CHW Medical Missions Blog

Mission of Mercy

Advance for Nurses published the first person account of Family Nurse Practitioner Michelle Telford-Vegas's experience on CHW's medical mission to Guatemala. Michelle joined us on our first mission in 2007 as well. She is the manager of the family health clinics operated by our Mercy Hospital of Folsom.

Here's a taste of the full piece:

Our patients came in with a wide variety of ailments and complaints. In La Cuesta, I examined a mom and her four kids, ages 6 months, 2, 4 and 7 years old. They were obviously very poor as was their hygiene. The kids all had colds and the mom told me the children's father had died. She was raising the kids on her own and her chief reason to see us was she had a headache. I just thought to myself, "Of course you do!" Still, she was most concerned with her children's health. They all needed treatment. One had pretty severe diarrhea. When I talked to her about the food available in the house, she said they only had tortillas and beans. The normal advice of eating bananas, bread and rice to treat diarrhea was ridiculous. All I could do was educate her about boiling water and prescribe some medications that would temporarily ease her kids' symptoms.

Another experience that stayed with me was the search to find the home of a 3-month-old baby who needed critical care. A local doctor who joined us on our trip had seen the baby a few days earlier for severe respiratory illness and possible sepsis and sent the child to the local hospital in Chanmugua. The hospital discharged the baby without providing the necessary care and the doctor feared the baby was in grave danger. Along with a pediatric ICU nurse, emergency physician, IV fluids and antibiotics, we drove a "tuk-tuk" (a small, three-wheeled moto-taxi without a lot of power) up a hill in a remote area of Esquipulas to try to find the baby's home.

We traveled through a very poor part of town where all the homes were fashioned from mud. There was no electricity in many areas and it was very dark. Some roads were so bad the tuk-tuk couldn't pull us so we had to walk. We eventually found the home and discovered the baby had gone into respiratory arrest twice since being seen. We just missed the mother (who had already lost two children) and baby who had gone back to the hospital via tuk-tuk. We later learned the baby was septic and died. The rest of the kids living in the house - all 11 of them - were just waiting for mom to come home. These kids were standing there in the dark with no shoes, no food and no water, but the oldest child had a cell phone!

The View From Your Mission | Jose Garcia

Jose Garcia, RN
Radiation Oncology
California Hospital Medical Center, Los Angeles

As I recall my time on the mission I am touched by the fact that everybody who participated was so humbled and there was no distinction on who was who. We were there to do a job and help others who had no means. I will always remember the young boy with the tumor on his optic nerve, the kid who threw up the worm, and the lady who came back after we had finished treating patients and gave me a kiss as a token of her gratefulness.

I thought that after so many years of living in the United States, the economic and health situation in developing countries had changed, but it appears to be worsening. I am getting more involved in my local community and will continue to volunteer for other missions like this one.

The only word I can offer to all my colleagues is to continue helping the less fortunate and continue doing what you do. This work is wonderful. I came home with a deeper sense of community and security. All of us sharing what we know was like watching angels work. I want to thank everybody for their help and understanding. This was, for me, an enlightening experience. I hope I will live it again.

The View from Your Mission | Sr. Gloria Miller

Sr. Gloria Miller, RN
Infusion Nurse
St. Mary's Medical Center, San Francisco, CA

What surprised me about this mission was that despite a difficult start to the trip - the long journey and the minimal time to get settled and organized in Esquipulas - we formed our teams, functioned well and saw so many more people than last year. The biggest miracle was that no one on the team got sick despite long hard journeys and clinical days!
 
Overall, I tend to remember some of the simpler things:

• There was an older woman who I discharged toward the end of the day in Chanmagua who only needed some simple medication. As I finished her teaching, she expressed gratitude for our being there in a very tender way and she told me that she was praying that we have a safe trip. Although regretfully I do not remember her name I feel like there was a strong connection with her through her gentle touch.
• On a home visit with Rachel and Sonia in Horcones we saw an elderly woman who was very limited in her mobility, spending most of her time in bed. We had a walker with us and fitted it for her. To her delight (and ours) this allowed her to get outside to a small porch on her own. Her smile, which radiates on her beautifully etched face, is captured in pictures and competes only with the smiles of Rachel and Sonia.
• There was a boy about 12 in Chanmagua who had had surgery for an optic nerve tumor. It was hoped that his blindness was temporary and he was still on steroids, making him quite bloated. He was obviously a happy child and interacted very normally with the people around him despite his ordeal. When he came to me for discharge, the first thing I said was that I heard he had had some very big surgery. He did not dwell on his predicament but cheerfully told me, "Yes, I have an incision from ear to ear." His situation made me wonder how his family managed to get him the surgery he needed and what kind of follow-up he would be able to get in the future especially if he remained blind.

As I reflected on this mission I found myself questioning the amount of resources that go into this project and trying to justify the "bang for the buck." Although I truly believe that the key to improving health of the people of rural Guatemala is in strengthening the resources within the country, there is also an incredible connection that happens among people of very different parts of the world that takes place in such missions. Hopefully, the fact that we were willing to travel to the extent that we did and to bring supplies to people who need them speaks of the level of concern of the team and of all those who supported us in so many ways — families and co-workers at home as well as those who provide financial assistance. The growing connection with the health promoters is an important link that was very evident last year and which has grown with the development of relationships through the year. It is the relationships that convince me that this is an important effort.
 
 
I served on this mission with an amazing group of people who were very adaptable, generous and caring, not only with the people but with one another. It was truly amazing how we all became a team from the beginning and worked together so well. Certainly there is a special bond of having had this common experience. My only regret this year is that with going to separate sites each day there were some people I didn’t have as much of a chance to get to know. I am truly grateful for each person who was with us and who supported us from afar—the effort of the group and the level of commitment to service is phenomenal.

Going forward, anything that can be done to promote local resources is critical. Having even minimally prepared people who can assist with care on an ongoing basis could make a big difference in the lives of these people. I think it was really important that more teaching was done this year with the health promoters and women who are in charge of the clinics and I hope that this can be increased in the future. I believe that the most important thing we can do is education and certainly the issue of clean water could make a significant difference in the health of the local population. As I was doing discharge teaching, I found myself giving the same little talk about boiling drinking water to just about everyone.

Walking Tall

We have an exciting update on the status of one of the patients we saw while in Guatemala last year. Juana Perez is a beautiful nine year-old girl with a big problem. She was born with severe bilateral clubbed feet. Her mother and sister took turns carrying her for the 3 1/2 hour walk over unpaved roads to our clinic in Tontoles. Aside from her feet, Juana is a healthy child. 

We provided her with a walker and a wheelchair to help improve her mobility, but she wouldn't be able to walk normally without surgery. Our team of caregivers, led by Mary Carol Todd, set to work finding an orthopedic pediatric surgeon who could take on her case.

Providence began to set in when Dr. Allen Hooper, an emergency room physician from St. John's Regional Medical Center who accompanied us on this mission trip, spoke to a reporter at the Ventura County Star about Juana's case. A story about the mission, and Juana, appeared in the Christmas Eve edition of the Star.

That story was serendipitously read by Heather Frankle, the international service director of the Rotary Club of Simi Sunrise, who was planning to accompany a group of volunteer surgeons to Honduras (which borders Guatemala) in January 2009 specifically to perform corrective surgery for children with clubfoot!

With the help of the Simi Rotary, our Guatemalan contacts, and the two college students from St. John's University who are volunteering in Esquipulas for nine months, we were able to secure passports for Juana and her mother and transport them to Honduras for Juana's surgery. Read more about the surgery here. And here's a picture of Juana now: