Panama Intercambio Blog - April 2008

Day 1 – April 12, 2008

The Continental Airline check in at KCI opens at 5:00 am. That leaves only one hour to check in a large group for a 6:00 am flight. Let me tell you, a 5:00 am at KCI with several international groups at check in is hectic! Eighteen of our group of 20 lined up with 36 large check-in bags. One thing you must learn on MMF trips is to roll with surprises. We had an AWOL passport that turned up on a garage floor. Consequently, one of the nurses arrived in Panama in time for our welcome dinner. At 5:55 am seventeen pulled away from MCI – the first test passed!

During Christmas 2002 in a dining room in Panama, Frank & Diane Koranda, Sonia Ehlers and Andres, her husband, imagined a “little mission” to Panama. Sonia knew women in the Association of Professional & Entrepreneurial Women (A.E.P) who might help. Thus began the Panama Intercambio. “Intercambio” is a sharing or exchange with mutual benefits from a shared purpose.

The ladies at A.E.P. are miracle workers. Their expertise and organization set the framework for the mission. This “little project” has performed 285 surgeries in two regions of Panama and we are starting our 3rd Intercambio.

The third group in our team is the Henry Pascal Foundation for Children - a group of doctors who volunteer with needy children throughout Panama. These doctors screen patients and work side-by-side with our team. The A.E.P. women set up housing and transporting the kids. And that “roll with the surprises” thing… a month ago this intercambio almost got cancelled. The scheduled hospital had a backlog of cases. Dr. Alex Arango, president of the Pascal Foundation, appealed to Antonio Medrano whose family owns and runs the Hospital Nacional (www.hospitalnacional.com/English) in Panama City.

These trips create a waterfall of more giving. The Hospital Nacional opened up on Sunday for our team and will have space for us on top of their full schedule. They are donating snacks and lunch for everyone and expendables that we need, will go through the hospital at cost.

The “little project” keeps growing. The afternoon was spent screening patients and organizing supplies.

A.E.P. provided us with a lovely buffet dinner as a welcome party. The highlights were getting to know one another, the food, and two singers with a guitar. We joined in the choruses of familiar tunes as we were serenaded. After flan and cheesecake, we went to the hotel for much needed rest.

Day 2 – April 13, 2008

Some of us slept well, but a group of Venezuelan’s staying in our hotel partied on the second floor and so two of us got very early wake up call. One showered and went back to bed, but the other made it to breakfast at 2:45 am. After the real breakfast at 6:00 am, we loaded the sorted supplies onto the shuttle for a two-block drive to the hospital.

Our inventory was supplemented by donations requested by Dr. Medrano for the H. Pascal Foundation. Dr. Medrano had a meeting to begin the day and surgeries began after we sorted and unloaded the boxes and bags in the auditorium. The auditorium is going to serve as the pre and post-op area Monday-Wednesday, because the hospital had cases scheduled, we used their regular areas on Sunday.

Today the ORs are filled with people from our three groups. Volunteers from several other hospitals came to participate. The Hospital Nacional night shift office and service people volunteered to extend their stay and assist us.

The windows of the auditorium look out on trees with spider bromeliads growing in them. These plant parasites make the trees appear as if they’re hanging with little spiky gardens. The trees also harbor noisy green parakeets and up the hill we can see our hotel. The A.E.P. women helped transport the children and their families from a facility; Fundacion Amigos des Ninos con Lucemia de Cancer (FANLYC). FANLYC is similar to a Ronald McDonald house where families with children undergoing treatment and chemotherapy can stay in a home environment. FANLYC donated the space to our project so that patients and family could stay in a place where after care was available.

While we had a lovely dinner at a fish place, Dr. Medrano and Dr. Josie DuBois, an orthopedic surgeon and a member of A.E.P., completed late rounds at FANLYC. Our dinner was great and then we all slept soundly.

Day 3 – April 14, 2008

The day began at 7:00 am and ended after 8:00 pm. We don’t have high numbers, but we have long cases. Dr. Koranda and Dr. Cowes, a Panamanian doctor, performed a complicated, three-hour plus nasal reconstruction on a previously repaired nose so that the boy can breathe. An eyelid case was equally as long with four doctors scrubbing in for surgery - four from Panama and four from the US. Many of Dr. Arango’s cases involved removing lengths of bone to correct long-duration deformities. A three-hour procedure for him is short.

Barbara Cusick and her son Christopher spent the day at FANLYC. Barb brought materials to create frames for the Polaroid and digital photos we have been taking of the patients. The picture project is wonderful. Many of the families have never seen themselves or their children in a photo.

Here is an excerpt from Christopher’s journal documenting his experience interacting with the children on the trip: “The waiting room for the kids and their parents was upstairs on the second level. They were all waiting nervously not knowing what surgery was like. My mom and I were in charge of playing with the kids and distracting them from the thought of surgery. For them, they had never been to a hospital because they could never afford it. So this was a first for almost all of them and it was a scary thought. So my mom and I brought coloring books and crayons so they can draw together. We also brought Beanie Babies to give to the kids to play with. The day before, while my dad (Dr. Doug Cusick) was interviewing kids, my mom would go around the facility and take pictures of the kids playing and with their parents.  So my mom got those pictures developed at a pharmacy and found the parents that were in the pictures and they made picture frames out of foam pieces of paper and they could put stickers on the sides and draw with Sharpies.”

This evening the H. Pascal Fundacion hosted an outdoor reception adjacent to the French Embassy. The stars and the view looking back towards Panama City were awe-inspiring. We all ended the evening with a late dinner.

Day 4 – April 15, 2008

Sunday two year old Luis Miguel Savedra Garcia had a release of syndactyly with Z-plasty and skin grafts to separate his fingers. The family from Los Santos near Chitre, where we worked last year, had arrived via a four-hour bus ride the day before. Luis slept peacefully until carried from pre-op to surgery, as his parents held each other and softly wept. In post-op all were beaming and very, very grateful.

Eleven-year-old Jans Morfi Abad came accompanied by his father, Benigo Morfi, and mother, Cornelia Abad, and his 12 year-old-sister. At 4:00 am on Saturday they got on a bus from Chepo, near the San Blas islands in the Caribbean. A doctor in Chepo had recommended the H. Pascal Foundation because Jans’ elbow was injured in an accident and there was an outgrowth of bone. The surgery was too complicated to be done in Chepo. Jans was “a little afraid but happy they would do it”. Dr. Arango corrected the subluxion of the radial head by removing a portion of the bone to return function to his arm. Jans’ aftercare will be in Chepo by a doctor in contact with Dr. Arango.

Eldina, the H. Pascal Foundation secretary, arranged a screening appointment last month for Jans. He and his family arrived Saturday at FANLYC. Jans said he was treated well, liked the facility, and would like to live there. Cornelia said the food was excellent, the people caring, and the place was pretty. He and his mother speak Kuna so his father translated into Spanish for them. Benigo works in Panama City six days a week at a video rental store. He catches a 9:30 am bus for his 4:00 pm – 11:00 pm shift and arrives home about 2:00 am. He wishes we could do a mission near San Blas, the Kuna reservation, because so many children need our assistance. Cornelia makes beautiful molas, the traditional quilted and folded designs of the Kuna. Her beaded jewelry takes about two weeks to make in a flat panel and two hours to attach to her ankles and wrists. She changes them every week or so.

Day 5 We packed until almost 8:00 pm. There were a dozen scheduled patients who couldn’t or didn’t make the arduous trip and several more that couldn’t be operated on because of a flu virus. The team held a press conference under a painting of Dr. Medrano’s father, Dr. Juan Medrano, who built the Hospital Nacional. There were five TV cameras, La Prenza news reporters, camera flashes - an exciting 90 minutes. Dr. Medrano, representing the hospital; Mayella Lloyd, president of A.E.P.; Dr. Arango, the president of the H. Pascal Foundation; a representative from FANLYC,; and Dr. Koranda, representing MMF all spoke about the teamwork and helping the children. Mrs. Juan Medrano and Katia, her daughter, said, “Dr. Juan Medrano would have been pleased by all we accomplished this week.” Walleska Wagner, coordinator of Social Projects at the US Embassy in Panama, was present and interested in all we are doing. This contact will be a great addition to our “little project”. In the evening, MMF hosted a farewell BBQ around the pool at the Panama. The buffet contained fruits, salads, civiche, chicken, pork, flan and other wonderful dishes. It was our last chance to be together as a team. There was a bittersweet feeling. The end is sad.

Day 6 A day to play! We scheduled a tour today. The early departures didn’t daunt our hopes of a good day. By the 4:00 pm return we had experienced a fantastic day. The Chagres River feeds into Gaton Lake, which supplies the water for the canal system. We drove to the Parque Nacional Chagres and got in motorized dugout canoes to travel up-river to a hiking trail that took us to a waterfall that is the source of the river. After a “short” (by Indian terms) hike, there was time to swim in the pool by the falls. Then we canoed back to one of the Embara Indian villages in the area. We climbed stairs to an elevated dining room and were served a lunch of fried fish and plantains which were in a “cup” made from a leaf similar to a banana leaf. Desert was tropical fruit. We went back down through the village to a meeting area where the Indians played music and danced for us and, then with us. The band consisted of a flute, a big and little drum, mariachis, and a pipe played by raking metal fork along its grooves. Then we had time to shop for Embara handcrafts. They weave baskets and make cavings from tagua nut, which resembles ivory when dried. On the river we saw caymens, herons, butterflies, birds, and a pet monkey. (If you would like to get a feel for our experience, try to catch the Discovery Channel special on the Embara Indians – it runs periodically.)

Addendum There are stories of interconnected lives for this trip. MMF brought Isella Smith, RN from St. Johns Hospital in Leavenworth to help with post op and give after care instructions. Isella is from near David, Chiriqi. She has lived in the US since she was 13. She and her daughter Linda Sperry, RN from St. Lukes on the Plaza, will extend their stay to visit family in Chiriqi. Jeanne Mae Pascal, who has volunteered with AEP since its inception 15 years ago, is from Iowa, as is Cerner volunteer, Tina Sanders. Jeanne met her husband at the University of Iowa, Tina’s alma matter. The Pascal’s moved back to Panama in 1980. Jeanne said, “It’s nice to be working with people from back home.” Her translation skills were appreciated because of her Midwestern accent and because she got the American jokes.