sabana

About the Sabana Grande de Boya Medical Project, 1997, with Medical Ministry International in the Dominican Republic

May, 1997, to Mom (North Carolina) from Barbara (South Carolina):

Terri Dees, our Sunday school teacher, and I are getting together a group of people from our church to go on a medical mission project in the DR this summer. We have shown our slides a couple of times, and a good many people want to go. However, with various scheduling difficulties, our group has been narrowed down to five, and Terri herself won't be able to go to the project. She'll join me for a week at Santana Hospital after the other five from church return to South Carolina. Yolanda Holmes, the administrator of the Ophthalmology Residency Program, wants us to catalogue the books in Santana's medical library.

Going with me to the Medical project from our church will be two physicians – Dr. George Bass (Internal Medicine); and Dr. Melvin Medlock, (Family Practice). Also going is a former student of Terri's, Jeff Reitzel, who is thinking about going into medicine. Leah Hanna, a teacher, and her son Charles, will be coming along as general helpers. Leah's husband, a dentist, is unable to make this trip.

Everyone has been busy collecting donated medicines. Leah's father-in-law, Charles Hanna, Sr., is a physician, and with her husband being a dentist, she's got lots of contacts in the medical field and really knocked on a lot of doors. We packed all the donations at church and had the fellowship hall filled up with duffle bags full of medicines.

I'm expecting the conditions on this project to be very difficult, particularly the heat. So Victoria is helping me as I try to get used to being hot. Whenever we go anywhere, we leave windows up and vents closed, no fan or AC, even on hot sunny days. It gets pretty miserable but she's been awfully good natured. I'm lucky to have such a sweet daughter.

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May, 1997, from Nancy Kelly, Assistant project director for Sabana Grande Project in the Dominican Republic:

In answer to your questions about the working conditions for our Sabana Grande Project, the team uses a local public hospital. In Sabana Grande, there is no running water, so the team brings it in by buckets. There is no generator, so when the electricity goes off, it's off. The hospital provides space and nothing else.

Sabana Grande is located in the mid-eastern area, and we work with Haitian sugar-cane workers. We are housed in a Christian Reformed School, the church that works with us on this project. The women are in sleeping quarters upstairs (up a winding narrow metal stairway) over the kitchen. We sleep in bunk beds in close quarters in two rooms. The bathrooms are located across a courtyard, with three showers and two stools that are flushed by "the bucket of water pouring" method. The men sleep upstairs over the chapel, and have the same shower/bathroom set-up.

I think this is our hottest project, temperature-wise. The clinics are in small churches where we all (doctors, pharmacy) share the same building. The dentist could be under the tarps or trees. It does get a little close when the heavy rains hit and everybody tries to get inside. Last year it rained hard everyday. Luckily, it happened usually at the end of our workday, so we weren't overwhelmed as in other times I've known.

As a staff, we consider this the hardest project of the year, given the heat, the rain, the facilities, etc. But we love the cooperation of the participants, and the 'go for it' spirit they have.

In the Haitian cane cutter bateys, they live in deplorable conditions. Nearly everyone has intestinal worms due to the poor nutrition and sanitation, as well as scabies. Most every man needs analgesics because of the daily hard work. Generally the babies are nursed and are quite round, even if they're not well-clothed. We dispense a lot of Mebendazole and Lindane, plus many vitamins.

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Sunday, June 8, 1977, to Ralph (South Carolina), from Barbara (Santo Domingo):

I'm here – ready to be a participant in this medical project with the group from church. The two physicians from church – Melvin Medlock, so quiet and sweet, and George Bass, jovial and fun (he pretended he'd lost my tickets in Miami…) are delightful to be with. Same with Leah Hanna and her nineteen-year-old son, Charles. Jeff Reitzel didn't know any of us at all before this trip, since Terri's not here for the project, but he's blending in well and we're all having a lot of fun. We had such a fun trip down here that it got us started off to bonding as a group.

Our flights were good. We arrived in the country with lots of other MMIers (so there was no applause on landing in Santo Domingo – not enough Dominicans on board).

MMI was waiting for us at the airport before we ever even got inside. Teo Beato, who's the Dominican project director, was there with his clipboard, checking us off as he saw us. I wasn't sure about him at first. He kept his eyes on the clipboard, glancing up without moving his head so he looked shifty-eyed.

The airport was hot, and it'd been cold when we'd left the church parking lot this morning. Poor Leah was wearing a nylon snow-suit looking thing and started peeling it off there in the airport. We stood waiting a good while as the thirty or so of us MMIers gathered, but we walked straight through the immigration line. Teo cleared us all at once. Also, by the time we went to collect our luggage, someone had already taken all the luggage with MMI tags off the carousel. All we had to do was verify that all our bags were on the carts. We all paid one American dollar for each bag, which paid for the transport of the bags out to the bus.

They'd had us pack "first night" bags, with everything we'd need for our first night, and asked us to carry those onto the plane with us. Great advice! We took those bags with us onto the bus. Everything else went to a big truck that had surgical supplies for the project, and we probably won't see any of that again until after we arrive at the project site later today.

We drove first to the guest house at Santana! I was surprised to be going there but was so happy to see it again, and to see Carmen and Romanita – a gorgeous young lady who is completely deaf (though gets by so well with lip reading she doesn't seem deaf). She lives in the guest house and works in the hospital. They'd prepared a large meal for us though called it a snack, with lots of fresh pineapple.

I finally got to see the famous Chicken Hilton. I had no idea it was walking distance from Santana last year or I'd have walked up and taken a look. I loved my bunk bed. The springs were like a hammock – I sunk deep into it which for me is great. No back pain.

The next morning we had orientation. I'll tell you what – I changed my opinion about Teo. He is priceless! And puts us all to shame. While we're all in our T-shirts and shorts, Teo wore dress pants and a freshly starched shirt. At first he looks stern and unfriendly, until he smiles. He's got a wonderful smile.

"My name is Teo Beato," he said, "Dominican Republic Director of MMI, or Medical Ministry International. I would ask for your patience because I do not speak English. So pay attention, and ask if you need anything. We do not know each other right now. But at the end of this week, we will be a close family.

"A Bible verse which I want you to put in your mind is Mark 9:41. 'I tell you the truth – anyone who gives you a cup of water in my name, because you belong to Christ, will certainly not lose his reward.' That's what we're going to do in this country. We're going to give some people a cup of water. We're going to help them – maybe medication, maybe surgery. We can't take away their thirst – we're going to give them some relief – we're going to give them a cup of water.

"Also, 'Whatever you do, work at it with all of your heart, as working for the Lord, not for men. Since you know that you'll receive an inheritance from the Lord as a reward – it is the Lord Christ you are serving.'

"So – welcome to the DR. We wish you a pleasant time here, as we're sure you're going to have. I want to remind you of a very important thing that you need to put in your mind. Wash your hands before and after everything. That is to keep you healthy.

"We're going to be working in Sabana Grande de Boya, and you need to prepare your mind, and to think – we're going to be in a nice place. Put that in your mind – it's going to be nice. Even though it's going to be hot, humid, muggy – it's going to be nice. It's going to be crowded, uncomfortable, interesting – yes – it's going to be nice. Prepare your mind for that, and it's going to be nice.

"It's 80 or 90 kilometers from here, but because of the road, it will take us from two to two and a half hours by bus. It's going to be sometimes good, sometimes slow, sometimes bumpy. But it's going to be nice. Just prepare yourself. You need to make up your own mind to have a positive mind. The philosophy of MMI is to be flexible."

When he described the delivery room at the hospital as not having air conditioning, one of the doctors on the front row said, "But it's going to be nice!" and everyone laughed. We're all getting into the spirit of a good attitude despite bad conditions. Most everyone. There's one teen-aged girl here who doesn't seem happy or excited about anything. This will be challenging for her.

I'll tell you, Ralph – Teo redefined the word "nice." Ha. His humor in approaching the difficult conditions in Sabana Grande de Boya was like John's humor. The frustrations became humorous. The challenges became like a game, to see who could think of it as being nicest. We're looking forward to a really, truly, very nice experience.

I asked Doug Kelly, an assistant project director, about the article in our local paper last month about Sabana Grande de Boya being one of three Dominican cities on epidemic alert. It was an alarming article, saying it was a highly contagious illness related to meningitis that kills in less than 24 hours. But Doug said it's not yet considered an epidemic. Sort of a "watch," not a warning.

Our group is made up of a dentist and his dental assistant, six interpreters, one nursing student, one registered nurse, nine physicians, one nurse practitioner, one resident, two surgeons, eleven general helpers, and six teen-agers.

Teo handed out a flow-chart of short-term mission outcome possibilities. Basically it said you can decide to be either happy, or feel patronizing, or wish you were home. That pretty much says it, I guess.

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Monday evening:

You would be amazed how little clinics have changed in the last two decades! When we arrived at the first clinic site, out in this primitive batay full of Haitian cane workers and their families, there was the usual crowd of colorfully attired people. Women holding babies, men in straw hats or baseball caps, little girls in donated pageant dresses… No evidence of electricity anywhere though there was a single power line swaying between the palm trees.

There are a few procedural changes in how clinics are run. Every day, before beginning the clinic, we form a circle out by the line of patients, hold hands, sing Alabaré and an English song, and pray. Leah was really touched by that, how even though we don't speak the same language, there was that common bond and we all knew why. We didn't have to understand them to feel God's love from them, and they didn't have to understand us to feel God's love from us. They considered us a gift from God though, as George said, we were the ones being given the gift.

Tickets now cost ten pesos, which Teo said is equal to about 80 cents American. They now have a department called "Integrated Health" where the people wait while the pharmacy fills their prescriptions. The Integrated Health workers are the ones who dispense and explain the prescriptions, and teach about washing hands, boiling water and brushing teeth. They also integrate all the physical needs with spiritual needs. If women are child-bearing age, they teach about care and feeding of infants after reading Bible passages dealing with God's care and spiritual feeding of us. They teach that checking for spiritual disease is just as important as checking for physical disease. The need to purify water is paralleled to Jesus being the water of life. Everything is tied to God's love.

Most of the clinic day is just like it was twenty years ago. The mobile pharmacy looks a little different but it's the same idea. They now try to give vitamins and soap to everyone in addition to the prescribed medications.

Jim Lockett, the seventy-year-old dentist from Tennessee, is outside since "that has the best light," and the villages have rare electricity. Jim's wife, Carmen, and Charles Hanna are working with Jim as assistants. Charles is good at that since he's assisted his dad a lot over the years. He's even gone with his dad on house-calls, having someone sit in their recliner for a dentist chair, so he was quite used to seeing some of the things that he's seeing on this project. They seated their patients in a rocking chair today, and Charles shoved rocks under the front of the runners, and held the backs down with cinder-blocks. He has a good system going – keeps gauss sponges in his t-shirt pocket, which Dr. Lockett helps himself to as needed. Andrea Leep, the translator from Montana, also keeps her hands full of clean gauss. Carmen and Charles hand Dr. Lockett his instruments. But I remember how exhausted those much younger dentists would get doing extraction after extraction. Seventy-year-old Jim Lockett runs circles around them!

Doctor consult rooms were arranged with the placement of the benches in the church. Each doctor has a translator. Julie Versluys, a Spanish teacher from Montana, brought several of her students.

We have an interesting mix on this project – an amazing abundance of doctors, and only one nurse! Several of the doctors have needed to work as nurses. A couple of them are working in the hospital as nurses, and one was in the pharmacy today.

The only sink in this camp where we're staying is outdoors and very public. We do have shower facilities, and there's a cistern on the roof so we have good water pressure. The toilets leave a bit to be desired. One of them is an out-and-out outhouse, and Leah and I glanced at it but decided against it when we opened the lid and let out a swarm of mosquitoes. The other has a porcelain bowl, no seat, and is flushed into the outhouse below using a bucket of water you take in with you from a barrel outside. The walls were painted a vivid Pepto-Bismol pink. Fortunately, I perspire so much here, I'm not having to use the facilities too often.

A project participant gives the devotional each morning, and George Bass gave it this morning. It was good, about making the best of difficult (Teo's "nice") circumstances. His good attitude, like Teo's, is contagious. And George is a lot like Teo – they think a lot alike in seeing what's good, focusing on that instead of complaining about problems. They both have that attitude of expecting that 'today's going to be a great day.' Very helpful, and they're both fun to be around. George thinks a lot of Teo. Says "He's a good positive person, the type you need in this kind of position."

I'm assigned to the pharmacy. Nancy Kelly is the RN on staff who is in charge of the pharmacy. At the end of the first day we had a "Medicine Unpacking Party." Nancy set out cardboard boxes into which we all sorted the medicines we'd brought. I was no help at all, though. I'd been on my feet all day, in bad shoes because I'd thought it'd rain (which it didn't), and my feet are swollen and throbbing this evening.

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Tuesday evening:

Our dorm is close quarters and it was awfully hot last night. We had a revolving fan in there but my bed was just beyond its range. It's maybe a ten by twelve room with six or seven sets of bunks plus all our luggage, and a few trunks of surgical supplies. Leah was smart. She brought along a little pocket fan that has a suction cup at the bottom. After lights were out, she stuck that fan to her abdomen and slept in great comfort!

Leah is hilarious, Ralph. You know how I fix everything with Scotch Tape? Doug Kelly, who is the maintenance expert on staff now for the surgical team, repairs everything with duct tape. For Leah, it's dental floss. She hung her mosquito net with it, and helped hang the tarp shading the dermatologist out in the clinic.

This will sound familiar – it took us nearly one and a half hours to get to the clinic today, even though it was only 19 kilometers from camp. Now that's a rough road! Yesterday, Nancy had me filling prescriptions which made me uncomfortable. I prayed before handing over every filled prescription, prayed that I was not doing more harm than good for that person because I felt too insecure, though Jeff Ries, the wonderful doctor working in there, would check each one for me, bless his heart. But today, I believe Nancy agreed that I was not pharmacy material so gave me a welcome demotion to chief pill-counter and rebottler of analgesics or vitamins, or whatever else Jeff or Nancy needed. I was much happier. For one thing, I could sit. My feet were grateful.

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Wednesday:

It's been hot. I asked George at the clinic today how hot he thought it was. He said easily over 100 degrees. I have my little battery operated fans with me, but so far, I've been amazed that I have not been bothered enough by the heat to have to use them. I want to wait until it's crucial before I do. Victoria's assisting me in getting used to the heat has really paid off.

My digestion felt a little iffy today, and I asked George about it, and he gave me some "iffy-fixit." And it did. The dermatologist has fixed me up a couple of times, too – for a rash on my face and about 100 "no-see-em" bites on my legs. That's one thing you've got to say for projects. If you need medical help, it's handy.

We now have another physician working in the pharmacy, Brian Riedel. There are two physicians consulting with patients besides George and Melvin – Gretchen Wasserstrom & Waldon Garris.

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Thursday:

I had a chance to talk to Teo today. I asked him how he got involved with MMI. He said that when he finished medical school, his brother-in-law, who was the engineer that built Santana Hospital, told him about it. So he worked there for a year, and then tried to get into the ophthalmology residency, but the competition was too tough. Then Willie offered him the job of working as his assistant. Willie made a wise choice! Teo has great talent for this job.

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Friday:

There was a tarantula in the clinic today. That was a fish tale that grew. Evidently Mesá caught it and carried it out to the chickens (who eat tarantulas) but they "ran away from it." Charles said there were several tarantulas in the room where the dentist set up. I'm glad I was working in the pharmacy. Only tarantula I saw was one someone pointed out to me, so I was prepared. Much better to go looking for one than to have one show up when you don't expect it.

I saw a sight today that I will not soon forget. I was sitting toward the back of the church, in the pharmacy, repackaging vitamins when I looked up and saw, in the back door, a man with a growth coming out from his jaw or cheek that was the size of a grapefruit. I don't think that he'd bought a ticket, but he came in through the back door and was looking around. As he would look from side to side I saw a string of thick drainage dangling from that growth. It was horrible. I believe that Teo sent him to the hospital, because there was nothing we could do in the clinic. It's sad when someone has a horrible problem that you're not equipped to handle. He must've come to us with hope, too. Poor guy.

Leah has been working all week with Morgan Magid, the dermatologist from California, or the "lump and bump" guy as they've been calling him. He's done removal of cysts and things, but he's also had to do some surgical work because no one else is prepared to do anything like that. One lady really got to Leah. She'd had to walk barefoot from miles away. It had rained so was muddy. When she was about half-way to the clinic, she stepped on a sharp rock and severely cut her three smallest toes on one foot, the little toe just barely hanging on. She'd had to continue walking to get to the clinic, and had bled a lot by the time she got there.

Leah had a hard time with that one. She'd done fairly well all week with all the various surgical procedures Morgan had done, but that case was rough. Leah was so moved because the woman didn't even flinch or grimace – didn't shed a tear when Morgan numbed her foot. Morgan was uncomfortable with the whole thing. That's just not his field! But he was the only one who had any Xylocaine or suture material to do surgical type procedures, so he got the honors.

Leah couldn't get over the high pain threshold in these people. They've had to live with so much pain all their lives, they are used to suffering! She said in the emergency room back home, people are groaning or screaming in pain, whereas here, when the evidence of pain was so visible, the people were stoic. They're used to tolerating pain.

One of my jobs was rebottling from large bottles of analgesics and vitamins into smaller bottles so we could distribute to more people, and we had lots of empty bottles with the childproof lids. The little Haitian kids loved to make music with those! They'd turn them without pushing down and they'd make that clicking sound. They'd just have themselves a little band, making music with those bottles.

Charles has been quite a sensation here. He said all the young girls here want to move away and he received several "love letters" shoved through the fence by the cute Dominican girls who hoped he'd be their ticket to America. One girl named Carolina told Charles she'd had a dream that she'd had his kids and had been able to move to the States.

Charles and one of these Spanish students here to interpret, Daron Dykema, also had a group of shoeshine boys they spent a lot of time with and gave American names to: "Larry, Moe, Curley and Bubba."

Charles had a funny experience in the latrine. He said he felt something like a bug, turned around and saw several little frogs up in the window. They had little suction cup feet and they'd jump onto him, and he'd shake his arm and they'd sling around and hang upside down because some of the suction cups had held while the others had gone flying. Then he'd have to check his pants before pulling them up to make sure there weren't any frogs in there.

Our group from church was ready to leave after supper at camp tonight, since all the rest of them are headed back home, and Terri is on her way here to work with me at the hospital next week.

Before we left, they were making plans to visit Embassy Beach tomorrow. They have found a cure for the sting of sea urchins. Urine. Dan Copeland, on staff here, said you could be proactive, and pee on your feet before going to the beach. Teo has taught his kids to "pee on demand," in the event anyone needs immediate application.

As we were about to leave, Melanie Goff, a nice young lady from Tennessee, requested prayer for a patient at the hospital. Someone nearly went into shock or something after surgery. Dr. Mary Gootjes, who is a resident and who everyone calls the "Hospital CEO" on this project, was on her way back to the hospital to sit up with this woman. Waldon Garris, one of the physicians who had been consulting on the clinic team, had already been taken to the hospital because of his specialties and experience. I am anxious to learn how all that went.

On the way back to Santana, Leah and I were bouncing around in the back of the van. She said, "Don't they have any traffic laws?"

Teo, who was driving, said, "Oh yes, we have all of the traffic laws. We just don't follow any of them."

Leah says that coming to this project was one of the most wonderful experiences that she's ever had, and she'll never forget it. Remembering how people back home complain about trivial things all the time, she wishes they could all come down here and see what it's like for the rest of the world.

I have loved watching Leah and Charles interact. I don't remember ever seeing a teen-aged boy and his mother get along so well. They have been delightful. Charles treats Leah like a best buddy instead of the nuisance most teen-agers seem to think of their parents. He's so cute the way he says "Maa-ma?" Just as cute as he can be. "Maa-ma? Look at what this girl wrote to me. What am I supposed to do about this?"

Leah mentioned too that it was nice our group from church was the size it was. It would've been good if more people could've been involved, but being such a small group, we were able to bond. Going through something like this is a very unifying experience.

George feels like he has received a lot out of the experience. He's been on a lot of mission trips before, all over the world. He said he got a lot out of this trip though doesn't think he imparted that much. At least not to the Dominicans, not in the form of outstanding care because, he said, "In all honesty, a week or two here is not going to make any difference in the manifold care of the person here. It means more to them that the Americans go wanting to give of themselves to the Dominicans – that's what means a lot." Isn't that an interesting thought – that the recipients of the medical care were more effected psychologically or spiritually than they were physically.

Melvin too feels it's been a rewarding experience for him, though he thinks we did more than just put a band-aid on a major wound. He said, "I think when we treat children's parasites, or adults for hypertension to prevent strokes – it can have a big impact. There were patients whose lives were improved, like a man with a large hydrocele who we were able to refer to the hospital. There were a number of sterilizations for people who had too many children already. That was a real service." He was also very pleased to learn that there had been some Christian conversions in the Integrated Health department. As he said, "We didn't preach, but we set an example."

Julie Versluys was Melvin's interpreter. He said that Julie, and the other interpreters, handled the Creole very well. I'd been curious about that, but Melvin said that in medicine, there are ways of conveying ideas even when you can't speak the language. Sign language always helps. But the interpreters were an important part of the whole thing and since Creole is a French dialect, there were similarities to Spanish so they could figure out what the person was saying.

He was surprised at how well dressed, clean and neat the people were, with their clothes freshly pressed. He said the personal pride among the very impoverished here is better than many North Americans with a good bit more money!

George has been on mission trips with First Presbyterian church before when they come to the DR, and Melvin has friends who have been on those trips too. The accommodations for the group from First Presbyterian Church were better. But like Melvin said, "We were at the right place. Those were the people who most needed our help so I had no complaints."

George was impressed with the better outlook those desperately poor Haitians out in those bateys had as compared to the typical the American outlook. He was impressed that they didn't get as worried about things as we get. "It's important to my spiritual growth to see these people that don't take things for granted that we do," he said. He was impressed with their patience when they'd stand in line waiting all day to be seen. That same patience impressed Terri last year at Santana. We North Americans are used to people pitching a fit if they have to wait more than 15 minutes at the Department of Motor Vehicles. We're all so impatient in North America!

George reminded me of Tony's first book, The Success Fantasy, by saying that we have a screwed up idea of what success really is. George said he considers that his parents were successful people because they believed in God, in their fellow human beings, and especially in their children. That's what made them successful. Not owning the biggest house or fanciest car. But they gave their children their work ethic and their faith. He thinks Americans having too many creature comforts actually perhaps prevents them from being successful in the true sense of the word. And that's what he gets out of a trip like this. Brings him back to basics about what's really important in life. Do we have what God deems necessary to the "good life?" That's the question – and we measure it wrong. "We're given a lot," he said, and repeated that verse you've always loved – "To whom much is given, much will be required."

Since he'd been to the Dominican Republic before with other organizations, I asked him how his experience with MMI compared. He's always had a good experience no matter who he went with, but he thought it was really neat the way MMI brought all these people from so many different locations. He enjoyed getting to know the people from all over the States and Canada.

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One week later:

I was able to go to the closing meeting tonight of the project participants who had stayed another week in Sabana Grande. For the two weeks of the project, they did 69 major surgeries, five minor surgeries, 679 adult consultations, 528 child consultations, talked to 1492 people in Health Education, gave 239 fluoride treatments, filled 3738 prescriptions in the pharmacy, did 36 lump & bump procedures, pulled 515 teeth from 205 people, discovered 49 cataracts, and reported fourteen decisions for Christ. Nancy Kelly said that this project always experiences the lowest number of decisions – something that puzzles them.

She said the first time she came down here, and experienced the press of the crowds, she understood how it must have been for Jesus when the crowds begged him for his healing touch. And that's what these medical professionals are here for – to provide Jesus' healing touch to these people. These folks are an extension of Jesus' hands.

Nancy had written to me before this project, about the "go with it" attitude of the project participants – and Teo had talked to us in orientation about how everything would be nice, and George had led that first devotional, about having a positive attitude. It was all contagious. I was able to cope with all of the conditions better than I expected.

Janelle Kamerman, one of the young interpreters from Montana, said some of the patients would mistake her for the doctor and wouldn't hesitate to show her their problem the minute they sat down, no matter how personal it might be. So she'd quickly introduce them to Waldon Garris, the doctor for whom she translated. Waldon always explained to her what he was doing and why, so she learned a lot.

The first day, when we formed a circle to sing and pray after setting up the clinic, Janelle felt frustrated. She said, "Look at all these people who've been waiting for hours for medical attention. Why do we have to take this time to make a circle and sing for them?"

But after we'd held hands and sung Alabaré, and the crowd had joined in, and Mesá closed with prayer in Spanish, Janelle said, "Wow! When all those voices started singing Alabaré, it occurred to me this is the most important thing we can do! We really have to acknowledge this before we can begin our work, don't we? I mean, we're here to serve our creator and we'll never be able to do it without His help!"

Several patients really touched her. One was a two-year-old girl who had a severe protein deficiency which caused kidney and pancreas failure. She was so swollen her skin had begun to burst in places which caused massive infections. So they immediately treated her infections, and sent her to Santo Domingo for more intensive treatment. The doctor said she would live for a maximum of two weeks if she didn't receive prompt treatment, but even then, her chances of survival were slim.

Janelle said, "At times like these, it's important to remember that our job was not necessarily to work miracles, but to do the best we could and leave the rest in God's almighty hands." Their theme verse was Philippians 1:6: "Being confident of this, that He who began a good work in you will carry it on to completion until the day of Christ Jesus." This helped them know that even though they couldn't remedy all the problems, they were part of God's plan and had to trust that the work would continue even after they left.

She said that the Dominicans and the Haitians seem content with what little they have. They don't center all their attention on their difficult living conditions.

I got to hear a good bit about what had been going on with the surgical team at the Sabana Grande Hospital, too, while we'd been going to clinics every day. One of the surgeons, Craig Cole from Mississippi, told about a man brought to them with an incarcerated hernia. Some miscommunication with the interpreter made the man think that the repair of his hernia meant he'd lose his manhood. So he left the hospital and went out for "one last time." He also ate, so when he returned they couldn't do surgery until the next day but that gave them a chance to explain to the man that he wouldn't lose his manhood, just his hernia. Dr. Cole was really surprised the man ever came back that first afternoon, believing what he did! He said the man's first question when he woke up from his surgery was, "When can I be with my wife again?"

Rachel Koch, from Connecticut, worked in surgery, and said they'd pray with each patient before going into surgery. One man just whispered prayers all during his surgery, done under local anesthesia. They asked a translator if he was praying himself through his pain, and the man responded, "How could any of us be in pain? We have waited and prayed for doctors to come and take away our pain for a long time. You are a blessing and an answer to prayer."

Julie Versluys, the Spanish teacher who brought several of her students to help translate, had a couple of funny experiences. One man was carrying a rope and she told him to drop it, but inadvertently said, (can you guess?) "Drop your clothes." And when she got embarrassed once she told the person that she was so pregnant… I wonder how often that's happened. That reminded me of the time you asked for the "Maricone" instead of the "Malicone" and got into so much trouble with police who thought you were asking for the "homosexual" instead of the "Highway by the sea."

Jeff Reitzel, Terri's former student, worked as a general helper in surgery. He told me about having to carry water from a well behind the hospital. They poured some of that into "sun showers" they'd brought from home, because that created a nice "faucet" for scrubbing. But it was disconcerting when they saw tadpoles swimming around in the bag of water.

"The first day," Jeff said, "the supply truck was packed from front to back, full of equipment. Doug Kelly said we'd unload and start operating by noon. I didn't think we could do it – I thought it'd take us a couple of days to get it all unloaded and set up. But we backed the truck up, unloaded, and by 1:00 we had everything set up and were ready to operate. A real team effort."

Because of the lack of nurses on this project, Jeff and others had to act as surgical technicians, taking turns rotating between assisting the two doctors, passing instruments, sterilizing, and acting as "scrub nurses."

Jeff's first surgery was a tubal ligation. He assisted the surgeon, Rawle Jibodh from New Mexico. By the second or third procedure, Dr. Jibodh let Jeff help. Jeff said, "He made a little incision a few inches below the belly button, cutting through the abdominal muscles, then stuck his fingers in and fished out the tub, pulled it out, clamped it on either side, cut it and tied off both sides. He let me clamp the tube, cut and tie it. I was so amazed to actually be there, scrubbed in, hands on – an experience I could never have, at this level, in the States."

Dr. Jibodh was someone Jeff really had a chance to bond with. The first day at Sabana Grande, Mesá had brought his guitar which Jeff picked up and started playing. Dr. Jibodh came along then and played some beautiful classical guitar music. Throughout the week then, he showed Jeff how to do various things on the guitar. Dr. Jibodh became a real mentor to Jeff that week.

Dr. Mary Gootjes, the resident from Michigan, whom many people called the "Hospital CEO," because she organized all their activities at the hospital, really impressed Jeff. She was mostly in post-op, making sure everyone was doing well. She wore herself out running – got dehydrated and nearly passed out because she'd be so concerned about everyone else she wouldn't stop to take care of herself.

Dave Clark, a family practice physician from Ontario, said he appreciated being able to pray with patients. At home, a doctor only does things to patients instead of participating in their lives and ministering to them spiritually. He came on this project with his daughter, Jennifer, and that had been a special experience for them to have together.

Bonnie Rademachu, a nurse practitioner from Connecticut, said the first day that she saw a family member helping one of the patients out of bed, she ran over to stop them since that's what they do at home – not allowing family members to participate in the patient's care, afraid they'll do something wrong. Yet, she realized that the family members knew better than she did how to care for their loved ones. And it amazed her to see family members of one patient offering water and assistance to patients with no family to care for them.

Doug Kelly was a tremendous godsend to the surgical team. Craig Cole said that he and Mary Gootjes had come on a project a couple of years ago and had a lot of difficulties. Even though many of the participants were well seasoned MMIers, there was a lot of confusion. Doug prevented all that confusion this year with his preparations. They call him "McGuyver."

Daron Dykema, the young man that Charles hung around with a lot, made everyone laugh when he said that he and Gretchen Wasserstrom, the physician for whom he translated, would "figure out what was wrong with the patient, then give them Mebendazole" [parasite medicine].

Jim Lockett, the dentist, said it'd been a long time since he'd worked so much with teen-agers, and it amazed him how they communicate by making all these funny sounds between giggles, and understood each other.

He had a very interesting observation, too. He said "If I looked at the whole project to see what contribution we made, it would be like taking a bucket of water out of the ocean. Not much would be missed; there's so much to do. I'd want to work hard to get through as many patients as possible, but I had to slow down and be sure to interact with the people, create that patient relationship rather than seeing how many I could take care of. It's difficult when you see that almost endless line of patients."

Rachel Koch said that her favorite part was praying and interacting with the patients in pre and post-op.

She said when she was packing for her trip, her mother wanted her to bring a mosquito net. She said, "No, that wasn't on the list. We're going to be living with American doctors, how bad can it be? They're not taking us someplace where we'll need mosquito nets!" Then she got here the first night and saw the mosquito nets already up, so that's why we didn't have to pack them…

Julie Riedel said that she got really nervous when she saw she was the only RN on the team, but the two surgeons led the way with incredible patience. Rakesh, Jose, Rachel, Jeff and Stefan were all helpful, always going the extra mile. So they all got through it even with only one RN by their good team spirit.

Jeff said that Julie Riedel did a good job tending to the emotional needs of the people working in the OR. She listened, was concerned, empathetic and caring – she made sure every member of the team was being cared for.

About this time in our meeting, which was maybe 9:00 in the evening, Teo came out and started talking about the trips to the airport in the morning. He said, "Those of you who leave on the earliest trip to the airport have already had your breakfast."

Then Doug Kelly said, after reviewing the statistics for the week, "It's not about statistics. It's good to know we saw almost 1500 patients. We provided a lot of good healthcare. We do not keep statistics on the number of people you've impacted with your work here. We can't measure that. But it makes an impact both ways – you'll take a part of this country home with you, and you all left part of yourselves here."