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PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY May 2013 | Archived Issues

Cedars-Sinai Team Performs More Than 100 Operations During Guatemala Mission

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For many residents, a visit from Cedars-Sinai medical professionals marks their only access to healthcare all year. This year's mission was to Joyabaj, Guatemala.

When the team from Cedars-Sinai arrived at the small town of Joyabaj, Guatemala, on April 21, the only medical facility was a single labor-and-delivery room in an otherwise empty building. A day later, the group of 85 volunteers had created a small hospital from the equipment they brought with them, complete with an operating room, a recovery room, and a clinic to see and treat patients.

"It was like a MASH unit," said Gary Hoffman, MD, an attending surgeon in the Division of Colorectal Surgery. "One day there's nothing there, and the next we're performing surgery."

Remarkable, but also business as usual for the annual medical mission – one of 11 such visits organized by HELPS International each year. A nonprofit organization, HELPS oversees volunteer work throughout impoverished areas of Latin America.

This year's mission took place in Joyabaj, a town of about 9,500, located in the highlands in central Guatemala. For many of the residents, most of them indigenous, the Cedars-Sinai visit is their only access to medical care all year.

Babak Larian, MD, division chief of Otolaryngology, serves as director of the Cedars-Sinai HELPS mission. A participant in the missions since 2003, he said he feels a special responsibility to his Guatemalan patients, who have so little access to medical care.

Hoffman was so moved by the experience that he changed his Memorial Day travel plans and flew to Dallas with Larian, Olivia Marroquin, their team leader, and Hoffman's son, Jordan Hoffman, MD, a second-year surgical resident at Emory University. There, they attended the annual HELPS International review meeting. All of the volunteer team leaders from across the nation were in attendance.

Father and son volunteered and will be leading a second, yearly Los Angeles/Cedars-Sinai team mission to Guatemala. That team's first trip will begin Oct. 18, 2014.

"My response to this was immediate and profound," said Hoffman, "and by leading a second team to an underserved area of the globe, Jordan will begin his career with a dedication to service, and I will be able to cap my career in the same way. It is right on so many levels."

Hoffman continued, "Let's see how many medical,  surgical, dental, nursing and staffing volunteers we can pull into this. I hope that everyone will answer the call, or at least answer my phone calls."

For Hoffman, a first-time participant in the mission, now in its 13th year, the experience was eye-opening in a number of ways. He was struck by the extreme need of the people, and their open-hearted gratitude. He also had the rare opportunity to see his son and Alexandra Gangi, MD, a Cedars-Sinai surgical resident PGY 4, at work in challenging circumstances.

"Watching Jordan and Alex work with the patients, seeing their level of skill, competence and their compassion, buoyed my confidence that we are turning out excellent doctors who are equipped for the challenges of our profession," Hoffman said.

"The entire trip was so well organized," he added. "I give all of the credit to Babak (Larian) and Olivia Marroquin for having organized this remarkable mission. The patients were the recipients of a real humanitarian effort."

Challenge was the order of the day. During the five days of the mission, the medical team, which traveled for 36 hours to reach its destination, saw 933 patients and performed 101 operations, said Marroquin, a surgical endoscopy tech at Cedars-Sinai. A native of Guatemala who moved to the U.S. in 1970, Marroquin has been the organizing force behind the mission since its inception.

The medical team started work at 7 a.m. and often finished at 1 or 2 a.m. the next day. Mission participants paid their own travel expenses and used personal time to be there. Operations included cleft palate repairs, gall bladder removal, hysterectomies, head-and-neck cancer operations, repairs of hand deformities and, to the joy of the participants, the birth of two healthy babies.

Susan Whang, RN, who works in the OR, joined the mission for the first time after hearing about it from her colleagues for several years.

"It was a great experience – I have never worked as hard as I did there, and it's the most rewarding experience I have ever had," Whang said. "I saw things I have never seen in practice – a fibroid as big as two basketballs – and when you see the need, you know you'll go back."

All formality and hierarchy were wiped away, and everyone, from surgeons and nurses to translators and clerical staff, worked as equals. Talk to almost anyone who has taken part in a mission and they say the same thing – this is medicine at its most profoundly satisfying.

"We in the U.S. are so fortunate; we rarely even see the kinds of cases that are routine in the Guatemala mission," Larian said. "And so we work 18-hour days – I literally have to force people to stop and get some rest, because all of us want to help as much as we can."