Gynecologic Surgical Services for Guatemala

Gynecologic Surgical Services for Guatemala Building surgical teams to provide much needed gynecologic surgery to underserved Guatemalan women.

We've been back for a few days now. Everyone has been busy, including me. Here's a post I was about to put up when my In...
11/08/2024

We've been back for a few days now. Everyone has been busy, including me. Here's a post I was about to put up when my Internet failed. This weekend I will write a final post summarizing our trip.

Kurt and Keith Doyle are brothers. Kurt is a mission vet. This is Keith's first time

The brothers have an interesting story. They grew up in Oklahoma. Oil was king. They both made good money in the oil industry, Kurt working various jobs and Keith becoming an accomplished welder.

But then the oil industry collapsed. Both men had families with small kids. They had to hustle to make some dependable money.

After checking around, they settled on nursing school. After a couple of years, Kurt chose the scrub tech path (here he is called "un instrumentista quirúrgico"). Keith stuck with the nursing path. He has served as our PACU (post anesthesia care unit) nurse.

We are happy to have both brothers with us. They are good-hearted souls who are always cheerful. We look forward to working together on future trips.

Boarding plane to Dallas now. Ready to cool off a bit. La Aurora airport has mostly glass walls which makes it warm insi...
11/03/2024

Boarding plane to Dallas now. Ready to cool off a bit. La Aurora airport has mostly glass walls which makes it warm inside even this time of year. The giant fans don't do much to help.

I liked it in Patzún. Nice and cool!

11/02/2024

Some observations about Guatemala and Guatemalans:

• Sidewalks here are narrow because Guatemalans are smaller than Americans and they built the place.
• There is no uniform height for stairs or stepups and downs. It's surprising how different that can be. Watch your step!
• Everyone greets everyone walking on the street - Guatemalan or not - with buenos días, buenas tardes or buenas noches, depending on the time of day. And I mean everyone. It's polite for us to do the same.
• Guatemalans love to light off "bombas" - large firecrackers or even tube-launched ones - at any time of the day or night. Special occasions (of which there are many) demand them. The rest of the time it's just for fun.
• Mayan women wear traditional dress every day, not just on Sundays.
• Traffic rules are advisory, not obligatory.
• Guatemala is noted not just for its coffee but also for its rum.

More? Please add in the comments.

11/01/2024

Today is Friday. No surgery today. We "slept late," meeting for breakfast at 7:15. We are now at the hospital where the doctors are doing rounds on yesterday's cases.

In a few minutes, we will have a group photo. We are told that Mother Esmeralda wants to say a few words.

Then, it is off by bus to Antigua where we will stay overnight before catching our flight home tomorrow. The trip to Antigua will take two to three hours, depending on traffic. On the way to Antigua, we will stop to enjoy a kite festival.

I probably won't be able to post until this evening for lack of an Internet connection. Until then!

Here are a few photos from the operating rooms.
10/31/2024

Here are a few photos from the operating rooms.

10/31/2024

Follow up reports: The surgeons successfully performed a hysterectomy on the lady who was bleeding so much that she came in wearing a diaper. They were able to fix her bleeding problem, too. Her hemoglobin level is good today now that the bleeding has stopped.

The 80-year-old lady the anesthesiologists were concerned about had adequate anesthesia and came through her operation just fine.

Kurt popped into the doctors' lounge a few minutes ago after watching the doctors drain a uterine cyst. He said "about a big bottle of pop and a half came out!" No doubt the patient will feel much better.

The story of the Hospital Corpus Christi begins with the efforts of Padre Aldo Justiniano Babuin, a Franciscan Missionar...
10/31/2024

The story of the Hospital Corpus Christi begins with the efforts of Padre Aldo Justiniano Babuin, a Franciscan Missionary priest. Padre Justiniano had been active in this area since the 1950s. Phillip Miller, a long-time missionary traveller to Patzún, wrote:

"By 1960 Padre Justiniano called for a mission school because the Cachequel (indeginous people of the Patzún region – one of the separate linguistic groups that collectively make up the Guatemalan Mayan peoples) did not attend government institutions."

"Sisters of Notre Dame from Minnesota answered Padre Justi’s call. They came to Patzún in 1960 and operated the school, San Bernardino, for years."

https://philip19miller.wordpress.com/

The year 1960 also marked the beginning of the Guatemalan Civil War. The war broke out after years of rural indigenous exploitation by wealthy Guatemalans, mainly of European descent, and foreign companies like the United Fruit Company. This cabal controlled much of the land. They paid almost no taxes which lead to conflicts with the rural indigenous poor who worked the land under miserable terms.

The war, which lasted over thirty years, devastated the indigenous areas of Guatemala, including Patzún.

In the 1980s, despite the war, Padre Justiniano coordinated with Sara Merdes Judd, a resident of Corpus Christi and benefactor, to open the hospital's predecessor, La Clinica Corpus Christi.

At some point, control over the clinic passed to the Sisters of the Immaculate Conception. Since that time, the clinic expanded and eventually became the Hospital Corpus Christi that we know today.

Thus, we have been working through a Catholic Congregation formed 150 years ago in a hospital with roots tracing back to 1960. The photos on the walls keep watching us to make sure we carry on.

Day 4 has arrived! Today the team is doing uterine prolapse cases. Uterine prolapse occurs when a woman's pelvic muscles...
10/31/2024

Day 4 has arrived! Today the team is doing uterine prolapse cases. Uterine prolapse occurs when a woman's pelvic muscles and tissuee weaken. The uterus then drops down into the va**na. Sometimes the uteris can poke out through the va**na. The surgeons push the uteris back into place and secure it.

Dr. Vories and Sonia have begun preparing the patients for surgery. They came into the doctors' lounge to cross-check about an 80-year-old patient. They intended to give the patient less potent anesthesia because of her age. The patient could be given other, supplementary anesthesia if necessary as the operation progresed. No issues from the surgeons.

Two nice Mayan ladies waiting for check-in insisted on removing their masks so that I could get a good photo of them.

We've finished day 3 and all of the patients have done well. We will be turning in shortly so that we're refreshed befor...
10/31/2024

We've finished day 3 and all of the patients have done well. We will be turning in shortly so that we're refreshed before our final day.

But before hitting the hay, I thought I would mention a special duty that some of the team have undertaken. In Mother Esmeralda's tour of the hospital campus, she showed us the temporary home for children whom, for one reason or another, the judicial system had placed for temporary care. Their ages ranged from infants up to 15, as I recall. Mother Esmeralda invited us to come play with the children.

Sonia Estes, Patricia Lewis and Elizabeth Pecina took up Mother Esmeralda on her invitation. They squeezed in time to visit the babies, where they held, rocked, fed and otherwise loved on the little ones. Here's a shout-out to them for sharing themselves with those who needed them.

You can learn a lot anout a place by looking at the photographs and paintings on the walls. I knew that nuns ran the Hos...
10/30/2024

You can learn a lot anout a place by looking at the photographs and paintings on the walls. I knew that nuns ran the Hospital Corpus Christi, but I didn't know anything else about them or about the hospital itself. Then I noticed a poster celebrating the 150-year anniversary of the founding of the Franciscan Sisters of the Immaculate Conception. The poster showed two headshots, one of a priest and one of a nun.

I had to learn more. The priest was Fray José del Refugio Morales Córdova. The nun was Sister María de la Luz Vázquez de Cristo Crucificado. They and two nuns-to-be organized the congregation in Mexico City in 1874. The Sisters have since been involved in various ministries, including education, healthcare, and social services, in line with Franciscan values.

One of the more noted Sisters was Madre Humilde Patlán Sánchez del Niño Jesús. She held several offices in the congregation, including serving as Superior General twice. Pope Francis venerated her in 2017. Her photo hangs in the hospital.

The congregation now has more than 1,100 Sisters. There are nearly 150 convents in various Latin American countries, the United States and in some countries in Africa. The Sisters continue to employ their charism, which is the education of the young, the teaching of catechesis, and the care of the sick and elderly.

10/30/2024

The boiler isn't done with us yet. The replacement element that Jason installed burned out. So for now, we are back to using the old, smaller autoclaves that got us through yesterday.

Fortunately, when Jason pjcked up the replacement element, it turns out there were two and Jason accepted both. Once the boiler cools down enough to work on it, Jason will install the secon replacement element.

Medical records: Dr. LaRue and José are inputting post-op orders into the computer. They customize from a template. Dr. ...
10/30/2024

Medical records: Dr. LaRue and José are inputting post-op orders into the computer. They customize from a template. Dr. LaRue dictates in English or Spanish while José types in Spanish. Then they print off a copy and place it in the patient's chart.

A photo of Drs. LaRue, Cooper, Daniels and McKown (l-r) waiting to be called to surgery.

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Resource for underserved Guatemalan women

In spite of the Guatemalan constitution stating that every citizen has the right to healthcare, barriers to care are many. Resources are limited due to lack of funding, a shortage of physicians, and difficulty accessing healthcare facilities. Rural areas experience additional barriers due to language. There are twenty-two idioms spoken by in different regions by indigenous Mayan people and many of them do not speak Spanish. In addition, the cultural mores are such that a traditional healer may be the resource they are comfortable approaching.

Reproductive care is especially scarce. Only 54% of women receive contraceptive services. Only 63% of births are attended by a skilled birthing attendant. Multiparity and ge***al trauma during childbirth contribute to gynecologic diagnoses that require surgical correction. Symptomatic pelvic relaxation and urinary incontinence may be more prevalent in these women. Additionally, women have poor access to care for management of common surgical problems such as uterine fibroids and ovarian cysts.

The goal of GSSG is to create a network of skilled volunteer surgeons and support staff that will work with in-country volunteers to organize a semi-annual excursion to Retalhuleu to provide gynecologic surgical services to women in need.

~Rochelle McKown, M.D., President