By Patricia Yoon, MD

We’ve had an amazing week down here and I can’t believe how quickly it’s gone by! Friday was our last day of surgery, and held our post-op clinic Saturday. Our days have been nonstop from dawn until dusk, and we’ve treated so many children. But with as much as we’ve packed into a few days, I can’t help but think about how much more work there is left to be done!

Maria
We were asked to see a consult at Juan Pablo Children’s Hospital, the only pediatric hospital in Guatemala. Dr. Aguilar, a local ENT physician who works with the Shalom Foundation, asked us to see Maria, a 2- month-old baby who was not able to breathe when she was born. She had required placement of a tracheostomy tube to breathe, but the cause of her airway obstruction was unknown.

Dr. Aguilar knew that Maria required a laryngoscopy and bronchoscopy to determine the cause of her breathing difficulties, but lamented that she did not have the equipment to perform the procedure – one which is performed multiple times in a typical day at Children’s Colorado.  Maria was on a ventilator in the intensive care unit, which was antiquated and bleak, to say the least. Lighting was dim – bulbs were flickering or missing, supply cabinets were empty, cribs were rusty, and duct tape seemed to be the savior of most of the equipment.  

Maria was on a ventilator, yet had a blue pallor to her face, and no oxygen saturation monitor available. Sadly, Maria will have to wait to receive a diagnosis and the care she needs – we could not transport her to our surgery center on a ventilator. Hopefully she will still be around next time.

Anna
Anna was another child who tugged at my heartstrings. She and her mother showed up in our clinic on our first day in Guatemala.  Anna was an 11-year-old girl born with a severe congenital malformation of her jaw. Her lower jaw was so small that she had no chin, and her mandible was fused to her skull so she has never been able to open her mouth.

She was full of love, giving us all hugs and kisses, and her mother arrived full of optimism that we could make her daughter’s jaw “work” and make her look “normal.”

Anna’s problem is complex, and she will need many surgeries by several different teams, using equipment which we do not have here at this time. It was very difficult to tell Anna and her mother they will have to wait, and that we cannot “fix” her this time. Anna and her mother were nevertheless unfailingly gracious and grateful. I hope that we, or another team, can give her better news in the future.

Exhausted but renewed
Our past few days have been packed with so many memorable and moving experiences. We left the surgery center every evening completely exhausted, but renewed in other ways.  It has truly been an honor to have this opportunity. And what we couldn’t accomplish this time will certainly give us a good reason to come back.

By Phillip Tennant

Mission complete.

We wrapped up our work here Friday during our fourth and final day of surgery. The week went by quickly.  The PACU had emptied out by mid-afternoon and our supplies were quickly stored away.

A sense of closure
There was a sense of closure at the end of the day yesterday that we normally don’t experience at the end of a regular day, or a regular week, at work.  All the patients scheduled for procedures had been taken care of as planned.  They all seemed more than happy with the results.  The lights were in the operating rooms were turned off.  There was nothing else for us to do.

As we talked in the late afternoon and evening, however, it was clear that our interpretation of the week’s events was far from complete. Questions remained. Thoughts lingered.

We did the best we could
Could we have done more?  I think this common question is easy to respond to — of course we could have.  We did not use all of our supplies.  We were tired some days , but far from over-worked.   And our last day in Guatemala will be spent not in the operating rooms, but in the tourist town of Antigua, for our one day of rest.

But we turned no patient away in the clinic, except for two or three that we felt we were not equipped to treat. We had the inpatient hospital rooms filled to capacity on the final morning.  We did the best we could, with what we had, in the situation that we placed ourselves in.

The real question might be, from a Guatamalen perspective, how did we do so much in a country that is accustomed to so little?  Why did we do so much?  How can we do surgery for free when they have been unable to afford an operation despite years of saving money?  Do we understand the hope that we have given them?

More more remains
Much work remains here in Guatemala.  It is but a microcosm of the challenging healthcare issues facing much of the world.   The truth is that we can always do more for as long as we live, but there is value for us, whether it is one surgical case or one hundred cases.

The value lies in the idea that we interpret our world through our interactions with the people surrounding us, and for me, that interpretation is magnified in a foreign land within a foreign culture.  In that sense, the value of this trip and of our work as a team here is complete.  We gave people hope and the opportunity for change through our actions.

One in the same
They showed us that the human spirit is still the same across borders and economic boundaries.  There is still laughter here, even without some added laughing gas, and there are still tears here, when they leave their parents to go to the operating room.  We are one and the same in more ways than we knew before, and that is something that I know the Guatemalans would like us to carry with us on our trip home.