Peru Day 2 - Clinic

"Mr. Anderson"

A full, chaotic, fulfilling day.  If you read my earlier posts I stated that I hate writing "diaries", that I really NEED something - an event to write about, to say something significant.  The problem that I am having now is that so much is going on, I want to say soooo much, that I have to narrow down what I post or else I will be up all night and too this point, I really have been up most nights working, dining and then blogging.  There are so many stories to tell, and I have only been here two full days. 
Today was our clinic day.  The word had been spread throughout Peru that there was a plastic surgery mission going on.  That the Americans were in town to "fix" cleft palates and cleft lips".  So when the team arrived at the hospital this morning there was a line of people waiting to be seen.  We hadn't even set the clinic up yet.  Each of the four surgeons, their nurses and anesthesiologist needed to set up their exam room, there was a room to take vital statistics a room for the pediatric nurses and doctors to conduct exams, the intake and waiting room, the dental room etc, etc, etc.  Some were there for the most simple of plastic surgery procedures; to to get rid of that tell tale sign of what was a cleft lip or palate surgery, that small scar on the lip or to repair some of the most severe clefts like the bi-lateral cleft lip and palate.  From 3 months old to 36 years old they came from miles away to be seen and to be "fixed".  There are so many stories to tell, but one truly melted my heart - his name is Anderson and he is 6 years old.  Anderson has fused hands and feet.  His toes are fused together, but he appears to walk just fine, his fingers are fused together so his mother has to feed him among other things that she has to tend to. He also has cranial deformities.  What is it about Anderson that touched me so?  Okay, I will admit the fact that he took the "fighting Duck" sticker that I gave him and then stuck it on his forehead and gave me the funniest face ever probably endeared me to him forever.  But he was such a clown and so happy.  His mom just really wants him to be able to do more things on his own.  There is a lot of work to be done on Anderson, but it simply cannot all be done in the short amount of time we are here in Lima, but "Dr. David" is going to do the best that he can to improve Anderson's (and his mom's) quality of life.  This Friday "Dr. David" will do a skin graft on Anderson, taking skin from his hips and give Anderson thumbs and perhaps pinkie fingers so that he has hands that he can work with.   Perhaps when Anderson has those working thumbs I can come back and teach him how to hold up both of those hands and give a big Oregon OOOOOOOOOOOOO.  One day.

Amy

The other story that touched me today was that of Amy.  Amy is five months old she has a bi-lateral cleft lip and palate. She is such a good baby and barely made any fuss as she was poked and prodded.  The problem is that we will be unable to perform surgery on Amy because she is "underweight" for her age.  But we were able to do is something as simple as placing tape or "steri-strips" across her upper lip; this will stay on for a few weeks and help to bring the upper lip together and prepare Amy for next year when she is older, weighs more and can have the surgery that she deserves in order to better her quality of life.

In all 76 patients were processed through the clinic today.  Not all of them will have surgery over the next two weeks, but many of them will.  Every moment I learn something new.  I must thank the doctors and the nurses who have taught me so much in such a short amount of time.  I love when the doctor says to me, "hey Joelle, come take a look at this", then shines the flashlight into a kids mouth and proceeds to explain to me what a bi-lateral cleft palate or a partial cleft palate, full cleft palate or what hyper-tuberism is.  I love that I can ask questions of them and get an answer that I can really understand.  We are 26 individuals that have been thrown together and we are becoming a team in very short order.  Becoming a team that is changing the lives of some of the most vulnerable individuals. 

End of the day.  Part of our very tired but silly team.

If all goes well tomorrow we will begin with surgeries.  The hospital decided to renovate the operating rooms and as of 8PM, they were still putting the finishing touches on them. We will be up early heading to the hospital and preparing the ORs for surgery.  As always the last thing I did today before leaving work, was to count the boxes, the first thing I will do tomorrow is....count the boxes.  36 is the magic number.

Meet Baby Luis

Baby Luis and his Parents

For the Love of a Child

The team arrived at the hospital sometime after 9:00 AM on the 10th. The first thing to do was hold a "press conference" the local Rotarians really wanted to publicize this cleft palate/lip clinic, to get the word out to as many people as possible, so that we could take care of as many people as possible in the short amount of time that we have.  TV PERU in HD was there to interview our Mission Director Tom Fox and the hospital administrators.  They also spoke with the parents of one of the prospective patients - Luis.  I wasn't sure what my reaction would be when I actually saw one of these babies with the cleft palate, I had never seen it before (other than on those TV commercials with Sally Struthers) and prayed that I would not "freak out".  But how could I, just like any baby, he was cute, cuddly and had the sweetest eyes.  Meeting Luis made me understand even more why we are here and why what we are doing is important.  As I learned in a fascinating class today provided by one of our surgeons "Ron"; having a cleft lip/palate holds a huge stigma for the person with it.  They can be shunned by family and strangers, some are literally and figuratively "kept in a closet".  I can't imagine that baby boy being hidden away from the public eye for something that he has no control over.  I also learned that in folklore it was believed that the cause of the cleft palate/lip was thought to be caused by a pregnant woman being struck by lightening or being near lightening.  Another thought is that if a pregnant woman walked past a rabbit  her baby would come out with a "Hare-lip" and now you know where that phrase comes from.  We also learned that the cleft lip develops in the first 12 weeks of pregnancy and most likely comes from hygiene issues, or some toxic insult to the mothers system in those first few weeks.  After the interviews were done, the hospital administrators thanked us for being there and kind of sort of made a "toast" to our arrival.  I thought it was going to be this great ceremony, a couple of young women entered the room with cups of a clear sparkling liquid.  Champagne?  No.  Sprite.  We all stood there with our cups of Sprite waiting for someone to propose a toast.  It never came.  We through back our cups of Sprite and headed out the door.  (Insert awkward moment music here)
Our morning was marred by the theft of one of our team members backpack.  When we arrived at the hospital we stood around waiting for the hospital administrators and the TV crew, while we waited we took pictures of the sprawling hospital grounds.  James put his backpack down right behind him to take a picture, in the time that it took him to shoot a couple of photos and then turn around the backpack was gone.  Thank goodness there was nothing really valuable in the backpack, it was a valuable lesson to everyone of us.  James was a  real trooper about the whole situation.  Later in the day he and I took off into Lima so that he could buy a new backpack.

That's right about where the backpack was taken

There was lots of advertising for the clinic

Getting There

The team at the Miami airport

So many things have happened in the last 24 hours, one of those things is NOT sleep. We arrived at Jorge Chávez International Airport after 10:00 PM Monday the 9th. With 26 souls and 36 boxes to go through customs it was going to be a very long night. We all made it through immigration without a hitch. Then we went to pick up our 1 each suitcase and the 36 boxes of supplies. I could give you all of the dirty little details of customs checking all of our boxes, but I am exhausted and it would take to long. I will say that they opened 10 of our 36 boxes, and really did a thorough check of what was in them and we thought that we were on our way....but then the man with the clipboard, collared shirt and tie came by and decided he needed to check some boxes too. I became slightly irritated at this point and was ready to go "sistah" on him, but since I don't speak Spanish goin' "sistah" on him would have only served to have made our night even longer. He probably would have said, let's put the crazy Black American woman in jail or something. So, I bit my tongue and waited while he did his cursory check of a few more boxes. We were met outside of the airport by our Rotarian counterparts from Peru, 2 buses and a truck for the boxes. As the "quartermaster" for this mission it is my responsibility to keep track of those boxes and their contents....oh did I tell you that at customs I had to sign my name on about 5 million documents AND they took my fingerprint! OK maybe I didn't sign my name that many times, but they did take my fingerprint. CREEPY. While the rest of the team climbed on the buses to head to the hotel I road with one of our Peruvian Rotarians to the hospital to off load and once again count the boxes.....36 boxes once again accounted for. This was my introduction to the hospital Hospital Nacional "Arzobispo Loayza" - 2AM, walking into a single story building that looked to be at least 50 years old, a ward of patients, men, women and children in beds lined against the walls suffering from various maladies, it was completely surreal.  I finally made it back to the hotel at around 3:30AM. Must count the boxes, must count the boxes... My wonderful roommate had my first ice cold Peruivan beer waiting for me

and a bottle of water. Then it was off to bed, for about 4 hours of sleep.