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![Hope... Reinforced with Rebar](https://static.wixstatic.com/media/5cbe4d_1afc6ea6d8b54b04a61756eea0a992d6~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_1afc6ea6d8b54b04a61756eea0a992d6~mv2.webp)
Zachary Self
Jun 25
Hope... Reinforced with Rebar
In our neighborhood- and throughout much of the world, particularly in low and middle income countries- rebar protruding from structures...
![](https://static.wixstatic.com/media/5cbe4d_a757a779c84c4b518772102ea1b67516~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_a757a779c84c4b518772102ea1b67516~mv2.webp)
!["I'm going to die!"](https://static.wixstatic.com/media/5cbe4d_a757a779c84c4b518772102ea1b67516~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_a757a779c84c4b518772102ea1b67516~mv2.webp)
Zachary Self
Mar 10
"I'm going to die!"
This is a story of near drowning. Recently a 71 year old female who had not been seen in clinic for several months returned. She...
![](https://static.wixstatic.com/media/5cbe4d_6bb858e07877453a910e86c92685daf9~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_6bb858e07877453a910e86c92685daf9~mv2.webp)
![Free Air &... Coconuts (?)](https://static.wixstatic.com/media/5cbe4d_6bb858e07877453a910e86c92685daf9~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_6bb858e07877453a910e86c92685daf9~mv2.webp)
Zachary Self
Feb 25
Free Air &... Coconuts (?)
Last week a 32yo male presented to our clinic with generalized abdominal pain. He was tachycardic with a soft blood pressure. On...
![](https://static.wixstatic.com/media/5cbe4d_eb810e174362423aa6e03bff9b778a23~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_eb810e174362423aa6e03bff9b778a23~mv2.webp)
![Bad Beans](https://static.wixstatic.com/media/5cbe4d_eb810e174362423aa6e03bff9b778a23~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_eb810e174362423aa6e03bff9b778a23~mv2.webp)
Zachary Self
Feb 17
Bad Beans
This week in clinic I saw a 48 year old male. We'll call him Juan (because that's his name). Juan had multiple vague symptoms (excessive...
![Epicenter of a Guillain Barré outbreak (?!)](https://static.wixstatic.com/media/5cbe4d_c36b4d97bbba40ecab07e2684e934f70~mv2.png/v1/fill/w_454,h_341,fp_0.50_0.50,q_95,enc_auto/5cbe4d_c36b4d97bbba40ecab07e2684e934f70~mv2.webp)
Zachary Self
Feb 11
Epicenter of a Guillain Barré outbreak (?!)
In recent weeks, there has been an alarming increase (to the tune of seeing a case number in the past few weeks that it would normally...
![Starving to Death... in a World that is Eating Itself to Death](https://static.wixstatic.com/media/5cbe4d_676c6ae08f284d13a7de7e71c96e8dc1~mv2.png/v1/fill/w_454,h_341,fp_0.50_0.50,q_95,enc_auto/5cbe4d_676c6ae08f284d13a7de7e71c96e8dc1~mv2.webp)
Zachary Self
Feb 4
Starving to Death... in a World that is Eating Itself to Death
A recent story in one of the local Guatemalan newspapers highlighted a sobering statistic. "Se observa un incremento del 25.7% de casos...
![](https://static.wixstatic.com/media/5cbe4d_37393451e5c5424cb2f24c620ad90b60~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_37393451e5c5424cb2f24c620ad90b60~mv2.webp)
![back, back to Cali, Cali (briefly)](https://static.wixstatic.com/media/5cbe4d_37393451e5c5424cb2f24c620ad90b60~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_37393451e5c5424cb2f24c620ad90b60~mv2.webp)
Zachary Self
Feb 3
back, back to Cali, Cali (briefly)
As an add-on to a scheduled work commute last month, I spent a couple of days back in Ventura, California before heading to Northern...
![](https://static.wixstatic.com/media/5cbe4d_b9cd21bbbb5240e7b0a549852fa35bb2~mv2.jpeg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_b9cd21bbbb5240e7b0a549852fa35bb2~mv2.webp)
![to the moon... with a lunchbox](https://static.wixstatic.com/media/5cbe4d_b9cd21bbbb5240e7b0a549852fa35bb2~mv2.jpeg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_b9cd21bbbb5240e7b0a549852fa35bb2~mv2.webp)
Zachary Self
Dec 31, 2023
to the moon... with a lunchbox
Meet my astronaut. He has been hanging out in the middle of the desk of my home office for the last few years. Despite standing just...
![Diabetes Care. Democratized.](https://static.wixstatic.com/media/5cbe4d_46b67996d51b454fa0954553d87e3027~mv2.png/v1/fill/w_454,h_341,fp_0.50_0.50,q_95,enc_auto/5cbe4d_46b67996d51b454fa0954553d87e3027~mv2.webp)
Zachary Self
Dec 14, 2023
Diabetes Care. Democratized.
Diabetes is a HUGE problem globally. Diabetes is deadly and affects in an asymmetric manner marginalized, under resourced populations...
![](https://static.wixstatic.com/media/5cbe4d_67516f8344f94ee38cfd08b9a5746ac7~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_67516f8344f94ee38cfd08b9a5746ac7~mv2.webp)
![Food. It's Important.](https://static.wixstatic.com/media/5cbe4d_67516f8344f94ee38cfd08b9a5746ac7~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_67516f8344f94ee38cfd08b9a5746ac7~mv2.webp)
Zachary Self
Nov 28, 2023
Food. It's Important.
We invariably come back to the basics: food and water. Our most recent post, highlighted the importance of access to clean water. Here...
![](https://static.wixstatic.com/media/5cbe4d_a88946ee96814f6c88f403edc34d2b10~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_a88946ee96814f6c88f403edc34d2b10~mv2.webp)
![Clean Water = Life-Changing Intervention](https://static.wixstatic.com/media/5cbe4d_a88946ee96814f6c88f403edc34d2b10~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_a88946ee96814f6c88f403edc34d2b10~mv2.webp)
Zachary Self
Nov 26, 2023
Clean Water = Life-Changing Intervention
Clean water is essential to health. No one disputes that fact. Sadly, the vast majority of Guatemala's water is contaminated and unsafe...
![](https://static.wixstatic.com/media/5cbe4d_2fb88017336d4c7280e355340b3b8ac4f000.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_2fb88017336d4c7280e355340b3b8ac4f000.webp)
![LEVEL UP](https://static.wixstatic.com/media/5cbe4d_2fb88017336d4c7280e355340b3b8ac4f000.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_2fb88017336d4c7280e355340b3b8ac4f000.webp)
Zachary Self
Nov 25, 2023
LEVEL UP
Recently the concrete roof of the remaining portions of the first floor of our roadside development project was poured. Here are a few...
![](https://static.wixstatic.com/media/5cbe4d_81df03881fec41339c151e9059bc723b~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_81df03881fec41339c151e9059bc723b~mv2.webp)
![ARETÉ & RUNNING WITH THE HORSES](https://static.wixstatic.com/media/5cbe4d_81df03881fec41339c151e9059bc723b~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_81df03881fec41339c151e9059bc723b~mv2.webp)
Zachary Self
Nov 3, 2023
ARETÉ & RUNNING WITH THE HORSES
Recently I revisited Eugene Peterson's excellent book Run with the Horses. It is an examination of the life of the Old Testament...
![](https://static.wixstatic.com/media/5cbe4d_ae9d7c5bcec04c54ac37ba1b5b26074d~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_ae9d7c5bcec04c54ac37ba1b5b26074d~mv2.webp)
!['Día de los Muertos' + Honoring Loss](https://static.wixstatic.com/media/5cbe4d_ae9d7c5bcec04c54ac37ba1b5b26074d~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_ae9d7c5bcec04c54ac37ba1b5b26074d~mv2.webp)
Zachary Self
Nov 3, 2023
'Día de los Muertos' + Honoring Loss
"Día de los Muertos" ("Day of the Dead") is celebrated in Guatemala on November 1st each year. It is a day, which, per Wikipedia, is...
![](https://static.wixstatic.com/media/5cbe4d_fa94d20c35224ec1a463e2ca342c4d7d~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_fa94d20c35224ec1a463e2ca342c4d7d~mv2.webp)
![kites, from small to... GIGANTE](https://static.wixstatic.com/media/5cbe4d_fa94d20c35224ec1a463e2ca342c4d7d~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_fa94d20c35224ec1a463e2ca342c4d7d~mv2.webp)
Zachary Self
Nov 3, 2023
kites, from small to... GIGANTE
Each year around the first of November (the date on which the "Day of the Dead" [Dia de los Muertos] is celebrated), kites become quite...
![](https://static.wixstatic.com/media/5cbe4d_b90d03531288448e8b27bbd34955ca5b~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_b90d03531288448e8b27bbd34955ca5b~mv2.webp)
![Broken Hearts (Echo Blog Series- Case 5)](https://static.wixstatic.com/media/5cbe4d_b90d03531288448e8b27bbd34955ca5b~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_b90d03531288448e8b27bbd34955ca5b~mv2.webp)
Zachary Self
Sep 15, 2023
Broken Hearts (Echo Blog Series- Case 5)
Case 5- "Me cuesta respirar" ("it's hard to breathe") Chronic Obstructive Pulmonary Disease (COPD) is seen not infrequently at our center...
![](https://static.wixstatic.com/media/5cbe4d_baca08e86df74b0a89613c8de769085d~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_baca08e86df74b0a89613c8de769085d~mv2.webp)
![1/2 the Man He Used to Be](https://static.wixstatic.com/media/5cbe4d_baca08e86df74b0a89613c8de769085d~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_baca08e86df74b0a89613c8de769085d~mv2.webp)
Zachary Self
Sep 14, 2023
1/2 the Man He Used to Be
Previous posts have highlighted our Diabetes Program as well as the plight of one our patients suffering from uncontrolled diabetes and...
![](https://static.wixstatic.com/media/5cbe4d_2b67f9ce1f294c86a738ffb18d517e53~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_2b67f9ce1f294c86a738ffb18d517e53~mv2.webp)
![Unreasonable Hospitality](https://static.wixstatic.com/media/5cbe4d_2b67f9ce1f294c86a738ffb18d517e53~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_2b67f9ce1f294c86a738ffb18d517e53~mv2.webp)
Zachary Self
Aug 27, 2023
Unreasonable Hospitality
UNREASONABLE: 1. a: not governed by or acting according to reason b: not conformable to reason 2. exceeding the bounds of reason or...
![](https://static.wixstatic.com/media/5cbe4d_913a32dafea74d48b8e5f9d93a4ad59f~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_913a32dafea74d48b8e5f9d93a4ad59f~mv2.webp)
![HALOs Revisited](https://static.wixstatic.com/media/5cbe4d_913a32dafea74d48b8e5f9d93a4ad59f~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_913a32dafea74d48b8e5f9d93a4ad59f~mv2.webp)
Zachary Self
Aug 5, 2023
HALOs Revisited
Several weeks back, we discussed in a blog post (HALOs & Chainsaws) the never-ending battle against skill decay as a healthcare...
![](https://static.wixstatic.com/media/5cbe4d_59de6c18332b4865a96b9a21fd873510~mv2.jpg/v1/fill/w_250,h_250,fp_0.50_0.50,q_30,blur_30,enc_auto/5cbe4d_59de6c18332b4865a96b9a21fd873510~mv2.webp)
![ROADSIDE MAKEOVER UPDATE- Bucket Brigade & Phase 1. DONE.](https://static.wixstatic.com/media/5cbe4d_59de6c18332b4865a96b9a21fd873510~mv2.jpg/v1/fill/w_454,h_341,fp_0.50_0.50,q_90,enc_auto/5cbe4d_59de6c18332b4865a96b9a21fd873510~mv2.webp)
Zachary Self
Aug 5, 2023
ROADSIDE MAKEOVER UPDATE- Bucket Brigade & Phase 1. DONE.
In prior posts (here and here) we've looked at plans to upgrade the entry to our health center with some significant roadside development....
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