May Surgeries

From May 21 to 28, the Daly group was here for what would be the final surgical brigade during my time in Honduras. Their goal was to expand upon the successful inaugural operations that took place in March. To do this, a number of projects needed to be completed, foremost of which were installing a backup generator in the event of a power outage and installing a water filtration system for the autoclave.

The generator and filtration system, along with many medical supplies, were to arrive two weeks before the Daly group came with technicians to install the equipment. With unsurprising Honduran reliability, the container was delayed at customs in Puerto Cortes by a broken computer system, and its ETA was completely unknown. However, to unload the generator inside the container, we needed to rent a mobile crane mounted on a flatbed truck and have it at the ranch when the container arrived. At this stage that I actually benefited by Hondurans’ aversion to schedules. I could not tell the rental company when we needed the truck, but they were content to wait until we called. When the container finally showed up on our doorstep a week late and without warning, we called the company, and they arrived within about a half an hour.

Everything came intact and was unloaded without a hitch. We even succeeded in enlarging the generator house to accommodate a larger than anticipated generator in the span of a week, no small feat for the ranch construction workers. I regret not having a camera handy to document the proceedings, especially the generator being lifted by the crane, which was impressive. Everything was in place for Dr. Daly and his team of technicians.

Dave Helgeson and Keith Hines installed the generator, Brad Weaver put together the water filtration system, and Becky Hines RN organized all the medical supplies. The generator was equipped with an automatic transfer switch to maintain a nearly constant power supply, keeping anesthesia machines and other life saving equipment running during surgery. The four orthopedic surgeons were now able to operate.

After screening patients in the external clinic, the surgeons selected a number of feasible operations. At final count, twelve operations were performed during two full days of surgery, ten orthopedic cases done by the U.S. surgeons and two elective, general procedures that Dr. Cerna completed on Pequeños. The Pequeños had needed their respective surgeries for some time. Of note was the most complicated procedure, removal of dead bone from a middle-aged woman’s wrist that had become infected after being operated upon by public hospital doctors. After taking out an unexpectedly large amount of dead tissue, she will need further surgery in August or November to finally correct the problem. None of the 10 patients from the community paid a cent for the operations they received.

All in all the week was a success, in large part because, with the invaluable help of Dave, Keith, and Brad, the final major components were installed to equip the building for function on a full scale. With these pieces in place, the Daly’s are ready to scale up operations in August to treat more needy persons. It was great to see a wide array of talented individuals give their time and work together to make large strides for the surgery center and the health of our community here.

Weblinks

Hello Readers. Just wanted to direct the attention of those interested to a few pages about the Surgery Center and my work as a volunteer. There is now a website for the Holy Family Surgery Center, http://holyfamilysurgerycenter.org/. It has news updates and some short biographies and testimonials from people involved with the project. The short piece I have written about my volunteer experience is basically the same one that is posted on the NPH International website: http://www.nph.org/ (put your cursor over "volunteers" on the left and click on "testimonials").

Not much else to report: I am gearing up for a visit this week by Dr. Daly's family and a slew of other visitors, including three other orthopedic surgeons, nurses, students, and experts who will help with some equipment installation at the SC. A container of supplies including a 100kW backup generator, water softener system, and seemingly endless boxes of medical supplies arrived last friday, and the goal this week is for the mechanics and technicians arriving with Daly to install these items to be able to operate again early next week. We will be having an all-day clinic Saturday to triage for possible procedures should everything be in place. Will keep you posted...

Forest Fires, Camping, Easter

Here it is HOT. The activities of the past weeks have all been within an environment of blazing heat, dust, and the smell of burning. For the torrents of rain that Honduras receives in the months of June through September, it sure settles the score with absolutely no precipitation for most of March, April, and May. I think all the volunteers are experiencing various degrees of insanity.

The dry season brings frequent fires, which on the Ranch’s largely undeveloped 2000 acres can quickly become unruly. Mostly the older boys track down and put out blazes, some with a crazed, fanatical exuberance, but depending on the severity everyone can be involved, including soldiers from the nearby military base in La Venta. My first encounter with fires was of special personal significance as my house almost burned down. When the flames jumped over the dirt road and onto the grass not 50 yards from where I live, I renewed my efforts to keep back the burning onslaught with green branches, some water, whatever my roommate and I could find. With extra help we eventually won the battle, and our house in the Hortaliza survived. In other forest fire news, an unrelated blaze later in the week came within about 10 feet of the surgery center, almost destroying my entire year’s worth of work. We’ll see what May brings.

The ranch celebrated Holy Week with much fanfare, highlighted by separate camping trips for the boys and girls. Along with other Buen Pastor volunteers I accompanied the boys over Palm Sunday weekend to Rio Grande, where we spent two days camped in tents outside an old school building without running water. We went swimming in the nearby river, made campfires, and the kids took a break from their strictly regimented schedule. Some made their own little tents with sticks, trees, and blankets and slept under the stars. In the afternoon on Saturday, the volunteers and Tio’s took on a group of townsfolk in a pickup soccer game, noteworthy because nobody died from heat exhaustion as we ran around in million degree weather, while smoke from nearby uncontrolled blazes burned our lungs. But overall camping was one of the best times I’ve had with the kids.

The rest of the week revolved around masses and religious celebrations of increasing duration and complexity. This culminated in a midday Saturday Stations of the Cross Bataan Death March, after which the shirtless Pequeño fixed to a cross and acting as Jesus really did look like he was dying. But the kicker was a 4am “Sunrise Mass” on Easter Sunday, where we assembled for a candlelight procession into the church and lengthy celebration during which it gradually became morning and various children gradually dosed back off to sleep. The church actually looked pretty cool, but whether it was worth a 330AM wakeup call could be debated. All in all, the planning and choreography of all the week’s events was rather spectacular. The ministry team, headed by three energetic, Honduran laymen, each of whom enthusiastically strums a poorly tuned guitar while singing with varying ability during the mass, was in top form. I don’t think they slept the whole week.

In any case, the Ranch has now returned to some degree of normalcy, weather aside, and its back to business as usual. This past weekend was the semi-annual volunteer retreat, a very relaxing time at Lago de Yajoa. My work is progressing unremarkably, as we look to a May visit by Dr. Daly, and I’ve began thinking a bit about my fast approaching August departure. Until next time…

The kids were all pretty exhausted on the bus ride back from camping. Also a view of the river where we swam.

Inaugurating the Holy Family Surgery Center

The customary overdue Hello, and an update on the recent events at the Surgery Center. Though progress has often inched along, both during my time here and in the 5-year history of the project, March 6-11 we crossed a milestone of sorts, blessing and inaugurating the new Holy Family Surgery Center as “complete” and performing the first surgeries with U.S. medical personnel. It was the fruition of years of hard work and dedication on the part of St. Paul orthopedic surgeon Dr. Peter Daly, his wife Lulu and family, NPH International Director of Family Services Reinhart Koehler, and a sea of other invaluable colleagues, benefactors, Ranch employees, and friends of NPH.

Dr. Daly and colleague Dr. Mike Forseth performed the first surgeries on two patients who came to the external clinic looking for medical assistance in the weeks leading up to their visit. One patient, an elderly woman, was in serious need of help. Last November, she fell out of a tree and broke both wrists (why a woman in her sixties was climbing a tree to cut wood in the first place is a question we did not get into, and likely would’ve led to a larger discussion on Honduran cultural norms and living conditions). The public hospital in Tegus, her only form of assistance, asked for somewhere in the neighborhood of US$10,000 to operate on her. She hasn’t seen that kind of money in all the years of her life, so she walked away untreated and continued to care for her children as best as she could despite her comprimised condition.

On triaging this woman and other candidates at the beginning of the week, hand surgeon Dr. Forseth determined that hers was a case that, while complicated, they could reasonably undertake. Along with the other patient (needing a minor cyst removal in her hand, lingering from a previously botched attempt at a health center in nearby Talanga) the two became the Surgery Center’s first patients to receive US trained surgical care.

The surgeries were successful, and both women expressed gratitude and dignified satisfaction with the care they received. A humbling and rather striking sentiment I realized was the pride and joy felt by the community that such a center has been constructed for them. The goal is to make the center of U.S. quality, and this is a level of care far and beyond what these people have experienced. It really does affect one’s psyche when the quality of the facilities and services available to you are in poor condition and third rate. For these Hondurans to be told that they deserve (and will receive) sound care in clean facilities uplifts their dignity and sense of worth, and it is an additional benefit that really can’t be quantified. To see the surprised smiles of these two patients as they received careful attention from dedicated providers, who listened to and answered their questions, was a terrific thing to behold. Thinking of the many future patients that are soon to come, it certainly solidified my faith in the project.

All in all the week was a success, and I think everyone involved left with a feeling of satisfaction and gratitude, including the patients. For now, we will continue to treat patients once weekly at the surgery center for minor procedures (with Dr. Cerna from Tegucigalpa), progress with details in building construction, and gather more patients as we look forward to a May visit by the Daly group, with goals of augmenting the services provided and numbers of patients treated at that time.

The medical team that came with the Daly's.



My 15 seconds of fame scrubbed in and sitting at the surgical table.

Please Donate to Nuestros Pequeños Hermanos and the Catholic Medical Mission Board

Ok, this is it – my one-time, simple request to readers to support the very good work happening at NPH. To recap, NPH is a non-profit, Catholic organization supporting thousands of orphaned and abandoned children in 9 countries across Latin America. These children are blessed with a stable, loving home that gives them food, clothing, shelter, health care, and opportunities in higher education and vocational training to better their futures and break the cycles of poverty, abuse, and neglect that they have experienced. The children also benefit from the work international volunteers, who give specialized skill sets to expand and enrich the services supporting the children. These areas include teaching, care giving, health, and physical and occupational therapy. The Honduras branch alone is the family for over 500 current Pequeños. NPH also reaches out to the local community with nearly free health care services to needy Hondurans in our community. My work as a clinic assistant is a part of this effort.

In my particular volunteer work as a clinic assistant, I have been blessed to have the sponsorship of the Catholic Medical Mission Board. CMMB is a non-profit that sponsors and places volunteer health care workers all over the world who dedicate themselves to improving third world health care. CMMB has financially supported my year of volunteer service, with airfare and health insurance, so I could come to NPH Honduras, support the clinics here, and work at the Surgery Center that provides direly needed surgical services for the poor at a token of the cost.

Please support these necessary efforts to lift up our brothers and sisters living in poverty in Latin America. As my grandma Treacy would tell me, you can give time, talent, or treasure, and all are important. NPH cannot function without the continued support of its sponsors, and it is all the more evident during this time of economic crises. Our home has laid off care givers, teachers, and the entire psychology department, just to name a few, in anticipation of a 30-40 percent drop in funding. While these are hard times for everyone, this definitely includes non-profits. If you are able to give, your contribution really will make a difference in the lives of these children. I know firsthand. Please give, and you’ll feel good about doing it!

Donations to NPH can be through Friends of the Orphans, the non-profit fundraising organization for NPH in the U.S. http://www.friendsoftheorphans.org/s/769/start.aspx. You can also choose to continually support a particular child, and exchange letters, photos, and communication with him or her.

If you would like learn more about the Catholic Medical Mission Board, please visit http://www.cmmb.org/. I have also set up a special page to help finance the support I receive, which can be viewed at http://support.cmmb.org/site/TR/Events/General?px=1109422&pg=fund&fr_id=1010. Thank you very, very much for your support.

Long Overdue Update: Christmas, David, Work

I'd bet that the countless loyal followers out there (if there are any left) are all but certain the blog has retired to greener pastures, but on a chilly February Sunday in Honduras I've managed to zap some life back in it. With so much to report, I’ll limit myself to give a hasty run-down of as much as I can remember from the last 7, 8 weeks (cringe)…

Well, Christmas was nice (a belated Merry Christmas to all and a Happy New Year). All the volunteers took a two week break from work and watched over the kids while the employees vacationed over the holidays with their families. It was something of a one-species Zoo. On Christmas eve and New Year’s we made gigantic bonfires, the kind of which could easily start a forest fire, for which the Discipulos Hogar, Finn, and I had to cut and haul about two dozen trees from the forest in which we live. Not fun. The kids roasted marshmallows as close as they dared, until the falling ash made such endeavors doubly dangerous and amidst their complaints we pushed them back for their own safety. No one was burned.

On Christmas day, all the kids went walked to various nearby villages to give away some of their clothes to residents. It was really quite heartwarming. Above are pictures in La Venta, a small town just up the highway. In the first, some Pequenos have stopped to bring clothing to the red house.

After two weeks of Christmas/babysitting chaos, my fellow volunteers and I were ready for a break. I was fortunate to then have the visit of my brother David from Jan 3 – 17. We spent a week on the Ranch and I did my best to show him around and give him the full experience. He weeded in the Hortaliza, swam at the dam, watched Dr. Cerna operate, and played with the kids during vacation courses. Then we escaped to travel Guatemala, which was a terrific time. We hit up a plethora of touristy but breathtaking sites, highlighted by a large clear lake nestled between three volcanoes, hiking an active volcano, and seeing the Mayan ruins in Copan. It was especially amazing to see multitudes of indigenous Guatemalans speaking their various local, indecipherable tongues as they conducted business in crowded marketplaces, wearing colorful woven cloths traditional of their still-vibrant native culture. The NPH Guatemala home also welcomed us for a night and showed us around their complex. It was a great week.

After seeing David head back to the U.S. to find a job, I’ve been focusing on work. Currently we are making final preparations to try to organize a surgical brigade from the States sometime this spring. My most important tasks are to install an automatic transfer system to turn our backup generator in the inevitable situation of a power outage during surgery, and get our license from the Honduran Ministry of Health. This is a tedious process involving applications, building plans, environment codes, and inspections. We also have the usual mix of nagging, minor construction projects (closet shelving, curtains, door installations, floor sealing, and other facile tasks made more difficult by a lack of dedicated, qualified workers).

That about wraps up the basics, for brevity I’ll leave it at that and spare more boring details. One last thing of note is that we are in the transition time for the January volunteers. We have six more here from the U.S., Spain, and Germany, and we are losing the old group (about 10, including my buddy Finn). Next weekend we will say goodbye to this incredible group of people, who will go their separate ways to travel Central America before heading back to the States, Spain, and Germany. They will be missed.

Soon to come will be information about how readers can donate to NPH and the Catholic Medical Mission Board. Stay tuned

Casa Emmanuel, and Pablo Goes Dark

One of the ranch’s small joys is Casa Emmanuel and its residents. Casa Emmanuel is the hogar for boys with disabilities on the Ranch. There is a home for girls called Casa Maria Reina. About 15 boys and girls with more profound conditions live in a special N.P.H. house in Tegucigalpa, Casa de Angeles.

Seven boys live in Casa Emmanuel, ranging from roughly 10 to 25 years: Omar, Carlos Perez, Luiz, Pablo, Joel, Carlos Joel, and Brian.

Omar is the oldest. He wears ear plugs, stoops a bit, and walks around with great vigor and alertness. His favorite greeting is when you hug and lift him up off the ground, and his appetite is voracious. This picture is of Omar in his Olympiades costume (more to come later about Olympiades).



Carlos Perez (right), Omar’s slightly younger brother, is sort of the father figure of the gang. He can be seen shouting orders to the others (indistinguishable to my untrained ear) if they are out of line before misa or skimping on their daily chores in the kitchen. Frankly, he has an opinion on most everything.

Next is Luiz, probably the quietest of the bunch, very soft-mannered. Pablo is autistic, he wears Plexiglas thick glasses and is typically rocking back and forth and rubbing his fingers together to music only he can hear. He likes to do his own thing.

Joel (19, left) is nearly always sporting some degree of a drooly smile on his face. On greeting you he offers a handshake and a hearty laugh, before inevitably trying to reach into your pockets to look for food or any kind of toy.



Carlos Joel (right) has huge ears and is perhaps the liveliest of the bunch, his growth on one side of his body is stunted from falling off a horse. Every time Carlos Joel sees me he asks when I am going to come visit them in hogar, with Carlos Perez often chiming in. They don’t need to do much to win me over. Last is Brian (no photo now), whose calm face often hints at an inner intelligence, though Dorie the volunteer in Casa Emmanuel says she’s yet to find it. Today I found him hiding under the table in Casa Emmanuel because he was upset about something. Though he arrived at the same time as Carlos he is nearly opposite, much more calm and withdrawn.

All are characterized by a stunning familiarity and exuberance with whomever they meet on the ranch. All are quick to smile except Pablo, and only because he’s off in his own world. Pablo’s independence actually led him into trouble a few weeks ago. It happened when the boys were returning across the ranch from working in the kitchen to Casa Emmanual, which they often do. Though they amble haphazardly as they interact with each other and passersby, they eventually make it to the right place. But this time, Pablo became separated and wandered off. In the afternoon Lolita, the Tia that day for Casa Emmanuel, realized he was missing. Soon a grand search was underway for Pablo, involving all the Ranch, employees, volunteers, ano familiares, even the military from the nearby base in La Venta. The extent of the search I am probably not conveying well, as I was off the ranch at the time and did not experience it firsthand. But suffice it to say that on a ranch of 2,000 acres, with hardly any fencing on the perimeter, there was plenty of space where Pablo could be hiding out. All hands were scouring the forests in the dark with flashlights, calling his name. Attempts were made at organizing the search so as to have even separation between the hunters to thoroughly cover as much ground as possible, but like anything here such efficiencies were out of the question, and in the end most did what they pleased.

The search lasted all night and through the morning, and it was not until 10 AM the next morning that Pablo was finally found, in the mountains miles from the ranch. He was found sitting in a hole, glasses intact, playing with a ball that he had been carrying with him the day before, apparently oblivious to the calamity of his situation. He had been missing 20 hours.

Needless to say Lolita, a Tia of ~20 years experience, was let go by the ranch not too long after. This was a very sad time on the Ranch. At least some questioned whether there weren’t financial motives behind the move, as the Ranch is in dire straits with the financial crisis and has let go many employees, including all of colegio (middle school). It was the third time Pablo has gone missing.

In the end, the fortunate thing was the Pablo was found and experienced no harm. There will certainly be more stories to come of Casa Emmanuel; they always find a way to keep things interesting.