from the ground up

I must admit from the get go, that I am dreading writing this today. I will get into why in a minute, just go easy on me today.
Your right, not that you wouldn't if I hadn't warned you.

The first day of  clinic in the Hospital

Here we are plugging away into early August. If you were fortunate to have relinquished your mailing address to me at some point in the past, you should have received our family midyear newsletter. If anyone else would like to subject themselves to any future newsletters, please send your name and address to me here, at RyanandKatieAnn@gmail.com .

A small portion of the supplies that came on the container

Since my last resurfacing, we have received and unloaded the entire contents of the most recent shipping container and opened the new facility to acute medical care clinics, two days a week. We are using this time to refine the new process and work the kinks out of the new facility. Each day when we open the doors to let the patients in, there are more and more people. We have also begun seeing an increase in patients wanting to be seen all days of the week.

Not a week has passed without being forced to turn away a neighbor in need. Some days its a young man with a sore back. Other days, its the parents of a newborn with a fever, or a worried first time mother in search of some explanation for the pains she is having. Whether the illness is life threatening or just a plea for help, each one that we must turn away is a missed opportunity. Whether to share the shade, or pass a smile, reassure a new mama or make plans for an emergency medical flight, they are all missed opportunities. Opportunities to love on these souls and share all we can. Opportunities where these people are coming to us in need and we are forced to turn them away, still hurting, still searching, and still scared.

For now, we have no choice but to ask most of these cases to return for a regularly scheduled clinic day, or to seek help somewhere else. Our hope is to be able to see patients around the clock, with the help of an on call physician and medical team.

This brings me to me next tangent....

We have seen such an amazing surge in construction support and progress over these last two years. With the facility being so close now, closer than ever, (duh!) the prospect of providing 24 hour medical care here in sleepy Canilla actually seems real, and at the same time completely overwhelming. In order to facilitate the growth of the ministry, one of the very real needs is full time resident housing.

If you recall, nearly 2 years ago we were beginning to wrap our minds around renovating our to-be home that we live in currently, and all that would need to be done before the dawn of the coming year.  Well, here we are, at it again. Same goal, same time line, only we are starting from scratch this go around.

We have officially broken ground for our new, new-to-us home. We will work together as much as possible with the help of the crew when they are not needed around the hospital construction site. Our hope is to move in, you guessed it, before January. So I guess you could say we are in the early stages of a long sprint, and I'm going in tired.

Setting up batter boards 

While our family will be downsizing, our relocation will literally open the door for any and all to-be resident physicians, long or short term, to stay on site and be available for medical emergencies, and always be close to home. This was always the plan for us, but we didn't expect it so soon. We thought maybe in a few years, but we know now, that it is time. So, the clock is ticking!!!!

This, unfortunately brings me back to why I am dreading this. Ugh...

Ready to dig

Since we first decided to commit, dig in, and get started on the house, I knew I needed to share the details with you all.  We will invest, a small fortune of $20,000 US, to build this ministry home over the next 6 months. With your help, we can continue to pour into this community, this nation, and the Church.

Our needs don't stop at windows, doors or roofing. Our monthly support has been severely hurting since we first moved down, in September of 2014. Why do I mention this? Well, I need your help. I am not going to asking you to take out your checkbook, or change your lifestyle. I need your help in prayer.
We have a small group of, very cherished, regular and some spontaneous, supporters. We lean on them each and every month. By God's grace, we are still here.

We have been working towards offsetting our donation deficit over the last two years. Aside from seeking Gods will through prayer, we have begun using our hands in other ways. We started butchering our own beef and poultry, raising egg layers, and we are also selling our own yogurt.

Honestly, I really enjoy having our children involved in putting food on our table and in their bellies. Ryan and I devote a large portion of our time to making these hobby-farm type tasks happen, and I am not sure how much more we can do, or how much more our time will allow.

We do not take any of our support for granted.  Could you help me by praying for these select few that have decided to support us?  In praying that their generosity would not go unnoticed, that they would continue to be blessed financially, and lastly, that more people like them would stand behind us in prayer, love and support. If we are to continue living and working here in Canilla, we are going to need the village behind us.
We are grateful to all who stand behind us, and we thank all of you who will thoughtfully consider joining our support team.

In the end, we know that if it is God's plan for us to serve here and raise our family, we will have all our needs met and will continue to be a blessing for others just as you have been for us.
Starting on the new home has been an exciting distraction for us, and u hope to keep you posted as we continue to turn our little patch of grass into a home.



Thanks for reading and for your payers.

KatieAnn Ficker

Ready to pour the floor and then start the walls!

When peace and quiet elude me

.......
Did you hear that?...I will do it again...
.......
Did you catch it that time????
I will spell it out for you.
nnnnhhh(Deep breath in)......aaaahhhh(and out)....
How about that time?
Ok, so if you have figured out that I am breathing by now, you get one point. If you have figured out why that is journal entry worthy, you get 50 points!
We are here in Guatemala city. We came in to the City on Wednesday morning. We arrived late afternoon, after an uneventful drive. We all enjoyed fast food for lunch (by the way, anyone who has ever lived overseas or outside the US for any length of time, knows this is something you come to enjoy and even look forward to) and pizza for dinner. I swam with Jacob and Audrey as Ryan played ping-pong with Joshua. We all slept well, and headed to the Zoo this morning. Joshua has been asking for a few months to go to the Zoo. After we were released from the Emergency room a few weeks ago when Joshua broke his arm, this was his first request.  The highlight was definitely the hippos for the kids, but for me it was the spider monkey momma with a baby latched on to her as she climbed in-front of us. Sighhhh!!!!

Another lunch at fast food, and then onto some actual errands, followed by more swimming/ping-pong.  We have just finished showers for the kids, and they are all tucked into bed laughing at the Spanish commercials in-between cartoons that they can watch and imagine what they might be saying. Before returning to the hotel, we were able to treat Ryan to some Father's Day Dairy Queen, your right that was just an excuse to indulge.
Now here I am, typing away, on the floor, in the corner of our hotel room, near an outlet. Why? Because I wanted to share this amazing moment, and because my tablet is dead.
I am breathing. Just normally. Not my normal deep breathing followed by a sigh in order to return to that happy place where I feel more calm. Just breathing, and when I am not breathing with a smile on my face, I have a smile in my heart.
We will begin acquiring groceries and other supplies tomorrow for our return to Canilla. Come Saturday morning, it will be back to our slice of reality. Canilla, our little remote town with a few paved roads, and a couple ways in and out. Canilla is a relatively quite town, with it's share of cantinas and churches. I think it is a peaceful place to live for most people.
For me, it has become where I fight to raise my family and balance work and ministry. The construction process has gotten the best of me on many occasions. I don't know if it is my personality, living on-top of all of it, or both. Either way, it is nice to gain a little perspective and french fries.
Leave it to me, to find my calm in the middle of a crazy Central American city!
Thanks for reading, sharing and pressing on. After all.... we're in this together. (gulp) Right?

To the Moon and Back

Have you ever wondered why some of Gods creatures are, for lack of a better word, ugly? Worms, and caterpillars that slither and slide, or beetles and ants that lumber and creep. We have many different insects here, in our home and out. The ones that irritate me the most are the ones that fly. As the rains start to come, at nowhere near the ideal frequency, the insects, plants, and animals start to grow and thrive again. As the sun goes down on our little sliver of Guatemala, the bugs start to come alive. In-between dinner preparations, baths and refereeing, I will squish and swat with a vengeance, and without mercy, except for when it comes to moths. They strike me as such unfortunate creatures.

Most children, as do mine, often confuse moths for butterflies. The easiest way to tell the two apart is by the way they rest. While moths rest with the wings open, butterflies rest with their wings closed together, hiding their beauty.  I sometimes wonder to which I bare more resemblance of in my life, either through my domestic capabilities and shortcomings, or character traits and flaws.

These past few weeks have been good for us with company from all over the country, and progress on the new facility. The fourth cargo container headed for Canilla has arrived in the Northern port of Guatemala. We will likely dance around requirements and paperwork for the next 4 weeks, until we are able to travel to Quiche, the closest town to us with paved roads, and receive the contents. This shipment contains the normal assortment of seemingly random, unrelated items for construction, but also includes a large portion of the medical equipment and supplies,  necessary for opening the doors of the new facility, and caring for the patients.

Ryan has begun hanging the doors we built for the clinic and outpatient services portion of the facility. It has been encouraging to see the rooms take shape and resemble something more than Lincoln-Log style structures.
The water system is now in place for the new well.  The system will provide clean, high pressure water to the entire facility, and surrounding dwellings.
The roofing progress has moved to the back portion of the facility as we install the 40 foot sections of steel roofing over the rooms for admitted patients and delivery related care. This is the last portion of roofing on the ground level, and it will likely move slower than the previous sections due to the length of the sheets and the intensity of the sun and its reflecting heat. Roofing has proven to be an exhausting task for the crew on the roof, mostly comprised of family, as they push to cover all the exposed walls and rooms before the rains pick back up.

Our little family farm is growing with the addition of chickens, both meat birds and egg layers. The kids are all pitching in with the animals.  Watching them learn to appreciate their food is encouraging.
The kids continue to grow and embrace this lifestyle. I had someone ask me if this was a good place for them to grow up. I enjoy raising them here, and I think, for the most part the benefits outweigh the disadvantages. I think our children have some of the best of both cultures, but they definitely have access to resources that most children their age, living nearby, do not.


Just last week, we were surprised with a spur of the moment trip into Guatemala City.
We made record time, reaching the outskirt of the capital, in just under 3.5 hours.  Though I wish it was for a break from the normal for a little R&R, we were rushing our middle child, Joshua, to a private hospital for medical attention. After a rather minor fall, Joshua fractured both bones in his left forearm. Despite having a reliable vehicle and finances to afford private care in Guatemala, I was still terrified at the thought of the unknown. During the 3 and a half hours it took to get to the city, as I held Josh, trying to buffer each and every bump, my mind would wander back to that scary 'what if' place.
We were escorted back for an X-ray, minutes after arrival. Within an hour we were discharged, payed our bill and left with a happy camper in a green cast.

As grateful as I am to all who helped with taking care of Josh, and with watching our other children, I feel obligated to return the favor.
If a neighbor would have a similar incident requiring medical care, he would likely drive to Quiche, and receive free, but typically less than good treatment. This doesn't seem acceptable to me. In a matter of months, the facility in our front yard will be equipped to handle cases identical to Joshua's, at little or no cost to the patient,  in a safe and comfortable environment, close to home, handled with love and care.  This is no small feat, and is actually near impossible without your support, prayers and encouragement and Gods favor.
As we work together each day, watching the swirl of responsibility pass over the ministry as a whole, we continue to push on. This is where I wonder if my work is that of a moth or butterfly. Typically, I feel like I can take some of the strain of daily life in stride, and flutter gracefully throughout the day from one task to the next. Unfortunately, when circumstances get the best of me, I sense I take on the traits of a less than glamorous moth. I will fight my way from one minute to the next, struggling to simply stay a flight. At the end of the day, I fall to the ground and rest, with all I have left in me, open, exposed and visible.
It is after those days of feeble flight and performance when I am more receptive to the gentle admiration of a loving creator.
Some day, I hope I can grow, and learn to float through the ripples and challenges, and maybe even soar through this trial of missional life. Thank you for all you do to make this possible, and your role in keeping our boots on the ground. If you are touched or encouraged by our story, trials or transparency, we ask you to consider standing with us int his journey, either through prayer or financial support.
And of course for putting up with me and suffering through my ranting.
Katie Ann Ficker

The construction zone outside my home

A rumble in the distance.

Here I sit, on the eve of a seeminly regular day to all, but I can't help but wonder, if the rumbling I hear is a sign of things to come or simply the side effect of a much needed rain for a nearby village.

We have had a calm Sunday here in Canilla. We enjoyed having some time to be lazy, but after those 5 minutes, we were able to catch up on a few chores and hobbies.

Ryan was able to fire up the engine in the old ford truck today. It is the first time in the last few (5 maybe?) years that the truck has ran. We started converting the truck about 5 months ago. It now has a Dodge engine and a Ford, well, everything else.  I could show you a picture, but it would look like something out of a scrap yard.  Maybe when it looks like a truck again.

We were able to make a few laps around the hospital on wheels today. This has been a fun family activity for us since the completion of the concrete around the courtyard. It was nice to coast around and around in circles. It is such a refreshing time for me. My most complicated decission is whether to turn right or left, and then, I just....coast.

This is it.... the eve of the day I have been dreading for over a year now... I am turning 30 tomorrow. I know, I know... in 20 years I will wish I could be 30 again. For me it is intimidating, and threatening.  I have to act like an adult now. All responsible and propper. Ehhhh, maybe I will get better at pretending.

I guess it is all what we make of it.  Either I am just getting older, or I am living to celebrate another year of life lived, life survived, and lessons learned.

I sure hope it rains tonight, but I wouldn't mind a quiet tansition into 30-hood tomorrow, maybe even a graceful one.

In Between

Here I am. Saturday morning. I don't typically write about nothing, but that is exactly what I am going to do today. 

I am not sad today,  I am not struggling, I am not angry, and I am amazingly normal.... your right it's all relative.

We finished off the morning of chores with a little cold cereal and fresh milk, thanks to my brother-in-law's Jersey cows. Then the boys started in on their laps around the construction site, and will intermittently trade off throughout the day. Audrey is out riding a scooter with our dog, Boone, on her heels. I hear laughter echoing off of the bare walls as she rides away from Boone, giggling. 

The background noises trade off from the air-compressor, which seemingly runs continuously, and the impact drivers the guys are using on the roof. Bilingual chatter is also a frequent, as we continue to talk to each other in English, while communicating with the crew in Spanish.  

There is a constant flow of motorcycle, bicycle and foot traffic, as today is the local produce market in town. The ministry holds one of its weekly, general medical clinic today, about 1/4 mile up the road, so I will see a steady flow of families walking back toeards town after they have been seen. Mostly, we are greeted with curious eyes, but we are always observed. Who can blame them. We are, well... different. 

Looking to the North

The sky is cloudy and the air is filled with a remarkably familiar sent. I swear it is Skunk, but I cant say I have ever seen one here before. When I first smelled the pungent odor floating thru the air yesterday evening, I was almost shocked.  This was a common occurrence for us around the house in Illinois, and I was surprised at how reminiscent that reminder made me. Your right, I am always on the verge of busting out some over romanticized version of life back home. Leave it to me to throw skunks into the mix!!!!  

Looking to the South

I feel like we are living in an eternal summer this year. It has been hot, dry, and brutal for about the last month, but we have had a few days of 80's, and we are all feeling like civilized creatures again, having dry clothes from not sweating and not having to avoiding the sun like vampires. Word on the street is two weeks till the 'rains' come. I will look forward to the rain, but this also means we have to keep pushing on rain preparation. Roofing, gutters, drains, and runoff will become priority once the rains start, especially if they don't fizzle out like last year. Maybe the rains will be consistent enough that we will have a normal growing season this year for all the farmers and livestock. I will appreciate our yard turning from straw and thorns back into grass, and the dramatic decrease in dirt in the house each day. We are accustomed to sand and dirt on our clothes as they dry on the line, and I don't think I will miss it.

Life definitely gets more complicated after the rains start, but it is almost like snow was back home. Production typically slows down, due to weather, and I enjoy the added family time and hoodies. I do love hoodies.

I hope I have not bored you, but I thought we could all use a little good, old-fashioned, normality, at least as I have come to know it. 

Happy Saturday.  Miss you all.

Katie Ann 

One of Those Days

Here I sit.

It is about quarter after nine, on a quiet Wednesday evening.  I sit awake in the living room, sweating. No, not from a late night aerobics binge.
It is just plain H O T, hot!

Yes, I am a Midwesterner, born and raised.  I should be able to take the heat, for I have suffered through 115 degree days with 90% humidity, and no AC.  I will not, however, tell you how many times we drove to the mailbox on those days, just to enjoy the luxuries of Air Conditioning in the car.

There is something about the sun here that makes you feel like one of those poor bugs, being fried under a microscope by an enthralled adolescent. It is unrelenting. It's got to rain at some point, though..... right?

I am having one of those days. And when I say days, what I really mean is years. At least I hope it is only one.

I have not written since last December, almost four months. I am amazed that I was able to squeeze something even slightly intellectually viable out then.   To anyone who subjected themselves to my recent writings, thank you for your unbiased support. And for those of you who haven't, lets just leave it there, in the past. Shall we?  Well, than don't say I didn't warn you!

Some of my close friends and family saw something coming. Whether they saw the writing on the wall, or had personal experience I should have learned from, I was clueless.

 What started out as occasional panic attacks during the night last June, somehow fully transformed into chronic anxiety. I began being relentlessly subjected to fear every moment of my day. When I was not panic stricken, I would live on edge, anticipating the next 'wave' of fear or the next 'attack' that was always lurking around the corner.

It could and did come-on at any moment, without warning. Because of this, I was no longer fit to be alone, or care for my children or our many, MANY ministry responsibilities. We went on in a state of shock for about two months.

At some point along the way, we learned that I was suffering from Anxiety and Depression.

I cant tell you I know when it started, but I think maybe when I was 8?  Or possibly after my oldest son was born, with postpartum depression? Or maybe after I turned 29, last April, and was stricken with homesickness?
You know what, maybe all of the above.
( Psst: That is a hard thing to write)

Maybe I have always struggled with anxiety. Maybe I have always struggled with depression.

Why in the WORLD am I here?  Why did I look like a good candidate for this lifestyle? I mean, really? ME?????
My credentials for the job are something like this:
Adaptability: I cringe at the sight of any bug.
Pacivity: Dirt in my hair or in my food freaks me out.
Tranparency/Communication: I am completely fine with remaining that face in the room, that will always smile, but never wants to talk, especially about myself!

I don't know if a less qualified missionary ever existed! And you want me to raise my family here? And you want me to help build a 20,000 sq/ft structure complete with O.R. suites?  And you want me to live off of 'good will'????

I wish I had another punctuation mark that was more dramatic than an exclamation point,
             !  is just not cutting it!

My Aunt Marilyn learning to make Dobladas

( Deep breath............ ahhhhhh)


Here we are. March, 2016.
 I am almost 7 months into my treatment plan, and I am again beginning to feel normal.
Maybe sadness and worry were my normal? So, I guess I am feeling better than normal.
(Psst: another hard thing to write)

If you are wondering if I have been avoiding another journal entry, or possibly dropped off the face of the Earth?  That is because I was and I did.

A bedtime story by flashlight

Yet here we are. 18 months in Guatemala.
In many ways we are still going strong, and in other ways we are not.
No sugar coating here. You have got the wrong girl for that!

We continue to push forward on the construction. Many days I grow weary. We have had extra hands on deck though, to lend a helping hand or a hug. Since the first of the year hands from all over have come to get involved: Oklahoma, Iowa, Arizona, Illinois, Texas, Kansas, Michigan, Nebraska, Spain, Argentina, and even from our Home Church, in Highland, IL.  The first of my family from back home came to visit and we had a blast! Thanks again for coming Aunt Marilyn!

We are encouraged by each face that steps foot into the construction, and offers gratitude for all the blood sweat and tears that have gone into it. I secretly enjoy watching as first-timers  must tilt their heads back to grasp the enormity of the full structure.

This is how we floor!

Today was one of those days. We started out early, ready to cover about 2,000 sq/ft of cement floors with sealer. We were greeted by our old friends, fatigue and discouragement. We eventually finished what we started.


 It makes me wonder if I have bitten off more than I can chew. Will I be able to see this project through? Will I remain mentally healthy enough to be a blessing and not a burden? Will I be able to protect my family from the sun, the bugs, the food and the motorcycles?  Will we continue to scrape by on what God has provided?

There are so many unknowns for us in each and every day.  Maybe that how it is supposed to work?

If I had all I needed to execute my plan, what use would I have for waiting on His?

Hmmmm???



Thank you for all your love and grace during this time of growth, for myself, our family, and this ministry.

I cherish each person who is limping along on this journey with us, and loving us along the way.
Thanks for your encouragement, patience, understanding and support.

        Katie Ann Ficker

One rare occasion, being allowed out of the
 house to help the guys with a wild fire, and loving it.