Guatemala Day 5: Hump day or Spadadzio

On the bus going to the hospital

Every morning I wake up before 5 a.m. and get ready for our day. It’s still dark outside as my roommate and I walk across the hostel grounds to the place where we have our 5:30 a.m. devotionals and at first it seemed really early...and really strange.

Now things are familiar. There’s that rooster that crows every morning in the distance, the occasional screech from a peacock, and our group gathering in our area and whispering in hushed tones as we pour our morning coffee or tea. It's starting to feel comfortable and even we were talking about how far we had come as a team in such a short time.

“Yesterday went much smoother than the day before. We now know what to do and how to work together,” said Dr. Surendra Sharma from Palm Springs.

Karen Prevatt told us this is because we are “spadadzio”, which means we eagerly push through no matter what comes our way.

"Last night I looked up and saw a big spider over Wanda Kay's bed. We expected the hotel to send up a big man to get the big spider, but instead they sent up up this little woman with a broom," said Karen during the devotional.

She told us this woman was determined to get that spider down. You have to keep in mind, that our rooms at the hostel don't have your average 8-foot ceilings. They must be close to 20-feet high. But that didn't stop this woman. She threw that broom up to the ceiling and eventually was able to get the spider down.

"That woman had spadadzio...and so do you," said Karen. "Where there's a will there's a way and you will find that way."

NO WATER; NO PROBLEM

The fire truck

We needed to be super spadadzio on Wednesday because as soon as we arrived, we discovered we didn’t have water -- again. But we were getting used to this. It was the third day in a row so we knew what to do. We called the fire department at 8 a.m. to bring their tank, but they couldn’t get there until 10:30 a.m. Of course, by now we knew this really meant 11ish, so we improvised.

“The instruments were sterilized last night and we can use our drinking water to scrub up. This way we can do the first two cases,” said RN Liz Pascual.

In the meantime, it was time for the doctors to do their rounds. The little boy with the tumor in his cheek who had to undergo emergency surgery the day before was doing fine. Dr. Mark Hoeplinger even thought the swelling looked a little less severe, which was good news. And our translator who had surgery on his nose was also doing well and would be going home.

Edgar was doing fine after his surgery

“Yesterday I was dizzy and was in Wonderland afterwards, but today I feel wonderful,” said Edgar. "Brad, Char and Dr. Mark totally changed my life."

The other patients were also doing fine and many of them were allowed to leave the hospital that morning including 75-year-old Andres.

He was a sweet man - and very passionate. He grabbed my hand as I walked past his bed and wouldn’t let go. Over and over he repeated, “Gracias, gracias, gracias. I pray for you. I pray for you.”

Apparently, the doctors had removed a hernia from him the day before. He said it used to pulse pain and now it was gone.

AS GOOD AS IT GETS

Andres was so happy his hernia was gone.

The first couple of patients in audiology that morning were in their 80s. Eulogio was 84-years-old and had come with his son. He had not had hearing in his left ear for the last 15 years and had only some hearing his right ear. Jodi and her team fitted him with a hearing aid and the transformation was instant.

It was amazing to see him go from non-responsive to responding to our instructions and talking directly to us. You could see the confidence return to his eyes. And he no longer had to look at his son for confirmation or guidance. He was independent again.

The second patient was the oldest patient of the week. His name was Isodoro and he was 89-years-old. He had hearing loss in both ears. At first Jodi was worried that the hearing aid they had on hand would be too loud, but he was lucky. It worked fine and we had another happy Guatemalan.

But Jodi did wish she could do more and provide better hearing aids.

“Because we only have one type of hearing aid, I can’t adjust the low and high frequencies. I can only make things louder,” Jodi said.

The hearing aids we have for the Guatemalans are analog systems and are great for poverty areas. They are durable and don’t require batteries as they are solar powered. However, they are not custom made and only work for certain types of hearing loss.

“They are one-size-fits-all so sometimes, if the fit isn’t right, they will rub and the person could get a sore in their ear,” said Jodi.

We want to do so much for these people, but we can only give them what we have available. It’s just so hard to accept that this is as good as going to get when you know back home there are many other options available.

THE LONG AND WINDING ROAD

Many of the patients we saw this week came a long way to have their operations done. They had met with one of the Faith in Practice doctors on the village team and then waited until we arrived. Nusli, a 21-year-old school teacher, lives on the other side of the country and traveled 15 hours to get here.

“We came with nine people. I stayed here with Nusli, but the others when on to Antigua,” said Nusli’s mother.

Nusli had her tonsils out and it was taking a while to heal. But even with the pain, they don’t regret their decision to come.

“We definitely would do this again. We were very happy to come here even if it was a long way,” said Nusli’s mother. “Faith in Practice has been wonderful. They have helped so many people.”

Each day we laugh at the lack of air conditioning in the wards, how it doesn't consistently work in the operating rooms and the way we always seem to have some sort of water problem.

Then there was the time we ran out of oxygen because the emergency alarm on the tank wasn't working. Here at the hospital the oxygen tanks are older and haven't been serviced. We also don't have the luxury of having AE Techs on hand to handle technical problems. Thankfully, we had CRNA Christian Cleveland-Peck, aka McGyver. on the team who was able to get everything sorted out.

"We wouldn't be doing all theat we are doing, if it wasn't for what he was doing," said Dr. Maggie Arner.

But even with all these flaws in the system, our hospital was pretty good when compared to Guatemalan standards.

"The public and national hospitals are much worse," said Joanna, our Faith in Practice coordinator.

ON A SAD NOTE

Our team of 31 all came to Guatemala to help people, so when we discovered a situation where we couldn’t, it was disappointing. It wasn’t just heartbreaking for us, but for the patients who had come so far to see us. They had arrived with hope, thinking if anyone can help them it would be us.

Every day audiology had to deal with heart breaking moments like this.

“Yesterday we told one woman we couldn’t help her daughter, she was so upset and didn’t want to accept the news,” said Susana. “It’s so hard giving out news like that.”

The woman’s daughter was 5 years old and had been deaf since birth. The hearing aids we had to offer had no affect on her at all, but the team was determined to give her mother some hope. They spent the afternoon calling around to see if they could find a place that could do a cochlear implant.

“The woman came back today to thank us. She gave us photos of her daughter and brought bananas and limes,” Susana said. “It was so touching that she came all the way back just to thank us.”

You can size of the mass compared to her rib cage.

Dr. Bland had a similar heartbreaking situation. His 25-year-old patient had a massive tumor that expanded from her breast and had spread up over her shoulder. The tumor was so large, it extended close to 6 inches out from the side of her rib cage. He suspected it was cancer, but even if it wasn't, the tumor was so large and intricate that it would be impossible to remove.

All he could do was take a biopsy to confirm the diagnosis.

“In the US, we may have been able to shrink it a bit with chemo and radiation to help prolong her life, but here she doesn’t have that option,” Richard said.