As the Rotary wheel turns...

Throughout the mission, Rotarian leaders have been on-site, opening their
homes, hearts, and wallets to any needs. Following the tragic events on day
4, they steadfastly served the needs of the team and the family involved.

The mission has been hard on everyone due to events earlier this week. One would easily expect that the medical and volunteer staff would take it really hard given that this is a first for Rotaplast and most of them have done multiple missions all over the world. But the quiet heroes this week have been the local Rotarians of Cebu Port City Club and the many Rotaract volunteers who have been a constant presence throughout it all. In fact, in the days following, they were quick to ask us how we were doing, offer a kind touch on the arm, and always a "thank you" for sticking with the mission. Truly committed servants.

From the beginning, they welcomed us and have done everything to keep us safe, comfortable, and well-fed – many of them cooking from home and bringing in favorite dishes for us to sample and enjoy.

They are the ones who really get a mission started, too. While we all book our trips and plan to leave our homes and jobs, they’ve already been working already for months, promoting our arrival and finding the families who we will ultimately serve. They’ve grown close to these people, learning their stories and making plans to host them in the city, feed them while they wait in long hot lines, and tend to and pay for any other needs – most which the patients’ families cannot afford to cover themselves. The generosity of these Rotarians is as present as the rising sun.

Following the tragedy earlier in the week, these same fine people continued to quietly serve despite their own sorrow. In the wake of it all, they stepped up to be an extra support to the family. As of last night, it was reported that they hadn’t left the sides of the family members, mourning the loss with them. They’ve set-up scholarship funds for the child’s two siblings, purchased a private and permanent burial plot for the family (typically plots are not permanent resting places due to cost and space) – the funeral is Saturday at 9 a.m. I’m told. They also have arranged to hire the father into a new line of work including retraining so that their lives can be that much more improved. They want to maintain a connection with this family and demonstrate their own grief by serving.

This is the way of Rotarians as I’ve learned since joining my club in February. The values run deep and true – even halfway around the world. This truly is a good organization and I continue to be proud of my membership.



Picture with most of the Rotarians leading the charge for the 2011 Cebu City Rotaplast mission



Wrapping up - Surgery Day 7

A father in the pediatric ward created a make-shift hammock that he
rocked all night to calm his son to sleep. At 16 months, JB had a
tough start being 22 weeks premature his father tells me. They lived at
hospital for 4 months. "He's strong," his father tells me. He's adorable,
too -- big dark eyes lined with long lashes.

Today feels different than the other days. It’s our last day of surgeries and when it’s all said and done we will have seen 104 patients, provided surgery on all who we could help (66). Many lives have been changed already and we’ve seen the happy faces leaving the pediatric ward. I’m told we’ll see many of them tomorrow at the post-operative clinic when they come for a final check by the surgeons, pediatricians, and dentists and receive any final instructions.

It’s been a long week and everyone is tired but pushing, offering the last of their energy, smiles, and love to the final patients.

Severall non-medical team members took the opportunity to watch the final surgeries. I declined the offer -- not out of disrespect or disgust, but rather, I know my limitations and I've seen more than I'd planned or hoped for this week. It's cool to see them come out after the surgeries feeling more connected to the patients and wearing expressions of impressed appreciation for our talented surgeons.

As the last patient, 19-year-old Jonathan, was wheeled out of the recovery room, he held up both thumbs and the remaining staff in the OR let out a cheer. The surgical work was complete, and our final patient was happy.

JB hangs out in his hammock

Next, the operation was mobilized again but with a new purpose – it’s time to pack up our things and prepare for tomorrow’s clinic. The huge boxes in which our supplies were shipped over with us from San Francisco started to appear again. I’m a little sad to see this. Within the hour we’ve repacked our boxes and are ready for tomorrow. The knowledge of what we face tomorrow gives everyone that last little boost of energy. The mission that felt impossible at several junctures is wrapping up. And, many of us will be returning home changed forever.

Our final stop at the hospital for the day is in the breakroom where a cake has been prepared and we again hear words of appreciation for all of the week's efforts.

Mission director Brian conducts "surgery" on the
celebratory cake -- no anesthesia or nurses.

Abegail

Later in the day (6^th day of surgery) I awaited Abegail’s arrival upstairs to the waiting area for surgery. She’s the young girl I spoke with earlier in the day down in the pediatric ward.

Needing a cold bottle of water, I left my station and headed through the hallway to find her seated in the waiting area with her mother, crying. I went to her thinking she was afraid. Her tiny body wracked with tears and unable to speak, her mother told me that she couldn’t have the surgery today. It turned out that she had a cough and cold coming on and the pediatrician and anesthesiologist concurred that it wouldn’t be safe to proceed. These are the kinds of tough decisions the medical team has had to make all week; it breaks their hearts to say no, but the safety of the patients must and always does come first.

Abegail is very disappointed. She’s been waiting to have her palate repaired, and the sadness that she must wait another year consumes her. I try to console her. I talk to her more about the possibility of coming to America as an exchange student. A good student, I’m really hoping I can find a way through my club or district to make it happen for her. I tell her I want to keep in touch and offer her my email address. She agrees to write with a nod, but has no words for the time being. I hug her repeatedly hoping that she knows my heart is sincere—I want to be her friend.

Later that evening after finishing the day of work, I log on to find that she has “friended” me on Facebook. We are indeed friends. Once again, I am blessed. A co-worker later gives me Abegail's artwork, a doodle page, where she'd written my name with a heart beside it.







Lynn was our jack-of-all-trades but helped a lot with transport
and entertaining the children as they waited their turn for surgery.

The man, the mystery -- Dave, our mission
photojournalist, doing what he did. This
is about all I got of him. :)

“Old babyface” – Surgery Day 6

The team is getting stronger with each day. The pain is still there under the surface, but people mask it to focus on the new cases walking through the doors. I arrive excited to see Ryene and hope that he’s happy to see me too.

Ryene commandos my iPhone

I set up my desk and pull the day's charts for Carolyn, asking her if it’s okay to go see my little friend. Of course – go! Coming into the recovery side of the pediatric ward, I see tired parents and children everywhere – some of the parents taking over the cots for a little shut eye after a long night comforting their children. I again stop and visit with each, looking at the amazing transformation of each child. Some see me in my scrubs and start to cry – us white people in medical uniforms are now something to be feared. I get it. I don’t really love medical stuff myself, but I do have a newfound appreciation for the people who give themselves to this profession.

About halfway through my stops, I feel some arms wrap around my waist and look down to see Ryene. His cot is at the far end, but he saw me and came over. His mother, a little embarrassed, is trying to pull him back to wait his turn, but he’s not having it. I let him hold my hand as I greet the remainder of the patients and families. It’s breakfast time and he’s supposed to be eating, but he wants to see “Caesar” again. I tell him to eat his breakfast first, to listen to his mama. I’ll come back in a few minutes.

Artists Ryene and Shenen hard at work, creating masterpieces
for me to bring home

I head over to the other side of ward to see the waiting patients -- those who will have surgery today. Shenen is there; she was part of our balloon game yesterday. She runs over and tags me on the leg to make sure I see her and then runs back to her cot. I say “hello” to the parents and the children before settling down on Shenen’s cot. I begin to show her pictures of my pets, family, and friends on my iPhone. Other kids start to gather around us looking at the pictures. We sit there for a little while and then the kids start fussing; I look up to see Ryene pushing them aside to get to me. He’s saying “Caesar!” over and over. I tell him to be nice and we all arrange in a circle while I continue to flip through the pictures. He’s letting the other children know he’s claimed me; we’re special friends.

Being an auntie, I keep a lot of children’s games on my iPhone. I whip out a few of them for the kids. Bug Squash is a favorite; this game has a screen with bugs racing across and the goal is to touch them (squish them) before they run off the screen. I’ve got about six kids all pounding on my iPhone and quickly realize that this little device won’t survive unless I find a less violent game. I pull up the matching game that has the kids using memory to turn squares over and find the matches. It’s really cute as they each take a turn, one after the other. They cheer when they finally make a match. We do this for about an hour and then I realize how much time has passed. I have to go back to work. Coloring books come out and the children go to work on their art. Ryene has to go change clothes so he can go home; he doesn’t want to go back to his mother. He pulls away from her grasp and insists on making me a picture first – a colorful horse, which he signs with his name before adding mine.

Me and Abegail having a little chat

As they color, I engage 16-year-old Abegail who is waiting for surgery later today. I ask her if she likes school. Yes, she answers shyly. What do you like to study? Math? No, she wrinkles her nose. She likes to read. Fiction, at that. I ask her if she as a boyfriend. Yes, again shyly, her eyes go down. Her mother jumps into the conversation and adds that grandfather is unhappy about this development. I then ask her if she wants to travel to America or somewhere else. Her face lights up – yes, she wants to go to America. Anywhere in America. I tell her to study hard at school and get good grades. Perhaps she can do an exchange. Maybe even with Rotary. The mothers hover around wanting to understand student exchange – one mother whose English is better explains it to the others. They all nod and smile together, and tell Abegail this is a good idea. I focus on her again and hold up three fingers and repeat three themes for effect: 1 – finish high school; 2 – go to university; 3 – then a boyfriend is okay. She smiles. She knows what I’m saying.

The mothers start asking me more questions. Do you have a husband? Children? Are you a doctor? No, no, no. I explain that I do business work, knowing I’ll never be able to explain what I do. They tell me they think I’m smart, and ask me how old I am. 44. Several shake their heads and start talking amongst themselves. They ask again. Then they ask me to write it down with a crayon as if something is lost in translation. They see the number and shake their heads in unison. One mother points to herself and says 44. Then another points at me and says “old babyface.” I have a new nickname from the moms.



Gift from my favorite Cebuano artist



My little Ryene – Surgery Day 5

So re-entry to the hospital was a little tough earlier today, but after playing in the ward this morning, things were back on track for me. I’m still thinking about "Ronny"; I’ll probably always think about him and wonder what he might have grown up to be. I’ve formed a connection with my Casanova friend, Ryene, though, and was able to spend time with him before his surgery. You could say that we have kind of a bond. It’s ironic that he’s the same age as "Ronny" and they look somewhat alike.

His and her tattoes (Ryene and me)

He’s brought up from the pediatric ward to the waiting area where we tattooed each other (he was careful to select a "girl" one for my while he opted for a fierce cobra one), played tic-tac-toe, he wrote my name, and then we played with my iPhone for a while. He loved the pictures of Caesar (my Chihuahua) and every time he flipped through the pictures would exclaim “Caesar!” Carolyn, seeing the connection, came to the waiting area when it was time and asked me to be the person to escort him to surgery and be the last person he saw before he went to sleep. Hand in hand we walked into the OR, and I picked him up and set him on the table.

The anesthesiologists started administering gas and after a few deep breaths, he decided he didn’t like it and started to fight a little. I rubbed his dark little legs while the team held him down and watched him give way to the gas, me fighting back tears.

I went back to my desk with his flip-flops in hand, pulled it together and proceeded to the waiting area to give them to his mother. Worried eyed, she asked me if he was okay. I told her he was sleeping and fine. She pointed to the OR and said “you go” wanting me to go back and be with him during surgery. I wasn’t prepared to watch a surgery, but I did go back into the OR as she’d asked so she would be comfortable knowing I was close to him. Carolyn later told me that when we went into the OR, Ryene and I, the mother began to cry. It’s hard to think about how these mothers feel letting go of their children and entrusting them to total strangers. Carolyn held her and told her he was fine and that I would be with him and that knowledge calmed her.

Back at my desk, I prepared tomorrow’s files waiting for Ryene to emerge. At one point a scrub nurse opened the door and starting calling out for things I didn’t understand. I panicked thinking that this might be a re-run of yesterday. Things settled down, thankfully, and I was assured my little friend was fine. And then, it was time to wait.

Phenomenal Fiona (anesthesiologist) and me

An hour later, he emerged from the OR fighting the anesthesia, literally. He’s a tough little guy. His mother  told me the story of how his father was murdered in their home. Ryene has two other siblings. He’s the youngest. When a mad-man came into their home, he stabbed the father. His mother instinctively put herself over her child and was stabbed herself in the chest. She showed me the large scar. Fortunately she survived. The father had been against Ryene getting corrective surgery; there are many people here who believe that’s how God made them and that it shouldn’t be changed. Without him to consult, the mother came to clinic and today he got the surgery. She is pleased that the other children will no longer make fun of his deformity.

Ryene's mother (grandmother in the background) - taken by Ryene

After we’d settled him down in the recovery room, I was asked to go get Ryene’s mother. She sat in the hallway alone – all of the other parents had already collected their children and been moved down to the pediatric ward for the night. Her face lit up with a question when she saw me. I told her he was more handsome and very strong. She was pleased and said “thank you” over and over as we walked into the OR.

In the OR she rushed to hold him and I’ll be darned if that little guy sat up and said he wanted to leave, shouting it at her. As she ignored him, understanding it was the drugs talking, he screamed at her “Are you deaf?!” He’s her baby and has been through a lot. Even with his post-anesthesia anger, he is my little friend. I’m excited to visit him tomorrow.



Ryene in recovery (if you look carefully, you can see that his lip
will be very attractive making this special boy even more
handsome)



Back in the saddle – Surgery Day 5




Recovery side of the pediatrics ward

I’m not saving lives here, but there are people counting on me. So I awoke at my usual time (5:30 am) and joined everyone in the breakfast room. Not really hungry, I ordered a scrambled egg. When it arrived, I could only guess that it was from an ostrich or penguin. Too much food. That’s been the theme this week. Not that I’m complaining. Everyone is doing all they can to take good care of us whether it be with food, security, or transport.

Picture with Ryene (pre-surgery)

Arriving at the hospital, it felt sad to be coming back to where there was so much pain and sorrow, but we were all encouraged to bring smiles today and focus on the work at hand. Digging into my charts, the first two patients of the day walked in with their OR nurses, much like "Ronny" did yesterday. It pulled at my emotions again, and Carolyn seeing it told me to focus on today and to push the images of yesterday from my mind for now. It’s been heartwarming to see everyone caring for each other throughout the day with a quick hug or “how are you doing?” – even a high five when "Ronny’s" surgeon emerged from his first case of the day – back in the saddle giving his best. The undeniable focus is on seeing this mission through.



S

Playing with Shenen, Ryene and pediatrician Mary

Mid-morning, the pediatricians (Mary and Sheila) encouraged me to visit the ward to see the progress of the previous day’s surgeries and meet those awaiting their surgeries today. It was the best thing I could have done. Arriving in the hot pediatric ward, I saw it split into two sections: one side for those waiting for their surgeries to start and the other side for those waiting to be discharged.

Ryene scoots in for a hug

I first took a walk through the side where surgery patients were in various states of recovery. I stopped to look at each child, spoke to the parents, smiled and winked at the kids. I have to say the transformations are amazing in such short time. I’m told I’ll see all of these kids again in a few days at the post clinic. The only dark moment was thinking to myself that I wished "Ronny" was down here laying on a cot in this hot, humid room.

In the waiting area, I was quickly greeted by the little flirt from the other day, Ryene. At six years old, this little guy has a solid future as a lady killer. Well, I’m smitten anyway. He led me over to his cot where his mother and grandmother were sitting, having me sit down and patting my leg as if I was doing the right thing by leaving the other children and joining him. I haven’t really had many pictures with the children so I handed my camera to Michelle, the ward coordinator, to snap a picture of us. After looking at our picture, Ryene grabbed the camera and shot a picture of me and then one of his mother and grandmother. Very pleased with himself, he led me to the play area where Mary was already playing with Shenen (a little girl who was rescheduled from yesterday and will have surgery tomorrow) and a yellow balloon. We joined the game of trying to keep it in the air; I played for about 30 minutes. Drenched in sweat, it was exactly what I needed. Ryene and Shenen’s happy faces made my day, and Ryene, true to his affectionate personality kept coming over to me for a confirming hug ever few minutes. As we were leaving the play area, I’ll be a four-legged fish if that little fellow didn’t goose me on the bottom with both hands!

While those kinds of moves aren’t really why I’m here, it’s good to be back. The kids really are a good reason to keep our commitment and press forward with the mission.

Lean on me

Important note:  This post, as with all on this blog, are my observations and experiences only. They do not speak on behalf of Rotaplast, any member of this mission medical or otherwise, or others on site. This is my unofficial blog only. The name of the patient has been changed out of respect for those involved.

Grief is an awful thing. Everyone does it differently. I tend to go find my hole, cry alone, and summon strength to face what’s next. Others sit quietly in small groups. Others talk about the situation or anything to take their minds off of reality. A few keep busy – asking what they can do, serving water and Kleenex. Tonight’s pizza party offered me new insight into how medical professionals do what they do.

What was supposed to be a fun after-hours event in the hospitality room turned into a somber support group. I had already holed up in my hotel room and tucked into bed after eating some ibuprofen, a pain killer and a sleeping pill to try and rid my mind of the mini-movies playing over and over. Fiona, the anesthesiologist from "Ronny’s" surgical team, had other ideas for me. She knocked on my door and when I opened it she said “Everyone is upstairs.” I say I’m not into a group scene tonight. “The team needs each other right now. You’re part of us.” I stare blankly at her red-rimmed eyes. She thanks me for my words earlier as we sat in the OR; I saw her sitting, head in her hands, and went to her. I offered a hug and told her how impressed I was with her during the events earlier, still feeling lame and useless, but speaking and acting from my heart. From my desk, I had watched her:  determined, professional, and willing the child to live. She told me that she’d only lost one other patient in her career – an elderly woman. And while it shook her then, she admitted that a child was a quite different feeling. “There must be a better way to make a living,” she said her eyes welling up. I didn’t feel like I could offer anything useful to her but sat by her and told her how phenomenal a person I think she is. But standing at my hotel room door hours later, she’s telling me it helped her and she’s asking me to be part of the team right now. To step-up, not only for myself, but for the others. She is right of course.

I quickly dress and head up to the hospitality room. Everyone is there and fresh hot pizzas have just arrived. I realize I hadn’t eaten all day given the events so manage to push in a couple of slices of pizza in…followed by a huge glass of wine. And another. The damn medications still unable to take hold of my busy mind.

Medical professionals are special. They know the risks of their work. Every patient deserves and gets their full attention – I’ll remember this the next time I impatiently sit in a waiting room for my turn. And when they lose a patient, they band together. There doesn’t have to be a lot of words. They seem to know what each other is thinking and feeling. And, they pass out hugs and reassuring looks amongst each other freely. Over pizza and drinks I watched them unwind from the day’s events and recommit themselves to pushing on with their important work. It’s not that the emotions aren’t there. They absolutely are. It’s just that these servants have learned that they can’t serve again and again as their jobs demand if they spend all of their strength and emotions on the things they cannot control or change. They came with a mission in mind and will see it through. So will I.