's 85!
As we talked more, the patient disclosed she was afraid of dying.
And this lead to a conversation in English-Spanish with a translator helping.
We talked about how none of us will get out of this life alive.
We talked about her life to now.
We talked of many things.
But mainly we talked of living.
And, on leaving, she gave us both a hug.
She said she felt better.
And I felt I'd been paid a fortune.

…..................

Weak.
Fever.
Short of breath.
Oxygen at 92%.
Heart too fast.
Crackles in the right lower lobe.
She had pneumonia.
I didn't need an Xray for that diagnosis.
I did need guidance.
We got her Tylenol.
A breathing treatment.
Oral antibiotics.
We talked to the patient and family about what to do next.
They were clear: antibiotics and take care of the matriarch at home.
With an admonition to goto the hospital if she worsened, we got a week of levofloxacin ready for her.
But how to get her from the clinic to the auto?
We didn't have a wheelchair and there were stairs to mount.
Up show the Bomberos, local Fire Brigade.
They made a Bomberos-chair.
A plastic resin deck chair and a few strong men, a trip up roads and trails and she is at home.
The outcome?
I don't know.

…..................................

Weak, tired, headache.
I'd heard it all before.
But not from her.
For each patient, you begin anew.
Their telling of their story to you is anew.
Muscles ache.
“Where do you work?”
“At home.”
“How many children?”
“Quattro.”
They were all in the room with us.
“Is there anyone else at home to help?”
“My husband is dead.”
She was young, just 25.
“I'm sorry to hear that; he must have been young. What happened?”
“Motor vehicle crash.”
Widowed. Young. 4 children.
Her pain was so much more than physical.
All I had to offer was a sympathetic ear.
And with the superb aid of an interpreter, we heard her story.
Sometimes all you can to is listen, witness.
And sometimes, that is enough.

…..................

“Las piernas duelan.”
My legs. They hurt.
She was on the far side of 70.
I am sure she had done her fair share of hard work.
Her legs hurt, she tells me, when she has to walk a long way.
How far? When?
Today. A half hour.
She had surprisingly good pulses; blood vessel blockage unlikely, especially with a ½ hour walk!
The varicosities on her legs told another story, long hours on her feet.
Caring for a family?
Working to make tacos, frijoles,sustenance for a family?
I couldn't change her life.
But with an elastic bandage for each leg, I could make her feel better.
And she walked out with a lighter step.

…..........................................

She was slight of build.
Her answers were swift, certain.
In summary, she just wanted to know she was alright.
She was.
So we talked.
“What are you going to do with yourself?”
“Go to university.”
“To study what?”
“Teaching.”
“What do you want to teach?”
“Math.”
“At what grade level?”
“High school.”
Great goal. And I thought she could do it.
“My daughter teaches in high school.”
“How does she like it?” she asked.
“Loves it and the students love her. When she complained about being short, her students corrected her: 'Miss, you're not short, you're fun-sized.'”
She laughed and got up.
And I made the only useful suggestion I could think of:
“No chicitos (boys).”
She laughed again.
I think she'll make it.

…..............................

An aside that is far from an aside.
With my skills at Spanish, i'd be sunk without help.
We have translators, interpreters.
What a privilege, to hear these stories.
They help immeasurably.
Of course, there's the nuts and bolts of ensuring I understand what the patient is saying and vice versa.
But there is much more.
I'll leave out names; those here will recognize these people.
I'll add names only  if given permission of the names' owners.
First is the lead translator; she met us at the airport and kept up a lively string of commentary all the way to our Base of Operations. (See Lat/long at the beginning.)
She volunteers her young daughter to help.
Although a bit embarrassed at some of the questions, she helps, especially in the Respiratory section.
There's a woman who works with street people. She helps me understand why people who are homeless return to the streets from a shelter. The streets are home. From her, I get an education on this population that I can apply back home.
And she studies me quickly. She learns my routine instructions so well that I can give the first sentence and she runs with the rest. She's like a macro; I'll work with her any day,
Then there's a familiar tone speaking unfamiliarly. That is clearly an Italian-accented Spanish speaking English flawlessly. (Aside: I love listening to languages and Italian is, to my ear, one of the most beautiful. In Spanish, it's even better.) We work together at the end of a long day. She is clearly tired; I am. But she gamely lies and accepts another patient.
Last and hardly least is a priest who accompanies us.
(OK, who this is is hardly confidential.)
His Spanish is smooth, practiced. And you can tell he's worked with people; my most intimate, embarrassing questions are translated both ways without a hint of judgment. Clearly, the people trust him. As do I.
We clinicians trust these people to help us make the best medical judgment we can for this population  in the circumstances we all find ourselves.
And isn't that what it's all about?

…............

The stories.
What a dream job.
I get to hear stories.
People tell me stories all day long.
What a dream job.
All I have to do is listen

…...........................

1/29/15:



Yours from Honduras;
Us



Nueva Capital, Tegucigalpa, Honduras
30 Enero 2015
0645 hours

Mission Honduras Medical/Dental team followers. 

And so it begins.  The last day of work for this team.  Yesterday was the 1st day of school for Santa Teresa school.  The day began with a slight drizzle.  The morning assembly held outside had over 900 kids attending.  School starts each morning at 0700 hours each day.  Imagine 900 kids until noon, another 900 kids until 1700 hours and then another 200 or so after that.  Kids running all over.  In the middle of this, our medical/dental team was conducting clinics.  Pulling teeth to giving out medicine and the doctors doing consultants all at the same time.

The weather today will be about the same as yesterday.  It looks like this morning will see the sun instead of drizzle.  Richard Seivert, the director arrived yesterday in Honduras and has joined the team.  Concurrently with this team, Then Feed Just One has a container arriving in Tegucigalpa, Honduras today bringing in needed food and many other supplies.  He will help unload the container.  The medical/dental team will hold the last day of clinics in Nueva Capital.  Later we will let various team members comment on this past week.

We will publish more photos later today.  I'm sure it will an emotional day for all the team members.  Two (2) of the team have to return to the USA today for other commitments.  They will be missed.

God  bless and peace to all. 

Mr. Francis
Imagine coming to your first day of school, but instead of having class you go to a clinic where you receive deworming medication and tooth extractions. Although this may not be our idea of a good first day, the children attending Santa Teresa school could not have been more excited!
Today we served 3rd, 4th, and 5th graders in the morning, and then Kindergarten and 1st graders in the afternoon. All of them equally grateful for our care, and getting out of some school.
We were also escorted in small groups to several homes of school children. It was absolutely incredible to see the homes that some people went home to, and to climb the rocky and steep mountain to their homes. Some of the homes that we saw happened to be fairly nice. They were definitely the more luxurious homes on the mountain. We found that the Honduran kids were not even phased by the trip up the mountain, for when we dropped them at their homes they decided to walk all the way back to the school with us.
In the dentist office today screams could be heard all around. The children did not enjoy the numbing shots, but soon realized that the dentists were there to help. Dental assistant, Krystal, said that one little girl was screaming so loud and trying to stop the dentists that they were ready to let her go. They continued to work, and the girl left the room in tears. Only minutes later the little girl, her mom, and her sister came back to the office and hugged all of the dentists in thanks for their help. Also from the dentist office, Stacie, dental assistant, reported that she was meeting a lot of new little buddies. Estaban is a little boy whom she met today, and says is her new pal! Stacie also mentioned how she noticed the difference that just removing one tooth could make on a child. One patient had about 10 teeth that could have been removed, but they could only remove 2. Although they would have liked to extract the bad teeth, they knew that just removing the 2 would change the patients life.

Pictures attributed by:  Ashok Kewalramani













Thursday, January 29, 2015

Nueva Capital, Tegucigalpa, Honduras
29 Enero 2015
0515 hours

Gehlen Mission Honduras Medical/Dental team followers.  Hello and happy day.

Currently it is 16.2 C or about 61 F with a light drizzle in the air.  The winds we up again during the night but I doubt many of this team really cared or were away of it including this writer who had his best nights sleep in many days.  The earlier blog last night said much about this.  Today's forecast is for clouds with a high of 25 C or somewhere in the low to mid 70's with a low of 12 C or about 54 F.  Since today all of our clinics are inside the weather should not be a factor.

Richard Seivert, the Director of Mission Honduras LeMars will be arriving today to join the team and then help unload the Mission Honduras LeMars container that will be in Tegucigapla later today in the afternoon or probably in the evening.  This container has 16 pallets of needed food and other supplies.  I know many of the boxes will come to the Nueva Capital area through the Cerro de Plata Foundation.  It surely is needed!

Yesterday, like the earlier blog written last evening said, was very busy, not from the standpoint of patients, but because of the disease states the triage team and the doctors saw and treated.  Although we were told that many of these people came from the exact same area as the other days, the medical evaluation form tells us a different story.  Many of these people we from a different area in Nueva Capital or from a different zone.

I have not had a chance to review the medical charts developed on each patient, but I agree with the earlier statement of at least 300 or so patients needing the medical element, and 53-55 dental patients with about 120 extracted.  Today we will meet with the school administration about the clinic's that will be held for the school kids.

I (and I know for sure every team members can say the same) will just rely a short story.  Before I begin with this, I want all of you to know how helpful the local Bomberos (Firemen) were today.  They are  based here in Nueva Capital and about 3 minutes from the school.  There were 5 Bomberos helping today. They helped with crowed control and lifting and directing patients.  This is a very valuable resource for us during this mission and for others in the future.  I spent time speaking with each of them.  Many are working towards becoming a paramedic and we let them help us in the medical area to the degree we could.  Many of these guys, like so many in the USA, had served with the Honduran Army.

So, this elderly woman was found in the line by the triage nurses.  Really struggling to breath.  She was carried immediately to the clinic area by the Bomberos.  During the treatment process I found out that she lives quite far away, and part of the area the road, if one existed, was impassable and she would have to walk or be carried by her family.  I have no idea how she was able to walk to the school and then stand outside waiting for us to open the daily clinic.  She got better after various nebulizer and other medical treatments.  Then the challenge.  She was still very weak and would not be able to make the long and difficult walk home.  The Bomberos said they could help but their  firetruck would not be available until until in the afternoon and then could only get so far towards here house.  I made the decision to have Julio take her and her family home in out Toyota 28D pickup,  Everyone said we could only get her close.  Well....Julio drove her right to her house where a road did not really exist.  Our Toyota is high and has the rugged tires for mountain travel.  The Bomberos were impressed and told me the truck was very tough.  I told them I know because Julio and I have been in many of these types of situations during the years.  The lady and family were very happy.

When I think about this type of situation, I and I know others on this team, know full well why we come to areas like Nueva Capital.  There we so many incidents of need and help yesterday, but I will leave it here.

Many of the team are still sleeping.  Yesterday was busy.  We hope to get other photos and parts of a daily diary from one of the doctors on our team posted later today.  God bless and peace to all.

Mr. Francis


Wednesday, January 28, 2015

Buenos Tardes from Nueva Capital!

Today was another busy day at the clinic filled with more deworming, daily vitamins, and a few unexpected incidents.
One man came to us with pneumonia and COPD, but left us in an ambulance. The Bomberos helped carry him from the doctor's office to the ambulance on a stretcher. Then we had to stop sending patients to the dentist office because there were so many people who wanted to see the dentist.
We saw around 300 patients today all of which were very grateful and patient. Doctor Tom Morgan reported that today's patients were more chronically ill: diabetes, respiratory issues,and hypertension. Many patients were diagnosed with anxiety and depression; we have also seen a few cases of domestic violence. Nurse Diana says "Another excellent day filled with patients." She cannot stress how great it feels to be here, and to be helping the needy people of Nueva Capital. Nurse Claudia reports that triage was more organized today, and the flow of people was excellent. Hello to everyone in Sioux Land from the crew!
Tomorrow school starts at Santa Teresa which means that we had to move all the doctors offices and the pharmacy to the basement of the school. There will be 1600  students from which only the most ill or needy will be treated by the doctors. Other students will be given daily vitamins, and deworming medications. We are all excited to see all the children in their school uniforms, and we cannot wait to meet them all!
Here are a few pictures from today. One of which is a blind boy who plays the piano!







Hello Jay Cooper!  We are learning to enjoy cold showers!  Hope you are well!  Good luck in upcoming track meet!  Love, Kelly and Mom

From One Doctor's Journal / Six Patients / Revealing


Hola Rapid City, RCCSS, Dan, and Kaci!
Kelly and I are sunburned and getting our tails worked off, but are experiencing something we could never have imagined! The people of Honduras are so genuinely kind and grateful and loving, not to mention patient!  We work as the aides, so we do whatever we are told to do.  We do the weighing and measuring and determine the children's Z scores (which is an indicator for malnutrition).  We get to cuddle lots of babies - so we are in heaven.  Most of the patients are so happy just to receive a 30 day supply of vitamins and some de-worming medication.
The days working the clinic are non-stop!  No opportunity to sit down or relax, but we usually have from 7pm till whenever we go to bed to relax.  Last night, Kelly stayed up and played cards and spoons with the boys who live and go to school here.  We also have Mass every night, followed by vespers with the boys (it's beautiful!).
The poverty that we saw on our drive from the airport to Santa Theresa school in Nueve Capital was unimaginable.  The houses are mere shanties erected on dirt - no water, electricity, or bathrooms.  But the people we are seeing who live in these shanties are very happy and healthy for the most part!  It shows that although they don't have much, they really care for one another and look out for one another.
We are very, very safe and very comfortable.  We are also clean, thanks to our 30 second, freezing cold showers (after which we feel very warm....seriously)!

9th and 10th graders:  hope all is going well in school - miss you all!
Kaci:  How was your tournament in Sturgis?  I miss you terribly, and can't wait to see you!  Love you so much peanut!
Dan:  How's Mr. Mom?  Love and miss you terribly!  Hope all is well!  Thanks for blogging back!

Adios for now.  It's going to be a hot one today - no wind and lots of sun!  God Bless!
Carol



28 Enro 2015
0517 hours
Nueva Capital, Honduras

Mission Honduras LeMars Medical/Dental team 2015.  Wishing all a happy morning.  It was a quiet night for the team.  It was the first night without heavy winds.  It almost seemed balmy in the area I was sleeping on the floor.  It was generally a nice day yesterday.  Sunny and warmer than the day before.  Many of the triage bunch got sun, one or two more than others.  Then about 1600 hours it clouded over, winds came up and it cooled off.  The temperature is currently about 15.2 C or about 59 F.  It is supposed to be similar in temperature to yesterday, or about 77 F.

The patient traffic flow problems encountered the lst day were solved.  Our meeting on Monday evening provided needed solutions.  The day went well.  Since the lst day of school  is Thursday there were many people and kids milling and running around.  This proved to be just a nuisance.  We had 4 members of the Tegucigalpa, Honduras Bomberos helping the team with crowd control.  They also received a number of needed supplies, like nebulizers, sutures, suture trays etc.  They were very happy.  This type of cooperation is needed.  They know most of the people.

The team medical element saw 292 patients and the dental element 64 patients with 104 teeth pulled.  We kept having trouble with keeping enough translators.  All in all, I had to ask 6 patients to return at 0800 hours today to see the doctor because we had no translators. They had to return to the city.  They were understanding.  It should be another day similar to the last two days.  We have used many more tablets of Acetaminophen and vitamins.  I was able to purchase (with Mata Sosa's help) more of each.  Hopefully delivery will be today,  We should have enough of all other medicines.  The diseases here are not the same as in la Montana de la Flor (MDLF) and since this is our lst mission here it was difficult to estimate medicine usage.

The team continued to see cases of lack of food and poor nutrition.  A number of people were referred to Hospital Esquela (the large public hospital in Tegus) for further care.  In some cases $$/limpera's were provided for bus fare and food for the trip.

I will always remember an elderly man, with his elderly wife and I presume a grandchild, that had asthma and needed care.  He was given 2 different nebulizer treatments and other medicines.  He was then given a nebulizer and received instructions on its usage.  The grandchild was instrumental in receiving these instructions.  He was very thankful and seemed without words when he knew it was a gift and he could take it home and use when he needed.  So for all of those that donated nebulizers just remember this elderly man.

I hope to be able to send photos along with this post.  If not we will work on this later today.  The internet is real slow in the evening.  If not I will have Dick send them along.

Thanks again to all.  Have a wonderful day.  I am in the kitchen having coffee and watching the cooks prepare breakfast.   God bless.  Peace to all.

Mr. Francis





Tuesday, January 27, 2015

Clinic Day 2

Hola!
Today was a very hot, sunny day. Although it was very warm it did not stop the hard work. The nurses treated around 300 people and sent about 138 to the doctors. Only the truly ill went to the doctors. Most of the people we saw only needed daily vitamins, and deworming medications.
Something that impresses us is the relationship between mothers. A mother would hand her child to another family, leave, and return to find their child taken care of by the other mother. The women seem to care for all of the children no matter whose family they belong to.
Another thing that surprised us was how much a toothbrush is worth to a family. When we pull out the toothbrushes, the people swarm!! A toothbrush here costs $2.50 and a visit to the doctor only costs 10 cents. Now compare that to the US, where a doctors visit would cost around $25.
The dentists today served 56 patients, and pulled 108 teeth. The last 5 teeth were pulled by the light of a head lamp due to the lack of light in the dentist room. We made many people happy by removing teeth that have been bothering them for some time.  They didn't enjoy having the teeth removed but they knew that they would not have a tooth ache next week.
The dentists and assistants have the best clinic on the mission.  We have two young translators that are so very caring with our patients and helpful, Roberto and Regina Sosa.  Brother and sister.  They are very dedicated to their fellow Hondurans.  Our space is perfect for our needs.  Walls of windows on two sides
 so lots of natural light.  The space faces just the right direction so the wind was not blasting through. We have the chicken pen just outside our door so we are well entertained.
We are ready for another busy day tomorrow. 
All the patients have shown amazing gratitude and patients for our care.
We look forward to the patients coming tomorrow, and we cannot wait to see what is in store for us over the next three days of clinic.
Nueva Capital, Francisco Morazon, Teguscigalpa, Honduras
27 Enero 2015
0513 hours

Gehlen Mission Honduras Medical/Dental team followers.  Happy Tuesday.  Today is going to be much the same as yesterday.  The weather patterns are really strange this week.  Yesterday, clouds, wind (and I mean strong) along with a light rain later in the afternoon.  Today's high in Tegus is projected to be 25 C or 77 F, with a low of 13 C or 55 F.  The report says this day should be warmer than yesterday.  I wonder where the warm will come from.  Last night was very cool and very high winds.  I just can't image how some of these people cope with this type of weather when they live in a shoebox for a home,  But, they do and we probably saw many of them yesterday.

The team members are still in bed and I'm sure they will be a little slower in getting up today after a very long day yesterday.

I have read Ms. Kelly's post and I will agree with her about the internet connection last night.  We tried many times to sign on after originally being able to do this.  We also tried to upload photo's from Dr. Benzoni's phone but apparently that did no work as well.  Currently I am sitting in the kitchen area with the 2 cooks as they are preparing breakfast.  The coffee is warm.  It looks like pancakes this morning  The food as been really good here.  A complete Honduran menu. Like yesterday morning the internet connection is really good.  I'm sure the weather effects it here in the mountains.

Like Ms. Kelly said the medical element of the team saw 256 patients in clinic, the dental element saw  41 and pulled 45 teeth and then because of the large volume we had to do a "pip line" later in the afternoon.  This is where we give patients de-worming medicine, vitamins, both kids and adults and then Acetaminophen.  We did not count those forms last night but Diana and I are estimating we treated abut 75 or more patients.  So this leaves us with patient contacts of over 350.

We had various problems with patient flow because of the high winds.  Another factor was that the school gave out (in advance) 300 numbers, which to us meant 300 patients.  The problem, a mother would show up with a number but with 3-5 kids.  This caused confusion in registration forms because these kids had no forms.  We had to work around this and will probably have some of the same problems today.

During our nightly meeting the team members talked about the day, the flow issues and possible solutions.  We will change some processes today with the hope of having a smoother patient flow system.  We will want to treat each and every patient.  I thought the people were very patient with us.  They value so much the time to have an American doctor tell them that their children are doing ok and with certain interventions will do better in the days ahead.

I did not look at the forms yet, but I do not remember in all the clinic days I have been involved with - did we have so many kids, many under age five (5).  Ms Kelly and her mother Carol did the weighing and measuring of the kids and then compared them to World Health Organization standards for height and weigh.  They reported many kids were at the median Z score with many others with a - Z score which means undernourished kids.  Later after the team leaves I will summarize these data points.

Well I better quit for now.  Maybe when Ms. Kelly gets up we can send some pictures.  The team members have great ones.  Have a great day.  God bless and peace.

Mr. Francis