L. S. Foley1, J. Schoen1 1University Of Colorado Denver,Surgery,Aurora, CO, USA
Introduction: Rural Guatemalans face obstacles limiting healthcare access that are common to impoverished, remote communities: lack of financial resources, limited transportation, discrimination, language barriers, and fear of unfamiliar health centers. Delivering surgical care within these remote communities is challenging. We hypothesized that delivery of sustainable surgical treatment is possible through coordination between existing Guatemalan health promoters and visiting surgical teams.
Methods: A general surgical team and translators from International Surgical Missions (ISM; Pueblo, CO) have joined with Asociación Compañero Para Cirugía (ACPC, local health promoters) in San Juan Sacatepéquez, Guatemala, through Partners for Surgery (PFS) in October 2012 and 2013. PFS is a volunteer organization that provides sustainable access to surgery and medical care by connecting indigenous Guatemalan communities and international volunteer teams. In advance, health promoters screened remote villages for individuals with surgical complaints. Those identified were transported, along with their family members, to a converted surgical center with communal living quarters. A Guatemalan family physician performed basic screenings and tests. ISM provided instruments, medications and surgical care.
Results: Data from the October 2012 mission were reviewed. Two general surgeons and two surgical residents performed pre-operative histories and examinations on seventy-seven potential surgical candidates identified by ACPC. Sixty-six patients (85.7%) were deemed appropriate candidates and underwent surgery over six operative days. Forty-eight cases (72.3%) were performed under general anesthesia. Fourteen laparoscopic cholecystectomies were performed without open conversion. Patients recovered in adjacent living quarters and were transported back to villages. Health promoters continue visiting villages to identify new surgical patients and anyone with post-operative issues. Patients in need of surgical attention are transported back to converted surgical center and evaluated by incoming surgical teams.
Conclusion: Sustainable delivery of surgical care in remote Guatemalan regions is possible through coordinated local and international efforts.