Guatemala humanitarian trip — February 2011
I had the great privilege of going again to Guatemala with the Hirsche Smiles Foundation in February 2011. These trips are always grueling, but also very rewarding. We have the opportunity to truly change lives as we operate on children with cleft lips and cleft palates. Following is my daily journal of the trip:
Friday, February 18 — I said good-bye to Susan with a prayer in my heart that our children would behave while I was gone. Thayne Wilson picked up Aubrey Palmer and myself early that morning, and we all travelled to Salt Lake International together. Aubrey is a sweet young woman in our ward that approached me almost one year ago about the possibility of participating on this humanitarian trip. She was born with a cleft lip, and thus has lived through the struggles that many of our little patients are now facing. It was fun to see old friends at the airport and feel the excitement of the group. I was so happy that our operating room group would be myself, Laura Clegg, Angela Chamberlain, and Dr. Jed Bindrup. Laura and Angela are wonderful friends from my Provo Surgical days, and I have worked with Dr. Bindrup before on one of our previous trips. We had uneventful flights to Dallas and Guatemala City, with the exception that I sat next to a man who unashamedly passed gas during our entire trip from Salt Lake to Dallas, and nearly asphyxiated me and other passengers. We were met in Guatemala City by Bishop Antonio Salguero, a wonderful friend of our group who has helped with all the arrangements for this trip. We spent a pleasant evening at the Hotel Barcelo in the city.
Saturday, February 19 — Awoke to the sounds of song birds outside our hotel. I exercised early (on this and every morning that we were here, except Sundays) and had a nice breakfast. Antonio had arranged that we would have a military escort every day, everywhere we went in our van. It was reassuring to have armed soldiers surrounding us all the time. There are many highway robberies committed in this area every day, so we were fortunate to have these soldiers. We traveled about four hours in our van to Retalhuleu (Reu). I sat near our driver, Julio, and spoke Spanish with him nearly the whole way. We descended from the relatively cool highlands of Guatemala City to the tropical humidity of Reu. The hotel is beautiful, enclosed by high rock walls. There are many peacocks and other unusual birds in this enclosure. We played miniature golf in the afternoon, had a nice dinner, and then took all our medical/surgical equipment to the hospital. The hospital is a small “nacional” hospital, very dirty and dilapidated, but we realize that these people are doing the best they can with limited funding.
Sunday, February 20 – I had an interesting time trying to sleep at night. The air is very humid, but the air conditioner in my room is so loud that there is no hope of sleeping with it running. Thus, I endured the heat and humidity. The peacocks and other birds keep up their chatter all night long. The cries of the peacocks are a piercing, penetrating call, and I would wake up with every screech. I tried ear plugs and also placing a pillow over my head as well, to no avail. I am doing so much better with controlling my eating this year. I am not eating between meals, I am refraining from sweets and desserts, and I am eating smaller portions. I am also exercising every day by jogging around our hotel’s enclosed area. We had a wonderful day in the screening clinic today. We had fewer patients than we had hoped for, but we are excited that we will be able to operate on some sweet children that desperately need help. I was in a screening room with Dr. Bindrup, Angela, and Laura, thus I was the only Spanish-speaker. I was so happy that I went the entire day without having to ask a native Spanish-speaker to come in and rescue me. It was especially fun to see some of our patients and families from last year, and it is a joy when we discover members of the church. All of these wonderful people live in such humble circumstances and are so grateful for our help. One mother brought in a 9-month old microcephalic baby girl, hoping we would be able to help her. We were amazed that this little one was even alive. The part of her face where eyes, nose and mouth should have been was a large hole. The baby gasped for every breath. She a large CSF cystic structure (emphalocele ?) where her eyes should have been. We were so sad to tell this mother and grandmother that the baby would not survive the anesthesia, and there was nothing surgically we could offer. The grandmother, through her tears, told us that they considered this little girl a direct blessing from God, and they would care for her and love her every day that they had her. The scene was heart-wrenching. Our operating rooms are rudimentary, with rust everywhere. My IV pole was rust from top to bottom, and large beetles crawled out from under the OR table when we moved it. I am not being critical or judgmental. These good people do the best they can with extremely limited resources. My anesthesia machine had a huge leak in it, and it took a lot of jury-rigging to solve the problem. I only had an ethrane vaporizer and a halothane vaporizer on my machine, so I decided to deliver sevoflurane through the ethrane vaporize for the week. This made inductions and wake-ups much more difficult and challenging. We thus far have dealt with bats (vampire!), roaches, cockroaches, ants, lizards, and beetles in our operating area, but life is good. I was saddened to receive the news that Brother Robin Hagberg, Stewart’s father, passed away today.
Monday, February 21 — I jogged early in the morning. Our first case on the first day is always a harrowing experience, full of anxiety and trepidation. All went well, however, and we were off and running. I have become quite proficient in the use of the Trach-lite, a lighted stylet used to intubate tracheas. I was 100% on my first day, despite these airways being some of the most difficult airways we deal with. We in our room had a sweet experience with the mother and grandmother of a little girl that we operated on. Out in the hallway, the grandmother took our hands and said over and over again, “Thank you, thank you, thank you, for what you have done. We will always be grateful.” She wouldn’t let go of our hands as she continued to heap praise on us. The day went well, and I was exhausted after our cases. The peacocks at the hotel have become an issue for most of us. They are so loud every night, all night long, that it is difficult to get a good night’s sleep.
Tuesday, February 22 — This was a very stressful day. I didn’t sleep well due to the peacocks, and I was tired before I even started the day in the operating room. I did anesthesia on a very difficult palate case, and 4 wide open cleft lips. Two of the intubations were very difficult, as I couldn’t use my Trach Lite due to the fact that the babies were small and I didn’t have my infant-sized stylet. I am also having a hard time in the OR due to the constant bombardment of Dr. Bindrup’s music. It is driving me insane. I was anxiously anticipating a good lunch and it was instead inedible chicken. We were in the OR until almost 7 pm. It was a long and grueling day. We are, however, blessed with mini-miracles every day we serve these little children. I am so much enjoying my interaction with the children, their families, and the Guatemalan hospital personnel. My Trach-lite is such a blessing down here, as it makes very difficult intubations much easier.
Wednesday, February 23 — Today was a smoother day. The peacocks were not quite as talkative last night and I was able to get some rest. I have exercised every day except Sunday, and I haven’t eaten snacks, desserts, or heavy meals. We did some very challenging cases in our room but everything went well. This day was very long, but it is so rewarding and gratifying to realize how much good we are doing for these little unfortunate children and their families. The cleft palate cases are very demanding, and we did two palate cases in our room today, along with several other cleft lips. We operated from 7:30 am to 7:00 pm with just 30 minutes off for lunch. We did a cleft lip repair on a little baby whose father had committed suicide in a jail just three days before. The story was that this father was very despondent that he could not pay for the surgery that his little baby needed to repair a terrible cleft lip and palate, so he tried to rob a store to get money for the surgery. He was apprehended and placed in jail. He grew so discouraged and depressed in jail that he hung himself. The day of his burial, his wife (the mother of the baby) heard about our humanitarian mission to help children with cleft lips and palates. She brought the little boy to the hospital where we were working, and we operated on the child two days after the husband had committed suicide. That same day we operated on a little boy whose mother worked in the local coffee fields 10 hours a day, 6 days a week, for $3 a day. She kept the little boy (15 months old) slung on her back during these long days because she had no one to watch him while she worked. We experienced a tropical downpour this evening.
Thursday, February 24 — We started our day with a challenging 2-month old with a difficult cleft lip. I was emotionally and physically spent today. We collected money for the two sweet women that I mentioned in my account of Wednesday, and our group elected me to present the money to them. I was able to do it in Spanish of course, and it was a sweet experience. They were overwhelmed and so grateful. We gave them both about $200 each. This was another long, challenging day, but very rewarding.
Friday, February 25 — We did six more cases in our room today, but just one major case. The United States Ambassador to Guatemala came to this little hospital to honor our group for the work we are doing. There were cameras, microphones, reporters, and the governor from the area also present. We completed our cases and then spent a very long and hot afternoon packing up all our equipment and preparing for our departure. I was grateful to spend this evening by myself and try to catch up on much-needed rest. The tropical birds have prevented me from getting much rest at night while we have been here.
Saturday, February 26 — The men in our group moved all the duffels and cases from the hospital storage room to the truck we had hired to take our equipment back to Guatemala City. We travelled to Quetzaltenango and saw the new temple that is under construction. It was very beautiful, and will be a great blessing to this area. We passed through some incredible pueblas as we traveled back to Guatemala City. The roadside vegetable and fruit stands were works of art! We ate dinner in Antigua, and I had a chance to go through the main cathedral there. We ended our long day at the Barcelo Hotel, and I slept so well that night, exhausted and grateful
Sunday, February 27 — Gratefully, we had an eventful trip home. It was wonderful to see Susan and the family again.
Cases I did:
Monday
Sebastian Morales, 4, hand and fingers
Gonzalo Gonzales, 5, cleft lip
Elisa Ramos Lopez, 14, facial scars
Jonatan Morales, 2, cleft lip
Tuesday
Alina Mendez, 6 mo, cleft lip
Justin Camacho, 11 mo, cleft lip
Guillermo Lopez, 2, cleft palate
Ana Maria Castro, 2, cleft lip
Lesley Bulux, 5 mo, cleft lip
Wednesday
Isaias Xiquira, 13 mo, cleft palate
Dilani Mayen, 10, frenulum
Ana Maria Hernandez, 10, cleft palate and lip
Bryan Cordova, 6, frenulum
Mario Chavez, 20, rhinoplasty
Elia Ramirez, 8 mo, cleft lip
Eduardo Gomez, 2 mo, cleft lip
Thursday
Macario Morales, 2 mo, cleft lip
Wilmer Ramirez, 17, cleft palate
Maria Lucia, 2, cleft palate
Juan Carlos Vicente, 8, cleft palate
Coralia Gonzalez, 24, cleft palate
Friday
Frida Escobar, 3 frenulum
Julio Gonzalez, 20, cleft lip and palate fistula
Justin Gonzalez, 4, frenulum
Jazmin Dasla, 14, facial scar
Jazmin Leon, 17, lip scar
Luis Lopez, 8 frenulum
Here is a wonderful letter I received from Aubrey Palmer, the wonderful 17-year old from our ward, after we returned home from Guatemala:
Dear Dr. Taylor,
This card really is not going to be able to fully express my gratitude to you and I will be forever indebted, but I just wanted to fervently thank you. Thank you so much for helping me get on the team for the Guatemala trip. Thank you for helping me with my preparation and for helping me on the trip. It honestly changed my life. Thank you so much for helping to provide me with such a wonderful opportunity.
Love, Aubrey
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