In a remote Guatemalan town, thousands wait in the hot sun for days—some in agonizing pain—desperately seeking a doctor. “We often drive in and see a half mile line of people waiting,” says Southern Surgical Arts’ Dr. Justin Gusching, DO, one of five volunteer surgeons on a recent medical mission trip with HELPS International.
The 120-member volunteer HI staff have their work cut out for them, using limited means in substandard conditions. While larger medical equipment is permanently stored in Guatemala, these volunteers must cart huge duffle bags full of supplies from American hospitals and other generous donors to fulfill their mission. Each trip, the team starts from the ground up establishing everything from the pre-op, to operating and recovery rooms, to the temporary medical clinic, to the sleeping cots in an abandoned school house or army facility they will call home for the next 12 days. “We set it all up. There’s nothing there. We basically operate like a poor hospital, using generators for electricity, donated and dated instruments, and sterilizing everything constantly,” says Gusching.
In less than two weeks, Dr. Gusching and his colleagues see hundreds of patients and perform more than 200surgeries. Amidst nearly back to back procedures from 8:00 A.M. to 10 P.M., Gusching joins nurse practitioners and physician’s assistants attending thousands of other patients waiting 36 hours or more for basic medicines and non-critical care. It’s a sobering, life-changing experience. “It kind of grounds you and reminds you why you went into medicine in the first place. It also makes you very thankful for what we have here in the United States,” he reflects.
The Guatemalan people are more than just poor—they live in a country still devastated by decades of civil war, where drug trafficking and corruption runs rampant. The vast majority of citizens spend long hours toiling in textile mills or crop fields, striving to feed their families. “The first time I went there I was absolutely shocked. Their housing is sheet metal just laid across cinder blocks or maybe only sheet metal walls,” says Gusching, who has participated in three HI medical missions. “Some have a stove for heat, but most build a fire inside to stay warm. We see a lot of children with lung disease after inhaling all that smoke.” In fact, according to HELPS International, the leading cause of death in Guatemalan children age five and under is acute respiratory infection.
Surgeons usually treat the same issues in these remote rural communities every year. Conditions such as congenital digital birth defects—an abnormal growth of fingers and toes—are very common in children and require amputation. Adults suffer a disproportionate amount of hernia conditions (a hole in the abdominal wall) primarily due to overexertion and consistently carrying too much weight on their heads out of necessity. “Patients have massive hernias they’ve had for years. These surgeries are more complicated than typical hernia cases in the States because of the amount of scar tissue built up over the years,” says Gusching.
Inside the site’s single operating room, there is little space and literally no privacy as medical teams surround five patients lying side by side. More than 25 staffers divided in teams comprised of a scrub tech, nurse, surgical resident, anesthesiologist and surgeon work simultaneously in a small, unairconditioned room for days. “To see 120 people all working together—it’s amazing what so many people with one common goal can achieve,” Gusching says of the dedication and teamwork he witnesses from his peers.
Despite the efficiency and speed in which the surgical staff works, patients are seen on a first come, first served basis; given the amount of people in need, not everyone can be treated before Dr. Gusching and the team must leave. The most difficult procedures are tackled at the start of the mission to allow critical patients the longest possible recovery time under medical supervision. Gusching and the staff educate patients on the increased risk of post-operative complications if recovery is compromised. “If they have to work and can’t take the time they need to heal after surgery, it’s dangerous; and if there is an infection, they can die from sepsis.” He is hopeful they will have the opportunity to lead a healthy life. “They are very hard working and humble, so grateful for anything they can get. They are always just very, very thankful.” Gusching is thankful, too, for the experience of serving those in need as he looks forward to his fourth medical mission in Guatemala next year.
