Dr. Paul Naylor spends only three weeks of each year at San Hermano Pedro Hospital in Antigua, Guatemala.
But he spends the other 49 weeks thinking about it.
He checks airfares, which have nearly tripled since his first trip 10 years ago.
He sends out fundraising letters, citing 150 major surgeries performed on poor Guatemalans last year by Knoxville doctors.
He rounds up supplies, basking in the generosity of companies like Stryker Orthopedics and DeRoyal Industries, stockpiling donations of gloves, drapes, saws, gowns and metal plates in a storage shed.
Later, it will all be crammed into the luggage of doctors, nurses, surgical techs and interpreters, 50 pounds at a time. The trip is expensive enough without paying for airline overages, and each volunteer on Naylor's Knoxville Medical Mission trip pays his or her own way.
"This was a tough year because of the economic conditions," said Naylor, an orthopedic surgeon with Tennessee Orthopedic Clinics. "Our donations were off."
Still, there hasn't been a shortage of volunteers since 2000, when a group of doctors in Parkwest Medical Center's surgical lounge were talking about doing a medical mission trip and a nurse anesthetist from Guatemala overheard them and suggested the clinic at San Hermano Pedro Church.
Naylor clearly remembers that year, a medical team of 25 arriving at a "hospital" in an old church building the length of a city block, only to find bare rooms in such disrepair that you could look through a crack in the ceiling and see sky.
"We were pretty naive," he said. "We went down thinking, 'Okay, we're going to fix people.' We didn't have enough supplies. We didn't have the right equipment. It was pretty backward."
The next year, they were better prepared.
Health care there is "rudimentary," Naylor said. You break your leg, and if you can afford to see the doctor, he might not have a metal plate to set it. You can buy one yourself on the black market and take it to him; if it's not the right size, he makes do. People go for years sometimes with broken bones, and since most are manual laborers, "if they don't work, they don't eat. A simple broken leg can be a life-altering event for them."
"These people don't complain," he said. "They live hard."
After nine years, San Hermano Pedro's are "the nicest ORs in Guatemala," Naylor said. Each year, the team takes one "big" piece of equipment down: an anesthesia machine, X-ray equipment. Problem is, when it breaks, it's useless. There's no one there to refurbish it.
He estimates they pay out an extra $65,000 to $75,000 in cash for supplies during each trip. Drugs, especially, present a problem; black-market prices are high. Covenant Health donates a lot, "but there's just some things we have to buy."
Often, they make do. There's no gurney, for example, so patients go from OR to Recovery in a rolling desk chair. And Guatemalan doctors retrieve and reuse the disposable items the Knoxville team brings.
Sometimes, they can do better. Stryker this year donated 22 top-line knee implants, wholesale cost about $6,000 each, and instrument trays, all so the doctors could do knee replacements exactly as they do them at home.
Naylor will return to Antigua in early December, to take X-rays and examine patients who will have surgery during the January 2010 mission trip. Others to go then include orthopedic surgeons, neurologists, ob/gyns, a pediatric surgeon and an anesthesiologist. They'll also teach local doctors.
"You have to go with the flow, knowing you're going to lose stuff, things won't work right, machines will break and patients won't show up," Naylor said. But "you'll never find a more thankful group of people."
(Contact xxxxxx of The Knoxville News Sentinel in Tennessee at XX(at)xxx.com.)
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