Traveling for a surgical mission trip is always and adventure, and this trip was no exception. It was wonderful to be able to share the experience with Sarah and Deb, who are both seasoned travelers. This was Sarah’s and my third trip to Kijabe and Deb’s first to Kenya, though she has volunteered for cleft lip and palate surgical trips in Vietnam and Ecuador in the past. We’ve attached several photos from our trip, and are very grateful for all the prayers and good wishes for our patients, our travels and our families.
After setting up the OR and settling into our hotel in Ambato on Saturday, we headed to the clinic on Sunday morning. We saw 50 patients, many of whom were returning for rechecks from prior operations. We also saw our preop patients. Here is a sampling of our day:
We started our day by meeting at PDX at 4:30 AM, some of us meeting for the first time. After brief introductions, we sorted out who could check the extra luggage, including the cardboard boxed item–an anesthesia machine. Once through check in, we paused to get a final photo with PDX’s soon to be replaced carpet. We numbered five at this point, with four others planning to join us in Quito, Ecuador. Our flights were uneventful and we landed in Quito, ready to retrieve the suitcases filled with surgical instruments, antibiotics, suture, anesthetic gases. And one very important card board box. That turned out to be the problem. Ecuadorian customs and immigration did not want to let the box through without opening it. That started a 90 minute deliberation, with us trying to explain what is is and what it does, who we are, why we need it. Finally, after several episodes of steam escaping from Dr. Clawson’s ears, we were allowed to take it through and make the next leg of our journey–a van ride to Quito. After a good night’s sleep, we packed up everything, especially the cardboard box, and made the
2 1/2 hour ride to Ambato (stopping for ice cream along the way). What a beautiful drive through and over mountain passes, past mountainside fields
Have you noticed that just when things seem to be routinized and your life is going along smoothly, that there seems to be an inevitable moment when suddenly things change? Sometimes for the better, sometimes not. And perhaps it will take some time to know for sure which type of change has just occurred.
I have been in a wonderful routine of going to Zambia each spring for my annual medical mission trip. It was delightful to return to many of the same doctors, nurses and even some of the same patients each year–a nice routine had developed and it felt comfortable. So, when I heard that this trip may not materialize in 2015, I was saddened and somewhat unsettled. What now? I thought. There would definitely be a void in my life without this soul-satisfying experience of changing lives and experiencing the privilege of working with these remarkable medical professionals and these delightful children and parents. Besides, I had fallen in love with Africa, and particularly with Zambia.
I lived in this limbo for a while, trying to discern the next step I should take. Perhaps a non-medical mission trip, or a local charity for which I could volunteer, or possibly even a family vacation. My answer came in the form of a New Beginning. Ecuador it is. I thank you for your good thoughts, well wishes and prayers as I travel to Ecuador for a cleft lip and palate mission trip in early 2015. Technology allowing, I will blog some photos of this newest adventure. Thanks so much to all of you who have supported me on previous trips and who have made donations to Dr. Clawson’s foundation, which has been responsible for helping over 3,000 children by repairing cleft lips and palates around the globe. He has been going to Ecuador for 26 years and maybe, just maybe, things are still routinized and going along smoothly for him…
We’re headed home today. In fact, I’m 35,997 feet up in the sky on a Delta flight. It is fun to have wifi in the sky. I’ve been reflecting on what it takes to pull off a successful medical mission trip like this. I keep telling Dr. Clawson that he should write a book on it, because he has got it down to an art form. First of all, you have to have
a dedicated, driven, passionate leader like Dr. Joe Clawson. He is not afraid to ask anyone for anything, in the name of serving these children. If you know him, you know it is very hard to turn him down. Here is a link to his humble website that he designed himself. If you feel so moved, donations are always appreciated and are what makes the wheels turn to treat these children. Follow this link for his website
Dr. Clawson runs five mission trips per year in Zambia, DR Congo, Ethiopia, Ecuador and the Philippines. He must procure suture, antibiotics, children’s tylenol, betadine skin prep, anesthetic gases, endotracheal tubes, gauze, scalpel blades, syringes, needles, lidocaine, suction catheters, etc for each mission. What he can’t get donated, he must purchase. He then organizes enough materials for the estimated number of surgical cases for each trip. He must maintain four sets of surgical instruments (estimated cost of $20,000 at initial purchase), two for cleft lips and two for cleft palates, so that one can be sterilized while the other is in use. He makes sure that there is a talented pediatric anesthesiologist available, or he arranges to bring one. For certain trips he needs another surgeon, and sometimes nurses and OR scrub techs, or photographers and medication preparers–thank you Madeleine! Travel arrangements, drivers and cars in third world countries, lodging and food, foreign medical licenses and visas, proper immunizations and all kinds of contingency plans (such as battery operated headlights for when the power goes out in the OR in the middle of surgery). He has a meticulous organizational system for numbering the patients, and prints and brings his own paper forms for this purpose, including pre-printed post-op order sheets.
Then there are the “just in case” materials he packs every time. I have my own list that I’ve developed over the past 6 years I’ve been doing mission trips, but I enjoy finding out what is on other’s lists. For example, he brings a candle and matches and has never needed them until he was in Congo last week. And, he brings a fly swatter ( I usually do as well) for malaria control. But, the most interesting item he brings is a mouse trap. Personally, I don’t want to think about that one too much and I hope I never regret that it isn’t on my packing list! We physicians tend to put in extra medications like antibiotics for traveler’s diarrhea or urinary tract infections, immodium, benadryl (which is illegal in Zambia, by the way). Duct tape and zip lock bags are on everyone’s lists as well. Last, but certainly not least, making friends along the way is critical. Connections and networking are key to making your trip fun, rewarding and successful. Anyway, I’m hopeful he’ll write a book about how to plan, pack for and execute a successful medical mission trip because he does it very well.
Some of the people in our village on this trip include Heather from CURE international in the US, Tim and Melissa Ebbers (he’s the Beit CURE hospital CEO), Dr. Giorgio Lastroni the medical director for Beit CURE, Pastors Harold and Na the Spriritual directors at Beit CURE, Dr. Tshoma the anesthesiologist at Beit CURE, the many wonderful nurses and OR techs at Beit CURE (including TangaNika, Cristabel, Efram, Idys, David, Esther, George, Fred–I’m sorry I can’t name them all personally. We were also joined in the OR by Dr. Giuseppe Poglio, an Italian maxillofacial surgeon now working in Zambia. And, we had two lovely dinners in private homes last week, one at the Ebbers and one with former Zambian President Banda. The Ebbers provided transportation to and from the hospital each day as well.
Most importantly, we are grateful to the parents and guardians of the children. They did not give up hope and through difficult situations, managed to bring their children from near and far to have surgery. Surely, it takes a village, and a lot of guardian angels. Thanks to all at home who’ve driven my carpool, house and cat sat for me, loved and cared for my youngest daughter and covered my call and patient care. See you soon! I’m over Salt Lake City right now…
Margaret is eleven months old and has a complete right cleft lip as well as a cleft palate. There is one photo that shows both defects and how extensive this problem is for her. She’s just crying because we’re holding her head still for a quick photo. You can see that she recovered quickly and was happier in the next photo. We did stage one this year, repairing her cleft lip. That will help the teeth grow in more normally. Next year, she’ll return for her cleft palate repair. It is nice to reach these children when they are small babies for the lip repair and young toddlers, 1-2 years old, for the palate repair.
Barnabus showed up later in the week, but we were able to work him into the schedule on Friday. He is almost three years old and has a right incomplete cleft lip. These are fairly easy to repair and it took us about 35 minutes. It is hard to fathom that this poor little guy has had to deal with this lip problem and the teasing that even small children will dole out, for three years. Especially when such a quick procedure can change things for him so easily. These children just work their way into our hearts. What a cutie! Here are some photos of Barnabus.
Grace captured our hearts when we met her on Sunday. She is so cute and playful. Don’t you love the hat? Here’s a brief photo journal of her time with us. Grace is four months old and has a bilateral cleft lip. She has a cleft palate as well. She’s just the right age for lip repair, and will return next year for her palate repair. The last photo shows Grace still asleep in the OR. She has orange tubes sutured in her nose to keep her nose open overnight (in case of swelling). Babies this age are obligate nasal breathers. We’ll remove the tubes tomorrow. Now that her lip is repaired, her teeth will come in much better and more in proper alignment. And, as mentioned above, she’ll return for palate repair next year.