September 2008 General/GYN Surgery

Team Participants: Surgeons: Enrique Duprat, Michael Trimble, Ben Doke, Robert Elder, David Moore; Anesthesia: David Craig, Al Jones, Eddie Milam; Family Practice: Miriam Duprat; Nurses: Dodie Brumbaugh, Barbara Burg, Alice Bush, Daniel Doyle, Caroline Evans, Elaine Griffin, Lauren Moore, Dawn Skinner, Amy Smith, Cindy Suppiah; Surgical Tech: Shannon Lowery; EMT: Cullen Copeland; Chaplain: Mark Smith; Translators: Dianne Martin, Patty Rood; Dental Hygienist: Linda King; Sterilization: Alfred Anderson, Guy Martin, Kelly Milam; Maintenance: Dennis Griffin; Nurses Aids: Pat Dwyer, Danielle Kuske, Beverly Milam; Team Leaders: Marie Agee, Julie Wheetley

The team arrived in Guatemala on a couple different flights but all between noon and one. One suitcase was lost so Marie talked to the desk while Julie led the team out to wait for the chicken bus. Once the bus showed up all the luggage was packed up, Pollo Campero chicken passed around and the team set off for Montellano. After a quick stop at the bathroom, we arrived in Montellano after a relatively quick drive.

Team members lugged their bags into their rooms and into the hospital. The surgical and sterilization crews got right to work familiarizing themselves with the hospital and preparing the OR’s. Bags were unloaded and the OR’s were ready to roll for the following day. The GYN team also saw some of their patients for the following day and started scheduling surgeries.

After dinner Mark Smith led the team in an abbreviated devotional talk and Marie and Julie followed with an orientation and information session. The first timers all took tours of the dormitory and hospital areas to familiarize themselves with Clinica Ezell, and the nurses held a quick informational meeting and everyone turned in for the night.

Sunday morning started off with black beans and eggs and church across the street. After worship Dr. Walter and Rosario gave their orientation talk about charting, orders and protocol. After lunch the OR burst into activity as the first patients were taken back for surgery. All in all there were 78 surgeries; 41-general, 35-GYN, 2-Ophthalmology. Things ran somewhat slowly on Sunday and Monday as the team adjusted to each other and our hospital, but by Tuesday it was smooth cruising.

In the recovery room we had some extra helping hands for the week. Four students from local schools came and worked with us. They are all studying to be assistant nurses currently and were with us to get some experience. They worked hard and were a great help to the nurses throughout the week.

We had a great group of nurses who were willing to help in any and every way they were needed. Several nurses came thinking that they would work in the recovery room, but they wound up circulating or scrubbing in the OR. They were happy servants who were willing to learn and pleased to help out. God continues bringing us the cream of the crop when it comes to our nurses! Sheri even came down for a few days from Chichi and worked in the OR!

On Tuesday evening the brothers and sisters from Chicacao and Montellano came to Clinica Ezell to pray over each of our patients. Their presence is always such a blessing and time of encouragement to the patients and nurses. We have a lovely partnership with our Guatemalan brothers and sisters.

Alfred Anderson spent a good portion of the week training our very own Danny Rafael on how to run the sterilization room. Alfred told us that Danny was self motivated and a quick study. Our hope is that Danny will be able to run the autoclaves and have sterile towels and gowns ready for each surgical team. This will be a great help and stress reliever to the sterilization room workers. In addition to training Danny, Alfred was pulled in a hundred different directions to do everything from fix things or find things to change out light bulbs. He is one of the guys that helps us to keep things running by doing all those little behind the scene things.

Mark Smith came with the Knoxville contingent and did an excellent job serving as our chaplain. He was enthusiastic about praying with patients at Ezell or hitting the road and spending the day at a mobile clinic with our patients there. We were blessed to have a man so well learned in the scriptures to lead our hearts and minds in the worship of our Lord.

Many people were able to experience a bit more of Guatemala when they participated on a mobile medical clinic or side excursion. Dr. Walter and/or Dr. David took a couple of people out into the villages each day where they were able to take blood pressures or see patients. On Thursday a couple of groups went to Xejuyup to see the waterfall and two other groups headed to the Cacao farm to meet the sweet family of Don Agusto. Everyone who went on a trip came back in awe of the beauty of Guatemala and excited to have seen more of the country.

The man with the cancerous arm who had been seen at the February clinic returned. We tried to get him to agree to see an oncologist in the city, but this time he was adamant that he wanted his arm amputated. He said he was in too much pain to wait any longer. So, we honored his request, and Dr. Enrique Duprat performed the amputation. It seemed very sad to us, but the patient, Demetrio, was happy to be done with it.

As always, we see patients that we can do nothing for. One such patient, a 42-year-old woman, came saying she had had surgery at a nearby hospital a year and a half before to remove a lump in her breast. She said she was so poor that she couldn’t afford a biopsy. Now, she was in really serious trouble with a lump the size of a fist on her chest that was hard as a rock, plus a pecan-sized lump up on the side of her neck that was equally hard. Another surgery was not an option for her, so Dr. Walter arranged for her to visit an oncologist in the city. Her prognosis seems dire at this point. Clearly, it is cases like these that prove the importance of our having a Mercy Fund.

Toward the end of the week we had something very special take place. Dr. Jerry Swale from the Chicago area flew down to Guatemala with his son Steve. At the July eye clinic Dr. Swale identified two patients as candidates for surgery but due to the nature of their conditions they would need to be placed under general anesthesia. Marie contacted Dr. Al Jones and asked if he would mind providing anesthesia for these two eye patients on Thursday during the September clinic. Dr. Jones agreed and Dr. Swale worked out his schedule to come back to Guatemala. Both patients were suffering from muscular problems which either made their eyes crossed or drift off to the side. Dr. Swale was able to operate and realign their eyes. Dr. Walter has since reported that the patients are seeing much better and have had no complications. They are grateful to Dr. Swale and continue to pray for both him and his family. Everyone was impressed with Dr. Swale’s compassion and willingness to make his third trip to Guatemala in less than 12 months for only two patients. His servitude and generosity are a blessing to our ministry. We pray that we continue finding doctors like Jerry to become a part of the HTI family!

Dr. Swale came so that he could operate on two patients identified at the July clinic

As hurricane Ike approached Houston, Texas, we began to wonder when we would be able to make it home. Marie talked with Tami our travel agent about the possibility of flying home on Friday instead of Saturday but after some discussion the team decided to just wait and see what would happen. The hurricane pounded Texas, and our flights were indeed canceled for a couple of days. Some team members were able to fly through Atlanta or other airports to get home but most stayed at Hotel Antigua and enjoyed the time of relaxation. The rest left on Monday and Tuesday once Houston was open for business. Everyone arrived in the USA by Tuesday afternoon safe and sound. We were much more fortunate than those who live in the path of Ike. We will continue to keep them in our prayers.

By: Julie Wheetley

Note from Marie Agee: At the suggestion of one of the general surgeons, Dr. Enrique Duprat, we instituted an important safety measure to our surgical routine. When a hernia patient goes to pre-op, the person who will start the IV interviews each patient privately and asks them to point to the spot where the hernia is that they want repaired. Following the patient’s pointing, the nurse, using a skin marker, marks the skin with an “X.” This ensures that there will be no mistakes in surgery by inadvertently operating on the wrong side. Dr. Duprat said that safety step has become routine in U.S. hospitals. We have never had a problem of this type in Guatemala, and hopefully adding this procedure will make sure that we never do!