Medical Staff Pulse Newsletter

Guatemala Mission Helps 1,000-Plus Patients

It started like this – nearly 100 volunteers, the majority from Cedars-Sinai, paid their own way to fly to Guatemala earlier this month. Most were strangers when they arrived at LAX, when they boarded the caravan of buses in Guatemala, and as they traveled for two days to an impoverished cluster of villages deep in of the rain forest.

On their return to the U.S. – having conjured a working hospital from an abandoned building, seen more than 1,000 patients and performed 124 surgeries in just four days – the group on this medical mission were comrades at arms.

"It is one of the most challenging things many of us have ever done, and one of the most gratifying," said Olivia Marroquin, a surgical endoscopy tech at Cedars-Sinai.

A native of Guatemala, Marroquin went to high school in the impoverished Central American country, moving to the U.S. in 1970, where she finished her medical training. Over the past decade, she has been the organizing force behind Cedars-Sinai's involvement in the medical missions.

"It's wonderful to feel like you're giving back even a part of all the blessings we have in this country," Marroquin said.

The mission to Guatemala is one of 11 such annual visits arranged by HELPS International, a nonprofit organization that organizes and supports volunteer work in that country. Clinical and administrative volunteers from different hospitals in different countries, come together to bring medical care people who have neither access to it, nor the means to pay for it.

"We all leave L.A. at the same time on a Friday night, and it takes two days to get to the village in the rain forest," said Maureen Fimpler, RN. The CNIII just completed her fifth Guatemala mission. "We bring 100 bags of medical supplies with us because the area where we were going had nothing."

Using equipment provided by HELPS, the team turned part of an abandoned 1960s-era military hospital in the southern part of the country into a clinic, treatment rooms and four operating rooms. Other rooms in the hospital became the dorm, where team members rolled out their sleeping bags on portable cots.

"This was our second year coming to the same site, and by the time we arrived on Sunday night, people were already standing in line and waiting for us," Fimpler said. "Some of us were still busy cleaning and dusting and setting up, and the internists were already checking patients."

The clinical staff got to work seeing patients at first light on Monday morning. Administrative staffers set up schedules to keep the work moving efficiently. With supplies so tight, as many surgeries as possible were performed with local anesthetics. More serious surgeries – 124 this year – were performed under general anesthesia.

"We do everything from general surgery, gynecological surgery and plastics, to scar revisions, cleft lips and palates, and ENT (ear, nose and throat) procedures," Fimpler said.

Dr. Gary Bellack, an otolaryngologist with Cedars-Sinai's Head and Neck Cancer Center and Sinus Center, was the sole head-and-neck surgeon on the trip. He was joined by five internists, three dentists and several anesthesiologists, each of whom worked from dawn until dusk for four days.

"The conditions there – well, let's put it this way, it's the only place I've ever worked where the lights go out and you're in the dark," Bellack said. "You're in the middle of an operation and you hear an announcement over the P.A. that says ‘Everyone with a working flashlight, please come to the O.R.'"

In addition to power failures, a limited water supply, the lack of a lab, X-ray machine and a blood bank, the language barrier proved a serious challenge. The patients spoke a Mayan dialect that first was translated into Spanish, and then into English. Every conversation, from the simplest to the most complex, had to go through multiple translations.

Difficult as it can be, the rewards are far greater, team members say. The villagers, many of whom earn less than $40 per year, brought the team beautiful handmade gifts. A small boy, his cleft lip repaired the previous year, had saved the photo of himself with his doctor. He appeared at the hospital again this year, where he showed everyone the photo in hopes of being able to see the doctor and thank him.

"The people are so gracious, and it's in a very different way than we're used to," said Sharon Huff, a senior administrative associate in the Department of Nursing Research and Development. Huff, who worked in the recovery room on the mission, has made five trips with HELPS.

"They kiss you and hug you in a way that honors you," she said. "For many of them, it's all they have to give, and it's a truly remarkable gift."