 Welcome to much more on medicine. I'm your host Catherine Norr. The COVID-19 pandemic has certainly focused the world's attention on medical care. But what about those people in developing countries who don't have access to much needed surgeries. Today, I'm pleased to be talking with Sylvia Marie Moore about surgical missions to Honduras. Sylvia Moore is a retired nurse anesthetist who began organizing and leading volunteer medical missions for Aloha Medical Mission in 1993. She's also a travel writer, photographer and has traveled to more than 65 countries. Welcome Sylvia Marie. Thank you Catherine. I'm very happy to be here. So my, the burning question I have in my mind is why, it's the big why, why Honduras, why do you do this and why is it needed? We in the US have such wonderful medical care and there are many places in the world where people absolutely don't have the access to medical care that we do here. So this all got started here in the islands with Dr. Ramon C. That's how Aloha Medical Mission got started. And it has blossoms so that groups of us go to places where there is a need to give, donate our time and our expertise to people who otherwise would not have an opportunity for medical care. And what type of problems do the people have that you help? Great question. You know, in developing countries, they have just about everything that you can imagine and a lot of things that we would never see in the US. When I take my group to Honduras, because that's primarily what we're talking about the kind of surgeries we do depend upon the kind of surgeons that I can take with me. So for the last six years, I've had some wonderful podiatrists, orthopedic surgeons, general surgeons and gynecologists. And this year I also had a pediatric dentist from here in Honolulu who came with me and took care of several hundred children in the local orphanage in the town that we visit. Now this seems like there's a lot of logistics and so tell me about what you do to make it all happen. Ah, well just about this time of the year, about six, eight months out. I will start checking to make sure everybody's coming back with me. If not, I'll start recruiting. I'll start recruiting new people to fill in the spots in my team. There's a lot of paperwork that has to be taken care of. There's a lot of coordination with the local hospital. There's a lot of documentation that needs to be passed between my physicians and my staff and the local hospital. Supplies to be gathered, transportation to be arranged, lodging. It's a major project. It's a major project. Now, gosh, it's so interesting because it seems so complex. Now if I have a medical problem and I live in Honduras and don't have the money, how would I connect with your program to get that opportunity to have surgery? It's almost like the coconut wireless. About six months before I go, I will tell the hospital, our host hospital, what kinds of problems we'll be able to take care of. They will put the word out in the community and when I say the community, I don't mean just the town or the village. I mean several hundred miles up into the mountains to reach people who have issues that possibly can be taken care of by the surgeons that I will bring with me. So these people will come all the way down into Fome Agua, which is the town where we are, and they will be screened by a couple of our local health physicians and they will, that starts their process. So if you have, for instance, a child with a club foot, you would bring your child and our physician in town would say, okay, yes. In January, we hope that we'll be able to take care of this problem. And then the mom and child go back up into the mountains, which could be several days of walking to get there. And then on the appointed week in January, they would come back and hopefully be able to be scheduled and have our podiatrist take care of them. So it's quite a long process for these people. They wait sometimes for years and years until someone from a medical team can come and donate the surgery that they need. And how do you recruit the medical team? Ah, when I was working, I would just do that in the operating room. I was constantly talking to people saying, hey, you've got to come with me. And I still do that through my friends. But it gets to be word of mouth. I have phenomenal people that come with me. And some of them have come with me every single year, 200 years for the last six years. And then they tell me about friends who want to come. So it builds. And every year people come and they continue to come. So I end up with this team getting larger and larger and being able to meet more needs in country. Now let's show the picture of the team. Oh yeah. This year we have 38 of us. Okay, and so it was that from the last from this year. That was from January 2020. Yes. Okay. And you, and are you closing in front of the facility that you, you know, where you, you work? Actually, that is the central courtyard. There's a beautiful fountain. And I think I gave you another photograph. It's quite a simplistic little area. It's a very tiny hospital. And it the hospital itself was actually built with generous donations from some other medical missions. So it's been in existence about 12 years. We have four operating rooms and everything we have there is been donated and transported specifically for that hospital and for medical missions. Okay, and okay, so now. Essentially, if I were a physician and I wanted to donate my time, or if I was a nurse anesthetist or someone else that would be on that team would, would I pay for my own transportation and everything or how does that work. You would pay for everything. My people come, they pay for all their own hotel, airfare, any incidental expenses, all their own meals, all their own pre trip shots if they need them from travel medicine, and they also take vacation time. So when you consider what the salary is of a physician who takes 10 days off, or maybe a little bit longer than that, takes 10 days of vacation and comes to do this mission. Or if you have a physician in private practice, who completely puts his or her practice on hold, just to donate their time. That is a tremendous dedication. And what, in terms of supplies, what kind of supplies are brought with you on the mission and who provides those. We try to recruit them. For instance, my orthopedic surgeons and my podiatrist will contact global companies and ask them to donate equipment donate saws and screws and all the different things they need for their kinds of surgeries. All my surgeons do that. And then after they get them donated, it's up to them to transport them a lot of times at great expense, and they bring them in their luggage down to Honduras. Okay, go ahead. No, that's okay. Okay. Have you had any problems with lack of equipment or you find you're, you're there and you don't have a very important item or, or piece of equipment to perform a surgery. Actually, that has not happened in my group. My surgeons are very good at anticipating and making sure that if they do a surgery, they've got everything they need before they plan to do that surgery. But you bring up an interesting point. If there is something that is lacking, and we have a patient who would need a surgery with something that is lacking, we would have to turn down that patient until a subsequent mission. So, when we go out and ask for donations. It's because it's something that's very important that we need that our patients need. So, when you're planning the trip. Are you aware of the particular patients that are going to be helped. I mean, do you have their names and the type of surgery in that preparation or are you just generally coming down to do surgeries. As I said about six months before I go, I send the hospital my list of personnel who are coming. So they have already been screening for the particular kind of surgeons that I'm bringing about six weeks before we go. We get an extensive list. Each of my surgeons will get a list of the possible surgeries they'll be asked to look at and possibly perform. So actually I will have names and possible diagnoses about a month and a half before we go. Okay, you know that makes that makes a lot of sense. Now, besides the actual surgical equipment and PPE and everything. Do you bring other items for the people there, you know, such as things that they might need or want. Yes, we usually bring we have one. One of our nurses is a retired colonel in the US Army, and he will bring huge boxes of clothing to donate to the children in the orphanage that adjoins the hospital. We also if you can't bring medical supplies say you're retired like me and you don't have access. I asked people to bring blankets. I asked them to bring stuffed animals and toys and coloring books and things for the children. So I do have people that bring a lot of supplies, because realize that our patients are incredibly incredibly poor and giving a child a little stuffed animal or a blanket to take home with them is a huge gift. So yes, we do bring supplies for our people. And let's bring up the picture of the person with the supplies. Oh yes. Okay, so now what, what does this picture show. I can't see it but I know that that's Debbie star Debbie is a registered nurse who practices sometimes here in Honolulu, and sometimes home in Montana, I hope she's watching. She acquired a ton of donations from Walmart, and I think it was target blankets and stuffed animals and that's the picture of Debbie with huge bags full of things that she brought to give to our kids. Fantastic and, and you know I've seen the photographs of, there's a photograph of a child holding stuffed animal looks like. That's quite an important thing and that probably provides them comfort as well in the surgery. I think that's a very good point it does. It gives them something to hold. And then when they wake up in recovery room that little stuffed animal is right there with them, and they get to take it with them. Fantastic. Well that, you know, that's just so heartwarming, heartwarming. And we're going to take a short break. I'm Catherine nor this is much more on medicine on the think tech live streaming network series. We've been talking with Sylvia Marie more about surgical missions to Honduras. I'm Kili Akina, the host of Hawaii together on the think tech Hawaii broadcast network. Hawaii together deals with the problems we face in paradise and looks for solutions, whether it's with the economy, the government or society. We're streamed live on think tech biweekly at 2pm on Mondays. I want to thank you so much for watching. We look forward to seeing you again. I'm Kili Akina. Aloha. Back we're live. I'm Catherine nor and this is much more on medicine on the think tech live streaming network series and we're talking with Sylvia Marie more about surgical missions to Honduras Sylvia Marie. How did this mission program get started. Do you mean Aloha medical mission as a whole. Sure. Okay. In 1983, Dr. Ramon C and Dr. Ernesto Espaldon, who are both physicians here in Honolulu, got together and decided they wanted to take care of people back in their home villages in the Philippines. So they got a bunch of their physician friends and nurse friends together and they all went to the Philippines and took care of some villagers. And out of that grew this tremendous organization called Aloha medical mission. So it's been around for 30 some years, and used to go always to the Philippines, sometimes to the islands one or two. And then I came on board in 1993. It was the first year they went to Vietnam. And I decided I really wanted to go to Vietnam and so I went and it was a wonderful mission. It was my first medical mission ever. And when I got home, I called them up and I said sign me up. I want to do this again. And they said, we're not doing Vietnam again. And I said why not. And they said because we don't have anyone to run it. So I said, I will put it together. And so that's how I got started, putting medical missions together was because they just needed someone who would do the organizing and all these years later here I am. Have you been doing it every year since. No, I took a break in the early 2000s, and I handed my by that time I had done a lot of Vietnam, we had done Cambodia, we had done laws for many years. And I had a point where I needed to hand it off and I handed it off to Dr Lisa Greeninger, who's a very dear friend she's a general surgeon here at Kaiser. And so Lisa did the laws missions for a number of years and then there were some technical difficulties, and we just stopped the law missions, and then about seven years ago, six years ago, when there was a need and Honduras, we picked it up again. And that's how we got restarted. Well, I'm sorry. Oh, no, go ahead. Tell me a medical mission also goes we as an organization they go to Nepal. Every year they go to Myanmar. They go to many places in the Philippines. We've touched a lot of the world with this one organization. Thanks to Dr Ramon. All surgical or is there non-surgical medical missions within aloha medical medical missions. Excellent. On some missions, and even some missions that I have done we have taken medical people to treat some of the medical issues. There are several dentists who do dental only missions, which is phenomenal because dental care is something that people in developing countries do not have access to Dr Dean sweater. Also from Honolulu came with me this year to Honduras. He also is planning to do a total dental mission to Nepal sometime in the next six or eight months. So we do missions that are dental missions, medical missions, and surgical missions, and sometimes a combination of all three. Are there local medical facilities that support these missions, whether it's supporting the doctors going or paying or providing supplies. Not really. When I get to Honduras, if there are some medications that legally you cannot transport across national boundaries, I will simply have to purchase them in country from the pharmacy. So those are not donated by local Honduran groups. And usually, I would say usually no. It's, these countries are poor, and they can't afford to supply us with medications or other things we might need. So if we have a need in country we have to purchase. Okay, actually what I meant are Hawaii medical facilities. That's okay. No, you answered an important question. So now we've moved from the local ones in country. And now let's look at at those organizations in Hawaii. Are there organizations in Hawaii that are supporting this. There are many organizations that donate to a local medical mission as a whole, which are really very, very important, and we really need that we need the continuing support, because even though all of my volunteers not only pay their own expenses, but put money into say a kitty, and we use that to pay for supplies and electricity and other things that we need on the mission. We come up short. So we need a law medical mission to help support my individual mission for instance, and the only way a little medical mission can do that is with local groups that support us by giving charitable donations. Yes. Okay, so do you speak Spanish? Or do you use interpreters? Poquito, poquito. My Spanish is totally from high school, and about one third of my volunteers are fluent in Spanish. Another third of us have rudimentary Spanish. The hospital provides us with interpreters. We usually have five or more local interpreters and they're very interesting. They've given us medical students who interpreted, and so this, we have no problems making ourselves understood. We have enough people that we have part of our group that can interpret for us, because truly our patients don't speak English. Okay, I would think that that would be the case. Now, let me ask you now with COVID-19, how is this going to happen for 2021? Are you planning for that? Catherine, we already have our dates. Before I leave Honduras, I sit down and we choose our dates for next year. It will break my heart if we cannot go. But Catherine, I'm very concerned because look at how the world is going. Honduras right now is in very bad shape. The top officials in their government are ill. I don't know what will happen in seven months. So right now I'm watching, I'm waiting, I'm going to see. If it's possible, we'll go. But I don't know if we'd even be able to transport ourselves and get into the country at this point. So that's a heart-wrenching question right now. You know, we certainly have an issue right now. It's good with quarantines and, you know, the 14-day mandatory quarantine with Hawaii. But hopefully that will not be happening when you go. Yeah, so I mean I'm sure that there are many issues for you to be concerned about. And then also I would think that the availability of PPE would be another issue as well. That's true. But being surgical personnel, I think we would have to provide that. We would have to make sure that we had enough for our people. So that that's another concern on top of everything else we have to deal with. And you bring up a very interesting point. With our 14-day quarantine in Hawaii, if that would still be in effect in January, that would really be difficult for the Hawaii members of my team to not only do a two-week mission, but then to come home and quarantine for two more weeks. That would be very difficult. Sure. You would probably lose a lot of the volunteers in that respect. Now, can laypeople become involved? Oh, good question. I have taken laypeople. It's very interesting. I've had laypeople that turned out to be veritable gold. One of my nurses said she'd like to come, but she wanted to bring her husband. She said, I don't know what he can do. Oh my gosh, he's phenomenal. He acted as a photographer. He helped the friars with carpentry projects, any number of things. He was my provisioner. I would send him with one of the local Hondurans to get snacks and foods for the break room for where my people can go in between surgeries just to get a quick cup of coffee. He's invaluable. So I have laypeople that come with me that are absolutely people that I need to have. So it doesn't just have to be medical people. Someone wants to donate whether supplies, teddy bears, clothing or money to Aloha missions. What do they do? They want to donate money to Honduras Mission. They can go on to the Aloha Medical Mission website and scroll through to donate. The first mission listed is the Honduras Mission. There's a picture of one of our anesthesia attacks with a child. I think you might even have that picture and just click on donate. And that money will be earmarked for Honduras Mission. Otherwise, they can get in touch with me and I'll tell them what to do. Before we wrap up, let's bring up some of the photographs, some of the pictures of the children and what we have a picture of a doctor holding a baby and we have a mother with a child with two casts. Can you tell me about that picture? This is a mom. Her son had bilateral club feet and our podiatrist worked their magic. They changed people's lives in the most amazing way. So that was the day after his surgery. She was sitting out in the open hallway cuddling her little boy. I love that photograph. She was very, very happy. And then when you saw that child ambulate post-operatively, it was quite amazing. I'm not sure what photograph you're looking at with somebody with a little boy besides that one. You'll have to describe it because I can't see it. That's actually perfect. And, you know, I thank you so much Silia Marie for being here today because we've learned so much about aloha medical missions and your Honduras surgical mission. And I hope very much that COVID-19 doesn't cause any serious problems for you. Thank you, Catherine. Thank you so much for having me here. I really appreciate it. It's been a pleasure. And we are out of time today. I'm Catherine Norr. This is much more on medicine on the think tech live streaming network series. We've been talking with Silia more about surgical missions in Honduras. Thank you for joining us today. Please take care of yourself, wash your hands and be kind to one another.