February 4th-11th, 2017: La Esperanza, Honduras

UHMLA returned to La Esperanza for another surgical brigade with Shoulder to Shoulder at the Hospital Enrique Aguilar Cerrato (HEAC).  Being the second trip there were many things we prepared for; however, as it is common in these trips there are many other things that we cannot prepared for, and we deal with them as they come.  Last year it was Shoulder to Shoulder that selected patients from us from La Frontera (border with El Salvador).  This year the HEAC publicized broadly our coming; and no patients were screened. As a result we found ourselves screening over one hundred patients until we filled the slots of our surgical schedule and had to stop.  The other incident was that one of the members of the team fell ill the day before our departure.   Therefore, we had more work and fewer hands; nevertheless, the team step up to the plate and did a spectacular job. 

Another new experience for us was bringing complex gynecological surgery in the hands of Dr. Michael Kuchera.  The rest of the team were: Diane Krutzler and Rolando Rolandelli for General Surgery, Gerry Lefever, Nancy Schultz and Meagan Judge for Anesthesia, Susan Kaye and Sejal Jain for Family Practice; Christina Jimenez, Mary Quinn, Tara Gonzalez, Paulette Garcia, Valentina Salvador and Cyprienne Lacaden for Nursing and Maggie Claudio, Suki Dewey and Mercedes Rolandelli for coordination and support.


Upon our arrival we met with our support staff from Shoulder to Shoulder, led by Kate Clitheroe and Paul Manship, and we distributed Spanish speaking people with each screening station: general surgery 1 and 2, gynecology, family practice, anesthesia and scheduling.   The hospital had undergone a major renovation and was really much improved from last year.  One problem was that the only radiology equipment in the hospital broke down.  We had several young doctors in their “social service” internship who were extremely helpful and fully staffed clinics and laboratory.  We completed the marathon scheduling 10-11 surgeries every day from Monday through Friday and made it back to Hotel to watch the half time of the super Bowl.  Maggie and Gerry had decorated the room and provided all of us with NFL paraphernalia.   We relaxed a little bit and got some rest to get the week started.


We tackle some hard cases first: in one room we removed an arterio venous malformation from the chest wall of a very cute 7 y.o. girl while in the other we did the first vaginal hysterectomy. Typically, it takes a long time to get started in this setting, but were finally underway and the patients did fine.  By the end of the day our nurses had to spend hours washing instruments to be sterilized for the next day. We did not finish until 9 PM and therefore, decided that as of the second day Suki and Mercedes would keep washing and drying instruments as we were finishing the surgeries. That was of great help; however, we kept running into difficult problems and saw daylight pass again; we made it back to the hotel at around 9 PM.  We decided that we would leave for Friday any possible tour into the center of town.


In total we did 5 vaginal hysterectomies, 6 total abdominal hysterectomies, 3 cystoceles, 2 oophorectomies, 1 diagnostic laparoscopy, 10 laparoscopic cholecystectomies, 5 hernias, 8 fistula in ano, 3 hemorrhoidectomies,  1 sphincterotomy and 1 excision of anal skin tags, plus the excision of the vascular malformation of the chest.  We also removed a port that was placed in the US for chemotherapy on a patient with rectal cancer.  In addition, we did 5 colposcopies and 10 ligation of internal hemorrhoids in the office.   We also saw several patients in follow up from last year and consultations in the emergency room.


On Friday we went into the town by 5 PM, most shops were closed except for some street vendors in the square of town. Those who were there for the first time got to climb up to the Gruta and get a panoramic view of Intibuca. We were hosted by Shoulder to Shoulder to a nice dinner and got back to the hotel to spend the little energy left in packing.  The fifteen duffle bags we had brought in were reduced to 7 by us either consuming or leaving behind the disposable supplies.  We packed the laparoscopic equipment using our scrubs for protection.   


On Saturday we were picked up at 5:45AM for a 4 hour drive back to Tegucigalpa.  We went through the checking in process quite smoothly and stood in long lines through customs and airport security to finally arrive to the gate.  As soon as we sat down we hear Suki’s name being called in overhead speakers.  She needed to be present to open her duffle bag by the Honduran “TSA”. That meant running back and forth through all the incoming crowds to find out that there was some stainless steel vaginal retractor that had gotten the attention of an agent.  We cleared customs through Miami with just enough time to board the next plane and arrived back to a frigid Newark all team members and the luggage safe and sound.   At the Friday dinner Gerry said: "we become so close in this short week that the day after we are back home we wonder where did everybody go", and that is the exact feeling.