Guatemala Surgical Clinic
September 10-17, 2005
|Participants: Drs. Benny Cleveland, Jerry Smith, Courtney Collinson, Robert Elder, Ken Mitchell, and Jay Ellis; CRNA Laura Hyatt; Nurses Barb Cornell, Carolyn Freeman, Elaine Griffin, Betsy Keene, Nancy Kulb, Vicki Ratts, Heather Rodriquez, Susan Smith RNP, and Norma Wall; LPN Billie Markoff, Student Nurse Sharon Rupinen; Surg Tech Richard Yates and Richard Lares; Translators Dianne Martin and Romer Rodriquez; EMTs April Van Fleet and Eric Middleton; Chaplain John Henry; Sterilization crew Alfred Anderson, Kelly Milam and Todd Ratts; Sonogram Techs Barbara Clemons and Helen Spohn; Maintainence Crew Dennis Griffin, John Davis, and James Massie; On-site Trained Nurses Aides Sarah Bell, Kelly Kyro, and Beverly Milam; Group leader Marie Agee.
Saturday, Sept 10: Twelve of the 32 people who were to fly on Continental out of Houston showed up at the gate after boarding began. Talk about tight connections! I was worried to death about them! But, we all made it to Guatemala safely, where Elaine and Dennis Griffin were waiting for us. They had come on a Delta flight. Carlos was also there. Alfred, Richard Yates, and Todd Ratts had gone on earlier in the day to get a head start on setting things up.
It was an unusual group in that at least two-thirds of the team was first-timers. But, for first-timers, they caught on quick! They were eager to do whatever needed to be done and did it with a smile! They were a joy to work with.
Sunday, Sept 11: Up bright and early for the two-hour trip, we arrived at Clinica Ezell in time for breakfast and church. Carlos led the singing in both English and Spanish. Baldemar Ruiz and John Henry, our chaplain, offered the messages for the day. It was announced that there was to be a baptism down at the river after church. We were all excited about that and followed the line of congregants as they walked along the busy highway down to the path that led down to the river itself. When we arrived, we found another church group already there having a picnic. Some of their little boys were frolicking in the water, fully dressed in their church clothes, having the time of their life.
River baptisms are special to me. This was only the second one I’d ever witnessed, but you get the feeling that this must have been what it was like during Jesus’ day. We gathered around Baldemar and our soon-to-be sister in the Lord, Lucrecia. Baldemar read scripture, someone prayed, Lucrecia made her confession of faith, and then she and Don Pedro made their way, still in their street clothes and barefoot, to a deeper pool of water near the center of the stream. Pedro had the pantlegs of his church pants rolled up, but it didn’t do much good as they were standing in waist-deep water. Without further ado, he immersed her, so quickly that few of us were able to catch it on our digital cameras! After she made her way back to dry land, one of the church brothers presented her with the Lord’s Supper. It was all very touching.
We strolled back down the highway to the clinic to find lunch waiting. When lunch was over and bags of supplies unpacked, the surgeries began. HTI board member and nurse, Vicki Ratts, acted as head nurse. She devised a work schedule for the nurses, calling for 8-hour shifts that were staggered throughout the day. It was one of the best plans I’ve ever seen and propose making it our standard. Vicki also gave a crash course in being nurses’ aides to several of the non-medical women. This, too, worked very well, as the women were a great help in the ward all week.
By the end of the day, we had completed 7 general and 5 gyn procedures.
Monday, Sept 12: The hernia cases scheduled for today were all pretty routine, but the gyn docs had a couple of challenges. One woman turned out to have a 40 cc mass, a pelvic inclusion cyst, that was causing her terrible pain. The three gyn docs worked together on all their cases, and they were able to remove it successfully.
A new addition to the patient ward is a large bookcase filled with Bibles in the language of many different Mayan dialects. There were Spanish Bibles, Quiche, Mam, and half a dozen more. Funds for this were donated by someone who wanted to ensure that a Bible was available for any patient we might have.
One of the cases that we didn’t do was a breast reduction for a young man. The general surgeons decided that since it was an elective procedure, it should not take the place of any of the more serious problems waiting for help. They asked him to wait until February when the plastic surgeon would be there.
While the surgeons were busily operating, Carlos took Vicki Ratts, the Milams (Kelly and Beverly), and me to San Basilio. Vicki had brought some Sunday school material for Pablo’s daughter, Reynaldo, who was teaching Sunday school at the new La Fortuna church. Reynaldo was delighted with the new resources that Vicki demonstrated for her. We stopped at La Fortuna on the way back and saw where the new water system that Boulder Valley C/C had started was coming into the community. Time ran out before Boulder Valley could finish the pipeline, so HTI is finishing it. We visited the La Fortuna church building and talked with some of the people there. La Fortuna is the newly established village that was settled by some people who had been driven off another piece of land. They came with only what they could carry, starting a new life from scratch.
Tuesday, Sept 13: Tonight the anesthesiologist came to me saying that we had enough drugs for just one more day! Swallowing the panic I felt, I began to search all the places I knew drugs to be stored. Thank goodness I found a large supply of Proponol that he’d overlooked, so we were back in business! We still needed some Valium, however, so Walter and Carlos said they would take care of that first thing in the morning.
We are short on facemasks, though. I know there are some in the container, but with the new shipping procedures instituted by the Office of the First Lady, we have no guarantee when we will get permission to ship the container. I asked the team to pray for this during the devotional time tonight.
Visitors who serve as maintenance men do some of the most needed tasks during these clinics. By popular vote, the most appreciated task of last week was done by Dennis Griffin, who lowered the curtains in each and every dorm room to allow for better air flow! James Massie acted as his able assistant. It made an amazing difference in the temperature of the rooms at night. Dennis also raised the curtains in the patient ward to block the afternoon sun that made the ward so hot each day. John Henry devised a screen covered with sun-blocking fabric to put over the vented part of the windows in the ward, so together their efforts should make the ward more comfortable. John Henry and John Davis spray painted some used office furniture that Carlos had gotten somewhere. Now when someone says to you, “I’m not medical. What could I do on a trip?” you’ll be able to tell them!
Several folks who had finished up early for the day went up the road to the swinging bridge. That’s always a good photo opportunity.
After the devo, several gathered around to sing. Several of the Guatemalans joined in, so we sang in both Spanish and English. It was great fun! I found out later that some who’d gone on to bed didn’t appreciate it as much as we did, however!
Wednesday, Sept 14: Today was “pediatric” day in the general surgery room. The youngest patient was two years old. They all had hernias and did really well. All went home the same day, which made for a much lighter load in the patient ward in the night.
One patient was a beautiful little Mayan girl, about 6 yrs old. Her mom, dad, and baby sister sat by her bed the entire time as she woke up. It was so sweet.
All the gyn patients fared well also. We’ve been really blessed so far with few complications of any type.
This morning I sent all who were free from work to the waterfall, about seven or eight people. Doing this will make it possible for everyone else who wants to go to be able to go tomorrow. We are short a vehicle because of the attempted theft of the van, which is now in the shop having the damage repaired.
We had a huge scare today when the big autoclaves suddenly quit. Fortunately, our sterilization crew included our own dependable mechanical genius, Alfred Anderson, as well as two electrical engineers: Todd Ratts and Kelly Milam! They first thought that a fuse had merely blown, but upon further inspection discovered that no electricity was coming in through the main outlet to the unit. Our Guatemalan “Resident Guard/Electrician,” Rueben, was able to identify the problem as a generator problem: a blown circuit. He rerouted the electrical path and put us back “online.” We were deeply grateful to all of them.
Thursday, Sept 15: The gyn docs did not operate today, and the general surgery patient load consisted entirely of cyst removal cases. One man had a golf ball-sized cyst in the calf of his leg, another had one in his forehead. There were six cases in all, but none of the cysts that they removed appeared to be malignant, thank goodness.
Dr. Walter did an incredibly good job scheduling the week because he had all the more difficult cases early in the week, then all the children on one day…and they all went home. Finally, he scheduled only cysts cases the last day. This was great because they, too, all went home the same day. We had only 6 patients in the ward overnight tonight! We sometimes have as many as 15 to 20.
The new nurse, Rosario, was on duty working hard to learn the drill. She asked lots of good questions and requested lists of meds and supplies to make sure she knew what to have in place each time. I think she will do well. There is, of course, an adjustment period. Some of the other staff weren’t clear on what her role was. Carlos managed this by explaining further to them how important her role is to the success of future clinics.
One final maintenance task that the sterilization crew tackled was to replace the autoclave circuit board that had malfunctioned during the eye surgery clinic in July. Someone had jerry-rigged a way to manually bypass it, which worked pretty well. Because they weren’t sure that replacing the board would be problem free, they waited until we completed our clinic to attempt it. Once they replaced it, however, it worked just great! Praise God for good help!
Friday, Sept 16: As we all arose to the task of packing up to leave, telling the patients goodbye, and last minute picture taking, the two ABC boys that the Milams support came to see them, all the way from San Basilio. They were accompanied by the mother. It was a delightful reunion, with all of them glad to meet each other. Beverly couldn’t wait to ask the younger boy about his pig that he had written them about. All were neat and clean, but the thing that touched Beverly the most, I think, was that the mother was barefoot. We had just been to San Basilio on Monday, so we knew well the rocky road the family had to walk over to catch the bus. It was uncomfortable enough in a vehicle, but the mother had done it barefoot.
The final patient total was 69 patients with 74 procedures, with all doing well. For this, we all praise God!
By Marie Agee