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Surgical Missions are a Rewarding Experience for Providers


This Physician Assistant recommends practitioners partake in a surgical mission in a third-world country, as he found it to be a rewarding experience.

As I write this, I am on day three of surgical mission with the HELPs International Team, the non-profit I'm involved with, in Cobán, Guatemala. This is the first visit to a remote part of Guatemala. Where do I even start to try to relate to you what this experience is like?

This is my second international mission, and you can read about the first in a previous blog from last May I can't believe that this is only day three of an onsite surgical mission. It feels like a lifetime. The trip to the site was arduous. We flew into Guatemala City on a Saturday and spent the night. Sunday was spent on a bus for six hours to Cobán, where we finally arrived at the Creompax UN military base, where we will live for the next seven days.

There was no rest on Sunday after a mid-afternoon arrival. The HELPs International Advance team, led by Dr. Pablo Garcia, had been working before the mission to bring in and set up the kitchen, heavy equipment and supplies. Our team immediately began the daunting task of unpacking and setting up the tons of supplies onsite and transported by the team to begin surgery early Monday morning. Needless to say, I didn't miss my normal workout as we spent hours moving heavy bags and boxes, and working furiously to get all the clinic, pharmacy, and surgical instruments and supplies ready for the first cases.

Being on a military base, the welcoming ceremony was military oriented and the base's Marimba band provided the music. The base commander, a three-star general, and a series of local dignitaries, welcomed and blessed us. It was finally time to get to work.

I spent the Monday morning and early afternoon on intake in the clinic with an emergency PA on day one. He is a rock and leads the clinical section. The two of us and an family nurse practitioner screened more patients that you can count. There are two constants here. What you see is either the only time you have seen it, or it is the biggest one you have ever seen. There is a thousand times the need of our capability to meet it. It is so sad and at times, almost overwhelms you with emotion and sadness.

There were 2000 people waiting for us patiently at the gate of the military base in the rain on Sunday and Monday. I have never worked so hard in my life. Rapid exam after exam, screening patients to fill the surgery schedule, was the order of the day. There was also the continuous stream of patients seeking medical attention. Having a surgical PA such as myself on intake expedited the evaluation of patients we could help, and the patients for which there was nothing that we could do. That is one of many sad parts. See the hope in people's eyes and their despair if nothing could be done. The good news is there were many we could help..

The surgical team consists of general surgery, oculoplastics, plastic surgery, ophthalmologists, and OB/GYN physicians. The field hospital is a single large room, with five surgical tables. It reminded of the TV show MASH. We have an army of helpers, technicians, cooks, translators, and support staff in a team of 100.

I was pulled to the hospital in mid afternoon and I did OP procedures until 10:30 pm. Suffice it to say you could put a fork in me at that point. I was done. I was rewarded with a trickle of a cold shower and a hard Army cot.

On day two, we were better organized and I spent the day in an emergency bay doing OP procedures as fast and efficiently as I could. HELPs International uses PAs, nurse practitioners (NPs) and certified registered nurse anesthetists (CRNAs) to their full potential. After nine years of 700 cases per year, I can handle fairly complex surgical cases and am allowed in this environment to use my judgement to take the cases in which I feel confident to successfully perform. It is liberating and fulfilling. My surgeon business partner has trained me well, and he arrives this morning for two days of plastics and reconstructive cases, which I have screened in clinic and are waiting for him.

One patient that I operated put a beautiful Rosary around my neck with tears in her eyes. I was hugged and kissed by many patients. The hope and expectation in their eyes is all you need to keep working until you can't work anymore. It feeds the soul, and puts into perspective all the things that affect us and trouble us in the modern life. Everyone needs this experience.

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