HONDURAS: DAY FOUR

Source: Blog Post

We have traveled to Honduras with a wonderful and skilled nursing team.  The team consists of three nurses from The Children's Hospital of Philadelphia (Michele Friday, Lori Merk and Pam Sarcinello), two nurses from the University of Iowa (Paula Woods, Deborah Fuhr), a surgical technician Lynn Burleson from the University of Iowa, and our team leader Mary Dowling from Wisconsin. 



 

The most challenging part of the mission is that OR nurses have to think outside the box with limited resources at hand.  There is little downtime for rest since the role of a mission nurse in Honduras is multifaceted.  It includes the tedious (and thankless) job of identifying, sterilizing, sorting, cleaning, and packaging the equipment and supplies needed for each surgical patient.  Without this meticulous attention to detail, it is impossible for the surgeons to successfully perform difficult procedures.  This year, a new autoclave (sterilizer) was donated to Sharing Resources Worldwide.  He has been nicknamed “Puddles” for various reasons: yesterday, two major leaks from the inlet line required repair (shout out to Paula Woods who dealt with the resulting flooding).  “Puddles” has been an improvement over our autoclave from last year, with shortened sterilization times, but also has some flaws requiring ingenuity in machinery maintenance. 

 



Our PACU nurses, Mary Dowling and Pam Sarcinello work closely together with the Honduran staff and families.  They prepare our loving and beautiful patients and their grateful families throughout their pre-op and postop experiences.  One of their challenges is working with minimal monitoring equipment.  However, the nurses have found ways to revert back to well-honed core nursing skills.  The cultural differences and language barriers create unexpected challenges, but with the help of the exceptional volunteer interpreters the PACU nurses feel confident that they are able to communicate successfully with families.

 

The nursing team came together from different regions of the United States and have become one awesome team of professionals caring for brave, strong and courageous children.  To a person, the nurses note that “our love for these children and their families made this mission trip an experience forever remembered”.



 

Today we took care of a seven-year old girl with bilateral ulnohumeral synostoses.  Her congenital difference has left her with a left arm that she uses for eating and hygiene though with much difficulty.  Her right arm is severely externally rotated - not in a good position for function and activities of daily living.  Hand surgeon Apurva Shah, MD MBA and hand surgery fellow Nicholas Beck, MD performed an internal rotation humerus osteotomy to place her arm in a more functional position for use.  Additionally she was seen by Meagan Pehnke, OT who evaluated her for adaptive aids to facilitate independence.  She will return to see us next year for further evaluation of her needs.



 

Additional cases included a child with Poland syndrome who underwent index/long and ring/small syndactyly releases with full thickness skin grafting, reconstruction of two thumb duplications, and a proximal interphalangeal joint capsulotomy for post-traumatic capsular contracture. 

 



The day was long.  There were many challenges.  By the time we climbed onto the La Providencia school bus to head back to our hotel, the team was tired and the sun had set.  But we are all looking forward to sitting down to a warm meal with good company – the challenges we have faced together have created strong bonds and new friendships.  Seven operative cases are scheduled for tomorrow.  Buenas noches from Siguatepeque. 

 

 “The sun is never denied the light it gives, likewise, you are never denied the kindness you bestow.”  -- Matshona Dhliwayo