Team Leader: Drs. Mitch Brock, M.D. and Steve Long, M.D.
Team Type: Otolaryngology (Ears, Nose and Throat) and Pediatrics
Campaign Summary:
Approximately 200 patients were triaged and 32 surgical procedures were performed. A separate program focusing on neonatal resuscitation was also presented to local first line providers.
Supporters:
Dr. John Donovan, M.D. – Salem, Oregon
Kaiser Permanente, Sunnyside – Portland, Oregon
Willamette Ear, Nose, and Throat – Salem, Oregon
Team Members:
Dr. Karoline Brock, M.D., Pediatrician
Dr. Mitch Brock, M.D., Otolaryngologist
Lorena Brown, R.N., Operating Room and PACU
Kassy Coker, Surgical Technologist
Carolyn Frkovich R.N.
Dr. James Grant, M.D., Anesthesiologist
Paul Gross, R.N., Operating Room and PACU
Linda Hayes R.N., Operating Room and PACU
Thomas Hayes, Handyman
Susan Heffernan, R.N., Operating Room and PACU
Dr. Steven Long, M.D., Otolaryngologist
Dr. Damon McBrinn, M.D., Anesthesiologist
Milo McBrinn, Assistant
Dr. Jeffery Meiners, M.D., Anesthesiologist
Josh Meiners, Assistant
Ryan Meiners, Assistant
Lourdes Quintana, Nun and Translator
Adena Shull, R.N., Operating Room and PACU
Timothy Shull, Assistant
Bonnie Steere, R.N., Operating Room
Anesthesiologists Damon McBrinn and Jeff Meiners Preparing a Patient for Surgery
Dr. Brock, Guido Del Prado and Steve Long Celebrate Another Successful Trip
Dr. Brock’s Team and Clinic Staff
Dr. Brock Performing a Tympanoplasty (Eardrum Repair)
Dr. Karoline Brock Demonstrating Resusscitation Techniques
Dr. Karoline Brock Teaching the Helping Babies Breathe Class
Intraoperative Photo of a Child with First Brachial Cleft Fistula
Neonatal Resusciatation Class
Patient in Stroller with Family After Surgery
Surgery with Dr. Mitch Brock, Bonnie Steere, and Anesthesiologists Damon McBrinn, Jeff Meiners and Jim Grant
Susan Heffernan Attending to a Patient Post-operatively in the Recovery Area
Narrative:
By Dr. Mitch Brock, M.D.
After an uneventful 23 hour journey to the beautiful Sacred Valley, the team was greeted at the Coya Guesthouse by Sandy and Guido del Prado with lunch and coca tea followed by an orientation to the Kausay Wasi Clinic. Our 11 arriving footlockers along with the 13 trunks in storage were then efficiently unpacked followed by preparation of Clinic exam rooms, recovery areas, and both operating rooms. Surgical instruments were generously provided on loan from Kaiser Permanente Sunnyside and several critical medications were donated by Dr. John Donovan, M.D. and Willamette Ear, Nose and Throat in Salem, Oregon.
The following day Drs. Mitch Brock and Steve Long saw around 100 patients for the first big day of triage. Patients had traveled from throughout the Sacred Valley and Cusco area with some traveling for almost 2 days. In triage, the incoming patients were interviewed and examined, with most directed to treatment with medications or other non-invasive therapies. Those with more serious conditions were offered surgery later in the week.
Monday morning started early with “morning report” to familiarize all team members and Clinic nursing staff with the plans for the day. Five otolaryngology cases were performed on Monday with Drs. Brock and Long seeing more Clinic patients between the scheduled surgeries with the help of Clinic staff and translators.
Patients were screened and safely anesthetized by Drs. Grant, McBrinn, and Meiners. Operating room nurses included Bonnie Steere, Kassie Coker, and Lorena Brown. All the nurses rotated daily in various surgical and supportive roles. The critical task of cleaning and sterilizing the surgical instruments was conducted smoothly by Tim Shull and Bud Hayes with assistance from Milo McBrinn and brothers Josh and Ryan Meiners.
All patients recovered uneventfully with oversight from nurses Adena Shull, Susan Heffernan, Carolyn Frkovich, Paul Gross, and Linda Hayes. The last patient headed home about 8 pm. This pattern was repeated each day starting with our morning meeting and not ending until the last patient was safely discharged. Approximately 200 patients were triaged and 32 surgeries performed during the week-long mission encompassing a wide range of general head and neck procedures. This included a relatively rare condition of a first branchial fistula in a 19 month old, resulting in a chronic infection extending from the patient’s ear canal several centimeters inferiorly into the neck. Many previous doctors had been consulted over the previous year, but no clear diagnosis nor treatment had been given. The thorough removal during our time there will hopefully remedy this chronic ongoing condition. The patient’s family was delighted with the treatment and brought a generous meal of a traditional Peruvian dish, roasted “cuy”, to the team on our last day.
Dr. Karoline Brock is an Oregon newborn hospitalist certified to teach “Helping Babies Breathe”, a program developed for third world countries by the American Academy of Pediatrics. She provided daily instructional programs and learning lab sessions focusing on resuscitation and care of newborn infants to approximately 50 front line providers in the Sacred Valley. After demonstrating techniques to aid breathing in newborn infants in their critical first minutes of life, attendees had the opportunity to practice these techniques on life-sized baby models. The materials and supplies were then left with the Peruvian providers for ongoing education and practice.