Medical Missions Foundation

Friday, July 30, 2010 - Mission End, Heading Toward Home - Final Blog

Right on schedule, we closed down the Ambato Medical Mission and departed for the five-hour ride to the hot springs at Papallacta.  We have 19 members of the mission team on a small bus rolling down the Pan American Highway in a light rain. Like our Oregon Trail, the Pan American highway winds through the bottom of an endless valley. However, instead of towering peaks and walls of snow we wind through pleasant country scenery replete with green hills and close mountains on both sides.  Think of a long river high in the Andes mountains and that’s us here today on our toll way. Even though we are running at altitudes that range from about 8,000 to 11,000 feet above sea level, everything is green. Green fields, trees, hills and totally green mountains.  Diverse green shades topography and agriculture give a patchwork effect.  There are 8-10 variations on the green theme. Yes, this high up, you’d expect to see expanses and whole mountains dominated by bare patches of granite rocks and crags as is pro forma for our rocky mountains or Europe’s Alps.  Nope, not here. At the equator we traverse a vast range of mounts all sporting shades of variegated green.  Altogether our color-wheel is composed of simply these greens plus cloud-colors, and blue skies blue, there are innumerable tints of those colors to capture and delight the eye. 

As a surprise bonus for our hard work, we stop for the night at the hotel Termas de Papallacta. Perched on a high Andean valley at the entrance route to the Ecuadorian Amazon jungle, the spa/resort is a well-earned respite. Each cabin room has large relaxing thermal baths.  We all spend hours indulging in the pampering spas of Papallacta. It is an enjoyable way to end a hard work week.   

Papallacta Facts:  

• The Papallacta route was taken by the Spanish conquistador Francisco de Orellana in 1542 as he crossed the Andes mountain range when ‘discovering’ the Amazon.
• Altitude: 3,300 meters (10,824 feet) above sea level. 
• Climate: Humid upper-mountain rainforest. Cold-wet climate 
• Average daytime temperature: 14°C (57°F)

This has been a grand experience. I learned and grew as I working in a beautiful country with fine people. I saw through their eyes what it is to serve our fellow man. I felt my heart grow big from the joy of people we gave reason to smile.

I’ll finish with the words of Martha Penaherrera our Ecuador Liaison, “ We have proven that with faith and love we can do it all. Because we, the Ecuadorian doctors, the Ecuadorian nurses and the Ecuadorian volunteers worked together with the Medical Missions Foundation, the results have been incredible. I hope that next we will join our efforts again to help even more Ecuadorians.”

Adiós Ambato --Mission Wrap-Up

Friday Morning July 30 – Good Deeds Done y Adiós

MMF Wonder Workers

Synergy is another word for achievement of both cooperation and collaboration.  And we have all, big time. In this short week MMF has worked wonders.  So far we have attended to more than two hundred and fifty of Ambato’s needy.  Our diagnosis and treatments aided 124 children and 127 Adults.  Corrective and restorative surgery was performed on 54. This work was enabled by a splendid team of nine translators - each is a medical student at Ambato’s PUCE (Pontificia Universidad Catholical).  Their interpretation was a mission-critical success factor.  They are a great group of men and women whose pleasant personality, solid background, and strong character effected a synergy between the Millennium hospital staff, our medical mission team, and the patients and families we wanted to serve. In other words, concerted efforts of capable medical translators together with a committed mission team yields more good results than does unadorned fellowship.

Alle Menschen werden Brüder -- Beyond the chance to share talents, our mutual motivations include a desire to make a difference to stop needless suffering. We share pride in working together to reduce pain, disfigurement, and ostracism and replace it with a new hope for tomorrow and a future of rich potential.

Today after two final surgeries, post-surgery follow-ups remove with this week’s surgery patients, we pack up and depart towards Quito and home.  First we will stop at a way-point high in the Andes. We are heading to the hot springs at Papallacta. That will be a warm respite on a cold day. Today it is about 50F in Ambato.

Restoration of Antony

By Andrews (Andy) Carter  -- Ambato July 29, 2010

Two years ago, little Antony Carrera was a happy one-year old testing out his legs in Guachi Progreso San Carlos, a small village just outside Ambato.  Children his age are universally curious, and Antony was no exception.  There was an iron on the floor, standing up and turned on.  It was interesting enough to Antony to grab and find out what this shiny object was.  The tragic result was that Antony severely burned his fingers.  As he grew, scar tissue formed and bent his index finger. 

The Carrera family does not have a lot of money, so they sought help at the public hospital.  The public hospitals were unable to help after repeated efforts by Juan Carrera, Antony’s father.  The family was determined to get Antony the help he needed, so they tried to save up enough money to get him treated at a private hospital.  Despite working several jobs, Juan was unable to make much headway.  After all, he had a family of five to care for.  

Two years after the accident, Juan saw the television coverage of MMF’s first day in Ambato.  He discussed it with his wife, but they were both skeptical.  No one would help them, they thought.  Miracles happen to other people.  Their relatives were not so pessimistic and urged them to make the journey to Ambato to see the American doctors.  

On Wednesday, Mama Carrera, Antony and his little sister made the journey and checked in at the clinic.   Could they possibly help Antony?  After an examination by Dr. Beverly Graves and by one of the surgeons, the answer was “How about tomorrow?”  The family could not believe what they were hearing.  Not only could the Americans fix Antony’s finger, but they would do it the next day.

Still a bit skeptical, Juan decided to take the day off from work and bring his family to Ambato.  With the exception of Antony’s older sister, they arrived at Millennium Hospital and were immediately ushered into Pre-Op where the necessary pre-operative tasks were compassionately carried out.  Dr. Phil Gutek expertly cut away the scar tissue to restore Antony’s finger.  The surgery required a skin graft to complete the surgery.

After surgery, as Juan Carrera held his only son, he said that miracles do indeed happen.  “We thank God and Medical Missions for restoring our son”, he said.  

Ambato Mission Wednesday 28 July -- Another good day at work.

We did well today. All players now know their respective role and their relationship to others’ jobs. Our success key was free and friendly communication. With that catalyst, we perfected our work methodology. Now each one of us know how best to receive a job, perform our own respective work and then quickly transfer it on to the next work station in the process chain.  I think  it is rather elegant.  Said another way, good collaboration has improved our work process flow by easing and simplifying work-transfer procedures between each step. 

As you know, good collaboration is the measure of operational cooperation. We measure up fine. Our amalgamation of experience, training, lessons and ’can do’ attitude has fused into a team operation that is both effective and efficient. Today we produced better results faster. That benefits our patients, their families and us. Patients and families enjoy superior results with less attendant time and trauma. Volunteers get to catch their breath and smell the flowers. 

Some of us have taken advantage by trying another role or observing different teams in action.  For example, some watched an operation start-to-finish. Starting with patient check-in, we moved along the patient from there to pre-op, transfer to the operating room, administration of anesthesia, pre-surgery set up and preparation, the surgery itself, patient transfer to the recovery room, recovery, final checkups and release. Interesting? You bet! How did the experience make me feel? Simply put, it made my heart big. Still does.

(Next time we will walk together through this magical tour and follow a burned child who regains full use and dexterity of a once deformed hand.)

MMF Beginnings: Volunteer Profile, Frank Custer Koranda ---  A seasoned medical missions veteran, Frank loves to give his time and talents to others. He feels that his work has paid dividends with interest. While purposeful travel deep into the heartland of foreign countries is a magnet, he treasures the affection and warmth from grateful patients whose horizons are thereby extended. Still greater compensation accrues from lasting friendships.  Sharing missions with likeminded volunteers has sprouted flowers of friendship and fellowship that blossom into bountiful gardens.

For the past 16 years Frank Koranda, an otolaryngologist-head and neck surgeon on the medical staff of Shawnee Mission Medical Center, has dedicated himself to Medical Missions Foundation.  Originally his motive was to scratch a long held itch to do meaningful volunteer work for the indigent. The opportunity to serve arose in 1996 when fellow doctors Tony and Luz Racela suggested a medical mission to the Philippines. Frank seized the proposition and stayed with it. Later that year, Drs. Racela ran with the concept and established our Medical Missions Foundation. Yes, a healthier world is a tide that raises all boats.  

Tuesday, July 27th - We Are A Well-Oiled Machine

Factoid: Due to near-equator: latitude. The climate in Ambato remains constant year-round at about 60F.

 It rained most of the night. We woke to wet streets. Today, our roof is clouds hovering below the encircling mountains that hug Ambato close. As yesterday, our team arrives at the hospital between 7 and 8 AM and immediately start receiving patients, diagnosing, counseling, and operating. This morning there are already about 25 patients and their families in queue. The waiting room fills up quickly because most every patient is accompanied by family members. In addition to moms and dads there are all the siblings too. The elderly and adult patients are often escorted by family and friends.

 Today our medical volunteers diagnosed about 45 new patients and performed ten surgeries. Each patient and family is escorted into our admissions room and documented into the MMF system Medical/Pediatric File. As you'd expect, working closely with our interpreters, we record weight, temperature, blood pressure, allergies, and medical history. We are fortunate that each of our seven interpreters is a medical student. With their help we also capture a narrative of the chief complaint and get a history of past illness. After this   document is logged, it is categorized and then reviewed by our nurses and doctors. Together they render a diagnosis and prescribe treatment. If the treatment involves surgery, that too is scheduled. Treatments requiring drugs or a prescription are filled free by the impressive makeshift MMF pharmacy.

The medical mission to Ambato was announced to the press and public via advertising and handouts that proclaimed:

Free Surgery for Ambato
Hospital Millennium, To Strengthen your life! 

(Proudly announced that two volunteer organizations:) 

Ambato "Thousand Hopes volunteers" and the USA Medical Mission Foundation have teamed up to provide free services to the needy including examination, consultation, and treatment for Cleft palate, burns, diabetes, high blood pressure, and other medical problems.  (Dates)"

Monday, July 26, Day One of MMF Ambato Mission

Factoid:  The official currency in Ecuador is the American dollar.

When we arrived at the hospital yesterday we'd planned to unload medical supplies, scope out the facilities, and do some preliminary patient assessment.  We figured that would take all of two hours, perhaps three at the most.

We walked in the door to find several hundred potential patients and their families waiting to be seen and diagnosed.  Thus our two-hour hospital check-out became a six hour marathon.  Teams were set up to get supplies situated and accessible in both the operating room area and in the patient check-in, interview, and diagnosis area.  As planned, our admissions and patient administration people started by sitting each potential patient down and opening a record document.  After review, this preliminary triage categorized patients and queued them.  Then, they were reviewed by the MD specialists for either examination by a doctor or counseling and release.

Dr. Beverly Dark Graves, clinic doctor (pediatrics) and Mission Co-Director

Dr. Leland (Lee) Graves, clinic doctor (internal medicine)

Dr. Philip Gutek, plastic surgeon

Dr. John Hubbard, anesthesiologist

Dr. Frank Koranda, plastic surgeon   

About six hours later, the last patient was interviewed and examined and we headed back to the hotel and bed.  I don't even remember what I had for dinner that night.  We had worked with some 83 potential patients and filled out much of our surgery schedule for the next week.

Today was our first day and our process smoothed out.  We had moments of patient overload punctuated by brief spells of reasonable pace.  Today we had about twelve operations and our pediatricians and internists reviewed about 53 new cases.  Doctors Beverly and Lee Graves smoothly questioned, examined, diagnosed, and prescribed for these patients.  Nice!  They were smooth yet evidenced real care and concern for all that had waited to see them.  In the operating room, we watched some of the surgeons work wonders.  Their reformation work gives these kids a brand new lease on an entirely new life and the joy in their faces reflected all of that potential and more.  It is a privilege to be associated with such good works.

Good teamwork allowed us to catch our breath, relax and dine by about 7:30 PM.  Then, depending on wish or whimsy, we strolled off to talk, shop, swim go to a mall, or try and catch pu on needed sleep.  Monday feels like it is already Wednesday.  We wonder what Tuesday will bring.

Ambato: Getting There, Images and Scenes

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No daylight savings time. Ecuador’s days and nights are a year-round constant. According to our hosts, the sun rises at 6:00 am and sets at 6 pm daily - always.

 Sunday Morning 25 July is cool and invigorating in Quito. Restful sleep. I’m up early to Tai Chi. Come 7:00 am we attack a hearty breakfast. Excellent Ecuadorian coffee fuels the cheery anticipation of our bus trip to our operations base,  ‘Hospital Millennium’ in Ambato. We head out through a Quito which still mostly  sleeping and quiet. Climbing up to the valley-hills, basking in the sun, we enjoy  nice visuals. Soon, these evolve into a myriad of green fields with fence lines of  tall trees. Yum: appetizer for eye-candy to-come.

Like yesterday, we head due south towards our host hospital which turns out to be a bright white complex sequestered in the valley-mountains of Ambato, Ecuador. The country envelops us. We move to a shifting vista. All around  verdant mountains hold scattered clouds pinioned captive with their crests.  Linked mountainsides glow with many greens under a scattered sun. …. Nice.

As our small bus chugs towards the top we pass crops and grazing livestock. At times ubiquitous black and white cattle mow the tall way verges. We climb into the clouds. Chilly now. 

A rest stop and way point is a historic plantation house built in 1850. On reaching the lovely La Cienega Hacienda at noon, we leave the bus at the massive iron gates so that we can stroll a half mile up the driveway to the front door. The path is lined with centuries-old eucalyptus trees that frame the central garden fountain and mansion   entryway. Then, like kids, we scatter and explore richly decorated rooms and extensive grounds of this combination hotel, working ranch, and floral gardens. On the central spiral staircase we gather for mission team photographs and award presentation. In a short ceremony, three of us are recognized for making this mission to aid the needy possible. Singled out for their unstinting work for the trip, including arrangements, scheduling, coordination, collaboration, planning, leading, administration, and of course 

logistics are:

o  Beverly Dark Graves

o  Martha Hipatia Penaherrera 

o  Dallas Lucille Rowan               

Onward to the Hospital Millennium we reach the mountain, hills, and valley city of Ambato. Ambato has a population of 350,000 whose homes, Dallas remarked, “Seem to be pasted on the sides and walls of the valleys   and mountains. Ambato is located in the center of Ecuador. With an average elevation (ASL) of 8,500 feet it rests lower than, and so is slightly warmer than, Quito. We unload our luggage into our rooms at the Emperador Hotel y Casino…. Nice hotel, our room looks onto the street with a view of the mountains and hillsides. We are treated to a welcoming and get-acquainted lunch at the Julio Cesar Restaurant. Benvenidos, Gracias por ayudarnos a ayudar.” Lunch was really good. Chicken soup with onion and cauliflower followed by steak in sauce, acorn dish, avocado salad and a fresh fruit desert. The translator team introduced themselves saying, "Welcome, thank you for helping us help." 

 At 2:00 PM we loaded the bus with all the supplies we’d brought and headed to the hospital where several hundred needy patients had lined up anticipating our arrival. This was the start of a long and busy work day wherein we receive over eighty paitents.

10:30 P.M. And All is Well and All Are Tired

Posts by Pat Works

 With an early start, we flew to Miami International Airport. We grabbed an airport lunch and left the States for the 1,800 mile flight to Quito. Flying due South from Florida, we crossed both Cuba and the Gulf of Mexico to bisect Panama in darkness. Night-flying across a chunk of the Pacific to landfall in the North West corner of South America, Ecuador.  It is a cloudy, dark night. Suddenly from the dark of a black ocean Quito’s bright city lights appear.  

Quito, the capital city of Ecuador, looks big with its population of 1.8 million. It is nestled in the Andes mountains at a perch of 10,000 feet above sea level.  We deplane into a crisp cool and refreshing 55F, even though the Equator runs nearby.

Our team of 24 loads onto a bus to overnight at Hotel Filandia.  Travel-tired we head for bed.  Me too.  Good night from Ecuador.

Ecuador Inaugural Mission

July 24 a team leaves for our first mission to Ecuador.  Please check back here for blog updates as the week progresses.