325 Bags of Cement Later, Antonio Fernandez, Builds a Basketball Court in Peru

Antonio Fernandez is a national proposal consultant with Kaiser Permanente. Last month, Antonio and 12 of his Kaiser Permanente colleagues traveled to Cerro Blanco, Peru to build basketball courts for Courts for Kids, a non-profit organization that partners with local communities to provide athletic opportunities for children.
We arrived in the village of Cerro Blanco, Peru on Saturday, August 16th, after more than eight hours in flights and a two-hour bus ride. Our group was met by Chris Cobb, the director from Courts for Kids, and a few Peace Corps volunteers, led by Kristen Jackson. We stepped off the bus and were greeted by the Group with workerspeople of the town, who were lined up waiting for us, with big hugs and even kisses on the cheek. No one in the town spoke English. The Courts for Kids group would be relying heavily on about four people to translate any communication that took place all week long.

We were well fed all week long. I heard that the village didn’t have a lot of funds to put towards the court, so much of their contribution came in the form of feeding our group and providing a lot of manual labor. Most of the food I believe, especially the meat, was raised right on the farm where we stayed. We ate meat almost every meal, which we heard was not common in developing countries like Peru. On one of the days, our volunteers Kathy Pantele and Angelica Velasco pitched in and made ceviche, a seafood dish wStove (Medium)ith its origins in Peru.

The morning following our arrival, the volunteers were up and ready to work at 9 a.m. After a minor setback—not having gasoline for the cement-mixer—the group finally started moving cement at about 10:30 and by noon we had finished the first square. The 25×30 meter court consisted of approximately 65 squares.   At the pace we started out at, it looked like we might get ten squares done by the end of the week.

Halfway through the week we found out that the contractor, the people of the village and almost anyone who lived in the immediate area and knew about the court didn’t believe that a group of volunteers would ever finish a court in a week. I never had a doubt. I have done many volunteer projects with Kaiser Permanente employees and I know that they always show up and give everything they have and then a little bit more. This group was no different.

By the end of Monday we had completed 17 more squares. After two half days of IMG_5473 (Medium)work, the group was nearly halfway done with the whole court. The energy at the end of the day was high and the group bragged about its work. We talked about the idea of being able to maybe finish by mid-week.

On Wednesday, I was totally bummed because I contracted some sort of a stomach bug. However, thanks to the marvels of modern medicine, by late Thursday morning I was back up on my feet again. I even jumped in and helped the group as we began to fill the last few squares. I found out quickly though that whatever bacteria I contracted, I was pretty well wiped out still. After about an hour of tough manual labor I stepped aside and let the healthier volunteers do the work.

Completed court with mayorsThe court was completed by Friday. Not only did we finish a court that was about one-quarter bigger than it was supposed to be, but we did it in only two and a half days’ time. Well, really five half-days. For most of the volunteers on the trip, I joked, “It was the toughest half a week most of us ever worked in our lives.”

Our statistics for the week included the following:

  • We emptied nearly 325 bags of cement, which weighed about 100 pounds each.
  • Each batch of cement filled about eight wheelbarrows. Each square needed about five batches.
  • I estimated that we also dumped approximately 1950 buckets of the sand and rocks, each bucket weighing probably close to 50 pounds, and almost 650 buckets of water.
  • In the end, we emptied about 2600 wheelbarrow loads of mixed cement.

For most of the volunteers, it was the hardest week of manual labor they have ever worked.IMG_5834 (Medium)

The first week back from the Peru I was stuck in existential crises mode like I usually am after going on a volunteer trip. I often pondered the previous week’s events and wondered what impact I made and if it was enough. It finally came to me after a few days of running it over and over in my head. The court was only one of the things that could have a big impact on the village. The new court might help generate some money to bring much needed improvements to the village. It could also attract others to come and live there, building a bigger community. It will definitely be a great place for the kids to play safely and for the community to hold events.

What came to me as I thought about what else might change the village was the story about a group of volunteers who showed up from thousands of miles away and gave themselves selflessly to a cause, asking for nothing in return.

After the trip, I asked some of our volunteers to reflect on how it affected them. Here is what they had to say:

Denise Dorado, is a Mammography Technologist at our Santa Clarita Medical Offices.“This was my very first volunteer trip of any kind and I must say I’ve learned I truly do feel a balance in my life when I help others. My job consist of helping others but there is nothing in this world like actually paying out of your own pocket to help others and in return receive smiles, hugs, laughter, joy.”

Ly P. Rivera, is a Change Management and Communications Analyst with our Pleasanton Medical Offices. “This trip incited my passion for altruism and, thus, I have decided with my family, that every vacation will be merged with a service project, as social needs exist almost anywhere at different scales.”

Donating supplies to the school

From a Clinic in Kenya, OB-GYN Deb Matityahu, MD, Shares One Young Woman’s Journey

Dr. Deb Matityahu, OB-GYN and Chief of Service for Kaiser Permanente in Redwood City, has returned to Eldoret, Kenya. She volunteers at the Gynocare Fistula Centre, a clinic dedicated to repairing gynecologic fistulae, which arise when a pregnant woman’s delivery stalls. Tissues are damaged when the baby dies and must be removed from the womb. Dr. Matityahu and her teenage daughter started a non-profit, “A Little 4 A Lot,” which works to rehabilitate the often poor and shunned women after their repair. ALittle4ALot.com has raised money to provide sewing machines and lessons for the women. Here is one of their stories:

Ann  is one of our patients.  She lived in a poor village, and had to drop out of school. She was sent to Nairobi to be a maid. While in Nairobi, she was dating a boy for just over one year and became pregnant.

At first, Ann didn’t know she was pregnant; she just thought she was sick.  When she found out, Ann returned home to her village and  went to the hospital.  When she delivered in the local hospital, she had a large tear through the rectum that was not repaired well.  This resulted in a recto-vaginal fistula (RVF). For those of you not familiar with RVF, it is a tear from the rectum to the vagina, resulting in stool leakage through the vagina.  Not pleasant, as you can imagine (understatement).

Because of the stool leakage, she was reluctant to eat or drink anything if she was out of the house.  She was embarrassed, ostracized, and depressed.  She lived with the fistula for three years before learning she could come to Gynocare (Fistula Centre in Eldoret)  for repair.  She was repaired in 2011.

Ann was tearful and crying through most of her story.  She recently finished her dressmaking class, and says that learning to sew has changed her life.  If it weren’t for us and for her sewing machine, she would be working in someone’s home again for 800 kes a month (the equivalent of $10 US).  Now, she knows she has a skill and has value.

Ann believes she will be able to return home to give her 5-year-old daughter a better life and an education.  On the sewing room wall behind her were about six tote bags that she has already sewn.   I plan to purchase them all and sell them in the states.

She continues to cry, insisting that we have changed her life and cannot thank us enough.  At this point, I am crying too and got up to hug her.  I don’t think I fully realized what we have started with this program, and what we have already accomplished in such a short time.

Dr. Deb.
Eldoret, Kenya

RWCDrMatityahu-L-Pt-ClinicDirector-R 2012

In this 2012 photo, Dr. Debra Matityahu poses for the camera with a fellow doctor and patient in a clinic in Kenya.

Cherri Dobson, RN, Serves Maternal/Child Health Mission in Belize

Cherri Dobson, RN, NICU, Kaiser Permanente Oakland Medical Center, was recently honored as a Volunteer of the Year with Project HOPE, an international nonprofit organization that conducts medical missions and health care and education training around the world.

She filed this from Dangriga, Belize – a town in southern Belize on the Caribbean Coast –  where she is on a  mission for Project HOPE, training local health care providers on obstetrical care.

May 14 – It’s my first week here, and we are focusing on maternal/child health and evaluating the Belizean health care system. We followed a rural public health nurse today into very remote areas to do immunizations and well-baby checks. This involved loading up an SUV with all the necessary supplies and traveling on unpaved, rutted, and winding roads.  Sometimes we would jostle ten miles into the hills just to see one child.  We saw both ends of the economic spectrum today – from kids who lived close to town in modern houses, to families living in shacks made of cardboard and corrugated tin roofs.

Cherri Dobson high res PHOTO 1The RPN was amazing. At each stop she weighed and measured the child, and gave the recommended immunizations.  Plenty of teaching went on about nutrition, preventative care, and growth and development.  When I asked if these visits were scheduled, she laughed and said that many of the indigenous people, such as the Mayans, would make it a point not to be home if they knew she was coming!  About 20 percent of the children we saw were underweight, so their mothers were told to go to the clinic and pick up a nutritional supplement, “Incaparina,” which is provided free of cost.  All healthcare from birth to 5 years of age is provided free of cost in Belize.

Tomorrow we will be at a prenatal clinic in Dangriga, and later in the week we will visit several clinics and hospitals in the southern-most region of Belize—Punta Gorda, where some of the poorest of the poor villages are located.  Then next week, I’ll be helping present a course called ALSO (Advanced Life Support Obstetrics), which is a course that is a collaboration of Project HOPE, the U.S. Department of Defense and the U.S. Air Force, to 30 providers from across Belize.  We hope to identify local providers who would be willing to become instructors so that in the future, Belizeans can continue teaching it as part of their effort to give evidence-based obstetrical care to all pregnant women.

Cherri Dobson hi res PHOTO 2I have been volunteering with Project HOPE (Health Opportunities for People Everywhere) since 2008 – my first mission was in Liberia – and after I got involved I got a whole new perspective on charitable giving and how it works. While providing clinics and disaster services are valuable, they don’t correct the root of the problem: many nations are poor in available resources and trained personnel.  Since HOPE’s focus is on sustainability and capacity building, I feel that this is where the most good can be achieved: by training the local professionals how to deliver evidenced-base care in settings lacking resources.

It awes me how grateful the providers are to have the educational opportunities that we provide.  I have seen a nurse model her behavior on mine in such small but powerful ways as simple as hand washing between patients or doing an actual, hands-on assessment.

Likewise, we are going to the host nations and treat providers as colleagues, and our focus is showing them ways to give excellent, evidenced-based care despite their scarce resources.

For me, this is nursing at its most basic and fundamental level best.  Sometimes we can get too overcome by all the bells and whistles we have at home, and it’s hard to see the patient. Out here, it’s truly patient-focused and seeing how much you can accomplish for them with limited resources.

I feel fortunate to be a Kaiser Permanente employee for many reasons.  My immediate boss, Pam Middleton, has been very supportive of me and has worked with me every time to ensure I can do these missions. I volunteered to help with the cholera epidemic in Haiti and only had three days’ notice before I left!

Secondly, my unit at the Oakland Medical Center NICU, has also been supportive.  Some of my colleagues work my shifts so I can go. Others send me supportive emails while I’m gone. Finally, the culture of Kaiser Permanente supports volunteerism.  When I first started to do this, I found that Kaiser Permanente has a national policy which supports volunteering and disaster relief.  Not many companies spell it out so clearly, and I feel fortunate to work for one that does.

Cherri Dobson, RN
Kaiser Permanente Oakland Medical Center

The End of the Mission to Guatemala

Susan Dean, RN, is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s seventh consecutive year serving on a Faith In Practice surgical mission.

The surgeries have been completed.  Seventy-nine patients have been served.  Many lives have changed – especially ours.

We saw 9-year-old Luis on our last day. He’s looking forward to going back home to his village, but his journey is not finished. His nose has been reconstructed, but he still needs more oral surgery at a later date. His speech has not been helped, but his looks have changed. Maybe the bullying will stop.

As for the team, we have reconnected with other people, other cultures, and why we went into the health care field. We looked out for our patients, and we looked out for fellow team members. There was always an offer of help from someone near by.

If you hear of a medical mission trip or a volunteer opportunity that interests you, take the extra moment and check it out. Your life might be changed forever! This team will go again next year. We need OR nurses, Recovery Room nurses, translators, assistant surgeons, and surgeons. This year, the specialties covered were plastics, gynecology, urology, and general. There is always a need for an assistant surgeon with other skills.

Come join us.

This slideshow requires JavaScript.

A Growing Number of Surgeries

Susan Dean, RN, is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s seventh consecutive year serving on a Faith In Practice surgical mission.

The days and numbers of procedures continue to grow.  We find that there are more people that need surgeries, which we hope to fulfill.

Some of the happiest patients are a group of four men that all had urological surgeries.  They are all recovering on the same floor and enjoy joking about their foley bags.  They call them

Gordon Haddow, MD, works with a patient in the local hospital.

Gordon Haddow, MD, works with a patient in the local hospital.

their purses, although one called it his suitcase while holding a urine-filled foley bag.

Another patient, Mariana, had a hysterectomy. She reported before surgery that she didn’t care what had to be done or removed. She just wanted to be able to go gather firewood without her insides falling out.

The world down here is very different.  As we check patients in we find that many of them are not able to read or write. In order to get their consent, they’re using their thumb prints as opposed to a signature.

The team performs surgery on an infant with a cleft palette.

The team performs surgery on an infant with a cleft palette.

Also, many patients that we treat are coming from villages that are hours and hours away, so the doctors take this into consideration when deciding on post-op and discharge orders.  Most of these patients will stay in the hospital longer simply because they cannot make the long journey back to their homes. And, in the case of a complication, it would be difficult for them to return to the Obras–or hospital.

The lives of many children are being changed dramatically by surgeries to help their appearance after many previous cleft lip and palate surgeries.  Their parents come to their bedside after surgery and just break down with emotion.  Most of them reported that their kids were being bullied at school because of their appearance.

The mom of Jocelyn, a 14-year old female in for rhinoplasty, while in tears of joy reported that this surgery is just in time for her Quinceanera.

Day One of Our Journey in Guatemala

Susan Dean, RN, is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s seventh consecutive year serving on a Faith In Practice surgical mission.

We are here enjoying the Guatemalan community as well as the community
within our team. Today we served 16 patients. We were able to offer the
same type of quality care they would receive at our own medical centers in the U.S., but the challenges are very different. In the afternoon, all of the
lights went out.

Our urologist, Carlos Felix- Fretes, MD, is here for the first time. He says that this is a humbling experience. “The patients are so grateful and happy.”

Mo Ghotbi, MD, an anesthesiologist on his first medical mission, says, “It has been a wonderful and rewarding experience. I would do this again in a heartbeat. I am already planning on returning this year!”

The patients here are truly resilient, having already experienced so much in a life.  The majority who come in for surgery are most concerned with how they will afford food while they are in the hospital.  Luckily, we are able to ease their concern with the help of Casa de Fe (their version of the Ronald McDonald house here in Guatemala).

Team 365, the Preston surgical team, will continue doing more surgeries today!

Susan Dean, RN, Returns to Guatemala for the Seventh Consecutive Year

Susan Dean, RN, is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s seventh consecutive year serving on a Faith In Practice surgical mission; last Spring she wrote several dispatches for this blog.

May 5

We arrived in beautiful Antigua, Guatemala for another week of surgeries. Our team of 34 members includes translators, cooks, surgeons, nurses, and anesthesiologists.

We are guests in a constantly changing system, and it has become even harder to bring our medical supplies and drugs through customs. The supplies are thoroughly scrutinized to make sure that everything matches the lists that were sent to the government a month before our arrival, but we made it with all of our supplies and equipment!

We have learned that 90 percent of the people here in Guatemala do not have access to health care. The country ranks fourth in the world for chronically malnourished children. Faith In Practice, the organization that we are traveling with, has 700 Guatemalan volunteers and 1,000 volunteers from the United States. There are eight village trips that triage patients for surgeries, along with teaching healthcare topics.

Our goal for the week is flexibility and fitting into the amazing Guatemalan community. We have come with a desire to help care for others and we are thankful that we are able to work in the hospital here.