Monthly Archives: March 2013

To Recognize National Doctors’ Day, An Interview with Hernando Garzon, MD

Saturday, March 30, is National Doctors’ Day. Since this blog was created to share our caregivers’ thoughts about their relief missions worldwide, it’s appropriate for National Doctors’ Day to recall the work many of them do abroad on their own time, serving populations after natural and manmade disasters.

One of the physicians who knows this work best is Hernando Garzon, MD. Dr.

Arif Seyal, MD, provides assistance to a mother and child.

Arif Seyal, MD, provides assistance to a mother and child.

Garzon is the director of Kaiser Permanente Global Health Programs, an emergency room physician at Kaiser Permanente Sacramento (Calif.) Medical Center, and the medical director of Sacramento County Emergency Medical Services.

Dr. Garzon was among the first physicians on the ground in Haiti following the 7.0 earthquake in January 2010 that left more than 220,000 dead. His initial dispatches from Port-au-Prince formed the basis of the “Dispatches From Haiti” blog, from which this blog is derived.

Dr. Garzon joined The Permanente Medical Group in 1992 and, three years later, was dispatched with a search and rescue team to the bombing of the Alfred R. Murrah Federal Building in Oklahoma City, in which 168 people were killed. Dr. Garzon’s relief missions have taken him from New Orleans (Hurricane Katrina) to Myanmar (Cyclone Nargis), and many places in between.

He sat down for this interview in late March, just weeks prior to departing for a mission to Central America. He talked about what Kaiser Permanente caregivers’ relief efforts abroad mean to both the populations served and the people of Kaiser Permanente who volunteer.

In your experience, what roles do doctors play in disaster relief efforts beyond providing medical care?

During relief efforts, people may come for medical attention and also ask, “Can you help me find my cousin?” or, “Can you help me find my sister?” In

Hernando Garzon, MD, helps out with relief efforts in Peru.

Hernando Garzon, MD, helps out with relief efforts in Peru.

the spirit of humanitarian relief, we do whatever we can. Frequently, we build contacts with not just the health care, but everything else. Depending on the organization we work with we get involved with other programs—water sanitation, distribution of non-food items, those sorts of things. We try to meet the other needs as well. Every disaster has been different.

During the earthquake in Pakistan in 2005, I felt very much like an ambassador for the United States. Pakistanis were shocked that we would come to help them. So we also serve a peace-building, ambassador-type of role.

What and when was your first disaster relief mission?

I joined Urban Search and Rescue when I started working for Kaiser Permanente. The first major deployment was the Oklahoma City bombing in April 1995. The search and rescue system had been designed to respond to earthquakes—we weren’t thinking at the time about terrorism, but it turned out that was the first response we did. I was very much a novice to the whole idea of disaster response to begin with. The thing that made Oklahoma hard for all of our rescuers was that it wasn’t a natural disaster, it was a man-made disaster. We tried to come to grips with what it would be like to go though the devastation. We were one of the first teams in before the sunset on that day. We spent essentially three weeks there going through the rubble.

What made you volunteer again?

I’ve certainly been to bigger events [than the Oklahoma City bombing], including 9/11 and evacuating New Orleans. But Oklahoma City has had the most impact on me. I realized then that we were serving a very vital function to help a community in crisis deal with the aftermath of the terrorist event and what an important role the Urban Search and Rescue system played.

 In your relief missions you often work side-by-side with physicians in host countries, and doctors from around the world. What have you learned from those experiences, both in the practice of medicine and as it regards our cultural differences?

It’s really fascinating. You can’t separate the cultural differences and the cultures they’re from and the practice of medicine. There’s definitely a kinship and a camaraderie when you’re there working alongside local health care providers.

Usually the American healthcare providers that come along for these events have so much more training than our international counterparts. They frequently look to us as the experts. We may have more years of residency training, but most of our people aren’t familiar with the environment they’re going into. We have less experience dealing with tropical disease. It’s usually a wonderful working relationship – they want to learn from us and work alongside us, and we learn from them.

What value do you think our caregivers bring back from relief missions abroad? Do you see your colleagues working differently or viewing the world differently after they return, and if so, how does that benefit their practice and Kaiser Permanente?

What each person takes away is really quite personal. I did exit interviews for all who went to Haiti. I was very surprised when I asked them how the experience was and the first 10 of 12 said it was life-changing. That was a universal experience for them.

For myself, it has changed not only the person I am but the way I do my work. I have a very different and deeper kind of compassion for my patients. I think it’s very much reaffirming for why we went into health care—to take care of people.

Editor’s note: While difficult to spotlight any single caregiver’s dispatches, we’ve gathered a few here that we think represent the spirit with which Dr. Garzon saluted his fellow Kaiser Permanente caregivers and their contributions:

Vivian Reyes, MD

Suzy Fitzgerald, MD

Mary Sue Carlson, MD

Jay Bachicha, MD

What is it like leaving a disaster relief site?

The thing that always defines the end of those missions is that it’s always very bittersweet and very surreal. I think on one level many of us—myself I know for certain—are ready to go home after we’ve worked two, three, four weeks 24/7 in the intensity of a disaster situation. We’re spent. We’re ready to rest and relax and see family again and have some elements of normalcy. But frequently it’s very hard to let go when you know the need is so great. As hard as we work as individuals, we’re still a drop in a much larger ocean.

Many of our volunteers have returned to Haiti. They’ve gone back to help in other ways after the earthquake. They’ve built upon the work they did there the first time.

Do you have any plans to volunteer abroad this year?

I’ve planned a trip to Honduras in April and May. I’m hoping to end up back in Burma at the end of the year. That will be my second trip in two years there.

Scales, Shoes and Smiles — Umma Amina, RN, Returns to Guatemala

  Editor’s note: Umma Amina, RN, is a nurse at Kaiser Permanente Oakland Medical Center. She volunteers with the Glens Falls Medical Mission Foundation, which since 1996 has served the needs of underrepresented populations in Guatemala. She is preparing to return to Guatemala this spring and provided this dispatch prior to her mission.

Looking forward to going back to Guatemala with the Glens Falls
Medical Mission. We will be starting IVs, eating warm tortillas, pulling rotten teeth, holding fresh babes, dispensing rehydration salts and reflecting.

We are a team of 40 doctors, nurses, interpreters and happy volunteers.
We see an average of 90 people per clinic per day in our five clinics:
general medicine, pediatrics, women’s, dentistry, and triage.

A scale is a major tool to diagnose general health.
In the past the towns of Cuilapa, Barbarena and Nueva Santa Rosa
population seemed healthier as they weigh the same or more.
In the poorer villages — Jumaytepeque, Cacoltapeque, Ojo de Agua, Monte
Verde — populations are usually not thriving as they have lost weight
and there are more cases of malnutrition in their babies and children.

As a rule of thumb we can tell who is poor, very poor and very, very
poor by looking at their feet; the condition of the their shoes if the
shoes fit, if a child is wearing his mother’s shoes or if they have bare
feet. Often they will borrow outfits or wear their nicest
clothes to see us.

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The smiles, gratitude and love we see from a poor barefoot
pregnant woman who is gifted a bag of baby clothes, or a child who is
given a gummy vitamin & toy, is priceless.

I am honored to be going back this spring to spend a week in the
company of such gracious beings.