NURSES ON A MISSION

[lmolinaRN, BSN, RN]

An avengers adventure mission tale

As everything in life, it all started as a vague idea in someone's mind, thanks to God this person was persistent and determined enough to make it a dream of her own. A dream that she made come true with the gut feeling that it was the right thing to do and the drive to help the people in need. During a short vacation to Cartagena Colombia, this "gringo" nurse who was relaxing and unwinding from her hectic life in the states, decided to check out a small local children's hospital that someone had suggested visiting while in there. She was in shock by the rudimentary conditions of the infrastructure, the lack of technology, the shortness of medical equipment and supplies, and limited staff members of the medical center. This is a small institution located in a poor neighborhood in the city of Cartagena, it is ran by altruistic nuns, wealthy citizens, doctors and nurses from the community. It was during this visit when she fell in love with this hospital and felt the need to help in whichever way she could.

It took four years for her to crystallize the idea and get more people interested in participating in a health charity across the sea mission, this nurse got some of her coworkers at Joe DiMaggio Children's Hospital in Hollywood, Florida, excited about the idea of helping sister hospitals around the world (making this small hospital in Cartagena their first target, since she had the emotional link and connections established). The group got to work, they contacted the administration at the "Napoleon Franco Pareja La Casa del Niño Children's Hospital" in Cartagena to express their intention of visiting the facilities, and seeking for help coordinating the trip. Meanwhile this dynamic group spread the word, they got their family members, coworkers and friends involved and to love this beautiful gesture of given back to children in need. After a year of planning the logistics of the mission, recruiting volunteers, raising funds and asking for donations; the dream was getting closer to becoming true. An initial trip to the hospital to assess the needs and current conditions of the institution was organized; the intentions were to implement a way to provide a permanent and significant help in the future.

Plans for the first mission trip started, communication with the staff at the Cartagena children's hospital was established. The first and most important thing was to raise funds for flight tickets, food and accommodation in Cartagena (most of the expenses were paid by these adventures themselves), and to buy as much medical supplies and equipment as they could. The avengers got to work and organized bake sales, raffles, T-shirt sales, and also collected donations from generous people. Everyone was excited counting the days left until the departure and thankful for all the support and encouragement they had received. They were felling strong and empowered to accomplish their goal, they were not intimidated by risks and the danger of traveling to a foreign country (like some people were telling them).

Finally, the day came, ready or not, the 10 Avengers (nurses and volunteering family members) headed to Cartagena. They were welcomed by open arms and smiling faces of Cartagena's beautiful women, and later taken to the hospital (not kidnapped) for the official introduction to the administrators (lunch included). The hospital's mission and vision statements were presented as well as current hospital's stats and future plans followed by tour of the installation. As the day came to an end, the details of the next day activities were discussed. It was concerted that next morning will be the starting with an educational exchange portion of the mission; the lecture started early in the morning, it was interactive and dynamic. Experiences were shared between nurses and doctors from both sides of the Caribbean shores. Code blue drills were done, an open questions seminar was a complete success and well received by all the participants. At the end of the day we were all exhausted but happy of our accomplishments.

We were pleasantly surprised by the facilities as we found a very organized hospital with separate departments, emergency, surgery, ICU, laboratory, radiology, pharmacy, hospitalization, outpatient, dialysis area, hemp/oncology services and outdoor health fair events for the community. It was so gratifying to see that the children's hospital is growing with the help of generous people in the community in addition to the help of some international organizations. There is no doubt needs are too many and the resources are limited, but there is a passionate staff willing to provide the best care to the sick children of Cartagena.

The hospital has about 100,000 ER visits per year, 50,000 outpatient consultations, 10,000 admissions, performs 1000 surgeries, and provide service to 200 children in the monthly community health fair in different poor neighborhoods. The hospital counts with 150 beds, 25 ER beds, 5 surgery rooms and 10 ICU beds. The short term goal is to build a cardiovascular surgery unit with the technology, staff and logistics necessary to provide a world class care for the children of the region with congenital cardiac disorder (cardiac malformations are very common in that population). A long term objective is to build two eight story towers with different pediatric subspecialties, the goal is to decrease the morbidity and mortality among children in the Cartagena, northern Colombian coastal region and the Caribbean surrounding area. The hospital is affiliated to some universities in the area; as a result it is considered a teaching hospital providing clinical training to nurses and medical students, and also receives volunteer international medical students from time to time.

On the second day, along with a team of physicians, social workers, psychologists, nurses and dietitians we visited a poor neighborhood for the monthly Pediatric Health Fair. We helped them with the children's medical histories and physical assessment, and gave out goody bags (toys, school supplies, toothbrushes and toothpaste) to more than 300 kids participating in the health fair. Our hearts were full of joy and satisfaction as we saw the happiness and appreciation in those children and their parents' faces. Later that day we did a room by room round at the hospital to make sure every little patient receives a gift bag; we wanted to make their hospital stay a pleasant experience.

On our third and final day, we officially gave the donated medical equipment to the hospital administration, with the hope they could contribute to achieve the hospital's mission of providing care to sick children in the underserved region. It was at this moment when we felt that our hard work and effort for raising funds were not in vain, as the hospital staff and administrators expressed their gratitude and appreciation for our donations and contributions to the hospital. We were also recognized as the first international visitors whose members took the time to participate in the community health fair, where they shared their knowledge, love and helped train the staff (lectures on different topics were given during the visit). The hospital is subsidized with government funds and donations, but that's not enough to maintain an operation of that magnitude, reimbursement from the insurance companies are low and as we all know is a long and painful process. We were told that recently at one point the hospital went through a very difficult financial situation, the staff worked for approximate a year without getting paid and was at risks of been shut down.

All our worries were in vain: (is it safe traveling to a foreign country?, where will we be going to stay?, what are we going to do?, are we going to have transportation?, the cultural differences, different health care system, the language, are we going to help and impact them?, are we going to fit in?), contrary to what we had imagine, we felt like fish in the water, we had no problems communicating with the locals (six of the Avengers speak Spanish and some of the doctors and staff knew English), none of us got sick (not diarrhea, not even a mosquito bite), we felt very safe during our stay, our recommendations and suggestions were well taken by the staff. Both the Cartagena Hospital's staff and Avengers understood each other very well, almost like old friends.

Our expectations were more than fulfilled, at the professional and personal level; we felt that we did a good job during our visit. We got to know the staff, the hospital's plans for the future, the population and the most common pathologies found in the area. All this will be very useful for future visits, as we now know the place, their needs, how we can help improving and fulfill their expectations (nurse education, disease therapy protocols, infection control, code blue, and respiratory distress management). We feel the time there was not enough to accomplish any significant changes or improvements, but plans to maintain communication were established. One of the goals is to contribute to the education through (teleconferences, sharing literature, futures visits to impart classes, hands on workshops and muck codes).

We all (The Avengers) feel personally very satisfied, but in a professional level, we know there is a lot more we can do and many things to share with the staff of this 70 years old institution. We do not see ourselves as heroes, we received no personal or monetary benefit from doing what we did during this trip, but we are willing to do it again. As human beings the mission was very gratifying and satisfying, sharing our most valuable treasure (knowledge) with other colleagues and the been able to help in any giving way. We may not have the finances, the resources or the answers for their questions, but we know that we can make a difference in the life of many children and their families, as well as in the hospital's employees, a grain of sand at a time will contribute to solve some of their needs.

We are very motivated to continue working to reinforce this new friendship and have plans to get more and more people and institutions involved in our noble cause. There is a colossal task ahead of us, funds to raised, planning, and logistics that have to be put in place to make frequent and productive visits to the Cartagena Children's hospital; with the objective to help this hospital provide care to children and the poor people in the community. We have just opened a window, but there is the need for stronger power to push a big door open, so there is room for your ideas, talents, knowledge and help in any way you are willing to help. You do not have to participate in all phases of the process or travel, if you are not able to, but your willingness to give back, cooperation, suggestions and enthusiasms will be greatly appreciated.

Not everything in Cartagena was work, we visited the old city every night, walked the narrow cobble-stones street tourists like to stroll when in town, appreciated the beautiful colonial architecture (full of majestic churches, beautiful, colorful balconies), dinned at the local typical restaurants (tried different exquisite Colombian food), and even went for a horse carriage ride (very romantic). The experience was one of a kind, we had the opportunity to interact with the native people who entertain the crowd: singing, dancing, and poetry; vendors dressed in the typical clothes selling their hand crafted souvenirs. On the fourth and last day we decided to relax by visiting the San Felipe Fortification and the old stone wall surrounding the outside of the city that were belted 500 years ago, during the Spanish colonization period to protect the city from pirates 's attacks. Cartagena is a big port and had an strategic geographical location on the corner of South America, at the northeast is Panama, it is near Venezuela and the Caribbean Islands (point of junction of central and south America, it is known as The Door or Pearl of the Caribbean); this particular characteristic made the city a target for invasions (a lot of history involved). On the last nigh we went to an old neighborhood where local gather in the town's square to enjoy the traditional dish, Patacon, a big green plantain fried and topped with beef, chicken, cheese and sausage. The only regret is not having enough time to enjoy the beautiful beaches and small islands close to Cartagena, but we promised we will be back.

Well, as everything, the mission got to an end and it was time to return home to our families, to work, to our normal life and start planning the next mission. The trip was a success, things turned out better than we had planned or expected. Today we can and are happy to say "Mission Accomplished ". Now we know what needs to be done and how to make it better next time and every time we go back to the Cartagena Children's Hospital or any other Hospital that ask for the avengers mission help. We all will remember this adventure with love and gratitude, and keep these memories in a special place in our hearts. One last thing to say:

"THANK YOU CARTAGENA ", hasta pronto... ( Gracias, Cartagena, see you soon ).

LUIS MOLINA, RN, BSN

JOE DIMAGGIO CHILDREN'S HOSPITAL

Hollywood, Florida

Pediatric Nurse

[email protected]

lmolinaRN (allnurses)