February 24, 2006

Team’s Guatemala mission a success, on many levels

Featured Image

LaDonna Reyka, R.N., worked as a recovery room nurse during the Guatemala surgery trip. One of the patients she cared for was 16-month-old Christofer Davila, who is being held by his mother. He needed surgery to correct undescended testicles.
Photo by Susan Kohari

Team’s Guatemala mission a success, on many levels

Jay Deshpande, M.D., examines 16-year-old Elio Donis in Guatemala. 
Photo by Susan Kohari

Jay Deshpande, M.D., examines 16-year-old Elio Donis in Guatemala.
Photo by Susan Kohari

A team of 14 surgeons, doctors, nurses and staff members from the Monroe Carell Jr. Children's Hospital at Vanderbilt recently returned from a weeklong surgical trip to Guatemala.

The team screened patients and performed 35 pediatric urologic surgeries on children at San Sebastian Hospital in Guatemala City from Feb. 5 to 11.

Children's Hospital partnered with The Shalom Foundation, a Middle Tennessee-based non-profit humanitarian aid organization, and the Guatemalan Pediatric Foundation, a non-profit based in Guatemala that provides health services and helps coordinate international medical missions and trips.

The groups plan to continue their partnership and Children's Hospital has committed to participate in other surgical trips to Guatemala in the future. Guatemala was chosen to be an official Children's Hospital surgical trip location for several reasons.

The groups that Children's Hospital are working with are well established and have many resources in the area, according to John Brock III, M.D., surgeon-in-chief of Children's Hospital and director of the Division of Pediatric Urology.

The country is poverty-stricken and its children have among the worst growth rates in the world due to rampant malnutrition and lack of quality medical care. The country's population is 14.2 million — half of which are children under the age of 18.

“Every one in the group had an integral part in making this trip work,” said Brock. “It was incredibly well organized and I can't imagine it going any better. We are indebted to The Shalom Foundation, the Guatemalan Pediatric Foundation and every member of the team.”

Brock and John Pope IV, M.D., assistant professor of Pediatric Urology, have made several surgical trips to Guatemala in the past.

Many of the surgeries they performed were on children much older than those who might receive the same procedures on in the United States. Limited resources and lack of specialists cause many children to suffer with defects and conditions that normally would have been corrected much sooner in the United States.

Specifically with Shalom, Children's Hospital has committed to help create sustainable programs to provide health care services, educate the community on health issues, provide staffing for surgical trips and share technology and information related to advances in health care in the country.

In the coming years, elective international rotations for pediatric residents and nurses from the U.S. may also be offered.

“The trip was an excellent experience for all of us,” said Jay Deshpande, M.D., director of the division of Pediatric Critical Care, who served as an anesthesiologist during the trip. “It was incredibly fulfilling emotionally and it was a rewarding and eye-opening trip. We are really fortunate and take a lot for granted (here in the United States).”

The inaugural trip required months of planning. Two preliminary trips were made to Guatemala. Children's Hospital staff members and Shalom Foundation representatives participated in a fact-finding tour and met with the Guatemalan Pediatric Foundation.

Susan Kohari, Children's Hospital Web coordinator and project manager for international services, was on that trip and also toured the hospital that Children's Hospital would use to perform the surgeries.

“It took a tremendous amount of coordination,” Brock said. “It was a real highlight to see people who have never done this before pull together. We really got back to the basics of why we do medicine.”

Children's Hospital had to bring virtually all the medical and operating supplies they would need to perform procedures with them from home. Before their arrival, Lori Graves, R.N., a charge nurse in the Children's Hospital Operating Room, spent three weeks packing supplies, often coming in on weekends and working long hours during the week.

Graves received donations from several areas of the hospital, and filled 26 crates to the brim with items as small as gloves to as large and expensive as two operating room lights. She even packed Champ dolls to give to each of the patients.

“We took everything with us and I am glad we did. We needed it all,” Graves said. “This place was very poor and they really didn't have much for resources.”

The team said the patients they helped left a lasting impression on them. One mother traveled eight hours by bus with her 8-month-old baby who needed a procedure. After the surgery, she made the long trip home with her child.

The Pediatric Foundation, who pre-screened patients for the surgeries, charges a small fee that is income-based to help subsidize their efforts. The mother of a teenager needing urologic surgery was too proud to tell the organization the family's real income level, so she said the family made more money and was asked to pay about $70.

Her 16-year-old son, who was a child laborer, saved up money to help pay for his surgery because the family couldn't even afford the small fee. When the foundation learned of this, the charge was adjusted.

“All the kids tugged at our hearts,” Deshpande said.

Added Brock, “I am truly indebted to the many outstanding people who gave so much of themselves to make this mission a successful reality.”


Michelle Barnes, M.D., anesthesiologist

Donna Beller, R.N., operating room nurse

John Brock IV, M.D., surgeon

Jay Deshpande, M.D., anesthesiologist

Lori Graves, R.N., operating room nurse

Eileen Griffin, R.N., nurse anesthetist

Susan Kohari, international services project manager

Will Lowrance, M.D., resident

Carolyn Maness, R.N., operating room nurse

Jeffrey Miller, R.N., operating room nurse and interpreter

Siam Oottamasathien, M.D., fellow

Amanda Pilkinton, R.N., recovery nurse

John Pope IV, M.D., surgeon

Ladonna Reyka, R.N., recovery nurse