Sunday, April 27, 2008

Jan Ahlberg Remembers.. & Says, "Thank You."


A big thank you to Iowa MOST 2008 for giving
me the opportunity to participate in the Cleft Lip & Cleft Palate Repair team trip to Quetzaltenango, Guatemala.

It was a week of inspiration as well as learning for me. The care and attention given to each child and family by team members was heart warming, and an example of how dedication to an ideal can bring life changes to others.

The posted pictures and stories bring back wonderful memories. I have told lots of friends about my week in Guatemala, but the pictures really describe it.

Sending heartfelt thanks to all. Jan



Jan Ahlberg served officially as the record keeper for Iowa MOST '08. She was especially commended for her work as translator & assistant for dentists Steve Hedlund & Bill LaVelle.


Wednesday, April 23, 2008

Emily Remembers Victor Victorino

It was the morning that Victor would have his surgery. I was documenting vital signs on all of the kids, when I heard an "Emily." Victor wanted to show me the coloring book page that he had just colored. He was so very proud. This fun went on all morning. Victor was very chatty with me and full of hugs.

Victor left for the OR (operating room). His mother waited patiently. When Victor's mother heard that Victor was ready to return to the pediatrics room, she skipped out of the room with excitement. Their reunion was heartwarming. Victor's mother cried as she and Victor left the hospital. So very happy, they hugged nearly the entire team goodbye.


Emily Berglund served as a pediatric nurse in Quetzaltenango, April 2008.

Wednesday, April 16, 2008

Post-Op Family Reunions at Xela











Last Night in Guatemala

Iowa MOST gathered in Guatemala City for a farewell dinner on Monday, April 14, 2008... a joyous occasion filled with expressions of gratitude for a good mission and continued team spirit.

The next morning -- a 5:45 a.m. wakeup call, a quick van ride to the airport, checking in & changing gears for leaving Guatemala & re-entry to the USA & our 'regular' lives... Safe arrival home with fond goodbyes to team mates & happy hellos to loved ones who came to meet us.

The 2008 Iowa MOST mission is completed, but the Miles of Smiles postings on this blog site will continue as team members send in their photos & stories of their perspectives and insights of our time in Quetzaltenango. We hope you will stay tuned as the valuable story of Iowa MOST continues to unfold...

Saturday, April 12, 2008

Last Day for Surgeries in Xela

The team finishes its mission in Xela on Friday, April 11, 2008, with a full schedule of surgeries & post op & pediatric care.




















Photographs feature ~
* Deb Strike, Chandra Beals, Pat Wehrle & Jodi Jones in surgery.
* Team members Ruben Zuniga, Mindy Bowen, Pat Plohman, Bill LaVelle, Robert Forbes & Susan Adamson taking a welcome break!
* Oscar Gomez, Dee Grems & Pete Wallace in the pediatric room.
* Emily Berglund & Viki Lopez Gutierrez attend to a patient in the pediatric room.
* The team's translator, guide & facilitator Francisco (Paco) Fernandez, takes time to flash his winning smile.
* Ruben Zuniga demonstrates how he steralizes instruments for the surgical teams.
* Lael Stander looks on as Jim Schuh & Jody Meyer prep a patient for surgery.
* Tom Cannon, John Canady, Jim Schuh & Jen Oliver prepare for surgery.
* Natalie Freed, Jodi Jones, Gary Pacha & Deb Strike in surgery.

Mucho Gracias a Rotario Quetzaltenango

Not enough thanks can ever be given to the Rotarians of Quetzaltenango for their generous hospitality & support to the Iowa MOST medical mission. Without their extensive efforts, the medical mission could not have been accomplished. Since July of 2007, when the second oldest Rotary Club in Guatemala said, "Yes" to team leader Gary Pacha's proposal for local Rotarian partnership with the mission, members here in Quetzaltenango have worked arduously to prepare for and ensure the success of the cleft lip/palate medical mission.


Rotarians of Quetzaltenango, Guatemala pictured in this post are among the many local Rotarians who were instrumental in partnership with Iowa MOST in April 2008:

Dr. Fredy Barrios, Sofia de Barrios, Christina de Cifuentes, Miriam Richter, Dr. Raul Cordon, Jorge Cifuentes & John Diehl.










John Diehl, who served as the main contact in Guatemala for Iowa MOST, said from the beginning, the Rotary Club in Quetzaltenango worked to involve the hospital administration with the medical mission, so that it would be a cooperative effort. He noted that Rotarian Raul Corden worked diligently before and during the mission as a liaison with the administration and medical staff of Hospital Regional de Occidente San Juan de Dios. In the fall of 2007, Cordon was instrumental in arrnging for an Iowa delegation's tour of the hospital facilities, meetings with hospital officials and staff, and securing needed rooms, equipment and staffing assistance. Cordon also put the requested drug list from Iowa into Spanish and took responsibility for ordering the necessary drugs for the medical mission. He also secured the loan of critically needed medical equipment from Dr. Schele in Totonipican to enable more surgeries to be conducted. Jorge Fuentes, Rotario Quetzaltenango President, dealt with overall organizational support with Dr. Oscar Marroquin's guidance based on Marroquin's experience with previous Iowa MOST missions in Huehuetenango, Guatemala.

Diehl said the biggest hurdle -- getting the impossible done -- that is, getting the shipment of Iowa medical supplies and equipment through customs in a matter of a few days, proved not to be a hurdle at all. He credited DHL's working with Caritas in Guatemala as making the vital difference. He noted that a Rotary committee led by Efrain Figueroa worked to ensure that temporary medical licenses were issued to enable the Iowa medical team to practice medicine in Guatemala. Diehl headed up the group that made passport and customs clearance of Iowa MOST members entering Guatemala run smoothly. Luis Lopez coordinated another Rotary committee's efforts to provide Iowa MOST mission patients and their families shelter and food during their stay in Quetzaltenango.

Fundraising efforts, including a play (Cavrona a Bruta), auctions, a raffle and donations from area Rotary Clubs, were undertaken by the entire membership of Rotario Quetzaltenango under the leadership of Salvador Aguirre. These funds were used to provide generous support for Iowa MOST, including noon meals, bottled water, transportation, countless supplies, logistical assistance, an excellent restaurant meal (with hosts Hans & Marina Vielman) and an evening farewell part at the Tennis Club in Quetzaltenango.

Fredy Barrios led a committee that did extensive publicity (news media, posters, contacts with priests, pastors and clinic personnel) to identify and get the word out to potential candidates and their families about the opportunity for cleft lip/palate surgery and dental work during the Iowa MOST 2008 mission in Quetzaltenango. Others helped with hotel arrangements, and all of these efforts wer ably and graciously assisted by the Women's Rotary Auxiliary, the Comite de Damas Rotarias.

Friday, April 11, 2008

Pat Plohman Says Thanks to Iowa MOST

As a first-time volunteer with Iowa MOST, I struggle to find words that adequately describe my experiences so far. From the moment we arrived, our very dedicated team has been welcomed and recognized in ways that extend far beyod what I could have expected. The courtesies of food and support as well as expressions of gratitude are so deeply heartfelt. The Rotarians and families of Quetzaltenango have words, smiles and gracious gestures that so genuinely convey their appreciation for all of our efforts here.

On a very personal note -- I have been able to witness the initial patience and pleading hope with which families passed through the screening process. The children greeted us with smiles and the parents smiled, too, but they also looked deep into our eyes hoping for the confirming "yes" for surgery. Those for whome surgery was scheduled responded with even broader, more grateful smiles. Being a part of this screening process meant that on surgery days, I got to recognize, hug, hold and love the precious smiles of the children afterour amazingly skilled team members had completed their work.

As if that wouldn't be rewarding enough to witness such a life-changing event for these special children. I was able to carry the children out of recovery and place them safely into the arms of their trusting parents. Exchanging hugs and glances with tear-filled eyes, we would say our farewells with those precious moments imprinted in my heart forever.

Thank you Iowa MOST for including me on such an invaluable mission that provides the surgery with the tender love and care for these children that we as parents all want for our children. I am also particularly grateful to John Canady and Gary Pacha for allowing me to share this once in a life-time opportunity with my daughter Jodi, who is one of the surgeons! I will leave Guatemala realizing what an incredible difference a relatively small group of compassionate people can make when the primary purpose has been motivated by the desire to do "good" where it is most needed!

Pat Plohman is shown on the right in the picture in this posting. She lives in Winnepeg, Canada.

Thursday, April 10, 2008

Miracle of Maricela

Here are photos showing four-year old Maricela with her mother on screening day, Monday, April 7, 2008, & on the very next day: Maricela's operation in progress & being completed by surgeons Drew Dillard & Antonio Rosal Alvarez, Maricela being held by Pat Plohman in recovery and then reunited with her parents while Emily Berglund checks her vitals in the pediatrics room.





But, pictures tell only a small part of the story...













Maricela's becoming part of the Iowa MOST 2008 story begins in a remote village ten hours travel ~ some on difficult, narrow dirt roads ~ from Xela. Francisco (Paco) Fernando, the Iowa MOST medical mission translator, explains that a non-profit humanitarian organization, Casa Colibri, established a medical clinic near Marciela's home in 2004.
On a medical mission to this rural clinic in November 2007, Paco served as a translator for the doctor conducting examinations. Paco's association with Dick Enders, Father Gerald Hagen and Rotarians Ulie Liechti, and Linda and Dr. Jay Eastman, all who have worked toward the development and management of the clinic, led him to become involved with Casa Colibri on a deeper level than as only a translator. The second patient to arrive at the November 07 clinic was Maricela. Paco saw the severe deformity of her cleft lip and was immediately convinced that he personally needed to ensure reconstructive surgery for Maricela.
Paco had served as translator for an Iowa MOST mission earlier theat year (February - March 2007) in Huehuetanango, and had witnessed the dramatic improvement for children who had undergone cleft lip/palate surgery. He said, "Last spring when I worked with Gary Pacha and Iowa MOST, I found a part of myself that I didn't know existed, that part of me that is deeply a human being, when I saw the change in the children who had surgery. It was almost as if their souls had been healed." He added, "It takes weight off the parents, too. So many of these people don't have access to medical services and no expectation of help, so providing it is important, and one feels in the gut, the enormity of it."
So, Paco told Maricela's parents to do all they could to keep her well and to be patient until the Iowa MOST mission came to Xela. He arranged through Casa Colibri for Marciela and her family to come to Xela on the weekend before the MOST screening. He felt certain, and the clinic doctor concurred, that Maricela would be a good candidate for surgery. She was accepted and had surgery on the first day that surgeries were performed at Xela.
The surgery transformed Maricela's appearance. Surgeon Drew Dillman used a specific type of surgery that Dr. John Canady had taught him. He was able to repair Maricela's severe cleft lip and open palate, and also keep her nose appearance normal. Drew smiled as he said of the surgery, "It's like being a baseball player, who normally has strong single base hits. Maricela's surgery was a home run."
Paco noted that a big problem in the rural mountainous regions of Guatemala is that parents often hide their children who have physical defects. They feel ashamed, and the children come to believe that their deformity is their fault. Some of the rural people feel that it is a spiritual thing, too, something to be accepted fatalistically. He said, "It is difficult to trespass this cultural barrier. Hopefully, with this example, others in Maricela's rural area will try to help their children and will overcome their mistrust."

Gratitude in Guatemala

Wednesday, April 9, 2008 ~ A Story from the Dental Team













Perhaps the most difficult part of the Iowa MOST medical mission in Xela has been having to make decisions to turn people away; to say no to their requests for reconstructive surgery, because they are too young to undergo anesthesia, have respiratory problems that could compromise the patient during surgery, or require a procedure that is too complicated and lengthy to complete in the time the team has available in Xela.

The latter condition applied to Severiano, a young man, who needed extensive dental surgery for a wide open cleft of the whole hard and soft palates. He had been scheduled early on Tuesday morning, because dentists Bill LaVelle and Steve Hedlund knew it would require four, possibly five days to complete the two impressions needed, the surgery, and the post-op checks to be certain that the appliance fit correctly so that it didn't cause a major sore and allowed a sufficient opening for appropriate speech sounds.

Unfortunately, when the dentists began work on Tuesday, they discovered they were in the midst of a hospital remodeling project that started that morning in the dental offices. Equipment, chairs, lights and supplies were removed, and a water pipe broke with a brownish water spreading across the floor. The Iowa MOST dental appointments had to be cancelled for the rest of day. The Severiano's appointment was moved to 9 a.m. on Wednesday morning, but then was cancelled due to the length of time needed to complete his procedure. The time available was shortened even more, because painters would be arriving on Friday afternoon to paint the dental offices.

Severiano arrived at 9 a.m. on Wednesday morning, even though he knew that his appointment had been cancelled. He pleaded to have surgery. He asked, "Could you do even part of what is needed and then finish the rest when you return another year?" Jan Ahlberg, who was translating, reported, "He begged, really begged for over half an hour, because he wanted desperately to be able to speak clearly." The answer was sadly, but firmly given: no.

That afternoon, the young man returned and sat quietly in the waiting room. When Jan asked him why he was waiting when he had no appointment, he said he had a gift to give. Jan invited Severiano to come into the dental office and he began to pull beautiful Guatemalan weavings from his sack to present to Bill, Steve & Jan with thanks from his heart. He kept putting his hand to his chest and saying, "Thank you from my heart." Then he added, "Even though I know you can't help me this time, you are helping others. Thank you from my heart." It was an incredibly humbling, deeply touching moment in the life of the medical team at Xela.

Wednesday, April 9, 2008

Tuesday, April 8, 2008 ~ First Day of Surgeries

Surgeries were done throughout the day... then the patients were taken to the recovery room & soon reunited with their families. Watch for details ~ coming soon ~ especially, the amazing story of Maricela.




Monday in Xela ~ April 7, 2008 ~ Screening Day

With no opportunity to set up supplies & equipment on Sunday afternoon, the Iowa team rose extra early and trekked along the bustling street filled with hurtling, colorful, crowded buses, vans & other vehicles spewing diesel fumes, then up over the pedestrian overpass, past tortilla stands, and through the hospital grounds gates and a maze of hospital corridors to set up for a long day of screening candidates for cleft lip/palate and dental surgeries.

A quiet crowd of intensely hopeful parents & their mostly smiling children, as well as a few adults seeking surgery, waited patiently in the lobby. But then, they began lining up, pushing insistently toward the door of the intake office, as the team worked quickly to set up the records and medical equipment needed for screening.

Then all was ready for the patients to be 1) charted, 2) examined by the surgical team to see if they would be candidates for cleft lip/palate surgery, and if they were, to be assessed by the 3) anesthesiology team. All the children, whether or not they were candidates for surgery, received examinations by the 4) pediatricians and 5) dentists. Support staff, including the vitally-needed translators, positioned themselves with the medical teams. Others on the Iowa Miles of Smiles Team worked throughout the day getting supplies, equipment and rooms ready for the upcoming days of surgery.



Screening Day Begins with Information Charting





April 7, 2008 ~ Screening Day in Xela


As families crowded around the door of the intake room, the staff began inviting the prospective candidates for surgery in to have their photos taken (Mindy Bowen), have weight & height checks done (Dee Grems), be checked for fever and respiratory problems (Emily Berglund), and get information (names, place of residence, etc.) recorded (Jan Ahlberg). Other staff assisted with this process throughout the day. All of this information was charted quickly and cheerfully... all the while providing assurance to the families before directing them to the surgical team.

Screening includes Height & Weight Checks





April 7, 2008 ~ Heights & weights are checked by the intake staff.