Last day in Cartagena

Today was our day of sight-seeing in the Old City of Cartagena. The Old City is protected by a large concrete barrier that surrounds the entire city. It was built by the Spanish when they came to Colombia and it was made to protect their gold and keep pirates out. We had a full day of shopping and taking lots of pictures. This evening we had a nice dinner with the entire team plus the Colombian pastors that we worked with this week. It was great to get together one more time before saying goodbye.

The team is sad to leave but ready to get home. I have a feeling we are in for a rude awakening when it comes to the weather... Anybody know the temperature in WI tonight?

Signing off one more time from Cartagena, Colombia.

Maggie

Dr. Esteban’s Blog

There are those who consider medical missions to be glamorous, exotic, fun even - - - a great way to get out of the Wisconsin freezer for a couple of weeks - - - see new sights, meet new people - - - a check off the bucket list - - - Christian vacationing.  Consider this: By the end of the day yesterday, over 3000 prescriptions were filled in a hot, humid, windowless, breezeless room little larger than a walk in closet.  One of our pharmacists, Megan Ose, was needed out in medical clinic as a physician extender translator and so was able to escape occasionally; however, Tom Robinson and Jim Wrass were not so fortunate.  They labored in that room, filling scripts safely, sometimes creatively for hour after hour with little let up.  What a wonderful pharmacy staff we have had.

Dr. Andrew Weiss and Joy Silva were the OB/GYN department.  They provided amazingly comprehensive histories/exams that were very much appreciated.  Dr. Nick Andriacchi evaluated a wound infection and culture upon which Dr. Andy was able to perform a KOH prep/stain.  Hyphae were detected, so Dr. Nick was able to provide antifungal coverage that will allow the wound to heal.  We were all impressed.  Also, Jim Conterado’s ultrasound machine was put to good use and some mothers were able to see their babies and be assured of their normal development. 

The Dental team did a great job.  After a very challenging first day filled with kids with rotting teeth, they found their groove.  Bret had to “borrow” electricity for his compressor/drill from a neighbor (think open wires serpentigenously meandering across a tin roof from a structure 40 ft away).  Bret would patiently be working away with Sheryl Wrass’s assistance and Twinky would provide comic relief/distraction/assurance for the patients and families.  We often heard laughter coming from the Dental Clinic - - - that’s an oxymoron - - - but they accomplished it.

The Optical team was tremendous.  Lorna, Karin, Ginny, and MaryBeth were solid with patients pretty much all day, every day.  They learned in a couple of days enough to provide needed refractions and eyeglasses for hundreds of people.  Each of them have very touching stories of different people they were able to help.  

After the clinic concluded yesterday, we had a thanksgiving service, led by Ron Silva and the Colombian Pastors.  They affirmed to us their deep appreciation for our serving and expressed how pleased they were with the many meaningful conversations and prayers in the spiritual clinic. Dr. Michael Caldwell and Ron very graciously expressed our gratitude for their hard work and the privilege of working with them.  It was a very touching service. 

We appreciate the prayers of all who have supported the team.  It was a great week.

A funny vistor at the eye clinic

We have been driving around in the same bus the past four days with the same driver. This morning he came into the clinic and had his eyes checked. Not necessesarily someone you would want to see getting their vision corrected...

Last two days of clinic

We were all warned Thursday morning that it was going to be our hardest day yet. Some reasons for this was because it was day three and we were looking forward to our last day (Friday), getting worn out from our two earlier days, and one larger reason: we were going to be losing three of our most general doctors for three hours right in the middle of the day. They traveled to a nearby hospital and gave a few lectures to the doctors and students there. Our patient demographic also changed quite a bit on Thursday. Instead of having 75% of our patients being children we had about 60% older adults and seniors. This was a nice change for me in the photo clinic because it was so interesting to see how happy an elderly woman or man was to get a picture of themselves. To see their face light up was a wonderful gift for me every time I handed out a picture.  We did make it through Thursday unscathed and were looking forward to Friday.

Friday at the clinic felt like a whole different dynamic. I was beginning to get a little sad about leaving the people of Cartagena. We planned on a half day and that is exactly what happened. Triage stopped taking in patients at about noon and we finished everything about 2:30pm. After we cleaned and packed up our gear, we had a short worship service with the Colombians. It was amazing to hear how extremely appreciative they were of us coming down and helping their people. It made me not want to leave even more. Over the past four days I created a close relationship with three siblings. Fabian, Sebastian, and Daniella. They stuck around the photo clinic with me for hours and practiced their English and helped me out quite a bit. When it was time to say goodbye today there were tears in little Sebastian's eyes. It broke my heart to see him cry like that but I also knew that what we did here really made a difference. We saw about 1,000 patients over the entire clinic and even though it does not even dent the millions  in the city's population our work has now spread like a spider web.

We are all relieved to be done with our "work" here but are sad to leave these lovely people we have made relationships with. The Lord has blessed our team with a successful trip and will continue to bless the people of Cartagena after we have left.

Dentistry!Pharmacy!Karin and Mary Beth in opticalMegan and Jim speaking to patients




 

 

 



Anne Marie and a cutie



[caption id="attachment_43" align="aligncenter" width="300" caption="From outside the gate "]
Many people waiting in line for the clinic
 


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Dr. Esteban’s Blog

 Well . . . one day of clinic is behind us, and the team is performing like seasoned veterans.  Triage with Ann-Marie and Omar inducted about 240 patients.  Church/School leadership helped with crowd control.  We had an excellent group of interpreters from the church who worked hard all day in the clinic – especially up in Optical.  We would have been extremely limited without their help.  Camilo, Dr. Mesa’s son did a great job in clinic.  He is intuitive and picks things up quickly.  We had a young lady who was difficult to get consistent refractive data, so I was called over.  I did a “fog refraction” to demonstrate without her knowing it that she actually had 20/20 vision and thus didn’t really need glasses.  Camilo, who had been observing all this, had already come to the same conclusion.  Karin, MaryBeth, Ginny, and Lorna are serving in Optical.  It was close to 100 degrees, humid, and no breeze up  in the optical area in the afternoon.  We are all going through liters of fluid.  Please pray that everybody holds up.  It was a bit of a slog yesterday - -tough going at times. We are fortunate to have such a strong optical team - - - hard working, compassionate, and cheerful through the difficulties.

 

Ronald Silva and Michael Caldwell are great leaders.  They have made multitudes of small decisions all along the way to make things go more smoothly.  They are serving the team even as they lead the team and are sensitive to the needs of the individual team members.  They are mature, providing solid, strong direction, and project a calm, good-natured, even cheerful confidence that has been reassuring for everyone.  They also are invested in furthering the incipient partnership with both the church association and the Cartagena medical community.  Dr. Jim Canterato, has spent several very significant sessions at two of the hospitals with the residents and their attendings, including department and surgical chairs, teaching Ultrasound Guided Regional Anesthesia Blocks. They are very appreciative.  One of the doctors has invited the entire team to have dinner at their home on Friday night.

Jack and Lisa comprise our pediatric department.  Though children are great - - I once was one, there is a reason I am not a Pediatric Ophthalmologist, It’s this thing called patience.  I can’t express adequately my respect for the job Jack and Lisa are doing in handling the lion’s share of these kids.  Jack was sharing with me today some of the issues he has addressed with these little ones and their families.  The parents are very appreciative.

Clinic Day #2 is now archived.  About 275 were seen today.  Giovanni started the day with a devotional about respecting and loving God.  Also, it was good to see Edgar, one of the church association pastors who was with us last year.  He is a wonderful Colombian brother whose grounded, practical Christian walk is an example to us all. 

 

Optical again was very busy.  The team is doing a fantastic job amidst very hot humid conditions.  During a surgery today, my surgical loops (magnifiers) became so steamed that it was at times hard to see the surgical field.  It was a first for me.  Fortunately everything went well.  The team in those same conditions handed out scores of glasses after taking histories and performing refractions.  Again there were very many appreciative people.

Signing off until tomorrow.

A Typical Clinic Day

How a day at clinic works:

Wake-up at 6:00am, 6:30 (or 5:30 if you would like to run along the bay with Dr. Nick) to be ready for breakfast at the hotel around 7:00. Eat, have a brief meeting with the team and the bus leaves by 8:00. It is about a 40-45 minute drive, depending on the traffic, to the school where the clinic is held. We arrive and have a short devotional with one of the pastors from the church, get set up and let the triage begin! The guard at the gate lets about 20 people in at a time to fill out forms and essentially take a number. They wait underneath a tent until their name is called. Anne Marie and Omar are our stellar triage team. They ask what the complaints of the patients are and give them the number of a room where they would be best helped in. Options for treatment include OB-GYN, dental, optical, pediatrics, simple surgery, and general medicine. After they have received treatment everyone stops by the pharmacy for vitamins and any other prescriptions that may be right for them. At the end of the medical portion of the clinic they are invited into the sanctuary (the only air conditioned room) for a spiritual clinic or they can come right to me in the photo clinic. All of this together makes for a fun and long day.

The ladies and gentlemen who work at the church have been extrememly helpful to us. Not only do they bring us lunch and water when we may need it, they also bring us Colombian coffee. A few times a day they come around and give us some coffee in an espresso sized cup. Let me tell you somthing about this coffee! It is black, sweet, and perfect. You really only need a little at a time even though we would not mind getting it in a larger portion. They must add a bit of extra sugar to it so it is sweet to our taste buds.

Something that the Lord has been teaching a lot of us is being patient with our interpreters from Colombia. Many of the interpreters that help us are younger men who are extremely eager to practice and learn more of their English. There have been times when getting frustrated with your interpreter is easy to do because they are jumping to conclusions about a diagnosis or they do not know the specific medical term for a given situation. When we step back and look at the bigger picture it might be easy to see a situation where we may have hurt their feelings by asking a "more skilled" interpreter how to communicate something that they could not. What we are learning is to simply take a deep breath of the Spirit in and let grace and patience flow from us. Please pray that our patience would continue to grow as the week moves along.

Looking forward to day 3 of clinic tomorrow!

Maggie

First "official" day of clinic

Today was our first day seeing patients from 9am until 5:30pm. The flow of patients into the clinic at first was steady and then picked up to full speed by noon. From where I was sitting I could not see the end of the line until 4pm. The estimated total of patients we saw today was around 240. What a great feeling to know that we have helped so many people already and we have two and a half days of clinic left. The first day is usually the hardest (so I am told because this is my first trip). Working out kinks in the logistics system, knowing how efficient each area can be with patients and so on. Today our patients were mostly children from the school where the clinic is held. I had the priviledge of taking pictures of patients after they had been through the clinic. It was rewarding to be able to take a picture, print it out, and hand it to the persons in the photo.

More updates to come tomorrow about our second day of clinic. We are all exhausted but it is definitely a good exhausted feeling. We know that the Lord is blessing us in many different ways even if it is not with extra sleep. God bless and goodnight!

Maggie

Dr. Esteban’s Blog

Today the phrase, “False Start” was proffered as a description of our day by Dr. Andy.  He likened the day to a race where due to someone’s jumping the gun, the runners are called back into the blocks to start all over again.  That does indeed express how it feels to be all ready to go with the clinic but be held back by contingencies outside our control. 

The travel arrangements worked flawlessly - - though if the room for each seat gets any smaller on these planes, soon we will all choose to simply remain standing.  If I feel crowded, you can imagine how Bret Van Dyken feels.  Fortunately, they found a spot with more leg room by an exit for Bret - - with of course the requirement that Bret block anyone who might attempt a stroll outside at 35,000 feet and depressurize the cabin midway over the Caribbean.  I doubt very much anyone could get past Bret.

We definitely have a solid team - - no complaints, everyone in good spirits, and yet very appreciative to get situated in the Hotel.  The one “glitch” which accounted for the “false start” was that our medications were held up through customs until almost noon today.  By the time we arrived at the clinic/school we could only set things up for tomorrow.  Those who were waiting for us to arrive were given tickets for priority service first thing in the morning. 

It was enjoyable meeting our many friends from last year.  The Colombian leadership, Jholman, Nafer, Giovanni, and Gulliermo worked very hard to prepare the school for the clinic, including work to get medications through customs.  Some national and some local circumstances made this more of a challenge this year; however, at the end of it all, there were smiles, handshakes, even hugs, and best wishes for the clinic.  It seems that some good relationships have been formed for future trips.  Dr. Juan Mesa, an Interventional Cardiologist from Marshfield Clinic and native Colombian on our team was invaluable in working with the government officials. 

Omar Rodriguez, the Reach Global Area Supervisor for Colombia, has been a great addition to the team.  He will be performing triage with Anna-Marie Belcore.  Drinking water from a fire hydrant is the operative metaphor.  They will be able to handle it. 

Ginny Bondeson is working in our optical area.  What a privilege to have her there.  She is picking up the optics very quickly and, of course, her Chinese is invaluable.  Actually, though she will probably not use her Chinese here in Cartagena, her heart for others will be! For many years, Ginny has led the way at Woodlands for a global concern and passion.  We all build upon the foundation she has laid. 

We have three pharmacists on this team, Tom Robinson, Jim Wrass, and Megan Ose.  They are all experienced with Medical missions.  Ron Silva, our team leader, observed them setting up their pharmacy this afternoon.  He was impressed with how well they worked together and organized the medications.  Starting tomorrow every single person seen in the clinic will go through the pharmacy, many with multiple prescriptions.  Sound busy?  It will be, and they will fill those prescriptions accurately, dispense them as safely as they do in the U.S., and do it with a smile.  It is great to have them on the team. 

Maggie Wallis is our photojournalist/blog administrator. Her smile, enthusiasm, and commitment to her responsibilities add lots of energy to the team.  She is the one to thank for this blog you enjoy.

Day 2!

 


 

There is the sweetest sight we thought we might never see.

We were greeted with a warm welcome by the Colombians. They sang us a song that made you want to dance!

They are behind us if you look closely...

Day 2!

Today was originally planned to be a set-up and half day of clinic but instead we were still waiting on our medical supplies. Our team leaders went to speak with Colombians who were in charge of customs at the break of dawn. They had told us to be ready by 9am to hopefully set out for the clinic. Nine rolls around and we get a phone call from Ronald saying that it would probably be another hour. So we all stuck around the hotel in case they were to come back early. 10:15 rolls around and another phone calls says that there is still no progress. We blame it on "South American time", everything happens just a little bit slower... The Lord was teaching us patience and adaptability.

In the mean time we were sent out to get lunch for ourselves, which required exchanging our American dollars for Colombian pesos. Another adventure ensued. So we walked and walked, and walked some more and found a bank that might exchange our dollars for us. I do not think that all of us were anticipating that there was going to be an exchange rate fee when getting pesos but fees do apply... So instead of getting $20 worth of pesos you would be getting $15 or $16 depending on where you do the money exchange. Better to exchange more money at a time in this case.

After lunch we arrived back to the hotel by about 1pm and the team leaders were back with great news! They were able to get the medical supplies through customs and we just needed to go and get them from the airport! Praise the Lord! We all jumped on the bus when it arrived and were ready to go. When we got to the airport and we saw our action packers it was a sweet sight. Who knew that black, grey, and red plastic bins could bring us so much joy! We loaded them onto our bus which had no doors and were on our way to the church where the clinic is held.  

By the time we arrived at the church it was about 3:30. We decided to not see any patients today but take the afternoon to set-up. We took the names of the patients that were waiting at the clinic so patiently and promised we would see them first thing in the morning. The pastors and members of the church were incredily helpful in our set-up process. We had electricians getting more power going to different rooms and men moving heavy furniture up and around the space for us. We set up the clinic in record time and it looks great. We are very ready to take patients tomorrow morning.

I do not mean to make anyone jealous back home but the weather here has been in the high eightys and there is a beautiful breeze that comes in from the ocean. The humidity is not quite as high as I anticipated it to be. I have curly hair and it is kind of humidity barometer for me. My curls definitely got tighter after we arrived. The area where the clinic is is not quite as breezy as we are here at the hotel. It is going to be a warm couple of days but we know it is well worth it. We just need to stay hydrated and out of direct sunlight.

God has been an amazing provider for us through this entire experience. The situation with the medical supplies was a bit of a strain on us mentally but we new that God had a plan in why the supplies were held back. We may not see the purpose for it yet but we know that the bigger picture will become more clear later.

That is all for now. Singing off from Cartagena.

Maggie

Safe Arrival

Greetings to our family and friends. Our trip down went fairly smooth.  What a difference in temps, 8 ° F in Chicago, when we left, 85° here in  Cartagena. Our medical supplies are held up at the aiport, between Customs and their equiv. of the IRS.  We are still waiting to get started, with promises that it will be resolved in an hour (it has already been several hours)

A few of us went for a run at 0600 this morning. The port area is very nice, a police officer every 100 yds as well as a Naval gun boat patrolling the harbor. There were many Colombians as well as visitors running, jogging, roller blading or just walking. It was great, only you had to keep your eyes open  for the el pero caca. ( apologize if my spelling is incorrect). The food of course has been great, especially the pescado ( fish).    Jim and Sheryl Wrass

Arrival

Hello family and friends! We have safely arrived in Cartagena, Colombia. After a blustery bus ride to Chicago, a connecting flight to Fort Lauderdale, and one last jump to Cartagena we have arrived.

                Unfortunately we hit one bump in the road as we were trying to get the medical supplies through customs at the Cartagena airport. They basically said that we could not take them with us. Prior to leaving for our trip the leaders had documents in order to get the supplies and medicines through customs just as they had last year. Between the time the documents were sent and now, an election was held in Colombia and the government has changed. So the people at customs explained that the documents were no longer valid because of the change in government. At this very moment the leaders of our team are still in contact with the customs people at the airport and have every confidence that our medicines will be available to us sometime tomorrow.

                Although this may seem like a road block at the present moment, we know that God has a much bigger plan than we can see.  All of our trust is in Him and what a secure trust it is. We would appreciate prayers to help move this processes along quickly so that we can be well on our way to helping the people of Colombia.

                After roughly 16 hours of traveling by bus and air many of us are ready for some nice long shut eye in an actual bed.  Stay tuned to our blog for more updates tomorrow!

Cartagena Colombia - 2012

Hi!  We are a team of 24 individuals who will be traveling to Cartagena, Colombia to hold a medical clinic for the people there.  This is our second year holding a clinic in Colombia.  We are excited to go serve the people in Cartagena & to see all that God does while we are down there.  Please be praying for us as we travel starting Saturday February 11 (@ 10:30 PM) and return early in the morning on Monday, February 20 (@3:30 AM).  Your thoughts and prayers are much appreciated!

A map of where Cartagena is located in Colombia.

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