Thursday, October 4, 2012

Antigua, Guatemala

By: Muyibat Adelani, MD

Operation Walk is a nonprofit medical volunteer organization that provides free surgical treatment for arthritis in developing countries. It was founded by Lawrence Dorr in Los Angeles in 1995, and now there are eleven teams from various regions in the United States who conduct yearly missions to perform total hip and knee replacements for those around the world in need.

I traveled to Antigua, Guatemala with the Operation Walk Virginia team. Based out of Alexandria, Virginia, this team was founded by Gerard Engh in 2006. It consisted of orthopaedic surgeons, anesthesiologists, operating room staff, internists, nurses, and physical therapists, all of whom were dedicated to not only performing the surgeries, but also pre- and post-operative teaching and patient care.

Day 1: As soon as we arrived in Guatemala, we went to the hospital, Las Obras Sociales Hospital, where we would be working for the week, in order to meet the staff and tour the facilities. This hospital is the only hospital in Guatemala where joint replacement is performed. The waiting list is 500 patients long. This hospital serves to host multiple mission groups in all specialties; they host 36 trips per year. The staff there is present to offer whatever support they can to these groups.

Day 2: The entire group went to the hospital bright and early to begin screening the patients. We divided into four teams, which each saw about fifteen potential surgical candidates. Most were elderly, some were young. Some had complex deformities. Some had complex medical conditions. When it was over, we met up together to discuss each patient and to determine who would be the best operative candidates. That afternoon, we operated on four patients.

Day 3: This was the first big OR day. We had four rooms running simultaneously. Each room had two surgeons and a surgical assistant (or me). In total, we did 12 patients. I did a total hip replacement in a 34-year-old man with a childhood hip disorder. That night, there was a big dinner for the entire Operation Walk team at a very fancy Argentinian steakhouse.

Day 4: Another big OR day. In four rooms, we were able to do 16 patients. I got to work with Dr. Gerard Engh, the surgeon leader of the team. We did four knee replacements together that day.

Day 5: This was the last day in the OR. We did 12 patients that day. In total, we did 54 joints in 44 patients. Six were hip replacements, and the rest were knee replacements. We also did a total knee removal, or explant, for a patient who had a knee replacement by a previous Operation Walk team, and has subsequently developed an infection.

Day 6: Everyone returned to the hospital to help take care of patients on the floor. We all passed medications, changed dressings, and walked with our patients. It was very rewarding to see how well our patients were doing so soon after their surgeries. We also had a postoperative x-ray conference, which gave us all a chance to see the results of our surgeries.

Day 7: The last day. Again, we all returned to see our patients. And then it was time to say goodbye. We took photos with the patients. We did final discharge planning. Then, it was time to return home.

I am very grateful to Dr. Engh and the rest of the Operation Walk team for the opportunity to join them on their trip!

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