Well our time in Dapitan City has come to an end- What an incredibly fun and invigorating surgical mission this was! As this will serve as the final summary blog, please read on as I describe the memorable moments and aspects of this surgical mission.

First and foremost, I must thank Mrs. Socorro Rogers and Mr. Rey SyGaco for helping to make all of the arrangements for the team both in Manila and in Dapitan City- This was a huge endeavor on their behalf, but it was executed so effortlessly.  Without their hard work and support this mission would not have been possible.  Both Socorro and Rey, old  nursing school classmates, showed the ISHI team such generous hospitality that we always felt welcomed and special.  Of course, Vice Mayor Patri Chan, our governmental host and an incredible VIP supporter of our team must also be thanked.  On our last day in Dapitan City we had the opportunity to visit her at city hall.  The local congress was in session.  She allowed our team to come into chambers, introduced us to all of the members there, and then later that day the same congress passed an official city resolution thanking both ISHI and Mr. Rey Sygaco for the successful surgical mission!  Now that’s a first! Truly, it was a very special gesture which made me extremely proud!

Our clinical accomplishments on this mission were admirable considering the short time we were in town.  We were able to perform 141 operations over a six day period, of which 52 were major cases.  Thanks to our surgical oncologists Dr. Ravi Chokshi and Dr. Chia-Chi Wang, we were able to offer thyroid surgery and other head and neck operations to our patients this year.  This was a first for ISHI and an exciting addition to our clinical repertoire.  These cases included thryoidectomy, submandibular mass resections, parotidectomy, a transnasal sinus cyst aspiration and more.  One patient presented with a follicular thyroid cancer and a palpable neck node.  We debated whether or not we should offer her an operation or refer her to a local surgeon.  We decided that we would perform the operation because the cost for her would have been prohibitively high had we referred her to a local surgeon, and we felt she just would not have another opportunity otherwise.  Her operation ended up being much more complicated than expected, necessitating a total thyroidectomy and a radical neck dissection, and lasted about 6 hours.  However the team stuck with it, carefully proceeded with the successive oncologic steps of the operation, and finally completed the surgery.  The patient woke up after the operation complaining of very little pain and in quite good spirits.  She was so very thankful and greeted us with a huge smile every day on rounds.  She was referred to oncologists in Cebu for further chemotherapy treatment.

Our volunteers are the most important part of every mission, and this one was no different.  We had so many first time ISHI volunteers on this mission- and each one played a critical role on the team.  New members of the team included surgeons, anesthesia and nurses, who all quickly adapted and worked together as if they had always known each other - Our volunteers are experts at home in their own hospitals, and they chose to donate their skills and time to provide care to the patients of Dapitan City. It is because of their generosity, enthusiasm and hard work that ISHI is able to plan and accomplish missions, and for that I am very thankful to each and every one of them.  I must say that I was especially thrilled to have Marlone and Earl join our mission this year- Both are scrub nurses from Escalante City, the city in Negros Occidentale that our team visited last year, and coincidentally also the site of the recent earthquake. They both volunteered to work with the ISHI surgical team again this year after the comraderie they felt during last year’s mission.  As for the 6.8 quake, our team did feel it while we were on the beach, including the after tremors, but they were small.  News reported 29 deaths from the quake, and it saddens me that this was in the area we visited last year. 

I was equally thrilled to include three surgical residents from our institution on this mission- Drs. Advaith, Amrit and Benson.  They worked especially hard this week and were an invaluable part of the team.  In addition to the clinical skills they learned, I hope they also saw firsthand how scarce good affordable healthcare can be in developing nations.  Their participation in this ISHI mission was a great educational experience for them, and I hope it influences them to continue helping less fortunate patients in the furture, wherever they may be practicing. 

Our OR and PAR nurses were excellent as usual- They were so conscientious and thorough- their extraordinary efforts made the OR run so smoothly and safely.  Patients were cared for exactly as they are in the US, as is our standard.  This year, all of our OR nurses and our PAR nurses spoke the local language.  This immediately put patients at ease, and also helped the physicians to communicate with the patients at any moment.

Special thanks also to Cathy for efficiently running the minor procedures area and to Megan for photodocumenting our mission so wonderfully.  I have asked Megan to continue to share her photos of the mission with all of us. Thank you to all of the OR staff at the hospital who helped us every day- Their assistance was also invaluable!

There were many lighter moments which were quite memorable during this time we spent as a group in the Philippines as well-  Drinking Turkish coffee in Manila, inquiring about #14, singing karaoke at the local bar, indulging on San Mig’s and Red Horses, Watching Ravi do the island dance (yes we have video!), zipping our luggage at night to avoid geckos, daily feasts, watching the superbowl on a laptop at the Dakak beach resort because there was no television playing it (Go Giants!), drinking mango shakes, watching the brave ones taste Baloot,  watching Megan pose for photos with the locals who thought she was Ms. USA,  learning phrases in the local language and then practicing them on the patients and staff (Sakit?  And Hooman-Naaa!), enjoying the scenic countryside and palm trees on a relaxing riverboat cruise, being greeted at the local high school by over a hundred hand drawn American flags and a drum corps, enjoying time with kids at a local orphanage, eating fresh pineapple and papaya with breakfast, drinking coconut water right from the coconut, reading the supportive messages on the blog pages, and so much more….

I would have to say the most touching memory for me will be the thanks from the towns people and the hospital staff which was given to us on our last night.  We were on a beautiful dinner riverboat cruise and just as we were crossing under a bridge we see a group of people standing on top of a bridge with a sign saying “Thanks ISHI”- simple, yet so elegant- a thanks to our team. It was a pleasant and unexpected surprise and brought tears to my eyes.  So beautiful. ( photo below)  On the banks I heard people shouting my name – “Dr. Bale!…Dr. Bale!…”- it turned out to be the OR staff at the hospital- Jay and others – What a great surprise!  And how thoughtful that gesture- It made me feel really happy and thankful- like we had true friends here, in this place on the other side of the world.  Just as wonderful was our visit to a local high school where one of the students learned the words to the star spangled banner just so she could sing it to us during our visit.  What a truly wonderful and special gift to our team!  Her voice was beautiful and strong and lovely.

Everywhere we went we were welcomed and treated with such warm hospitality.  One of our volunteers said to me this was the best mission they had ever been on- what a compliment to everyone! To our hosts, to ISHI, and to all the members of our team! 

As this trip comes to an end and we all return to the hustle and bustle of our lives back in the US, we will all fondly remember this mission to Dapitan City.  We are very proud of our accomplishments there and hope that we can return one day to contribute more to the community that has treated us so warmly. Thank you Dapitan City- for trusting us, hosting us and enriching us in many ways.

Appreciatively,

Asha Bale, MD

Team Leader

ISHI Dapitan City Mission 2012