Puno, Peru Surgical Trip

Reunited With Mother

  Yeni Maribel, Mother Celia, and Liz Spona 
  Originally uploaded by interplast.

Yeni Maribel is a 5 year-old patient who had an ear tag removed. She was reunited with her mother in the recovery room. Liz Spona, the second recovery room nurse, reviewed the child’s condition with her mother.

Host Country Empowerment

  Percy Rossell, Zulema Tomas, & local intern 
  Originally uploaded by interplast.

Percy Rossell is a surgeon and Interplast Surgical Outreach Director in Peru. Zulema is the pediatric anesthesiologist who works regularly with Percy in Lima, Peru.  This is her first Interplast trip. One of the elements of this mission is to facilitate the integration of local medical staff with our Interplast colleagues. This helps achieve the Interplast goal of host country empowerment.

Interplast thanks Ronald McDonald House Charities for its generous sponsorship of this trip. Together, Interplast and RMHC have changed the lives of thousands of children in Peru and around the world.

High Altitude Issues

  Kim and Oxygen Tank 
  Originally uploaded by interplast.

Recovery room nurse Kim Yates, ensures that oxygen supply is adequate each morning. The high altitude of 13,000 feet presents the team with new challenges as they become familiar with the baseline respiratory status of the patients, and their response to surgery and anesthesia.

Carefully Distributing All The Cases

  Josh Korman and Tessa Scheduling 
  Originally uploaded by interplast.

Working hard to meet the deadline, Josh and Tessa work out the second week’s schedule by carefully distributing all the cases.

Team Leader Dorothy Gaal

  Team Leader Dorothy Gaal 
  Originally uploaded by interplast.

Dorothy Gaal, the Puno Team Leader and Chief Anesthesiologist, digs for more supplies in the central storage area. She appreciates how carefully the Interplast staff, volunteers and colleagues packed for the first trip of the Interplast season.

A Long Day Of Surgery

  Amanda, John, and Diane 
  Originally uploaded by interplast.

Anesthesiologist John Stanec, Interplast 2005-06 Webster Fellow Amanda Gosman and OR nurse Diane George work together on a long day of surgery.

Difficult Clinical Decisions

  William with father and uncle 
  Originally uploaded by interplast.

William is a 15 year-old patient who was tragically burned in July 2005 by a high voltage wire in his high school. There were significant burns to his dominant hand and foot. In Puno, clinical decisions are difficult because of the severity of the injuries, hospital conditions, family expectations and the complexity of the ideal operation. Arrangements for further care were achieved with assistance from team members Zulema Tomas, Percy Rossell, Josh Korman and colleagues in Lima, Peru. We wish William well.

Josh Korman scrubbing with Kiran Nakarmi

  Josh Korman scrubbing with Kiran Nakarmi 
  Originally uploaded by interplast.

Josh is seen here scrubbing with Kiran to assist him due to a lack of local nurses. Josh is an Interplast board member and the team’s chief surgeon.  Kiran is an essential member of the Interplast Surgical Outreach Center in Nepal.

We are grateful to the Syde Hurdus Charitable Foundation, whose supplemental funding of this trip made it possible for Dr. Kiran Nakarmi of Nepal to join the team, bringing his expertise from the Himalayas to the Andes in order to help Peruvian children in need.

Making The Rounds

  Mary and Raul 
  Originally uploaded by interplast.

Mary, the Puno team pediatrician, examines Raul while making morning rounds through each ward. The team makes rounds every morning and in the evening, making sure that the patients were showing signs of recovery and following the post-op orders of pain management, infection control and wound care.

After Nelson's Lip Revision Operation

  Tessa and Nelson 
  Originally uploaded by interplast.

Tessa reviews the post-op orders with Nelson and his father. Nelson greatly appreciated the daily handouts of coloring pages and stickers that were given to him after his lip revision operation.  We are all grateful to Ronald McDonald House Charities for their generous sponsorship of this trip to Puno, and for the donation of coloring books and stickers for all of the kids.

Nurses on Strike

  Nurses' Strike 
  Originally uploaded by interplast.

On August 10, nurses nationwide initiated a nationwide strike with the goal of receiving better pay. This has affected the team's work significantly: the lack of local nurses in the operating room (OR) was yet another struggle that the Interplast team has had to cope with. Fortunately, later in the first week there was local support provided. It was given with enthusiasm. The Interplast coordinator in Puno, Ricardo Gutierrez, was instrumental to achieving this change.

Efficiency and Safety

  Tessa and Dora 
  Originally uploaded by interplast.

The Puno team’s two coordinators and interpreters, Dora and Tessa, found that organization and preparation of patient information were crucial to the efficiency and safety of the day's work. Free time was minimal for them.

Dealing With Challenges

  Dora, Local Nurse, and Susan 
  Originally uploaded by interplast.

Dora interprets between the local nurse and Susan, the Interplast scrub nurse. Susan was a bit shocked to find out that one of the two cautery machines had blown out before the Puno team had even started their first day of surgeries. With scarce supplies and equipment, the team was faced with many day-to-day challenges.

Positive Attitude

  Luisa Priscila 
  Originally uploaded by interplast.

Luisa Priscila greeted us with a strong "hello" everyday and always kept a permanent smile before and after her operation. Her positive attitude was felt in the recovery room and in the ward, as she became friends with all the nurses and her neighbors in the wards.

Hoping to be accepted by Interplast on Clinic Day

  Clinic Day 3 
  Originally uploaded by interplast.

Eagerly anticipating the schedule to be announced, this mother and child are hopeful for the child’s acceptance.

Clinic Day at the Puno, Peru Hospital

  Clinic Day 2 
  Originally uploaded by interplast.

A mother with her child on her back talk with the volunteer clinic secretary. Many of the patients came from towns several hours or days away, and arrived with different modes of transportation, the most common being the backside transport.

2005 Puno Surgical Trip Clinic Day

  Clinic Day 1 
  Originally uploaded by interplast.

Bundled with layers of blankets and alpaca sweaters, the parents and their children desperately wait for the patients’ names to be called. There were approximately 140 patients seen on clinic day, all with various conditions: cleft and lip palates, severe burns, rhinoplasty and congenital deformities.