It's Good to be Home!

News from the conclusion of the 2019 general surgery mission trip to Santa Cruz

Written by Jodi Grahl

I’m back in the office today after wrapping up our week of laparoscopic surgeries at the San Juan de Dios hospital in Santa Cruz. While the three of us who traveled to Bolivia for this mission—general surgeon Dr. Magued Khouzam, team chaplain Aida Segura, and myself—are easing back into our home routines, we are eager to know how our patients are doing. So I review our online records to check their progress.

Ana Paola (second from left) is pictured here with her parents and US missioner, Dr. Magued Khouzam.

Three patients – Ana Paola, 19; Oscar, 63, and Diane, 51 -- started the week not only unable to swallow solid foods, but struggling to pass liquids. Each suffered esophageal achalasia, in which nerve damage prevented their esophagus from squeezing food into the stomach. Rare elsewhere, we occasionally see this condition in patients infected with Chagas disease in Bolivia. It can be managed by a minimally-invasive surgery called the Heller myotomy with Dor fundoplication, but few Bolivian surgeons have the opportunity to learn this highly-specialized laparoscopic procedure. Ana Paola, Oscar and Diane are all home now, where they are gradually transitioning back to solid foods and are expected to enjoy a normal diet within a couple months. Dr. Magued performed the first of these surgeries on Monday, closely assisted by two Bolivian surgeons, Dr. Johnny Camacho (who traveled from Cochabamba to learn this surgery) and Dr. Diego Artunduaga. Dr. Magued then closely guided Drs. Johnny and Diego while they performed the following two surgeries. The team also diagnosed a fourth patient who will need a Heller procedure once he completes a series of pre-operative medical treatments.

Before his surgery, Jose offered a serenade for Dr. Magued Khouzam and volunteer interpreter, Denise.

I am also relieved to see that all seven of our hernia surgery patients have been discharged home as well. Reading through their names, I remember each of their stories. After years of discomfort, Gustavo, 19, finally underwent surgery for a congenital hernia that would have most certainly been diagnosed and repaired at birth in the United States. Enrique, 69, can walk normally again after surgery for a hernia so large it impeded his gait. And José, 74, is not only home but back to his singing and songwriting career after his hernia repair.

While the San Juan de Dios surgeons took turns operating alongside Dr. Magued in one O.R., they also rotated to operate a total of 11 gallbladder surgeries in the adjacent room. After honing their skills in laparoscopic gallbladder surgeries through previous Solidarity Bridge missions, the San Juan de Dios surgeons now regularly perform this surgery, restricted only by the scarcity of specialized supplies. Thanks to donations we carried to Santa Cruz from donors including MAP International, AmeriCares, Hospital Sisters Mission Outreach, Dr. Khouzam, and others, our Bolivian partners were able to make these additional 11 surgeries possible. In each of these surgeries, our Bolivian partners were assisted by the hospital’s young surgical residents. It was exciting to see these surgeons passing along the training they received just a couple years ago. It demonstrates to me the ripple effects of what is possible through our mentored surgery model. All of the gallbladder patients have been discharged as well.

As I complete my review of the 22 patients we operated, I note that just one gentleman is still in the hospital. Jaime, 57, underwent the most complex surgery of the week, a laparoscopic subtotal colectomy with ileorectal anastomosis. Our Santa Cruz-based social worker, Carmen, will keep me apprised of his progress, and the Santa Cruz surgeons know they can reach out to Dr.Magued to discuss any concerns about his follow-up care.

It is good to be home—for Aida, Magued, and me, as well as for our patients, some of whom had been in the hospital for weeks or even months waiting for surgery. I send my deepest gratitude to all of you who have followed our mission trip from your homes, and whose support makes our work possible!