Location: Guatemala City, Guatemala
Dates: 04/09/2016 - 04/16/2016
Surgeons: Dr. Henry Rice, Dr. Sherry Ross
Focus: General, Laparoscopy, and Urology
Average Mended: 60
Where in the World
The Republic of Guatemala is located in Central America and is one of the poorest countries in all of Latin America. It is bordered by Mexico to the north and El Salvador and Honduras to the south. Guatemala has a population of 15,824,463 people, 56.2% of which live below the national poverty line. 36% of the entire population are children below the age of 14. 40.5% of the population is made up by the indigenous community, facing harsh socioeconomic inequalities to this day.
Healthcare in Guatemala
Guatemala has some of the highest infant mortality rate and lowest life expectancies in the Central American region. Many Guatemalans lack access to healthcare services, as there are currently only 16,000 physicians for the entire population.
Our young patients come from all over Guatemala, some enduring long walks out of their mountain villages to reach roads in order to get rides into the capital and the Moore Pediatric Center. Current research has not yet confirmed why so many Guatemalan children have congenital birth defects, but suspicions lie in some genetic corn strains that block the absorption of folic acid. Unmet surgical care can contribute to the various diseases children die young from, and better perioperative care for those who are lucky enough to receive surgeries could improve the overall survival rate of these children.
Our mission to Guatemala this April consists of our medical team from Duke University and UNC at Chapel Hill. Besides performing the free, life-changing surgeries for children in Guatemala, Dr. Henry Rice and Dr. Sherry Ross will provide training to local Guatemalan surgery residents on techniques in pediatric laparoscopic and urology surgeries. Dr. Brad Taicher will similarly provide training to local Guatemalan anesthesiology residents on proper anesthesia protocols and quality improvement systems. Unfortunately, hundreds of children in Guatemala lack access to proper, specialized care. We have begun to provide training platforms for local Guatemalan residents in order to ameliorate this issue and look forward to the progress of these efforts.
Dr. Rice has gone above and beyond each year with adding access to equipment and training seminars. Two years ago he was granted a donation from Storz for laparoscopy equipment for the Moore Pediatric Surgical Center where we operate, and now other missions teams that travel there are able to use it as well. In 2015, he and his colleague, Dr. Obinna Adibe, brought together local and regional surgeons for a 3-day training seminar to train them on laparoscopic techniques. Dr. Ross, in addition, provided training on pediatric urological surgeries, as too many Guatemalan kids are without access to proper specialized care. She not only provides training for the local surgeons, but has also set up a mission-to-mission system to refer complex cases to future teams traveling to the surgical center.
Besides the service missions to Guatemala, in October 2015 Mending Kids sponsored an observership with surgical residents from Guatemala (Dr. Gustavo Perez and Dr. Daniela Palencian) at Duke University. They observed surgical procedures for the entire month, learning from our surgeons’ and anesthesiologist’s standards of practice and patient bedside manners. We know that this part of our work is an invaluable aspect of training and we hope to do more observerships with teams in the future.
Publications and Presentations
Gulack BC, Heydari S, Solis-Sanabria C, Figueroa L, Tew S, Madden-Fuentes R, Taicher BM, Ross SS, Boyd D, Hall-Clifford R, Rice HE. Ranking and rating analyses of barriers to surgical care for children in Guatemala. Pan American Journal of Public Health (Submitted).
Tew S, Gulack BC, Hernandez Diaz EM, Ross SS, Rice HE, Taicher BM. Implementation of a simplified universal protocol in Guatemala. World Journal of Surgery (In preparation).
Tew, S, Pecorella SRH, Taicher BM. Knowledge and Understanding of the Role of an Anesthesiologist in Guatemala. Society for Pediatric Anesthesia Annual Meeting, 2015.
Pecorella SRH, Neifeld JL, Zucco SE, Ross SS, Rice HE, Taicher BM. PONV Prophylaxis in a Resource Constrained Environment. Society for Pediatric Anesthesia Annual Meeting, 2015.
Tew S, Funk EM, Neifeld J, Gulack BC, Madden-Fuentes R, Ross SS, Rice HE, Taicher BM. Retrograde Light-Guided Laryngoscopy: A Useful Teaching Technique for Beginners. Duke Anesthesiology Academic Evening, 2014.
Tew S, Funk EM, Neifeld J, Gulack BC, Madden-Fuentes R, Ross SS, Rice HE, Taicher BM. “Sombrero Azul:” Implementing the Universal Protocol in a Developing Country. Society for Pediatric Anesthesia Annual Meeting, 2014.
Tew S, Funk EM, Neifeld J, Gulack BC, Madden-Fuentes R, Ross SS, Rice HE, Taicher BM. Effectiveness and Validity of Subjective vs. Objective Pain Scoring on a Medical Mission to Guatemala. Society for Pediatric Anesthesia Annual Meeting, 2014.
Nguyen K, Bhattacharya SD, Maloney MJ, Figueroa L, Taicher BM, Ross S, Rice HE. Self-reported barriers to pediatric surgical care in Guatemala. Sept 2013. The American Surgeon. Vol 79: 885-888.