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What exactly will be my role in our medical trip to Uganda this April?  That is a thought familiar to me from when I went on a previous medical mission trip to repair cleft lips/palates in Indonesia some Aprils ago.  I know I want to help.  I know I can help.  What is not always clear before your arrive, is what is most needed at the destined site.  There routinely seem to be surprises in these situations and without fail, the need shows itself on a daily basis.

While in Indonesia, the need quickly became evident as our tightly woven days became longer as more and more patients were in need of services we could offer.  It was not uncommon that the least amount of time we had between any 2 meals was the abbreviated time between dinner and tomorrow’s breakfast.  Generators on standby to keep the OR running as long as possible past dark; medical staff trading off to keep the support flow going; surgical team members assessing, repairing, and teaching, to help as many children and local providers as possible in our tiny grateful village.

Going to an area not yet visited by such a traveling medical clinic presents a challenge in arrangements, supplies, and complex details.  We are very fortunate to have Liz Wood, as our organizing leader, in addition to a group of dedicated civic and medically minded volunteers –getting their paperwork in order, immunizations obtained, and dollars spent to make this trip a reality.  All understanding that one of the biggest “knowns” we can be sure of is that there will be a lot “unknowns” in our commitment to this service. But we also know, the rewards are not small.  We can take part in changing the lives of many through individual surgeries, providing services/equipment not previously available, and assisting the community with further medical education.   It is a win:win arrangement of which I am proud to be a part.

Mishelle

Putting a surgical mission trip together truly takes a village. Often people ask about the details so I thought I’d include some of the logistics here. For this trip, we have Liz Wood–Hallelujah!!! Liz is very experienced as an ER and OR nurse who has traveled with and organized numerous surgical mission trips around the world. She also has an incredible knack for procuring donations–including her latest coup– a Valleylab cautery machine! We are excited about that, though pondering how to pack it. I think she already has five large suitcases stuffed with items such as gauze, IV tubing, syringes, needles, IV start kits, endotracheal tubes, and patient gowns just to name a few…

I’ve also got suitcases in my office with anesthesia medications, antibiotics, surgical instruments, a cardiac monitor, intubating laryngoscopes and suture. My instrument sets are wrapped in wraps made by Kim Rispoli (who I have not had the pleasure of meeting).  Her sister, Deb Gritzbaugh, connected us. Deb marked all the instruments with color coded instrument tape to keep the trays separated and organized properly–Deb is a retired OR nurse who has traveled to Kenya and Ecuador for cleft trips. This was done after Juliana Bertucci painstakingly cleaned off old instrument tape (the tape is color coded to the sets, so they are easy to keep separated). That project took hours, and involved a small cut to her finger–no worries, she’s fine now. Paul Bertucci (Secretary, board member) set up the domain name for the website, is making some adjustments to the monitor we’re taking to allow use of multiple types of blood pressure cuffs, and has been involved in editing Bylaws and other documents. He also customized my Woodson, a stainless steel instrument used for cleft palate surgery. Jim Fielding of Orthomed, Inc., helped me fill out my cleft lip and palate instrument trays, customizing a tongue retractor for the Dingman and donating another instrument. Mishelle Nace is collecting information and bottles/nipples for feeding babies with cleft lips/palates, until they are surgically treated. She is  gathering bottles for dispensing acetaminophen and antibiotics post operatively and organizing teaching materials for Ugandan medical staff. Mark Simon has procured 4 pulse oximeters from Americares that we will take with us and plans to do training sessions with the hospital/clinic staff on their use. Clay Van Leeuwen is bringing instruments and additional suture necessary for the surgery. Sarah VanderZanden has been collecting financial donations, coordinating supplies and secured a donation for much of the Dermabond (tissue glue) we need! MAP International donated some of the needed suture.

Nina Bertucci has been writing and collecting information for website content. Jennifer Searls (board member) has put together a beautiful website in 36 hours after tactfully offering to do so when she saw what I had struggled to put together–Thank you Jennifer! She is instrumental in planning out our communications, editing media and documents and cheering me on for the past 10 years until I finally formed GMAST. Elisa Burgess, who has traveled to the Philippines on several cleft trips, and Emily Hu have been collecting methylene blue which is used to mark out the incisions prior to surgery. Ed Bleynat (board member) has reviewed Bylaws, financial policies and other legalistic items. Several of our supporters have clicked the DONATE button and supported us financially to offset the many expenses that add up for a week of specialized surgery. Many, many people have clicked to Like us or to Share our stories to spread the word. All of the team members have had to submit volumes of paper to the Ministry of Health in Uganda to become licensed, as well as having had to pay the licensing fees. We’ve all had to update our Yellow Fever, Typhoid, Hepatitis, Meningitis, Influenza, Tetanus vaccines if we didn’t already have them. We’ve all gotten prescriptions for malaria prophylaxis as well. The list goes on…and I will try to update it and recognize everyone. Please ping me if I’ve temporarily forgotten to mention you!

Thank you to an amazing village that keeps growing–bridging the gap between what people need and what they have, one smile at a time.

The upcoming trip to Uganda will be my first medical mission. I’ve always loved to travel but often wish I could experience new cultures in a more meaningful capacity. More than just being a tourist on the sidelines, I’d like to give something in return. It wasn’t until I had graduated with a degree in nurse anesthesia and gained a few years of experience in my career that I felt like I had some skills to contribute on a mission trip. After months of searching for volunteer organizations that would be a good fit me for, I found myself confiding in my friend and fellow CRNA, Nicole McCune, about my dreams to volunteer. Coincidentally, she had similar aspirations and introduced me to her friend Liz Wood, who has organized and lead many surgical trips. When we heard that anesthesia providers were needed on the Uganda mission, we excitedly/nervously signed ourselves up!

Holly

As I lay here in my bed struggling with the side effects of 7 vaccinations necessary to make this trip to Uganda, familiar thoughts and emotions surface…why am I doing this? I really should not be gone from work right now. I shouldn’t spend this much money!  The self doubt and questioning of my sanity usually strikes half way through the trip, when we have a difficult case, almost lose a patient or really struggle with the environment to the point of well, even danger.

And then…we see the miracles start to happen.  Patients who “see” their grandchild for the very first time.  The patient with a tumor so far advanced we didn’t think she would survive the surgery and yet she recovers long enough to have several more years with her family.  The child who came to us in Vietnam with an enlarged eye because we were an ophthalmology team there to do cataract surgeries.  Unfortunately this child had a brain tumor causing the eye deformity…oh, but wait. We just happened to have a neurosurgeon joining the team a week later.  She survived the surgery with a full recovery. 

The rich exchange with the medical communities who host us, the language of “surgery” transcends all other communication barriers and we experience first hand how 90% of communication is nonverbal.  As I write this blog the memories come flooding back of all the sweet relationships developed with team members from all over the world and the patients whose lives are changed because of a surgery performed.

I never go on these trips lightly, but with fear and trepidation, praying…God please give us wisdom and healing in our hands, above all…let us do no harm.

Janet

It started in 2006 when Janet Stookey a fellow OR nurse, invited me (or maybe I invited myself) along on an Indonesian surgical trip she was organizing. On arrival there was an elderly lady, I think was expecting to die from a ruptured appendix, as the surgeon there had died two weeks earlier from rabies. We hurriedly unpacked what we needed, removed her appendix and I was hooked. The years passed and I longed to do more international surgical work so I organized a dental trip, and then another surgical trip to Indonesia. All of these trips were made with the aid of International Friends of Compassion, http://www.ifcus.org/.

The next step in my journey came when I had the good fortune to get introduced to Dr. Joseph Clawson http://www.jpclawsonmedicalmissionsfoundation.org/. I was lucky enough to travel with and assist him doing cleft lip and cleft palate surgeries. From the Philippines to Zambia to the Democratic Republic of the Congo, I was able to travel to up to three countries a year with him. I was touched by the impact we were able to have in improving life for so many people.

My heart soars each time I think of the joy on the faces of parents and siblings seeing their loved one for the first time after corrective surgery. I remember the excitement in the voice of the five year old waking up from anesthesia after a cleft lip repair turning to her grandmother and saying, “NOW I can go to school”.   There was a father with a huge smile and tears in his eyes, seeing his 21-year-old son after he had his cleft lip and cleft palate repair and saying, “now HE can marry”. The stories are many, the emotions deep, the joy indescribable. I feel I’m the lucky one to be able to be a part of these surgical trips.

So, Uganda…Last April after a week of cleft lip and cleft palate repairs in the Congo, I allowed myself three days in Rwanda to see the silverback gorillas. I had a driver, Enos for those three days. He was interested in what had brought me to Africa and I shared some before and after photos of the patients we had just treated in the Congo. He wondered out loud why there were no cleft lips in his country, Uganda. I assured him they were there, as cleft lips/palates occur anywhere from 1 in every 500-700 births but because people do not have the opportunity for repairs, they hide from the public eye. Before dropping me off at the airport, Enos asked if I would come to his country and help his people. Who could say no? So I told him what it would take to get a team there, like a doctor to sponsor us, a hospital that would let us use their operating room, housing, transportation etc. I told him if he was willing to do some ground work in his country, I’d do what I could to bring a team there. And now, in just a few short weeks, we will be in Uganda.