August 2015: Antigua, Guatemala

The Mission to Guatemala was a great success. We operated at the Hospital Obras Sociales del Hermano Pedro in Antigua, Guatemala.   We screened about 75 patients and did surgery on 48.  All surgeries went well without complications.  The hospital is extremely efficient with an OR turnover of 5 minutes and electronic medical record.   We did laparoscopy with many disposable instruments reprocessed on site.  All local personnel is highly skilled and extremely devoted to their job.  Part of their skills and efficiency comes from the fact that every week there is a different group coming to do a totally different type of surgery. As we were leaving a group of Orthopedic surgeons from Syracuse came in through a Foundation “Operation Walk” ($6M operational budget) to do 100 hip replacements.  The hospital houses 240 chronic patients with cerebral palsy that, for the most part have been abandoned by the family. They take great care of them from nutrition and physical therapy to dental health (while we were there a group of odontologistsfrom Spain was doing work on them).  We paid a fee to Asociacion Companero para Cirugia, part of which is used to bring the patients and house them in Antigua and part is for the Hospital to subsidize the operations of the hospital. Once we made a tour of the hospital we realized that it was money very well spent.

The team was made up of Billy Diehl, Ted McLean, Ankit Dhamija and I doing the surgeries; Marina Debanich and Lauren Minotti scrubbed with us, Monica Grzelak (Halina) and Ruben Milan circulating, Carol (Cassé) Santana did the access, Cyprienne Lacaden  and Valentina Salvador did the recovery, Jordi Pineda was the troubleshooter and my daughter Florencia took photos and videos.  They all returned to the US by Sunday the 23rd while I headed to Tegucigalpa, Honduras.  In the airport I met with Susie Kaye, Chair of Family Practice at Overlook and long time founder and supporter of Shoulder to Shoulder in Intibuca, Honduras. This organization runs about 20 clinics in the most remote places of the most impoverished areas of Honduras.  The clinics offer primary care including Ob and pediatrics as well as dental care. They have been in operations for about 14 years but they have never done surgery.  Before climbing up to “La Frontera” (border with El Salvador) we stopped in La Esperanza at their Hospital and in the municipality. We met with the hospital director and the only surgeon and the only gynecologist. This is the only hospital in the entire Intibuca, what does not get resolved there goes to Tegucigalpa.  There are only two ORs and the possibility to make another one.  They have very rudimentary equipment for laparoscopy and work with nurse anesthetists who do general and regional anesthesia.  I was told that there is only 3 colorectal surgeons in the entire country and all three are in Tegucigalpa. When they heard about the possibility of addressing colorectal problems they became very interested.

After La Esperanza we drove to La Frontera through unpaved mountain roads and reached Concepcion, Camasca and Agua Salada (a village of 50 families).  I learnt that Honduras is the second poorest country of the Western World after Haiti, and this particular area, La Frontera, is the poorest of Honduras.  I met great people from the US working full time there as well as Hondurans.

We set as the date for our Surgical Mission in Honduras February 20th through the 27th, 2016 where we will follow the model we applied in Guatemala.  We are also planning to return to Guatemala in late July/early August, 2016.

I would like to thank everyone who supported us in this mission. I feel that we initiated a new tradition for the Department of Surgery which will bring the excellent care of Morristown to the most impoverished areas in The Americas.