Children’s Hospital International Services

The Shalom Foundation recently shared the following update about Josie in their newsletter:

Joseline Vasquez, 5 years old

Jocelyn “Josie” Vasquez, 5 years old, developed a life-threatening mass – Lymphangioma – in her neck as a baby.  Through joint efforts with the  Shalom Foundation  and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Josie received a charitable surgical procedure by Dr. Steve Goudy, an ENT surgeon at Children’s Hospital, when she was 2 years old.  In February, Dr. Steve Morrow, a general surgeon, and surgery team helped to complete her healing process at The Moore Center. Dr. Morrow was part of Josie’s original surgical team. It was very moving to see Dr. Morrow with Josie and see this team help her again. She stayed overnight, was discharged the next afternoon looking well and happy and has already started school again.

Her parents were most grateful to the surgery team, Shalom’s surgery center and to all the people who made this second surgery possible. “I have no words to express my gratitude for the kindness and care that I have received since 2008 when my daughter had the first big surgery at Children’s Hospital at Vanderbilt through the efforts of the Shalom Foundation and now, 4 years later they continue to care for her,” said Veronica Vasquez, Jocelyn’s mother. ” I really thank all who support The Moore Pediatric Surgery Center – it has made it very special to us.”

The team was definitely ready on Monday morning, and we hit the ground running.  We evaluated 15 more children Monday morning and six more on Tuesday. While not all of the additional children were surgical candidates, we were able to add 15 more cases for a total of 63.

Monday’s surgeries went very smoothly. We were able to do 15 cases by 6 p.m.  Most of them were hernias, circumcisions and undescended testicles. Nothing too glamorous, but they were surgeries that needed to be done for the patients. On Tuesday, we opened a third room.  This allowed us to accomplish 20 surgeries!  We did have to cancel one child do to illness. Even the children in Guatemala get upper respiratory infections.

There were a lot of room changes and staff movements, but everyone went with the flow and got things done. Megan, Mary and Robin were especially receptive to all of my patient rearrangements!

Montezuma has yet to rear his ugly head, and everyone seems to really be enjoying the food. Maria Jose’s mother has cooked lunch for us everyday so far, and it has been fantastic!  We’ve also had some great dinners here: Italian, Mexican and Guatemalan.  It’s funny to think about, but they have all the same ethnic restaurants that we have.  There is a Japanese sushi place in the hotel, and we pass by a Chinese restaurant everyday on the way to the hotel.

Wednesday will be the big test.  By now most of the initial energy from being in a new place is starting to wear off.  I think that this crew will make it through unscathed!

Sunday started with us arriving at the hospital at 7:15. By 8:00, we were in full swing. The OR staff was busy unpacking instruments and figuring out logistics. The surgery and anesthesia teams were busy seeing patients. We had a total of 103 possible patients. Out of those, 65 arrived.  After further evaluation, we were able to book 53 cases.

Many of the cases that could not be done were too far advanced to be done safely this trip. Some of the children didn’t make it due to the distance they had to travel. We will see them Monday morning before the day starts.  Everything was streamlined for us and we had minimal interruptions.

We were all back to the hotel around 4:30.  Just in enough time to freshen up and head down to the hotel restaurant for the big game.  The hotel has a sports themed restaurant that showed the Super Bowl in English. It was amazing how many groups of Guatemalans that were there as well. Everyone enjoyed the “American Food” (Cheese burgers, wings, jalapeno poppers, etc), but not everyone was happy with the final score (cough, cough Dr. Roke!)  The team is definitely anxious and excited to start work on Monday!

Children’s Hospital has a general surgery team in Guatemala City February 4-12, 2012. Surgeon Dai Chung, M.D., anesthesiologist Chris Karsanac, M.D., and OR nurse Megan Davis, R.N, lead the team.  Please follow along as Dr. Karsanac posts about the trip.

Surgery Team Arrives in Guatemala

Saturday morning came early at 4:30am. Everyone made it on time to make the flight. Some were cutting it close (Ci-Ci!), but we all boarded with time to spare. Maria Jose and Dr. Ligia at the Guatemalan airport met us. Customs was a breeze and nobody got stopped. We piled into a couple of vans and 5 minutes later, we were at our hotel.

 The Barcelo Hotel in Guatemala City is incredible. Everyone seamlessly got the room reservation. Dr. Roke and Warren were initially assigned a room with only one king sized bed. In the end, they decided that they should probably get a room with two twins instead. Dr. Chung then challenged the anesthesia team in a game of basketball on the hotel basketball court. We politely declined with the thought of Dr. Morrow and Dr. Martin towering over us.

We met back in the lobby to tour the hospital. Again, the Shalom Foundation has done a great job at keeping up the rooms and equipment. All of the staff was there to greet us and make us feel at home.  We went to “Hacienda Real” for dinner for a taste of Guatemalan cuisine. I don’t think there was a single person that didn’t like their food.  Many even tried the salsa on the table. Only time will tell if that was a mistake…

Post by Caroline Hale, trip coordinator:

Monday morning began our second and final day of surgeries. Our team left the hotel a few minutes earlier than usual to avoid rush hour traffic. Apparently, most hours are “rush hours” in Guatemala! Nashville traffic pales in comparison.

We arrived at the Moore Pediatric Surgery Center at 7:30 a.m. and made our way to the locker rooms to change into our scrubs.  We then disperse to begin each of our normal routines: prepping the operating rooms, assembling and priming IV tubing, rounding on surgical patients from Sunday who spent the night, or pre-oping children for the day. Our 13-member team defines ‘team’ in the best sense of the word. Everyone works together to make the overall experience the best it can be for every patient and family. Watching the interactions between the children and people such as Dr. Landsman and Dr. Tanaka–and frankly everyone on our team–an outside observer would know we work at an institution that fervently supports family-centered care.

The children here are so adorable and gracious, even when facing the burdens of severe poverty. It is an overwhelming feeling to realize the positive contributions the team is making in the lives of these children by providing much-needed surgical care. Additionally, the care provided by the Guatemalan nurses and doctors who staff the Moore Center is remarkable.

The intent of this trip was ensuring all equipment and operational processes were in place to support later trips by larger teams. All 13 surgical cases during this trip happened without a hitch. The center is equipped with everything needed to make a surgery trip of this kind successful. I believe I represent the collective feelings of our team by stating we have all had a wonderful time, and the beautiful weather has not hurt!

Later today, we will board a flight back home to Nashville. We owe a huge thank you to the Shalom Foundation, Steve Moore, Dr. Ken Moore, Maria Jose, Allison Bender, Kevin McQuaig, Dr. Luis Perez, and so many others who ensured the success of this trip. In the coming days, we will put together a slide show of pictures from our stay, so please check back soon!

Karin League, Caroline Hale, and Anna Brummel during a quick lunch break.

Our team, with members of the Shalom Foundation, after the last surgery.

Dr. Ira Landsman with Abner, 2, and his mom before surgery.

Sunday was our first day of surgeries. We scheduled six cases, and included one add-on case later in the afternoon. The first surgery began at 8 a.m., and with the exception for a brief break to refuel during lunch, our team worked 8 1/2 hours in the operating rooms. It was a very busy day.

Dr. Karsanac and Roni Nylander anesthatizing a patient before surgery, as Carolyn Maness looks on.

Maria Jose, program director of the Shalom Foundation, carries Sarahi (and Bella, her stuffed animal) through the holding area before surgery.

After a long day of screening patients and prepping the operating rooms, our team returned to the hotel to quickly freshen-up before the ceremonial opening of the Moore Pediatric Surgery Center. It was a  moving event, with about 70 leaders from Guatemala and the United States, including members of Shalom Foundation’s advisory board, gathered in the surgery center’s beautiful courtyard for the ribbon cutting. Steve Moore, founder of the Shalom Foundation, gave a passionate speech describing the long journey behind the surgery center. Dr. Brock spoke briefly about the wonderful partnership between Children’s Hospital and the Shalom Foundation. 

We have scheduled 12 patients for surgery: Six on Sunday and six on Monday. Please check back for posts as we continue our work. 

Dr. Brock, Lori Graves, Carolyn Maness, Dr. Landsman, Cindy Sisco and Dr. Tanaka at the cermonial opening of the surgery center.

Left to right: Dr. Ken Moore, Dr. Sheny Vasquez, Allison Bender, Maria Jose de Gallardo, Dr. John Brock, Steve Moore, Pastor Alvaro Perdomo, Dr. Luis Perez, Dr. Sidney Hagen.

Saturday was a whirlwind! Several members of our team screened a few dozen children for surgery while others prepped the operating rooms for cases on Sunday and Monday. Below is a post from Carolyn Maness about the day.

PACU nurse Anna Brummel screening Carlos, 12, for surgery.

Post by Carolyn Maness

After a great night’s sleep and wonderful breakfast, the team made its way to the Moore Surgery Center in Zona 1. The waiting room was full when we arrived.  As the physicians began their work assessing the kids for surgery, the OR and PACU team members began their work.

We have three fully equipped operating rooms and a four-slot PACU. The hospital is beautiful. I can only imagine how many volunteer hours were spent renovating the space and packing supplies to make sure we have everything we need to provide these children the best possible care.

I am so proud to be part of this wonderful team and to be an OR nurse in Guatemala!

Marcos, 12, and his family being screened by Dr. Brock for surgery. Dr. Carlson is helping to translate.