Medical Missions Foundation

Antigua Day Four- The Importance of Post-Op Care

Work continues here in Antigua, as more and more patients are moved through the Obras each day. After surgery, patients are required to spend the night in the hospital, in one of several rooms set aside for rest and recovery. If their surgery was fairly minor, the next day they are given antibiotics, painkillers and vitamins and sent on their way.

Most patients who are released are highly encouraged to stay at the Obras’s sister organization known as Casa de Fé, especially if they live more than an hour away. Doctors say that there is a possibility of complications arising after surgery, and if the patients go home immediately there is a chance that, should something happen, they might not make it back to the hospital. Medical Director Dr. Pamela describes the worrisome situation as such: “the people that have their tonsils out—there is a risk of [their scars] bleeding out after surgery. If they go home to their villages, there are no doctors to care for them—and they could die.”

Many patients do not want to stay at the pseudo-Ronald McDonald House, for varied reasons. Some have responsibilities at home that they must attend to—for example, in some cases mothers will be forced to leave their children at home unsupervised and need to return in order to take care of them. Other patients are concerned about money; the longer they are away from their job, the more they lose, and the harder things become for them financially. Spending an entire week away from home can be devastating to a family, especially when 30% of the country’s population subsists on less than a dollar a day. Due to these reasons and others, many patients who live many hours away face a grueling journey consisting of travel both on foot and in tightly packed, dangerous “Chicken” buses.

However, because of the grave nature of the complications at hand, much effort is made to keep patients from returning home. Because patients are more likely to stay if there are things to do, the Art Team is instrumental in this effort. This afternoon, the art team headed over to the Casa with DVDs of cartoons for the patients to watch and puzzles and crayons to keep them occupied. Along with them was nurse Kathy, who made rounds and made sure recoveries were going along as planned. According to Mission Coordinator Deborah, this also contributes to an increased number of patients staying behind.

Back at Las Obras, there was another full day of surgeries.

 

Lost in translation: when asked to smile, this young boy at the Obras pulled his cheeks back

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

At Casa de Fe, volunteer Jack instructs a young boy on how to brush his teeth.

Day Three in Antigua- Successful Surgeries

Day three in Antigua marked the successful completion of many more surgeries, including a nephrectomy, the removal of a kidney, performed on a sixty-nine year old woman.

Doctors say that the woman originally came to local physicians, complaining of abdominal pain. After an
ultrasound treatment, it was discovered that her pain came from a malignant tumor in her left kidney. The doctors referred her to the MMF group working at the Obras, after deciding that she should have her kidney removed. Today, urologists Drs. Jason and Mark removed the cancerous kidney in a two hour procedure. When family members arrived, they were able to inform them that their loved one was now cancer-free.

After three clean days, many of the team members are beginning to fall ill. Some show signs of a GI sickness (in the breed of the famous Montezuma’s revenge), while others show symptoms similar to the flu. Unsurprisingly, most of the sick team members ate at the same restaurant the night before. On top of all of the illnesses, Dr. Steven fractured his ankle Monday night after tripping on a wet section of the uneven cobblestone streets. He came to work despite his injury, and seemed to be in high spirits.

Even considering all the sicknesses, the group continued to work tirelessly, completing another successful day of surgeries and rounds.

Many of the patients who received care yesterday were sent to Casa de Fe to rest and recuperate before they began their long journey home. Although some patients decided not to stay at the establishment, doctors strongly encouraged them to, so that they would be moments away from medical care in case complications arose. Although the mood was fairly hushed at the Casa—many patients were still in pain from their recent surgeries—spirits were generally high, as recuperating patients watched several DVDs and constructed puzzles to pass the time.

First Day of Surgeries in Antigua

This morning at 8, fourteen volunteers piled into a van headed out of Antigua to an area in the outskirts known as Jocotenango. There they arrived at the newly finished clinic known as the Asociacion Nuestros Ahijados, or “Our Godchildren." There they hoped to spend the day giving medicinal care to people who weren’t able to make it to the Obras in Antigua. The center is run by a charitable organization known as God’s Child, which has several stations throughout the world, including one in El Salvador, as well as two here in Guatemala.

The center in which MMF volunteers are working doubles as a secondary school for impoverished children. The organization provides a high-school level education, for free, in a relatively safe place—walled off from the surrounding neighborhood and
protected by armed guards. The crew working today included medical doctors, pharmacists, medical students, interpreters and two members of the MMF Student Ambassadors. Although the start of the day yielded only a few patients in the waiting room, including four young children playing with wooden tops, and their parents, the clinic hopes to serve many patients who aren’t able to come to the hospital in Antigua.

Back at Las Obras, the first day of surgery was a success, with the ENT group alone completing 23 successful surgeries, including multiple tonsillectomies. In another room full of doctors and nurses, Dr. Steven and Dr. Bryan led a talk explaining how to use the new ventilator (a machine used to help patients breathe) donated to the Obras by MMF.

On another high note in the OR, today was the beginning of the first annual Most Hideous Scrubs Contest. The competition is expected to continue the rest of the week, with surgeons searching through piles of scrubs to find the tackiest and hideous combinations possible. Today, many of the male surgeons of the urology team were spotted in floral v-neck shirts and neon pants, while the ENT men were showing off their Spongebob fandom and affection for shamrocks.

The Art Team spent another day in Obras, entertaining children and adults alike with puzzles, coloring books, and arts-and-crafts activities such as decorating foam visors and making paper airplanes out of construction paper. A musical interlude was provided by the team’s own Kelsey, who provided a concert of violin music and fiddle tunes. At one point, the team learned that today was one of the children’s birthdays and proceeded to loudly sing “Happy Birthday” in Spanish.

With the team’s help, the atmosphere at Las Obras was lightened considerably. However, as more and more surgeries are completed, many team members leave with patients toward another section of Antigua: Casa de Fe, a sort of Ronald McDonald house for Las Obras. Here the Art Team’s duties expand beyond entertaining patients. Whatever is asked of them, they will lend a hand, from washing windows to making beds.

             

Getting Started in Antigua

Today is the long day, with most of the volunteers working for more than 12 hours. Hundreds of Guatemalan natives line the walls of the Obras, dressed in their Sunday best, waiting for the chance  to meet the American doctors. No surgeries or miracles will be performed today, but most patients will be diagnosed in preparation for the rest of the week.

After a 6 am breakfast, the mission team shuffled over to the hospital, medical equipment in hand. After a few group photos under the cloudy Antigua skies, the mass of volunteers was brought inside for a tour of the facility, led by Odra, the OR director, and Anabela, the administrative assistant. The tour brought the team through the different sections of the Obras, including the acute and chronic care facilities, where many patients who are not able to care for themselves are given shelter, food, and medical care.

Today also marks the inauguration of the hospital's brand-new audiology clinic. In the past, audiologists had to compete with the sounds of noisy celebrations and church services being broadcast over the PA system while attempting to perform hearing tests on their patients. But now, hearing specialists have a quiet spot in the Obras, nestled in the higher reaches of the hospital away from other patients and sonic distractions. The audiology department, constructed just last week, produces some of the more fairytale-like miracles— granting the gift of sound to grandparents who haven't heard in thirty years, or allowing children to hear their mothers' voices for the first time.

The inaugural clinic's inaugural patient was a young one named Diana, whose hearing seems to come  and go. Her parents cannot tell whether or not she has a legitimate hearing problem, or is at times simply choosing to ignore them. The doctors performed several hearing tests in their new premises, including one in which Diana was asked to don a pair of earphones and raise her hand each time she heard a sound. Such tests are used by the audiologists to determine the sensitivity of each patient's hearing, and in certain cases whether or not to grant the patient a hearing aid.

 

Meanwhile, as Diana was being tested, another part of the team was hard at work. For the patients, waiting can be a dull, miserable, or even frightening experience. A hospital can be an uncomfortable environment, especially for young children, and many patients are nervous to meet the doctors and be diagnosed. Here to combat this anxious environment is the art team, also known as the Student Ambassadors.

This year, composed mainly of teenage volunteers, the Student Ambassadors spend their time by handing out crayons, paper, art supplies and puzzles, and encouraging the children to engage in games to help lessen their boredom or fear.

Usually at the end of a long day, the team will meet up at the Cafe Sky, a restaurant known for the beautiful views on its rooftop bar. But not today, as grey clouds and constant drizzle stop the plans for relaxation after a days work. Once again, small groups disperse throughout the town, rushing to find a meal in the downpour.

Team Arrives in Antigua

After a day of maintenance problems, delays, and many long hours of flight, the 61 members of the Antigua mission have finally touched down safely in Guatemala.

Another hour of driving, and the team was in Antigua. After a short break, the team met in the hotel courtyard to discuss the plans for the week under the guidance of the team Trip Coordinator Deborah Nicklaus and medical director Dr. Pamela Nicklaus, sisters with over 12 years of combined mission experience under their belts.

With ideas and schedules in place, the families and groups dispersed to their rooms or to explore the town, a night off in preparation for a week of strenuous work and dedication starting Sunday.

Throughout the week, my brother Nathan and I (Andrew) will keep you updated on the Antigua mission trip and their work in Guatemala.

Upcoming mission: Antigua, Guatemala

This Saturday, 61 Medical Missions Foundation volunteers will head to Antigua for MMF's 12th year traveling to the region. 

Check back next week for stories and photos detailing our critical work for children and their families in Guatemala.