ISMS

Trip to Peru in May 2009 is my fourth volunteering experience abroad.  Previously, I have participated in the medical mission trips to Peru, Vietnam and Brazil.

Initially, I was reluctant to go since I had already been to Peru, but the fact that I knew everyone involved including the pediatric surgeon Dr. Valda, the trip organizers Joan and Colleen, and the rest of the group, made my decision pretty easy.

The distinguishing features of the trip were the high levels of quality and professionalism. All participants including nurses, surgeons, and others were top-notch in making this trip a great success.

The most memorable case for me, personally, was definitely the four day old child with tracheo-esophageal fistula who was born just two days prior to our arrival.  This case, even in a tertiary American hospital would have presented multiple challenges.  All team members needed to consider many factors including the availability of night personnel, a post-op ventilator, feedings, and blood transfusions.

After much discussion, we decided to give this kid a chance and perform the surgery.  In the discussions that included local doctors, we were told that the majority of these kids die without surgery, making us obligated to give this our best.
What did we do to overcome our obstacles?  Blood was donated by one of the family members, the ventilator was located for post-op care, and the PICU staff was educated on how to use it.

All were required to perform at their very best, which included overcoming not only the clinical challenges but also the multiple language barriers among the local care takers.

Before committing to the procedure, we hosted an open discussion with the mother.  We explained to her all potential risks and benefits of surgery.  The mother agreed and understood that without the surgery, the chances for her child were poor.

After 6 hours of surgery, the child was doing well.  Dr. Valda, the main pediatric surgeon, was able to repair the defect and correct the pathology.

On the second post-operative day, the child was weaned off the ventilator and extubated.

Through our correspondence with the local team, we learned that the child is well; gaining weight, sucking the bottle, and growing.

As a pediatric anesthesiologist I will remember this case for the rest of my career.