Dear Family, Friends, and Colleagues,
Our 17th medical mission to Piña Palmera (since Oct 2002) included both optometry (general optometry and screening for surgery) and ophthalmology (eye surgery). Yet in a larger sense, it included reunions with old friends, a global sense of family, God’s constant hand of guidance, and dancing. Somehow, the sight of a goofy, 6’3” gringo dancing around the place has always brought joy to Malena (the oldest resident of Piña), on my left, with Jose and volunteer Katherine on my right.

23 JAN – 1 FEB 2014
Kata Loukan Medical Missions:
Optometry and Eye Surgery at Piña Palmera, Zipolite, Oaxaca, México

For over 25 years Piña Palmera has brought joy and hope to persons with disabilities in this rural area of southern Oaxaca, now a world leader in “Community-based Rehabilitation.” With teams of volunteers from around the world, they establish partnerships with even more rural villages to provide care and instruction. Although there are several residents at their home base in Zipolite, their emphasis is to support persons with disabilities remaining n their homes and communities. KL has traveled with Piña teams to many villages in our history, and we now have an established surgery space in Piña. n the first photo, we are dancing on the porch directly in front of the residence. You can see our surgery space painted in orange just over my shoulder. Our surgery patients are doing pre-op/post-op in the same space where the residents are spending their day. The first surgery photo above shows Dr. Brian LaGreca (Billings, MT) operating, with his wife Stacey assisting him to his right as surgical scrub. Dr. Hector Cámara (Mérida, Yukatán, Mexico) observes, and nurse DuAnne Diers (Sheridan, WY) is in the foreground as circulating nurse. In this photo you can see the relative size and importance of the surgical microscope, which was transported from the US in Feb 2005.

Optometrist Dr. Tracy Ammann (Riverton, WY), her mother, Joyce Meling, and I arrived on Thursday afternoon, 23 Feb, and immediately began our optometry clinic, providing care, glasses where needed, and screening patients for surgery the following week. We screened Thur-Sat and then welcomed the surgical team on Sat to prepare for surgeries Mon-Thur 27-30 Feb. This report will focus on the surgical side of the work, while Tracy and Joyce will follow with more details on the optometry clinic. In summary, we saw well over 100 patients in the optometry clinic, and performed 25 surgeries, 23 for cataracts, one iridectomy (for glaucoma) and one pterygium.

The morning after each day of surgery, the docs check the eyes of all of the previous day’s patients, take notes, provide and review post-op instructions. Here, Brian checks the first eye of the first patient of this year’s mission. This man was scheduled for surgery last year, but was unable to complete the surgery due to a cough. A year later, he was the first candidate on the list.

When the team arrives to Piña on surgery days, everyone has a role. While Brian and Hector check over the patients, Joyce is usually the first person they see as she removes the gauze and eye patches which were placed over the surgical eye the day before. These are often dramatic moments, especially if the eye receiving surgery is the first expression of clear vision for many years. After helping with post-op, Joyce returns immediately to assist Tracy as she measures patients for the current day’s surgery, and then they receive more optometry patients for the current day.

Cheli, a physical therapist on the Piña staff, has become indispensable to our work. Shown here with Brian, she lines up patients from the several communities, maintains communication, and is the most important voice in establishing the post-op instructions and any follow-on care necessary. Thanks be to God and all the people who work with us, our success rate is very high, with no reports of post-op infections, largely credited to Cheli’s careful instruction. In this rural area, our patients must care for their surgical eye for several weeks, due to potential damage from sun, dust and smoke from cooking fires.

My role in the team is predominately with recruiting, logistics, and technical assistance. However, thanks to the several docs who have trained me over the years, I also work with optometry screening, circulating in surgery and occasionally scrubbing-in. In surgery week I began my days greeting patients, then worked to clean the surgery as DuAnne and Stacey prepared to “open” the first case. Then I returned to assist Tracy and Joyce with optometry until all patients are seen. At day’s end, I get to “play,” and enter the surgery to provide breaks for DuAnne and Stacey. Here, I was privileged to scrub-in for Hector as he operated, with Brian looking on.

I took this photo in order to provide Brian and Stacey with a shot for their Christmas Card next year! Couples elect to do many things with their vacation time, and this was Stacey’s first visit to Piña. Scrubbing for surgery is very intense, and one cannot help but feel the pressure of providing just the right piece of equipment and response to each request from the surgeon. To see Stacey and Brian function as scrub/surgeon/wife/husband was like watching a couple dance who have danced together for many years. From the observer, they appeared gentle, seamless, and effortless. But the reality is that the inner intensity is constant until the surgery is completed.

The residential building which houses our surgery space was renamed “Casa Gary” in February 2012, after our dear and late friend, Gary Benson. The caption reads, “Por su compromiso con Piña Palmera a travez de Kata Loukan.” “For your dedication to Piña Palmera through Kata Loukan.” On of the scriptures we considered on this mission was II Corinthians 4:6 “For God, who said, “Let light shine out of darkness,” made his light shine in our hearts to give us the light of the knowledge of God’s glory displayed in the face of Christ.” We hope, in our continued work, not only to reflect the ‘face of Christ,’ but also the face of Gary in all we do. Amen.

All roles have been introduced so far with the exception of Elena. She has been a dear friend and partner of KL for many years, and returns with us not to perform dentistry (her specialty) but to assist us with pre-op/post-op on the day of surgery. She has a heart as big as the mountains of Oaxáca, and we are blessed to have her as part of our family.

The best part of building something – like a tree house – is standing in it. The best and most comforting part of this work is just sitting in the surgery at day’s end. Breathing, looking around, listening, and giving thanks to God for giving us the ideas and the wisdom to carry out the vision. We firmly believe that God pays for what God orders. If the Lord wants it done, it will be done, and we must constantly trust in that. If the Lord does not want it done, no effort on our part will establish it. I’ve never seen a physical mountain moved by faith, but I have seen an eye surgery built in México, and it’s still there.

After finishing in the surgery, DuAnne and I walked to the neighboring village to look for our docs, and passed by Elena, seated by the outdoor dining area. With music blasting from my phone, we danced again, and this photo well-describes the event.

We expect medical professionals to give their time and their lost earnings from their respective practices, in order to come with us to offer care to underserved children of God. For our part, we want to make sure that those partners eat well and rest well. Since our first visit to Piña, we have stayed at the place called Cerro Largo, which has become for us a ‘home away from home.’ The colors and the light reflected in this evening meal goes far in capturing the refreshment we find in good food and time together at each day’s end. Last night and this morning, I feel like a young child returned from summer camp, missing my fellow campers greatly, and wondering how I can press on without them!