Medical Missions Foundation

Saturday in Panama

MMF Panama Mission Day 7

Saturday is finally here!  A number of our group have decided to do nothing but sleep in, maybe sit by the hotel pool and generally relax after a number of very long and tiring days.  The rest of us were up at the usual time to get in the usual Toyota van.  This time we were not going to the hospital just down the road, but up to the Chagres River, where we would visit an Embera Indian village.   After the ride up to embarkation point, I was convinced that there are more chuckholes than pavement on many of the back roads!

We embarked in a dugout canoe for the two-hour journey up the Charges.  At first the river was wide, deep and slow moving.  It became progressively shallower and narrower as we moved upstream, with the rapids becoming more frequent.  It took all the efforts of the two man crew to guide what is essentially a tree trunk with an outboard motor up the winding river.  The bow man used a pole to push us away from the larger rocks and snags.

Arriving at the village, which is located on a bluff overlooking a sharp bend in the river, many of us were glad to be back on solid ground.  It was almost like going back in time, except for the telephone booth in the middle of the village!  We were allowed to wander about until it was time for a talk on the history of the area and a lunch of fish and fried plantains. 

After lunch, we took a hike with the “botanical man” to visit a garden where local plants and herbs are grown for medicinal purposes.  Dr. John Hubbard seemed especially interested in the little berry with local anesthetic properties.  He said he didn’t plan on using it in the operating room, however.

After a trek back to the village, we were entertained with some native dancing.  Our trip down the river was quicker than the one upriver. Our bow man had replaced his broken pole with a new one which he was able to use to keep us out of trouble once again. 

We finally returned to the hotel for a quiet dinner and final packing for our trip home tomorrow. 

Friday wrap-up

MMF Panama Mission Day 6

Friday is usually the last day of the surgical side of any mission trip, and the 2011 mission to Panama was no exception.  The team had relatively few surgeries scheduled today.  There were eleven, but that seems light after days with numbers typically in the twenties.  We started packing up the supplies that were not going to be left for either the AEP to pre-position for next year’s trip or given to the hospital.  In the more relaxed atmosphere, there was additional time to reflect on the children who were helped this year.

The Panama mission was truly a joint effort, with as many as five Panamanian surgeons joining our doctors to perform an astounding total of 98 surgeries for the four and a half days of operations.   A total of 48 plastics cases were done, 32 orthopedic cases and 18 ophthalmic surgeries.  The team did not get to interact with all of the patients, but there were numerous children whose stories are typical of those we helped.  The second day, there was Vilma with the beautiful eyes and wonderful attitude, who desperately wanted her malformed ears reconstructed.   There was Alexander, who was our last surgery on the hectic Wednesday, an orphan who lived in a group home with nine other boys, who also needed surgical revision of his malformed ears.  He waited patiently all day and was cared for by Doctors Koranda and Hall during a multi-hour surgery late in the evening.  Alexander, a boy who literally had nothing, not even parents, now has hope for something better.

Today, there was Roy, known in his village as “Veintidos” because he had six toes on each foot.  All he wanted was to be able to wear regular shoes like his friends.  Dr. Hall gave him normal feet this morning. 

After packing up, we headed back to the hotel for lunch before heading out to see a bit of Panama City and the Panama Canal.  Panama City has glitzy high-rises and grimy slums and a lot of history.  We only had time for a brief visit around the French Square before we had to leave for the Panama Canal.  It was fascinating to watch ships move through the locks on their way to or from the Pacific Ocean.  We ate dinner overlooking the locks.  I never thought that having dinner while watching what is essentially an industrial process could be so enjoyable. 

A Satisfying Day

Yesterday was hectic, with little time to do anything but try to do as much as one could. Today, though long, was a little more relaxed and provided a bit of time to reflect on what has transpired over the past several days.

Stepping back from the controlled chaos of the pre-op and post-op areas and the operating rooms, an answer to what an MMF mission is all about becomes a bit clearer. What the missions provide is life-altering surgeries which give those less fortunate than ourselves a chance to realize their full potential. We can't know the ultimate outcome, but we do know that we have provided a positive experience.

We had a bit better situation today because we were able to utilize a third operating table and our Doctors Koranda and Hall were able to team with Doctors Garrudo and de la Rosa to use their talents to do another twelve cases. Today, we were actually out before nightfall!

The extent of the cases is truly astounding. Today we repaired the hand of a small  boy who had several of his fingers joined to together. Another procedure corrected conjoined toes of another child. In both cases, we enabled normal functioning which will give these children a better life. Other cases today included a bilateral otoplasty (reconstruction of both ears), removal of growths from the faces of children and correcting drooping eyelids. It was another long, but very satisfying day.

A "Mount Everest" Wednesday

Wednesday is sometimes referred to a "hump day". Supposedly, after Wednesday, there are only two days left in the work week and it's an easy coast to the weekend. Here in Panama, the "hump" looked more like Mount Everest, especially in the rearview mirror!

We stayed true to the usual MMF form by getting the maximum done in a very short time. Hospital from 7:30 AM until 11:00 PM. Twelve plastics procedures (out of a total of twenty-five). It took eating both lunch and dinner (rice & beans, beans & rice) at the hospital and managing some complicated cases, but we got the schedule clear.

Tomorrow promises to be another challenge, with ten more cases scheduled. Everybody is up for a new challenge, although right now we are TIRED!

Paying it Forward

In the movie "Cool Hand Luke", the sheriff's diagnosis is, "What we have here is a failure to communicate." It takes a trip to a country where English is not widely spoken to make one realize that effective communication is an absolute necessity. Nowhere is this more apparent than in the pre-op and post-op areas. The nurses must ask the parents numerous questions about their child's health status and must accurately explain what is going to be done to the child in surgery. Post-operatively, they must accurately communicate the child's condition and relay the dctor's instructions about post-operative care. This is a tall order when everybody speaks the same language. When there are different languages involved, translators who "get it" are really needed.

Our newest volunteer, Nivaldo is such a person. Nivaldo gets it because his son Raul had an orthopedic procedure yesterday, and Nivaldo and his wife Itzy experienced the need for accurate information first hand. Since Nivaldo's mother teaches English, he speaks and understands the language well; he thought that he could give back to the mission for the kindness shown his son.

Bright and early this morning, Nivaldo was there, helping bridge the language barrier between anxious parents and children and the MMF volunteer nurses. Although his available time is limited for this trip, he has already signed up for next year's trip. All he has said that he needs is a little notice so that he can take a vacation from his job. As trite as the phrase is, Nivaldo is "paying it forward" in the best sense.

Meanwhile, the entire MMF team played a little catch-up today, completing 22 surgeries and putting us back on schedule. Although it was a long day, the process worked better than yesterday, with everybody finding their "rythmn" and meeting the needs of a significant number of children. Also helpful was our "mission debrief", which is held nightly by the pool at the hotel!

A Busy First Day in Panama

Our exhausted group headed back to the hotel after a long 14 hour day! All in all, we got a  lot accomplished for the first day in the new hospital, especially considering the dedication ceremony in the afternoon, which included an appearance by the President of Panama, Ricardo Martinelli.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Every mission starts a bit slowly, but soon ramps up to an efficient operation. With four operating rooms in use by Mission de Amor, a variety of surgeries were carried out today. Our pre-op and post op nursing staff, Denise and Lucy did an outstanding job of handling patients and organizing what became a combined pre-op and post op area.

 

The patients from the far West of Panama, near Cost Rica, were scheduled for today because of the long trip home. Dr. Hall worked on a bilateral cleft lip with Dr. de la Rosa and when the patient came to recovery, Dr. Hall declared the experience was "awesome". This is an great way to start the day!

 

One young boy with cerebral palsy had come to David in 2006 but was too sick for the operation. The ladies of AEP arranged for him to get a wheel chair at that time and he returned in his chair today for the long awaited surgery. This is an amazing example of the synergy a mission trip provides, benefitting children even if we cannot help in our primary surgical mission.

The day could be described fairly as hectic, with surgeries lasting until after 8:00 PM. The women of the AEP arranged for both lunch and dinner to be served in the break room. Chicken and rice are the staple menu items. Fresh fruit is a highlight; Panamanian grown pineapple, papaya and melon are all sweet and abundant.

We have ten plastic surgery cases scheduled for tomorrow, along with an equal number for the opthalmologist and orthopedic doctors.

 

A New Hospital, A New Beginning

Day one of the fifth annual MMF mission to Panama ended with the team returning to the hotel after a long but productive day.  The operating room staff and the anesthesia team spent the day setting up the pre-op area, post-op area and the operating rooms for their first patients...ever!  The hospital is so new that none of the surgery facilities have ever been used.  In addition to the usual tasks of prepping spaces for patients, the team also had to verify that all of the installed equipment, including the piped in gasses were working correctly. 

Meanwhile at Escuela Nuevo Belem, an elementary school where the AEP is housing the children and their accompanying adults, Drs. Koranda and Hall were evaluating approximately half the nearly fifty plastic surgery patients that will be treated during the coming week.  After finishing their evaluations, our doctors met with their Panamanian counterparts, Drs. Dellarosa and Gerrudo, who had evaluated the other half of the plastic surgery patients.  This is a true "intercambio" cooperative effort with both teams of doctors working together to treat the less fortunate in Panama.  In addition to repairs of cleft lips, malformed ears and corrections of other problems, the Panamanian contingent also will perform opthalmic and orthopedic surgeries.

The entire operation is organized by the AEP, a Panamanian association of business and professional women.  Although it is a small group, the AEP conceived the mission project five years ago and serves the people of Panama by conducting the initial screenings of patients and providing housing and meals (over 800 per day!) to them while they are away from home, which is often a great distance away.  Without their amazing industry and dedication, the mission could not have helped so many in Panama.

The Medical Missions contingent is made up eleven enthusiastic volunteers, including several "Old Panama Hands" and veterans of other MMF missions to other countries.  We are fortunate to have three volunteers making their first mission trip:  Dr. Hall (plastic surgeon), Lucy, R.N. (pre- and post-op nursing) and Matt (operating room technician).  We are all looking forward to the first day of surgeries in the newest hospital in Panama.