Category Archives: Guatemala

Susan Dean, RN, and a Dozen Kaiser Permanente Colleagues Return 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 sixth consecutive year serving on a Faith In Practice surgical mission; last fall she wrote several dispatches for this blog.  We’ll publish subsequent dispatches from her mission this spring as she has time to send them.

March 14, 2012

The majority of the group flew into Guatemala City on Friday, March 9,  and then traveled by bus to Antigua, where the work would take place.  The trip took all day.  Saturday was spent touring the hospital and Casa De Fe (a place to stay for post surgical care before returning home to the villages).  Sunday was a day for triaging patients and setting up the operating rooms with the medical supplies brought from home.  Eighty patients were scheduled for surgery, approximately 10 patients could not be scheduled for lack of operating room space/time and another 50 were helped on the spot!
…And the team was ready to go.  The team was made up of translators, cooks, the pastor, doctors/surgeons/anesthesiologists, pharmacy person, patient advocate, group journalist/photographer, scrub techs and nurses.  There will be pictures posted on the Faith In Practice website. Please look under volunteer missions – group 315.  Thirteen of our team’s 38 members are from Kaiser Permanente.

Kaiser Permanente San Rafael Medical Center
Brian Bane, MD, Director of Anesthesia

Kaiser Permanente San Francisco Medical Center
Bonnie Souva, RN (OR)
Rae Ann Gustafson, RN (OR)
Paul Preston MD, Department of Anesthesia
Robert Karoukian MD Department of Anesthesia
Susan Dean RN, Manager, Medicine Department

Kaiser Permanente San Mateo Medical Center
Karen Preston, Physical Therapist

Kaiser Permanente Santa Clara Medical Center
Brenda Gips, Admin, Department of Anesthesia
Gordon Haddow, MD, Chief of Anesthesia
Rachel Scheuring, MD, Dept of Anesthesia
Sharon Rose RN, CVICU
Johny Zapanta RN, CVICU

Kaiser Permanente Vallejo Medical Center
Anatole (Tolak) Besman, MD, General Surgeon

We were able to help 79 patients with surgery.  We ran four rooms: two general surgery, one Gyn surgery, and one plastic surgery room.  There were 21 children,  most of whom had cleft lips and cleft palates repaired.  Two kids had hernias repaired.  The adults had gall bladders removed, hysterectomies, and hernias repaired…One patient had an infected mass across the top of his shoulders removed.  He had this mass for 10 years and tried to cover it up by growing his hair long.  He felt ostracized.  When his surgery was scheduled he felt relieved.  The first words out of his mouth following his surgery were, “Thank you.”

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Our week had words and feelings repeating themselves.  Some of these were “blessed,” “connected,” and “team.”  The team felt blessed to be here.  That the Guatemalan people would allow us to enter their lives.  They trusted us and did not even know us.  The feeling of being connected…  We felt so fortunate to meet these patients.  We felt connected and yet could not even speak the same language.  I had a patient who spoke Mayan.  Her husband was able to speak Mayan and Spanish.  He spoke with one of our wonderful translators in Spanish.  The translator conveyed all of the information to me in English.  We had a long, productive, and informative communication. We had a group of 38 volunteers who became a team.  We had a team of cooks who made amazing meals for all, at the beginning and end of long work days.  We had many teams in the operating room, all working closely to help patients, some who were in very difficult situations.  Since care is at a minimum, the surgeries seem to be more difficult.  Patients have had to wait longer for care and had to  endure more suffering. One of the surgeons shared his thoughts…”At home if you do not provide the care someone else will do the work.  Here, no one else will do it and it won’t get done.  The patient will not be taken care of.”

The team felt that being here was such a privilege and an opportunity.  We are so lucky.  The gift of knowing that you are helping someone who might not otherwise get help is fulfilling as well as overwhelming.

In conclusion for now, I would like to share a story.  The cooks went to the marketplace.  They wore their badges, which included our group name.  The woman in the textile stall got excited when she saw our Faith in Practice name. She ran down the hallway to another stall and introduced the cooks to her daughter who had a cleft lip repaired by Faith in Practice many years ago. She went on and on about how thankful she was. All she could say was “Gracias” over and over.

…And this is why we come to Guatemala.

Susan Dean, RN
Kaiser Permanente San Francisco Medical Center

Susan Dean Returns from Guatemala, Reflects on a Job Well Done

So now the team is back home and what have we learned?  A few facts about Guatemala:

  • The average Guatemalan gets 4.1 years of schooling.
  •  Only 30  percent of the population pays taxes.
  • Public school is free, but students pay for their own books.
  • In Antigua, Guatemala, the average family has two or three children; in the villages, however, the average number is eight per family.
  • This is chronic malnutrition in Guatemala; in fact, worldwide the three most malnourished countries (in order) are Afghanistan, Yemen, and then Guatemala.

…and what have we learned about the Obras Sociales del Santo Hermano Pedro, the hospital where we worked?

  • It is the home of over 250 people.
  • More than 250,000 people are served here annually. They are the sick and the poor.
  • The hospital was destroyed in 1976 and rebuilt with a greater vision. Programs now include education, recreation, and social programs for students.
  • The hospital now has a nutrition recuperation center.  Patients stay for 1-3 years, or for as long as they need to stay. Parents come into the hospital to take care of their children.
  • The hospital has a daycare program, allowing parents to work outside of the home.
  • Outpatient services are provided. They include colonoscopies and substance abuse programs.  Special cervical cancer screening tests are also done.  Sadly, cervical cancer is the leading cause of cancer-related deaths for women in Guatemala.
  • An audiology department is being built!

So the way I see it,  we are part of a growing, and incredible hospital and outpatient clinic….and this hospital is a part of me.

So, I invite you to join us some time on a “health care trip” and see how it changes your world!

Susan Dean, MD
Kaiser Permanente San Francisco Medical Center

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Susan Dean Writes From Guatemala: Renewal for Patients, and for Caregivers

 May 2

We started surgery today.  There were two gorgeous babies (girls) today who had their cleft lips repaired. The parents were super happy with the results. These will be perfectly normal babies…with beautiful brown eyes!

They get to all of us.  On a sad note, a 35-year-old woman came in hoping we would help her have babies, but the laparoscopic surgery found so much scar tissue and we could not help her.  Children are really valued down here.

I am pooped.  We started really early!!

More updates to come. Need a Guatemalan latte.


 *   *   *

May 3

We have been starting our mornings with inspiring devotionals surrounded by beautiful blue sky and active volcanoes.  Today we heard the story of the wealthy father who took his son to see how a poor family lives.  On the way home the father asked his son what he had learned about the poor family.  The son responded: instead of having one dog they have four; instead of walls around the house to protect them, they are surrounded by the horizon; we have a pool that goes to the middle of our yard and they have a creek that runs forever; we buy our food and they grow what they eat; instead of having walls, they are surrounded by friends.  Then the son adds ¨Thanks Dad for showing me how poor we are.¨

This mission gives me many moments to realize what life is really about. The Guatemalan patients trust us and give us a reason to be grateful to be here.  The Guatemalans, who don’t have much, are a happy people showing us how we have forgotten the most important things in life. Rich or poor is not dependent on money. Personal wealth is not measured in money.

Today, while doing cases, we were told we needed to finish and stop operating because we were losing power.  Power at the Obras went out at 4 a.m. so the generator switched on. Then the generator overheated. The OR was using up too much power and the generator could not keep up with the demand.  Our hopes were dashed.  We want to do as many cases as possible.  Now the plan is to work late the rest of the week so that all of the scheduled cases will get done.

This is what happens when you are in a third-world country.

By the way, the seven Kaiser Permanente team members are:

  • Rachael Schering, MD anesthesiologist, Kaiser Permanente Santa Clara Medical Center;
  • Gordon Haddow, MD, anesthesiologist, Kaiser Permanente Santa Clara;
  • Robert Karoukian, MD, anesthesiologist, Kaiser Permanente San Francisco Medical Center;
  • Paul Preston, MD, anesthesiologist, Kaiser Permanente San Francisco
  • Tracy Liu, RN, Kaiser Permanente San Francisco
  • Margaret Petrie, RN, Kaiser Permanente San Rafael Medical Center.
  • And me!

I will try to send more pictures soon!

Take care,


May 4

We all wondered what we would find in the OR today.  Would we have power?  Would we be able to operate?  We all just knew we were here to do whatever was possible. We don’t know if we will be able to regulate the temperature in the OR tomorrow, but we know we have a full day.  We will do our best to help as many people as possible.

I will write more tomorrow; today, the computer connection is bad.


May 5

We started our morning with a special,  non-denominational chant/song. Looking around this outdoor room one could tell what the group was thinking, meditating and contemplating. All of the words and the Kleenex and sniffling gave it away.  The song reminded us how we had connected and “heard” the Guatemalan people we had met. We were there for a reason. We could empathize with these people.  They weren’t strangers anymore. We are here to offer them the best of us. We realize that these people are poor and have no understanding of the medical system. They don’t understand what their procedure entails or the healing process, and yet they give us their complete trust in allowing us to treat them.

The group is smiling yet tired.  What is making us get up at 5 a.m. to get to the operating room?  (Could it be the great Guatemalan coffee that is waiting for us?)

We are all inspired. We are not just here alone; we are surrounded by each other.  The people that we care for are so different from us yet we are the same in so many ways. We are all inter-connected.  Our patients come in scared and nervous, realizing that something bad could happened to them and nothing is in their control. We can hold their hand and use what we have learned to help them.

As the doctors make morning rounds, we find our prayers have been answered; our patients are doing really well.

May 6

Good morning,

All of our surgeries have been completed. Seventy six patients have been treated.  More than 80 procedures have been done. Our team has learned a lot: We each carry part of the world within us.  When we change the world, we change ourselves.

Getting outside of our routine, day-to-day experiences and having the opportunity to do this work is a renewal of the spirit. Some people concentrate on their bodies with classes and retreats. We, on this team of 40, have found this same type of renewal through caring for patients. We give to the Guatemalans medical treatment and hope, and receive back renewal hope and love. We are lucky this team needs people that translate, people that enjoy cooking, recovery room nurses, operating room nurses, anesthesiologists, and surgeons. This allowed us all the opportunity to have this experience….and what a life-changing experience it was!

Susan Dean, RN
Kaiser Permanente San Francisco Medical Center

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