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A Portrait of Courage
We heard of German's case while still in the CAMO office in Ohio, preparing for our fall medical teams. One morning Kathy and I received a fax from Dr. Rosario Cabañas, technical advisor to the Honduran First Lady's philanthropic Fundación María. She wrote to us of a patient who had been injured in December of 1998, both legs broken below the knee. Orthopedic surgeons at Hospital Escuela, the largest hospital in Honduras, wanted to operate on German to try to repair the poorly healed multiple fractures he had sustained when hit by a car. They asked if CAMO would be able to find the orthopedic hardware they needed through our contacts in the U.S. We called Dr. Dona Alvarez, orthopedic surgeon in Oakland, Maryland and an active CAMO volunteer, and explained the situation to her. Dona said that she would see what she could do and requested a complete set of x-rays to work with. So when I arrived in Honduras I asked that German be notified to come to see us, which brings us to Hospital San Felipe in October of 1999. Dr. Nancy Neubauer, radiologist from Oregon Health Sciences University, was in Tegucigalpa working with the multidisciplinary Breast Clinic staff. Nancy knew about German's case and was there when he arrived at the hospital. He walked slowly and cautiously, wearing only plastic flip-flop sandals on his feet and using well-worn wooden crutches. But he walked evenly on both legs, his head held high and with a smile and a sparkle in his eye. Nancy and I, along with one of the X-ray technologists from the hospital, walked to the Hospital del Tórax to meet with German and Miguel Angel, a friend and traveling companion, where we would take the x-rays. German and Miguel Angel, traveling by taxi, should have beaten us there. We waited for ten minutes. Fifteen. Finally they arrived, with German sweating, shaking and teary-eyed. I asked him what had happened, moved by his obvious pain. "No, I'm fine," he said. "The taxi drivers were asking too much money to drive me here. So we walked." German, by no means a well-to-do man before his accident, couldn't afford the $2 it cost to take a taxi instead of suffering through a fifteen-minute walk with his severe injuries.
I gave the x-rays to Dona Alvarez, who consulted with a fellow orthopedic
surgeon and with Synthes Three months, constant planning, and several thousand dollars worth of donated orthopedic equipment later, we were on our way. German traveled with his wife, Amada, and Miguel Angel to Santa Rosa on March 5, 2000. With his warm character and inner strength, he was soon a well-known personality in the hospital. He and his wife were very devoted to one another; German always referred to Amada as "his lady." While we talked with the couple, Dona asked me if I knew specifically how German had been injured. I asked German and Amada, who looked at each other and smiled. "I was finishing up work for the day at my job as a watchman for the day care center. Amada came from home to meet me and we decided to have a special chicken dinner. We walked to the store on the way home from my work and bought groceries. To get to our house you have to cross a highway with a median in the middle. We got to the median and Amada started to cross without looking. There was a big truck heading straight for her, a semi. I pulled her back just in time, but another truck hit me. I went down and the driver just kept on going." Amada leaned down and touched German on the cheek. German had saved Amada's life at the cost of his freedom. On Monday, March 6 the orthopedics team spent eight hours preparing the equipment for the surgery, with back-up plans, and back-up plans for those back-up plans. After fifteen months, Dona and Marco Antonio didn't know what they would find once they began the procedure. This operation was not without incredible risks. If German's legs got infected after surgery, he could lose them. The surgery just might not be successful. We all tried to explain the potential complications to German, but every time he'd just smile and say, "I trust you. And I have faith that I will walk again. I don't need to think about the risks." On Tuesday, German underwent a seven-hour surgery. Dona and Marco Antonio worked with Jeff Keller, CRNA and Nancy Byerly, RN of Aultman Hospital in Canton, Ohio and Otilia Flores, a nurse at the hospital in Santa Rosa. The team finished up with a sense of relief. Despite the level of difficulty and the many possible complications, the procedure went smoothly. German, still groggy from the surgery, repeated over and over again, "I'm going to walk again. I'm going to walk soon." Amada stayed with German day and night to make sure he took his medications,
ate and drank enough food and water. After five days We arrived at the house, out of breath and sweating, ten minutes later.
It was a mud house, dirt floors, tidy and organized, with no electricity
or running water. German was waiting for us, sitting in front of
his house, with a huge smile on his face. "I knew you wouldn't forget about
me! God answered my prayers and you are my angels." We carefully
unwrapped German's dressings and breathed a sigh of relief. His incisions
were healing well, without signs of infection. We returned to German
and Amada's house three times to change his dressings and monitor his progress.
He has been truly blessed with a smooth healing process. His recovery
will take much longer, with physical therapy, hard work, time and patience.
It will also take faith, which I know German has in abundance. German
is an exceptional human being, with enough spiritual strength to teach
us all what it takes to overcome seemingly impossible situations such as
his. He never gave up, never stopped believing. When Kathy
and I saw German and his family for the last time before returning to the
U.S., it was an emotional leave-taking. We all had tears in our eyes,
knots in our throats. "I don't have any way to repay you for what
you've done for me," German said. "My heart is so big with gratitude
that I can hardly speak. All I can do is thank you, and promise you that
I will follow your instructions and when you see me again I will be walking."
With his faith and positive approach to healing, this man was an incredible
inspiration to all of us. I have no doubt he will be walking when
we see him again.
February/March 2000 Team Summary Something wonderful happened this year. After almost eight years of hard work and tiny steps toward CAMO's goals of sustainable medical programs development, we're seeing the results. Every year, we've seen advancement in patient care and technical skills. This year is exceptional in the sense that the improvements are so marked. During CAMO's spring team this year, comments were passed from one team member to the next, "Don't you think post-operative care is going much more smoothly?" Or, "My counterpart has taken this program on and has done a great job with it!" Three CAMO programs that exemplify the progress and success that we've seen this year are the Multidisciplinary Breast Clinic, the dental program and the CPR instructor's course. The breast clinic, located in the Hospital San Felipe's oncology department, has grown by leaps and bounds since its establishment November 1, 1999. For the first time, patients in the public health system can find services in detection, diagnosis and treatment for breast pathology in one location. Patient tracking is being streamlined and treatment is speedier. Over 300 women and men have received attention through the breast clinic and mammography program. In 1994 when CAMO initiated its dental program volunteer dentists performed 100% extractions because the majority of patients they saw had rotted teeth that could not be salvaged. Team dentists and local dental personnel taught oral hygiene and continued with extractions for several years. They traveled to remote villages with mobile dental units, and local dental staff continued that operation throughout the year. By 1998 dentists saw a change; patients were returning with better oral hygiene and the number of patients requiring extractions was down to 75%. Twenty-five percent of the patients who arrived during the dental team needed restorative work and preventive cleanings. Those numbers continue to improve. Health Region #5, through cooperative development work with CAMO's dental health volunteers and equipment donations, currently runs the most successful public health oral hygiene program in the country and this year held a national conference for dental health directors to share strategies and assist with program development. CPR training is something we all take for granted. It's available in almost every community; we expect all of our medical professionals to possess CPR skills. In 1997 CAMO organized the first Advanced Cardiac Life Support course at the Hospital Regional de Occidente and found that many professionals lacked even basic CPR training. In Honduras very few nurses know CPR though they are responsible for direct patient care. It's not from a lack of interest; they simply didn't have access to the trainers. This year Jim Cress of the Stark County Paramedic Association conducted a four-day CPR Instructor's course for registered nurses at the hospital. Four of the participants passed the course and they have already begun training their fellow nurses and auxiliary staff in CPR skills. The CPR Instructor's course symbolizes the realization of one of CAMO's primary goals: to provide skills training to medical professionals in the public health system so that the human resource is available to patients on a permanent basis, not just when CAMO volunteers are present. With year-round monitoring and communication between the CAMO office in Orrville and our counterparts in Honduras, we are able to respond to material and training needs efficiently and to anticipate new developments within CAMO's scope of service. CAMO volunteers, with their hard work, thorough planning and enthusiasm, have initiated and sustained well-supported programs. The medical staff at the Hospital Regional de Occidente in Santa Rosa, the Hospital San Felipe in Tegucigalpa, and the Health Region #5 in western Honduras have put incredible time and energy into making the CAMO-initiated programs work. With three weeks of teams in Santa Rosa de Copán and Tegucigalpa, over sixty volunteers and 21 specialty teams, this year was an unqualified success. All of the CAMO programs are noteworthy and remarkable. We could easily spend chapters on each program, and would like to recognize the work of each team.
Reflections on Health Programs Development in Honduras What Makes CAMO Programs Successful? CAMO's role in the process of medical programs development is three-fold: to promote and support the development of appropriate programs through training, materials and equipment donations; to offer continued support to existing programs in the form of continuing education and equipment donation and maintenance; and finally, to respond efficiently to specific requests on the part of the Honduran medical professionals who devote their time and energy to CAMO/Ministry of Health programs. In this way we serve both patients and medical professionals better. Our U.S. volunteers are extremely committed to their programs and their Honduran counterparts. Our Honduran counterparts are equally committed to serving their patients better. The long-term relationships that develop through counterparting, sharing ideas and skills between U.S. and Honduran medical professionals, contribute to the growth of CAMO programs. Many of our programs begin small and grow rapidly; they require constant
monitoring and expanded coverage to match their growing services output.
We have a responsibility not only to the people who depend on the public
health system for medical care but also to the medical professionals who
provide treatment; we must anticipate the needs of our programs to allow
for growth and development. It is partly through these efforts that
CAMO helps to retain the commitment of talented medical professionals at
home and abroad, and that CAMO-sponsored programs are successful.
Our commitment to long-term development and our continued responsibility
to both the patient and healthcare provider form an integral part of sustainable
health programs development.
Laundry Construction Update The construction of the long-awaited laundry facility is well underway, with the first floor's walls and floor completed. Through volunteerism from Santa Rosa de Copán's local Rotary Club, the engineering and monitoring of the construction has been donated. A very active, local women's group, the Damas del Voluntariado Vicentino, has managed the finances for the project so efficiently that we expect to finish the facility under the original estimated cost. The structure, a 90' x 70' brick building, will house the industrial laundry facility, with a front section with office space for the nursing staff. The completion of the laundry, with new industrial washers and dryers, will signal a drastic change for the hospital. Instead of four women washing 800 lbs. of laundry by hand every day and depending on the sun to dry the linens, the staff will have four industrial washers (two 35 lb. and two 25 lb.) and four 50 lb. industrial dryers. In order to manage the immense quantity of linens that it must process, planners designed the laundry facility with a flow from a receiving area for soiled linens, washing area, drying area, press, sewing, storage and distribution. The second floor, presently limited to a library and conference room,
will measure 61' x 20'. The library and conference room construction
is made possible through a generous grant from the International Foundation
of Montville, NJ. The library and conference room will serve as an
education center for the 25 medical interns who are assigned to the Hospital
Regional de Occidente every six months. They currently have no facilities
in which to study or receive classes from instructors. This new academic
space will tremendously improve programming quality. Construction
is expected to wrap up in late June or early July. The final price
tag on the laundry/library facility will be approximately $100,000 including
materials, labor and equipment.
Warehouse Renovated at HRO by CAMO for Projects Thanks to the hard work of Carl Edwards, Bob Russell and Harold Shetter CAMO now has a beautiful space in Santa Rosa de Copán to store supplies, equipment and tools. The space, located in the Hospital de Occidente, was originally a poorly-lit, unventilated and under-utilized space. At a cost of $3000, CAMO volunteers helped improve the space, which includes new windows, repaired floor and walls, installation of wiring and plumbing, a new work bench, custom-built rack system, a storage area for tools, bars on the windows and locks for the doors, and paint. This area is exclusively for CAMO use and is guaranteed through a written agreement with Hospital Regional de Occidente director Dr. Alonso Pintor. The use of this space will allow for efficient distribution of materials and equipment, secure storage and easier access for teams. Upcoming Projects 2000-2001
CAMO Volunteers Run Warehouse Like Pros! Patsy Baxter, Faye Beegle, Helen Smith, Dick Kohler, Vernon Lehman: these are the names that Kathy says in her thankful prayers when she walks into the warehouse every morning. For the first time in seven years Kathy returned from a seven-week stay in Honduras to find CAMO business in perfect order. Where normally she would spend a week of 16-hour days to catch up with packing, inventory, financials and correspondence, this year Kathy catches up with family, church, friends and future plans. What has changed? The answer is the dynamic team of volunteers who run the office and warehouse! Helen Smith, an experienced Office Manager and recent retiree, devotes two days a week to CAMO's communication and record keeping needs. Patsy Baxter is a certificate candidate from Orrville's Career Center in computer technology. As part of her certification Patsy interned with CAMO, initially for 120 hours of service. One hundred twenty hours have long since gone by but Patsy still comes in two days a week to manage the Access program used for inventory and material donations accounting. Faye Beegle, RN worked at Wooster Community Hospital for many years in inventory and ordering and, with help from Dick Kohler, has been a great asset in packing and organizing the medical supplies donations. As always, Vernie Lehman keeps things in great shape at the warehouse. With each step in CAMO's growth from a duffel-bag operation to a large-scale development program, the responsibilities for administrative work and inventory management have grown exponentially. Thankfully CAMO has been provided for every step of the way and is blessed with these four volunteers who have given long-term commitments. It's clear that Patsy, Faye, Helen, Dick and Vernon are a winning team! Many thanks to these lifesavers! Stow Presbyterian Church Annual Fundraiser A Great Success Once again Stow Presbyterian Church's excellent Ministry of Music and Drama has done it! For four years running Stow Presbyterian Church community members have organized and staged wonderful presentations that benefit CAMO's work in Honduras. In this year's production of Cotton Patch Gospel, Stow Presbyterian raised over $4,500! Grateful thanks to Stow Presbyterian Church for their support and faith! Thanks and Prayers for Laurie Harris As many of you know, our friend and co-worker Laurie Harris was in a serious car accident in late December of last year. She has made a wonderful recovery, for which we are all very thankful. Due to many changes in Laurie's life since December she has decided to step down from her position with CAMO. We are very grateful to Laurie for her hard work and dedication as Assistant Director of Materials Management for the last 15 months. Laurie will be in all our thoughts and prayers as she makes this transition.
Satellite Office Opening in Colorado on May 1 Rachel Ollar, CAMO's Assistant Director of Education and Development, will be relocating to Boulder, Colorado on May 1 of this year and will be opening a CAMO satellite office. She will continue to work in programs development and team coordination, and will have an expanded role in fund-raising for CAMO. Rachel will also continue to travel to Honduras four to five months out of the year with the medical teams and for programming purposes. Please keep in contact with Rachel at the CAMO office in Boulder at the following address: 3705 Martin Dr.
Calendar of Upcoming Events * Community Update, Salem Mennonite Church ....June 11, 2000
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The first thing he said to me was, "I knew God would send someone to help
me." I took a deep breath and explained to him that we would do the
best we could to evaluate his condition and go from there. We couldn't
promise anything yet. He smiled, leaned heavily on his crutches and
shook my hand with an enthusiasm that expressed his hope and fear.
He'd been waiting nearly a year, after all, and suddenly we were his last,
best hope.
Nancy, German,
Miguel Angel, three technologists and I all filed into the X-ray suite.
German removed his slacks and sandals and showed Nancy where the car had
hit him. It didn't look as bad as I thought it would. Then
he took his left leg with both hands and said, "See this? I don't
think this ever healed," while moving the two halves of his lower leg back
and forth in opposite directions. You could have heard a pin drop
in the room. We were all shocked; this man had been walking on mobile
fractures for a year. The pain must have been incredible. Later,
we all stood around the developer, waiting for the x-rays to dry.
When they did, we were once again speechless. "I've never seen anything
like this," was Nancy's response. To live with that severe an injury
for so long was unthinkable. We told German that we would do what we could
and that we would let him know as soon as there was news. As we left
the room, German grasped Nancy's hand tightly in both of his and said,
with tears in his eyes, "Doctor, please help me. I'll do anything
to walk again. Anything."
orthopedic
products representative Sue Campbell. Sue helped Dona plan for the
surgery, cataloging the equipment that would be needed to complete the
procedures on both of German's legs. I contacted the surgeons in
Tegucigalpa, to confirm their participation in the surgery. They had some
bad news. They were overwhelmed with cases already on wait lists,
many of whom had waited for almost as long as German had. Additionally,
their C-Arm x-ray unit, which would allow the surgeons to monitor their
progress during the surgery, had just gone down. If the surgery were
performed, it would have to be done without the C-Arm. Dona decided
to continue with preparations; she would plan the surgery with Sue in the
U.S. and perform it in Honduras with her counterpart, Dr. Marco Antonio
Bones. Jeff Keller, CRNA administered the anesthesia and monitored German
throughout the surgery. The equipment in the background of the picture
has been donated by CAMO over the last five years.
in the men's surgical ward, German wanted to go home. On the day
the last CAMO team left Honduras, we took German and Amada with us to San
Pedro Sula and on to nearby Nuevo Chamelecón. We dropped them
off at a friend's store, thinking that his home was easily reached.
We arranged to meet German and Amada to change his dressings in a few days.
When we returned to Nuevo Chamelecón to change German's bandages,
a friend of the family offered to show us the way to their house.
We went up a steep embankment and ran across the neighboring highway, avoiding
traffic as we went. I realized as we crossed the road that this was
the very same place where German was hurt. Across the highway was
a rock face with a ravine cutting down through it. Next to the ravine
was a rocky, muddy footpath on an 8% grade. This was the way to German
and Amada's house. No road, no access by car or even by horse.
How could German get up and down the mountain to go to the doctor, to come
to see us? It turned out that his neighbors, for the past 15 months,
had carried German up and down that steep mountain in a hammock. Theirs
was a humble neighborhood perched on a mountainside, a loving and generous
community who supported this injured man without hesitation.