Thursday, September 29, 2011

El Salvador, part 3- People

News Flash- The people in El Salvador! They were nice! Shocking, I know.

As I've mentioned, the people on the mission with Operati0n Rainb0w were all volunteers who spent their own money and used their vacation time to come on this trip. They were all incredibly hard working people who were very good at their jobs. The surgeons performed complicated, difficult surgeries and they did it with about half the tools they were used to and they often creatively manipulated the equipment they did have in order to make it work for our particular cases.
That's a lot of plates and pins, yo.
The OR nurses worked side by side with the surgeons, on their feet allllll day lonnnng, handing them equipment, keeping instrument counts (to make sure nothing got left inside the patients), prepping the patients for surgery, getting the cast materials ready, and probably a hundred other things I didn't see.
The anesthesiologists were also in the OR all day long, giving the patients (you guessed it) anesthesia required for surgery. They would also manage some patients' pain with epidurals.
The recovery room nurses took care of the patients after surgery, making sure their vital signs were okay and that they woke up from anesthesia, and then discharging them to their hospital floor.
The physical therapist went around to all the patients post operatively and taught them exercises or how to walk with crutches or a cast shoe.
The translators ran around between everyone, helping the doctors assess patients on clinic day, helping the patients ask questions, telling them not to eat before surgery, going with me up to the floors to see the postop patients and give them discharge instructions, and helping the PT give them exercise instructions.
Notice she's wearing scrubs and a gown? That's because she also had to be in the OR and the preop waiting room. And the recovery room. All the rooms, pretty much.
The medical equipment preparer cleaned and sterilized and re-packaged up the surgical tools over and over again all day long. We used almost exclusively tools that we had brought with us and there was a two hour turnaround time for steam sterilization of equipment, which meant the surgeries had to be scheduled in such a way that all 3 ORs had enough of the proper equipment at the right times.
... Which leads me to the coordinators. One of them was an Operati0n Rainb0w employee and she worked tirelessly to coordinate the whole trip. She worked with the El Salvadorian government to allow us to be there, she coordinated with the hospital to let us use their ORs and their X ray machines, she kept us on schedule and on time and dealt with the hundreds of other things that came up along the way.
She also saw a lot of the postop patients with me, kept a master list of them, and printed out the final copy of instructions that I made with one of the docs.
There was another coordinator who was also an OR nurse so I didn't see her much during the days, but I know that she was in charge of packing all of the equipment we brought-- ALL the tools, the surgical instruments, the drugs, the drapes, the cast materials, the saw, the drill, and on and on and on. Everything was packed into thirty giant duffel bags which were labeled and listed for contents. These two coordinators (plus my dad) also came up with the final OR schedule that allowed the team to perform 42 surgeries in four days. That's... pretty awesome.

But the Operati0n Rainb0w team wasn't the only group of people in the OR area. The El Salvadorian doctors and nurses were there, too. They worked alongside our team, assisting the surgeons, helping coordinate and find equipment, and learning as much as our doctors could teach them. Our being there created lots of extra work for them and they didn't get paid any overtime.
The director of the hospital gave gave us permission to use three ORs and gave us priority use of the surgical sterilizing equipment. The surgical director took on the responsibility of following up with all 42 patients after were were gone.
The Ladies of Pediatrics Association is a group that runs a cafe in San Miguel to donate money to the pediatrics and they volunteered to host us while we were in the hospital. They cooked our lunches at home and brought them to us in the hospital. They made sure our fridge was stocked with water, gatorade, and sodas, and they also brought us snacks like pupusas and pandulces every few hours.
We gave them flowers.
And at the end of the week they threw us a party.
We walked in and thought we were in the wrong room-- it looked like a wedding or something. There was a live band and dancing and lots of speeches and the Ladies of Pediatrics Association gave us all certificates and gifts (El Salvador tee shirts!).
They demonstrated a traditional El Salvadorian dance.
Everyone was so nice to us. So nice and grateful and kind and sincere. I seriously can't find enough words to get this across. I was most amazed by our patients. They were so quiet and stoic and, well, patient. Throughout the day I would go around around to the different rooms and see all the postop patients. I would make sure they knew their care plans and when they would be discharged, that their pain was relatively controlled, and that they had seen PT if they needed to. The patients came from far and wide to see our surgeons. One even rode in on the back of a coffee truck. They never complained. Not when the waited all day long to find out the surgery schedule. Not when they waited all day for surgery. Not when they woke up from surgery in pain, with a giant cast.
There seemed to be no middle ground for their pain. They would be stoic stoic stoic and not complain once until the pain became unbearable and then they would cry. And then they would lay quietly grimacing with tears streaming down their faces until I noticed and offered them medication. They never demanded anything, never even asked. If there was pain medicine they would take it, but if not? They would grit their teeth and wait it out.

When we were leaving everyone thanked us again and again and gave us hugs and took photos with us.

"Will you come back next year?" they asked, "Please?"
"We will try."