Today was the last day of surgery - only three patients - all teens having cartilage grafts to build up their nasal bridges. There were two 15 year old girls and one 18 year old boy, and the boy was also having a revision of his lip scar. None of them wanted photographs taken, and since the volunteers never take any pictures without asking, I didn't take any of these three. The young man in particular had a remarkable change in his appearance, and once he was awake after anesthesia, he couldn't stop looking in the mirror. He was oblivious to the rest of the people in the room - lost in his new look and perhaps fantasizing about the reactions he would experience from his friends. It was a great way to end the mission.
While these three patients were having surgery, we all began packing up our areas. On the ward, we pack any unopened medications, bandages, IV materials, antibiotics and various other supplies, but leave the opened packages as a donation to the hospital. We also donate extra hospital gowns and arm restraints that are used to keep the kids from pulling out stitches or putting their fingers in their mouths after surgery. We try to leave the ward as we found it so that the hospital will want to invite us back. In the case of Hospitál Infantíl, we have found a real partner. They really enjoyed having us and we loved having the mission here. Not only is it a beautiful facility, the administration and nurses - everyone has been so welcoming and helpful. This is definitely not always the case.
I'm still learning about how all this works, but Op Smile pays the hospital that hosts the mission. I think it varies country by country, but in Guatemala, the hospital is paid $10,000. For this, they turn over some of their operating rooms - (in this hospital they have four operating rooms, each with two operating tables and they gave us two rooms) - empty out some wards for our patients and supply linens if they can, feed the patients and parents if they can, and supply us with some nursing help. All of this varies depending on the country. On my trip to Bhubaneswar, India, the hospital had only a few sheets and no cribs, and the food for the parents was so sketchy that Op Smile had to supplement it. In contrast, the hospital in Guwahati, India provided wonderful meals that made us want to trade in our box lunches. When the mission is over, the hospital receives quite a lot of stuff in the form of drugs and supplies as any open package can't be packed up for the next mission. Even with all of that, some hospitals really feel invaded. The last time I was in Guatemala City for a mission, it was held at the military hospital. The top brass decided to host the mission but the surgeons and nursing personnel were definitely not on board. Using candy and cake and lots of friendly overtures, the pre/post nurses and I managed to win over the ward nurses by the end of the mission, but the OR remained tense. The outcome was that the military hospital said they'd host again but only if the fee was raised to $30,000. So, here we are at the lovely Hospitál Infantíl, a much better choice.
I have four quick anecdotes to relate and then I'm off to the final dinner. I'll write a wrap up tomorrow morning and perhaps have a few more photos. I've been trying to get photos from the roof where I'm told one can see all three volcanos one can see on clear days. The problem has been fog or darkness or no time each morning, but tomorrow at least two of the three won't interfere as I won't be getting up early to go to the hospital.
Ok, anecdote number one: Oscar, one of the surgeons from Guatemala, a really great, elegant, gentle older man who is the team leader for the surgeons, started todays's wrap-up at the morning meeting by saying, in Spanish, "Leaving out all the bad, everything in the mission has gone quite well." The coordinator looked startled but translated it to English. Oscar kept a straight face for about 15 seconds while the team members looked around at each other silently, wondering what bad things he meant, and then he burst out laughing, practically falling over, clapping his hands and chanting, "I got you all," over and over. It was especially effective because he is so soft spoken and polite in a sort of old fashioned European way. One would never expect Oscar to do something like that. He clearly had planned it and was so gleeful about carrying it off.
Anecdote number two: Every morning the surgeons make rounds, taking out tongue stitches. (a brief diversion here: at the end of surgery for a palate repair, the surgeon puts a stitch through the tongue and brings the suture out onto the cheek and tapes it there. The purpose of the tongue stitch is to have something to grab onto to pull the tongue forward if the child begins to bleed and you need to get the tongue out of the airway while you put pressure on the palate. If there's no stitch, you may have to use a hemostat (clamp) to grab the tongue which would be quite painful.) Taking the stitch out is painless as it requires just a clip of the thread which then slides out. This morning, they entered the first room en masse as usual, and the one year old in the first bed, took one look and swung his little arm across his body to point directly at the child in the next bed. He didn't cry or cringe against his father, he just stared right at the closest surgeon and said, silently, with very eloquent sign language, "It's him you want, not me!" Yay babies!
Anecdote number three: One of the Guatemalan surgeons is young and tall and handsome; looks like an ex football player, and all the young nurses swoon whenever he comes to the ward. Turns out he's happily married with two little boys, very polite and not flirtatious, unlike some of the older surgeons with less movie star qualities. This morning, after he took out the tongue stitch on a seven year old boy, he took a flashlight and asked the boy to open his mouth so he could check the palate. He looked for awhile and then sat down on a chair next to the bed. He asked the boy how old he was and after the boy told him, he gave a big sigh. Then he said to the boy, "look in my eyes so you can see that I'm serious while I talk to you. You're seven now so you are old enough to be responsible for your own teeth." He then talked to the boy for five full minutes about brushing his teeth twice a day, how to do it, why he should do it, what foods could make his teeth get holes in them and what foods might make his teeth stronger. The boy was mesmerized and never took his eyes off the surgeon. At the end, the surgeon said to him, "remember, you only have to brush the teeth you want to keep." I was very impressed.
Anecdote number four: In Latin America, people greet each other with hugs and kisses. Strangers get a handshake, but if there is any chance you have met before or any connection at all, there is a full body hug and kisses on one or both cheeks. Small children are encouraged to give kisses in greeting and on leaving and they learn this very young. Today, as yesterday's patients were leaving, I was kneeling on the floor doing a pre-op check on one of the teens who was having surgery today. A 15 month old who had had a palate repair came toddling up (at her mother's urging,) leaned in and hugged my arm and kissed my cheek. She then toddled around to the other side to repeat the hug and kiss on the other side. Manners 101 in Guatemala!
Off the the party - more tomorrow.
While these three patients were having surgery, we all began packing up our areas. On the ward, we pack any unopened medications, bandages, IV materials, antibiotics and various other supplies, but leave the opened packages as a donation to the hospital. We also donate extra hospital gowns and arm restraints that are used to keep the kids from pulling out stitches or putting their fingers in their mouths after surgery. We try to leave the ward as we found it so that the hospital will want to invite us back. In the case of Hospitál Infantíl, we have found a real partner. They really enjoyed having us and we loved having the mission here. Not only is it a beautiful facility, the administration and nurses - everyone has been so welcoming and helpful. This is definitely not always the case.
I'm still learning about how all this works, but Op Smile pays the hospital that hosts the mission. I think it varies country by country, but in Guatemala, the hospital is paid $10,000. For this, they turn over some of their operating rooms - (in this hospital they have four operating rooms, each with two operating tables and they gave us two rooms) - empty out some wards for our patients and supply linens if they can, feed the patients and parents if they can, and supply us with some nursing help. All of this varies depending on the country. On my trip to Bhubaneswar, India, the hospital had only a few sheets and no cribs, and the food for the parents was so sketchy that Op Smile had to supplement it. In contrast, the hospital in Guwahati, India provided wonderful meals that made us want to trade in our box lunches. When the mission is over, the hospital receives quite a lot of stuff in the form of drugs and supplies as any open package can't be packed up for the next mission. Even with all of that, some hospitals really feel invaded. The last time I was in Guatemala City for a mission, it was held at the military hospital. The top brass decided to host the mission but the surgeons and nursing personnel were definitely not on board. Using candy and cake and lots of friendly overtures, the pre/post nurses and I managed to win over the ward nurses by the end of the mission, but the OR remained tense. The outcome was that the military hospital said they'd host again but only if the fee was raised to $30,000. So, here we are at the lovely Hospitál Infantíl, a much better choice.
I have four quick anecdotes to relate and then I'm off to the final dinner. I'll write a wrap up tomorrow morning and perhaps have a few more photos. I've been trying to get photos from the roof where I'm told one can see all three volcanos one can see on clear days. The problem has been fog or darkness or no time each morning, but tomorrow at least two of the three won't interfere as I won't be getting up early to go to the hospital.
Ok, anecdote number one: Oscar, one of the surgeons from Guatemala, a really great, elegant, gentle older man who is the team leader for the surgeons, started todays's wrap-up at the morning meeting by saying, in Spanish, "Leaving out all the bad, everything in the mission has gone quite well." The coordinator looked startled but translated it to English. Oscar kept a straight face for about 15 seconds while the team members looked around at each other silently, wondering what bad things he meant, and then he burst out laughing, practically falling over, clapping his hands and chanting, "I got you all," over and over. It was especially effective because he is so soft spoken and polite in a sort of old fashioned European way. One would never expect Oscar to do something like that. He clearly had planned it and was so gleeful about carrying it off.
Anecdote number two: Every morning the surgeons make rounds, taking out tongue stitches. (a brief diversion here: at the end of surgery for a palate repair, the surgeon puts a stitch through the tongue and brings the suture out onto the cheek and tapes it there. The purpose of the tongue stitch is to have something to grab onto to pull the tongue forward if the child begins to bleed and you need to get the tongue out of the airway while you put pressure on the palate. If there's no stitch, you may have to use a hemostat (clamp) to grab the tongue which would be quite painful.) Taking the stitch out is painless as it requires just a clip of the thread which then slides out. This morning, they entered the first room en masse as usual, and the one year old in the first bed, took one look and swung his little arm across his body to point directly at the child in the next bed. He didn't cry or cringe against his father, he just stared right at the closest surgeon and said, silently, with very eloquent sign language, "It's him you want, not me!" Yay babies!
Anecdote number three: One of the Guatemalan surgeons is young and tall and handsome; looks like an ex football player, and all the young nurses swoon whenever he comes to the ward. Turns out he's happily married with two little boys, very polite and not flirtatious, unlike some of the older surgeons with less movie star qualities. This morning, after he took out the tongue stitch on a seven year old boy, he took a flashlight and asked the boy to open his mouth so he could check the palate. He looked for awhile and then sat down on a chair next to the bed. He asked the boy how old he was and after the boy told him, he gave a big sigh. Then he said to the boy, "look in my eyes so you can see that I'm serious while I talk to you. You're seven now so you are old enough to be responsible for your own teeth." He then talked to the boy for five full minutes about brushing his teeth twice a day, how to do it, why he should do it, what foods could make his teeth get holes in them and what foods might make his teeth stronger. The boy was mesmerized and never took his eyes off the surgeon. At the end, the surgeon said to him, "remember, you only have to brush the teeth you want to keep." I was very impressed.
Anecdote number four: In Latin America, people greet each other with hugs and kisses. Strangers get a handshake, but if there is any chance you have met before or any connection at all, there is a full body hug and kisses on one or both cheeks. Small children are encouraged to give kisses in greeting and on leaving and they learn this very young. Today, as yesterday's patients were leaving, I was kneeling on the floor doing a pre-op check on one of the teens who was having surgery today. A 15 month old who had had a palate repair came toddling up (at her mother's urging,) leaned in and hugged my arm and kissed my cheek. She then toddled around to the other side to repeat the hug and kiss on the other side. Manners 101 in Guatemala!
Off the the party - more tomorrow.
No comments:
Post a Comment