Faith in Practice/Obras Sociales del Hermano Santo Pedro – Alexandra (Jana) Freeman, MD

Written by Alexandra (Jana) Freeman, MD, PGY-4 at Kaiser Permanente San Francisco Ob/Gyn Residency Program while on Global Health rotation at Faith in Practice/Obras Sociales del Hermano Santo Pedro in Antigua, Guatemala in May 2017.

Sunday was triage day.  We unpacked all of our surgical equipment, set up the operating rooms, and saw over 30 patients who had travelled many hours on foot and by bus for surgical evaluation and treatment. Some could not afford the operation in their home village, most simply could not access care.  We organized our week and scheduled the most complex cases at the beginning of the week so we could watch them over several days post operatively: older women with complete uterine prolapse, young women with cervical dysplasia, pelvic masses, many with

severe symptomatic anemia for abnormal bleeding requiring hysterectomy.  All extremely grateful for the care they were to receive.

Under the tutelage of Dr. Diane Sklar of Kaiser Permanente San Francisco (urogynecology) and Dr. Mindy Goldman of UCSF (general obstetrics & gynecology), I assisted in multiple surgeries, including total abdominal hysterectomies, ovarian cystectomies, colpocleisis, total vaginal hysterectomies, LEEP procedures and dilation and curettage. We worked together with an amazing and complete surgical team at Faith in Practice who ran a very well organized, thoughtful, and comprehensive surgical mission group. Our specific team consisted of an anesthesiologist, scrub tech, circulating nurse, and PACU nurses. The entire team ensured the utmost professionalism in providing comprehensive, sensitive care to the women of Guatemala.  Each morning we saw our patients from the days before and sent them home when they were clinically stable and performed operations for the remaining of the full work day. I also served as the team doctor. It was an amazing experience.

At the end of my residency, this surgical mission trip has solidified my passion for global health and continued drive to maintain fluency in medical Spanish.  Ultimately, I have returned to Kaiser Permanente San Francisco with a fresh and rejuvenated mentality, a newfound grasp of surgical gynecologic care in a resource limited setting, and an overwhelming sense of appreciation for the availability of our surgical capabilities here at Kaiser. I am so grateful for the support of my medical education to continue my work in global women’s health especially as I begin oncology fellowship on July 1^st at a new joint program together with UCSF and Kaiser Permanente San Francisco.