Annual mission trip brings surgical care to rural Dominicans

Mission Trip GroupFront row: Nate. Stoikes, MD, Ross Thomas, CRNA, Kameron Thomas, Angie Lewis, RVT, Jaime Cavallo, MD, Linda Zhang, MD Second Row: Brent Matthews, MD, Gary. Perotti, CRNA, Gosia Borchardt, CRNA, Wes Vega, Peggy Frisella, RN, Susana Rodriguez, Carla Nitz, RN, Sara Baalman, Gladys Tse, MD, Clayton Cummings, MD

Every year in late January, impoverished people in and near Santiago, Dominican Republic, undergo surgery for various types of hernias, a common medical problem often linked to the country’s agrarian lifestyle. This care is made possible by a dedicated surgical team assembled by the Washington University Section of Minimally Invasive Surgery and year-round efforts to raise money and organize the week-long trip.

This year’s team – led by Minimally Invasive Surgery Chief Brent Matthews, MD, and Nate Stoikes, MD, a former Washington University minimally invasive surgery fellow – left Jan. 26 and performed 91 operations from Jan. 28-Feb. 1. The surgeries – also performed with the assistance of minimally invasive surgery fellow Linda Zhang, MD – were open procedures with small incisions to correct inguinal, umbilical and epigastric hernias and other surgical conditions.

The 16-member team included three other doctors, three certified registered nurse anesthetists, two interpreters and others who supported the team in the operating room and a clinic.

“Most of these people have never been to a doctor,” says Susana Rodriguez Ferrer, medical secretary to Matthews and an interpreter for the team. “They may have had these hernias their whole lives, and they are so happy that the pain is going to go away.”

The surgical team, which completed its fifth medical mission trip this year, works with the Institute for Latin American Concern (ILAC), a health advocacy group, and complements the efforts of a Creighton University team that performs hernia surgeries in November of each year. Using a system of health-care workers called cooperadores, ILAC brings surgical candidates to the clinic to be examined by doctors during both teams’ visits. The Washington University doctors identify candidates for the Creighton team, and the Creighton doctors, in turn, recommend patients for the Washington University team.

“It’s a win-win situation,” says Peggy Frisella, manager of research operations for the Washington University Institute for Minimally Invasive Surgery and lead organizer of the mission trip. “We don’t arrive here just hoping patients haven’t had anything to eat or drink after midnight. The other team tells these patients to show up prepared – and they do.”

In the past five years, the surgical team has performed 536 operations, including 385 general surgical procedures and 151 local procedures involving conditions such as abscesses, lipomas, and other skin issues.

Contributing to the Washington University team’s success each year has been its ability to communicate well with patients. 

The services of interpreter Rodriguez-Ferrer are especially important with children, who may be as young as 3. She gives them toys and dresses stuffed animals as she talks with them, then accompanies them into the OR. She also works with adults who have high blood pressure, which is widespread in the Dominican Republic. Even though the clinic supplies blood pressure medicine, nervousness can cause blood pressure to spike, and an important part of being an interpreter is to calm patients, at times by joking with them, so their blood pressure is low enough to have the surgery.

In the recovery room, fellow interpreter and team member Wes Vega talks with patients as they wake up and makes sure their recovery goes smoothly.

Frisella spends most of her time troubleshooting when problems occur and serves as a liaison between the clinic and the operating room, but she stresses that all members of the team pitch in when needed.

“We accomplish a lot with a skeleton staff,” says Frisella. “I think the key to our success is that we work hard but are all happy to do so.”

Upon returning to the School of Medicine on Feb. 2, the team thanked the Barnes-Jewish Hospital Foundation and other sponsors, then Frisella began work on next year’s trip – once again lining up funding and asking for donations of medical supplies.