We had a full day scheduled for Sunday. I was up early enough to sneak in a run, but I wanted to keep it short as there was a hike scheduled for the afternoon.
At sunrise every day (6am) a pair of very loud birds woke us up with a weird hooting sound (at first some people thought it was monkeys). They sat in a tree in the courtyard and I got some photos of them but they were all black, average-sized birds so really no way to identify them. A few times I tried to record their call (the Cornell University bird app will identify based on audio) but they always were quiet when I had video going and then as soon as I stopped they would chirp/hoot away. There was a waning half-moon the first day we were there (oriented up/down at the equator versus right/left at home) but it was a little overcast the next few nights and soon gone. In the daylight, I could appreciate how big the Moscoti Center was.
I had promised my family I would not go on any adventurous runs on my own (jeez, I got lost ONCE in an African jungle and they won’t let it go) so I planned to stick to the dirt roads of the ranch and not the paths. As it turned out Matt (the PT) and Steven (a Podiatrist from Long Island) joined me on the run so I had a full medical support team in case of any running injuries! While talking to Steven about being from Great Neck I mentioned I had just been in the city 2 weeks ago running the marathon with Alex and he had ALSO run it. He had entered the lottery for the Berlin Marathon for next year and liked my Berlin and London marathon tattoos. I had saved an image of the NPH map and had also downloaded the Google map of the area so I could use the app even with no cell service (which there rarely was on the ranch and usually just barely enough to make a phone call or simple text).
We ran at a “chatting” pace. I was amazed at how much infrastructure there was. We saw lots of cattle and dairy cows, a few horses, and several cute cats.
After stretching I “tested” one of the hammocks. VERY comfortable.
Breakfast was a delicious buffet. My “no carne” meal was in a styrofoam box (so unrecyclable!). We had papaya, pineapple, and watermelon a lot but never saw a banana for some reason. We had 24-hour access to coffee/tea/cocoa, soda, and snacks at the outdoor kitchen in the courtyard. Eggs and chicken were farm items they did not produce themselves anymore, it turned out that it was costing more to maintain a chicken flock than just buying the products.
At 9am we assembled outside and were led to the surgery center. Rather than walking on the dirt road we used the nicer cement paths that go all over the NPH campus. I imagine in the rainy season they are MUCH preferable to walking in mud everywhere. It was a half-mile walk to the surgery center (mostly downhill on the way there), and bridges crossed two streams.
We started in the clinic’s very nice chapel. There was also a chapel at the Moscati Center and an actual church with an outdoor amphitheater on the campus. Both NPH and One World Surgery had a strong “catholic” message but I don’t think there was any actual connection to Rome. The mission team was certainly of all (or no) faiths. We got a brief talk on the history of One World Surgery. The link below has the complete story but basically, Dr. Daly (Minneapolis, Orthopedic Surgeon) and his wife volunteered at NPH Honduras in 2003 (not as medical professionals, just regular volunteers) and then took home an orphan for a year of surgeries that could not be done in Honduras. They then got his Summit Orthopedics group in MN to support a project to form a charity to build a surgery center on the NPH Honduras site. Later the SCA surgery center corporation (later acquired by United Healthcare) became involved and then Optum Health (the physician employment arm of United now with 90,000 MDs nationwide).
Nuestros Pequenos Hermanos has 9 sites in Latin America. The Honduras site is the largest. The site in the Dominican Republic has had a One World Surgery primary care clinic but will also be opening a surgery center next year. The link below has lots of info about them but basically, it started in 1955 with one priest in Mexico and has grown over the decades to a huge charity trying to improve the lives of orphaned, abandoned, and abused children.
We then had a general orientation by the local staff of the medical facility which included 3 operating rooms, a procedure room, a very large primary care clinic, a pharmacy, and even a clinical laboratory.
More about him later but I had the pleasure of giving anesthesia for for one of Dr. Merlin’s cases. Juan Carlos (JC) was infinitely helpful to everyone on our mission. After the general info about the clinic and its policies, we broke off with the Surgical staff heading to the ORs, the primary care people to the clinics, and the general volunteers to learn about their duties. I knew the anesthesia machines and monitors were decent as I had been sent information about the anesthesia workflows with photos of the ORs (the machines were less than 10 years old versus the 40-year-old one I used in Fiji). There was a Glidescope video laryngoscope and an excellent ultrasound machine for nerve blocks (I had brought my handheld one that works with my iPhone but never had to use it). One of the OR managers had brought her daughter with her (as a Sunday there were no patients in the clinic). I practiced my Spanish, asking her name and age, and then seeing she had a smiling shark on her shirt asked how to say Shark in Spanish (Tiburon). She liked the photo of me wearing my shark hat for the NYC marathon last month. Everybody down there liked my sea turtle (Tortuga Marina) earring.
We looked over the operating rooms, pre-op, and post-op areas, and Looked over the supply areas and what was in various drawers in the anesthesia machines and carts. We found a staffing schedule for the week.
It was hard for me to keep track of even just the anesthesia staff as the other four were all women and once wearing masks and hats it was hard for me to keep them straight. And the schedule didn’t list Theresa Bowling and Marcia Bergen’s first names. There was a surgery schedule for Monday and ….. surprise…. the first patient in room 3 was only 6 years old. Luckily I noticed so Aliya (CRNA) and I could prepare the room in advance. After orientating ourselves as best we could we all trickled back to the Moscati center for lunch.
After lunch, there was a tour (mandatory for those here for the first time) of the NPH ranch/campus led by two of the staff.
I took notes on my iPhone as I knew I would not be writing anything until back in Florida. On the tour, we stopped at lots of the buildings and were told more details about the history of NPH and One World Surgery. After a few stops, I was a little bored. Normally on group tours I wander off and take photos while the guide talks but felt that would be disrespectful in this case. This blog entry is already getting long though so I will sneak in all the stuff I learned in other entries (I imagine the surgery day ones will have less content).
NPH has a volunteer program where young adults from all over the world (South Africa, Europe, US currently) commit to volunteer for 13 months. They get room and board and some time off to travel around Central America.
They also have a building that houses needy elderly people who act as “grandparents” to the orphans. This is a great idea!
I was so excited to meet Panther (one of three dogs on the ranch). He joined us for the rest of the tour, even coming into the girls’ residence where he tried to sneak off with a girl’s flip flog! Just like Fifa. Several other volunteers also took lots of photos of Panther, clearly already missing their dogs at home, like myself.
The young girls’ dormitories had nice grounds and one of the many amazing outdoor play areas. The girls and boys were housed on opposite sides of the campus. We went to a pond (one of 4 dammed reservoirs on the property ) where we were told the children could swim but it looked pretty stagnant and muddy to us.
At the farm we saw the livestock and vegetable gardens, the pigs smelled awful.
NPH allows the kids to stay until age 18, if they go to college it is paid for as are living expenses. For those who aren’t college-bound, they have a big vocational facility that teaches everything from electrical and mechanical to hairdressing. Local teens from the nearby villages are also allowed to attend the vocational center.
After the tour, we were back at Moscati and then there was the option to go on a hike. I had a quick snack of Coke sin Azucar and cookies.
Dinner was another delicious traditional meal and afterward we had a lecture about the history of One World Surgery (which was a little repetitive after all we had been told already).
