After 15 years without 24-hour medical care, the Guatemalan town of Santiago Atitlan celebrated when the doors to its hospital reopened in April.
By Laura Smith-Spark
Mud buried hundreds of homes and poured into the Hospitalito Atitlan
Six months later, torrential rains in the wake of Hurricane Stan brought devastating landslides crashing on to the town's Panabaj area.
Hundreds of homes were buried under mud up to 12m (40ft) deep and a thick slick poured into the corridors of the hospital.
The indigenous Mayan Tzujuhil people dug desperately in search of friends and relatives swallowed by the mud - but eventually the hundreds missing were declared dead.
Meanwhile the hospital staff - mostly volunteers from US-based charity Pueblo a Pueblo - moved their patients to the nearest safe building and carried on treating a stream of injured and traumatised people.
Two weeks to the day after the 5 October mudslides, the doctors reopened a temporary hospital in tumbledown premises on the other side of the town, on the shores of Lake Atitlan.
The hospital has reopened in temporary premises across town
And despite the disaster - and a lack of running water - they are determined to offer as good a service as possible to a community shattered by loss.
Dr Bernadette Page said: "The building is old and not set up right but it's up overlooking the lake and it's a beautiful site, which is balm to the soul."
No-one yet knows whether the move is permanent - or whether in a few weeks or months time they will return to the original site, now yards from the mud tomb of hundreds of villagers.
"There are cultural fears [of the spirits of the dead] - so there's the question, would we be allowed back, would the patients come back?" said Dr Page.
"There's another question arising and that is, is that area prone to another landslide? We're hoping a geologist will tell us if it's safe to come back and build."
That question also hangs over those villagers who survived - but lost their homes and everything they owned.
"We still have 5,000 people in shelters - that's the best estimate I've heard - and they are guessing probably a thousand dead," said Dr Page.
Fewer than 80 bodies have been recovered so far - and it seems likely Panabaj will be declared a mass grave.
Meanwhile, patients have been showing up at the new hospital mostly with minor complaints.
"I think they are really here for us to say 'It's okay, you are going to live through this'. Nobody thought they would wake up one morning to find their neighbour had disappeared," Dr Page said.
Leah Abraham, another volunteer doctor who was in Panabaj on the night of the mudslides, said it had taken time for the magnitude of the disaster to sink in with villagers.
"They are suffering tremendously. The people who lost their family members are also the people who lost their homes, so they are in the refugee centres, living in terribly hard conditions.
"The area that was hit the worst was the most impoverished area of the town. A lot of people, I think mostly the refugees, are pretty despondent."
There are signs of recovery in the town on the shores of Lake Atitlan
However, those residents unaffected by the mudslides have come together to help those who have lost everything, she said.
"The indigenous community is very close-knit and doesn't have a lot of contact with the outside world - so the idea of moving to another location would be unthinkable to them," she added.
Despite the hardships, Dr Page believes the town as a whole is slowly beginning to rally round.
"People are starting to get back to normal," she said. "Tourists are starting to come back into town and most of the businesses have reopened."
Some medical supplies are still needed and the future remains uncertain - but two days after the Hospitalito, as it's called, officially opened its doors at the new site, the first baby was delivered.
It represents, perhaps, a sign of hope for the hospital and the community it serves.