Date: October 2009 Location: Centro de Salud Barbara Clinic San Juan Sacatepequez, Guatemala Team Size: 20 Length of Mission: 7 days Number of Surgeries Performed: 54
BACKGROUND & OBJECTIVE
For ISHI's first-ever mission, we decided to collaborate with Partners for Surgery (PFS), a nonprofit organization based in the US, dedicated to helping population in rural Guatemala. PFS, who has a longstanding relationship with the indigenous populations, has developed several healthcare teams, and this new facility in San Juan Sacateqpequez to ensure that high quality healthcare is accessible to these communities.
PFS triaged the patients for the ISHI surgical team, so prior to our arrival in Guatemala, we had clinical information about the 50 to 60 patients who would be coming to see us for surgical care, including diagnoses, test results and even some photos. Some of the diseases seen included groin and abdominal hernias, chronic infection of the gallbladder with stones, and soft tissue masses.
MEDICAL SUPPLIES AND EQUIPMENT
We packed 20 boxes of surgical supplies and arrived in Guatemala without any difficulty at the customs. We were met at the airport by PFS representatives, who arranged for our supplies to be delivered to the facility. We had arranged for the purchase of IV fluids, anesthesia medications and narcotics locally, as these items could not be transported by our team on an international missions.
Since we had an idea of the case-types we would see, we were able to collect donations of surgical supplies, instruments and medications for the mission. We were pleased that the facility we worked at- Centro de Salud Clinic Barbara had two operating rooms, with functioning anesthesia machines and equipment to sterilize our surgical instruments. The laparoscopy equipment at the facility was not yet functional. Additionally, laparoscopic instruments and supplies were not available, so all procedures were performed using "open" surgery.
We were informed that the majority of our patients are from the K'iche' indigenous community. K'iche' peoples represent approx. 7% of the total Guatemalan population. Because of language barriers, fear of traveling to urban areas and mistrust of local hospital systems, the K'iche' peoples do not commonly seek out healthcare locally. Our triage day was quite an exciting experience, as we quickly learned that the K'iche' patients spoke their language (K'iche) with very little Spanish. Our patients were all smiles, as we talked to them about their condition, and then proposed operations to help.
We used both English to Spanish translators, and then Spanish to K'iche translators, so that we could effectively communicate with our patients. Many of the patients signed the consent forms with a thumbprint instead of a signature. Patients were brought to Centro de Salud from as far as 10 and 14 hours away by van via unpaved mountain roads. Most had a family member accompany them. Patients had accommodations in a hostel-type building, which was behind the Clinic. PFS provided all of the patients meals while on site, and transportation back to their villages after their surgeries.
TEAM AND LOCATION
Our team included 20 volunteers; some had never done international work prior to this experience, but all were enthusiastic and ready to work. San Juan Sacatepequez is a small town whose main revenue comes from growing and exporting fresh flowers. Every morning on the way to the Clinic we would drive by the flower market and see the wonderful colors of the market- the bright reds and oranges of the local women's dresses and the vibrant purples and yellows of the freshly cut flowers ready to be sold that day. Our volunteers were able to develop an appreciation for the K'iche' culture, while at the same time providing their medical skills to a population in need. Two ISHI team members were able to participate in the "Take Me Home" Program, in which the patients were taken back to their villages after their operations and recovery. Our team members got a unique look into the lives and the homes of the K'iche' peoples; they were treated to a homecooked meal, and shown the generous hospitality that is commonplace in these parts of the world.
Dr. Dennis Grech - Anesthesiologist. Dr. Leslie Osei-Tutu - Anesthesiologist. Mae Tingston - Operating Room nurse. Irene Banares - Operating Room Nurse. Socorro Galano-Rogers - Operating Room nurse. Pushpa Goel - Operating Room nurse. Natalia McTighe - Recovery Room nurse. Sherine Varghese - Recovery Room nurse. Alison Baker - Recovery Room nurse. Dr. Diego Reino - Surgical resident. Dr.
Leonard Mason - Surgical resident. Sue Walsh – CRNA Nurse anesthetist. Dr. Asha Bale - General and laparoscopic surgeon. Dr. Ziad Sifri - General and trauma surgeon and team leader. Dr. Kevin Clarke - General and oncological surgeon. Dr. Cha-Chi Wang - Surgical oncology fellow. Mary Ann D'Urso -Journalist. Vishnu Hoff - Photographer. Charlie Khoury - Logistics, photographer. Zeina Wakim - Logistics and translator.