Tag Archives: cleft palate

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.

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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.

Susan Dean Shares Impressions From Guatemala

Susan Dean 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 fifth consecutive year serving on a Faith In Practice surgical mission.  She sent along this dispatch. We’ll publish subsequent dispatches as she has time to send them.

May 1, 2011
The team arrived safely in Antigua, Guatemala … some from the Bay Area, others from Chicago, Oregon, and Ohio.  Seven are from Kaiser Permanente! All of us are looking forward to doing a lot of cases.  The expectation is to do 80 cases this week…plastic, gynecology, and general.

Lots of children were in the triage area, some for hernias and others for clefts.  We heard a very interesting presentation by a man named Jose from Faith In Practice. Jose was a patient found by a village team and brought in for surgery.  He’s so grateful for the care he received that he spoke with some of the FIP team and ended up working for FIP as an assistant to the Obras director.

We spoke about why some of us are here.  We are grateful how the patients trust us; we feel privileged to be able to come and care for them. We are all traveling out of our comfort zone and feel an obligation.  It is a privilege to come to Guatemala and participate in this mission.

Our intent is to bring the same high quality of care that we give at home, here — just in a different setting. We will be doing time outs and debriefing just like we do at home. Patients are checked and double checked.  Lab work is checked.

But it’s definitely different than home. More than 75 percent lives in poverty here, making $2 a day.  The infant mortality rate is 25 per 1,000 in Guatemala; in the United States it is 6 per 1,000.

Faith In Practice expects to serve 25,000 patients in 2011. That care will be delivered for 16 weeks by FIP personnel; for the rest of the year, it’ll be delivered by volunteers like us from around the world.

Here’s a photo gallery for our team.

Take care,

Susan Dean
Nurse Manager,  APC1, APC3 and HIV/AIDS Module
Kaiser Permanente San Francisco Medical Center

Dr. Jack Cochran Returns From Tanzania

Note: Jack Cochran, MD, FACS, is executive director of The Permanente Federation, which represents the national interests of the regional Permanente Medical Groups, which employ 15,000 physicians who care for 8.6 million Kaiser Permanente members. He has traveled regularly to Tanzania for the past 23 years on behalf of Global Health Ministries to provide free surgeries to children/adults with congenital deformities. He traveled there again in February and provided this dispatch:

Just a quick update on our trip to Arusha, Tanzania, which included one other surgeon from the Colorado Permanente Medical Group. Our team of four surgeons did 121 surgeries for the week, of which approximately 76 were ‘major cases.’ We saw a lot of cleft lip/palate and other congenital deformities, burn scar contractures (many very disfiguring), and a variety of tumors and traumatic deformities. We operated 12 hours a day and I was gratified  to carry my load!!   I look forward to next year and keeping my commitment to the group.

Two positive changes are the really high level of training and skill that the young Tanzanian physicians are getting today.  Many are truly world class. Second , the number and skill of young women becoming physicians…a much needed and welcome evolution.
A negative is that trauma is now a more common reason for hospital admission than malaria in spite of a high prevalence of malaria. The reason is the recent boom in motorcycles in the country. They have gone from virtually nonexistent to being everywhere in the past 2 years. The number of motorcycle accidents is truly disturbing and will be another hit on well-being and productivity for too many young Tanzanians.

Jack Cochran, MD, FACS