Catholic Diocese of Spokane, Washington

From the

Official News Magazine of the Diocese of Spokane

Deacon Eric Meisfjord, Editor
P.O. Box 48, Spokane WA 99210
(509) 358-7340; FAX: (509) 358-7302

Spokane medical teams head to Guatemala to perform sight-saving surgeries

by Jerry Monks, for the Inland Register

(From the Feb. 5, 2004 edition of the Inland Register)

Maureen O'Keefe, Clara MonksNurse Maureen O’Keefe (left) and Clara Monks load some of the supplies that have been sterilized in Sacred Heart Medical Center for the cataract surgery project at the Novillero Clinic in Guatemala. These are some of the items that would eventually fill 24 large bags. (IR photo from the Guatemala Commission.)

“We can do that – let’s do it! I’ll talk to Dr. Wilkerson, and I bet he’d go. And maybe his operating room tech would go too! And I know some other nurses at Sacred Heart. I’m sure they’d love to help. It’ll be fun. Let’s do it!”

When it comes to sharing her time, talent, and treasure with the poor – and enticing others to do the same – Maureen O’Keefe seems to be a natural-born catalyst. Once she learns of someone’s need, especially that of a child, her Montana-nurtured generosity takes over. And she starts generating remedies. Ones that frequently draw others into the camaraderie of a humanitarian venture. More often than not, the venture involves passports, travel, and the volunteering of medical care in some underdeveloped country.

The number of “comrades” who ultimately get involved in one of Maureen’s medical mission projects is deceptively surprising. On the surface, it appears to be only a few willing souls. But Maureen’s enthusiasm typically entraps the support of countless other unsuspecting individuals. A look at some of the activities associated with taking a medical team to Guatemala reveals the diverse number of volunteers who contribute behind the scenes.

Why Guatemala? For the past 45 years, the Diocese of Spokane has worked in a supportive capacity with the Diocese of Sololá, Guatemala. During that time, Sister Immaculata Burke, manager of health care activities for the mission, has developed a clinical care system that has served thousands Mayan Indian people who would otherwise have no medical care.

For years, Sister Immaculata’s dream had been to find a way to help the numerous Indians who have lost their sight due to cataracts. She knew that the only solution was surgery. However, her patients were far too poor to even travel to a distant city, much less pay the cost of an operation. Moreover, her clinics were not equipped for surgery. Nor were there any surgeons in the mountainous area she calls home.

Cataract surgery project is proposed for Guatemala

Two years ago, Sister Immaculata’s problem and Maureen O’Keefe’s enthusiasm converged in a triangle. The third side of the figure was the Adopt-A-Family (AAF) organization. AAF is an economic outreach program of the Diocese of Spokane. It links Spokane families with an extremely poor Mayan Indian family, to help the Mayan family learn a skill so they can become more self-sufficient. However, it also engages in other activities, such as construction of enclosed stoves, latrine construction, women’s programs, and the support of clinics.

Sister Immaculata had received support for her clinics from AAF for many years. Maureen O’Keefe had been a long-time sponsor of a Guatemalan family through the Adopt-A-Family program. When Sister Immaculata voiced her dream to staff members of AAF and Maureen was alerted to the need, her catalytic personality went into gear: “Let’s do the operations there, in the clinic in Novillero!”

An anesthetist who works in the operating rooms at Sacred Heart Medical Center, Maureen O’Keefe had been on earlier medical missions. She had spent 3 years in Korea, had been to Romania with N.W. Medical, and to Guatemala with Healing the Children. Thus, her impulse to take on a cataract surgery project in Guatemala was not naïve. But performing surgery in a remote mountainous area where they had never been done before was destined to be a real challenge. She would need lots of help.

The AAF organization already had an experienced field staff in Guatemala and well- established communication links with their headquarters in Spokane. Clara Monks, co-director of AAF, was tapped for the project management responsibility. She would have to coordinate everything from Spokane, relying heavily upon Sister Immaculata Burke and Sister’s clinic physician, Dr. Jose Miguel, plus Natalia deLeon, the AAF coordinator in Guatemala. Maureen O’Keefe, in turn, would provide medical expertise – and lots of energy.

Feasibility of performing surgery in Novillero

Although the need existed, the feasibility of doing surgeries in Novillero was not yet established. Countless uncertainties would eventually have to be resolved:

How would the mission be funded?

Who would go?

Where will they get the expensive equipment needed for surgery? And medical supplies?

How would they get the medical team to Guatemala, and move supplies and equipment through customs?

There are no hotels in the area. Where will everyone stay, and how will they get around?

Patient issues needed attention too. What records should be designed – and in what language? English, Spanish, or the native K’iche? How would patients be notified, screened, and prepared for sterile operations? Eye measurements would have to be taken, and a custom-built lens procured for each patient – how would that be accomplished?

Two medical teams would be needed rather than one.The first group, optometrists, would screen patients and take eye measurements during the first week of February. They would fax, or e-mail, the data to Spokane so that custom lenses could be procured from suppliers in Texas or New York during the second week. The surgery team would then bring the lenses with them. They hoped to perform eight or 10 surgeries per day during the third week of February.

The small Novillero Clinic was not designed to accommodate the sterile operating environment needed for surgery. Yet, Sister Immaculata was sure it could be used. She had treated thousands of patients there, and felt the necessary modifications could be made.

Financially, the project was difficult. Some items of equipment could run as much as $80,000. The Sisters of Charity of New York would donate $25,000 to get things started. Then AAF could appeal to the Catholic Medical Missions Bureau (CMMB) and to some medical corporations. Support from some individuals could certainly be expected.

Some of the uncertainties began to be resolved as more volunteers were drawn into the process.

Funding the project

In addition to the $25,000 from the Sisters of Charity, an anonymous supporter of mission activities pledged $35,000. Donations from 30 individuals through AAF would add another $13,800. Gifts from Assumption, St. Mary, and St. Ann parishes would bring the available funds to just over $75,000.

That left considerable need for help from larger organizations. They would have to be convinced to donate some of the expensive equipment and medical supplies, or provide them at an extremely low cost. Other expenses would be mostly for airline fares for a few of the medical people who would need help, plus food, housing, and transportation within Guatemala.

It might take hundreds of phone calls and pleas for humanitarian assistance, but the $75,000 was enough to proceed to the next step.

Forming the medical teams

Who could resist the temptation of signing on for the trip after hearing Maureen O’Keefe describe the joys of traveling to lovely Guatemala? Dr. Craig Wilkerson, the ophthalmologist, had already done some work at the Pediatric Foundation in Guatemala City. His operating room scrub tech, Dorie Buechler, and office tech, Shawn Shepherd, were quickly on board as assistants. Maureen was in as the anesthetist.

Molly Shine, a nurse from Sacred Heart, and Mary Zimmerman, recently retired from St. Joseph Care Center, signed on for pre-operation, and circulating nurse duties. A call to Dorothy Rebholtz in Boise filled the post-operation nursing position.

But Novillero is a remote site. What if the power goes out or some of the equipment malfunctions? That could be critical if Dr. Wilkerson were in the middle of an operation.

Sister Immaculata would have to purchase an emergency generator in Guatemala and get it installed to handle power failure emergencies – which do occur in Guatemala. Roy Munyan, a clinical engineer from Sacred Heart, would join the team to handle any on-site instrumentation problems.

Dr. Mike DeRosier, an optometrist in Deer Park and a long time supporter of AAF, had no hesitation in volunteering to head up the screening team. He soon had the endorsement of optometrist Rich Ryan from Spokane, Kelly Cochrane from Kahlotus, and Kevin Ikeda from California.

Preparing facilities and securing equipment

Procuring the equipment and supplies brought more participants into the project. The first step was to confirm the suitability of the Novillero Clinic for efficient screening and surgery activities so that it could accommodate many patients in a limited amount of time.

Dr. Jose Miguel took room measurements and mailed a floor plan to Spokane. Dr. DeRosier, along with others, designed a layout to accommodate the five-stage screening activities. The surgery activities of pre-operation, surgery, and post-operation would use the same rooms two weeks later.

Sister Immaculata and Dr. Miguel procured a dental chair that would be used as an operating table. Sister also had some local people construct tables for the screening equipment. Dave Dodroe, a Spokane native volunteering in the Mission, helped her acquire and install an emergency generator. A ground wire was added to the electrical system.

For cataract surgeries, physicians use a phacoemulsification system that vibrates, emulsifies, and vacuums the cataract out through a very small incision. The phaco machine, along with a surgical microscope, sterilizer, and other equipment, is costly. Purchasing new equipment would have consumed the entire $75,000 budget.

Providence Sister Rosali Locati, the Director of Mission and Values at Sacred Heart Medical Center in Spokane, suggested contacting Larry Dickson at Providence Health in Portland to see how they could help. He recommended a medical refurbishing firm in St. Louis as a supplier. Dale Brodsky, of St. Louis Ophthalmic, proved to be most accommodating. He arranged for the shipment of much of the needed equipment within the available budget.

Obtaining needed medical supplies

In addition to on-site equipment, each surgery would entail the use of a large number of support items. Individual sterilized packs containing gowns, gloves, needles, oxygen tubing, and so forth were needed for each patient. Thirteen types of medicines were needed for screening activities and more than 20 more items were needed for surgery. Some of the drugs are quite costly. Catholic Medical Missions Board could supply one essential item.

Maureen O’Keefe’s past experience proved invaluable in assembling kits and securing the needed medicines. By utilizing excess and/or discarded (but unexpired) items from Sacred Heart Medical Center’s warehouse, volunteers were able package 75 kits. These were then sterilized at Sacred Heart on weekends, when unused capacity was available.

Dr. Wilkerson favored the use of Alcon lenses for his patients at Rockwood Clinic in Spokane. An inquiry to Carolyn Cate at Alcon about the possibility of donating medicines and lenses brought a positive response. She contacted Mike Kuykendall of the Alcon Humanitarian Division who welcomed the Spokane team’s request of a long list of medicines for the screening and surgical activities. With the help of Larry Fay in Portland, and Steve Nelly, a Division Manager, Alcon also agreed to donate the lenses once the measurements were faxed to them.

Forms, records, and travel support

Forms had to be designed for patient records. Medicines had to be collected, itemized, packed, and passed through Guatemalan customs. All the personnel and materials had to be met at the Guatemala City airport and transported to the highlands.

More individuals became unwitting volunteers as the project progressed. Amanda Driscoll, a Gonzaga Spanish language graduate, volunteered to translate pre-operation and post-operation forms into Spanish. Bob Toshack and Rob Joyce of the Gonzaga SBA Computer Center helped download nonstandard correspondence from Guatemala. Fran McDonald, along with Jim and Jeanette Barrett, joined the Sacred Heart warehouse team to help assemble packs, and prepare luggage for the air lines. Angie Taylor, a Spokane agent for United Airlines, sought special permission for extra bags on United. Casey Reinke, the station manager for Alaska Airlines in Los Angeles, did the same for team members traveling with his company.

The project also drew in a surprising number of officials who helped prepare the way for passing through Guatemalan Customs and moving supplies to the highlands. Letters of invitation were provided by the director of Public Health in Sololá, the Guatemalan College of Medicine, the Pediatric Foundation, the bishop of Sololá-Chimaltenango, and by Bishop William Skylstad of Spokane. Natalia deLeon, the AAF Program Coordinator contributed many hours preparing for customs approval and making local travel arrangements with the Pediatric Foundation.

Beyond sight to the blind

When Maureen O’Keefe said “Let’s do it!” she set in motion a countless number of unsuspecting volunteers, many more than those mentioned above. She did this knowing that the number that counts most is the number of the poor who will be blessed with restored sight.

But sight is not the only benefit the poor receive from the many volunteers and contributors whose efforts merge into a medical mission like this. By going to Guatemala, the team is evidencing a concern for the condition of those who have no one else to care for them. They are saying, on behalf of all the volunteers, that “We care about you.” In doing so, they are affirming the dignity and self worth of those Mayan Indians who have so little of this world’s goods. And that affirmation is not limited to those who receive surgery.

(Jerry Monks is a member of the Spokane Diocese’s Guatemala Commission.)

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