First days in Coroico, Bolivia

We apologize for the delay in these updates from our Multi-Specialty Mission Trip blogger, Mara O'Brien. The team has had limited access to Internet during their stay in Bolivia, but that has proven to be all the better for immersing themselves in their work and in the culture of Bolivia! Read on to catch up on their journey: September 26, 2013 Day 1 in Coroico, Bolivia Written by: Mara O'Brien

After traveling 27 hours, we arrived safely in Coroico, Bolivia. I am aware that being here is God's desire. He has watched over us closely and protected us on the journey.

Coroico is a quaint town in the foothills of the Andes. Nestled on the mountainside at around 8000 feet, every view is spectacular. As our bus carefully maneuvered through the crowded and windy streets, people looked up at the bus with curious eyes, interested in the medical team they’d heard was arriving. We looked out, taking in the faces that would soon touch us in our 10 days here.

The view from our hotel.

The hotel is just a short walk away from El Hospital General de los Yungas. Arriving at the hotel, we are already on Bolivian time (running late), exhausted, but excited. We drop our carry-ons in the clean and simple rooms, eat a quick soup lunch and head off to the hospital. Our 35 suitcases with supplies have been delivered to the "Salon Multiple" (multipurpose room).

The "Salon Multiple."

1pm: We divide like worker bees and each team knows what to do. Surgeons and anesthesiologists complete pre-surgery screenings on patients our Bolivian partners have identified. Clinic doctors and nurses prepare supplies and exam rooms. Interpreters bridge the language gaps, and everyone else helps unpack and organize the supplies.

Three quick hours later, eight surgical patients have been screened for tomorrow's surgeries, the "store room" is set up, cardiology, pediatrics, gynecology, internal medicine, and two dermatology clinic rooms are readied.

Solidarity Bridge's Dr. Dan Yousif and Bolivian partner Dr. Juan de Dios Ruiz screen Mabel, a 21-year-old candidate for laparoscopic gall bladder surgery.

4pm: The group gathers at the hospital's center garden. The mayor, town officials and hospital staff greet us warmly beneath the colorful Welcome and Bienvenido signs. Mayor René Valencia Mamani says, "Here you won’t be paid in cash, but in hearts. Like Pope Francis said – we don't have a lot of money or things, but a lot of gratitude."

As I stood taking photographs, I heard and understood the Pope's words in a new way. I wanted to tell René and all the people of Coroico, "The gratitude is ours, for welcoming us into your town, your lives, and your hearts. Our lives will be changed and enriched through this experience." I know mine was already.

Drs. Mark Ottolin, Dan Yousif, Ricardo Palop and Magued Khouzam are welcomed.

We walked up the hill to the hotel for dinner and bed, exhausted, but inspired and ready. As we ate, I looked around and saw in each missioner's eyes a radiating sense of excitement and anticipation. The mission has begun!


Joining Mara O'Brien on the Multi-Speciality Mission Trip is Lisa Haufschild, a guest author, who has shared her reflections on their recent days in Coroico, Bolivia:

September 28, 2013 Parasites and Fiestas

It’s the second day of Coroico's annual Fiesta de San Miguel, celebrating the Catholic archangel and saint. The hospital's brick driveway leads to the cobbled main street where three days of costumes, dancing, singing and music are in full swing.



But inside the hospital, it's different. In the pediatric room, Jon Powell, MD and his interpreter Gustavo Mendoza see a new patient with common complaints every 15 or 20 minutes. Many moms convey that their children have stomach pain, low appetite, and are vomiting and experiencing diarrhea.

Luz, 5 and her brother Edilson, 12 have come to the clinic with their mother from Mururata, a town about 2 hours away. Dr. Jon distracts Luz with a very convincing bird whistle and places the stethoscope on her chest.


Both kids are diagnosed with a parasitic worm or "gusanos." Edilson also has some pain from a hernia he's had since he was a baby. Dr. Jon tells mom that surgery is the only cure for the hernia. He's not sure if she can afford it.

Outside, we hear the band playing La Morenada, a traditional fiesta song, over and over again. Inside, reports of stomachaches, low appetites and vomiting are becoming just as familiar.

Dr. Jon writes another parasite prescription.


September 28, 2013 Staying Open

This is a place where plans are made and revised many times a day to accommodate unfolding realities. The unexpected forearm fracture that came in overnight pushes back an already packed surgical schedule, a fact the Solidarity Bridge surgical team discovers while rounding on yesterday's patients. Dr. Magued Khouzam, general surgeon, Missy Koopmann, PA, Natalie Rodriguez, interpreter and Dr. Juan de Dios Ruiz, a Bolivian staff physician, strategize a new plan. A family cheerfully agrees to move their surgery spot to Wednesday. Five general surgeries and three gynecological surgeries are planned for today. Hurray!


September 29, 2013 A Spiritual Journey

Cirugia Mujeres (Women's Hospital Room): Six beds. Five filled. The early morning is hushed in the hospital room for the women who are very sick. A simple white screen surrounds one bed. Behind it, a daughter holds her mother's hand. Father Bob joins the vigil. A prayer is offered. A hand is held. Consoling words gently soothe a hollow-eyed spouse in the hallway. The untreated cancer has taken over and these are the last rites. The final bridge is nearly crossed. There are endings and beginnings here. Life is happening.


September 29, 2013 First Out, Last In

The surgical team - surgeons, nurses and interpreters - is the first to leave the breakfast table each day and the last to return at night. It's busy for everyone here, but these teams disappear each day into a mysterious, scrubbed-in world where miracles occur – like Coroico's first ever hysteroscopy and a complex emergency appendectomy that saved a life. The "Scrubs" emerge from the OR at night after the sun goes down. On the short walk home, they have a minute or two to reflect on the miraculous space between order and controlled chaos within the small hospital in a small town in the Andes.



September 30, 2013 Knowing What's Wrong Helps

Hortensia, 58, has traveled from a town eight hours away with her son Miguel, 40. She explains her symptoms and suddenly starts weeping saying she just can't get a deep breath.

Ellen Palop, from Suffolk, NY, is interpreting for Cardiologist Dr. Mark Ottolin, from Naperville. Ellen, Mark and their Bolivian medical assistant, Margalit, are all quiet for a moment before Dr. O begins gently asking exploratory questions.


"Is it hard to breathe lying down?" "Yes, I can hardly breathe lying down." "Are you from an area with chagas?" "Yes many, many people have chagas."

Dr. O says, "I know you have difficulty. We're just not sure if it's your lungs or your heart. I'm going to take a picture of your heart. It won't hurt. We'll find out what's wrong."

Mark and Ellen help her to the bed so the portable echocardiogram machine Dr. Ottolin brought from home can deliver a small miracle - a live action picture of Hortensia's beating heart at work.


"It's not chagas," says Dr. O. "Let's get a chest X-ray to rule out heart failure."

When the X-ray results arrive a little later, Hortensia's diagnosis is made for the very first time - bronchospastic asthma, a pulmonary problem. Just knowing what she's dealing with makes a big difference. It's not chagas. It's not heart failure. Dr. Ottolin prescribes medication that will help her greatly. Then her son, Miguel, heads off to internal medicine for his own appointment.