Return to Palenque

     The trip down was complicated.  One participant had their flight from Kansas City to Atlanta cancelled last night because of weather so she will not join us till Sunday.  We all went to the airport in Wichita around 4 am to check in.  No one had to pay for their bags and we had not ask to be able to take our baggage for free.  Prayers had been lifted up this year for our supplies and baggage after problems we had had in years gone by.  Unfortunately, bad weather in the east coast had delayed arrival and departure in Wichita and everywhere (all planes had to be de-iced prior to departure).  So we sat on the tarmac in Wichita for 40 minutes waiting to leave after our "on time departure".  Since our connection time in Atlanta was 45 minutes, we were afraid that we would miss our connection (the only flight until late in the evening to the DR).  Nowadays, Delta has Wi-Fi while in the air so you can stay connected to the internet and that allowed me to receive a text from the Delta computer informing me that our flight to Santo Domingo was leaving 5 minutes early.  Great! So, that same helpful computer automatically rebooked me since it was sure I couldn't make the departing plane.  As I looked at the flight info on my new flight I noticed that it was thru Mexico City.  It did have the courtesy to ask if that was OK to which I responded with a polite NO.

     When we landed the flight attendant informed me that the plane to Santo Domingo was being held for us.  We hadn't ask and they almost never do that.  So we all made the connection and arrived 5 minutes late to Santo Domingo as if nothing had happened but God had been working hard behind the scenes.  We had people back home praying for our travels.  Passing thru the Las Americas International Airport is always a surprise.  It is kind of like Kellogg Expressway in Wichita, it is always different and under construction.  After going through the new location and procedure, we came to the baggage and customs ritual.  This year once again, we didn't have a letter from the head of customs (we never found out why) and after 45 minutes of standing around discussing, motioning with our hands and arms and making phone calls, we were able to take all our supplies and baggage without having them go thru them or leave anything behind.

     We arrived at the camp after the 45 minute bus trip to Sabana Grande de Palenque.  The retreat center was much the same as we left it in September.  We did Covid test upon arrival following our new protocols.  We were vaccinated and feeling well but one of the participants tested positive.  So, we placed him in isolation before we had spent much time with him.  He was given a private room and had his meals separate from us as per protocols.

    Sunday was a blur.  We followed the usual routine with breakfast, devotions, orientation and unpacking at the camp as we usually do on these projects.  By 11 am, we were able to head to the small hospital in Palenque.  It was a pleasant drive along the coast for 15-20 minutes.  Upon arrival, there were 75-100 people outside the front door waiting for us.  Being a Sunday, that meant that all of those people were there to see us since the weekends at a small hospital are usually very slow paced.  After a walk thru of the hospital with the nursing director, we were given permission to use certain rooms similar to last year.  While the project director and I were doing that, Edu had the patients and participants deep into prayer and song outside.   

The patients then opened a path to the door and applauded us as we walked into the hospital building.  We then began the unload and set up process.  We did stop briefly for lunch (PBJ or Ham and Cheese on hot dog buns).  While the set up was in process, we set up our consultation clinic at about 1 pm to screen and schedule patients for the week.  There were 2 rooms for gynecology patients and one for general surgery patients and I set up in the hall to set the dates for surgeries after seen by the docs.  The rest of the team continued to set up the rooms including the two ORs, central supply, pre op and post op rooms.  By about 4 pm they had finished as much as they could for the day.   I sent that part of the team back to the camp.  The consult clinic finished seeing 71 patients by 5:30 that afternoon and cleaned up the areas we used and returned to camp by 6:15.

    The dinner bell rang at 6:30 and we had dinner and a debrief of the day's activities.  We had 12 new decisions for Christ reported today alone. God is good!  We retested the participant that had been positive and his test today was equivocal but faintly positive so he will stay in camp in isolation and we will retest him tomorrow.  I completed the paperwork for the surgery schedule and visited with friends to complete my evening.

    Monday was a very busy day as usual.  I awoke early at 5 am with my mind swirling with mostly the things that are unknown ahead of us here.  After breakfast, we were off to the hospital. After doing so much yesterday, we were able to start the first case by 9 am, earlier that most projects.  There was only room on the schedule for 6 patients for the rest of the week, so I saw them during the afternoon.  We were able to do 11 major and 3 minor cases.  Major cases are those that are done under general anesthesia.  The end of the day in surgery did not come till 7 pm.  We had anticipated having some patients cancelled due to Covid or simply not show up, so the schedule was booked heavier than we wanted to actually do.  All patients checked during the week were negative for Covid.  When we got back to camp our participant in isolation tested negative for Covid so he was allowed to rejoin us for dinner.  I didn't last long after evening report and was back in my room by 8:30 and asleep by 9:15.  A great first day for sure.

    We were able to complete our Tuesday schedule and get back to camp by 6:15.  So dinner was on time!  Most of my time this year has been circulating from station to station, answering questions and talking to folks.  Our volume of cases is similar each day.  We did have one patient that we had to cancel due to uncontrolled high blood pressure, that was part of the reason that we got back to camp on schedule.  I am used to pushing a little, but this trip we really can't due to the Covid protocols.  So far it has worked.  Mask wearing in the hospital by the people in town has been very good.  I have had to keep reminding myself that there is a bigger goal with this project compared to our regular projects.  Being able to demonstrate that we can do a larger project safely is very important as a sign to future project participants.  We did get to enjoy ice cream bars after dinner, but I remain pretty tired so I turned in early to be up early.

    Wednesday was another long day.  I had scheduled 14 cases for us thinking that we would have had some cancelations but everyone showed up for surgery.  One elderly (72) gentleman came in with a history of hypertension.  He had taken his med but his blood pressure was still 178/138 (dangerous by our standards).  We worked to lower his pressure with the usual things but not until the Edu (they call her the evangelista) came in and prayed for and with him.  He committed his life right there and when we rechecked his pressure it decreased to a level that we could proceed with his surgery.  We repaired his inguinal hernia and he was able to be dismissed the same day as surgery.  Our last case of the day didn't finish until 6 pm but then we waited and worked with her for an hour and a half after surgery because her pressure was low.  We were concerned that she might have been bleeding but it turned out to be more related to her spinal anesthesia.  I had sent the rest of the team back to camp and a few of us remained with the patient.  We didn't get back until 8 o'clock and everyone had waited dinner on us.

    No cancelations or no show on Thursday so we had a packed scheduled.  We had no one complaining about the busy schedule.  It is amazing to have a group of people who all want to be here and do everything possible to help others.  We had a patient after surgery who was having trouble maintaining her oxygen levels in spite of increasing her nasal O2.  She was beginning to panic and breathing fasted to try to get more air.  Once again Edu was there and prayed for and with the patient.  All of a sudden her oxygen level began to rise to normal and her breathing slowed.  She likewise committed her life to Christ.  Our difficult case from yesterday had turned around by the time we came in and was able to be discharged. 

The final group returned to camp after dark but we celebrated a couple of birthdays in the group with a Dominican cake and some ice cream.  Everyone was a little on edge since tomorrow was the last day of surgery and also the day for us all to be retested for Covid to get a release to go home on Saturday.

    I didn't sleep well, so I was up earlier than others.  I was first in line for my Covid test and yea I passed as did all the other participants.  This was a different project with the mix of 3 General Surgeons and 3 Gynecologists in addition to me.  So, I was not needed in the OR to do surgery with only 2 tables doing surgery.  That made for a lot of sitting around later in the week (think Ecclesiastes 3:1).  Our day went by very fast with 13 major cases completed by 2:30 pm.  None of those would require overnight stays so they were discharged soon after their surgery.  But we had to tear down our "hospital" and load it all onto the big white truck to take back to the warehouse.  That allowed us to be back to the camp in time for some R&R prior to dinner.  Some swam in the pool, some walked to the beach, some to the cliffs.  And all were able to appreciate the beauty of the country.

    Dinner was followed by our sharing time and debriefing for the project.  Many appeared to be deeply touched by our experiences.  The time of sharing was very special.  Then to bed after taking time to casually visit in the cool of the night outdoors with friends.  In the morning, I awoke earlier than I needed to wake, but it's hard to go back to sleep with a thousand things on my mind about this project and about the next ones.  After breakfast, we loaded up and began the drive back to the airport.  We stopped by the MMI warehouse in Los Alcarrisos, a municipality on the east side of Santo Domingo. 

It was good for the team to get a bigger picture of MMI in the DR since most are limited in their experiences to their own projects.

    In the air flying home, I continued to reflect on the project of the last week.  

Defining success looks different to different people.  To the 65 patients we saw and operated, success would be defined in the relief of physical and mental suffering.  For the 32 new followers of Christ, a redefinition of their eternal trajectory.  For some of the 21 other participants, it represented relief from burn out, fulfillment of their God given passion and awareness of a new direction in their life.  But to me it was an affirmation of purpose and a sense of peace.  

And the greatest success was in the glory that was given to God for all he has done and is doing and will be doing.