Guatemala--Day 9

Guatemala Day 9

I woke up at 5:30am to see the group off.  It was bittersweet as I made a bunch of new friends and hope I am able to stay in contact with them in the future.  They headed off on the to bus Guatemala City and I went back to bed.  The 3 of us remaining left Santiago at 10am for another winding trip back towards the city. We stopped in a town called Antigua, which is a beautiful little place and very touristy.  The city has strong Spanish architectural  influence and gorgeous buildings with cobblestone streets and a central city park.  The area was ruined by an earthquake, so there are many buildings partially destroyed, some restored. We just spent the day seeing the city and eating great food, and we are heading to bed early as we head out on an early flight to Tikal.

Here are some more pictures:

 

Guatemala--Day 8

Guatemala Day 8

Today was our final day operating, we took care of six kiddos and hopefully made a big change in their life.  They all have been so cute and fun to take care of , I wish we had a good way to see follow-up pictures of them once they heal from surgery.  The hospital has been very gracious and friendly to us, and today they cooked us lunch (although my stomach wasn't feeling up to eating...maybe Come Tacos is coming back to haunt me).  

After the last case we cleaned up the OR and it looked like our team had never even been there.  We headed out to a fancy restaurant for dinner and drinks, and got the medical student  shot of tequila to celebrate the fact that with the completion of the last kiddo his medical school was done ( he officially graduates next month).  

From a team standpoint I couldn't have been more fortunate to work with a great bunch of people.  We got along great as a team and had an enjoyable time both working together and spending our evenings together outside of the hospital.  I have made new friends that I will hopefully remain in close contact with, and maybe even travel on a mission trip again with in the future.  It was great to get to spend a little extra time with them before we parted ways.  In the morning most will leave back to Guatemala, while a handful of us will stay and do some tourism first.

Guatemala--Day 7

Guatemala Day 7

Today I got out of the hospital a little earlier, we did 6 kiddos and the 71 year old man I previously mentioned.  On arrival to the hospital this morning the first person I saw was the older gentleman, who had a bright smile on his face as we walked up to the front door.  He was waiting outside for us to arrive and it was obvious he was very excited for this opportunity.  He did great with his surgery, and from what I understand he was a joy in the recovery room.  He apparently found red Gatorade to be amazing...he had never experienced Gatorade before so he wouldn't stop drinking.  

Being the fourth day of surgery it was obvious that the team was starting to slow down after so many long days.  People have started to feel the ill effects of the change in their normal dietary intake and I even had to put an IV in one of our team members to give her IV fluids because she wasn't feeling well.  But overall the morale of the team is high after seeing how great these kids are looking and how happy the families are for our help.

Outside of doing the cleft lips and palates, I also had the opportunity to watch the local docs try their best to help a patient who had a bad infection of her c-section incision.  They needed to clean the wound, but did not have anyone to provide anesthesia so the physicians (ob and family practice) used some mild sedation and numbing medication.  It was a very eye opening experience, as I realized the years of training I have received have definitely provided me with a skill that is very unique and not common to all physicians,  and that there is an inherent level of safety that I am able to provide my patients that is lost when we are not available.  There were so many things about the situation that made me uncomfortable, and to realize that this is the level of care that significant portions of the world receives is amazing.   I hope it turned out well for the patient, and that the procedure was able to be completed safely without her having pain, but from what I witnessed I am afraid that neither of these two things were accomplished.

After dinner we again went out to find some local food besides the hotel restaurant.  We ended up at a place called Come Tacos, which was similar to a Portland food cart with a few tables.  We had fresh guacamole made before our eyes and excellent tacos.  One could say that it may not have been the safest choice of places to eat to keep from getting sick, but the food was too good to pass up....I'll hope for the best.

So I'm off to bed now, tomorrow is our last day of surgery for this trip.  On Saturday morning the team leaves for home except for those of us from Portland. We are staying in Guatemala until Tuesday, spending a few days in Antigua with a trip to the Mayan Ruins at Tikal.  Pictures will come at some point.

**Editor's Note (aka Jill): 

Jenna and I have heard from Jeff daily, although the internet connection is poor at the hotel so usually we have to talk as fast as possible before it freezes and shuts down. Yesterday, Jeff was able to call us from the hospital, where the internet was better. It was nice to have a full conversation and Jenna got really excited and kept saying "Da-da-da" and pointing to the screen. Jeff mentioned that he wished that he would have brought some of Jenna's used clothes with him on this trip. I can't believe we didn't think of that! I wondered if we could mail to the person that from Guatemala that is helping out, but he said they live too far away. Maybe he will think of something and we can still get some clothes to those kids.

Guatemala--Day 6

Guatemala Day 6

Luis (med student) and me. I'm teaching him how to intubate the kiddos

 Well my wish for a shorter day didn't happen, left the hospital around 7 tonight.  It was an interesting day, I started with a palate surgery and then was asked to help in the hospital's other OR.  Currently Hospitalito Atitlan has two ORs but the facility is really only set up to mostly function as a clinic. They have no surgeons or anesthesiologists and the ORs are only used for emergencies...if time is available they transport all patients to a regional facility.  The ORs are minimally equipped and they use anesthesia equipment from another era (things I have only read about in books) and medications that have long since expired.  Aside from the local Guatemalan physicians, there are currently 3 family practice docs and OB doc in the facility from the US.  The OB doc is here for short term like us, but the family docs have 3 year commitments with the hospital and take care of almost everything at the facility (two of them are from Oregon).  If a trauma arrives or a pregnant lady needs an urgent c-section they are responsible, meaning they are often doing things well out of their comfort range.  Today they had a patient needing an OB procedure done under spinal anesthesia, and while they had a visiting OB doc to do the procedure they had no anesthesia providers to provide the spinal......so the family docs do occasional spinals when needed.  I was in the interesting position of being a resident but teaching a doctor who was about 15 years out of training how to do a spinal.  It was a great experience and the doc really appreciated my help, and hopefully now she will feel more comfortable in those emergency situations when she needs to fill the position of an anesthesia provider.  

Otherwise we had a tough day with some unexpected challenges, but everything ended up great.  We helped seven kiddos.  We even had one mom and son show up to the hospital after hearing we were there to try to get help for her son.  He had a cleft lip & palate but the repair needed was too extensive to be able to be done with the equipment we brought...so unfortunately we had to turn them away.  

After work the group headed in to town or a great dinner, and now we will all sleep well knowing that we are over halfway towards our goal of 35 surgeries.  

One last thing....the story of today was me standing in the back of a pickup truck to get to dinner....a rather common form of transportation here although this was the first one that I had seen as picking up tourists.  You would think that a group of medical personnel would be a little smarter then getting in the back of a pickup and standing up riding with a total stranger, but we were all really hungry, and it only cost 75 cents.

Guatemala--Day 5

Guatemala Day 5

We had another long day in the OR, woke at 5 am again and did surgeries on 8 kiddos (4 palates & 4 lips) and we finished after 7.  The cases all went great. Additionally, all the kids from yesterday did well and were sent home.  

On the walk home there was five of us, and out of the bushes came somewhere between 3-5 dogs all growling and barking...it was like a scene in a movie where they kind of surrounded us and followed us almost the entire way back to the hotel...kinda scary. I thought for sure I was going to have rabies by the end of the walk...but I live to tell about it.

 

After work one of my fellow OHSUians and I headed down to the market in Santiago with two high school students who were on the trip with us (they helped their high school in Minnesota raise $50,000 for Smile Network International).  We rode on a tuk-tuk (I have no idea how to spell, but it is a small red three wheeled cart) to get there, and we found a restaurant serving more authentic Guatemalan food then we otherwise have had...it was great.  Interestingly one of the students had recently visited Bellingham to look at Western Washington University, and she said she chose not to go there because it seemed like everyone there smoked a lot of pot.  Looks like she got a great impression of the northwest.

After dinner we walked through the market, which was full of people on a Wednesday night before heading home.  

Story of the day...lunch included a spider baked in to the casserole meal...mmmmmmmmm.

It was a great day, but I'm exhausted...hopefully a shorter day tomorrow...14 of the 36 kiddos complete.