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Medical mission team in Guatemala sees increased need for care

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The goals are the same, but the situations always change when the team based at Cedars-Sinai travels to Guatemala on its annual medical mission. This year 96 doctors, nurses and support staff found the city of Joyabaj to be in extreme need.

"The people we see on these missions are always really poor," said Cindy Renick, MSN, CCRN, who served as section leader for the recovery room. "But this time, it seemed as though there was even greater need than we've seen before."

Guatemala 2 220pxThe Cedars-Sinai team recently completed its 12th mission – all volunteers who used vacation time and paid their own way to spend 10 days providing medical care to isolated and impoverished parts of Guatemala. It costs each person about $2,000 to make the trip, which is arranged by HELPS International. A nonprofit group that organizes and supports a broad range of volunteer activities in Guatemala, HELPS brings medical services to far-flung villages where people have limited access to doctors and no way to pay for the care they need.

Joyabaj is a town of about 9,500 people in the Sierra de Chuacús mountains, the central highlands of Guatemala. The team set up shop in a local hospital.

Other than a small clinic and a couple of functional rooms, the hospital was empty, said Babak Larian, MD, an ear, nose and throat specialist who has participated in the missions since 2003.

"The hospital had been built for the area, but only 10 percent of it was being used," said Larian, who has served as director of the Cedars-Sinai HELPS mission for the past four years. "They didn't have the equipment to fill it, or the money or the staff to run it."

Using equipment provided by HELPS, the team turned a portion of the facility into a functioning hospital with four operating rooms and a recovery room, besides clinic and treatment areas. Of the four ORs, one or two would typically run until midnight. The recovery room was staffed 24-7, with nurses working eight-hour shifts.

In between performing surgeries and seeing patients, the Cedars-Sinai team pitched in to help the local doctors.

Guatemala 3 220px"The doctors running the ER there were so poorly trained, and I felt so bad for them," Larian said. "We helped them with the ER patients the whole time we were there."

One of the cases the local doctors couldn't handle was a middle-aged man whose leg was so badly infected, it had to be amputated.

"It was an un-healing wound that he had for four years," Renick said. "That's big. In all my time with the team, we have never done something like that."

But there was no choice – without the surgery, the man would have died.

"And he did so well – two days later he was sitting up and smiling, so happy to feel better," Renick said.

After four days in the recovery room, one of the nurses taught the man how to use crutches. A few days later, he was given a wheelchair made from bicycle tires and a plastic lawn chair.

"I asked his son how the father had managed to get around without crutches, and his son said, ‘I carry him,'" Renick said. "Everything about that case really touched me."

In all, the Cedars-Sinai team saw 1,500 patients, performed 134 surgeries, and did 200 dental consults and procedures. Part of the team traveled to the tiny village of Laguna Seca and operated a small clinic for several days.

"We like to arrange for outreach to smaller villages in the vicinity where we take a pediatrician, pharmacists and a couple of internists and set up a mini clinic," said James Laur, vice president for Legal Affairs at Cedars-Sinai. Laur has taken part in HELPS missions for the past 12 years.

"I got to be a helper with the outreach action squad this time," Laur said. "We showed up at the village health center and the entire village was lined up at the back door and the front door, waiting to see a doctor for the first time in years or in many cases ever."

The gratitude of the people they help is overwhelming – and humbling, Laur said.

"These are people who have very little, and yet they will always give you a gift, a hand-woven scarf or a tortilla they brought from home," he said. "And as they're leaving the recovery area, if they see you have (a HELPS ID badge), they'll stop you and give you a hug."

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