The end of stage 1 - on to stage 2

Well, it's been a while since the last entry but there really hasn't been much to tell. I have spent all my spare time since the hospitalito doing work on the battery rejuvenation project and taking some more Spanish classes. And now... the project is finished and so are the classes. I was supposed to be meeting with the director of Alterna (Steve Crowe) this morning but he was caught up at a remote pueblo where he was doing repairs on a mini hydro electric system so we have put the meeting off until Monday. I don't think the project could go any further no matter who was doing it. From my work it appears that battery rejuvenation through desulphation is most definitely feasible but the project was to find out if it could be done overnight and the answer to that is a resounding NO.

Yesterday afternoon there was a march by the students from San Carlos university. This is an annual event that protests against decisions made by the government and the church. It started off years ago when to do something like that would most likely get you arrested so they wore masks to hide their identities. And that tradition continues. There were floats denouncing the government's intention to legalise some drugs and others denouncing the catholic church's stance on contraception when so many families here can't afford to keep having kids. It was a huge procession that went on for about two hours.

But the most important news is that while I am writing this blog entry Chris is half way across the Pacific on her way to Dallas and then to Guatemala. So in one more day she will be here in Xela. Now THAT is what I call news worth celebrating.

So, to cap it all off, I will have no more news to report on my volunteer work (except for how my final meeting with Alterna goes) because from here on it is all vacaciones. I will probably keep posting photos and information about places we go but if you were only interested in my work here then it is time to say goodbye. So... goodbye and thanks for reading!



This is Jorge, my Spanish teacher. Cool chavo.



A diploma to prove I can speak Spanish.



One of the, probably, 100 bikes with students on them. Often 3 or 4 at a time.



This guy dressed a little differently.



Lotsa people



This is a cool pic. There were people dancing behind this ute and this is the sound system. There is a PA in the back powered by a generator and in the cabin is a computer hooked up to a powered mixer. What a system. Better than just a sub!



On for young and old.



Not sure what these guys were trying to say.



This float was protesting the proposed legalisation of marijuana. There is a giant scoob in the skeleton's mouth that kept puffing out yellow smoke.

Location:Xela

Back in Xela -Sunday 25 March

Well, I am back in Xela after the big week in Santiago. After leaving Santiago I had to spend about 5 hours in Panajachel waiting for the bus and let me tell you this about Pana. It is like every other tourist destination in the (2nd/3rd) world. The market stalls are full of lower quality products at inflated prices, there are gringos everywhere and you have to keep an eye on your wallet and camera. Also, while I was having a cup of coffee I had 7 people come inside to my table and try to sell me their wares, and while I had lunch I had 17, yes 17, people come in to try and sell me stuff. And not only did I not want to buy anything, it was junk! They are also very insistent and you have to be quite rude to make them go away. I really hate that sort of scene.

Anyway, the trip back was OK but it did get cold and there was a bit of hail, but only for about 20 minutes. After that it cleared up again. In all the time I have been here it has only rained for a couple of hours plus this one episode of hail. Oh yeah, there was one bit of anxiety. I had booked a bus ticket to get back to Xela but had selected 24 April instead of 24 March. That took a bit of talking to convince them to change the booking but they were cool about it in the end. Especially seeing how they already had my money and there were spare seats available.

Today is Sunday and I am going to go to another procession later at the park. I also took a few photos of the the city centre because until now I hadn't actually done this.

One final thing to mention is that the hospitalito gave me a certificate for the work I did along with a nice little 'Hospitalito Atitlán' notebook and an embroidered (yep) pen with my name on it. And Henry's daughter, Ammy, drew me a picture of a kangaroo as a going away present.



This is a footbridge over a road in the lower part of town. I am told that when it rains this road is like a river and people need the bridge to get across. All the houses down the street have water marks and peeling paint from the constant flooding.



This looking the other way from the bridge. You can see the water damage on the buildings. This is an annual occurrence in the wet season.



This is, according to Ammy, what a kangaroo looks like.




The notebook and pen.


And this is the certificate from the hospitalito.

Location:Xela

Henry's family

Finally got Henry's family to pose for a photo.


They are Jimmy (son), Concepción (grandma - abuelita), Elena (wife), Ammy (daughter) and Henry. I love how Concepción doesn't even come up to my nipples.

Location:Henry's house - Santiago Atitlán

Last day at the hospitalito

Well folks, this is the end of a very long, challenging and highly successful week. It has been one of the most satisfying things I have ever done. Today Henry and I finished up our week's work and went home spent.
So what exactly did we achieve in the previous five, very full days? Read on...

This is a list of the equipment we have verified/repaired from the storeroom of unchecked, donated equipment. We managed to get through the lot!

5 x aspirators
7 x nebulisers
2 x Sullivan V constant positive airway pressure units
3 x Baxter infusion pumps
2 x pulse oximeters
1 x Genius tympanic thermometer
1 x ATS tourniquet system
1 x sequential compression device
3 x Valleylab Force 2 electrosurgical units
1 x Datex Capnomac Ultima
2 x oxygen concentrators

This is a list of the 'in use' equipment we verified as OK.

1 x Philips Merlin monitor with non-invasive blood pressure & ECG
4 x pulse oximeters
1 x Dinamap non-invasive blood pressure monitor
1 x Ohmeda Ohio infant warmer
2 x cardio-toco graphs
2 x anaesthetic machines/ventilators
2 x Valleylab Force 2 electro surgical units
8 x Welch Allyn wall-mounted diagnostic units
1 x Lifepak 7 defibrillator
3 x 'Hungwa' non-invasive blood pressure monitors
1 x infant transport incubator
4 x wall-mounted sphygmomanometers

While this was going on the 'engineering' boys knocked together some shelves for the 'new' equipment. Today we put all the gear on the shelves and made an inventory. I also wrote some 'check sheets' so that Henry could verify the stuff on a regular basis. I wrote them in spanglish and henry is going to rewrite them correctly. The hospitalito is really lucky to have him. I know I've said it before but he is a switched on guy. And he donated his entire week this week to learn about this stuff. He is not employed by the hospitalito so he lost a weeks worth of money to do this!

Tomorrow I travel back to Xela to continue my project with Alterna and I am pretty sure that next week will see the end of that project too, so the timing is pretty good. And on the following Saturday Chris arrives in Guatemala. Woohoo! Schwing!!

Lots of photos this time so apologies for the long downloads you will have.



Climbed onto the roof of the hospitalito to take these photos. Apparently it is not an OHS issue here ;-) this is looking north.



This is looking east.



This is looking south



This is looking west. That is Volcán San Pedro.



These are two of the 6 solar hot water systems (on the right) and there are 8 solar electric panels (on the left). They have boxes downstairs containing another 700 panels that will provide 28kVA when installed. Another big project.



This is pathology... One scientist and about 6 bits of equipment.



Emergency department



Maternity



Medical imaging



Laundry



Shelves with 'new' equipment



And this is the team. Me and Henry (of course) and Lyn ( the lady who has been my contact for the months leading up to being here). Lyn is like the motor for this place, she never stops.



These guys run a little take away shack called Las Lagartijas (the little lizards). They make the most yummy burritos, tacos, falafels, etc from this little 'swamp people' type shack. They are originally from California and everything is organic and fresh. Really, really yummy!



Of course, some things you can't escape.



And finally, just to prove where I am. Tuc tuc and all!

Location:Santiago Atitlán

Day 3 in the Hospatilito

The days here just keep getting bigger and better.
Couldn't get into theatre first thing as planned because there was a caesarian going on so we did some more repairs and verifications. It is amazing some of the junk that has been donated to this hospital. In Mackay I would throw it in the bin. I am pleased to say that the stuff we have sent to other countries was all functioning well and in a state of repair. We can all be proud that it would be immediately useful at its destination.

Lunchtime was a welcome distraction because two volunteers here (one is a doctor and one is a nurse) are leaving tomorrow to return to USA. They have both been here about a year but need to go back for family reasons. Anyway, there was a bit of a nosh up and all very yummy with a barbie, avocado, tortillas, frijoles and some sort of drink made from boiling hibiscus flowers for a couple of hours. All very tasty.

After lunch Henry and I managed to get into theatres (the are two) and checked another two ESUs and both anaesthetic machines. Everyone here calls ESUs 'Bovies' but no one can tell me why. When they asked me what ESU stands for I told them 'electronic scalpel unit' to which most said 'como?' For those who don't know, it is actually 'electro surgical unit' but the former gives a closer description. The two anaesthetic machines they have are different, one of which is familiar from years ago. However, the other is some Japanese thing I have never seen before and it was a bugger to work out how to drive. Anyway, we got there in the end and fortunately it passed all tests.

So, that is day three finished and two to go. The days have been long and full-on but really satisfying. Once again I have to say how glad I am to have Henry with me, he is such a quick learner and a lot of fun despite the fact he refuses to smile in my photos. Normally his face is lit up like a lightbulb. Things are still looking very viable for completion before the weekend but there is no guarantee things will remain the same. Watch this space.



Henry and me after working on the old Excel 210 anaesthetic machine with a 7900 ventilator in theatre one. I had managed to score a couple of old Wrights spirometers in OZ so we used them to verify flow with a stopwatch.



This is all they have in theatre two.



This is an oxygen outlet on the wall in theatre two next to a hole in the
wall labelled 'scavenge waste gas'. It is literally just a hole into the wall cavity.



This is recovery.



And, especially for you, Tina, this is CSSD. I thought the steriliser was a coffee roaster.

Location:Hospitalito Atitlán

Day 2 in el Hospitalito

Another huge and successful day today. Henry and I continued working on dead and suspect equipment and ended up with quite a tally. We checked;
4 x electro surgical units of which two were faulty but managed to get one to work by ratting parts from the other.
2 x ATS (automatic tourniquet systems) of which one was faulty but repairable.
6 x different aspirators that all checked ok.
7 x nebulisers that just needed cleaning and a bit of adjustment.
2 x CPAP units that were ok.
2 x oxygen concentrators of which one needed some minor pneumatic repair, and finally
1 x old pulse oximeter that needed the LCD display cleaning on the inside.

There are now only about six light sources left to check but we will start on them later in the week. Tomorrow we are going to go into theatre to check the gear in there. They have an anaesthetic machine, ventilator, ESU, infant crash cart and a couple of other odds and sods. It should be very do-able in a day.

The only other thing of note is that today seemed to be 'hippie exodus day'. There were dozens leaving with their bags after Sunday's festival. No photo, sorry, but it was quite a sight.



This is probably the only picture telling a story of today's work. The ESU tester I brought with me failed and this is Henry fixing the tester. Turned out to be two dry joints so nothing major fortunately.

Location:Santiago Atitlán.

El primer día en el Hospitalito

Well folks, it has finally happened. I have just completed my first day in the hospitalito. Had a bit of a Cook's tour initially and met a lot of staff, most of whom I cannot now remember their names. Everyone seems pretty cool and the hospitalito is open and spacey. There is not that much equipment here so perhaps I won't need too much time after all.

Today was a 'bring out your dead' equipment day and I ended up with;
Three Baxter infusion pumps,
Two oxygen concentrators,
Two NPB40 pulse oximeters,
An aspirator (that some dopey person had allowed fluid to be sucked into)
A Genius 3000 tympanic thermometer, and
A LifePak 7 defibrillator.

Before I give you the boring details I would like you to know that Henry was my offsider all day. He is an electrician and I am staying with him at his house. When I go he will be da man for biomedical issues. He is a fast learner and I reckon given six months with a mentor he would be brilliant.

OK, these are the boring bits suitable only for other techies.
Managed to get two of the infusion pumps working (haven't looked at the third yet).

Of the two pulse oximeters, one has been fixed using parts from the other. The photo below shows why I couldn't fix both.

The aspirator took some work to clean out. All the fluids had dried and it was a mess. In the end goodness prevailed and now it just needs a new bit of tubing.

The tympanic thermometer only needed a clean on the tip because (surprise surprise) someone had put it into an ear without a probe cover. I don't have a calibrator here but when I tested it on myself I got 36.6. Near enough😏

And the defib? Well, the monitor and printer do not work but the defib itself is fine. I brought a small monophasic tester with me that was donated by Engineering World Health so I could very defibs. After some time the problem was tracked to a faulty -12V rail and I think there is a blown 7912 regulator. I can buy these at Jaycar for about $1.20 but god knows where you can get them here. Henry said he doesn't know of anywhere to buy electronic components. I may have to ask Chris to go to Jaycar for me and bring it with her when she comes. I can only hope that that is the only problem. It feels pretty good doing component level repairs again?

So, all in all it has been a very productive and satisfying day. The hospitalito is nice, the work has been challenging and rewarding, and Henry is great company and really switched on. One thing Henry is in the process of doing is installing a 28kVA solar/electric system that is expected to save them about $10,000 a year in electricity. The batteries and inverters were donated by a north American company and the panels were donated by a company in Perth! ¡Qué bueno!

Time to kick back now, I think. It's been a good day.



This is Henry and me after fixing our first machine.



This is the room they have given me to use as a workshop. Heaps of room!



A wide-open LifePak 7. I have the service manual on my iPad in the foreground - thanks to Dave Gilbert at Medtronic.



This is why I couldn't fix one of the pulse oximeters.



And finally, the battery banks for the solar panels with the inverters in the background.

¡Adios amigos!

Location:Santiago Atitlán

Stunning Santiago and Lago Atitlán

The new world.
I left Xela on Friday afternoon and headed for Panajachel. Things didn't go all that smoothly because the 3:00 pm shuttle did not leave until 4:30. However, once underway there were no real hassles apart from having to call the posada to tell them I wouldn't be there until 7:00 (they close reception at 6:00). My Spanish must be getting better because I called them on the mobile from inside a noisy bus and when I arrived everything was as discussed.

Didn't see much of Pana because it was dark when I arrived and I left on a plancha (boat type thingy, think oversized dinghy) at 9:00 for the 25 minute trip to Santiago. On arriving at Santiago I jumped into a tuc tuc and went straight to the house where I am staying. I met a couple of the family members and chatted for a while then took another tuc tuc to the hospitalito for a bit of a squiz. It felt quite surreal to be actually standing in front of the place after so many months of preparation. I met up with Lyn (my contact here) and she suggested I just spend the weekend relaxing and checking out the town. So I haven't had a Cook's tour yet but come Monday it will be full on.

Anyway, on Saturday there was a full day music festival here so I forked out my Q125.00 (about $20.00) and kicked back listening to the music from about midday until 10:00pm. The music was of all types with heaps of different bands and the sound engineering was better than a lot of gigs I have been to in Australia. And it was full-on hippie! Which meant the food was all magnificent organic stuff - I love that kind of tucker. In fact, there were so many old hippies there I honestly think the hippies from 60s America moved here to continue living the dream. There were lots of young people too and they were obviously neo-hippies with fire twirling, weird interpretive dance and the like. It was very much like a small Wintermoon or Port Fairy Festival. All in all it was excellent. The crowd mostly consisted of gringos and the family I am staying with called it 'El Festival Gringolandia'.

So, I am sitting in a lounge chair writing this blog and looking out at Volcán San Pedro only about 1 kilometre away. Lake Atitlán and the mountains here are absolutely breathtaking. This has to be one of the most spectacular places on the planet!

OK, the next blog will most likely be a synopsis of the Hospitalito.



My room in Panajachel.



View from the roof (terrace) of my room looking over Pana.



On the lake heading for Santiago.



The Hospitalito. Probably the most modern and clean thing I have seen in Guatemala!



Lots of old hippies like this at the festival.



Not a great shot but these guys were great. Mostly Latin grooves.


This is the view of Volcan San Pedro from my window. It looks a bit yucky with the wires and buildings so see below...



This photo is better and is taken from the end of the street (about 200 metres closer to the lake). The canoes in the foreground are all rough hewn timber used by the pescadores (fishermen).



I took this picture of the men sitting in the shade while the women work in the market. Did I hear someone say 'that'd be right'? Check out the pants. A lot of the men here wear these traditional mid-length pants that are highly decoratively embroidered.



This is Henry in his shop. He is an electrician and is going to shadow me in the Hospitalito to learn how to do basic verifications on biomedical gear. He started a course in electronics this year and last night we discussed phase angles, reactance and impedance. Normally that stuff doesn't faze me (no pun intended) but it is a different story trying to discuss mathematical concepts in Spanish! I am staying with him and his family at his house.

Location:Santiago Atitlán,Guatemala