Honduras: Day Six

Source: Blog Post

Today was our final day of operating here at La Providencia.   We began our morning rounds by checking on patients who stayed overnight from yesterday’s operating schedule.  One of our cases from yesterday:  a 13 year-old male born with a brachial plexus birth palsy on whom we performed a rotational osteotomy of his humerus, was all smiles this morning in recovery.  Prior to surgery, the patient demonstrated significant trumpeting with bring his left hand to mouth.  His surgery will allow him a greater functional range of motion.  His pain was well controlled and he was ready to travel home.  He will follow-up in the clinic with assistance from local orthopaedic surgeon Dr. Silvio Gonzalez.


Our goal is typically to have patients who do not have to stay overnight as we leave early tomorrow morning to head back home.  Today’s cases included: reconstruction of an index finger in a 2 year old who sustained an open fracture dislocation one year ago, removal of hardware in a 6 year old boy who we performed a radius and ulna osteotomy on last year and a soft tissue rearrangement with PIP contracture in a patient with an open soft tissue injury to his index finger.


For surgeons operating in a foreign country, our challenges center around equipment issues and care of patients with poor access to treatment.  For our anesthesia providers, the issues are more complicated.   Returning to the anesthesia team this year are Melinda Seering, MD and Cindy Haas, CRNA from University of Iowa along with newcomer Laura Covalli, CRNA from Children’s Hospital of Philadelphia.  


They have been challenged throughout the week and have done a phenomenal job keeping our patients and staff safe.  Today – a 2 year-old boy had a bronchospasm on the way to recovery with a decrease in his oxygen saturation.  Through team work and quick thinking, the child was resuscitated, a quick combination of propofol, epinephrine, albuterol and steroids.


On both of our missions to Siguatepeque we have been fortunate to travel with the dental team from Verona, Wisconsin.  They treat the students at the school and often have patients who are unable to undergo dental procedures in the clinic.  Our anesthesia providers were able to deliver anesthesia services to three of their patients today, including one 4 year old who here for a dental procedure due to the inability to eat from tooth pain.


As a group, we are thankful that we did not have equipment issues and successfully dealt with power outages without any complications.  We learned how to ration our limited medications to provide safe anesthesia for all of our patients this week.  This year permitted us to perform some bigger operations due to better surgical equipment and fluoroscopy machine.  We had some challenges with more post-op pain than last year, but we were able to do a landmark axillary block to help.  We would also like to thank the wonderful interpreters, Julie, Melody and Melody (yes, there are two interpreters named Melody) for their help with “happy” mask inductions. 


The team is happy to see the week end safely.  The mission has been a great success.  We are proud of our group’s culture and ability to function like a team that has been together for years although some of us just met at the beginning of the week.




“The happiest people are those who do the most for others.” -Booker T. Washington