Jalapa, Guatemala -- Medical Mission
In February 1995 we joined a surgical team of doctors, nurses and support personnel from Kentucky on a medical mission to Jalapa, Guatemala. In the course of one week the team screened over 400-500 children to select 40 who received surgical treatment. Day one started with carrying in and setting up all the surgical equipment/supplies brought from home and screening many children to select a few who would receive surgery.
Day two through seven saw nonstop surgeries from early morning to well into the night.
Many life-changing stories unfolded that week in the clinic in Jalapa. Here we present a few…
Maybe This Time….
Maybe it would happen this time. Walter had traveled fifty miles on foot from his home to the clinic in Jalapa where he had heard a team of foreign doctors were treating children. He had tried before to get his deformed hands operated on by other foreign doctors but the lines of children waiting to be treated were so long he never did. Perhaps this time would be different.
Since the last time, things in his life had changed and now it was more important than ever. Since the last time foreign doctors were here his mother had died leaving him and his two younger sisters, both paralyzed, alone w their father. Now at the age of 13 it was his duty to get work to help his father care for the family. He needed surgery to repair his webbed fingers so he could take a construction job he had been offered.
Finally, after waiting in line all night and most of the day it was Walter's turn to be seen, he was at the front of the line. He entered the clinic and was ushered into a small room with a foreign doctor and a volunteer translator. The doctor examined his hands and put him on the operating list for that week.
With so many other children waiting Walter feared that he still might not get his surgery, even though he was on the list. He befriended one of the volunteers and insisted that he wanted to help. Before long he was helping with bathing the children preparing them for surgery and accompanying and comforting them after surgery as they recovered from anesthesia. As he worked along side the other volunteers day after day he never complained, only occasionally reminding everyone that he too needed surgery of his hands.
Finally, late on the last day of surgery Walter's name was called and his co-workers prepared him for surgery. The operation consisted of making ziz zag cuts along the webs between his fingers to release them from each other. The surgery went well and he awoke from anesthesia to the familiar warm smiling faces of his new friends. Though his hands hurt he seemed to understand and from his lips came the words Gracias, Gracias, Gracias….
The team left early the next morning and didn't get the chance to say goodbye to Walter. Months later one of the volunteers with whom Walter had worked got a letter from him in Kentucky. It read "Thank you for caring for me. I can now work for my family" and, thank you for being the mother I never had."
Antigua, Guatemala -- Medical Mission
In September of 1995 we organized a medical mission to Antigua, Guatemala. A team of Plastic and Pediatric Surgeons, residents, medical students, Anesthesiologists, nurses and several volunteers, from Louisville Kentucky, spent a week treating Guatemalan children who otherwise would not have received care.
Below are individual stories written by and to the volunteers of this medical mission to Antigua:
Journey of Hope Leads Sisters to Antigua
They came by bus, a 2 day trip, from the Peten jungle located in the northern most region of Guatemala. They were 6, 8 and 10 years old and they made the trip with their father and 2 small bundles containing their belongings. Several months earlier a missionary doctor had visited their small town. He told them that in early September a group of doctors from the U.S. would be in Antigua to treat children with their disease. All 3 sisters had been born with large cleft lip and palate defects.
They arrived in Antigua in the morning when it was still dark and timidly asked for directions to the clinic where the foreign doctors would be seeing patients. When they arrived at the clinic they found a crowd of hundreds of children with their parents huddled in small groups, waiting to see the foreign doctors. The oldest and middle sister immediately noticed something very odd about many of the children in the crowd. They noticed that many of them had the same ugly defect over their mouth as they did. The younger sister was too young to go to school and so other children had not made her feel different yet. She didn't notice anything different about the other children; to her they looked the same as her 2 older sisters. The older 2 sisters knew better, they had already suffered the cruelty of their classmates at school, they knew they were very different from other children.
Suddenly the attention of the crown focused on the street where 2 large busses pulled up in front of the clinic. The doors of the buses opened and out stepped many tall, fair skinned foreigners, all dressed the same, with blue shirts and pants covered with white lab coats. They stayed close together as they pushed their way through the crowd to the front door of the clinic and as quickly as they appeared from the busses they disappeared through the clinic doors.
It was as if knowing that the foreign doctors were in the clinic changed the crowd, all the families became anxious and the seemed to lean both physically and with their hopes toward the entrance to the clinic as though to say, please doctor treat my child first. The 3 sister huddled close to their father, they didn't really understand the crowd, they just felt the push toward the clinic door and so they to pushed.
Months of hoping has passed since the missionary doctor had first told them of the foreign doctors. After months of expectation days of travel and hours of waiting outside the clinic it was time. Suddenly they heard their name called and they pushed their way in through the clinic doors. As they were escorted across a large room filled with waiting children it was as though all the eyes in Antigua were on them.
As they stood in front of the doctor he spoke to them but they didn't understand. One of the foreigners spoke words in Spanish that they did understand, words like Hola, Como te llamas, cuantos anos tienes, abri la boca, cerra la boca, mira arriba. As one by one, each of the sisters followed the orders, the doctors looked closely into their mouths and discussed they saw. Even though the sisters didn't understand what the doctors were saying when looking into their mouths they felt safe as the doctors held their hands and caressed their hair. These tall, fair skinned foreigners had something kind about them and just their looks made the sisters feel as though everything was going to be fine.
These friendly doctors were going to help. When the doctors were finished examining all 3 sisters the one foreigner who spoke Spanish told their father not to let them eat anything that night from midnight on since the next day they would have surgery. The sisters and their father then left the clinic and found a place under a tree where they would spend the rest of the day and night waiting for surgery.
Early the next morning the sisters awoke and made their way with their father to the clinic where they would have surgery. The day was frightening and confusing with waiting, being bathed and dressed in strange clothes, the smells and masked people everywhere in the operating room, falling asleep on a table with lights everywhere, awakening from this dream and still the same masked people all around talking a strange language.
At the end of that seemingly endless day the three sisters woke one-by-one and were relieved to see a familiar face, their father, even though he was crying when he saw them. As the anesthesia wore off the sisters looked around and with a puzzled look was each other. Though familiar there was something very different about each others face, each sister now looked like the other children at school. One of the foreigners brought a mirror and each sister looked at themselves and they too looked like the other children at school.
A Learning Experience for a Plastic Surgery Resident
I still haven't recovered from my Guatemalan experience. I went along expecting to have a full week of operating on unusual children surgeries and doing a little sightseeing. Instead I retuned with a newly rekindled passion for me profession. For the first time inyears I saw my profession as a calling rather than a vocation. It is so easy to become blurred into a routine here in the US. The routine is like a machine, so that it runs smoothly the regulators and the huge hospitals have homogenized the whole experience. I guess ultimately we do care for the sick, but why here in the US do I feel so much like a cog in a machine doing it.
All it took was my first morning in the clinic in Antigua to erase that pattern, the routine. We walked into a tiny poorly equipped building that here in the US wouldn't pass for a tenement, and were suddenly swallowed up by a sea of 300 patients. We later heard that some had walked all night or had taken a 25 hour bus trip with the hopes of being seen by one of our team.
The pathology was overwhelming: adults with unrepaired cleft lips and palates, horrible burn contractures, near amputations from congenital constriction bands, huge undiagnosed tumors.
All of them clamoring for our attention, as if being screened by us was like winning the lottery. At the end of the day a volunteer stood on a makeshift stool in the middle of the crowd and called out the names of a few lucky children. These were the few who over the next week would would be treated for their diseases. It was at this moment that I realized how adequate the lottery analogy was, of the 300 who came with hopes of being treated the names of only 76 children werew called out that afternoon. Even with my hesitant Spanish I could sense the disappointment in the sad quiet eyes of those who were not chosen. Even with this bad news they thanked us for taking the time to see them.
I now realize that the satisfaction I felt at the end of that day came from those warm, friendly and thankful people. Rather than feeling like I was "delivering a product" they made me feel as though I was giving them a gift. I remember looking over at one of the senior surgeons on the team and he was smiling at me. Back home, he said I looked like the passion I felt for these people had overwhelmed my normally cynical demeanor. He was right.
The camaraderie of the team made for fast friends. We all felt the same reverence for the people and the work at hand. No one complained about the long hours, the hard work the makeshift operating rooms or the general lack of facilities. We worked in a team until we could no more, then we loaded our equipment on our backs and made our way back to the hotel through the streets of Antigua. At the hotel we would relax and go over the events of the day and get a feeling of bitter-sweet, as I thought of all the children we turned away. In those hours of relaxation we could have operated on a few more.
Back at home we returned to our routine, but now when we pass each other in the hospital corridors the enthusiasm quickly returns as our conversations turn to that wonderful week caring for children in Guatemala.
A Medical Student's Experience in Guatemala
I benefited from my involvement in the medical mission to Guatemala in many ways. If I searched for a lifetime I could not have found an experience that encompassed my two major interests in life so perfectly; Medicine and Architecture. As first an Architect and now a medical student I had the opportunity to experience the medical mission in Antigua from two very different yet equally fascinating and heart warming perspectives.
After finishing my degree in architecture and a three year internship, I decided to pursue my life-long dream to study and practice medicine. I am finding my medical studies to be both intense and enlightening. However, I am somewhat disappointed at how much governmental policies and public opinion overwhelm the field of medicine today. I find this to be confusing and disheartening. It is not hard to see how in this environment a doctor could forget what the profession is all about i.e. providing health care for those in need. While in Guatemala we cared for children in need. There was no talk of healthcare reform, insurance, HMO's, provider taxes, malpractice, Medcicaid, Medicare, just a medical team of individuals working together to provide the best possible care to as many children as possible with the resources available.
Imagine a place where patients travel a great distance and wait for days to be seen by a doctor, and then consider themselves fortunate to be seen at all. Imagine a place where after al the distance traveled and all the time wasted the patient is turned away (due to the lack of appropriate facilities in which to care for their complex disease) and rather than being angry he/she warmly thanks the doctor for taking the time to see his/her child at all. Imagine a place where patients place all there confidence, trust and hope in a doctor who can not even speak their language. Imagine a place where rather than demanding and suspicious a patient is trusting and thankful to a doctor for trying to help. Imagine a place where physicians worry about giving the best possible care to his/her patient rather than worrying about the legal implications of each decision made. Imagine a place where physicians, nurses and support staff all work together helping each other with the single common focus being, the health and well-being of the child before them.
Although I have a long road ahead I will never forget the families who traveled for days to be seen by physicians they had never met. I will never forget the doctors, nurses and support staff who at their own expense volunteered their time to work day and night just for the simple satisfaction of seeing the smiles on the faces of the small children and the warm hugs of their appreciative parents. This trip will forever influence me in my studies and my practice of medicine. No matter how difficult or confusing the future of medicine will be my experience in Guatemala has strengthened my resolve to follow my lifelong dream to study and practice medicine. Thank you From a Thankful Patient Dear Doctor,
I hope that you and the other doctors are well and I hope that you remember me; I am the patient who you operated on to remove a cyst from behind my ear. Excuse me for writing to you, dear Doctor, but I admire you and your colleagues for what you have done here in Guatemala.
When I left the hospital I didn't get a chance to thank you in my own words so I wanted to write. You changed my life by curing me of this disease I have had for so many years. I feel very fortunate to have been taken care of by such caring hands, hands which so tenderly give to the sick children of my country. Every night when I go to bed I pray to God that he takes care of you and the other doctors.
In this letter I wanted to tell you that ever since I was a little girl I always wanted to help people like you and the other doctors do. Now after seeing and experiencing what you do, I have decided that I would like to become a doctor. Not a doctor like so many I have known who seem to practice medicine only for the money they make. I would like to become a doctor like you who does medicine for the love of people. When I saw how you and the other doctors cared for the children it suddenly occurred to me that here is the real payment doctors receive, the satisfaction that they have helped to better someone's life. This has inspired me to become a doctor when I grow up. I promise you I will work hard to become a good doctor like you. I think that if there were more people like you in this world it would be a better place.
I know you are busy but if you have the time please write to me. When you return to Guatemala I would like to come visit you and thank you personally. At that time I would like to take a photograph of you so I will remember you, even though you have already left me with something that I will remember for the rest of my life, the cyst behind my ear I had for so many years is gone.
At night before I go to sleep I will continue to ask God that he protect you and the other doctors so that you can keep helping the children of Guatemala. Thank you, thank you, thank you.