Mission - 2nd Stop - Cebu

 The second week of the mission trip was planned quickly and added to our itinerary in order to help some of the victims of Super Typhoon Hayian.  As most people know this typhoon hit last November 8th, killing over 6,000 people and affecting over 14 million.  Those numbers are staggering to me when you think about the geography of the Philippines.  It consists of over 7,000 islands, but only a few are able to accommodate any number in the millions of people.

Even though our group has shrunk to 21, we packed lightly because we had lots of supplies and meds to carry.

The enormous Manila Ninoy Aquino International Airport won my heart over when they had hundreds of televisions inside, all playing U.S. NBA basketball.  Whaaaaa?  I quickly figured out that during the rest of the trip when I needed to communicate with a local or even a child, all I had to do was start talking about basketball.  I even caught a couple of Thunder games!  
  We board, and we are all sitting together at the back.

Here is one of my "take-off" pictures.  I can't help it.  I shoot pictures out the window of planes everywhere I go.  Until I am interrupted by this... an announcement.  "We need a doctor!  Is there a doctor on board?"  I am sitting near about 5 or 6 doctors, and they all look at each other like, "are you going to go?"  "I don't know."  "Do you want to go?"  

Dr. Sharma (yellow and white) receives the hero award, because he gets up first, and heads to the front of the plane where the small commotion is occurring.  Yvonne and Christine follow.  Everyone is quiet.  We can't see the patient or any action, other than people talking.  The cute gray headed lady is a well-renowned dermatologist who is with our group, and she was the first to get there.  I guess she was sitting closer, and we didn't see what was happening.  It turned out that a child was experiencing a febrile seizure.  This sometimes happens in children who are younger and have a high temperature.  Usually non-life threatening or unlikely to cause permanent damage, they are treated with acetaminophen and the child is kept safe and slightly restrained so they don't hurt themselves.  This type of seizure lasts a few minutes or less.  Upon arriving in Cebu, we were all escorted off the back of the plane, so that emergency personnel could come quickly in the front.  Later, Christine and Yvonne made the comment that, "doesn't this happen nearly every time we get on a plane?"  All I could think of was, well, I want to be sure and be on a plane with a bunch of doctors if I am going to have some kind of medical emergency mid-air.  I haven't even started talking about Cebu and our experience there.  It was a wild day just getting there.  More to come.

Mission - 2nd Stop - Cebu

Nope

No, you didn't miss it.  There is no post today.
Maybe tomorrow.
:)

Nope

Vague Vacation Verbage

On the way back from the Philippines, I convinced the farmer to meet me in Hawaii at the usual spot.  I think we had the best time EVER.  So relaxing.  And just fun and relaxing.  I'm throwing a few pics at you today because it is my mom's birthday, and they are coming over for dinner. 

First, you know I am unimpressed when I see this.  Please don't touch it!

So you can imagine that I am equally impressed when I see the same treatment of the kleenex.  Okay, no more complaints.  This is supposed to be paradise.  I wanted to show you that nowhere is perfect.

Daily drink combination that started at lunch... this was our favorite place.  Look at our feet...

Okay, his feet - mine missed the foot selfie.  But don't his feet look great?  It's due to that pedicure that he gets, but denies getting, everytime he goes out of town.  Maybe not everytime.

 

Well, look who bought 4 bikinis on this trip.  The girl who will only wear them in front of strangers.  Here's one.  Oh?  You can't see it?  Dang.  You probably won't see the others, either.  I think it was some kind of pre-grandparent rebellion.  Mike had some kid working in a store tell him what a legend he was since he was wearing some old limited edition something or other board shorts.  Believe me, Mike never set out to buy any limited edition board shorts, and if he did, it was totally by coincidence.  He puffed up and fist bumped the guy.

Spoiled, yes.  Fully rested, yes.

Vague Vacation Verbage

He Didn't Tell Me 'No'

Since the day I observed the first cleft palate and cleft lip surgery, my mind has been running the gamut of how to describe to you what I saw and felt.  Previously, I mentioned Dr. Gamy, the plastic surgeon who performed all the cleft palate surgeries.  These pictures shouldn't be very gnarly, but don't look if you think it will bother you.  Dr. Gamy was only with our group for the first week of our mission, but during those few days, the number of lives he dramatically changed cannot be counted.  To say a number of surgeries he did would be guessing, but the children and family members surrounding those kids will forever be changed.

There's an in-detail story on the medical-mission.org website about one of these children, Jayden.  I was standing right by Rommel, who wrote the blog post about Baby Jayden.  I could feel the massive impression that it was making on Rommel since he had undergone that procedure many years ago.  We both stood side by side, never spoke, and I think we were barely breathing.  I wasn't sure where his head was, so I said nothing.  It was a highlight for me to be able to go in and observe surgeries like this with my medical background - none.

Here is the operating room I told you about where they were able to perform more than one surgery at a time.  There's Dr. Manny in the center back - he is handling both anesthesia applications.  This is an unusual situation, but it shows you that this group did everything they could with whatever they had.  That is the mantra I heard from members of the team over and over.

Prepping this little girl for surgery... she was calm, or maybe that anesthesia was kicking in...

Here's a close up look at the case.  It is a single cleft palate and lip procedure, and Dr. Gamy tells me there is nothing uncommon about it.  After watching several of these surgeries, they all look totally and completely different to me.  I can assure you, this is not something I see everyday.

Dr. Gamy is very capable and usually prefers to work alone.  He likes to grab his own tools.  He likes to move the light to the perfect place.  He moves quickly and smoothly.  This local nurse/or resident, has no idea how lucky he is to be standing there learning from the master.

It is a bit hard to see exactly what is happening here, but it is shortly after the procedure started.  

This is still part of the "release," as Dr. Gamy explained it to me.  I was told there is no cutting.  Gosh, I have a lot to learn.  Some of the most interesting things that I learned about myself during watching all these procedures and surgeries involved the lack of any "ick" factor.  Nothing bothered me.  Nothing made me want to turn away.  I never felt nauseated.  I wanted to see more.  I wanted to watch more.  I wanted to hear and understand more.

In fact, as the days progressed, I would have team members approach me and ask me to go "work some magic with Dr. Gamy" to see if we could fit in 'one more' surgery.  He never told me no.  He would say, "what do you have?"  I might say, "she's a 9 month old with a double."  He would follow me out front to do a quick evaluation.  He never told me no.  One of the most touching stories was a patient who had a cleft palate and cleft lip.  After his initial exam by one of the doctors, it was determined he had a heart murmur, and that meant he would not be a candidate for surgery to repair his cleft palate and lip.  He was being shown the door when I saw this child with a cleft palate and cleft lip heading outside, instead of down the hall to the operating room.  I felt a tug.  I went up and asked them where they were going.  When they told me they were leaving and why, I said, "Can you hang on just a minute?"  They stood perfectly still.  I said, "Please wait here."  (This is where not knowing what is going on can play to your advantage.)  I broke into a full-out run toward the back of the hospital where the operating rooms were.  By now, Dr. Gamy knows my system, and he knows that I am going to be asking for something that only he can help accomplish.  Quickly and succinctly, I explain that there is a patient with a single cleft lip and palate, under the age of 12 months, and the child has a heart murmur.  I ask, "Does that completely eliminate him from the surgery?"  He tells me to bring the patient back to the surgery area.  Being carried by his uncle, Dr. Gamy listens to the child's chest, back, and immediately, he hears the murmur.  He says, "It's an 'xyz' kind of murmur."  He turns to the anesthesiologist, Dr. Manny, and asks him to listen.  They are in complete agreement.  They discuss it for a couple of minutes.  One asks if the other feels confident enough about proceeding.  The other says, "I do, if you do."  After a bit more discussion, they smile at each other.  It happens.  He didn't tell me no.  In a matter of a few minutes, this child's life could have been one way, and things totally flip, and the child with the murmur gets the surgery.  After that kind of surgery, the kids spend one night in the hospital.  The next day, the little boy's uncle tracked me down.  I think I hugged him tightly, and I was trying not to cry.  I will remember that little boy for the rest of my life knowing his life will be better, only because Dr. Gamy didn't tell me no.

There were stories like this every day.  That's the kind of impact the mission made.  

I have to go back.

He Didn't Tell Me 'No'

The Beautiful People

I cannot do justice to describing the beauty of the people in the Philippines.  Inside and out, these people were strong, stunning and authentic.  They seemed to be hardworking and resilient.  I am about to run out of words.

This was the long line of people, actually just the beginning of the line, 

waiting for us every morning.  Usually between 500 and 600 ultimately made the line.  The worst part was having to turn people away when we ran out of hours in the day.  

An awful feeling.  But here are some of the wonderful patients...

More beauty.

I couldn't believe it when this gorgeous woman told me her age.  Nearly -- well, no need to tell all the secrets.  But you would be shocked.  So sweet.  I could have chatted with her all day.

Gorgeous.  This little family reminds me of a person or two at home.

By this point, I am seriously starting to consider adoption.  She made my heart melt.

This is Ethel.  She was one of my favorite local girls in Angono.  Looks like a nurse, doesn't she?  Nope, she is a midwife.  We really hit it off very well.  We have been keeping in touch, and when I go back, I plan to meet up with her.  Since she lives in the province of Rizal, she is close to Manila -- 

so we should have no trouble finding each other.

 Bus ride at the end of the day.  Dr. Christine and Rommel work closely on the mission all year, so they are constantly tweaking and taking care of big and small details.

Vanessa and Samantha -- still all smiles on the bus at the end of the day.  Have I told you about Vanessa?  She is a hard working nurse who lives in the Philippines.  This is only the second year for her to participate in the mission, and she is unbelievably helpful.  Knowing the dialect is more than half the battle in treating all these patients.  She is sweet, quiet, very smart -- and extremely hard working.  And here is a daily detail about Samantha, she runs.  She runs ultra marathons.  I had to ask what that was.  They are 50 miles long.  I called her a name.  Crazy.

Nandy has been coming on these trips for longer than I have;  okay, I have no idea how long.  But she clearly knew what was going on and what needed to happen.  We should probably call her "The Organizer."  She made things come together seamlessly, and we lost her to illness on the second half of the trip.  She was missed.

This was upon arrival at the hospital one morning.  Elvie, Luz, Neo and me.  (Nurse, nurse, local volunteer and me.)  Have you detected my selection of photos today which show my tallness?  I'm telling you, I was a giant.  Kinda fun, kinda awkward.

Dr. Yvonne went over the top to see this little girl one day.  Her parents didn't want her to miss school, so they came and stood in line for her.  When they were called up, the daughter still wasn't out of school  They explained her symptoms, and Yvonne wanted to give them the help they needed.  Yvonne waited while they literally ran to the school, scooped up this little punkin, and brought her back.  Not sure of the diagnosis, but I know she was helped.  Can you feel the preciousness?  Just darling.

Going rogue here...

There were unwelcome visitors in our cabin at the water park resort.  Dr. Christine was my roommate for the first half of the trip.  It was all fun and games while the reptile was on MY side of the room and above MY bed.  Yes, it was near the ceiling, but not tolerable if you think I am going to close my eyes until I know he is gone.  I can be tough when I have to be tough.  If there had been a man within 50 feet, you can bet I would have carried him into that room to help us.  But I ran outside, and it was a ghost town.  No one in sight.  I found a big dead palm leaf branch that was about 5 feet long.  I couldn't take pictures and perform the extraction of the reptile, and Christine was pretty helpful, over there standing on her bed -- so I slowly encouraged, with gentle nudges, the lizard toward the door.  As the lizard moved, he fell down on the window.  That was when Christine started screaming.  When she started screaming, I couldn't help myself, and maybe I started screaming a little bit.  Her sister, Yvonne, heard us next door, and knowing that two really tough women screaming and yelling couldn't be good, she did what any good sister would do, ran out of her own room, away from ours, found Ed, one of the local Rotarians helping the group, and she sent him towards all the commotion.  (Excuse the run-on sentence, but it all happened very fast.)  He came in, reached up and grabbed the lizard with his hand, took him outside and disposed of him for us.  Our hero.  Never a dull moment.

The Beautiful People

White Rice

There is something I think you should know.  In the Philippines, white rice is served with every meal and as a snack.  So 3-4 times a day, I was eating white rice.  The reason for that is because some of the other choices, like dried fish with heads and tails on them, were not an option for me.  Call me picky, but I prefer food without bones you have to eat.  Luckily, I don't salt my food much, because I don't recall seeing a salt or pepper shaker anywhere.  But I do kind of enjoy spices and some sauces -- just a little flavor.  There was no soy sauce, nada.  I managed fine, but I am happy to say I haven't had white rice in about 8 days now.  

Every morning our first adventure was making the drive to the hospital.  Check out these "jeepneys" -- I didn't make that up, that's what they are really called.  Most people don't drive.  If you drive, you are driving a motorcycle.  The people in these vehicles would jump in and out the side and back of the truck as they wished.  Same with boarding -- just jump on or in, and you are welcome to hang on the side!

Here is our transportation to the hospital.  It is along the lines of a limo, 

having air conditioning, and all.  And please meet my bud, Samantha.  She is a recent VMI graduate, and she came on this mission trip with her super-young mom, Luz.

In fact, most days, we took a picture of Samantha and Luz, just because they are so darn cute.  At home, Luz is a nurse in Kansas City.

Later in the trip, I was lucky enough to get to room with these two.  New friends for life!

We look pretty fresh early in the morning.  Always ready to go! 

I shot this picture of Dr. Gamy without his knowledge.  He usually avoided the pictures.  He wanted to get to work.  I considered him a, "c'mon, let's get started," kind of guy.  Usually working somewhat independently, he was the plastic surgery doctor who did all of the cleft palate surgeries.  I have a lot more to say about that later.  Pictures included.  He is definitely a superstar.

Here's Tess in the green.  She is performing the first step for the patients who had waited in line for hours.  We took their histories, asked about allergies, took temperature and blood pressure -- we just started the paperwork for them to take inside the hospital to give their doctor a head start on getting them diagnosed.

I'm telling you, I played every role.  Except I didn't operate on anyone.  But one particular morning, Dr. Christine wasn't feeling her best.  Without much of an exam, I was able to determine her problem, and even prescribe exactly what she needed.  She was doing better in no time at all.  Lucky I was there.  Enough said.

I missed seeing this C-section, but the baby was doing perfectly fine, and it was a remarkable reminder of the miracle of life to see such a tiny perfect baby.

ALERT

A surgery picture is upcoming.  I don't consider myself to have an iron stomach, but if you don't like to see the inside of the human body, look away.  It's not awful, but I am just putting out the warning.

This was a cyst removal from an ovary.  They knew the size was large, and thought the ovary would also become a casualty of this cyst, but it was saved and was able to stay.  There were four OB-GYN residents in the hospital on this day, so that's why there are so many people in the picture.  The large round object with four hands on it is the cyst.  I was really surprised that there wasn't more blood.

This hernia surgery was going on in the second operating room.  There wasn't quite enough light, so note the headlamp that Dr. Fred is wearing to give him a bit more of a light advantage.  There was another surgery going on in this room at the same time, and our awesome anesthesiologist was able to maintain both simultaneously.  The patient was about 7, I think.  Poor little guy.  Glad they were able to help him.

This board on the wall was very interesting to me.  It lists all the tools used and the quantity, so I assume they count at the end to be sure nothing is left behind, like inside the patient.  It kind of makes me cringe to say that, but part of me is reassured that they count.  I heard them count out loud and repeat after each other several times.  I also learned the difference between an Ochsner and a Heany.  Gosh, it was fun.  I loved it!  The surgeries were probably my favorite part.  I've got more surgery photos coming!

White Rice

My Actual Duties in the Mission

I entered into this mission trip not knowing what my role would be.  It was really cool that I got to perform many different roles.  Remember, I have NO medical background.  I bought myself some scrubs, and I was hoping for the best.

Yes, I wore a stethoscope, carried lots of things in my pockets, and strangers called me "Doctor."  Clearly, no one could read my name tag that said, Volunteer, after my name. LOL.

I performed pharmacy duties.  One of our rules we had to follow with the Philippine government was that we had to buy our medicines there.  We could not bring them with us.  So, once we were there, and the meds were purchased, we had to bag and divide them into dispensable portions.  Really, we didn't have a large variety of prescription medications to dispense.  The main things we filled scripts for were penicillin, cough and cold medicines, and vitamins.  In the United States, I thought most people were allergic to penicillin.  What is up with that?  Maybe I am misinformed, but I don't think I have one family member that can take penicillin.

Here is our daily drive to the hospital.  I don't see many lines on the road here.  When I did see lines on the road, they were merely a suggestion.  

Check out the flower arrangement on the dashboard.  Nearly every night they had a banquet for us.  Somehow, we ended up with an extra arrangement, and we thought we would encourage our bus driver by providing him an enhancement for his driving view.  The traffic time to and from the mission was great bonding time for our group.  

And here is Neo, he was in charge of attitude adjustment.  He has been involved with these missions for more than several years.  A local guy, who works with this group, he seems to read minds.  I took him up on this offer at the end of a long day.  There was no wine.  My options were few.

How cute is this little girl?  She doesn't look sick.  She seems happy, and she is clean.  Absolutely precious.  Darling.  She wouldn't stop smiling.  She was very typical of the patients we saw.

Look at this cute little girl!  She is wearing her school uniform.  I wanted to bring her home.   These kids were beyond precious.  So sweet.

Nearly every day ended with a banquet.  We were exhausted.  Or at least, I was.  But these folks went to so much effort to entertain us.  I think this was the night I provided part of the entertainment by jumping up and down around horizontal cane poles while they were being clicked on the ground.  Sorry, don't have a picture of that...  maybe someone else does.  :)  It was successful, because I didn't fall down.

We were treated royally.

My Actual Duties in the Mission