We are in Antigua

Yesterday afternoon we arrived in Antigua, and are staying at a very nice hotel. It is a welcome respite after a week of long, yet rewarding days. Some of the group are going zip lining today, others are hiking a volcano, others are going to attempt to play golf, and others are touring a small village with weaving and jade factories. We leave late this afternoon for Guatemala City, and then off early Sunday morning for the airport and our trip home.

Steve Aquilino, Prostodontist

Steve Aquilino is a Prostodontist at the College of Dentistry, and is one of two dentists on this mission.

"I became involved in Iowa Most through Bill LaVelle, my mentor at the University of Iowa from 1982 on. Four years ago I went to Huahuetenango with Bill and it was my first mission trip. I had always wanted to do something like this, and I jumped at the opportunity. It's a type of dentistry I don't do in my practice at the University. I returned to Huahuetenango two years later, and this is my first time in Quetzeltenango.

The overall highlight for me (there are many more individual ones) is the MOST team. It is an amazing thing to come down here and see how this team melds together to work in such an efficient way toward such a positive outcome. It would be great if the whole world could work this way."

Ayman El-Sheihk, Pediatrician

Ayman is one of two pediatricians on this misison. This is his first year, and he responded to an email put out by John Canady, telling about the MOST trip. Ayman was on a medical mission to Nigeria 16 years ago, and wanted to be part of one again. He has so enjoyed experiencing the appreciation and satisfaction from the families of the children seen by MOST, knowing that we are making a difference in the life of the children. Ayman has a new appreciation for the simple things that we in the States take for granted--good medical care, availability of sub-specialities, even transportion.

Mindy Bowen

Mindy is a Post-op Recovery nurse at the Universityof Iowa Hospitals and Clinics , but on this mission she worked on the Pediatric floor in post-op. She was recruited by Pat Wehrle 4 years ago to be a part of this mission, and knew instantly she wanted to be a part of this team. The best part of the trip for Minday is seeing how grateful the parents are for all that has been done for their children. In America, Minday notes, we expect our children to receive palate treatment, but in Guatemala the parents hope that something will be done. Mindy also is touched by the loving chidren, who are happy despite their troubles speaking and eating because of the cleft lips and palates.

Kristopher Day

Kris is a medical student at the University of Iowa Hospitals and Clinics, and is one of two scholarship recipients from the MOST mission. He has wanted to go on a Medical mission since he was in college. He wanted to be part of a team, and witness all that is involved in making something like this happen. This mission has offered him the opportunity to play a significant role in surgery in a foreign country. Kris is so grateful to have the change to make an impact on the lives of kids.

Karin Franklin

I became involved in Iowa MOST since 2006 through my local Rotary club. I was involved on the first mission as a recovery room assistant, and I had no medical experience prior to that. On the next mission I got involved in supples, and became increasingly involved in the organization in 2008, 2009, and 2010.

This year's highlight for me was a a delightful 11 year old boy named Christopher. He came to feel very at home in the hospital, running all over and stopping in with a smile on his cheery little face. He asked for a stuffed animal (something we usually save for post-surgery) and I wondered if it might be a problem for the other patients, but I gave him a black teddy bear. He gave it a huge hug and walked back to the ward. It was then that I learned he was an orphan and........(tears indicating she won't forget him).

Lucia de Leon, Quetzaltenango Rotary Member

Lucia de Leon is an invaluable member of this Iowa MOST mission. She has been a Rotarian in Quetzaltenango for 35 years, and has volnteered her time during this mission by acting as translator between the medical staff and the families of the patients. She and her other Rotary members have also provided much needed lunches for all the medical staff. She is shown her with her friend, Judy Estrada, who has also volunteered her translating skills. Both Lucia and Judy are so happy to be a partner with Iowa MOST, because they know that this mission is changing the lives of all these children. They know that the lives of the children will be improved by how they look, how they talk and how they eat. But most importantly, their self-esteem is improved.

This mission would not be possible without the joint partnership between the District 6000 MOST Rotary Clubs and the Rotary Clubs of Quetzaltenango and Huehuetenango.

Diane Miller, OR Nurse

Last year was the first mission trip for Diane. She too was encouraged to be a part of the Iowa MOST mission by Pat Wehrle, her co-worker at the University of Iowa Hospitals and Clinics. Diane was anxious to be a part of Iowa MOST. She had already been on one medical mission through the Army Reserve, and was so glad to be able to offer her talents on another one. Diane is so pleased to be making a difference in somebody's life.

Riley Stringham, Anesthesiologist

Riley Stringham is a Resident in Anestesiology at the University of Iowa. As a resident, he was able to apply for this Iowa MOST missio. and was excited to be accepted. He views this as an opportunity to experience the practice of medicine in another country. The highlight of this mission for Riley is the experience of seeing the faces of the families as they view their little ones after surgery. He is especially touched by their appreciation to the team.

Dennis Wilson, Biomedical Engineer

This is the third year on the MOST mission for Dennis Wilson. As a Biomedical Engineer, his skills are invaluable to ensure the each machine is operating correctly in the operating rooms. If something is not working, Dennis is right there to get it back on track. Dennis became interested when his supervisor was a part of the mission, and Dennis jumped at the opportunity three years ago to become a part of MOST. Dennis is somewhat familiar with the culture, as his wife is of Mexican descent.

Helping kids is the most important reason for the trip, and being able to contribute to this cause leaves him with a good feeling. Dennis also enjoys the opportunity to travel and experience another culture. In Dennis' words, "the best day is a quiet day, because it means nothing has gone wrong."

Ruben Zuniga, Sterialization Technician

This is the second year on the Iowa MOST mission for Ruben Zuniga. He is a Sterialization Technician at the University of Iowa hospitals, and speaks fluent Spanish. In 2007 his collegue, Pat Wehrle, recruited him to become part of the mission. Pat has been on these missions since 2005, and she thought he could fulfill two needs: his occupational skills and his fluency in Spanish. Ruben was excited to be a part of this because he would be helping those less fortunate than others. He takes real joy in seeing kids return with happy faces. And he especially likes the closeness of the team that he experiences every year.

Trudy Wright, Recovery Nurse

Trudy Wright is one of the 2 recovery nurses that are a part of MOST. This is her first year on this mission. Trudy is actually a cardiac recovery nurse at Mercy Hospital in Iowa City, and general recovery is not her speciality. Hence she thought her skills were not needed. But in fact Trudy was "recruited" by Pete Wallace, one of the pediatricians of the group. Her children have gone on missions before, and she so wanted to be a part of one. For Trudy, the most rewarding part of this trip is her chance to see the success of the surgeries, and be able to see the joy in the parents faces when they are reunited with their little ones.

Our Team

There are 35 members of the MOST mission here in Quezaltenango. 29 of us flew in from Iowa City/Dallas, and we met up with the other six here in Guatemala. Everyone's job is important, but in the next few blogs we wanted to feature of few of our volunteers.

Mateo's story continues

This is part 3 of a story. Please read the previous two blogs first.

...Mateo Hernandaz had a good night, and was discharged by the MOST pediatrician. The other three children in the group were also discharged, and all of their things were packed up for the trip. It was quite an entourage that lef the ward this morning. Four moms and their babies, each with beautiful new smiles, marched down the hallway and down the steps out of the hospital, and made their way to the truck that was taking them back to their village.

The dads laid down a foam pad on the bed of the truck, and everyone climbed in and settled down. Then a tarp was tied on the supports of the truck bed to provide shade and protection, and the group was on its way. There were about 15 people who were making their way to their village, a day and a half trip covering 150 miles of very winding, steep and extremely rutted roads.

Mateo's mom and dad left two very happy people, carrying their beautiful child. It was the most rewarding feeling for everyone, knowing that this small child had experienced big, positive changes. This story is just one of dozens that are happening this week, and have happened since 2006, thanks to the joint efforts of the Iowa MOST and the Rotary Clubs of Quetzaltenango and Huehuetenango.

Catherine Lane and Kathryn Wallace

Mateo Hernandaz, continued

Mateo Hernandaz was number three on the surgery schedule. He was wheeled from his room and his mom waited patiently at the doors of the operating hall, standing against the wall.

Mateo's surgery was straight-forward. He was going to have his cleft lip repaired now, and his parents were encouraged to come back in a year or two to complete the palate repair. But other children's repairs require more steps. Because good dental hygiene is uncommon for folks living in these remote villages, many children who need cleft lip and palate repair first need to have decayed teeth extracted, in order to provide the surgeon a disease-free mouth. On this particular MOST mission, there is one youg child who is scheduled to have 18 teeth removed. (Children typically have no more than 20 teeth).

After spending time in the recovery room, Mateo Hernandaz was wheeled back to the post-op ward, where the two earlier patients were also recovering. Both his mother and father were there to embrace their son. Throughout the course of the day in post-op, Mateo would be joined by three other young children who were all from the same area of the country. All four families came to Xela together, and all four wanted to leave together.

Sometimes, if everything goes well, if the surgery isn't complicated, and if the child is robust, he or she is able to leave the same day as the surgery. In the case of Mateo, and in the case of the other three from his village, he spent the night. This was partly due to his low weight, and partly due to the distance that needed to be traveled to his village.

More continues in the next blog...

The story of Mateo Hernandaz

Monday, February 22, 2010

Mateo Hernandaz went home today, his future made brighter thanks to the donation of time, talents and money from many people both near and far. He was born ten months ago in Los Angeles, a very remote village in the area of Xoxlac, in the western mountains of Guatemala. He was born with a cleft lip and cleft palate, and his feedings were going to be very tedious and time consuming.

His mother, who is 18, already had several small children at home, and at his birth was overwhelmed with the time involved with his feedings. It was suggested by a local clinic that she swap babies once per day with other nursing mothers in the village, in at attempt to stimulate her own milk production. The couple agreed that they would try this. Then, 10 months later, Mateo was referred to the Iowa MOST program in Quetzaltenango.

The history of Iowa MOST begins in 2005 when folks from Iowa went to explore a relationship with a Rotary Club in Huehuetenango, Guatemala, in order to repair cleft lips and palates. In 2006 a joint Medical Mission entitled "Miles of Smiles Team", sponsored by the Rotary district 6000 Clubs of southern Iowa and the Rotary Club of Huehuetenango came to Huehue to repair cleft lips and cleft palates of the children in western Guatemala. This mission was made up of surgeons, anestheologists, dentists, and nurses, all from Iowa. They volunteered their time for a week, and changed the lives of many.

This mission was so successful that it has become a annual event for the past 5 years. In 2008 the Rotary Club of Quetzaltenango, also located in the western mountains, became a partner in this, and so sites are now alternated between Huehue and Quetzaltenango, (also known as Xela).

In 2006 Juan Francisco Fernandez, or "Paco," who lives near Guatemala City, joined the team as translator and in-country coordinator. It was through Paco's involvement with this MOST mission that the family of little Mateo Hernandaz became aware of help for their little son.

Two or three months before the MOST mission arrives in Guatemala, the Rotarians of Huehue and Xela advertize through various venues. Radio and television ads are placed and targeted to those living in the mountains; flyers are printed and placed throughout the region; local clinics are asked to let their patients know of this help; and Rotarians spread the news by word of mouth.

This year, on February 18th, 29 persons traveled with the Iowa MOST mission to Xela, firm in their commitment to this cause and anticipating the week of service. The first day of clinic was Saturday, February 29th, and the MOST members were greated by patients and their extended families lining the walls of the waiting room. Some had traveled 1 1/2 days through the mountains to get to the hospital. Mateo Hernandaz and his parents were part of this group. Others were local residents of Xela. All were happy to see us.

The MOST mission group began the day be setting up all the stations necessary to evaluate each potential patients, ad the order in which each patient would be evaluated. The stations included registration, vitals, surgery, anesthesia, dental and finally pediatrics. To impose some sense of order, it was initially decided that those who had traveled the furthest would be seen first. And so, Mateo Hernandaz was one of the first to be seen. Mateo Hernandaz and his parents worked theirway through the evaluation process. He was diagnosed with aleft unilateral cleft lip complete and a cleft palate. It was also noted that he had poor weight gain in his short 10 months of life, and so nutrition was discussed with his family. He was cleared for surgery, and he would be one of the first to have surgery the next day.

He was admitted to the hospital the same day as his evaluation. This was not true for everyone. MOST members were going to perform surgeries for 5 days, and so some would have to come back to be admitted. But Mateo Hernandaz was assigned a bed in the pre-op room, where he and all the other surgery patients, along with their families, spent the night in one big room.

The story continues in the next blog.....

Order Out of Chaos

What we want to share with you today is a little about what we call Comnmand Central.

Command Central is a room of 317 square feet on the third floor of this hospital. In this small room the following takes place:

Coffee

Lunch

Storage: Countless necessary bottles of water for all staff; all office supplies; some of the medical supplies; one printer; one photo printer; 22 chairs; one tiny cupboard; one large box/crate turned upside down to serve as our only surface area from which to work.

Traffic: Every member of the team enters and leaves this small room at least a dozen times a day. People meet to deliver and pick up supplies, exchange communication, learn about admissions/discharges, and to change and re-change schedules. Local Rotary members also visit frequently with food, encouragement, and interest. (It is their project, too.)

Noise: The guesstimate for numbers of conversations (of varying lenghts) per day in this room is 120, with as many as four going on at once.

Out of this comfortable chaos comes the results that are being described in this blog.

Kathryn Wallace

Another Way Most has Changed A Life

Today a young boy, Anderson (age 1 1/2) was scheduled for surgery. Anderson had spent the night at the hospital in preparation for today's surgery. While doing his last minute checkup, the nurse heard a heart murmur. This was verified by the pediatrician. For his safety and health, Anderson's surgery was postponed. But MOST feels a responsibility for follow-up to this problem.


Our pediatricians worked with local resources. Local doctors arranged for Anderson to be seen by cardiology at another hospital. A cardiologist at this hospital recommended that Anderson be placed on a Holter monitor for 24 hours. There were two problems with this: (a) financial and (b) how to get the results of the tests. After much help with translation and with MOST agreeing to finance the monitor (the cost in Guatamala is a fraction of what it is in the U.S.), Anderson went to the other hospital to pick up the monitor. He will return to the hospital where MOST is working and spend 24 hours here as the monitor tracks his heart.



Anderson has not received what he expected from the MOST team; he has, however, received important information about his heart which will hopefully be followed; and he will return for cleft work next year. The MOST team considers this a very positive outcome.



Kathryn Wallace

We did feel the earth

This is just a quick note. For those of you who may have heard through the news, we did feel tremors from an earthquake today. The first tremor we felt woke some of us up about 5:00 a.m., and then two more forceful ones were felt about 9:00 a.m. and 9:15a.m.

Obviously we were scared, and have since heard that there was indeed an earthquake, with it registering about 5.0. Everyone is fine. Catherine Lane

The day started out on a happy note. Oscar, the gentleman who wasn't able to make his appointment yesterday because he couldn't afford the bus ride, was able to find the funds to make the trip today. We were all elated, but especially the dentists. In the morning they made an impression of his upper teeth for the purpose of make an obturator, which is a speech appliance. It will fit around his teeth like an orthodontic retainer, with an extention to the back of his throat. The obturator will close a defect between his soft palate and the back of his throat, thereby enabling him to speak clearly for the first time in 65 years.

Oscar will have to come back in the afternoon, at which time the portion of the appliance which will help correct will be formed. That will then be converted to plastic, and will be inserted in his mouth on Thursday. Funds will have to be found for him to make that bus trip.

The motto for this trip, which is posted on the door to our "Mission Control" is the phrase, Blessed are the flexible, for they shall never be bent out of shape." Adherence to this motto was certainly important today.

This was a wonderful day of surgery and recovery. The children all left the operating room with their futures bright. Their moms were all aglow, each enjoying showing off the beautiful new faces of their little ones.

But flexibility was important, because schedules for the next few days were changing. For example, one gentleman who was scheduled for dental work didn't show up because he could not afford the bus fare. Another family canceled the child's procedure because due to hospital policy, no more than four people per patient are allowed in the room, and this meant grandma could not come along.

The language barrier is always there, because many of these people speak the Mayan dialect, which necessitated two translations. And directions and explanations get lost in the translation. But this group of professionals handles challenges very well, and tomorrow brings another bright and sunny day. Catherine Lane

First day of surgery

This was the first day of surgery, after evaluations and scheduling yesterday. 7 surgeries were done today, with ages of patients ranging in age from 7 months to 15 years. Everything went well.

Six stayed overnight because of the distance from home. Four of these all came together in one truck, and these four were traveling home the same way. Each family is provided with a "before" and "after" photograph, a momento of this life-changing experience.

The Rotary Clubs in this area have been so supportive. Not only have they provided lunch for us, but they have provided many amenities for the patients and their families. They have been invaluable to us with their translation skills, and sensing a need, have promised to provide food for all the families of the patients tomorrow.

This has been a very long day, hence this day's posting is somewhat short. More details will follow tomorrow. Catherine Lane and Kathryn Wallace

Screening Day, February 20

Today was "seeing patient" day! The group was very enthused and energetic, and the walk to the hospital went very quickly. Patients were already patiently waiting to be seen. To those of us who are new to this mission, it is humbling and amazing to see the trust that these people place in us.

Out of the organized chaos of setting up work stations at a site that hadn't been used before, the patient faced the following steps:

1. Registration

2. Surgical evaluation

3. Anesthesia evaluation

4. Dental evaluation

5. Pediatric evaluation

6. Scheduling for appropriate procedure

Patients who have been scheduled for surgery then needed to meet with a medical student from this local hospital to complete their registration. (Educating these students is also part of this medical mission,)

It was a long day for each of these patients, and their extended family. Some have traveled long distances to be seen. I was so impressed and in awe of their patience and graciousness. I left at 4:30 p.m. because my job was done, and many of these families were still waiting for their surgical schedules.

At the end of the day 71 patients were assessed. Some were directed to physicals at the hospital for admission tonight for surgery tomorrow; some where scheduled for surgery later in the week, with the local Rotary Club assisting with housing for those who needed it; and the remainder, who were not appropriate candidates for surgery at this time, were sent home with the possibility of being seen next year.

Kathryn Wallace, Volunteer

fFrom Guatemala City to Quetzaltenango

We arose early this morning and started out to Quetzaltenango (Xela) about 7:30. It was a long, slow bus ride. We initially fought rush hour traffic, and discovered just how close two vehicles can actually get without pulling off a rear view mirror.

Our trip went along the Pan American Highway, or Central American One. Once outside of Guatemala City, we were into farming country, with many small plots of farming, each one tilled by hand.

Xela is located in the western hill country of Guatemala, and our trip took us through some beautiful countryside. These small farms used every inch of land, with many plots of planted vegetation along some pretty steep slopes.

We finally arrived in Xela about 12:30, and had a nice lunch of sandwiches provided by the Rotary Club of Quetzaltenango. And then we were off to the hospital to get ready for tomorrow.

We walked to the hospital, which is about 1/2 mile from our hotel. For those of us who are on this trip for the first time, it indeed is a sobering picture to see the facilities. People are camped outside on the steps, probably waiting to be admitted. There is no heat, nor air conditioning in the hospital. It is what I would think a U.S. hospital would look like in the 1920's.

Tomorrow is a big day, with screening and physical evaluations to be done. We expect to screen between 70 and 90 patients. Some of these young folks are traveling 1 1/2 days for this treatment. Some are coming from Hue Hue. These kids will be evaluated and a surgical schedule will be set up for the week. Catherine Lane

MOST team arrives in Guatemala City

Greetings, it is about 11:00 p.m., and the team has arrived at the hotel in Guatemala City. All of our connections went well, there is a wonderful spirit with the group, and we begin another day tomorrow very early. We have about a 5 hour bus ride to Xela tomorrow, and then the work begins. Will keep you all posted. Catherine Lane