Cakchiquel, Guatemala

The smoke from a cooking fire was illuminated by a single naked light bulb and filled the top quarter of an open room inside a Cakchiquel home in the mountains of Guatemala. At six-foot-four, I found it difficult to breathe with my entire head enveloped in the haze. In the corner was the bed where the family would sleep, and it was easy to see why respiratory problems were so prevalent in these villages. Some houses had no latrines, some no clean water supply, and some children were malnourished. It was difficult to imagine living like this. But Luke Society director Dr. Axel Suquen doesn't have to imagine it. He grew up in nearby Patzun in a home very similar to the ones we saw.

During my childhood," he said, "poverty was such an overwhelming thing. I often stayed home alone, and many times I was hungry but I couldn't find food to eat. I remember that we didn't have a bed to sleep on. All of my family slept on the ground. I remember the cold nights and sleeping on the ground. It was something I can't forget very easily."

Those memories are what drove him back to the region with such a passion and vision after graduating from medical school. He's seen the needs of his fellow Cakchiquel people first-hand and has dedicated his life to improving theirs. But it wasn't always so.

When Axel was 19, he attended a military school. He was a fiery leader, angry with his government, prone to violence and on the track to becoming a military leader. When a Christian friend invited him to church, he went out of curiosity. His friend didn't show up, but Axel stood outside the building and listened as a man inside preached the gospel. His heart was changed dramatically.

He became a doctor instead of a soldier, but his fiery nature stayed with him. Most churches in Guatemala were teaching that the only thing that mattered was to save the soul of a man and to fill up the churches. But as Axel studied the Bible with others at his university, he saw that Jesus wanted us to minister to the physical needs of people as well.

He also found himself at odds with his professors in medical school who taught only how to treat diseases and prescribe medicines. Axel saw that most of the diseases in Guatemala were preventable and decided that he would go into the rural areas and teach people how to avoid the biggest causes of illness.

With the help of the Luke Society, he was able to establish Asociacion VIDA (the Guatemalan ministry of the Luke Society) with a health clinic in Patzun and outreach to various Cakchiquel communities in the mountains. The projects he has helped initiate are specifically designed to meet the most pressing needs in each community and are led by local health committees he has helped establish and train.

On a cool, clear night in the village of Popabaj, representatives from ten local families were gathered under the fluorescent lights of the school building. Each was building a new home with materials provided by VIDA, and staff member Modequeo Lares was teaching them how to divide the homes into different rooms with the kitchen outside and the latrine far from the kitchen.

"To promote the health of the people in villages, we need to change the basic things they need to live in the communities," Axel said. "Things like the housing projects and nutritional projects, those are the main needs for some of them."

Luisa, a community health nurse with the Luke Society, teaches women in the village of Pachut how to prepare a variety of vegetables to add much needed nutrients to the family diet.

Indeed, the health of families is closely tied to their living conditions as many diseases stem from a lack of latrines and indoor cooking fires. These ten families are among the poorest in the village, living in houses made of mud or flimsy corn stalks. The children typically sleep on the floor with insufficient blankets for the cold air in the high altitudes or in the same beds as parents. The new houses are designed to provide separation of children from parents and to keep fathers from being tempted to take advantage of their daughters.

In the town of Pachut, Manuel proudly shows us the house he has built with the help of VIDA. A room with cement floors and two new beds keep his seven children from sleeping on the floor.

Subsistence farmers like Manuel are often hesitant to build because even though his family has lived here for generations, legally they've never been able to acquire the title to the land. If they want to cut down a tree, they have to get permission from the mayor. Since no one owns the land, people tend to abuse it. Mayors of some villages have sold rights to the trees to logging companies for their personal benefit. What was once dense forest has become barren, ruining the soil and forcing families to go long ways to get firewood.

Population growth has also reduced water and land availability. According to United Nations estimates, more than half of the population lives on less than $2 a day. The Luke Society is helping families grow vegetables and raise rabbits to supplement their diet that consists primarily of corn and beans. This is especially important for children under five who often face chronic malnutrition.

Luisa, a nurse on staff with VIDA trains mothers in Pachut how to prepare vegetables they've begun growing in their gardens in an effort to provide their children with a more balanced diet. They practice cooking spinach, carrots, celery, red peppers, radishes and beef over low fires while children play freely outside or sleep quietly in cloth packs on their mothers' backs. Some of the older kids proudly show off the albino rabbits that many families are now raising for food, another VIDA project aimed at adding protein to their diets.

Axel began working in this village at the recommendation of the Ministry of Health whose data showed a high level of diarrhea and intestinal disease. There were no trained health promoters or midwives here, but now the Luke Society has trained three to take care of the most common diseases and is currently training three more.

One promoter, Luis Espantzay, oversees the community medicine chest. Axel has established small pharmacies in each of the 12 villages where his ministry is most active. Luis' previous encounters with evangelicals like Axel had always been confrontational, but he's come to appreciate the way that Axel bases his teachings on health on the principles of the Bible and begins each training class with a Biblical lesson. Luis' own faith has grown as he's been involved with the Luke Society, and he's sharing that faith with his neighbors.

"In the beginning when people got sick, they didn't trust me or seek my help and they would die," he said. "Now when I visit a person and give them medicine, I teach them that it's a gift from the Lord. I'm glad because I'm saving lives. People are trusting me now, and the kids aren't dying like they used to."

Before they can operate the small pharmacies, promoters like Luis are trained in administering 23 different medicines, from antibiotics to creams for skin infections. They are also able to teach people in the community how to make a natural oral rehydration solution to combat diarrhea.

VIDA has trained more than 100 health promoters and 125 midwives in villages around Patzun. For some of these volunteers, the training is life changing.

"A year ago, VIDA staff came and asked members of our community if we wanted to participate in a meeting in Patzun on community health and development," said Jose Luiz Ajquijay, a health promoter in La Pila. "Four of us wanted to go hear about it. I had something empty in my heart, and I felt that the empty part was filled with the message they shared that was based on the Bible."

When Axel first tried to work with the people in La Pila, a village of about 90 families, he met a lot of skepticism. But at a meeting of the health committee, all seven members were eager to talk about the difference Axel's ministry had made in their community.

"Now we have 20 new homes with the help of VIDA, 26 latrines and 23 families with vegetable gardens," said Luicio Morales. "One of the best things we can do is to be trained to teach the rest of the people here about diarrhea and respiratory infections."

Axel is thankful to be able to meet some of the immediate material needs , but his goal is to transform communities on a broader scale.

"I want to change the hearts of people and the way they think," he said. "I want them to be aware that they can organize and work together as a family. People here don't have a dream, don't have a vision, and that's a long and hard process that we need to help them develop. I'm sure that if I can change the way people think in the communities, the rest of the projects will become easier."

As we met with people in the villages, it was obvious that this was beginning to happen.

While some staff members are working in the communities, others, like Dr. Fidel Loch Cua, remain at the VIDA clinic in Patzun where nearly 3,000 patients received professional, affordable treatment last year. Fidel began working at the clinic as a favor to Axel, but without much of a vision to serve the rural regions.

"In the university, they say you need to make money and think about yourself after working so hard in school," he said.

He was earning a nice salary in a private hospital in a much larger town. After agreeing to come out to Patzun a couple times a week, he began feeling that he wasn't serving God at the hospital, only seeking money.

"When I visited the villages, the first thing that touched my heart was seeing kids playing, and seeing their desperate situations," he said. "I wondered why the government was doing nothing for these children. God just touched my heart."

Axel's wife, Lourdes, a dentist, also works in the clinic. And Axel recently added Oscar Paredes, an obstetrician/ gynecologist, to the staff, filling a great need in the area. He hopes to expand the building in the future adding a lab and hiring more specialists to improve the care people receive in Patzun. One of the biggest challenges in achieving that goal is that people who have studied 10 or 11 years to become a doctor aren't often excited about leaving the cities for a place like Patzun.

"If the Lord wants us to have a hospital, we need to pray now for new staff, for medical students who God will call in the future to do something different."

Spending time with people like Axel, Oscar, Lourdes and Fidel, it's easy to see that God has already begun providing godly people with a vision to serve.