From Jessica Gimbel, Nursing Staff

The most memorable patient I had was a teenage girl who came in for a scar revision; her upper torso was so badly burned that she had lost most of the range of motion in her neck. It was somewhat difficult for me to communicate with our patients since they spoke Spanish and my only background in the language dated back to high school. Because of this, there was frustration on both sides and I couldn't tell whether or not she trusted me as her nurse. She was even more unhappy when she had to stay overnight because we had so many surgeries scheduled. 


However, when her name was called the next day, she was overjoyed; I put on her cap and booties and wheeled her to the OR. Right before I left, I was surprised to hear from one of our translators that she was asking if I would be there to take care of her after surgery- I was surprised and flattered, but also felt an even stronger sense of responsibility to make sure that her recovery would progress as smoothly as possible. When she came into the recovery room, she was unconscious and shivering. Ten minutes and five blankets later, she woke up and looked me right in the eye. "Is it over?" "Yes."

The next day (after a few rounds of pain meds and deep breathing), I showed her how to take care of the surgical site and gave her discharge instructions. After paying close attention to the teaching and getting dressed, she was ready to leave. With a big smile on her face, she gave us the customary hug and kiss on the cheek, then squeezed our hands with a sincere "Gracias!"

This girl reminded me of my reasons for coming on the Ayacucho medical mission- to help treat those in need, and to do so with a sense of compassion and mutual respect. This was my first medical mission, and it helped open my eyes to the world while simultaneously showing me the avenues through which a single person can make a difference.

Anonymous entry from a General Volunteer

I came, I saw, I…..learned. As a general volunteer who spoke little to no Spanish, I had expected to be set aside as some extra, called upon only for menial labor. However, it turns out that each and every member is an integral part of the system. On the first day, I was placed in the pharmacy, where I was part of the team that dispensed the medication. Throughout the week, I was placed in various other services including OR, where I observed the surgeons perform dozens of miracles, family medicine, where I learned about the basic examination techniques, and "crowd control", where I helped other volunteers keep order in the waiting area as dozens of patients wait their turn. I learned so much from this trip and I met so many amazing people. Hopefully I’ll have a chance to come back next year. 

from Candy Sopp, Licensed Clinical Social Worker

Mark De Antonio, Mission Psychiatrist, and I were asked to see a 20 year old female  patient who initially came to the mission for medical care regarding a broken nose.  The mission surgical team decided that the patient did not need surgical intervention at this time, but referred them to us to address her immediate mental health needs.  


We initially met with the patient and her father.  After talking with them both together and getting some family history and learning how she broke her nose, we asked to meet with the patient alone.  This was a challenging case to deal with due to the family dynamics and family violence which led to the patient having a broken nose.  We were finally able to work only with the patient without her father in the room to provide crisis intervention to her regarding her current home situation.  


We were also able to refer her to the mission mental health clinic, COSMA for ongoing mental health services including continued medication management and counseling.   The father of the patient was adamant that she needed surgery regarding her broken nose due to the potential negative psychological effects of not doing surgery.  However, he then reported if the mission does not perform surgery on his daughter, she will hound him for the money to have the surgery, $2,000.   In talking directly with the patient, she told us she was fine with not having surgery, but was extremely distraught about the home situation and not feeling safe in her own home.  We provided her with a information for a domestic violence shelter in the community as an additional safety resource.   She was open to the resources we provided and  willing to follow up.  It became very important to speak to her alone as her father was not ultimately a support to her in achieving safety and psychological support.  


This was a rewarding experience for us to be able to help this  patient.  We also realized in working with this  patient that surgery is not always the answer.  In cases like this, the mental health interventions we can provide are of primary importance.  

from Traci Fortney, OR Nurse

What another rewarding year for me!  This was my third year in Ayacucho, and despite being exhausted from so many long, grueling days in the OR, I left once again with an immense feeling of satisfaction of being able to help so many people.  The most meaningful part of my week was being a part of the operations for our kiddos that came from so far away to have their cleft lips repaired.  I was able to meet the kids from Puno Sunday morning as they arrived at the hotel just as our plastic surgeons walked in for the airport.  Seeing the looks of desperation on the parents' faces as the surgeons put down their bags and sat in the courtyard to examine their new patients was saddening.  But as I met the surgeons, I knew the adorable children were going to be in good hands.

Monday morning rolled around and the OR got off to the normal slow start as we tried to relearn where everything was and what supplies we had available.  But as soon as the first cleft patient rolled in, we got down to business.  It was amazing to watch how Dr. J and Dr. Liu marked out their incisions on the lip and figured out how they could move tissue around to turn the cleft into a natural looking lip.  As we put the final sutures in, I had such a sense of accomplishment as I knew we just helped to change this child's life forever.  That feeling continued as the workday moved into the "worknight".  Yes, we had late nights in the OR all week, but we were able to touch so many families' lives that the missed sleep was worth it.

I am already counting down the days until I can return to Ayacucho and be back among the people of the Andes that I have grown to love so very much over the past few years.  As I was able to tell the director of the hospital at our farewell dinner when he asked who in the group was Peruvian- ¡soy peruana en mi corazón!

from Irit Barak, Recovery Room Nurse

I am back in Los Angeles still speaking Spanish, and my friends can't understand me. When went to eat lunch with friends, I still tried to pay with Peruvian money (Nuevo Soles).  I feel like I am still there.   I had great time and I am very impressed with how Loretta (the Nursing Director) worked with each one of us. Today, I'm spreading the word in Kaiser and I already have 3 nurses that would like to join us.

from David Daar, medical student

The cool thing about ultrasound is that it doesn't need translation.  What you see on the screen is what you get, and for the patients in Ayacucho that haven't seen technology like this before, being ultrasounded is both useful as a diagnostic and a psychological therapeutic.  While seeing patients with Dr. Cesar Aranguri, mission director and cardiologist, we performed a cardiac ultrasound exam on nearly every patient that came in. There was one rare case in which we used ultrasound to diagnose a patient with rheumatic fever - matching the clinical signs with the valve defects identifiable on ultrasound helped Dr. Aranguri effectively care for his patient.

But for the most part, our patients presented with muscular chest pain, in which no significant therapy was needed.  So Dr. Aranguri performed what he called "therapeutic ultrasound" on these patients.  Examining their heart and telling them it looked healthy and strong gave them a piece of mind they didn't seem to get in any other way.  This is one of the powers of medical technology, especially in areas like Ayacucho, and by helping lower the anxiety level of these patients, ultrasound proves to be a powerful tool for mission trips like these.  Hopefully next year, we can find a way to bring another machine or two!

from Susana Gutierrez and David Chen, volunteers

Our experience in Ayacucho has been unforgettable and truly wonderful. We specifically remember a mom who came to our clinic because her daughter had a foot infection. The mom had walked two days from the jungle with the daughter who had an infection and her younger daughter on her back. Amazingly, they had not eaten for two days. It was an extraordinary case of strength and perseverence. Thankfully, everything went well and the mission was able to finance their stay in Ayacucho, as well as their return to the jungle. What we have learned here in Ayacucho will forever change our lives.