Screening Day

Rabiby

 SCREENING DAY.....is one of my favorite days of the mission.  This is the day when kids and their families travel from far and wide to be evaluated by the Operations Smile medical team for surgery.  For some of the kids, it's their first time seeing a doctor and for others it is the first time they will be evaluated by a surgeon.  This experience affords them a free opportunity to be seen by multiple specialists including Plastic Surgeons, Pediatric Intensivists, Pediatricians, Speech Pathologists, Dentists, Social Work, and Nursing for vital signs, phlebotomy, etc.  When we arrived at the hospital at 7am, there was already a line of kids and parents waiting outside our unit. This little guy on the right was our very first patient, well behaved and waiting patiently to be seen.

I worked the "final chart review" station with two of the Recovery Room nurses, Kristin and Irene.

I'm so glad I agreed to work at this station.  We reviewed the completed charts after the kids went through and were evaluated by all of the services including the social history-how they traveled to the screening day(by bus, jeepney, boat, donkey, motorcycle, etc), where they live, family history, what they believe, if anything, caused their child's deformity.  Since this was only my second mission it gave me a much clearer picture of how the entire process works.  FASCINATING!!!!

7am-Initial line of patients waiting to be evaluated.

One of 3 plastic surgery stations.

Our little dancer. She was a total wild woman, moving and shaking all over the place like her life depended on it. :)

This day brings about a conflict of emotions for me.  The kids and families arrive with such hope.  In most cases the team will be able to bring their dreams to life by performing a successful surgery on their child.  Unfortunately, in some instances the child is either not a good candidate for surgery or is not medically stable enough to undergo surgery.  The upside for many of the kids who can not undergo surgery is that during the medical evaluation they may be directed to the proper specialist who can further access their condition and formulate a plan to help. ie-cardiologists, hematologists, etc

This little pumpkin screamed with excitement and pointed at Kristen and I as soon as she walked in the door. Blonde hair was all the rage in the Philippines. ;)

Andrea Jane is 4 going on 24. From the moment she walked through the doors she was a charming sassy little one. I'm pretty confident she may become a pop star someday now that she has a repaired palate. More on this little fireball later. ;)

Kristen and Althea, one of the happiest babies I've ever seen in my life.

Beautiful Azel Marie

A Jeepney picking up right outside the hospital

All the stickers donated through my amazingly thoughtful and generous friends via Facebook made for some incredibly happy kids!

The Student Volunteers from Bolivia along with their fearless leader Carlos brought along suitcases full of toys for the kids, clothing donations and themed costumes for each day for the medical staff to wear.  The screening day theme was "Smile Heros",we all equipped with capes and Op Smile tattoos.

Smile Heros

Rosie the Smile Riveter :)

Our "security guards" AKA Domenick and Jeffrey our male nurses from Manila.

It was interesting to see what the parents believed to be the cause of their child's deformity.  We saw everything from hereditary, unknown, karma for mothers or family members making fun of people with clefts, pregnant mothers going outside during an eclipse, riding a motorcycle during pregnancy, etc. There are multiple factors researched regarding clefts but in many cases the scientific cause is unknown by the medical community.

More cuties!

It was a great day with approx. 240 kids from all over the Philippines evaluated by our medical staff and most of them scheduled for surgery.       Hooray!!!!

Cebu City, Here We Come!!!!

After a moment of panic as the bus doors where closing in front of our hotel in Manila when i realized I left my passport and US dollars in the hotel safe(that would have been AWFUL!!!) we were on our way to the airport to fly to our mission site in Cebu City.

I was fortunate enough to sit next to Marilyn Moonan on the plane.  Marilyn is a pediatric nurse from Boston who has been on over 20 missions and would be acting as the pre/post op charge nurse.  She has a wealth of knowledge, I was able to pick her brain about the experience and it was nice to chat with another nurse from the Northeast.  The time flew by chatting with Marilyn and in a blink of an eye we were in Cebu City being greeted by a huge welcome committee of Local Volunteers.  We came down the escalator from our gate to clapping, cheering, a huge banner and people draping beaded Cebu necklaces around our necks like Hawaiian Leis.

Well...at least it was phonetically correct, last mission my badge said Merlissa Merliss. ;)

Waiting for our bus outside the Cebu Airport on Mactan Island.

 The bus took us straight from the airport to the hospital to take a tour.  As I stared out the window on the ride over, I was in awe of the stark contrast between wealth and poverty. There were countless tin roof shacks right next to multi-million dollar malls and high rise buildings.  I didn't sense that there were any traffic laws or if there were people weren't following them. Bicycles, Jeepneys, cars, vans looked like a sea of ants crawling across the road whichever way they could, with kids running through the streets often times weaving around the cars.

One of the local doctors welcoming the international volunteers.

We were working out of a public government hospital.  It was like nothing I'd ever seen before.  On the way to the unit reserved for Op Smile, we passed by an adult ward that had at least 50 patients lines up in beds approx. 1-2 feet apart, no curtains separating them, everyone talking amongst themselves in the 80 degree heat. A far cry from the inpatient units in the US where patients/parents often complain when they have to share a room with one other patient.

The hospital was open air and the set up kind of reminded me of the high schools I used to see on TV shows set in LA or Florida when I was a kid.  This was the view looking out the back of the unit designated for Op Smile. There was tons of wreckage and several roosters crowing around the clock, they clearly didn't get the memo that they are "God's alarm clock", not "God's snooze button".  I wish they weren't such overachievers. ;)

 This was the long corridor/room that served as the pre/post op area and also where the screening day would take place.  We divided it in 4 sections, the pre-op area was in the far corner, post-op area in the long hall on the right, lunch/break area for the staff on the other side of the wall on the left and the nurse's station inside the wood walls in the center.  There would be over 100 narrow stretchers filled with little patients and their families, lining this corridor in just a few days. It was hard to imagine.

This was the OR. There would be 8 OR tables running simultaneously, with a recovery area in a hallway just outside this room. 

After the tour the buses took us to our hotel to check.  We stayed at the Radisson Blu Hotel which is owned by one of the major sponsors of our mission here in Cebu so we had the luxury of staying in the gorgeous 5 star hotel that was decorated like a Wintery Christmas Wonderland. 

Another stark contrast to the poverty we had just witnessed at the hospital and hard to wrap my brain around.  We were all grateful to have a place so refreshing to rest between our long hours ahead on the mission.  The local team treated us to a welcome party of hors d'oeuvres, cocktails and desserts from all over Asia.  I sampled every dessert and they were all divine! There was a live band and the medical directors even got up on stage and sang for us.  We soon discovered this display of live music and officials getting up on stage to sing was not out of the ordinary. ;)

This was my favorite, red velvet :)! Mmm!

Our rooms were gorgeous and I lucked out in the roommate department! I was placed with Jamie Gibson, a child life specialist from South Carolina, who is the biggest Clemson football fan I've ever met.  Everyone who knows me well knows I'm not from the south but I kinda wish I was, Jamie was like a kindred spirit. So funny, sweet, considerate and easy to live with.  Hallelujah!

Thanksgiving in Manila

How much can one do in a 1/2 day in Manila???

My new friend, Clive who is an anesthesiologist from the UK, and I were two of the first volunteers to arrive so we decided to find out!

The View from my hotel room

 After laying with my feet straight up in the air for an hour, the fluid levels in my lower extremities were balanced out enough to head out on an adventure.  We took a taxi to Intramuros, the old city of Manila. We visited San Augustin Church which was built between 1587 and 1606 and is one of the oldest church in the Philippines.  It was the only building left intact after the destruction of Intramuros during WWII.

After exchanging money at the bank which was guarded by an armed police officer(a little scary) we passed by the Manila Cathedral which was stunning. 

Manila Cathedral

 Then we shopped for some hand crafted jewelry and walked over to Fort Santiago.  The Fort is now a memorial to Dr. Jose Rizal who was imprisoned there in his final days before being executed in 1896 for inciting a revolution against the Spanish colonials. There was a lush park full off colorful plants, palm trees and fountains on the way to the front wall of the fort. Inside there is was a pathway with brass footprints marking Rizals final steps to his execution site.  The fort now contains an open air theatre, small museums, and lots of roosters couped up in the back.  It was swarming with a tourists and teenagers hanging out after school.

This was pretty funny!  As we were walking through Fort Santiago, local people mainly teenage boys and girls kept stopping us and asking if they could take a picture with me.  First, we thought they had me confused with somebody famous but then one boy said "Ma'am you look like a real live Barbie and we don't have real live Barbie's in our country".  Bahahaha.....what?!!! So from then on Clive decided to start taking pictures of the kids taking pictures with me, it was quite comical.  One kid said "will you be here for a while, I want my sister to see you and I think she's at home, i can run home and get her, she loves Barbie".  lol!
At times when I've traveled internationally I've felt like people looked at me like I have 3 heads because I look sooooo American.  In the past, its made me feel unsafe but this was a much friendlier experience.  They were all very sweet and polite and it was enough entertainment to keep my sightseeing partner and I awake as the jet lag was beginning to set in. 

 It was starting to get dark and we were having trouble finding a cab so upon the suggestion of a local, we decided to take a Jeepnee back to the hotel.

Uh oh!!!

A Jeepne is a cross between a bus and a jeep.  It's the most common form of public transportation in the Philippines. You just hop on and off the back and pass along your small payment to the driver and hold on for dear life.

  
It was quite the experience! A little exciting and a little frightening! We made so many detours that we weren't back to the hotel in time for me to take a cab to meet my friend Chad Africa in Makati City.  Upon the suggestion of the Jeepne driver, I got off and attempted to get a cab.  Yes....."attempted".....I'm typically not a nervous traveler but this got my heart racing.  I couldn't speak the language, there are very few traffic laws in the Philippines, I stuck out like a sore thumb, there were cars everywhere, and none of them wanted to give me a ride.  I found a woman dressed in a nurse's uniform who spoke English and she directed me to a bus to the mall.  Mom-if you're reading this, DON'T WORRY-I was fine and promise to travel with friends next time. ;)

Malls are all the rage here and we were meeting at a restaurant near one, so I was beyond thankful for the lead from the nurse.  I arrived just in time to meet this lovely group I was fortunate enough to have Thanksgiving dinner with. I've been away from home before on Thanksgiving but never without mashed potatoes, turkey and pumpkin pie. These guys made it all ok!

They ordered a table full of traditional Filipino dishes and we had a feast.  It was a different kind of Thanksgiving dinner, they treated me to dinner and I was very thankful! ;)  It was wonderful to catch up with Chad and get to know his friends.  Chad and I met 3 years ago doing a production of Kiss Me Kate with the Village Light Opera Group in NYC and he moved back to Manila last year. The restaurant we went to was at the Green Belt Mall, which was decorated like a Christmas Wonderland with Harry Connick Jr., Mariah Carey, and every other 80s and 90s artist singing their version of classic Christmas songs.  We were talking about the history of Thanksgiving in America and all of the hype surrounding Christmas in the Philippines. One of Chad's friends explained that the Filipinos are so thankful for the coming of Christ, since they don't have a Thanksgiving Day to celebrate in November, they start celebrating the Christmas season in October to show how thankful they are. LOL!   I've never seen so many Christmas decorations or heard so many different renditions of "All I Want For Christmas Is You", in my entire life.

It was so nice to catch up with Chad and see a familiar face on the other side of the world.  We finished off the night with ice cream and taro bubble tea. Yum!

I made it home just in time to crawl in bed before I fell asleep standing up.  I walked in to find a sleeping roommate who is one of the Student Volunteers from Bolivia.  This mission is like the United Nations of Operation Smile, I love it! :) Can't wait for tomorrow!

Korean Air Rocks, Chasing the Darkness, and Cankles

I HEART KOREAN AIR, I really can't say it enough. I seriously could be their new spokesperson!!!

After being informed that I was bumped from my aisle seat to a middle seat because I was one of the last people to check in(even though I showed up more than the suggested 2 hours ahead),  I made my way through the security check staffed by very unpleasant and rude TSA employees. Then things turned around for the better.  I came upon my departing gate which was full of lovely, friendly, calm Korean people and this group of Korean flight attendants who looked like a throw back to the 1950s Pan Am Stewardesses. They were stunning, beyond polite, perfectly dressed and groomed in their powder blue silk perfectly tailored blouses, jackets, cream colored pencil skirts, and matching hair bows.  I couldn't stop staring at how lovely they were people must have thought I was a creeper.
I made friends with a little guy named Nathan who came over and shared his Incredible Hulk figure with me, to his parents surprise, and then a few minutes later, I was staring off in the distance at the lovely flight attendants, I feel little Nate crawl up into my lap and put his face up by my ear and say "I'll keep you company until we leave, Mommy has Daddy on that bench so I'll sit with you".  It was a little like a scene from a movie and the perfect remedy to calm my slightly heart which was slightly anxious about flying to opposite side of the planet by myself.

Ok, so more on Korean Air. I board the plane to find a large blanket folded neatly on my seat with a plastic cosmetic bag filled with cloth sandles, a tooth brush and toothpaste, headphones, and tube of chili sauce that came in what looked like a tube for acne medicine or craft glue(random but amusing).  I was barely seated when the flight attendants came around with warm wash clothes for our faces and hands. There was even a little clip on the back side of the tray table to put the wash cloth until the flight attendant came around the retrieve them. Check out the back of the seat, there is a pull out hook on the left to hang a sweater, an outlet on the right to charge your cell phone/Ipod/computer/whatever, and a TV with tons of movie, tv and travel map options.

It was a bit surreal to watch the world map color coded in real time with daylight and darkness.  I knew based on my flight time that I would be traveling backwards in time until we reached the international date line but to essentially be chasing the darkness on our flight and not see the light of day for close to 25 hours was a pretty surreal.  I also had plenty of room in my middle seat because I was definitely one of the heavier people on the flight.

We also had 2 full meals and multiple rounds of snacks and wine on the 15 hour flight from JFK to Seoul.  The first try at breakfast was on the recommendation of the Korean American woman sitting next to me.  It was Green Tea Porridge, let's just say "I tried it......."

This is what the flight attendant brought me when she saw the look on my face after the first few bites.

This was all in economy class! If you can't tell I'm a little enamoured by the little things in life. ;)

The Seoul airport was stunning and impeccably clean.  It was like an enormous mall with airplanes parked outside.  I had a 4 hour lay over before my connecting flight to Manila and so a I sat down at this beautiful restaurant at 5am(Korea time) on the 2nd floor of the terminal with floor to ceiling windows and had this delicious Korean vegetable rice soup for "breakfast".

My flight from Seoul to Manila was an entirely different experience.  The passengers were mostly Filipino men coming from some kind of golf outing in Korea and were pretty rowdy.

I was very excited to reach my final destination for the day and these lovely ladies were at the gate to greet me when I arrived in Manila.  Aaaaahhhh, it feels good to have someone know your name on the other side of the planet when traveling alone.

They were very helpful watching my carry on bags while I elbowed my way through the rowdy golfers to get my luggage off the baggage carousel. Sheesh! They kindly escorted me through customs and to the Operation Smile Team Coordinators waiting outside baggage claim.


I noticed that my ankles were unusually stiff and my jeans felt a little tight on the flight but it wasn't until I got to my Op Smile team and relaxed for a few minutes that I noticed how heavy my legs felt. I did sleep for 7 hours straight with my feet on the floor on the plane which was a small miracle but I never thought it would produce this kind of swelling. These socks were loose when I boarded the plane in NYC. When I took my shoes and socks off, I developed "cankles" with pretty moderate pitting edema.  I thought "Ok, great, I made half way across the world with out as much as a sore back but now this". Oy vey! 

To no one's surprise I didn't want to spend my only full day in Manila in the hotel room with my feet propped up so I laid on the bed, feet resting on the wall almost straight up in the air for about an hour until my legs felt a little less like tree trunks and off I went to explore Manila. :)