Mission III: Accomplished!

Today was our last day at Roosevelt!  Carolyn and Mark flew home this morning, so Caroline, Imani, and Ananya went into the hospital.  We spent most of the day wrapping up and saying our goodbyes.  We started the day by testing the baby monitor that we worked on yesterday at the Neonatal Intensive Care Unit.  It was the final piece of equipment we officially fixed! Afterwards we delivered some medical supplies to the hospital that BJC had graciously donated.  We then said goodbye to some of our favorite people we met this year.  Mynor (the respiratory nurse who helped us last year), Silvia (the head ICU nurse), Dr. Rivera, Gladys, and the Gastro nurses were some of these amazing people.  Horacio was incredibly helpful in sorting things out for us today, and saying bye to him was the hardest.  He promised that he would see us next year when we return.

To finish up our night, we went out to dinner with Manuel, one of the head residents from last year.  It was so nice to catch up with him and hear how his new job at the hemodialysis center is going. 

Overall, we had a wonderful and productive trip, and we are so grateful to everyone who helped us make it that way.  We will continue making progress throughout the school year, and absolutely cannot wait to be back next summer!

     

Day 12: My Final Day in Roosevelt

It is hard to believe that Mark and I are leaving tomorrow and had to say goodbye to Roosevelt this afternoon. We spent our last day at Roosevelt working on diagnosing the remaining ECGs and monitors we had been given. Unfortunately, many of the ECGs were missing crucial parts such as printer parts and batteries. We have added these parts to our list of things to purchase. Hopefully, through strong communication, we will be able to teach the staff at Roosevelt how to replace these parts and the equipment will operate correctly. We were happy to have fixed another monitor for the Neonatal ICU before leaving for the day.

In total, we have fixed: 4 endoscopy towers, 1 incubator, 3 monitors for the neonatal ICU, and a digital blood pressure monitor. We have also donated: 2 portable pulse oximeters, 2 pulse oximeters to connect to monitors, single-use electrodes, ECG clips, a blood pressure cuff and pump, and new cables for ECGS. We also will be using money we obtained through the Gephardt institute to purchase filters for respirators, electrodes and leads for the gastro unit, the unit we spent most of our time in during this trip.

Saying good-byes to all the fabulous staff at Roosevelt is always hard and truly bittersweet. Knowing that we would be spending the rest of the day in Antigua with Carlos made things a little easier. Antigua is one of my favorite cities in the world and we were all extremely excited to spend the
afternoon exploring a city that was once the capital.

Ruins of a church that was destroyed by earthquakes in 1773.

Carlos generously drove us to Antigua where we spent 4 hours walking around, looking at beautiful architecture, and enjoying food at one of my favorite restauranta, Luna de Miel.

We had a great time in Antigua with Carlos, it was a great way to end a great trip!

Day 11: The bubble

Today was a day that was extremely different than what we had planned. Last night we were advised not to go to Roosevelt today at all. Some even advised not leaving the compound our hotel is located in. Knowing that the protests were growing this much was exciting, anxiety-provoking, frustrating because we were unable to work, but also gave us hope that the political situation will slowly improve.
It was hard to spend the morning in the hotel while knowing that major protests were taking place at the same time. After looking at pictures posted of the protest it was clear that we would have undoubtedly have a lot of trouble simply getting to the hospital. However, the protests continued to be peaceful. Many described them as passionate but peaceful; many families with children were in attendance. To see pictures visit: prensalibre's website.

In the afternoon, after things had died down we headed to Cayalá for lunch with the Universidad del Valle (UVG) mechatronic students interested in working at Roosevelt. It was first almost ironic to be meeting in Cayalá on a day of public protests. Cayalá is technically a city. It is about 70 acres of high-end, expensive, new and elegant housing, dining, shopping and entertainment. It is a community that was built to provide it's civilians with absolutely anything they may need. For me, it seemed like a place whether wealthy could reside without being exposed to the poverty and chaos seen everywhere else in the city, again this was just my impression. 

The pristine streets of Cayalá.

Meeting with the UVG students was great. After catching up and getting a lot of different perspectives on the protests, including historical context, we discussed our plan for the future with the university. It is clear they have a desire to volunteer at the hospital. Unfortunately, due to the political situation, it has been extremely difficult to get clearance to allow them to enter the hospital. There are a lot of hypotheses as to why this would be. It is simply important to remember the hospital is ultimately controlled by the government. We will continue to continue to communicate with them throughout the year, share our knowledge, and work with them to establish a strong relationship with Roosevelt. It is always fun to spend time with the UVG students, are we are excited to keep working with them. Hopefully they will receive clearance soon!

Day 10: Enhancing neonatal care

We had another successful day at Roosevelt. Upon arriving to our work area in the old ICU we turned on the incubator we repaired yesterday and tested its ability to both heat up, stay and change temperatures. It was successful on all accounts!

It successfully heated up to the desired 37 degrees Celcius

We then continued working on two patient monitors from the infant neonatal critical care unit. We were soon ready to return to the unit and test the monitors. This critical care unit seems to be one of the busiest places in the hospital, partially because it is a relatively small unit, and because there always seem to be a dozen doctors running around and mothers anxiously awaiting news. A resident assisted us in testing the monitors on a patient, an adorable baby named Daniel, who was almost ready to go home. The monitors proved to detect his heart rate, SPO2 levels and print ECG patterns correctly. We gave the unit 2 more usable monitors!

One of the monitors was almost 30 years old.

The two monitors we fixed, on a cart ready to use!

Checking the readings of the monitor.

After returning the repaired monitors we returned the repaired incubator as well. Returning equipment after fixing it is extremely rewarding. Our help is appreciated immensely and there is no doubt that the equipment we were asked to fix (and was completely out of use) will help Roosevelt provide to care to the countless number of patients seeking care daily. We spent the rest the day at Roosevelt working on some ECGs we were just given- unfortunately they are missing essential parts and are hard to troubleshoot, but we are doing our best.
Before we left we had to say goodbye to the fabulous Jose who has been our point person throughout the trip, he has been an integral part of making us feel welcome here and helping us whenever any problems arise. We also met with Dr. Mejia about the potential of UVG entering the hospital to work us. Last summer we had meetings between the deans of UVG, Directors of Roosevelt, myself and the mechatronics students interested in working at Roosevelt. By the end of our trip they had been granted full access to the hospital. Since the change of security at Roosevelt they have been unable to reenter the hospital. Dr. Mejia confirmed that, due to the tough political times in Guatemala, granting the students access to help in Roosevelt will be difficult and will have to be postponed for at least a couple of months. Politically, Guatemala is in a state of flux, as I have mentioned in previous posts. In fact, tomorrow, we have been told not to go to Roosevelt at all.

The notice about the protests.

There will be mass protests all along the routes to the hospital, in the capital and at the hospital (a public institution that suffered due to government corruption). The number of warnings we received tonight about the protests and the fact that everyone insisted we stay at the hotel tomorrow has been sobering. We are disappointed we will be unable to return to Roosevelt tomorrow, we are close to repairing an ECG, but understand that we must put safety first. We will keep everyone updated tomorrow. To read more about what is currently going on in Guatemala: Read this.

Day 9: Week Two Begins!

A guest blog entry from Ananya and Caroline:

Today we set up camp in the old ICU, which is now empty and is being used as a storage area for old, broken equipment.  It was great to see that the new ICU, which was our work area last year, is now in use, after much petitioning on Carolyn’s and others parts.

Entering the old ICU which was fully functioning about 6 months ago.

This area has become another warehouse for broken equipment

With the help of our new maintenance friend Horacio, we began work on two incubators. We determined One  could not be fixed, as it is ancient, and had evidently been previously tampered with.  There were screws missing, things were put back together incorrectly, and parts of the circuit board has been detached and broken. The second incubator was successfully repaired, after much battery work and sodering by Mark and Ananya!  

Working hard.

Good work, team!

We were also given another ECG from the pediatric ICU and two monitors from the Neonatal Intensive Care Unit to look at.  We are still working to determine exactly what is wrong with each, and plan to continue working on them tomorrow.  Unfortunately, poor Horacio got stuck in an elevator trying to bring us the equipment.  This, along with no working lights in the old ICU, exemplify the daily problems that the people of Roosevelt have to face. 

On a happy note, we visited Gastro to deliver and officially donate some pulse oximeters and a blood pressure cuff.  Our three favorite nurses were happy to see us and told us that both monitors and the endoscopes we worked on last week are officially working!  Together we worked with them to test the blood pressure monitor we saw last week.  It can now also be used. 

A monitor we fixed now in use.

Testing the Blood Pressure monitor we fixed, it worked!

Afterwards we got some delightful homemade popsicles from the food stand outside the hospital.  Everyone enjoyed the delicious mango.  For dinner we returned to La Chapinita for traditional guatemalan fare and Mark was finally able to get that Hard Rock Guatemala pen that he wanted  We look forward to another productive day tomorrow! 

Our Weekend in Panajachel

We just arrived back to Guatemala City after an amazing vacation in Panajachel. Panajachel is in the Guatemalan highlands and provides views of 3 volcanoes and sits on Lake Atitlan. The trip from the city to Pana (an abbreviation we picked up from locals in Panajachel) is important to mention when describing our trip. Up in till this point our group has only been exposed to a few select places in the city and nowhere outside of it. This bus ride provided us with insight into different parts of the city, villages and towns outside of the city, and everything in between. It is hard to describe everything we saw on our trip but I’ll start by mentioning a few things are adding more pictures than I have been—we all took a lot!

      1)   To start, driving in Guatemala is, in one word, dangerous. There are no speed limits, lanes are   often disregarded, it is seldom that cars yield to pedestrians, and the exhaust that is emitted to the   countless “chicken” buses driving around would definitely be illegal in the states. Driving is   always…exciting and during rush hour, even more so. 

A view from the car.

      2)   The city is divided into 22 different zones. Our hotel is in Zone 10, the safest zone. Besides     Roosevelt, Zone 11, we stay in the area near our hotel. This trip took us into other zones where many   patients coming to Roosevelt to live. We were exposed to  more communities of cinderblock houses,  dilapidated store fronts with children playing out front, sections of highway covered with workers  from the villages returning home to places we wouldn’t consider homes at all. Once we were in Panajachel it was interesting to see many children wearing shirts that had clearly been donated from the states.

Children staring into the street from their from yard.

Looking down on a village in Sololá

     3)   There were political messages everywhere we looked including billboards, the side of the  mountain, painted onto shops and homes, on guard rails, etc. As we left the city we observed a large  number of signs for LIDER, the Libertad Democrática Renovada. We were later told that this party spends an exorbitant amount advertising particularly outside of the city. Many villagers are unaware of exactly what the political parties stand for, many do not speak Spanish, and many are therefore without the  means to vote in an educated fashion. There are campaigns that pay families and towns to paint their logo on houses and mountains etc in order to secure the vote of the villagers. Unfortunately the most prominently advertised campaign, LIDER, is not the most attentive to the villagers needs.

Home supporting it's party.

One of the only proper billboards with a political sign.

We got to our hotel in the middle of a downpour and decided to spend the rest of the night at the hotel restaurant chatting and playing card games, excited for the sun to come out so we could begin exploring the town.

Saturday was amazing, we started with a traditional Guatemalan breakfast complete with beans, plantains, eggs, tortillas, queso de oja, and, of course, coffee. We then wandered around the market place, spoke with vendors about their products and often whether they are familiar with Roosevelt—everyone is. 

A view of a shop in the market.

We then took a boat across Lake Atitlan to San Pedro, a volcano and island. We enjoyed walking around this “hipster” island complete with plenty of rocks to jump off of into the water, hidden restaurants and cafes and views that are hard to forget. As we were enjoying San Pedro, anti-government protests were beginning around the country read more here. We are interested to see what results from these protests in the coming days, weeks and so forth.

Enjoying the lake from San Pedro.

The boats we took from Panajachel

Once we got back we headed to dinner and a bar, Pana Rock to listen to some live music. The band that was playing definitely had talent but we weren’t sure what to think of the falsetto singing and strange electronic noises. We spent Sunday morning relaxing on the docks, kayaking, swimming and taking a last minute look at the markets before heading back to the city, sad to see such an amazing and relaxing weekend end, but excited to start a new week of work at Roosevelt. 

The view of the volcano from Panajachel.

Day 6: Moving Right Along

It is crazy to think that it’s already Friday and our first week at Roosevelt has come and gone. We spent the morning in Gastro working on the remaining broken equipment there. It’s amazing that in only 3-4 days we have made a significant impact on their equipment. Today we fixed another monitor, tested outlets, worked on a blood pressure monitor that is more than 50 years old and potentially repaired the last broken monitor they have, we will find out on Monday if it’s functioning after it’s new batteries recharge. 

Before we fixed the monitor Imani's heart beat was a little spastic...

Working in gastro has been extremely rewarding for a number of reasons: we have successfully fixed 2 endoscopy towers, 2 monitors (potentially 3), we work along side a wonderful staff of nurses who have always been welcoming and informative while working along side us, we have been told countless times, particularly after a repair, that we are a “blessing” and that we are saving the hospital and patients thousands of dollars and directly impacting the state of the unit. We have promised them filters for their respirators, a new bp cuff and pump and a pulse oximeter we have brought with us. 

The WUGI team with the wonderful gastro nurses.

They definitely have a great sense of humor that's made gastro (of all things) fun.

We spent the second part of our day touring the infant ICU that actually has large plastic crates full of broken equipment. The infant ICU and maternity wards are extremely crowded—there is hardly room to stand. It is clear that any help we can provide them will be appreciated.

Outside the entrance of the maternity ward.

Inside the infant ICU.

They decorated for mother's day in the marternity ward.

We left Roosevelt a little early to get ready for our weekend of truly being tourists. We are headed to Panajachel, a beautiful town on Lake Atitlan. More to come on our trip, breathtaking pictures guaranteed!

Day 5: Success

Today was all around a fabulous day. It was beautiful outside, we were successful in our repairs and met with our friend, Andres, for dinner. We started our day at Roosevelt, instead of heading straight to gastro to continue our work on the endoscopes, we had a meeting with Dr. Mejia, the director of Internal Medicine, and toured the women’s ward which was nicely decorated with mother’s day banners. The nurses there brought us a broken ECG and a broken SpO2 sensor. 

We discovered that the ECG was missing a number of important parts including a paper role, pin, and battery. We asked a nurse whether she could locate a paper role and the pin, but apparently the pin has been lost making the thermal printer of the ECG unusable. It was also particularly interesting to see that the battery was simply missing from the machine. A general consensus from the staff was that the battery had to have been stolen and sold on the market. However, as this model of ECG is no longer manufactured we are having a lot of trouble even locating a replacement battery. Unfortunately the ECG battery was not an unique case, the SpO2 sensor was also missing a battery. It had also clearly been opened up before and put back together ad-hoc. It led us to many questions about how this equipment has been treated and who has damaged it in the past. For now, there is unfortunately nothing we can do except look to order more parts for these machines.

What we found where we expected to find the battery of the SpO2 sensor

We then returned back to gastro, determined to make headway. We are happy to report that by the end of the day we fully repaired two endoscopes!!! It was incredibly rewarding to see just how grateful the nurses and doctors were for our help and the machines are immediately being  put to use for procedures tomorrow.  Each endoscope we repaired saved the hospital about $4,500, money they truly do not have to spend.

We fixed it! Don't worry, Mark was happier than he looks

We left the hospital with more spirit than we’ve had the entire trip. We were feeling useful, needed, appreciated and finally confident in our abilities. We spent of the day completing research until we met up with Jorge Andres Bonilla, a friend from last summer who took us all out to dinner and drinks. It was great seeing Andres again and great to hear how successful he’s been since he finished his residency at Roosevelt. After a great night of catching up we’re all tired and ready for our last work day of the week.

Thanks for a great night, Andres!