A Transformative Return to La Ciudad de la Esperanza

​Two weeks have passed since I returned from Guatemala, yet once again, my heart is still in the clinic. Every morning, I wake up wishing I were back at La Ciudad de la Esperanza, greeting familiar patients, making new connections, bringing laughter to children, and serving alongside a team that continually reminds me what compassionate healthcare looks like. There are very few places where I have ever felt the depth of fulfillment, purpose, and joy that I experience within those clinic walls. Now that I’m home, I find myself carrying the same sense of guilt I felt last year, wishing I could do more, stay longer, and continue learning so that one day I can return with more knowledge and skills to better serve a community that has given me so much.

When I reflected on my first trip to Guatemala in last year’s blog post, I ended by holding onto the hope that one day I would find my way back to the clinic and continue sharing my privilege, my love, and my education with the people of Guatemala. I never could have imagined that just one year later, I would have the privilege to be walking through those same doors again. Returning to La Ciudad felt like coming home to a place I had never truly left, a place whose lessons, people, and love continued to guide me throughout the year I spent away.

Last year, my final memory before leaving the clinic was meeting a little boy named Henry. He proudly covered our faces with stickers so we could match, wore his favorite Lightning McQueen hat, and carried a smile so contagious that everyone around him couldn’t help but smile too. Wearing those stickers, I didn’t just carry a child’s joy; I carried the weight and warmth of a community’s love. The stickers Henry placed on my face last summer eventually peeled away, but what they represented never did. Long after I returned home, I continued carrying the joy they symbolized, the warmth of a community's love, and the hope that filled every corner of La Ciudad de la Esperanza. 

Then, on the very first day of clinic this summer, I saw Henry again.

There he was, still wearing his favorite Lightning McQueen hat, still smiling the same unforgettable smile, and still laughing with the same contagious joy that had stayed with me long after last year's trip had ended. I had the privilege of spending nearly the entire first day of clinic with him, and it felt as though no time had passed at all. Seeing him again was a full-circle moment that reflected the very foundation of why I hope to pursue medicine. It reaffirmed my belief that empathy, presence, and the willingness to pause for small moments of genuine connection are at the heart of caring for another person.

Children like Henry are one of the many reasons I know I am pursuing the right path. His eyes tell a story of both hardship and resilience, but they also shine with the strength, hope, and love that surround him. His story reflects the countless stories of La Ciudad de la Esperanza, a place where people are cared for not only through medicine, but through compassion, connection, and community. Through Henry, I see everything this clinic stands for: hope, love, faith, and resilience.

Beyond the personal connections and memories I carried home, this trip was also a meaningful step forward in my journey toward becoming a healthcare provider. One of the greatest honors of this experience was being able to step into a nursing role within triage alongside such an incredible team. Although I have not yet begun my nursing clinicals or earned my RN license like many of the incredible nurses I worked alongside, this experience allowed me to continue learning, growing, and discovering the kind of provider I hope to become. One of the most meaningful parts of this experience was realizing how much my Spanish had grown and how that growth allowed me to connect with my patients in a more genuine way. I was able to listen to their stories, understand their concerns, and create moments of connection that extended far beyond the medical reasons that brought them to the clinic. There is something incredibly powerful about sitting beside a patient, speaking with them in their own language, and allowing them to feel truly seen, heard, and cared for. I was also amazed by the way our alumni team came together, each person bringing their own experiences, knowledge, and compassion to provide thoughtful, specialized, and meaningful care for every patient we served. From helping provide prosthetics for baby Sofia, to running labs, to witnessing the continued advancements in the medical resources and technology available at the clinic, it was inspiring to see how much hope and healing can come from a group of people united by the same purpose. This experience has only deepened my excitement to begin my nursing clinicals and use both the knowledge I have gained here and my own experiences to care for others with compassion, understanding, and love.

Thank you, once again, for allowing me to be part of a community, a journey, and a purpose that continues to remind me who I am and who I hope to become. When I left Guatemala last year, I carried home a few stickers and a heart forever changed by the people I met. This year, I returned carrying a year of growth, a deeper understanding of myself, and a heart ready to continue learning. As I leave again, I carry the stories of my patients, the laughter of children like Henry, the love of my team, and the unwavering hope that fills every corner of La Ciudad de la Esperanza. 

Guatemala, I will carry your lessons, your love, and your spirit with me always. I promise to honor you, to keep fighting for change, and to return with more knowledge, hope, and care.

Hasta que nos volvamos a encontrar, gracias por cambiar mi corazón.

Con amor,

Ava DeBell

About the Program

Our aim and mission is to build medical and holistic healthcare capacity in partnership with the “Ciudad de Esperanza” in Coban, Guatemala, so that over a period of 5-10 years the community can be self sustaining in meeting their own health care needs. In keeping with Regis University’s mission as a “social projection,” to respond in solidarity and shared faith, hope, and love, with the people of Guatemala and to help our students encounter the “other side” of the immigration crisis at the US southern border.

+ The project begins each fall with the selection of 10-12 nursing, pre-med, and other pre-healthcare professional students, to help support an existing but rudimentary clinic in Coban, along with a medical team of volunteer physicians, nurses, and a pharmacist.

+ Interested Regis University students apply and interview for a spot on the team in September and those selected begin weekly meetings with the medical team during the fall semester to learn about Guatemalan history and culture and develop the skills necessary for clinical triage. In the spring, the Regis team will travel to Coban to run a primary care clinic, seeing patients all week, rotating through triage, shadowing an internist and pediatrician, and assisting in pharmaceutical, optical, and dental care.

+ The team will assist local community healthcare workers educate the community in healthcare practices such as the importance of clean drinking water, nutrition, dental hygiene, diabetes prevention and treatment, and newborn care. The team will partner with the Guatemalan company Ecofiltro to provide subsidized home water filters, and will stock the clinic pharmacy for a year.

+ The team fundraises enough annually to sustain the stipend for the clinic to have a Guatemalan physician year-round at the clinic, part time; as well as a full time Guatemalan nurse.

+ The interfaith dimension of the trip underscores the centrality of faith in the context of holistic wellbeing (physical, mental, spiritual) and celebrates the diverse ways the human family expresses such faith. The Ciudad de Esperanza staff a full-time social worker and human rights advocate, and its founding priest, Padre Sergio Godoy, is guided by the vision of Catholic Social teaching.

+ The project empowers Regis students to begin their healthcare careers with an emphasis on learning from and serving marginalized communities. As needed, the medical team will provide virtual support to the community healthcare workers in Coban for follow-up of chronic patients.

+ The projected budget for the project is $85,000-$90,000 per year. Students will each contribute $500 and participate in fund-raising activities throughout the year. The medical team donates their time and services, though their airfare and related travel expenses are covered.

Medical director: Lauri Pramuk, MD – pediatrician and 1993 Regis University alumna

Richard Walter, MD – internist; Stephanie Ibemere, PhD RN; Kristen Kellogg, MSN, FNP; Eric Bertelesen, RPH, Pharmacist; Christian Alegria, DMD, dentist; Deborah Bauer, DPT, physical therapist; Monse Pineda Lagunas, RN; Ricky Perez MBS;  Christopher Pramuk, PhD theology and Regis University Chair of Ignatian Thought and Imagination.  We have two Spanish interpreters that join us from the US - Mari Molinar and Antonio Soriano.

A Voice found in Guatemala

This year, I had the honor of serving as a trip coordinator. Not an easy task to say the least, and honestly I only saw a fraction of the work that goes behind being a trip coordinator. After months of preparation, having zoom meetings, coordinating with a group of 20 people across 13 states, and organizing a weeklong medical trip in a different country, I learned how much patience and flexibility the role required.

 When I got the phone call from Dr. Lauri asking if I would take on this position I was in utter disbelief. I questioned what she saw in me, a 21 year old, at the time in my senior year, and with little medical experience, that made her believe I would be capable of this. I would typically consider myself a very shy, quiet, and timid person. Anxiety has often made it difficult for me to even speak in front of a room full of people, let alone lead one. Yet I agreed and was incredibly grateful for the opportunity. As the months went on, I was supported by the entire Guatemala team and felt very prepared and genuinely excited for this trip, until about two weeks before leaving. The anxiety hit and I began to tell myself that I had no business going, let alone serving as a trip coordinator. I had what's often called imposter syndrome and I felt like I had been wearing a mask of confidence that would inevitably fall. The closer the days got to leaving my excitement slowly gave way to anxiousness which was really hard for me because I knew that this was such a special opportunity that I wanted so badly to  be excited for.

When I finally got to meet all the alumni and medical team that I hadn’t met in person before, some of my anxiety left. I realized they weren’t as scary and intimidating as I had convinced myself they were. But I didn’t want to get too ahead of myself, I knew that the real work was yet to come. The first day of the clinic, anything that could go wrong did. Every preparation and schedule we had spent months preparing for went straight out the window and it was time for fast on the go thinking. There were times that I had to take initiative, when I had to speak up, times when I had to simply go with the flow, and countless times that I had to step outside of my comfort zone. It was stressful and I found myself criticizing and second guessing everything I was doing. Then everything settled for just a moment. I paused and looked around and I was amazed. I had forgotten all about the beauty of La Ciudad de la Esperanza, I had forgotten about all the faces filled with hope, the incredible strength of the people, and the families who carried unimaginable burdens while still showing up with resilience and gratitude. I had lost sight of the bigger picture. Suddenly all of the chaos, the anxiety, and the stress seemed so small, so minute, and so incredibly worth it. 

It was as if an internal switch had flipped, I found myself speaking louder, becoming more assertive, more confident, and less afraid of the unknown. For the first time I truly felt like I had found my voice. 

For Edwin Adolfo and Edwin Aberlado, 10 year old twin males with a history of cerebral palsy and  meningitis, I found my voice. For their mother who’s a recent widow with 5 children making less than $50 a year, I found my voice. For Dana Sofia, a 3 year old female with bilateral below the knee amputations whose resilience and joy inspired everyone around her, I found my voice. For Ramiro, who lives with severe rheumatoid arthritis and traveled 6 hours on a bus just to receive medical care, I found my voice. For Cesar, who lives with frequent gout flare ups, hypertension, esophagitis, yet who always has a smile on his face, I found my voice. And for every person with limited resources, few options, and the constant uncertainty of what tomorrow may bring, I found my voice.

I am beyond blessed to be able to have the opportunities that I do, to be surrounded by people who support and believe in me, and this trip showed me that I cannot be afraid to use those blessings to advocate for those who don’t have the same opportunities. I didn't find my voice because I stopped being afraid, I found it because the people I was serving mattered more than my fears.

Once again I leave Cobán, Guatemala feeling more complete than I did when I arrived. I boarded the plane wondering whether I deserved to be there and I left knowing that the greatest privilege was discovering how to use my voice to serve others. 

As I continue my journey toward becoming a physician I know there will be moments when I’ll feel unprepared, overwhelmed, and incapable, but now I’ll always have this experience to look back on. I’ll remember the people of Cobán who reminded me that medicine isn’t about having every answer, it's about showing up with compassion and a willingness to serve. 

- Alexxis Munoz

Spreading the Power of Knowledge

  Three years ago, I first came to Guatemala and witnessed the magic of Ciudad de la Esperanza. I remember the awe I felt watching each member of team treat even the most complex patients with confidence and ease. As an aspiring student of medicine, I knew I wanted to be just like each member of our team. I wanted to be like the nurses who lead with efficiency and order. I wanted to be like the incredibly creative PTs who push their patients to achieve their dreams. I wanted to be like the pharmacist who thrives in patient education and precision. I wanted to be like the dentist who can persevere through the toughest of cases. And, most of all, I wanted to be like the amazing doctors that can treat their patients complex history with a well crafted history and physical exam. As a health care provider, I am able to equip someone with knowledge that can truly change their life and allow them to live longer on this amazing earth. There is nothing more valuable. Education is a true gift and it is a gift that can change a life. 

    In Guatemala, people come to our clinic searching for information. Each of them wanting to learn about their bodies and how to make themselves, and their family’s, lives better. It’s an exciting opportunity to meet a person eager for knowledge, growth, and positive change.

- Logan Taylor, PA-S

The Face of God

The last few years I have gotten to know Laurel Petralia, the senior director of advancement at Regis.  She has helped me with grant writing for the Guatemala program.  Sometimes when I tell people about the Guatemala program I can tell right away if they "get it” or not.  Well, Laurel “got it” from the beginning.  She has never wavered and has been a strong supporter of the program for a few years.  Knowing that you really don’t know the full depth of this experience until you actually come to Guatemala and the clinic, I realized her support lived in her head, but maybe not in her heart.  So, when we were putting together the alumni trip participants last fall and I knew we were going to do a public health project (the community needs assessment), I knew that this trip would contain some team members who didn’t necessarily have clinical skills, but would nonetheless be very valuable members of a “public health pod” for this trip.  So, I asked Laurel last fall if she wanted to come on the alumni trip.  She did not hesitate in her yes.

She told me a few days ago that in talking with her spiritual advisor before coming on the trip he had asked her to think about where she could see the face of God on her trip. After a few days of being in Guatemala she told me about that missive from her spiritual advisor and how she was finding it hard to answer that question.  To her, I think she was struggling with how hard life is here and how people can see God in that struggle.

Last Thursday night Padre Sergio, the Guatemalan priest who founded this whole community, took the core medical team members (Stephanie Ibemere, Eric Bertelsen, Richard Walter, and myself, along with Laurel) out to an amazing dinner at a 5 star, world renowned restaurant, about 30 minutes outside of Cobán.  The meal was amazing but it was the company and conversation I will not forget.  Padre is a busy person and often when we are there with the Regis team he is not in town or in the country.  So, to have a whole evening to just spend with him was a unique opportunity.  At one point Laurel told him about the missive from her spiritual director and how she had been struggling to find the face of God due to the intense pressures put on people by poverty. She asked Padre where he found the face of god, and he hesitated, then the twinkle came to his eyes.  He has the same twinkle that Dr Richard is famous for on our team.  He began to tell the story of before the school was built.  He would go and feed the children living near the landfill and play soccer with them.  He distinctly remembers seeing a little boy who was about 2 and had a dirty face.  Padre bent down to clean his face and the two locked eyes and it was as clear as anything to him that he was, at that moment, looking at the face of God.

When we are born, our first instinct is to find a face.  The blinking infant is searching for something to bond.  Any parent who looks upon their child’s face for the first time, knows this feeling.  The most important, and formative thing a parent can do for a baby is to gaze into their face, and engage the eyes.  God, who is the giver of faces, shows us divinity in one another’s faces.  It is so easy for me to see that in Guatemala.  I have been blessed to look into so many peoples’ eyes in this community and see the face of God. I think Laurel has now experienced that herself in this community.

Lauri Pramuk, MD

Padre surrounded by the children at Ciudad de la Esperanza

Love in Action

 There is something incredibly special about being part of a group of people from different backgrounds and different corners of the world who come together to create something rooted in love—love for one another, love for humanity, love for equality, and love for the world.

As I sit here reflecting on my time in Cobán, I am overwhelmed with gratitude.

When Dr. Lauri called to ask if I would like to be part of this year's alumni team, I was overjoyed. My first experience in Guatemala four years ago changed who I was—not only as a nurse, but as a person. Returning this time as an ICU nurse with years of additional experience felt different, yet in many ways remarkably familiar. The people of Cobán—both those I met for the first time and those I had the privilege of caring for years ago—once again shook me to my core. They reminded me why we do what we do and how essential it is to protect the passion that first called us into healthcare.

One of the greatest gifts of this trip was witnessing the progress this community has made over the past four years. I was able to reconnect with patients I had cared for previously and see them healthier, stronger, and filled with hope.

One moment, in particular, will stay with me forever. The elderly man who had adopted the two orphaned boys I met in 2022 returned to the clinic this year. The boys had grown so much. They were smiling, healthy, attending school, eating regular meals, and receiving healthcare through the clinic. Seeing them thriving was a reminder that meaningful change often happens quietly, one family and one life at a time.

Another moment that I know I will carry with me forever was meeting a little girl named Sofia, who was born with amniotic band syndrome. Her family traveled six hours to reach us, accompanied by a family friend who volunteered to make the journey with them. That alone spoke volumes about the kind of community that exists in Guatemala—one where people willingly carry one another's burdens simply because they can.

Our team had the privilege of fitting Sofia with 3D-printed prosthetics, and for the first time in her life, she stood and walked.

There are moments in healthcare that remind you exactly why you chose this profession, and this was one of them. The joy on Sofia's face was unforgettable, but what moved me even more was watching her family. Her parents, brother, and family friend watched with tears, smiles, and overwhelming pride as she took those first steps. It was impossible not to share in their joy.

Watching an entire room celebrate something many of us take for granted was a powerful reminder that hope often begins with people choosing to care. It wasn't just Sofia who took her first steps that day—everyone in that room walked away believing a little more in what is possible when compassion, innovation, and community come together.

Every person I encountered—whether in triage, with Dr. Lauri, Dr. Richard, or during physical therapy—showed us extraordinary kindness. They wanted us to succeed, even though we were there believing we were the ones helping them.

Although my Spanish is still embarrassingly limited, every conversation became a lesson in how much can be communicated without perfect words. Every patient met my mistakes with patience, encouragement, and grace. The people of Cobán embody resilience, kindness, and strength in ways that continue to inspire me.

This year we were also asked to share the knowledge we have gained in our respective fields with the community. It was an honor to prepare educational presentations for the people of La Ciudad de la Esperanza. Watching my colleagues teach was just as meaningful as teaching myself. Our audiences were engaged, curious, and eager to learn, and our team responded with remarkable adaptability, creativity, flexibility, and compassion. I left with peace knowing that when we all return home, each of us will continue spreading that knowledge, compassion, and hope wherever life takes us.

Dr. Richard reminded me of the profound impact that simply slowing down and truly listening can have on someone's life. Patients return to him year after year because, in one way or another, they believe he saved them. His compassion, love of teaching, gift for storytelling, and ability to make every person feel heard are qualities I deeply admire. I hope to carry even a small piece of what he demonstrates every day into my own practice.

Dr. Lauri has shown me what is possible when someone transforms passion into purpose and inspires others to do the same. She has instilled in me a love for teaching and for sharing knowledge with those around me. Thank you, Lauri, for helping shape not only the nurse I have become, but the person I continue to strive to be.

Stephanie amazed me with her ability to connect with every single person she met. She is not only an exceptional nurse but an incredibly strong and compassionate human being. I hope that one day I can make people feel as seen and cared for as she does.

I learned something from every member of our team. Whether it was Eric's empathy and unwavering dedication or Alysa's remarkable ability to fully engage every person she worked with while making even the hardest work joyful, each person left an impression on me that I will carry forward. Thank you to everyone I had the privilege of serving alongside. I am deeply grateful and endlessly inspired by each of you.

As Juan Pablo reminded us, I will carry with me the small part of heaven we found in Cobán and do my best to spread that love everywhere I go.

We travel to Cobán believing we are bringing our knowledge, our skills, and our expertise. Yet year after year, we are the ones who leave having received far more than we could ever give.

Kara Rodeheaver, BSN, RN, CCRN