Waiting for the Doctor
Part two of a continuing series
Read Part 1
Last week, The Catholic Spirit featured the first article in a series about the Diocese of Metuchen’s Global Solidarity Partnership with the Diocese of Santa Rosa, Guatemala. Having established five health clinics in the city of Chiquimulilla and its surrounding villages, a medical team from Saint Peter’s University Hospital, New Brunswick, traveled to Santa Rosa in late February to work with the local medical team it had hired to operate the five clinics.
Unlike other missions to the developing world in which medical teams fly in, treat patients and fly home, the Saint Peter’s medical team has partnered with Catholic Relief Services Metuchen to transform the health care delivery in Santa Rosa and make a significant and lasting difference in the quality of life of the people. Working side by side with the local medical team, the Saint Peter’s team identified a number of issues affecting the functioning of the clinics.
This week, the series picks up at the conclusion of the medical mission. Find out how the issues affecting the operations of the health clinics were addressed and what Dr. Sabah Kalyoussef and Dr. Mario Pereira, two Saint Peter’s residents participating in their first medical mission, learned from the experience.
By Kathleen Ogle
Managing Editor
CHIQUIMULILLA, Santa Rosa — On the final morning of the medical mission, members of the Saint Peter’s University Hospital and local medical teams divided up and headed out to the health clinics in the villages.
With the help of CRS Metuchen volunteer Hector Escobar, Dr. Bipin Patel, chairman of the Department of Pediatrics at Saint Peter’s, and pediatric resident Dr. Sabah Kalyoussef examined and treated nearly 60 children at the Oliveras Health Clinic.
Most of the children they treated had colds, coughs, fevers, infections, skin rashes, diarrhea and stomach pains, and most of their health problems were associated with public health issues. “A lot of these kids would be healthier if there were clean water, clean cooking energy and better nutrition and sanitation,” Dr. Patel said.
He feels the Saint Peter’s team has made a lot of progress working with the local medical team — “One year ago, this community didn’t have a health clinic and didn’t have a doctor,” he said — but he also knows it will take a long, sustained effort to really improve the situation.
“Maybe gradually we can make this better, but not in a day, and not in a year,” he said.
He described medical mission work as “a bonus,” both enriching to his pediatric practice as well as his life. “Because we are physicians, and because Saint Peter’s was interested in doing this, we have an opportunity to do something good,” he said.
“I don’t feel I’m doing something extraordinary. This is something where if you could do it, you would do it,” he said.
He believes the hospital’s resident physicians can gain from the experience as well. In addition to Dr. Kalyoussef’s enthusiasm and love of pediatrics, her facility with the Spanish language was an asset to the mission. She was able to interview children and parents on her own, whereas Dr. Patel, who recently began studying Spanish, had to rely heavily on Escobar’s translation skills.
Although Dr. Kalyoussef had a bad cold the night the team left New Jersey for Guatemala, she set her mind to not complain or be a burden. “There are other people coming here to do good, and you can’t be complaining when there isn’t hot water,” she said. “It was hard but you keep working because there’s work to do.”
She traces her desire to help others to her Catholic upbringing. “I’ve always been surrounded by the idea — both from school and my mom — that you have to give back. I’m lucky,” she said, “and I have to think of other people.”
Working it out
While the medical teams were delivering health care in the village clinics, CRS Metuchen director Father Joseph J. Kerrigan, volunteer Ernest C. Revoir and Saint Peter’s nursing director Jacqueline Carey met with Father Raoul Monterrosa, pastor of Parroquia Franciscana de la Santa Cruz and the director of Santa Rosa’s social concerns agency, to discuss the functioning of the health clinics.
Following the meeting, Father Kerrigan said he believed some progress was made. Not only was the CRS Metuchen/Saint Peter’s team able to discuss their concerns, the Santa Rosa administrative team brought their concerns to the table as well.
Two of the most significant issues addressed were the budget for operating the health clinics and the medication supply. At the initiation of the project, the Santa Rosa team was given a month’s advance on salaries but they had fallen behind in submitting receipts. The vigilantes (community leaders) had not been paid for three months due to problems managing the accounts on the Santa Rosa side and now instead of being a month ahead, they were behind three months.
Instead of buying medications on a monthly basis, the Santa Rosa team wanted to purchase a larger supply twice a year at a discount, store it and avoid the cash flow problem.
Improving communication between the two teams was also discussed. In addition to the language barrier, another factor contributing to communication difficulties between the two teams is different management styles. CRS Metuchen and the Saint Peter’s delegation function as a team with various point people depending on the issue or project. In Santa Rosa, a more traditional style is employed in which Father Monterosso directs. A flow chart helped everyone sort through the various components of the partnership and the roles people play.
On Thursday morning, the entire CRS Metuchen/Saint Peter’s team reconvened at the parish as a follow up to Wednesday’s meeting.
A comprehensive list of issues was addressed including additional education and training for the Santa Rosa medical team, medical records, patient education, shelving for medication and even treatment algorithms for the growing number of patients with diabetes.
The outcome of the meeting was that the CRS Metuchen/Saint Peter’s team empowered Dr. Luis Hernandez, the local physician, to serve as medical director of the Santa Rosa health clinics and to obtain the medications and resources he needs, including his own truck and a laptop with Internet access so that he can communicate directly with Saint Peter’s.
Powerful moment
In what may have been the most powerful moment of the week, Father Monterosso apologized to the CRS Metuchen/Saint Peter’s team for the areas in which his team failed to meet their expectations.
Carey, in turn, apologized to Father Monterosso for the ways the Metuchen team failed in its communications with Santa Rosa. The exchange was both a moving and telling example of the good will that both partners bring to the relationship.
Following the meeting, Dr. Patel emphasized the importance of working through administrative issues. “Administrative issues are part of the mission,” he said. “Delivering care is one part of the mission. That administrative functioning needs to be as good as the clinical care. It’s not a negative when we try to solve the administrative issues as well as the clinical.”
Dr. Patel believes the medical mission, in which the CRS Metuchen/Saint Peter’s team worked side-by-side with the Santa Rosa medical team, was symbolic of the Global Solidarity Partnership between the two dioceses. “It was very, very important that we included them as part of the team and that we treat them with respect. They are our equals,” he said. “We learned things from Dr. Hernandez,” he said, adding that he was impressed with how well the local medical team functioned with so few resources.
He also praised the administrative team in Chiquimulilla. “They put a good bit of logistics together that were fairly complicated with three teams running around. They managed to do a very good job,” he said.
Making a difference
Later that afternoon, the teams from CRS Guatemala, CRS Metuchen, Saint Peter’s and Santa Rosa gathered on the grounds of the Oliveras Health Clinic to celebrate the progress of the partnership.
Speaking through a translator, Dr. Hernandez told The Catholic Spirit that he sees the clinics making an impact and is gratified to be part of the effort to help people who really need it.
In addition to spending one day a week at each of the five clinics, Dr. Hernandez supervises the nurses and vigilantes, and with their assistance, he cares for the men, women and children from the villages who visit the health clinics.
The most challenging part of the job, he has found, is educating the people. “It is more difficult to educate the people than to treat their illnesses and conditions,” he said.
So far, he has been successful in convincing people to boil water before drinking it to prevent parasitic infections, which are common.
Looking back
Before heading back to the Unites States, the medical team gathered for dinner and looked back over the week.
Having grown up in El Salvador, Dr. Pereira found himself surprised at how much he enjoyed the experience. “I remember being gung ho, but I was probably thinking about how much work it would be. I probably was not thinking about the rewards and how good I would feel good afterwards,” he said.
“I guess my Spanish helped but I think more than anything else, my contribution to this was my great desire to help these people because I consider these people my people. This is my blood, even if I live in the U.S., and I speak a different language, and I use dollars and I live in a rather comfortable way, my roots are still here and I feel like I owe to these people sacrifice and devotion, just like I do for my patients in the U.S.”
He also believes such missions help make better human beings out of their participants. “It builds your character, it builds your principles; if you already have them, it just strengthens them,” he said.
For Dr. Kalyoussef, the mission showed her how lucky she is is to live and practice in the United States. “I knew it was going to be long hours and I was up to that,” Dr. Kalyoussef said. “I kept thinking, what can I do to help these people? It’s humanity and you have to help. It’s good for us not to be self-centered.
“I still think about those children and all their issues, their basic needs. I’m going to go back to the U.S. and it’s still going to bother me that they don’t have any water or electricity or dental care,” Dr. Kalyoussef said.
Father Kerrigan acknowledged the grace with which the members of the medical team managed the difficulties of the mission. “There was no ego,” he observed.
“For sure you have to leave your egos at home,” Carey agreed.
Beyond the satisfaction of participating in the mission, Dr. Nayan Kothari, chairman of Saint Peter’s Department of Medicine, said he was grateful for the opportunity to get to know his Saint Peter’s colleagues. “It’s not just about building relationships with people in Guatemala,” he said. “We are building relationships with each other. We’re getting to know our own friends. We’re getting to know Saint Peter’s.”
Despite all that was accomplished, Father Kerrigan believes the success of the mission remains to be seen. “For Sabah and Mario, it’s still just planting the seed. If in 20 years from now, they’re both in swank Somerset County or Westchester County practices and they’re not dealing with the poor, then you have to say this was partially a failure. It’s a ‘feel-good’ for the week, but it’s our hope that it will open their eyes to play some kind of favorites with the poor for the rest of their careers,” he said.
Father Kerrigan said he and Revoir did not make as much progress as they had hoped regarding the San Antonitos water project, but he actually likes the fact that the project “keeps us uncomfortable,” he said. “You can’t just pat yourself on the back and say ‘Job well done period.’ You can say ‘Job well done,’ but there’s the next phase, too.”
*The attached/referenced article was originally published in The Catholic Spirit, the official newspaper of the Diocese of Metuchen, and is protected under U.S. and international copyright law