Partner for Surgery

News from Partner for Surgery: July to September 2011

noreply@blogger.com (Partner for Surgery) — Wed, 07 Sep 2011 18:20:00 +0000

The summer has been busy... Maynor is a helpful and courageous boy who always has a smile for everyone. As his mobility is restored, Maynor has a lot to smile about.

Read more about Maynor and Partner For Surgery's summer activities..

Mayan Families Family Aid Program: Great News for Cristobalina!!

noreply@blogger.com (Partner for Surgery) — Fri, 02 Sep 2011 03:13:00 +0000

Mayan Families Family Aid Program: Great News for Cristobalina!!Christobalina was brought by Mayan Families Family Aid Program to our July surgical mission with Faces of Hope. The story of a courageous and talented young girl, as she receives some much needed help ...

Ten Years and Growing: March - June 2011

noreply@blogger.com (Partner for Surgery) — Mon, 18 Jul 2011 10:55:00 +0000

As we celebrate our 10th anniversary, Partner for Surgery continues to transform lives. The last three months have seen medical missions, surgical teams, a successful fundraiser, new staff and recognition from Rotary International. The work goes on, with our patients providing the inspiration to move forward. Read more...

Medical Triage in El Quiché in May 2011

noreply@blogger.com (Partner for Surgery) — Sun, 05 Jun 2011 20:36:00 +0000

Partner for Surgery medical triage mission in May 2011.
Destinations are Chupol, San Juan Cotzal, Sacapulas, and Chicaman, all in Department El Quiché.

In Chajul, Volunteer Becky visits with Fredy's sisters. Fredy was a cleft baby who was placed on the Partner for Surgery nutrition program, allowing him to gain weight and thrive with enriched formula and a special nurser designed for babies who cannot suck properly.

Director of Rural Operations Fife Bentley asking about Fredy, a cleft child who was put on the PfS nutrition program, which likely saved his life. Fredy will be programmed for cleft repair surgery once he gains enough weight and is old enough.

Fredy with his grandmother and older sister.

Arriving in Chajul for a home-cooked lunch of Boxboles, squash leaves steamed with corn polenta and served with spicy tomato-based or peanut-based salsa.

The Partner for Surgery triage team awaits instruction on where to setup their examination rooms and equipment just prior to the medical mission in Sacapulas, El Quiché, Guatemala.

Volunteer Becky reading in Spanish to local children outside the medical center in San Juan Cotzal, El Quiché after a successful triage.

Centro de Salud (Local Health Center) in Chupol, El Quiché, Guatemala. Patients have lined up early to be screened for surgery

The Partner for Surgery Triage team visits the Iximche Ruin on their cultural day.

Volunteers Becky and Lynn overlooking La Antigua, Guatemala, from the Cruz del Monte path. Volunteers met up in Antigua for the medical mission.

May Quiche Medical Mission

noreply@blogger.com (LynnS) — Sat, 07 May 2011 16:35:00 +0000

We are awaiting the arrival of the remainder of the team. Dinner with the team this evening. We depart Sunday morning- destinations are Chupol, San Juan Cotzal, Sacapulas, and Chicaman, all in Department El Quiche. We will post updates and photos as we are able.

Frank Peterson awarded Rotary's highest honor -- Service Above Self Award.

noreply@blogger.com (Marybeth Haneline) — Sat, 23 Apr 2011 04:26:00 +0000

Frank Peterson, President and Co-Founder of Partner for Surgery, was awarded the Rotary International's highest honor-- Service Above Self Award.

Rotary is a worldwide organization of over 1.2 million members. While many Rotarians distinguish themselves through service; the Service Above Self Award recognizes those outstanding few who have indeed made service a way of life. Only 150 or fewer individuals receive the Service Above Self Award each year.

Read more ...

Partner for Surgery Founder Frank Peterson Honored

noreply@blogger.com (bcarome) — Wed, 20 Apr 2011 14:24:00 +0000

Partner for Surgery founder Frank Peterson was recently named recipient of the Service Above Self Award by the Rotarian International Club. Read more about Frank and the award in the attached McLean Sun Gazette Newspaper article.

Dr. Stolee's Surgical Mission 2010 - A Photo Journal

noreply@blogger.com (Marybeth Haneline) — Sat, 12 Feb 2011 21:25:00 +0000

Dr. Stolee's Surgical Mission 2010
A Photo Journal

Click on Images to Enlarge

Our Perham based surgical mission headed for another mission in Guatemala. We started our planning in February in order to have smooth travels now. We found team members from Fargo, Moorhead, Pelican Rapids, Fergus Falls and Perham.

We drove down to the Twin Cities Wednesday October 20th. We got up at 2:30 am Thursday to get to the airport on time. As usual, we had to pay for every bin over one per person.

We had more than the usual hassles in customs. It took 2 hours for them to look through every bin and check every bottle of meds that we brought. It is very frustrating that people get in the way of helping other people.

We drove to Antigua and checked in to our hotel. We then took a brief walking tour. This gentleman gave us a tour of the original cathedral. The cathedral was first built in 1545 (just 53 years after Columbus sailed the ocean blue). It was destroyed and rebuilt several times over two centuries before the city was abandoned.

We gathered for a meeting and supper at Frida's. Everyone was excited to get going.

Bev Wirth (a member of our team last year who could not make it this year) made scrub caps for us this year including this special one for me that was presented at dinner.

Pat Glynn (our anesthetist from Fergus Falls) made a friend.

We took a tour of Common Hope. For half the team, this was the first time.

Gina Nelson (Pelican Rapids) got to visit her sponsored child.

This is where he normally sleeps. The hole in the wall was created by a boulder rolling down the mountain during the recent heavy rains.

This is the group hiking up to visit Betty's sponsored child.

This is the view from the trail.

Our men's group at church (The Fishermen) sponsors a child. This is the family of Josue. Josue was working in the city and could not attend the visit (this is their summer school break). Josue is 15 years old and going into 9th grade. Most boys in Guatemala don't even finish 6th grade.

This picture of their microwave reminded me of the back of our microwave after we moved from Los Angeles.

This is the contents of the bags of food that we brought to the families on our visits.

We ate lunch at Common Hope. Brenda (nurse from Perham) met this little girl there.

Later, someone in our group saw this group of kids being moved from one school building to another.

Brenda got a kick out of this: she paid for a pop and she was given this bag and a straw and they poured the pop in the bag.

We needed to do some shopping for our lunches for the coming week so we got a taste of Guatemalan grocery shopping.

Saturday morning we headed to San Juan Sacatapequez where our surgical suites are set up. We unpacked the bins and got to work right away.

These are some of the people waiting to be examined by the surgeon. They have been previously checked by triage teams closer to their home towns but need to have their surgery confirmed and scheduled.

Amberlee Jackson is a nurse from New Mexico who volunteered to serve as our translator. Sometimes there was an additional translator from Qi'che to Spanish. I would then approve the surgery and discuss the risks and benefits with the patient or family.

Pam (left) was our administrator. She used the information I gave her from the triage to set up the schedule. She did a great job and tailored a schedule that started ridiculously hard and got progressively better through the week.

Meanwhile, the rest of the team unloaded bins and set up the preop, OR and recovery areas.

This one is not happy to be at the clinic.

This little one has an umbilical hernia. I was showing him how I could make it go away.

Pat Glynn loves the little kids, even when they are scared of him.

He would sing to them as they went off to sleep. Most were soothed by his calming voice.

Every hernia in Guatemala is bigger, more scarred and more difficult than we see in the U.S.

Upon awakening from anesthesia, the kids were usually happy. The parents were always grateful.

I saw all the patients each morning on rounds in the Alberge (patient shelter).

This little girl does not look frightened at all.

Pat is explaining what will happen back in the O.R.

He walks her to the O.R.

Since she sees Pat as kindly, she doesn't mind taking the anesthesia.

After a successful surgery, she is in the able hands of Brenda.

Felipe (right) is the director of Partner for Surgery in Guatemala. He made all the arrangements for our transportation, hotels and food while in country. His wife (Dr. Lopez - left) was the Guatemalan doctor responsible for our patients. The medical school that runs the clinic we were in wants a Guatemalan doctor to supervise all surgical activities. She was very helpful.

At night the clinic has armed guards. They look imposing but Pat was able to make friendly. Note the height difference.

We were doing 10-13 cases per day so I was one tired hombre by the end of the day.

Another cutie at the clinic.

This child is one hour postoperative a hernia repair.

Pat gives the kids a stuffed animal before they go off to sleep and that is the first thing they ask for after they wake up.

Some were entertained by books after surgery.

In attendance of this child are parents and gerentes/promotores (these are part of the Partner for Surgery team - they help the patients get signed up and find their way to the clinic).

Another happy child going off to sleep.

Yes, there was an operating team there.

The whole team worked seamlessly together to provide compassionate care. This is the recovery room team.

Juanita (right - now the manager of environmental services at Perham Memorial) resumed her prior role as our sterilization tech. Rick came along with Pat Heaton and functioned as Juanita's lackey.

Corin Boese and Sara Bergeron are ICU nurses that adapted well to their roles as circulating nurses in the O.R.

Here is the whole team wearing the hats made by Bev (who couldn't make this trip).

Here is the cap in action.

Pat and Pam at the end of a hard day - still smiling.

What do you think has this group so captivated?

They are watching me take this off (sorry to disappoint but I am omitting the gross pictures).

I made sure all the patients were doing well before we left. They departed for home the day before we did. They had up to 17 hours of travels ahead.

We finished the week by packing up the remaining materials and taking inventory.

Our hosts at the clinic put on a short ceremony for us after we packed up. Pat gave a nice toast. They gave us each a small gift to remember Guatemala.

This is the whole team with the Guatemalan nurses and doctors as well.

After closing up shop, the ladies went to the market to shop.

Some rode the Tuk Tuks back to Casa Damasco (the retreat center where we stayed - more or less a hostel).

San Juan Sacatepequez is the center of a large kite festival November 1st. Unfortunately we missed the festival but we got to see lots of people making or flying kites. This one was the cutest.

Right before heading back to Antigua we took one more group shot.

Once back in Antigua, everyone got right to shopping.

Being it was Halloween weekend, a few superheroes turned up.

The colors of the market make an interesting contrast to the colors of the Guatemalan mountains and ruins.

We were invited for drinks to the house of Linda Peterson. She is the wife of Frank Peterson, the founder of Partners for Surgery. We had cheese and crackers on her roof and watched the volcano puff away.

Thar she blows.

We had our last meal together at a nice restaurant called El Arco. We had the best filet mignon ever for the price of regular steak.

Linda Peterson joined us for the dinner.

I will include a couple last miscellaneous photos from the trip. Here Betty gets her brow wiped after heating up in the afternoon.

This would be typical transportation for people (and our patients) in Guatemala except there usually isn't a railing.

Pat Glynn and I have been quite a team the past two missions. It is a lot of stress and time to put together a team like this. Pat is going to take at least a year off to focus on his family.

Goodbye Guatemala for another year.

Changing Lives, One Patient at a Time

noreply@blogger.com (bcarome) — Sun, 23 Jan 2011 03:50:00 +0000

Sunday January 10th – Monday, January 11th, 2011. Comunidad de Ruiz, San Juan, Sacatepequez, Guatemala. On Saturday, January 9th, a 17-person team of surgeons, nurses, operating room technicians, translators and support staff - calling themselves Team Renova – walked out of Guatemala City International Airport. Upon arrival, they were met by Partner for Surgery (PfS) staff members Christine Record and Felipe Sutantri and shuttled northwest to the complex of facilities we commonly refer to as the Centro de Salud Bárbara (CSB) – a modern surgical center and a pre- and post-operative residence facility for patients and their families located in this small town on the outskirts of San Juan. PfS jointly shares and operates the surgical center at CSB with our Guatemalan partner organizations Compañero en Salud (CenS) and Asociación Compañro para Cirugía (ACPC). At about the same time as the surgical team was arriving, so too were 67 surgical candidates who had been identified during our rural medical “triage” missions over the last several months. In addition to the patients themselves, in most cases entire families made the journey together in support of their ailing loved one. Men, woman and children of all ages traveled up to eight or more hours in search of the life changing, sometimes life-saving surgery that the volunteer surgical team can provide. Yesterday (Sunday, January 10th), I made the hour long trip from Antigua to the CSB.

One of the patients that immediately caught my eye was Lucia Pop, a 16 year old girl who was here at the CSB for the second time. She’d traveled the over 180 kilometer, eight hour journey with her parents in November 2010, but was turned down because the reconstructive facial surgery she needed was beyond the expertise of the team of volunteer surgeons who staffed that mission. November’s surgical mission had been organized by Dr. Joseph Giordano. Recently retired, Dr. Joe had worked as Emergency Room Director, and more recently Chief of Surgery, at The George Washington University Medical Center in Washington, DC. One of the organizers of Team Renova, Dr. Philip Iorianni had trained under Dr. Giordano, and Doctor Phil was determined to deliver the surgical care that Lucia needed and so desperately desired.
As a result of a condition that first presented when she was a week old, Lucia arrived Saturday with what looked like a severely swollen black left eye. In fact, she had a naturally occurring sac of blood corpuscles under the eye – a disfiguring condition that worsens if untreated, but which could have routinely been corrected when she was a small child. Unfortunately, access to routine medical care for those who live in remote areas of this nation, not to mention the specialized care Lucia needed, is in nearly all instances a non-existent luxury.

While her parents had accompanied her in November, on Saturday, Lucia had to travel the eight hours alone because her mother went into labor as they were preparing to leave. So, unable to speak a word of Spanish (she is from an area where the Mayan dialect of Keachí is spoken) she set off alone, determined to break free of a condition that, according to Lucia, caused great shame, often kept her out of school, and isolated her inside her home and away from friends. Essentially, it was robbing her of the childhood she deserved. Upon her arrival, Lucia reported that her condition made her “feel ugly,” and that she was depressed and sad about the way she looked. “Before I learned I could receive treatment,” she said, “I did not want to go on living with my face like this.”

On Monday morning, I had the privilege of speaking with Lucia, through two interpreters, just a short time after she had been wheeled out of surgery into the recovery room. According to Dr. Iorianni, the surgery was a smashing success. Check back to this site in the coming days to see post-operative pictures of Lucia and an interview with Dr. Iorianni. (Brian Carome is Director of US Operations at Partner for Surgery, a not-for-profit organization based in McLean, VA and operating in Guatemala.)

Let me introduce you to Santiago, age 5-months

noreply@blogger.com (bcarome) — Thu, 13 Jan 2011 05:39:00 +0000

Saturday, January 8th, 2011. Near Chiché, Quiche Guatemala. At 6:20 am on Saturday, Frank and I drove out of Antigua, and began a trek designed to orientate me to our Infant Nutrition Program (INP). At just after 9 am, we arrived in Santa Cruz del Quiché, the bustling commercial capital of the Department (State) of Quiché. Twice along the way the four lane highway was reduced to two where repair work was underway to replace 500 yard stretches of roadway that, following heavy rains, had plummeted into the valleys, and in some instances, the homes below. In Santa Cruz we were joined by Diego Aurelio Cordova Toma, a Guatemalan nursing student who is one of the Rural Coordinators of our INP. It would be Aurelio who would introduce me to the families of two infants – Santiago Isaias (age 5-months, shown at left with his mother Josefa Morales Guarcas) and Mely Tzalam (age 4 months) – both of whom were born with clef lips and palates so severe that their mouths were unable to latch on to their mother’s breast. As a student at Boston College, I had frequently spent long afternoons at the Kennedy Library. There I had seen the archival footage of Bobby Kennedy’s journey into the heart of Appalachia, used to demonstrate his awakening to the shocking condition that some American families lived in. Today, walking into this remote Aldea (small village), I too was startled by the poverty around me. I will write more about Mely in the March 2011 edition of our newsletter. Here I will share a little bit of the Isaias’ story.

The Isaias’ home is five kilometers from the nearest paved road and over 300 yards from the small adobe church where we parked our car. It’s about 300 yards from the well that serves the surrounding area. Their home is constructed of mud, stick, cardboard and plastic. Their “kitchen” consisted of an open fire on the packed mud floor. The Isaias family, like the other families in this tiny rural enclave, are without work because of the dry conditions that currently exist in this agricultural region. I was startled by the poverty. I was also struck by the wealth of spirit, generosity, pride and playfulness I witnessed (pictures of my visit will be posted to this blog upon my return to the states next week).

I was immediately drawn to Santiago, noticing at the same time his beautiful, brightly alert eyes and what looked like the tip of a pinky finger protruding out of his mouth. Often thought of as an unsightly facial deformity, the severe form of clef lip and palate that Santiago was born with can be a death sentence because he cannot latch on to his mother’s breast. The survival rate for children like Santiago is grim. Market rate formula, let alone the supplies needed to prepare and serve it, are financially out of reach. Partner for Surgery’s INP offers Santiago and children like him their only chance for a normal life.

Santiago was born at home with the assistance of a mid-wife. Once he came to the attention of Aurelio in December, when he was four months old, he and his family were entered into our program and immediately brought, for the first time ever, to a hospital where he was evaluated against standards of healthy infant development. He was then sent home with the same chart that parents of children in the U.S. receive during their child’s first healthy-visit to a pediatrician, usually on or around the third day after birth.

The goal of our INP is to perform the facial and respiratory passage surgery needed to close the palate and nasal cavity and construct a full upper lip. Even infants who survive into childhood remain at risk of respiratory infection if the palate is not closed. An underweight child will not survive the reparative surgery that a volunteer surgical team can provide. Aurelio’s job is to work with Santiago’s parents to usher the child toward nutritional stability and normal weight benchmarks, providing them with low or no cost formula and the skills they need to use it effectively.

Aurelio began by teaching Santiago’s parents how to properly prepare and serve the formula. During each return visit – one to two times a month – he’ll weigh Santiago and chart his overall growth. He’ll also continue to instruct the family in safe preparation of the formula. I look forward to the day when I meet the post-surgery Santiago and he returns my smile with one as beautiful as the dark bright eyes that followed me around as he sat peacefully in his mother’s lap on Saturday. In my next posting, I will be sharing my first ever observation of a surgical mission in action. (Brian Carome is Director of US Operations at Partner for Surgery, a not-for-profit organization based in McLean, VA and operating in Guatemala. He will be writing here about his visit to Guatemala through January 12th.)

The Fire is Lit, Now for the Real Guatemala

noreply@blogger.com (bcarome) — Mon, 10 Jan 2011 04:06:00 +0000

Friday, January 7th, 2011, Antigua, Guatemala. I think the legal term for what happened is “spontaneous utterance.” Whatever it’s called, when, with the advantage of sunlight, I was able to take in my immediate surroundings yesterday morning (Thursday, January 7th), I exclaimed “oh, my God” at the spectacular sight of Mount Fuego, one of the many active volcanoes that stand out as exclamation points in this culturally rich and beautiful nation. Spewing ash into the blue sky above, Fuego, I now understand, foretold the fire of passion, respect and awe that would be lit inside of me as the hours of the following two days unfolded.

As you may have come to expect, my days begin with a run. The Antigua morning rush hour I now know is a mix of bicycles, buses, pedestrians, diesel trucks, mopeds, motorcycles and SUV’s. In opting to put in a morning run, the choice is often between glancing downward to navigate the cobblestone streets and rutty paths beside the roadway, or upwards to avoid the rush of oncoming traffic on the paved roads. What’s obvious is that at 6:30 am, this nation and its people are already hard at work.

Since my arrival at Partner for Surgery last November, I’ve developed a growing appreciation for the hard work that our staff here on the ground are engaged in day by day. Yesterday, I spent 9 ½ hours with our leadership team here – Director of Rural Operations Jessica Momberg, outgoing Director of Operations and External Relations Felipe Sutantri and Director of Operations and External Relations (In-Training) Christine Record. With their front-line service and office support staff, these faces of Partner for Surgery blanket a wide swath of this predominantly rural country with the systems, structures and caring expertise needed not only to deliver quality, life-saving medical care, but the training and knowledge that the Guatemalan people need to respond to their own community health care needs. During this all day staff meeting, we evaluated our successes and challenges and created renewed vision for evolving our approach and focus in the hope of expanding our impact in the year that lies ahead. This evening, we met in Guatemala City with the leadership of our Guatemalan partner organization Compañero en Salud, and mapped out an exciting new vision of cooperation between our two organizations to meet even more of the existing need in the years to come.

Tomorrow morning the focus of my orientation switches to what our staff here refer to as the “real Guatemala.” At 6:00 am, Frank and I head out of the city of Antigua into the rural heart of the country where we will visit with some of the families being served by our Infant Nutrition Program. I imagine that the long journey from Arlington, Virginia through Guatemala City to Antigua might in retrospect seem like a scenic stroll once I’ve seen life outside of these two cities. (Brian Carome is Director of US Operations at Partner for Surgery, a not-for-profit organization based in McLean, VA and operating in Guatemala. He will be writing here about his visit to Guatemala through January 12th.)

Meeting Good People Along the Way

noreply@blogger.com (bcarome) — Fri, 07 Jan 2011 03:57:00 +0000

6:00 am, Antigua Guatemala. After yesterday’s pre-sunrise run, I completed some frantic last minute packing and began my journey with cab ride to the McLean, VA home of Partner for Surgery (PfS) founder and President Frank Peterson and his wife Linda -- my seasoned colleagues, travel-mates and guides on this, my first ever trip to Central America. Like the night prior to so many of their previous missions to Guatemala, the Petersons had been kept up Tuesday night deftly squeezing essential medical supplies and equipment – including an Ohmeda Anesthesia Gas Monitor, a sophisticated medical device essential to surgery – into the six oversized suitcases we were transporting down with us. We boarded the first of our two flights for the day at 11:20 am. Skipping forward over a day of both pleasurable and educational conversation for me, at just before 8 pm local time, I was getting my first glimpse from the air of the lights of Guatemala City – a scene not unlike my first-time arrival in other major cities. Temperature on the ground – lower sixties after what the pilot said was sunny afternoon in the mid 70’s. Gracefully we breezed through customs without having to pay any unexpected or burdensome import taxes for the donated medical supplies we were carrying and met our driver Jorge – a Guatemalan citizen who once taught driving lessons in Annandale, VA – at about 8:30 pm. In the airport at baggage claim, the Petersons had an unexpected but welcome meeting with Ricardo Umana, former Chief Justice of the Guatemalan Supreme Court and a longtime friend of the organization. Our bags were quickly thrown on top of Jorge’s tourist van and we joined about seven other international travelers for the one hour drive to Antigua. (La Antigua Guatemala ("The Old Guatemala") served as the capital of all Central America from 1543 until 1773 – source: http://www.mayalandia.com/guatemala/colonial-history.php.

As we approached the center of Antigua, paved roadway turned to cobblestone streets and I got my first quick look at local businesses – restaurants, small hotels, a gym, a sushi bar, a gas station, a local market stocked floor to ceiling with provisions of daily living – in this quant and cosmopolitan small city of 31,000 (source: http://en.wikipedia.org/wiki/Guatemala). I spent the entire drive chatting with two American Peace Corps Volunteers (PCV’s) both of whom were returning from holiday visits home – Alicia Swift from Oregon and Aliyya Shelley from the San Francisco Bay area. Both know Jessica Momberg, PfS’s Director of Rural Operations, a former PCV herself. Alicia talked of her work in the Peace Corps Healthy Schools Program evaluating and monitoring the delivery of curriculum in Guatemalan elementary schools that introduces concepts of everyday best health care practices to school children in rural communities. She also spoke about her familiarity with international volunteer engineer missions working to improve access to affordable, accessible water. Aliyya, a third year PCV, now supports the work of over 30 first and second year volunteers who work with teenage girls and young women to promote behaviors and decision making that create economic opportunity and sustainable family planning. Alicia, a graduate of the University of Oregon, reflected on how her experience in the Peace Corps and rural Guatemala was challenging her to grow personally and professionally, reminding me of the early years of my own career working in a shelter for homeless adults in Washington, DC in the mid 1980’s. Their lives and career choices deeply impacted by the work in Guatemala, both talked about their plans to pursue degrees in public health or a similar field.

Finally, a few minutes before 10 pm, Jorge dropped us and our luggage at the Peterson’s home in Antigua. Just before the van departed with the remaining passengers, Aliyya generously advised me on a suitable route for my Thursday morning constitutional run. At the house, we settled in, Frank orderly arranged the medical supplies we’d brought and, after a quick snack, we said good night and called it a day.

Memories of the journey and the conversations I’d had throughout the day, great wonder about what beauties and treasures that sunrise will reveal, and anticipation for the 8:30 am staff meeting and the new introductions it will offer are the thoughts crowding my mind at the close of this exciting day. During our layover in Dallas, I learned that a last minute glitch was threatening to disrupt our long planned and painstakingly arranged training of Guatemalan Ministry of Health nurses later this week in Fray Bartolomé de las Casas. Trouble shooting? Brainstorming improvisational solutions? Adjusting expectations for this important effort to detect and treat cervical cancer. Which blend of these activities will greet me in the morning? (Brian Carome is Director of US Operations at Partner for Surgery, a not-for-profit organization based in McLean, VA and operating in Guatemala. He will be writing here about his visit to Guatemala through January 12th.)

A World Away or Closer than I Imagine?

noreply@blogger.com (bcarome) — Wed, 05 Jan 2011 17:15:00 +0000

6:50 am ET, Arlington, VA. In just a few hours I’ll board a plane at Dulles International Airport and begin my journey to Antigua, Guatemala beginning a new and important phase of my orientation as Director of US Operations at Partner for Surgery, an organization I came to work with on November 1st, 2010. I am just back after my daily morning run along the Custis Trail. The temperature in Arlington this morning was in the mid 30’s. Even at 6 am, the hum of rush hour traffic on I-66 was already buzzing. I wonder how that will compare to rush hour in Guatemala City. Along the run, I tried to assess my expectations for this trip.

I’ll be meeting the staff and leadership of our independent Guatemalan partner organization, Compañero en Salud (CenS), as well as my colleagues at Partner for Surgery’s Guatemalan headquarters in Antigua. There will be lots of new names, faces, stories and languages – both Spanish and the many Mayan dialects spoken by our patients, staff and many translators. I’ll have a chance to see a team of volunteer surgeons and other health professionals from Montgomery County, MD at work in our surgical center in San Juan, Sacatepequez starting next Sunday. And as a husband and father of four daughters, I am particularly interested in hearing about the success and challenges of the training we are sponsoring this week of Guatemalan Ministry of Health nurses in the use of an innovative protocol to detect and treat cervical cancer among women in remote Mayan villages. I am told that during the training we’re expecting upwards of 1000 women, all of whom are coming in to be screened for cervical cancer.

What other images might I encounter as I step off the plane in Guatemala City later this afternoon and head west to Antigua? For the last 25 years, I have worked locally here in the DC metro area with children, adults and families who were homeless. How different will those experiences prove to be when compared to the medical and health education services Partner for Surgery delivers in Guatemala? I am about to find out. (Brian Carome is Director of US Operations at Partner for Surgery, a not-for-profit organization based in McLean, VA and operating in Guatemala. He will be writing here about his visit to Guatemala through January 12th.)

Benefit Opera coming up Friday at 8:00...

noreply@blogger.com (Marybeth Haneline) — Wed, 21 Apr 2010 02:23:00 +0000

Reminder of the Benefit Opera coming up Friday at 8:00. Be sure to stop by and enjoy the music and support Partner For Surgery...

Visit http://www.partnerforsurgery.org/opera-benefit.asp for more information....

"Hyster Sisters"

noreply@blogger.com (Partner for Surgery) — Fri, 27 Nov 2009 21:54:00 +0000

Another remarkable story from the mission with Project HANDS comes from two sisters who arrived together, both to have hysterectomies. Partner for Surgery came across Silveria and María Concepción Gonzales in their cervical cancer screening in Salamá, Baja Verapaz. Both were recommended to have hysterectomies due to ovarian cysts and the substantial amount of pain they were having. Without knowing that these two were sisters, the surgical team coincidentally scheduled their operations on the same day. It wasn't until they were already side-by-side in the recovery ward that their relationship was discovered and they were affectionately dubbed the "hyster sisters."

After speaking with María, age 29, about her situation at home and how this operation is going to help her, I was awed by what this woman has been through, apart from the 12 hour trip to the clinic. She started working at age 12, helping in other people's homes and sewing in a factory. At age 18 she got married and the following year had her first child. She now has three kids, ages 6, 8 and 10. Her husband has since left Guatemala to find work in the U.S. as an illegal immigrant. He sends money back to her when he can, but there is little work for him at the moment in housing construction. María talks to him every day, and expects him to come back within a couple of years. Her husband sent money for her to pay a caretaker to take care of her kids and mind the house while María is recovering. Upon returning to her villiage in Baja Verapaz, she is looking forward to a relaxing recovery and being able to work pain free.

Silveria came accompanied by her husband who showed immense concern for his wife during and post-operation. He suffered for the pain his wife was having prior to the operation, so much so that he wanted to sell everything they owned in order to pay for an operation in Guatemala, which they told me would cost Q14,000 (about $1,700). The couple has 5 kids at home from ages 3 to 13, who are being cared for by her brother.

Both María and Silveria were amazed by how well they were treated by the team of foreign doctors and nurses. As María put it, "They see us as equals," which is apparently more than they have seen in their past experiences. "They neglect us when they see the 'cortes'," the traditional skirts that indigenous Guatemalan women wear. To them, the traditional dress means no money, and they often cannot receive treatment. María and Silveria feel very fortunate to have had this opportunity and were eager to find out how they can help with our mission. They are determined to return to their villages and show the others how their life has improved because of the operation they have had. Hopefully this will help to alleviate the fear that other patients have had concerning surgery and assist us in reconfirming more patients that need operations.

H.A.N.D.S. Recap and Mirsa's Story

noreply@blogger.com (Partner for Surgery) — Mon, 23 Nov 2009 01:48:00 +0000

Today marked the end of an extremely successful surgical mission with 72 surgeries completed. On the first day of the mission, only 45 patients were scheduled of the 60 some originally confirmed. Partner for Surgery had originally booked plenty of patients, but many did not show up on the day they were to travel to San Juan, Sacatepéquez for surgery. Many of the no-shows don't come simply because of fear. They do not understand the specifics of an operation and are unnerved by such invasive procedures. Additionally, coming to San Juan for a week often means several hours of transportation to get here, and a week off of work (a week less of pay). Many people just can't afford to give up that much work and still put food on the table. Furthermore, who is going to take care of the 12 children at home? Excuse my exaggeration, but I'm not exaggerating. It is common to find women who have 8 or more children. Therefore, with all this extra room in the schedule, we were able to find several patients in the area who were able to receive surgery.

One particular walk-in was a family that included a mother with two children, ages 2 and 4mo., and a grandmother. They patiently waited for their turn to be evaluated, and after the surgeon was able to screen them, they left with two surgeries scheduled and antibiotics. The grandmother was scheduled to have a lump removed from her breast. Mirsa, the two-year-old girl was scheduled for a hernia operation. Oscar, the four-month-old received antibiotics for a lung infection. Good thing they decided to stop by. Mirsa was scheduled to be operated on the next day. She came in with her mother scared and hungry from not having eaten. She quickly forgot about her woes while she was distracted with bubbles and crayons. Everyone immediately fell in love with Mirsa and her family. They were incredibly cooperative with all the photos being taken of them.

Mirsa's mother entered the O.R. with her when it was time for her surgery. She was asked to be there to keep her calm until the anesthesia took effect. I passed by her as she was taken out to the waiting area. I can't imagine the stress on a mother when her child is in the operating room. I was surprised to find out that her son received the same operation at age four. I guess one can never really get used to such a thing.

The surgery started at 9am. Initially, the surgeon could only find lymph nodes and the hernia was not obvious. As he was pulling away at the lymph nodes and excising them, he accidentally cut a vein that connects to the main artery of Mirsa's leg. The wound quickly filled with blood and the atmosphere in the room became tense, but the surgeon reacted with a calmness that only a veteran could display in this situation. He asked for a smaller size suture that we didn't have at hand, so the circulating nurse and I ran into the next room to find the appropriate size stitch stashed away in one of the boxes while he managed the bleeding. We found the suture, quickly ran it into the O.R. and the surgeon patched up with tear with ease. Once this crisis was averted, the overall mood lightened to its usual pleasantness. The hernia was repaired swiftly and Mirsa was out of there in no time.

While in post-op recovery, Mirsa started to feel panicked as the anesthesia started to wear off and she found herself in a strange place with foreigners. Her mother was quickly called in to console her and she was soon comforted in her mother's arms, tears streaming down both their faces.

Mirsa recovered quite quickly, and the family was able to go home that afternoon. It is amazing how quickly children are able to recover after an operation. Within no time, she was smiling and playing in her bed, enjoying the oreos the nurses gave her. Mirsa's mother was incredibly grateful that the surgical team was able to do away with her daughter's pain.

Project Hands Surgical

noreply@blogger.com (Partner for Surgery) — Mon, 16 Nov 2009 03:42:00 +0000

Another surgical mission with a team of Canadians from the group, Project Hands started yesterday with pre-op triage and evaluation. What a looong day. The patients have all been pre-screened, so it should be a quick in and out consultation just to verify that they do need surgery. Unfortunately, it hasn't gone as smoothly as we would like. The ginecological patients seem to be very demanding of the surgeon's time, and some of them have been labeled as surgery unnecessary. Kind of defeats the purpose of the initial triage...

The hardest patient we had to turn away was a 47-year-old woman with stage four uterine cancer. Unfortunately, PfS has decided that we cannot help cancer patients. We simply do not have the resources to be able to pay for aggressive series of treatements, and sadly, neither do the patients. It is a shame that this woman, Marta, made it all the way to San Juan thinking she was going to be operated on. It wasn't until further testing was done on the woman that her terminal illness was known. So we sat down with the woman after her consultation with the doctor and explained to her that an operation would not fix her problem. I only listened in on the conversation while my co-worker did the talking. I wanted to get an idea of what to say in the even that I should have to have this same conversation with a patient some day. It was painful even as a spectator. My co-worker told me that she avoided completely the word "cancer" because people freak out when they hear that word, and we don't have biopsy results to say that with 100% confidence. After thorough explanation to the woman that she had an "illness" that needed very aggressive treatment and an operation would not cure it, she seemed to understand. She asked how much the treatment cost and we explained that we couldn't really guesstimate a price but it involved a series of trips to Guatemala City, which is about 5 hours from her municipality by bus. We told her that we can help set up an initial appointment for a biopsy, but from there they are on their own. There is no doubt that they do not have the money for chemotherapy, so the most she will be able to do is go home and enjoy the rest of her life. The woman's daughter seemed to understand the situation a little better, for she welled up with tears, but the woman kept her composure and simply nodded. All she wanted was an operation to help with the pain when she urinated. As it turns out, her illness was a lot more involved than she thought.

On a lighter note, I observed an abdominal hysterectomy today, which was most excellent. I have yet to see a surgery that I don't enjoy. I've been keeping pretty busy translating here and there and haven't gotten quite as much OR time, but tomorrow we have a full day of cases, so I expect to see a lot more.

Surgical Mission with Team ISHI

noreply@blogger.com (Partner for Surgery) — Sun, 08 Nov 2009 23:18:00 +0000

At the end of October I had the amazing opportunity to be part of a surgical mission in San Juan, Sacatepéquez. The clinic there called Centro de Salud Bárbara (CSB) has recently installed two fully loaded operating rooms, complete with air conditioning! (A real luxury) Partner for Surgery has helped to equip these ORs and find surgical teams to come and put them to good use. This month's team was from New Jersey and goes by the title International Surgical Health Initiative (ISHI). A team of 20 came down to Guatemala, including 6 surgeons, 2 anesthesiologists, 1 nurse anesthetist and 7 OR and recovery room nurses. They even came with their own journalist, photographer, and two people to handle all the logists and plan making. This was quite an organized bunch, to say the least, and I can't say enough about their efficiency. We had a total of 60 patients scheduled to be operated on over the course of 5 days, but team ISHI finished in four. Although they were very serious and extremely focused in the OR, team ISHI certainly knew how to have a good time when they were off the clock.

The patients came from a variety of areas within the departments of Alta and Baja Verapaz. The majority spoke Q'eqchi', some spoke Spanish, and a few others spoke A'chi. The language barrier would have posed quite a problem if it weren't for our collaborators from these areas. Partner for Surgery contracts a few special local area managers who travel with the patients, stay with them at the patient shelter, and translate from Spanish to their native Mayan language. We certainly kept these people busy as they were constantly on call; translating for the inital evaluation and often times entering the OR with the patient to keep them at ease. Some of the patients really appreciated having someone there who spoke their language. Others blindly followed whatever instructions the nurses were able to convey through body language and gestures. I helped to interview some of the patients with ISHI's journalist, and most felt fine about the fact that the doctors didn't speak their language. They said they were so happy to be able to have the surgery, an operation that they wouldn't be able to afford under normal circumstances, and they trusted this team of foreign surgeons to do a good job.

On a personal note, the whole week was incredible. As someone who is interested in going into medicine, the experience couldn't get any better. I was able to observe any surgery I chose throughout the week. What was not a big deal to the doctors made my day, my week for that matter. All of the doctors were incredibly nice and patient about explaining anatomical elements and answering all of my questions about the procedures. I'm wondering if there is any possible way I would get experience like this in the States.
(photos to come)

VIA-CRYO Cervical Cancer Program

noreply@blogger.com (Partner for Surgery) — Fri, 06 Nov 2009 17:46:00 +0000

In my second week with Partner for Surgery, I had the opportunity to participate in a course for Guatemalan nurses and doctors that teaches cervical cancer detection and treatment. PfS teamed up with Faith in Practice to educated 20 or so medical professionals on this simple, easy technique taught by Dr. Peter Thompson. VIA stands for Visual Inspection of the Cervix with Acetic Acid (vinegar) and CRYO is short for cryotherapy, the subsequent freezing of any pre-cancerous lesions on the cervix.

Acetic acid treatment serves to identify cells that are pre-cancerous or affected by the Human Papillomavirus. When a positive case is identified, the patient undergoes cryotherapy, in which the infected cells are frozen using nitrous oxide. Throughout the course of several months, the frozen cells are replaced by new, healthy cells. Women who receive cryotherapy are only required to return after one year for a follow-up.

The students followed a schedule of daily review and theory in the morning and clinical practice in the afternoon. We were allowed to use a space at the National Hospital in Salamá, Baja Verapaz to set up 8 make-shift clinics separated by bedsheets. PfS helped to gather patients that arrived every day to be screened, many of whom had never even had a pap smear before. The patients were greatful to be educated on feminine health and cervical cancer prevention, a theme that is not widely discussed nor taught in the outlying regions of Guatemala.

The implementation of VIA-CRYO courses and screenings has been of great value to the Mayan cultures of Guatemala. Studies have shown that this system of screening and same-day treatment is much more effective in developing countries. That is not to say that it is better than the pap smear; rather, it eliminates the need to return for results and/or further treatment. Many of these women travel hours by bus to be screened and leave their daily responsibilities behind. Returning to the clinic for consecutive visits is simply not an option for the majority of them. In this way, the women can be screened at the clinic with the acetic acid test, receive cryotherapy treatment if results show a positive lesion, and return home the same day.

October 2009 Medical Mission

noreply@blogger.com (Partner for Surgery) — Thu, 05 Nov 2009 01:31:00 +0000

With the help of Project Hands, Partner for Surgery had yet another successful medical mission to the department of El Quiché. The team of Canadian medical professionals included: Drs. Tony Dunlop, Pat Connick, Dennis Saunier and Nurses Sandee Saunier and Jacquie Clayton - a laid back bunch that was ready to roll with whatever came at them (stomach flu included).

We visited the municipalities of Chiché, San Antonio Ilotenango, Cunén and Chajul for triage as well as the municipalities of Kumacaj and Acul for some cultural immersion. At the end of the week, 379 patients were evaluated by the doctors, 145 of those being referred for surgery. Among the referrals included patients with hernias, sebaceous cysts, cleft lip and/or pallet, and prolapsed uterus.

One of the most heartbreaking cases that stands vivid in my mind was a boy with an obvious limp due to a nagging foot ailment. When he removed his shoe - without socks I must add - he revealed a deformed foot with toes that seemed to form one big open sore. No wonder this kid was limping! It was determined by the doctor that the boy had a problem with incontinence, perhaps due to nerve damage. A conversation with the mother revealed that she had gotten tired of changing her son when he wet his pants, which apparently happened often, and left him to fend for himself in urine soaked pants and shoes. In a hygiene discussion with the boy and his mother, we instructed her how to care for the child's poor, infected feet. Additionally, we stressed the importance of putting on clean clothes and, more importantly, clean socks. We suggested that she take him to the bathroom every two hours to prevent him from wetting himself, but it's hard to say whether she will follow up on that or not.

We returned to Antigua -some of us still suffering an unpleasant stomach flu- and met at Frank Peterson's house (the founder) for one last meal as a team. Some of the team left the next day while other stayed to get their fill of Antigua. Dennis and I decided to tackle the volcano Pacaya. Our guide affectionately dubbed us team Puma and encouraged our ascent to the top of the volcano. My impatience was getting the best of me during our hour or so ascent as I persistently asked our guide when we were going to get to see some lava. It was certainly worth the wait to arrive at the top. Seeing the flowing river of lava snake its way down the side of the volcano was like nothing I had seen before. We sat at the top with our celebratory sack lunch and watched as other climbers roasted marshmallows over the lava. I will definitely go there again.