The Accidental Mission

I am presently in the Philippines visiting Tacloban City Hospital with the World Surgical Foundation. We are here to check on the progress of the hospital rebuilding and determine what else WSF can do to help. This was supposed to be a simple visit with no major operations scheduled, but there is a young girl here today in need of an operation immediately to remove a choledochal cyst in her bile duct. Since this surgery was not planned, Dr. Alvear does not have all the equipment he would normally use like a harmonic scalpel or GIA staples. He will be doing it, “the old fashioned way” and expects to be operating for three hours.

As I watched her going under anesthesia, I got chills knowing this life is going to be saved or changed. Her pain and difficulties gone. I am going to watch her surgery because it is all just so incredible to see. Words cannot describe seeing this little body under the blanket with her tiny arm poking out. I have to hold back the urge to hold it. But it is soothing knowing that everything will be better for this little angel. I really understand now that having good health and good health care is such a blessing. I have to mention we arrived the day Pope Francis was leaving, and I believe this was no mistake. I say this because this first of three missions in the Philippines is already mind blowing, just the beginning of the magic. The World Surgical Foundation is making a difference one person at a time. This little girl will have a life she couldn’t have imagined before without cost. Not a even penny, because the hearts of WSF are ready to go.

The second case that hit me in the heart like a bomb is a sweet young mother with her baby boy who has an inguinal hernia. The procedure itself only took a half hour, but this woman, her brother, and child were displaced by Yolanda and live under a bridge. Homeless as can be, she works doing laundry for pesos. I could not let them leave here without giving them something. I was not going to let them just go back under the bridge. So I changed out of my scrubs and walked to a store to find some kind of useful gift before he was discharged. I remembered seeing a store on the way to the hospital that sold children’s bedding and bought a small mattress pad for her baby so he would not have to sleep on the ground.

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A city completely leveled by the devastation of Typhoon Yolanda, Tacloban is really picking itself up and moving on. I took a tour around town and was actually shocked at how the survivors here are generally happy, grateful, and amazing people. I have completely reassessed my views on what really matters. I am so grateful to be here. So grateful of the Alvear family for creating this movement. Because that’s what it is a movement. With all the tragedy around the world today, I believe people are finally starting to reach for something greater. And WSF makes it easy for volunteers to get there.

Next stop? Manila and then a long bus ride to Talavera on Saturday for a week-long, multi-specialty mission.

-Mikaela Lannan

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Posted in Philippines, Philippines 2015 | Leave a comment

Surgical Day 5: “There’s always one.”

“There’s always one.” Sister Martin said looking back at me this afternoon as we hurried through the hallways of General Santos City Hospital, jumping from the OR to the PACU. We were walking fast and going through doctor’s notes, trying to figure out the discharge instructions of a post-op patient who had a total hysterectomy 2 days before. “The one” Sister Martin was referring to was baby Cyril, the little girl I will always remember. Cyril is one of the many young WSF patients that has been operated on during this mission and staying in the Pediatric PACU. Cyril, now 16 months old and her mother Marysol, traveled over 2 hours from Sarangani Province to have her unilateral complete cleft lip repaired. Cleft lip and palate repairs are usually simple procedures and are given a couple weeks after birth however in developing countries like the Philippines the cost of surgery is impossible for many. Cyril’s surgery was successfully completed on Monday evening (day 1 of surgeries) however due to a high fever she has been staying in the pediatric PACU a little longer than expected.

Cyril on day  waiting to be screened by WSFCyril getting ready for surgery

I’ve noticed that Cyril and her mother are usually by themselves unlike the other patients who always have an entourage of family members by their side. Due to the lack of resources and funding, GSCH does not have the same patient accommodations that we would expect to see in the United States. This makes the presence of family members vital to the patient’s well-being before surgery and recovery afterwards. During our 12 hour shifts together in the PACU I’ve heard Sister Martin, a highly experienced ER nurse, say repeatedly, “Now remember, you are the nurse now”, to family members who agree by nodding their heads as they listen closely to her instruction. The hospital does not offer meals so the patient’s relatives are responsible for providing breakfast, lunch, dinner, and water. There’s a water pump and makeshift wood stove outside next to the hospital building that families can use to wash dishes and cook food. In a small room filled with over a dozen other families, they share a bed with their loved one who is either waiting for surgery or who is recovering from it. They even bring sheets and pillows from home so their loved ones do not have to rest on a bare and dingy, thin mattress after surgery. The patients that the WSF serve are financially poor but they are rich in family however it seems to me that maybe Marysol and Cyril have neither a large network of family or money. Yesterday I witnessed a little girl run over to Marysol and kindly give her a mango to snack on. Marysol quietly whispered, “thank you”. The little girl who gave her the mango was the sister of another young WSF patient waiting to have her cleft palate repaired. At 6 years old, her mother had to pull her out of school because she was being constantly teased by her school mates for “talking funny”. Children with cleft lips and palates can not eat, drink, or speak properly, but they also face a social stigma that can sometimes result in staying home from school and isolation. Despite how hard each one of these families have it, physically and socially, they are still willing to help one another out. That is absolutely amazing to me.

Cyril after surgeryTrying to keep Cyril's fever down with a cool washcloth.

From screening day until now, day 5 of surgeries, I’ve been visiting Cyril every morning, afternoon, and before we leave the hospital for the evening. Usually when I visit, Cyril is either sleeping or very fussy. Every time I try to talk to her she starts crying, clings on tightly and hides her face behind her mother’s shoulder, making sure that our eyes never meet. I don’t know what it is but I do not think she likes me! I still love visiting her.  And I love visiting all of the children in the pediatric PACU but there’s something about Cyril that pulls on my heart strings. She reminds me of my daughter Sophia who is thousands of miles away from me right now. When Sophia, now 7, was Cyril’s age she was that same little girl who held her mommy tightly and wouldn’t dare give anyone else the time of day. Cyril has a head full of dark hair, big brown eyes and olive skin just like Sophia and they both have mothers who love them dearly. On Sunday during screening, I remember seeing Marysol holding Cyril in the crowded registration area. You could tell she was nervous about whether or not Cyril would be scheduled for surgery by the WSF team. When I introduced myself, she replied back quietly and had the sweetest smile. After Cyril’s surgery, I visited her immediately and exclaimed to Marysol how beautiful Cyril was. Marysol said in her soft-spoken voice “it’s true”. But the way she said it I wasn’t sure if she was agreeing with my compliment or if she was asking if it was true that Cyril is beautiful.

The most important and life–changing parts of this mission are the operations the surgeons of WSF perform but there’s definitely something gratifying about volunteering in the PACU as well. We get to know the patients and their family. We talk to them, we comfort them, we identify with them in some kind of way. Today being our last day at General Santos City Hospital, we got to leave earlier than usual and say our good-byes to the wonderful staff members and nursing students of GSCH. I made my way over to the pediatric PACU. Cyril was still there. Her mother said they would be leaving tomorrow and Cyril was not running anymore fevers and eating much better. I wished her good luck and to take care. I tried to hold Cyril for one last picture but she didn’t want anything to do with pictures or me and of course she cried… something Sophia would have done. I will miss all of the patients and will always remember my experience at GSCH but most of all I will miss Cyril. Sister Martin was right… there’s always one.

Last picture with CyrilA thank you note that Cyril's mother wrote

Posted in Philippines, Philippines 2014 | Leave a comment

General Santos City Mission PACU

Posted in Philippines, Philippines 2014 | Leave a comment

Super Heroes Are Real!

By Maria Seiders (WSF Support Staff Volunteer)

My name is Maria Seiders. I am from Harrisburg, PA, and this is my first time volunteering with the World Surgical Foundation. I am sharing my experience from a postoperative perspective. What you are about to read may be a little different from past WSF blogs but I trust you will be able to feel my experiences through this.

The mission is going smoothly, and all surgeries performed so far have been successful. WSF is not only blessed with volunteers from central PA and other U.S. neighbors like Nova Scotia but also Hong Kong and Manila assembling a team of true super heroes. As a first time volunteer, I have been assisting in the PACU (post-anesthesia care unit) for the last 4 days and have seen so much that my emotions are flooded with both happiness and sadness.

It brings me joy to see the 16-year-old boy finally getting to live a normal life after having a colostomy closure but pains me to see him lie on a rusty hospital bed with a piece of cardboard as his mattress. My own family values are reinforced when I see a young child comforting her mother after surgery, staying night after night in a hot, humid room filled with 30 other post-op patients. Despite these sad conditions there is not one complaint from the Filipinos. Instead they are beyond grateful. The “thank you’s” never stop. The hugs we receive for being here come daily. And the pictures!! I’ve probably had my picture taken with over 20 patients by family members who want to remember their WSF friends forever.

Without blinking an eye the World Surgical Foundation came to save these people, but if we keep our eyes open even longer, we see they have also saved us. They’ve inspired us and showed us what courage, strength, and sacrifice really mean. We are their heroes but they are ours as well.

Posted in Philippines, Philippines 2014 | Leave a comment

Patient Screening and Mission Setup at GSCH

By Arantxa Sison (WSF Support Staff Volunteer)

All volunteers of the World Surgical Foundation were transported from their accommodations at Roadhaus Hotel to General Santos City Hospital (GSCH) the morning of 16 February 2014 by 10 AM. Just outside the entrance of the hospital, large tents were positioned as a waiting area for prospective patients. The tents were filled to capacity. According to Asma Akmad, Special Project Officer from Govenor Solon’s office, prior to WSF’s arrival potential patients and/or caregivers were asked to give a voluntary donation of blood to the Filipino Red Cross. This gesture fostered ownership among the beneficiaries of free surgical care and a sense that they, too, contributed to a necessary and worthy cause.

In the words of Dr. Ofelia Kaguyutan, “Surgical camps always promote and encourage ingenuity and improvisation.” Those words rang true from Day 1. The first day at GSCH began with support staff unpacking and organizing medical equipment, medicines and supplies that would be utilized during the six-day surgical camp. WSF volunteer surgeons screened and assessed patients in two large rooms prepared by GSCH staff. Each surgical specialty had a designated intake station. The majority of the day was spent screening and assessing patients and preparing the operating rooms for the following day.

Hernias, bowel issues, anorectal repairs, penile malformations, cleft lips and palates, goiters (non-toxic), thyroids, bladder repairs, TURPS (prostate/ kidney), hydroceles (prostate), tumors, cysts, and hysterectomies were the types of procedures that were slated to be completed during the six-day surgical camp. After screenings and assessments, it soon became clear that the World Surgical Foundation’s humanitarian campaign at GSCH would have to be limited to “critical cases,” cases which are complicated in nature, taking hours to complete in some instances and that would put to best use the surgical specialists’ expertise and time. Unfortunately, only several “lumps and bumps” (less complicated cases) would be attended to during this year’s surgical camp.

WSF team members left GSCH on the first day with a sense of anticipation of what the next five days would hold. The first day at the hospital also gave all members of the surgical camp, local and foreign, the opportunity to get to know one another, coordinate care, and begin to collaborate as one unit toward a specific goal — that of improving the lives of patients and in some cases, saving them. The common denominators among participants was a spirit of volunteerism, the principles of humanitarian assistance, and the overriding belief in providing care to the most vulnerable among us.

Posted in Philippines, Philippines 2014 | Leave a comment

Safe Travels to General Santos City, Mindanao, Philippines

By Arantxa Sison (WSF Support Staff Volunteer)

Some East Coast members of the World Surgical Foundation raced to leave Harrisburg, Pennsylvania ahead of an impending snow storm on Wednesday, 12 February 2014. With East Coast flights canceled, a bus was chartered to drive volunteers through the night from Harrisburg to Detroit International Airport. The bus left Harrisburg at 11 PM with snow already accumulating on the ground and drove eight hours through falling snow and icy conditions. WSF arrived safely at the Detroit airport in plenty of time to check-in and board the 3 PM flight to Nagoya, Japan. After having traveled by bus for eight hours and 500 miles (800 km), the next stages of WSF’s travels: a 13.5 hour flight to Japan, a connection to Manila, and the final destination of General Santos City in the Philippine archipelagos southernmost tip, seemed “easy”.

Once volunteers arrived in Manila at midnight, travel became seamless with the coordination by WSF’s Filipino hosts. The East Coast contingent of WSF made the transfer from international to domestic terminals with all the luggage, medical supplies, and medical equipment via an awaiting shuttle. The flight to General Santos City, Mindanao departed as scheduled at 6 AM. Needless to say, upon arrival in GenSan less than two hours later, most volunteers were exhausted. But they were ecstatic travels were over and excited their humanitarian work would soon commence.

At General Santos International Airport most volunteers thought the World Surgical Foundation had coincidentally happened upon a celebration. Festive music was playing just outside baggage claim. To our surprise, the local hosts in the City of General Santos and Sarangani Province had organized a marching band composed of talented local youths to greet and welcome the foundation volunteers to their magnificent city and province. There was a large banner which read “Welcome World Surgical Foundation” and once WSF team members realized they were being so graciously welcomed in this manner, tiredness from the travels immediately disappeared. The music and performance was truly spectacular and simply a preview of exactly how gracious, accommodating and hospitable our hosts would prove to be during the entirety of the surgical camp.

The rest of the arrival day was spent getting acclimated to the new time zone and resting at the Roadhaus Hotel. Accommodations at the Roadhaus were courtesy of Congressman Manny Pacquiao and Vice Governor Jinkee Pacquiao. Later that evening, World Surgical Foundation volunteers were treated to a welcoming dinner. Local dignitaries were in attendance such as Governor Steve Solon, Dr. Arvin Alejandro, Sarangani Provincial Health Office, General Santos City Mayor, Ronnel Rivera, and Director of General Santos City Hospital, Dr. Benjamin Pagarigan along with other officials from General Santos City, Sarangani Province, and General Santos City Hospital. Dr. Domingo Alvear, founder of the World Surgical Foundation, and Dr. Lester Suntay from Makati Medical Center also made brief introductory speeches and thanked our most generous hosts.

Posted in Philippines, Philippines 2014 | Leave a comment

Skill and Preparation

Ready for anything, Dr. Alvear’s first case today was off schedule and without batting an eye he was completely prepared for a baby boy delivered in the wee hours of the morning diagnosed with gastroschisis. The newborn was actually born with an abdominal wall defect called an omphalocele in which the intestines, liver, and occasionally other organs remain outside the abdomen in a sac and is associated with a high mortality rate (25%) and severe malformations. Once again WSF stepped in with God’s hands and saved another life because Dr. Alvear happened to bring a “silo” which is a plastic pouch to gently squeeze the intestines and other organs into the belly. I later spoke with Dr. Alvear who said that he sees these “surgical mission surprises” and is always prepared for such cases.  He also performed a colon interposition today. It is rare that a surgeon might encounter two of these procedures in his or her whole career and Dr. Alvear has done one in the first two days and expects to two more by the end of the week.

The most anticipated procedure of the day was an eight-year-old boy who was having reconstructive surgery on his ear, in which Dr. Leber took a piece of cartilage from his ribs and created a perfect ear where there were just bumps and malformations that looked nothing like an ear before. Video and before and after shots were priority for us today, because how the whole thing went was spectacular.  Witnessing this is the most moving and special opportunity I have ever been gifted. I may be redundant, but it feels so huge to be a part of this mission. The sheer medical brilliance and gifted staff makes me wonder why only a few special doctors of this caliber have taken their time and spent their own money to participate. If only the rest of the world could see all that is being done here, I know that WSF doctors and volunteers would be unstoppable in helping these people.

For some reason the general surgeons are booked solid with gallbladders and decided on alternating back and forth. I wonder if there is something specific about Hondurans and their gallbladders or if it’s the same everywhere. There just seems to be an unbelievable number of gallbladders that Dr. Rovito and Dr. Delone are repairing laparoscopically or removing the organ altogether. They worked together on the last case because of a complication during a previous gallbladder surgery where Dr. Delone spent three hours on one patient. Dedicated but making the general surgeons’ already long day even longer.

I haven’t mentioned much about what’s going on in the vascular OR because their first few cases took much longer than expected. Dr. Campbell brought some of his own supplies, as he explained to me on the bus ride to the hospital this morning. He uses a Gore-Tex product to recreate femoral veins in patients whose vascular system has completely lost accessibility for IV’s after years of dialysis or multiple IV use. One was a young woman who had been on dialysis for years and at only ten needed to have a new femoral vein created by using veins in the opposites legs reattaching them with the Gor-Tex vein. She will have a fully functioning vascular system in hours thanks to the excellent work of Dr. Karima Fitzgerald and Dr. Joe Campbell. The vascular room always includes the awesome anesthesiology of Luis Lara or Dr. “Eskor” Inyang.

The ORs are always rocking out with great music as many surgeons prefer operating while music is playing, maybe to help them relax and get into the magic of what they are doing. When Dr. Rovito stepped in on a small bowel evisceration he put his iPod speakers on immediately before scrubbing in. Ironically playing Guns N’ Roses “Knockin’ on Heaven’s Door”… I commented on the irony of his choice of music and he responded, “He’s just tappin’ that’s all, he won’t be seeing heaven’s doors anytime soon… certainly not on my watch!”

Posted in Honduras, Honduras 2013 | Leave a comment