Until Next Time

I am truly at a loss for words. After over a year of hard work, the trip is over, and I’m sitting at home in Chicago for the first time in three months. The past year was exhausting but exhilarating. It’s crazy to think that in one year, we created a student group, raised hundreds of dollars, maintained contact with Roosevelt Hospital, received hands-on equipment training, researched and attended lectures, and organized and then executed a two-week trip for a group of five students. I could not be happier with the outcome of the trip and do not regret a single moment I spent working on WUGI this year (even the ones that resulted in three hours of sleep). It’s embarrassing to admit, but I’ve come close to tears while reflecting on the trip and the potential for the upcoming year. The trip was an absolute success, and we accomplished everything we set out to do and more.

During the past two weeks, we not only worked on equipment repair and assessment but also began new projects, started new partnerships, explored the beauty of the country and met incredible people. The residents, UVG students, doctors and staff all went above and beyond our expectations in welcoming us to Guatemala.

Special thanks to Dr. Carlos Tapia and all the residents

            It is hard not to compare this trip to last year. Looking back at the final blog post from last year’s trip was particularly powerful. After spending only a week at Roosevelt, I left passionate, motivated and ready to continue making a difference at the hospital. I was determined to return and, as I say, I had “caught the bug.” Prior to this trip I really wasn’t sure how the group would react to the hospital, the conditions, our living arrangements, or just the general environment of Guatemala City- I truly hoped that they would leave feeling just as determined to return and sustain our work as I was. My wish has been granted, and I think everyone has truly fallen in love with the country.  Having a group of passionate engineers with me in Guatemala, learning about Roosevelt, the country and the conditions was a blessing. There was nothing better than hearing the group talk to staff about returning. Everyone would always ask us when we were planning our next trip. Every time I heard someone in the group promise to return or insist that the trip meant more to them than a two week trip to Central America was truly heartening.

            I want WUGI to continue to grow and make a true impact on Roosevelt Hospital, for WashU engineering students and now for La Universidad del Valle. Our work will never end but that’s part of the beauty of the program-we can sculpt WUGI however we would like. As mentioned in other posts, we want to expand our equipment work to UNICAR and INCAN and to also start working on larger projects such as an organizational database and equipment design. There are many paths to accomplish our one true goal: to use engineering thinking and technology to support and enhance Roosevelt Hospital in a sustainable and impactful way.

Carlos just sent me some pictures of Mainor, the respiratory therapist using the ventilator Kelsey and I spent the majority of a day or two on. It's working well, and, as Carlos insisted in his typical upbeat and supportive way, “U see! Your hard work is saving people!!!!”

Mainor using one of the newly repairs vents in the ICU

Day 13: Lake Atitlán

Saturday, July 19th, 2014

                 We designated our last day in Guatemala as a relaxation and celebration day. To celebrate the trip we decided to go to Lake Atitlán with Carlos, head resident Manuel and his girlfriend. If anyone was even the slightest bit hesitent about returning, I’m fairly sure spending a day enjoying the natural beauty of Guatemala acted as a sure-fire way of motivating the group to return.

The group after breakfast 

            Lake Atitlán is the deepest lake in Central America and is surrounded by three volcanoes and many villages where Mayan culture is still prevalent. “Atitlan” is a fusion of Nahuatl words that mean “at the water.”  The lake has been labeled the “most beautiful lake in the world” various times and, Aldous Huxley famously compared it to Lake Como of Italy saying, “Lake Como, it seems to me, touches on the limit of permissibly picturesque, but Atitlán is Como with additional embellishments of several immense volcanoes. It really is too much of a good thing.” We definitely agreed with Huxley, our last day in Guatemala was full of good things.

View from the road

Carlos picked us up at 7AM and we started the drive to the lake. The drive itself was absolutely gorgeous and we passed a lot of typical Mayan villages we hadn’t seen as a result of working in the city. We passed Chimaltenango, San Lucas, and Sololá until we reached our final destination of Panajachel. We took advantage of ourfinal opportunity to go shopping in the market places and then hopped on a little motor boat to sail across the lake to visit San Pedro (La Laguna).

The boat ride got a little wet

The view of San Pedro from the boat

We had been warned that a lot of tourists have been known for going to San Pedro and never leaving. Within minutes of just standing on the dock, we understood why. San Pedro is a little paradise on the southwestern shore of the lake. The town is packed with little shops, colorful clothing, tropical plants, and, of course signs advertising Gallo everywhere. We started off the most logical way, testing just how warm the water was-after all we were all a little wet from the boat ride anyway! We then went to a little restaurant recommended by a different resident for lunch and by the time we’d finished our smoothies and sandwiches it was time to head back across the lake, and head back towards Guatemala City only stopping to look at the waterfall and for dinner in Antigua on the way. It was a perfect way to spend our last full day in Guatemala.

Waterfall on the way to the lake

Day 12: Our last day at Roosevelt

We have officially finished our last day at Roosevelt Hospital. After 10 full days working at the hospital our work for this rotation is complete. Our final day  in the hospital was just as full as any of the others, but in a different way.

The rows of hemodialysis machines found in the basement

            Our day started in the ICU organizing the equipment and sorting it into different rooms based on its final condition. Shortly after we finished up, Dr. Barnoya stopped by to take us on a tour of a part of the hospital we still hadn’t seen (and that I didn’t have the opportunity to visit last summer either). We first went into the basement where we ran into a hallway that was entirely filled with hemodialysis machines, none of which were in working condition. The current hemodialysis unit is one room and can only treat  up to 10 patients a day despite the surprisingly large amount of patient who come to Roosevelt requiring this treatment.  During out equipment inventory, the nurses working in this unit were especially expressive and insistent that they had absolutely no way of treating all their patients as a result of their lack of equipment and everyday we were asked at least once by different staff whether we were capable of repairing hemodialysis machines. Each day we regrettably responded the same way, admitting that these machines are truly out of our scope. Knowing just how desperate the need is for these machines made seeing this collection of about 15 hemodialysis machines even more frustrating. It was clear from the amount of dust that had accumulated that these machines haven’t been touched for some time.

Some insight into the complexity of a hemodialysis machine

            Down the hall from this makeshift warehouse was La Unidad de Oftalmología. Barnoya explained that this ophthalmology unit is separate from Roosevelt and therefore receives it’s own funding. Unlike Roosevelt, this unit has the ability to control exactly where to designate their funding and also has a technical maintenance staff trained to repair ophthalmology equipment. Regardless of these extra funds the unit still has equipment problems and on our tour we were sown a number of machines, chairs and lights that needed attention. This morning I received a list from the unit detailing exactly what their needs are. This list is indicative of the level of organization and proactive nature seen at the unit. It would be  more difficult, or at least require a lot more time and energy to receive the same kind of lists from Roosevelt.

            Directly after our tour, a nurse showed up to lead us to the auditorium for a “public address.” We truly weren’t sure what this would entail and were definitely surprised when she lead us into an auditorium full of residents.  We were sent to the very front where Dr. Mejia was leading a lecture. He graciously introduced us all, described our work and thanked us in front of all of the residents. Despite being embarrassed it was great knowing our work was being recognized and it will benefit us in the future to have face recognition in the hospital. 

Gladys and nurses from the Hemodialysis unit

          We ended the “address” with a final donation of two additional pulse oximeters we had purchased through fundraising and a large bag of single-use electrodes. With some final handshakes and of course a couple pictures we returned to the ICU to be met with another surprise. We have only met one other volunteer at Roosevelt. Her name is Gladys and she works in the Hemodialysis unit – we mentioned our first meeting with her in a previous post. Gladys had made us 2 homemade apple tarts to thank us for our work and celebrate the past two weeks. During the half hour or so before she had to rush back to work we all sat around the new ICU. Different nurses stopped by and, as we handed out WashU apparel, letters, translated manuals and summaries of our work we received more thanks and well wishes than I could ever have imagined. The sentiments and thanks of the medical professionals at Roosevelt were heartfelt and will always serve as a reminder of why this work is important and worthwhile. I have never felt more welcomed or appreciated as I did by the staff at Roosevelt. They truly are the ones to thank. These nurses, therapists, residents and doctors work day in and day out in extremely difficult conditions, without proper rest or resources. They are truly lifesavers and heroes. It is an honor to work with them and I will continue to work to ensure WUGI is doing everything it can to continue to support and help the staff take care of Roosevelt Hospital and the countless patients that visit daily.

Using one of our donated pulse oximeters outside of the ER

Day 11: Wrapping Things Up

It’s unbelievable that today was our second to last day at Roosevelt when it seemed only yesterday we were looking at the machines and meeting the residents for the first time! Time really flies by here because our days are so jammed packed and today was no exception.

Today was our last day to finish up all equipment repair, cataloging of equipment, writing manuals and translating troubleshooting guide. Needless to say we had a lot to do to wrap up our work at Roosevelt to ensure that our final day goes smoothly and we can properly communicate to staff about the outcome of our work. We started by taking one last look at the ventilators. We had unfortunately gotten to a stopping point with many of the vents. For example, there was one Vela vent whose screen and battery we had fixed. Despite these repairs the vent was still showing symptoms of internal issues that would require replacing a part. Like the majority of the equipment we see at Roosevelt, this vent was outdated and the manufacturer no longer produces the proper parts needed to repair it.

Patient bed in the ICU

Running into various roadblocks, whether that means: missing parts, having parts stolen, lacking maintenance, or lacking communication, is the everyday reality of a public hospital in Guatemala and we hope to improve that in the near future. Broken equipment accumulates every day in various parts of the hospital and it is difficult to keep up with the various types of equipment and models. However, we are excited to know that our work will continue even as we leave Guatemala with the help of La Universidad del Valle (UVG). This morning we met with Dr. Mejia, Professor Roberto Sevaria, and two students from the UVG Mechatronics association this morning to discuss with Dr. Mejia exactly what the partnership would look like and how it would benefit each of three parties. The meeting was extremely successful and it was clear everyone left with a common understanding of what the next steps are. After the meeting we were able to show our UVG guests around the ICU and also the ER to give them a better idea of exactly what and whom they’ll be working with. It was great introducing the amazing staff at Roosevelt to new engineering faces who are already ambitiously thinking of new ways to improve the hospital including creating an app to track equipment information that any nurse, volunteer or doctor could update. Every medical professional we have spoken to is extremely enthusiastic about the UVG students.

Outside the ER

After the UVG students left it was back to Oakland mall to work on manuals, final reports, thank yous, translations etc until Dr. Barnoya picked us up to go to dinner. We went to Vesuvio, the same place he took me my first night in Guatemala last year. After a couple hours of good pizza and a lot of insight from Dr. Barnoya we headed back to Uxlabil to keep working in the early morning to ensure all our reports and manuals were ready to hand over…during our last visit to Roosevelt of this first official rotation of WUGI.