Daet, Philippines, Feb 9-22, 2012

3/8/12

Posted by Ethan Handler, MD (a fourth year Head and Neck Surgery resident from Kaiser Permanente Oakland in while serving a global health elective in Daet, Philippines with Bay Area Surgical Mission).

We left for Manila around 11 pm on Feb 9^th from SFO.   Seventy large boxes overflowing with medical supplies accompanied us in the belly of the plane.  This was the first of two flights, capped off with a four-hour bus drive over rugged terrain, through sparsely inhabited villages, stopping at the buried church for a quick photo op, to finally arrive at our destination, Daet, located within the Camirines Norte province.  An active town of over 100,000 people, bubbling with life, overcrowded with hundreds of motorcycles jimmy rigged to decadent and colorful sidecars. 

Our accommodations were very comfortable, located a few blocks from the windblown beach famous for kite surfing, and a few kilometers from the hospital.  We arrived on a Saturday afternoon, Friday, a day that only existed in our minds.

Sunday morning we were awake and working, furiously unpacking supplies, setting up the two connecting operating rooms that would house a total of 4 OR tables.   The local government was very generous to grant us use of their hospital for our mission.  Unpacking was followed by a trip downstairs to evaluate the packed clinic for surgical candidates.  Native Filipinos traveled from a variety of provinces, alerted to the medical mission by radio and television broadcasts.  Three services were represented during this trip, Oto-HNS, General Surgery, and OB/GYN.

The majority of our head and neck cases were subtotal and hemi-thryoidectomies.   There is no iodinated water supply in these far reaching areas and as a result there is a higher incidence of thyroid goiters and disease.   In addition, a few thyrogloassal duct excisions were also performed.   No mass was under 5 cm. 

Right outside the OR doors was the designated “procedure room”, although in reality it was a hallway.  The lighting for these cases was via heat lamps that doubled as warmers for the newborn infants.  This was epidermal inclusion cyst heaven.  Every conceivable place for EIC’s to grow, we found, and removed.  The largest was a 10 cm mass on the posterior scalp, successfully excised without bursting. 

Every patient was beyond thankful, gracious, and possessed incredible toughness.   Even when offered, they would seldom take pain medication.  The recovery area and patient rooms consisted of 85 degree, 100% humidity rooms with patients and their families crammed onto cots.  Yet nobody complained.  Their stoicism and strong will was an example for all of us, and a point to remember.

We operated full days, all week long.  Our nights were packed with various hosted events sponsored by local organizations.  Everyone was gracious.  I feel blessed to have spent time with these people, inspired by their courage and resiliency, while forging lasting bonds with the group members.  I’m always amazed and thankful as to how close you become with others when sharing in an experience such as this one.  Without a doubt, I would go back in a heartbeat.

A few pictures are included below: