Monthly Archives: October 2012

A New Perspective

10-1-12

This morning Sister Colleen discussed the importance of perspective. Today, the few of us non-medical personnel on this Mission got an entirely new perspective as we were invited into the operating rooms and later put to work as extra hands to scrub down gurneys between surgeries. I witnessed my first, second and third surgeries as I was able to move from operating room to operating room, then follow those patients to PAC-U (post-anesthesia care unit) where the nursing staff took excellent care of the patients.

OR 1
Yesterday, I spoke to Gretel, a young woman whose husband is one of the cooks at our hotel. She was the first patient for Dr. Patterson, anesthesiologist Dr. Bendebel, scrub tech Alexandra Bierne and nurse Susan Olson in OR1. With a lap choley scheduled, she had no complications, and was moved to recovery rather quickly. With four surgeons and only 3 OR’s, Dr. Biderman was circulating and was kind enough to offer a play-by-play description of the procedure for me as it was happening. One of Dr. Patterson’s last patients was Clementino whose daughter, Valentine, was a patient of Faith in Practice when they sent a team down who fixed cleft palate. Valentine is a year and a half old and has one more surgery to go. He said that he feels good about being here because everyone had taken such good care of his “little princess” when she was here. As they were taking him to the operating room, he had such a huge grin and was so enthusiastic about having his surgery.
OR2
In OR2, Dr. Rivera, anesthesiologist Dr. Olson, scrub tech JC Chop and nurse Arlene Howe, they had a patient with a far more difficult lap choley than originally anticipated. The gallbladder was “scared in” with lots of stones, so it took longer than originally anticipated. The crew in the OR worked diligently to successfully help their patient. Their last patient of the day was a far less complicated case. Kimberley Reyes is a 19 year old beautiful young lady who had an inguinal hernia since age 7, but had been causing her a lot of pain since age 15. She told us she is going to school and working taking dictation. Her surgery went beautifully and her mother expressed such gratitude it brought tears to the staff’s eyes and was a good end to the day.
OR3
Our most predictably complicated case of the morning was the elderly gentleman who broke down in the waiting room last night because he was in so much pain and so grateful to receive the surgery. He was in OR3, a tiny operating room Dr. Morrow, anesthesiologist John Nguyen, and nurses Lynn Miles and Karen Rice crowded within along with Dr. Biderman used every inch of that space. I did not think there would possibly be any room for me to fit, but they welcomed me in and explained what they were doing throughout the surgery. They also provided some excellent learning opportunities, explaining that he is “a little guy who had a very large hernia” and at 77 years old and only 87 pounds, the surgeons were most concerned about this gentleman and still had successful results. In the recovery room, as he woke up, he said he was in pain but he knew he would be ok.

Providence trip to Reu, Guatemala

Today, our team prescreened and examined over 70 patients hoping to have surgery this week. Throughout the process today, I learned that, in a hospital, no one walks anywhere, they move at a breakneck pace and hardly anyone ever sits. The team had to be reminded to stop and have lunch as they were working so hard to set up the rooms and see all the potential patients who had traveled for hours and waited all day to be seen by one of the surgeons. There was a constant flow of people who went to the surgeons for pre-op consultations, or the anesthesiologists for exams and tests to determine whether or not they could be operated on at this time. Some were triaged to the house physician for non-surgical treatment and some, heartbreakingly, were told that they were not candidates for surgery at this time. You could see how affected everyone was by those cases as Sister Colleen and Faith in Practice volunteer Joanne comforted those patients and made alternative arrangements for these patients to be seen at the Los Obres Hospital in Antigua or to receive a different course of action. Our translators were working overtime as they made sure the patients could be interviewed thoroughly and the pre-op instructions were communicated to both the patients and loved ones. The nursing staff and the scrub techs HUSTLED to set up all the ORs, unpack all of our crates, and organize all the supplies. I have never seen people work so fast and so well together, that it seemed more like a choreographed dance. They were truly amazing to watch. Finally, after all patients were seen and we were waiting for tomorrow’s surgical schedule to be generated, one very thin, older patient was came out of his room and began expressing his thanks to the staff for taking on his case. Everyone gathered around to listen as he broke down and was comforted by those around him. It is moments like those that make you realize why we are here. Finally, with the day’s work completed, we headed back to the hotel for dinner. After an emotional day, it was nice to gather together for food and hear the laughter, stories and overall camaraderie from the entire team. With 20 patients on the schedule for surgery tomorrow, it was a quick run to the only room at the hotel with wireless to touch base with family and check email, then off to get some rest for that early start tomorrow.

Crossing of the teams

Yesterday, the transition from one Providence team to the next took place as the public health team from the Northwest crossed paths with the surgical team from Southern California. Each group’s tasks so incredibly different, and yet they are both grounded in the same spirit of service, compassion and love. Sister Colleen called to mind the continuity of care that occurred between the two groups in the realization that the public health team worked with a family that had had a surgical operation by the very same organization that the surgical team would shortly begin work with. It sent shivers down my spine as I considered the intimate connection of the relationships that had been built in the homes of families from one team and the craft of the surgical team that would provide such healing to the wounds and needs of the very same communities. The mandate of this initiative- to expand beyond our borders to address the health needs and improve the healthcare capacity of Guatemala- is indeed a challenging one. It requires the commitment and skills of many people throughout our healthcare system. It requires the collaboration of many moving parts both within Providence ministries and with our international counterparts. It requires us to understand the needs of our NGO partners and institutions, carefully identifying opportunities for us to share our talents. However, in this short time we have been here, it is clear that Providence staff are both excited and competent to rise to this challenge. There is not a doubt in my mind that this multipronged approach that Providence Health International will take will not only be successful, it will truly change lives. In fact, it already has. In two short weeks, 35 families now have stoves with adequate chimneys and ventilation to help prevent respiratory illness, over 60 surgical interventions will be provided to relieve extensive pain and suffering for individuals unable to afford the healthcare support they need and deserve and 40 Providence employees have learned from and been touched by the people of Guatemala. More pictures and stories can be found on our other bloghttp://faithinpractice.org/blogs-and-media/340

Our last day in Chitepey

There is something about the eyes of the people we’ve been with in the community of Chitepay. They don’t look away. Even though we could hardly come from more different worlds, I find a mutual searching in the depths of each other’s gaze that transcends our many differences. At breakfast, our team reflected together on our Vision, “As People of Providence, we answer the call of every person we serve: Know me, Care for me, ease my way.” We asked ourselves, “who is the ‘me’ in this vision?”, and wondered if it didn’t point us toward something sacred, hidden in “the least of these”, but shining so brightly in the eyes of the people in Chitepay.

We piled in the van and headed off for our last day in the village. Four stoves remained, so we divided into four teams and marched off in the cool rain to finish our project here. I found myself in the home of a young couple, only 18 years old, with a 5 month old daughter. The home was simpler and smaller than most and the low ceiling of the small kitchen area hit me at about shoulder height. The fire on the cooking table filled the area with smoke and the value the new stove would bring was apparent.The last of 35 stoves to be installed was in the home of Domingo, the “mayor” of Chitepay, who had identified the families in greatest need of stoves and organized the men of the village in work parties to assist. He put himself last on the list, knowing there might not be time for his stove to be installed by the group.

We braved steep and muddy trails to return to the school where the entire community was gathering for a farewell celebration. I will never forget playing soccer with the kids, splashing in the mud and rain, laughing and smiling from ear to ear.

The celebration began with Gladis and Jorge provided translation between English, Spanish and Q’eqchi’. Again and again, the community thanked us for coming from so far away. They were grateful for the stoves, but also for the personal interest in their community. Listening to the Q’eqchi’, one word jumped out again and again: “B’antiox”, “Thank you”.

We all pitched in for school supplies, soccer balls and a jump rope, which we presented to Domingo for the use of the school. To our surprise, the community invited each of us up individually to receive a gift, presented by people we had each connected with. Each gift had been made by hand in Chitepay.

The community asked us to sing a song. We scrambled and Scott led us in a verse of “Amazing Grace”. As I looked out at the community watching in delight and listening to our own words, “I once was lost, but now am found, was blind, but now I see”, something in my heart cracked.

The rest is a blur. We made bright pipe cleaner bracelets for the kids who mobbed us, reaching out their hands, pressing in, so eager for these simple gifts.

Then it was time to leave. “Adios”, “B’antiox”, we heard again and again. It was especially difficult to say goodbye to the children. We each has felt an attachment to a few favorites—usually those kids who “picked” us and followed us from house to house, laughing at our terrible Q’eqchi’.

My tears came easily and my heart ached as we left Chitepay. Even now, it’s difficult to understand why this experience touched me so deeply. It’s extremely unlikely that I would ever see any of these people in Chitepay again, but that’s not it. I have a strong sense of how vulnerable they are—especially the children—and it’s overwhelming to begin to recognize the many forces that put their future at risk. But my tears are about something beyond even this.

We shared with each other the feeling of heaviness in our hearts. The weight of this feeling is from both a sadness and a fullness. We transcended many differences to discover real human beings, people we could love and relate to. People we felt attracted to. People we started to care about in real ways. And while I’m sure Chitepay is a very special village, it’s almost more than my heart can bear to recognize that these same human hearts beat in us all. What hurts, is to realize how invisible the people of Chitepay are to the world and to the powers that be. “Why do these gringos think of us? Even the government doesn’t think of us”, one person asked of our hosts.

We were reflecting on this with our team and Matt reminded us that the people of Chitepay may be invisible to the government or to the rest of the world, but they aren’t invisible to each other. They aren’t invisible to Medical Teams International and they aren’t invisible to us, in Providence now either.

There is responsibility that comes with knowing some of their story, with looking into their eyes, with tasking their corn and laughing with their children. We who have so much power, influence, education and money now face the challenge of sorting out what we do with our heavy hearts.

Entering Into the Homes

We arrived at the community at our gathering point, just outside the three classrooms of the school building, creating a bit of a commotion as some of the children burst from the classroom to greet us. We have become more efficient in prImageeparing to go into the homes, with a group effort to cut the wire mesh that wraps the stovepipes to create a barrier for inadvertent touches by little fingers. Our team was excited to learn it our destination was going to be our first turn in the upper reaches of the community. The walk in to the first home became a hike, with ever increasing effort required as the trail became steeper. It was a marvel to see the steep fields of corn and marvel at the effort it must take to cultivate and harvest the annual planting cycle of corn and beans.

We arrived at the home after our strenuous climb, gazing across the valley at the splendor of the valley of the community. We have come to determine the relative wealth of each home by the little nuances: the siding of the home was either very uneven or had close tolerances, the presence of a little garden or not to create a variety of food, the evenness of the dirt floor, and the number of occupants as measured against the space available in the home. Our first home today was a home of little material means, consisting of an older man, his unmarried 25 year old daughter, and the two children she had cared for since her sister had died some years before. The siding was uneven, the dirt floor required a lot of work to create a level spot for the stove, and there were very few material possessions evident.But we were enthusiastically welcomed as members of the community with a god in common. We went to our by now familiar work, brick by brick, piece by piece, climbing what passes for a ladder to cut a hole in the corrugated metal roof, sealing the hole around the pipe, and topping it off with a “sombrero” cap. Our interpreter then gave instructions about the stove, building the fire as she talked while the open table cooking fire of the day still created a smoky environment inside the home.

We ended with prayers offered by the residents and our team. The father thanking god to deliver us to them and present them with this gift, and we offering that our little gift couldn’t measure the gift of welcome this family had offered us today by welcoming us into their home. Then up the hill some more, on to the next home, and continue our journey.

Day 2

Today was our second day in the village, which also represented a second opportunity to rekindle our new friendship with the community. We looked forward to seeing the same faces that filled our spirits and hearts the day before – we were not disappointed when we heard the names Marco, Aim, Alejandro, Mateo coming from our new friends. After a quick game of soccer, we traversed our way through steep 12 foot corn fields to be welcomed into the homes with warm welcomes. Knowing the stoves would be essential tools of daily living, we took great pride to ensure both the small things like the dirt ground being level to the caulking around the stove pipe water proof. We were humbled by the expression of gratitude as we would leave the homes – prayers, hugs, kisses, prayers, and as well as a live chicken. As we were leaving the village today, we heard a voice translated to say – we hope you never forget us or our village. There is not a chance any of us will ever forget this time for this is a time we have grown in understanding about us by looking into the eyes of others.

First day of work

The team broke up in to smaller groups and, joined by a group translator and stove installation expert, we made our separate ways to the homes of families set to receive a stove. The 20 minute trek from town to the homes of families was a journey past banana, palm, and long-needle pine trees, through a forest maze of 12 foot high cornstalks, along deep chocolate walkways, that rose and fell against almost impossibly steep hills. Everything felt lush and overflowing and alive, but nothing compared to meeting people—families with children of all ages and extended families—in their homes. It quickly becomes obvious that, while the purpose of the work is to install the stove and transform the space of cooking to create a healthier environment for the family and reduce the risk of acute respiratory illness, the real work has very little to do with stoves and has everything to do with the relationship between us as guests and witnesses in the lives of this family in this moment, on this hillside, above this valley… Learning the names of children, struggling to speak a few broken words of hello, thank you, what is your name in Q’eqchi’, all the while transcending the limits of different languages to meet each person where they are, in their home. Many of us shared our thoughts afterwards and talked about engaging with our eyes as well as our words, with our hearts and our hands. Each visit ended with a prayer of shared thanks giving.Image