Wednesday, July 8, 2009

HOPE Volunteers Begin Work in Nicaragua

Project HOPE hit the ground running in Corinto, Nicaragua after a one-day transit from El Salvador. Elie Malloy and Diane Speranza headed to the most remote site Continuing Promise has set up so far—far enough from the ship that they’ll remain there tonight and the next two days in order to make the logistics feasible. (To be honest, I’m a bit glad I can’t reasonably make it all the way out there—it is hot enough in the town of Somotillo, away from the coast, that the locals say its “where the Devil takes vacation.”)

At the closer of the two remote sites, in the nearby village of Chinandega, Dr. Ken Iserson and HOPE’s pediatric nurse practitioner, Faye Pyles, charged in to begin administering primary care to the CorinteƱos and Chinandeganos—people of Corinto and Chinandega. Amy Bream and Marley Gevanthor’s triage skills kept the first day—always the hairiest—running smoothly and efficiently toward the primary care providers.

Meanwhile, HOPE volunteer Elise Chamberlain was leading a training day on pain management in one of the classrooms at the hospital. She and other volunteers covered four topics—Pain, Pain Management, Acupuncture, and Physical Therapy—to interested doctors and nurses from the Chinandega hospital.

The first two days of Continuing Promise’s presence in a country are also unique because we run a surgery screening clinic in addition to the primary care facilities. Here, volunteer general surgeon Bob Coleman saw as many patients as he could possibly see today (and will again tomorrow) to fill up his OR schedule for the next 9 days. He’s got several tough cases coming up for himself, including a woman with an incisional hernia that has been operated on four times, unsuccessfully.

“After the last time, the doctor looked at me and said, ‘I won’t touch it again,’” she told Dr. Coleman.

The injury is pretty large, and after his examination, Bob told her the risks of further operation, and the risks of leaving the injury as it is. He believes he’s found the reason why the previous surgeries failed, and that he has the equipment onboard to evade the same problem. She’s chosen to come onboard with us and go under Doctor Bob’s knife—we’ll see her in the hotel tomorrow.

Dr. Coleman was also asked for a special favor today, something somewhat unusual in Continuing Promise—the two-man general surgeon team showed him into the ICU where a young girl (she looks much older here than her 10 or 12 years) was in recovery after having had severe inflammation and infection in the abdominal area, tachycardia up to 120 beats a minute, and a very high fever. The surgeons had performed an appendectomy and opened several pockets of severe infection—now she is stable, but with a large surgery wound in her abdomen. They believed that she was on her way to recovery, but simply wanted his opinion on the case.

She was eating, talking, and fever was lower, which along with some other indications led Dr. Coleman to agree with their assessment. But the biggest thing was that when she saw our HOPE shirts, she sat up in bed and began excitedly pointing into her mouth—hardly the behavior of a fatally sick child. It turned out that she was just more excited to tell us about how she had come aboard the Comfort on its last visit, in ’07, for a cleft lip/palate surgery, which looked good enough now as to be almost undetectable. Abdominal wound, fever, whatever—this was important!

Thanks for reading-Jacob

PS—also, the US Surgeon General toured the Comfort and the worksites today. Nothing but kudos from him to the sailors, soldiers, and civilian volunteers that are keeping this mission afloat.

PPS—Happy Fourth of July!

1 comment:

  1. great job jacob! we love hearing and seeing what Dr Bob and all the wonderful volunteers are doing.

    bobs fam