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Making a Big Impact Doesn’t Always Take a Lot

Global outreach is an important component of Penn Medicine’s mission.  According to Penn’s Center for Global Outreach, our clinicians support 26 clinical care activities worldwide. For example, Energize the Chain, a program founded by Harvey Rubin, MD, PhD, of Infectious Diseases, ensures the delivery of vaccines to people in the most remote regions of the world. And the collaboration neurologist Michael N. Rubenstein, MD,  formed with the Foundation of African Medicine and Education provides neurological care and training in northern Tanzania. 

In addition to these ongoing efforts, our clinicians are often on the front lines, caring for people in times of global emergencies. For example, teams from the Hospital of the University of Pennsylvania went to Haiti after its catastrophic earthquake in 2010, and to Liberia two years ago during the Ebola epidemic to care for patients and train others to do the same.

But not all of Penn Medicine’s global outreaches are on such a large scale.  Some smaller – but no less important – endeavors target populations that have little or no access to basic health care. Such was the volunteer effort that six HUP staff undertook earlier this year, working 12- to 14-hour days to help members of Guatemala’s indigenous populations get the health care they need.

The outreach was done through Children of the Americas (COTA), a nonprofit organization that provides free medical and dental care to indigenous women and children in Guatemala. Robin Gibbs, MSN, CRNP, of HUP’s Cardiothoracic SICU – who led this year’s team – has volunteered her time and expertise for the past 11 years. Each visit brings them to a different area of the country.  This past year, they went to the National Hospital in Retalhuleu and worked in 90+ degree weather (with little air conditioning). Next year, the group will travel way up into the mountains of Guatemala.

Each year the U.S. team comprises nearly 100 members from throughout the country. Beyond clinicians, there are many support personnel, including cooks for the group, translators, security staff … even an electrician. Generally, “we bring everything we rely on — OR tables, anesthesia machines, even light bulbs!” Gibbs said. “We never know what going to be there when we arrive.”

The clinical staff started their week-long effort at a 7:00 a.m. triage on Sunday. Every year, hundreds of women and children are lined up waiting. “Word goes out on radio and on signs in town that tell residents ‘They’re coming.’ People line up for hours and hours,” she said. “Some women walk for miles, many carrying children.” By noon that day, the surgical schedule is filled, but triage continues for the medical, dental, and prosthetic clinics.

Gibbs said that electronic health records do not exist in these hospitals. “A couple years ago a young nurse came who had never documented on paper. I had to show her how to do it,” she said, laughing. “They look at the forms and say, ‘This makes no sense!’”

This year surgeons performed 143 surgical cases, ranging from repairing cleft palates and lips to hernias and hysterectomies. Gibbs said it’s not unusual to operate on multiple family members – one child may need a cleft lip repair and another a hernia repair. Generally the day ends by 7:00 p.m. but “we work till the last case is done.” Following surgery, all patients head to the PACU (post-anesthesia care unit) – where Gibbs generally works – and are then sent to either the women’s or pediatric ward. This year the team cared for more than 2,200 patients!

Gibbs said it feels good to provide much needed medical care, but she also enjoys “the intimacy of working with HUP people, spending time with them outside of the work environment.” All volunteers pay their own way, often using their vacation time to cover the days away.

Over the years, Gibbs has cared for hundreds of Guatemalan patients but with every trip “there is a least one story that touches your heart and makes you think twice,” she said. “The woman who has carried her child with cerebral palsy since birth who now has a wheelchair to use. Or the mother of a child with a cleft palate who now considers COTA the miracle she had prayed for.

“I always wanted to do something to give back,” she said. “In our country, we have so many resources, but in Guatemala, it takes just a little bit to make a huge impact.” 


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