I agreed to
serve for a week with a Kentucky surgical team traveling to Honduras. To serve
was my only expectation. Once I returned however, it felt as if I had taken a
very restoring vacation instead. I will go again, and I highly recommend it to
all my healthcare colleagues. The following is a summary of my week.
team consisted of 2 general surgeons and 1 GYN surgeon, 3 CRNA’s, 2 CRNA
students, scrub techs, and nurses of various backgrounds. All others provided
nonmedical services, perhaps doing the most important work of the trip.
CRNA Jennifer Boils (Campbellsville, KY) masterfully coordinated the entire
trip stateside. Lemuel and Tammy Baker (Kentucky RN’s serving as missionaries
in Honduras) coordinated the trip once we arrived in Honduras. Through
Jennifer’s direction, all 45 team members arrived together in Tegucigalpa,
Honduras with an enthusiastic team and a shipping crate full of every necessary
supply. Through Tammy and Lemuel’s direction, all 45 members had safe
transportation, good food, and a flawlessly operating hospital.
Work on the
first day involved unpacking the supplies from the shipping crate, and
assessing all the patients for the week. I quickly gained a new respect for those
who organize back home the many supplies required just for anesthesia! We
unpacked hundreds of donated items, then organized them so that future teams
could function more easily.
patients was interesting. It was necessary to transition our thinking from
“what acuity can we personally manage” to “what acuity can we manage HERE.” The
nearest hospital was 2 hours away. The mission would have to pay cash for any
complications or extra care required. There was no blood bank and limited
began from the start when the surgeons and CRNA’s collaborated while evaluating
patients. We worked together to determine the most appropriate patients for the
week. Common comorbidities included hypertension, diabetes II and heartburn.
Assessing cardiac function began with “How far did you walk to get here?” as
most walked or biked several miles. We were vigilant with our stethoscopes and
actually palpated the neck, abdomen, and ankles of most patients. The biggest
struggle was translating the Spanish pharmaceutical nomenclature.
There were 4
operating rooms which were surprisingly modern. The gas machines were
several-generations old Narkomed 2B’s and functioned adequately with Sevo and
Iso. The only limitation was oxygen supply. We elected to hand-ventilate rather
than use the ventilators in order to assure our oxygen tanks would last the
were the ubiquitous HP/Philips modules, with separate “etch-a-sketch” gas
analyzers. I felt very fortunate! Two of the rooms had old Bluebell carts,
while the other 2 simply used a table for anesthesia supplies. The beds were
older Amsco 2080’s, which used hand cranks and foot pedals. They grew on me
because they worked every time. Our supplies were more than sufficient. We even
had Bair Huggers, LMA’s, and a bronchoscope. A backup generator automatically
started several times a day in order to maintain consistent power. All of this
had been donated from the states!
Each OR day
began with breakfast together. Someone usually shared a story or word of
encouragement while we ate. We would break for lunch as a team and eat together
(surgeons and all) which facilitated unique bonding. When the CRNA students
didn’t need help, I stayed busy giving breaks, mopping floors and washing instruments.
cases were completed, we usually joined one of the nonsurgical teams. We
helped locals carry water buckets, visited a church and an orphanage, and gave
candy to the kids. While our surgical setting was mostly familiar, these visits
into the community were nothing like home. The poverty was real as most homes
were maybe 15’x15’, with dirt floors, and walls which were penetrable by the
elements. Having realized this, I noticed my most meaningful observation of the
entire trip: the people were happy. They were smiling and joking. The kids ran,
played and laughed. I was compelled to reevaluate my concept of happiness and
analyze the things which I felt contribute to my joy.
went very smoothly, and there were no complications. Nearly every patient
thanked us with a smile and warm embrace. By post-op day 2, all patients were
discharged with acetaminophen and ibuprofen for pain control. And they seemed
to manage very well!
final case, we restocked our unused supplies and prepared the facility for the
next surgical team which was due in several weeks. It was a life-changing
trip, and my desire would be for each CRNA reading this to be able to
experience something similar to enhance personal growth, as well as enhancing
the lives of those less fortunate than us.