Operation Esperanza 2016 Mission Report

 We are so thankful for another very successful Ecuador Medical-Dental Mission, January 29- February 7, 2016, and so grateful for your generous donation of running shoes for disadvantaged young people in Cuenca, Ecuador. This has developed some elite runners and they were so very appreciative of your gift!

Fifty seven team members traveling with approximately 100 hockey bags filled with over 2 tonnes of supplies, arrived at the new Quito airport at midnight January 28. Even though I had been working on documents required by the Ministry of Health in Quito for 4-5 months, prior to departure we still did not have the letter we needed from the Minister that would allow us to do our work in Ecuador. Thankfully, Dr. Manuel Avila was there to meet us in Quito and like last year, he had the necessary letter. Subsequently, we sailed through Customs.

The team was taken to a hotel 45 minutes away and after a short night of rest, we were back at the airport for the flight to Cuenca - 40 minutes by plane. We received a warm welcome from Dr. Avila’s family and many members of the Tomebamba Rotary Club. Cuenca is at 8500 ft and most of us needed a few days to acclimatize to the altitude.

On Saturday, Jan. 30, we held a large follow-up clinic, seeing patients who had surgery in previous years. These people were doing well and so grateful for their changed lives! The next day we held an intake clinic and saw many new patients. 130 adult patients were seen in consultation and numerous children were examined by the pediatric team. Sixty seven adults were booked for hip or knee replacement surgery. These patients were then seen by an anaesthesiologist to make sure they were in satisfactory condition for surgery. Then they were seen by the dental team. If there were any dental problems of infection this was dealt with before the surgery.

We had restraints on available operating time but we were still able to do 34 hip or knee replacements, including a major hip revision and a major knee revision. Two patients had both of their hips replaced. Some of the partially dislocated and arthritic hips were a challenge. The Pediatric surgical team was able to complete 16 operations on dislocated hips and club feet. They saw around 110 children in consultation.

This year we focused also again on Vocational Training. This happened in many different ways:

Local orthopaedic surgeons joined us in our clinics, in the operating rooms, as well as for an evening meeting where Dr. Nelson Greidanus made a presentation on diagnosis of postoperative infection in joint replacement surgery. In addition, challenging cases were discussed. The pediatric team had an Ecuadorean orthopaedic surgeon operating alongside them for the entire week. Significant teaching was provided by the surgeons, and also by the ward nurses, the operating room nurses, and the physiotherapists.

Lisa RN, and two other team members taught decontamination of instruments, and sterilization of instruments. Lisa also had this written up in Spanish.She brought posters for teaching the nurses about anatomy and physiology. Our nurses  also taught by example the important work of cleaning instruments, soaking , and cleaning times.

As well as the adult surgical candidates they treated at the hospital, the Dental team provided dental care to poor children in rural schools, some days travelling  an hour each way up to altitudes of 13,000 feet. Accompanying the dental team this year were eight students who were in their final year of dental school at the University in Cuenca.

Even though the eight students were on “Spring Break”, they were an extremely helpful, diligent and motivated group.

Having the 8 Ecuadorian dental students as well as 3 Ecuadorian dentists join the dental team throughout the week (one attended the intake clinic) was extremely significant and special.  Not only was there some very significant vocational training completed, but there was a true sense of mentoring and learning that occurred.  The impact of this is that the University in Cuenca is committed at making this experience a part of their curriculum training.

The stats for the dental team were 278 patients:

451 x-rays; 313 fillings; 185 extractions; 240 sealants; 46 cleanings; 1 root canal.

We had six Canadian teenagers as general helpers on our team. We enjoyed their youthful exuberance and interest. I believe seeds have been planted for them to consider reaching out to the poor and disadvantaged later in their lives.

We had a very successful Mission. We gave a lot to help the poor and suffering, but team members also received a lot in return.

Thank you for your generous support of this Mission!

Respectfully submitted,

Thomas H Greidanus, M.D.

Team leader, Operation Esperanza