Past Trips

SUNDAY, August 13, 2005

We assembled at the Indianapolis International Airport for the Ambassadors For Children (AFC) flight to El Salvador. By doing our trips with AFC, we were able to save significantly on the cost of our flights. President, Sally Brown had been great to work with, and she had gone with us to Guatemala the previous year with her daughter.

It was a direct flight to San Salvador. On arrival it was hot and sunny. We had no problem with customs thanks to Maria Cruz our trip organizer there. She is the niece of Ana Ligia Mixco Sol de Saca, the First Lady of El Salvador. Jeff Cardwell had met her on one of his previous trips to El Salvador and promised her that he would bring teams to help the children of El Salvador. Now here we were!

We were transported by bus to the Radisson Hotel about 45 minutes away. After settling into our rooms, we were taken to a local restaurant to eat some of the local cuisine. That evening we met outside near the pool area for a time of spiritual bonding. I asked the question, "What is the most important thing in life?" The answer is relationships - first and foremost our relationship with God, then our spouse, then our family, etc. Life is all about people, but so often we are so busy that we don't take the time to develop the relationships that God wants us to. Our relationship to Jesus is critical because He said that He is the Vine, and we are the branches. If we are separated from or cut off from the Vine, we receive no nutrition, and we will die. God placed us here on earth to fulfill His dream to bring Him glory. By living the abundant life that He provides, we find meaning and purpose and our greatest personal fulfillment. But God is not only interested in us bearing fruit, He also wants us to abide more deeply with Him. He wants us to be in a deep personal relationship with Him and remain closely connected. We do this by not only praying (talking to Him) but also listening. It says in Psalm 62:1 "My soul waits in silence for God only." I encouraged every member of the team to wait on Him daily to listen to what He has to say.

After I spoke, we celebrated Communion together and had a time of prayer. We went to bed excited to begin our work the next day.

MONDAY, March 14, 2005

We loaded up our bus and traveled about 30 minutes to Apopa just on the edge of San Salvador. Apopa has a population of 500,000. It would be considered similar to a suburb of Indianapolis.

We were working with Centro Internacional Alabanza (CIA - The Center for International Praise), a daughter church plant of the main church in San Salvador. They had over twenty volunteers there to help us, and many of them spoke great English and had come to translate for us. Maria introduced us to Pastor Ernesto and his wife Joanna, who were in charge of this project for the church.

It took no time for Kappy and his dental team to set up all their equipment. I was very impressed by how incredibly organized they were, but they have done this many times in many different places. Bob and Sandy Joseph and I were working with the nurses preparing the area where we would see our medical patients. Suddenly I realized that I had not said anything to Diana about how to set up the triage and check-in. When I turned around, she and Bob had everything set up and were working with the volunteers from CIA! I thought how awesome it is that God sends me people who only need to be shown once in one place what to do, then they just figure it out and do it in the future. Win Turner and his family set up the pharmacy in an adjoining building up a set of stairs.

Before we began the clinics, the Mayor of Apopa came and presented to us the key to the city in appreciation for our coming to help the people there. It was 85 degrees, but not real humid. Fortunately they had some air conditioning in the church.

By the end of the day, we had seen 420 patients in the medical clinic and over 120 in the dental clinic. Everyone was exhausted and hot. I think that night we all slept like we were dead!

TUESDAY, March 15, 2005

The bus left the hotel at 8:30 AM, and the clinics began at 9:00 AM. Although it was hot again, it seemed easier. We saw over 300 patients in the medical clinics. Unfortunately, we had to stop seeing patients because of the concern by Win that we would not have enough medication for the next two days of clinics. We had planned to see 1200 patients in the four days, and we were already ahead of schedule in large part due to the unanticipated help of some of the local doctors who joined us.

There were periodic screams from the dental clinic, usually due to some of the children being afraid, rather than from pain. Bob Joseph and Sandy are both fluent in Spanish and bonded with the local doctors. They exchanged email addresses. Bob said that in years to come because of these connections, we might be able to bring specialists who could do surgery.

One young boy probably about five years old was curious about my stethoscope. So I placed it in his ears to let him listen to my heart. He had obviously been watching me intently, because he then started placing it over several places on my chest instructing me, "Respire!" (breathe)

Working closely with so many of the members of CIA afforded us the opportunity to build close relationships,

Bob observed that there were definite differences in the patients we saw here in Apopa, an urban population with limited access to medical care due to economics, versus the rural population of Guatemala with an absolute absence of doctors. In Apopa we saw more chronic disease such as hypertension and diabetes. Bob did get to visit the municipal clinic in Apopa and was amazed that they could do so much with so little. The whole building was only about 1000 square feet with three exam rooms. The pharmacy consisted of four shelves about three feet wide. Yet, somehow, they managed to see about 100 patients per day.

On Thursday I was to fly to Guatemala to see Dr. Julio Fuentes to plan our mission trip for 2006. CNN had just reported another riot in Guatemala City. "Great!" I thought, "This is just what I need going into the country." We had cancelled our mission trip to Guatemala this year just because of such violence. But, I realized that this is what God wanted me to do, so I trusted in Him. Besides, what better time to go into a country than right after riots when the police are on alert?

WEDNESDAY, March 16, 2005

Wednesday was the team's free day to relax and enjoy El Salvador. Some were going on tours and others to the beach. I was asked by the First Lady to see a young man named Hector. Hector was 21 years old and was the top student in the university in San Salvador. He had had surgery to correct a congenital internal hernia in his abdomen. Postoperatively he developed severe pain requiring re-operation. The surgeons found that the entire small intestine and half of his colon had died due to lack of blood supply when the main vessel to the gut thrombosed (clotted off). All of the dead bowel had to be removed, and he was being kept alive on TPN (total parenteral nutrition). I was asked to consult about his current treatment and the possibility of transferring him to the USA for a small bowel transplant. The doctors were grateful for my input, especially when I told them that the care they had rendered was even better than he would have received in many American hospitals. The possibility of a transplant was a whole other issue. They had contacted Tulane University and were given a price of $500,000 and the need for Hector to remain there for one year! All I could promise was that I would return home and see what I could do. It would require medical, political and financial connections. Before we left, I asked Lisa, the First Lady's Assistant, if it would be alright for us to pray for Hector. Hector was grateful; so we all laid our hands on him, and as I prayed Maria's sister translated.

That night Betty Cardwell, Jeff's mother who is a nurse, and I went to the service at CIA. We were introduced to the congregation, many of whom we knew after having worked with them in the clinics. We loved the time of worship, and Pastor Xavier preached a wonderful sermon on how what we do now will determine our rewards later in heaven. I was very impressed with his command of the Word at such a young age of 29. After the service, we spoke of coming again next year and what the trip would involve. We hoped for a long relationship together.

THURSDAY, March 17, 2005

I ate breakfast with some of the members of the team, and after saying goodbye to Bob and Win, who would be in charge the next two days, I left for the airport to fly to Guatemala.

The team headed to a very poor section in Apopa. There were hundreds of one room homes hooked together for as far as the eye could see. They set up the clinic in a open-air community center. There was a roof but no sides. Triage was set up outside under a tent, providers spread around the inside perimeter of the center, the dental team was on the stage area and the pharmacy was located in a separate, covered area attached to the main building. As usual Diana and Bob set up the clinic to flow excellently. The goal was to see about 350 patients. Word came to us that the meeting with the First Lady of El Salvador, scheduled for that evening, had been cancelled due to the extended stay of the Taiwanee's dignataries. Therefore, plans were amended to run the clinics even longer than originally thought. Five additional physicians from El Salvador joined us. Dr. Bob Joseph and Win talked about the El Salvadoran doctors' expectations. Win asked that they limit/amend their prescribing "habits" so that there would be enough medications to care for as many patients as possible. Although they seemed to understand, their action on the request forms went unheeded! The Mayor of Apopa stopped by with her camera crew to make a short appearance. By the end of the day, the team ended up seeing 400 patients and headed back to the hotel late in the afternoon.

I flew to Mexico City, and after a layover of a couple hours, flew to Tapachula, Mexico. Julio met me there. Julio is a surgeon who owns a small private hospital in San Marcos, Guatemala named Hospital El Jardin (The Garden Hospital). I first met Julio in Indianapolis at a meeting of the Christian Medical Foundation in 1989. We hit it off immediately, and he invited me to come to Guatemala for the first time in April of 1990 to help train him in endoscopy. San Marcos is an area serving some 300,000 people. It had no endoscopic services available. I subsequently returned to Guatemala in1991 and 1992 to again teach Julio. Later in 1992, he came to Indianapolis and worked with me at Saint Francis Hospital. He became a very accomplished endoscopist. The first year I was in Guatemala, I worked in the National Hospital in San Marcos which Julio tells me has changed very little. Sometimes surgeries can't be done because anesthetic gas is unavailable! Families of hospitalized patients have to go down the street to a pharmacy to buy the medications to be given to their sick hospitalized relative. If they cannot buy the meds, the patient never receives them. For these reasons, Julio and his father opened their own private hospital like many other physicians in Central America do. Julio returned to Indianapolis in 1995 and worked with Jon Mandelbaum, a surgeon at St. Hospital who trained him in the techniques of laparoscopic surgery. Jon had promised Julio he would one day come to San Marcos and work with him. In 2003 Jon kept that promise.

It was so good to see Julio, who had become like the brother I never had over the past 15 years. We drove across the border and arrived at his home in about 1 ½ hours It was like being home again being with him and his wife Gloria. We had great conversation until late into the night.

FRIDAY, March 18, 2005

The clinics were held in the same site as Thursday. Word came to us that the First Lady had a time to see our team at 11:00 AM that morning. We were quite concerned with this offer since it would cut into our clinic day. Through negotiations with Maria Cruz, Jeff Cardwell and other key members of the team, it was determined that those who wanted to take the time to participate in the reception with the First Lady certainly could do so. Jeff Cardwell was in conversation with the First Lady's staff and was assured that this was an acceptable plan. Early in the day, conversations with Diana, Bob Joseph and Win led to the conclusion that we could see about 350 patients. At that point, it was realized that most of our resources would be exhausted. Once again we met with the El Salvadoran physicians to explain the plan and to ask them to use restraint in their prescribing. Like the day before, this was somewhat ignored! Diana made multiple checks during the day to monitor the supply of drugs available for the needs of the clinic. Several times, the gates were opened, and additional patients were registered. By the end of the day, the team had seen 500 patients. This brought the total count cared for by the medical team for the week to 1600 patients. The dental team saw an additional 400 patients over the four clinic days.

There had been a plan, verbalized earlier in the week, for a team reception at the end of the day Friday. We had not heard any other information about this possibility all week and, due to a sick child, Maria was not with the team on Friday to verify if a plan was still in place. So, at the end of the day, as we loaded up the buses, we thought we were headed back to the hotel. Imagine our surprise when the bus started to wind through the back streets of Apopa, and we ended up in front of the Clinique Municipal. We were informed that this was the site of the reception in our honor!!! Many on the team were less than excited about attending, but we convinced them it was the correct thing to do. We would try and limit the time there as much as possible. It was a fun occasion. I think everyone agreed they were glad they had attended. Every team member received a large wall calendar and a certificate of appreciation presented by the Mayor of Apopa. We were served papusas, cold slaw salad and soft drinks. Delicious! We stayed for about one hour and then returned to the hotel.

In San Marcos Julio took me to see Tacana, an area about two hours drive from his home. Tacana is high up in the mountains at 9000 feet elevation. The people there number over 200,000 and have very little access to medical care. Julio told me of his plans to build a small hospital in Tacana to help the people. He had already found a place to start a clinic and one of his doctors who works in his hospital had expressed the desire to staff it. We talked of plans to perhaps bring a large team to help build the hospital in 2007. The long drive gave Julio and I very much needed time to just talk. God was definitely there in the midst of our conversation. That night we had dinner with Rubin and Annabella Perez, the owners of the Hotel Perez, where our mission teams had been staying every year for 15 years. I felt so blessed realizing that I really had two home countries where I enjoyed rich friendships.

SATURDAY, March 19, 2005

Due to exhaustion at the end of the week, many team members chose to spend Saturday relaxing or enjoying some light shopping in San Salvador. Others had made arrangements to go to the beach. The beach was beautiful but, unfortunately, the group left after only about one hour. The tour guide determined that the accommodations were not what were expected and decided it would be best to leave. The group did enjoy seeing some of the coastal lowlands and other sights along the way which, otherwise, we would not have had any chance to see. We don't often have the opportunity to see a cow butchered along the roadside!

SUNDAY, March 20, 2005

The team packed up in the morning and checked out of the Radison. The stay during the week was very enjoyable and comfortable. Many team members suffered from exhaustion and GI distress due to the tiring week. Be that as it may, it was obvious that the week had impacted all in a positive and real way. Carrying out the Great Commission may not always be easy, but the rewards are immeasurable. It was time to head home to share the moments of the trip with family and friends and to also reflect on the call we all answered to go to El Salvador.

We arrived back home in Indianapolis Sunday evening. The Customs' officers got us through the processes efficiently. It was good to be home, but we will miss our new friends in El Salvador and look forward to returning.

EPILOGUE

Our trip to El Salvador was so successful that Jeff Cardwell invited Ana Ligia Mixco Sol de Sacca, the First Lady of El Salvador, to come to Indianapolis for a visit and to see the Indianapolis 500 Race and Parade. She accepted the invitation and came on Friday, June 27, 2005 with several people accompanying her. That evening she attended a banquet at Riley Children's Hospital. We had the opportunity to share with many of the doctors at the dinner about the medical situation in El Salvador. Some expressed an interest in going to El Salvador in December when Jeff was leading a medical fact finding group.

On Saturday evening People Helping People Network in cooperation with Ambassadors for Children hosted a dinner in honor of the First Lady at the Columbia Club. Many of those who had gone to El Salvador in March were able to attend. Habitat for Humanity gave a check for $5000 to the First Lady to begin a building project for the construction of homes. Over $22,000 was raised for the children of El Salvador. The First Lady presented plaques of appreciation to Host Committee Members.

On Sunday evening St. Francis Hospital hosted a reception for the First Lady at their new South Campus. St. Francis committed to work with Dr. Elmore to raise funds to help the medical needs in El Salvador. Dr. Elmore will be returning to El Salvador in June of 2006 with another medical/dental team.