From the Desk of the CEO of Sharp Memorial Hospital

This week I am incredibly inspired by a beautiful story of community that spans from San Diego to Guatemala. This story begins with a group of difference‐makers that decided to transform health care for patients in Guatemala. Many of your SMH colleagues, led by Dr. Greg Imler and Crystal Rubin, created a medical mission opportunity that brought care and hope to those in the most desperate of situations. Their compassion and clinical excellence provided services for hundreds of people, many of whom thoroughly walked for days to reach this mission clinic. Their generosity yielded health for this community and hope for a new future. The story of Marito begins with a young child that was born blind. During their medical mission in Guatemala last month the team came to learn of Marito’s needs. While caring for countless others, they found the time to raise the money necessary for an eye transplant that may help Marito gain his vision. Just this week, the team that so generously gave of their talent and their treasure learned that Marito’s surgery was a success and he can now see for the first time! Through this surgery, this family’s life will forever be changed and was only possible because of the genuine desire to help others.

Inspire as a vision, inspire as a motto, inspire as a way of life!

Tim Smith,

Chief Executive Officer

Sharp Memorial Hospital

In Guatemala, a Comadrona is a traditional birth attendant with little formal education or training.  They usually have very few supplies, difficulty transporting patients during an emergency, and oftentimes work in unsanitary conditions.  In Guatemala, Comadronas who have little or no formal education attend 80% of all childbearing indigenous women.  Guatemala has one of the highest maternal mortality rates in Latin America, with national figures reported to be between 156 and 270 deaths per 100,000 live births.

The Comadrona Project with Helps International works to reduce infant and maternal mortality in rural Guatemala through the training of these traditional birth attendants by midwives, obstetricians, and/or nurses.  These trainings take place in the Comadronas’ communities and use visual and participatory curriculum to teach healthy birth practices and emergency response.   The Comadrona Project is undergirded by the belief that training the traditional birth attendant in Guatemala, where the vast majority of births are attended by unskilled providers, remains a necessary component of decreasing maternal and infant mortality in this region.  The emergency methods we teach are critical to survival until the woman and/or baby reaches a referral facility.

In October of 2011, a Comadrona Training Team made up of Five Iaomai volunteers and led by Dr. Stephen Hebert came to Guatemala to train 11 Comadronas in Huehuetenango during four days.  The year prior, a smaller Iaomai team had met with these same Comadronas and gave a brief training during two mornings.  We saw the need to extend the training to be more detailed and complete so Dr. Hebert worked hard during the past year to organize the training and find donors that would give materials for the Comadrona birth kits.  The 11 Comadronas that we trained varied in age from 15 to 65.  We had 3 generations of Comadronas: Grandmother, Mother, and Daughter.  Esterfina was the oldest most experienced Comadrona in the group and her granddaughter Nayeli was the youngest and has not yet attended a birth.  It was amazing to see these 3 generations of Comadronas with such pride and passion for their profession.

Normally, the Comadrona team would travel from the Military Base in Huehuetenango to the Comadronas’ community; however, Dr. Hebert had slipped a disk in his back and was advised not to travel on bumpy roads for long periods of time.  After talking with the Comadrona coordinator, we agreed to transport the Comadronas each day from their community to the Military Base and back.  In order to get to the training, most of the Comadronas had to walk anywhere from an hour to two hours to a river.  This river is big and deep and there is no bridge for vehicles, just a small footbridge.  From the river, Erin Treinen, Helps’ Preventive Health Program Coordinator, would drive the Comadronas 30 minutes to the MilitaryBase.  And in the afternoon, she would drop them off at the river to begin their long trek home.

Our training began on Tuesday morning, talking about what the Comadronas had experienced during the past year with their patients: how many complications they had seen, how many transports they made, and what materials were useful.  After a long discussion and some icebreakers, we talked about preparing the birth area and sterilizing equipment.  We watched the Helps International Comadrona videos on preparing for the birth.  After that, we simulated the process by washing our hands and sterilizing the equipment, step by step.

 

 

 

 

 

 

 

 

 

 

 

 

The following day we had Beth Muser, RN specialized in neonatal resuscitation, train on stimulating the baby, mouth to nose/mouth resuscitation, feeling for pulse, and compressions.  We watched the Helps International Comadrona video on Helping Baby Breathe and then simulated the process with the Comadronas.  Beth had brought a CPR baby simulator so the Comadronas were able to practice all of these techniques on the baby.  They also learned how to feel for the pulse and to recognize a normal and abnormal pulse.

On Thursday, the training focused on complications.  First we discussed warning signs during pregnancy focusing on bleeding and symptoms of high blood pressure.  We then talked about blood loss and used “bloody” towels to demonstrate normal and excessive blood loss during the birth.  This demonstration was very impactful because the Comadronas really understood how much blood is too much by seeing the amount on the towels.  We also touched on retained placenta as it is one of the most common complications in the area.  After lunch, we took a field trip to Casa Materna, a clinic for pregnant women nearing their due date that are high risk.  The clinic has beds for women to stay for up to weeks at a time.  Casa Materna has nurses working around the clock and doctors who do consults during the day.  It is located right next to the National Hospital so when the women have dilated 4 centimeters, they are transferred to the hospital to give birth.  Many Comadronas knew of Casa Materna before but had never visited so they found it beneficial to have a tour and ask questions about services provided and cost.

The last day of our training we had all the Comadronas come to the hospital for a medical consult with the Iaomai team.  After each Comadrona was seen, we had a celebratory lunch in which we all thanked each other for our efforts and participation.  Then we had a “graduation ceremony” in which the Comadronas were given a diploma, a group picture, and their backpack filled with materials for attending births.  The birth kits included: scissors, bulb syringe, towels, gloves, soap, nail brush, floss, plastic tarp, baby hats, bleach, container for storing sterilized instruments, and a poncho.  The training group and the Comadronas were very happy with how the week went and we look forward to visiting with them in 2012.

By

Erin Treinen

Coordinadora de Salud Preventiva

HELPS International

 

As pastoral support for the team in Guatemala, I had the privilege of praying for many people. One of my favorite situations however, came unexpectedly. I was working in the clinic, where all of the patients filter through.

The clinic was very busy all day long with many patients needing to see the doctors. I was tired and frustrated, but worked very hard at not showing it. Then all of the sudden a entourage of men in camouflage came walking through the clinic.

Sure enough, the guy in charge comes right up to me, and says through a translator, “you’re the guy I see praying for people.” I introduce myself to him, and he asks me to pray for him. Feeling this overwhelming sensation from the Holy Spirit, I prayed for him, his soldiers, and his country.

When I was finished, he said that now he wanted to pray for me. It was a beautiful prayer that I will never forget. And as he finished his prayer in Spanish, he said in clear English, “In Jesus’ Name!” What made this situation even more special is that I found out that this wasn’t just a soldier, but the General of the camp.

By

Rev. Tim Neisler

 

 

 

 

 

 

 

 

 

 

 

 

The Iaomai Medical Ministries group included a team to treat patients with cleft lip and palate and other facial deformities.  The team included 4 surgeons, 2 anesthesiologists and a nurse.  Their task was to change the way these patients looked, functioned, and felt about themselves.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

One patient, a 36 year old male, had his upper lip revised while his wife waited anxiously in the waiting room.  He told Iaomai volunteers that he always felt he was ugly and hoped that could be changed.  When he came out, she saw a face that was totally different.  This patient’s change of face was welcomed by his wife and she could be seen smiling often at the bedside.  The most amazing moment was when the patient was given a mirror. His face lit up, hopefully putting behind him all thoughts of being ugly.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This story could be retold over and over as the days passed.  Children with clefts would come in with only the perspective that the mirror showed them.  Many of them had also been the objects of jokes because of the way they spoke.  After these surgeries, the reflection in the mirror is going to present these patients with a whole new way of being seen and hopefully they will be able to express themselves in a way that is much more understandable.  It was the goal of this team to provide these patients with a new way of life.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Over the first 4 days of the trip, there were 6 cleft lip surgeries, 21 palate surgeries, and 2 special lower lip surgeries on patients with vascular birthmarks that provided a 11 year old and a 23 year old man with a new appearance and hope.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The swelling will still go down more as the lip heals.

 

 

It has been a joy and privilege to serve with this team and our small part in the big picture was a major blessing to all of us on the facial plastics team.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This little boy had a palate surgery which will help him eat, breath and talk better. He still needs to have his cleft lip repaired, this is why we continue to return each year to Guatemala.

By Dr. Lisa Buckmiller