Wednesday, March 14, 2012

Thank You!

On behalf of the students, Thank You! We are so appreciative of all the support we received and all the people who made this experience possible. First and foremost, thank you Dr. P for arranging this experience. This course provided a wonderful capstone for those interested in low-resource healthcare and broadened the perspective of future engineer, doctor, and business person among us. Few and far between are opportunities like this where students can apply and develop skills simultaneously and the fruit of their labor is not a letter on a piece of paper soon to be recycled, but is a new chance at life given to those dependent upon the equipment we serviced. Thank you, Dr. Paschal.

Dr. P was always quick to redirect praise to the Shalom Foundation, so I will follow her lead. Thank you, Tommy Sanders, Kevin McQuaig, Claudia Hurtarte, and the rest of the Shalom Foundation for providing us with a means to accomplish the lofty goals we set before ourselves. We could not have had this experience if it weren't for your experience in logistics, your presence in Nashville and Guatemala, and your support in-country. Your work inspires us to share our skills and passion with our neighbors around the world.

A warm thank you to Dr. Matthew Walker III. As our second faculty advisor and co-leader, Dr. Walker  shared his extensive expertise in medical equipment and treatment. Thank you for sparking great conversations and reflection periods at dinner and sharing your observations on the unique features of low-resource healthcare.

We have a long list of people who made this trip possible. Certainly, this list can be even longer if I could personally thank each of you who read this blog! The value of this experience is greatly amplified by sharing and encouraging others to advocate and serve in the way that suits them best. Thank you for joining us on this adventure.

Warm thanks to:
Our translators Jorge Santizo, Pablo Castaneda, and Juan-Jose
Moore Pediatric Surgical Center
Professor Carlos Esquit
Sergio Perez
Odra Flores
Vanderbilt NICU
Vilma de Perez
Megan Bowles
Avery Dickens de Giron
Center for Latin American Studies
Tina Shaw
Brenda Ellis
Patti Landers
John Dunbar
Ray Erlandson
Steve Wadley
VUSE Dean's Office
Smith & Nephew
Edwin Garcia and Alfredo Duarte
Stephanie Smith
Michelle Kovash
Becky Spires
F Clark Williams
Amanda Lowery
Kenny Moore
Nina Warnke
Teresa Rogers
Suzanne Thingpen

Tuesday, March 13, 2012

Saturday 3/10/12

 Waking up at the crack of dawn would have meant sleeping-in today! Indeed, this was the first day none of us were able to catch the sunrise atop our hotel simply because we were already on our way to the Pacaya volcano by 6:00am. A scenic, albeit frighteningly aggressive, drive later, we found ourselves at the base of Pacaya. There we were swarmed by young locals renting out walking sticks and horses for the climb. Accepting the former, we began the hour-and-a-half climb with our guide. The horses we turned down followed closely behind in case we grew weary (the only catch being the gradual increase in price which conveniently matched the difficulty of the hike).

In another life, Dr. P was a volcanic-ash snowboarder

We were struck by the unique beauty of this hike along a path that was made by a volcanic flow in 2010. We roasted marshmallows and hotdogs over a volcanic vent and even burrowed into a cave. We knew we were close to the base when we were again swarmed by kids asking for us to return our hiking sticks.

After mid-day power naps on the drive back to Antigua, we rinsed off, rested, and head to town for some time at the market. There we found countless booths offering similar, beautiful Guatemalan products. We all practiced our bartering skills, but Laynie rose above the ranks by trading a few granola bars for a several friendship bracelets! Dr. P and Dr. Walker then treated the team to a wonderful dinner in town as a capstone to our week.

Sunday, March 11, 2012

Friday 3/9/12

Our team at work
Today was sadly our last day of work in Guatemala. We returned to Hermano Pedro Hospital for the second day to wrap up our projects and leave the hospital with repaired equipment or recommendations for proper use or subsequent repair.
Amongst our early-morning progress in the hospital, we began nervously checking our watches. The collective mumblings and concerns asked, “Where is Pablo? He said he’d be here half an hour ago…” In casually dramatic fashion, Pablo graces us with his presence and relieves our concerns. Not only did he have the dozens of pounds of coffee we ordered, he also explained his tardiness – Pablo had printed custom Vanderbilt labels on our coffee bags! Giddy and appreciative, we found our bags and deeply breathed in the aroma of recently ground Guatemalan coffee beans.
Our senses saturated, we returned to work for the afternoon. Lowell and Danny put their brawn to work by fixing adjustable joints on a C-arm used to take X-Rays in the operating room. Evan revived a VERY dead computer by installing a new power source and brought the unit to full working condition. Mallette cleaned a surgical headlamp and later found a way to connect the gas anesthesia to a computer monitor, allowing for safer surgeries.

Becca and Liz investigate the source
of the unstable operating table

Surgeon Juan Jose and Anesthesiologist
Corey observe the ECG on Cat
Britney and Laynie worked on a set of anesthesia vaporizers which they determined to be beyond repair. Later in the afternoon, they joined Becca and Liz who were conquering a difficult project of steadying an operating room table which was prone to shifting mid-surgery. This project also recruited the help of Laura after she placed orders for batteries for a blood pressure monitor and Erica after she worked on a pulse oximeter. Cat worked with Corey on an operating room electrocardiogram in the morning before working on an ESU foot pedal with Britney in the afternoon.

Our team with Jorge (top left), Juan Jose (top middle), and Pablo (bottom right)
With all our projects wrapped-up, we packed up our supplies and prepared to report our work to Odra, our coordinator at the hospital. Odra was extremely appreciative for the information we provided and the work we accomplished. Even when Evan proclaimed, “I fixed it!” while holding up a gutted power source with dozens of colorful wires hanging out, Odra sweetly said, “Thank you” and flashed a kind smile. Later, we were all humbled by the gift of a diploma from the hospital with a picture of our group, our name, and nice words of gratitude. Leaving the hospital, we had to offer more warm farewells to our wonderful drivers/translators Jorge and Pablo and our third translator Juan Jose.
In the evening, we debriefed our projects and had a relaxing night-in with games hosted by our “People Wrangler,” Cat. We were all tired from the week of work and looking to save energy for our ascent of the Pacaya volcano the next day!
(Spoiler alert – we all survived the hike and flights to Nashville)

Friday, March 9, 2012

Thursday 3/8/12

Just when we got comfortable in Pedro de Bethancourt , we switched gears and began our stay in Hermano Pedro hospital. For more information on the history of our worksite for the next couple days, click here: Information on Hermano Pedro Hospital.

Britney's turn for a hug from Mercedes!
A brief stroll along the cobblestone roads brought us to this nearby hospital where we were greeted warmly by Odra Flores. Odra led us on a tour of the hospital and introduced us to some of their beloved extended-care patients. First we met Mercedes, who has a contagious joy that knows no language barriers. She enthusiastically hugged each and every one of us and even gave Danny the customary cheek-kiss. Quickly thereafter, we met Wendy. With our team lined up in a long hallway, Wendy walked person to person, asking "¿cómo se llama?" She was then generous enough to offer her opinion of whether she approved of each name or else a swift "no me gusta" was given. Congratulations to the parents of Catherine, Rebecca, and Laura for choosing names liked by Wendy. We then met a cheery gentleman who took Corey by the hand for a personal tour of several laps of the nearby courtyard. Our last stop was the nursery where we visited babies preparing for cleft-lip and cleft-pallette surgery. This last stop led well into our jobs for the next two days which centered on equipment commonly used for such surgeries.

Corey caught writing this
blog during work hours
Perhaps an ode to our refined reverse-engineering skills, great progress was made on our new set of projects. Corey, Danny, and Lowell installed a new light source in an endoscope thanks to a donation from Smith and Nephew. Becca and Britney fixed the printer on an ECG patient monitor and brought the unit back to full working shape. Evan worked with Mallette on a surgical headlamp then an oxygen/carbon dioxide monitor. Laynie and Liz also brought an oxygen/carbon dioxide monitor back to life. An automatic tourniquet system, ultrasound prope, autoclave bag sealer, and ESU pedal were all found to be beyond repair by Laura, Cat, and Erica.

Roommates Corey and Danny
competed in a contest amongst the
surgeons for the most ridiculous scrubs
In the afternoon, many of us were given the opportunity to scrub-in on a couple hernia surgeries. Corey, Danny, Erica, Liz, and Mallette watch Dr. Hendricks masterfully perform a hernia repair while providing us with a wealth of information on the history of surgery and his Iowa football days. Meanwhile, Cat, Laura, and Laynie watched Dr. Rodriguez perform a similar surgery, who also giving unforgettable lessons in hernia repair surgery. Both surgeons and their anaestesthiologists were serving through Faith in Practice who sends surgical teams 36 weeks per year.
While walking back to our hotel, we followed the music to find a brass band in the city square playing traditional Guatemalan music. Later, we enjoyed the company of Dr. P's Spanish tutor at dinner. To cap off the evening, some of our group found more live music in town and even Salsa danced with locals!
Erica "the model" shows off her Tango skills with a local

Thursday, March 8, 2012

Wednesday 3/7/12 - "A day in the life of Pabs"

Today we experienced the closest thing to a routine we’ve had this week. Once again, we awoke to a spectacular sunrise and breakfast next door. The team was anxious to resume our projects in Pedro de Bethancourt with fresh ideas and renewed vigor. Disclaimer: if you enjoy this blog entry more than others, it is because this entry features multiple guest bloggers filling in for Corey, who spent the day (successfully, at least!) fighting off some stomach bugs. Fortunately, Corey was at the hospital just long enough to see Cat celebrate the opening of her dastardly autoclave! In the end, all it took was 2 days, 6 engineers, half a bottle of WD-40, a crowbar, a giant wrench, a lead pipe, and the biceps of Pablo.

Danny continued his work bringing the Neonatal Intensive Care Unit (NICU) into the future by converting maternal education videos from VHS to DVD. He then worked with Britney in the afternoon repairing hotplates. Lowell also continued his work from yesterday by putting new sensors in infant warmers and Evan worked with Erica on a donation of four suction regulators ready for use in the NICU. Erica also worked with Liz on installing a sound system in the NICU that can be used for music therapy and Danny’s new maternal education DVDs.

Britney and Laynie continued their progress on a few ventilation units also in the NICU. They had to work quickly on their feet since one of their repairs required a baby to be on manual ventilation during their inspection.

Becca was able to finish her project on a custom Bililight and proudly passed along the equipment to Sergio, the chief engineer. Laura worked with Becca on this project and afterwards, as icing on the cake, they repaired a pulse oximeter together.

After a hard day at work, the team was treated to a glimpse into ‘a day in the life of Pabs’ and a private tour of La Finca Filadelfia, a sprawling coffee plantation on the outskirts of Antigua. Pablo, one of our drivers and translators who doubles as a coffee guru, led us through the precise and delicate steps of coffee bean preparation. He walked us through the harvesting of coffee berries by hand, selection by size, pulping, drying on the tile roofs, and shucking of the shells to expose the precious coffee beans ready to roast. The tour was followed by a walk through the luxurious on-site five-star hotel and relaxation outdoors while admiring the picturesque views of the surrounding mountains and volcanoes. The amenities were so tempting that, when it was time to leave, Dr. Walker even momentarily considered ditching the group and staying there for the rest of the week! For those at home envious of our VIP coffee tour, you just may get a little piece of this paradise in the form of Pablo’s hand-roasted and blended gourmet Guatemalan coffee!

Wednesday, March 7, 2012

Tuesday 3/6/12

Looking ahead to our first full day of work, the city of Antigua offered us a beautiful sunrise easily seen atop our hotel. With the sun sneaking up behind the mountains, the clouds and volcanic fumes stole the show with an orange glow scattered about the sky.
After a nice meal at our new favorite breakfast place literally next door, we packed our tools and drove on the cobblestone roads to Pedro de Bethancourt, our hospital for the next two days. There we were given a tour of the facilities and the locations of our assigned equipment we have been researching and studying without ever having meet (online-daters may sympathize best). We found an unused patient room to call our control center and then split up to begin our repairs.

Becca hit the floor running with her custom Bililight she had created before coming. She set up a longevity test of the light and supported a few other teams as a translator. Lowell and Corey installed new fuses in a defunct infant warmer and made progress towards recovering its use as an automated thermoregulator. Danny also worked in the Neonatal Intensive Care Unit on a VCR-DVD writer and successfully soldered a hand dryer in the scrub zone.

Cat encountered her new nemesis – an autoclave that has been jammed shut for years. The day concluded with great hope in the power of WD-40 to loosen the joints overnight.

Although Mallette and Liz would love to talk about their work identifying the root problem with their incubator, I have a hunch they would first want you to know how ridiculously cute was the little Guatemalan boy who blew them kisses. Liz also worked with Laynie, Erica, and Becca on ventilators and saw first-hand the restraints of power availability in the hospital. Laynie also worked with Britney on a ventilator and discovered a hole in the device and the parts needed to perform a repair. Likewise, Laura was able to identify problems with an antique microscope offered the prognosis of retirement.

Our work was energized midday by a delicious traditional Guatemalan lunch prepared by a generous mother of a Shalom Foundation employee.
With the hospital closing down around 4pm, we found ourselves with a couple hours of daylight before dinner to wander the cobblestone streets of Antigua. We reconvened for dinner at a great restaurant nearby. Among many options for entrees, Liz stumbled upon this vegetarian gem that is "perfect with steak."

To cap off the evening, one of the three volcanoes enveloping the city, Santiaguito, hiccupped and gave several of us atop the hotel a brief show. No pictures here to temper your imagination!

Monday, March 5, 2012

Monday 3/5/12

Thank you for your patience! I hope these pictures and stories are worth the delayed post.

Our team at Universidad del Valle
At a bright and early 6am, we began our day before the roosters. After a traditional breakfast of eggs, plantains, bread, and coffee, we set sail for Universidad del Valle (UVG). There we held a mini-conference with three student presenters from our school and theirs. After an inclusive introduction of Nashville and Vanderbilt by Dr. P, team Proto-life from UVG presented their research on a prosthetic hand and elbow. We later had the chance to hold their prototype and were all very impressed! Our very own Danny then led off with a charismatic presentation on his senior design project also focused on prosthetics, but from the angle of quantifying the selection process for a prosthetic leg. A fourth-year student from UVG presented his work on customizing the learning environment to improve attendance and accessibility to online lectures, among many other ideas. Erica then gave an overview of her senior design project which peaked the interest of mechanical, electrical, and biomedical engineers in the audience with a new way to diagnose tuberculosis. The final UVG presentation, given by team Profectus, proposed a wheelchair capable of ascending and descending stairs and automated navigation controlled by the users’ voice. Mallette finished the presentation session by highlighting her team’s progress on a low-resource, smartphone-based endoscope. We were then given a tour of the beautiful UVG campus and advanced engineering facilities. We then relaxed over lunch with the UVG students and were able to learn more about their experiences as students in Guatemala City.

Following our mini-conference, we had the pleasure of being driven by our favorite Pablo and Jorge to the Moore Pediatric Surgery Center. We were given a tour of the facility and a brief history of its role in Guatemala City. If you have a minute, I would highly recommend you to glance through their website to learn more about this unique surgery center.

Lowell and Laura attempt to repair a light
generator in the Moore Pediatric Surgery Center

Before heading to Antigua, we needed to pick up some essential supplies at a quant store, beloved by locals: Walmart. Everything in the Walmart was oddly familiar except for the prices which, after the $1 to 8 quatzales exchange rate, presented us with Walmart quality goods at Ralph Lauren Polo prices. We quickly got back on the road and no sooner did we find ourselves in the jaw-dropping Guatemalan countryside. We wrapped around mountains, valleys, forests, and maybe even some volcanoes. The beauty of the countryside was somehow matched by the beauty waiting for us in Antigua. We are all very excited to be calling this old Spanish colonial town home for the next few days. Once inside our hotel, we found an interior that mirrored the majesty of the exterior.
Our stunning seniors in the courtyard of our hotel

We ended the night with dinner at a (very) nearby restaurant which featured chefs who would prepare salsa and guacamole in mortars at our tables. Laynie, Liz, Mallette, and Corey took on the challenge of a Pollo Fajitas platter suitable for a family of kings.

We couldn’t make it a single evening in Antigua without a quick walk around the central square, where we stumbled upon a picture which ought to be your new desktop background for the next few weeks.

Sunday, March 4, 2012

We have arrived!

Dear loved ones,
Rest assured; we have arrived safely in Guatemala City! All students showed up on time to leave Vanderbilt and the flight to Dallas was exceptionally easy. Eerily easy, some may say. The turbulence flying into Guatemala was noteworthy, but the adventure started upon arrival. With our faces glued to the windows, looking at the sprawling city, Evan pulled a quick joke about leaving his passport on the plane.
A joke, right?

Nope. Evan and Corey rushed back to the plane to beg an airport employee to go to seat 28A on the plane that just landed. With minimal confidence, Evan returned to customs empty-handed. Our fearless leader, Dr. P, stayed behind while the rest of the team casually passed through customs and hoped for the best. An appropriately dramatic length of time later, Evan and Dr. P emerge triumphantly.

Crisis averted, we pass through the second stage of customs and meet our Shalom Foundation heroes, Claudia and Tommy. They led us all safely to our cozy hotel for the night.

Mallette, Danny, and Erica will be presenting their research at Universidad del Valle bright and early tomorrow morning. We look forward to our first day of work and beautiful Guatemalan sunshine.

Until then!

Thursday, March 1, 2012

Final Preparations

Danny practices his presentation to be given at the Universidad del Valle
A mere two days from now we will be flying to Guatemala City to begin our Service Learning experience!

We have researched our assigned medical equipment and are prepared to troubleshoot and repair on-site. We have acquired service manuals, donations, and Becca even designed a new Bilirubin light! With our bags packed, we are excitedly looking forward to putting our freshly refined tinkering and Spanish skills to work.

After a late flight Sunday night and an early rise Monday morning, we will have a mini-conference with students at Universidad del Valle and work in the Moore Pediatric Surgical Center in the afternoon. Then we will drive to Antigua where we will be working at Pedro de Bethancourt Hospital and Hermano Pedro Hospital for the next few days. On Saturday, we will take a mini-vacation by hiking the Pacaya volcano and gift shopping for loved ones (by reading this blog, your chances of a gift are at least tripled!).

We will keep this blog lively, colorful, and active with daily posts. Please feel free to leave comments! We look forward to sharing this experience with you as we learn more about the culture and healthcare system in Guatemala City and Antigua.