A Day In the Camaign by Rich Lopez

Each morning the clinic team leader Anne conducts a staff meeting. This follows an earlier education session for the student nurses.  The team realizes that their impact will be greater if they can provide more information on common medical issues and do so each morning.

Anne conducts the morning staff meeting
Anne conducts the morning staff meeting

Each morning the clinic team leader Anne conducts a staff meeting. This follows an earlier education session for the student nurses.  The team realizes that their impact will be greater if they can provide more information on common medical issues and do so each morning.

At the 8:30 staff meeting, Anne outlines the anticipated activities and provides additional information.  There are a few openings for surgery at the hospital over the next 3 days.  This is important because some clinic visits result in needed surgery.  Anne mentions that patients who might request birth control pills can get them for free at the DIF (public health department).

Dr. David Rodriguez, with his son Andres interpreting

The next part of the staff meeting is another educational piece on the history of medical care in Mexico.  Dr. David Rodriguez, with his son Andres interpreting, explain that Mexico has a population that speaks 52 indigenous languages.  Most of the people relied on traditional medicine until the Spanish arrived.  Medical care has evolved into four basic types; charity, private, institutional and popular.  However, 50 percent of the population do not have access to medical care.  48 million Mexicans have no health insurance.  Even those that do have coverage must pay for the actual supplies used by the doctors.  Imagine having to go buy an implant for your knee.  “Mr. Lopez, it looks like you need a 33 regular, would you like to see a titanium model or are you going to go with a more inexpensive steel knee?”  Most of the population (85 percent) live on minimum incomes and pay no taxes.  The middle class makes up 12 percent of the population and pay some taxes.  The upper three percent are “ricos’ or rich and pay no taxes.

These facts underscore the importance of this medical mission.  Our patients would have virtually no opportunity to receive the quality medical care provided by the BCH Medical Mission.

Tuesday finds me back doing intake for the GYN clinic.  Dr. Laurie Coryell is my doc and I’m assisted by Johanny and Peral, both second year student nurses.  Dr. Carson is seeing children today in the pediatrics section.  I think he was glad to rotate when he saw me passing out business cards as his patients left.  Just kidding.

Rich helps with intake for the GYN clinic assisted by Johanny and Peral

dscn16731dscn1675Dr. Coryell suggests a way to improve patient flow by stringing a sheet up in the corner of the room to create a changing room for the patients.  A few minutes later a rope and sheet arrive and presto, a changing room.  The women that we see have a variety of concerns,  bleeding, menstruation irregularity, inability to conceive, weight loss and breast lumps.  They sit quietly on a row of chairs in the courtyard, shifting chairs as the next patient goes into the converted office to see Dr. Coryell.

I sit outside with them, Peral asks them their name, age, address, medications, special diet and then asks them to “what are your problems.”  Together we fill out the forms and hand them back to the patients.  Some patients bring lab reports and ultra sound images.

About mid morning a large mobile examination van arrives.  This van had been sent by the State government but had a mechanical breakdown before it arrived.  Anne asks me to help move the GYN supplies to the van during the lunch break.  There are two examination rooms and tables so two of the doctors can work together.  I ask one of the nursing students to write the doctors names on a piece of paper to place on each of the two entry doors.  Why not custom tailor the van a bit.  Unfortunately, the small exam rooms are air conditioned and feel like a meat locker.  Dr. Coryell opted to remain in the much larger and warmer converted office, complete with changing room.  The involvement of the State government is both helpful and sometimes a hindrance.  The State expects us to use the van.  Perhaps today, we will find a way to fit all the supplies into the van and turn down the AC.

The medical mission provides an opportunity for the team to see patients with conditions that they may only read about back home.  Cleft palates in young children are regularly seen.  Some children have been using a plug to seal off their mouth from their nasal cavity.  With surgery they will live a better life.  As I was filling out an intake form I noticed a 3 foot tall man walk by.  Not a dwarf or midget, a normally proportioned man who looked to be in his 50’s.   Anne thought he might be Mayan.  Later over dinner, some of the doctors explained that there a some genetic anomalies that result in tiny people.

Several children come in with “crossed eyes” and others with different eye problems.  Fortunately we have an Eye Surgeon on the team and this afternoon he drops in at the clinic after a morning of surgeries at the hospital.  One 12year old boy has what called “jittery eyes.”  His eyes would move left and right rapidly.  It’s hard to imagine how he could focus, let alone walk.  The Eye Surgeon, Dr. Ticho, is from California and his Anaesthesiologist, Dr. Ticho, is from Chicago.  That’s right, Simon and Ben are brothers and for the very first time since become doctors, they worked together here in Mante.  The medical mission provides opportunities for family reunions.  Charlie Jones has been assisted in surgery by his daughter in past campaigns.  Anne Donovan and her daughter Abigale Stangl, an landscape designer, are here from Boulder

Then there is the husband and wife team of Dr. Carolyn Sanders and Dr. Eric Boyen.

Police van ride back to the hotel

At the end of the day I accompany Dr. Sanders to the hospital for a tour.  When we arrive we walk through the surgery wing, past a woman being prepared for skin grafts.  She was horribly burned a year ago and the repairs to her body are slow and hopefully not too painful.

The work day ends in a Police Van.  The nurses, docs and I pile into the back of a van to be delivered to our hotels, we hope.  The chatter reflects on the day’s work and we talk about a dinner party being given by Juan Villareal, the bother of the former mayor, Javier.  He throws a party for the medical team in his back yard each year. Why?  Just one of the friendships that have developed over the many years of the campaign.  A time to renew friendships and enjoy some delicious food and drink.  Tomorrow is another work day.


THE FULL MANTE Vol 11, No 4 – All the News To Print That Fits – February 3, 2009

Today’s message read “the grand essentials of happiness are: something to do, something to love, something to hope for.”  Howard, PACU’s team builder- nurse extraordinaire, posts daily missions on the scheduling board.  Today at the Hospital General the surgical teams, PACU, the bio-medical technicians, triage nurses and assistants, and the sterile processing department (SPD) assistants started their days early and began patient care before 8:00 am.    With sixteen beds open for patient recovery, PACU was ready to take a full load of patients.

In the OR, the life of a tiny three month old Pablo was changed by an hour long surgery that corrected his cleft lip.  As he was brought into recovery, his mother and subsequently all of the nurses burst into tears of joy.  Next year he will have his cleft palate repaired.  This IS life changing because it affects nutrition, speech and language development, peer and social acceptance for him.

There are words of appreciation that bring tears, even without the drama of surgery.  At the end of work yesterday, Laurel and Margie welcomed 43 yo Maria.  They filled seven prescriptions for her… medicines she would not have been able to afford.  She burst into tears of joy, “because of you, my whole day is beautiful.”  “It’s why we are here,” was the response.

Of course, there are moments of humor.  Erick looked at the wooden, worn-down, too-long, crutch with no rubber tip 67 yo Magda was using.  “It’s too long…wouldn’t you like a new one?”  “No, I like it.”  “Well, maybe you will grow some more.”

Victoria, a 17 year old girl, came to the hospital with a 2.5 kilo (5.5 pound!) noncancerous growth under her arm.  All she wished for was to be able to wear a dress like all of the other girls in her village.  Yesterday she travelled an hour in the back of a pick-up truck and then a six hour bus ride to Mante.  Tomorrow she will return home with her wish granted.

Here’s some more interesting and useful info about DIF.  Every morning DIF provides a free hot meal for every school child.  Sometimes it is their only meal for the day. We learned it is illegal to not allow kids to attend school if they cant speak.  On a different focus, DIF provides free birth control pills.

Some situations we cannot help.  Some congenital anomalies are not ‘fixable.’  It may be enough to provide reassurance for the parents that they are doing the best possible.  And, occasionally there is an angry response.  Yolanda, 52yo, came demanding a prostheses.  We no longer have any to give.  She stated that all of her friends had received one, she deserved one, and we should supply them.  Again, thanks go to DIF who will provide these for poor women living in Mante.

Every year “The Perfect Person’ comes for a ‘useless’ piece of equipment.  43yo Pedro lost both legs in an accident.  He supports himself shining shoes at the plaza.  He has been using a broken-down chair.  PT had one wheelchair with no legs, and a Jay-pad, used to prevent pressure sores.  Pedro has no use for a chair with legs, and the Jay-pad was a perfect fit for his size and needs.

What does ENT stand for?  Maybe it is ‘Ear, Nose, and Toes.’  Sarg went from a T&A to next remove a baseball-sized dermoid cyst from the foot of 78yo Patricio.  Now he can wear his dancing shoes. Because of some problems, OR didn’t finish till 10:00pm last night.  Hopefully that will not recur. The flexibility of folks here is amazing.  The results of our work bring tears of gratitude.

Adios from your reporters Abby and Jean

THE FULL MANTE Vol 11, No 3 – All the News To Print That Fits – February 2, 2009

The word is out that the 19th Medical Campaign is in full swing. Crowds of patient patients waited at the three venues: Cruz Roja, Escuela Enfermera, Hospital General. The sun shone to greet us, too. There are so many persons of need, it is sometimes hard to focus on our MISSION STATEMENT:


A serious situation with the Eye Team is missing supplies. A box of VISCO-ELASTIC, Ocucoat brand has never shown up. This is essential for cataract surgery. Jenelle, the Eye Team Lead, will try to get an additional donation of this, valued at $70 per dose. If none can be provided, it may affect the numbers of surgeries that can be performed. (Check your departmental supplies to see if there is a weird box).

New gadgets for use in Mante include an Automated Keratometer. It measures the cornea/surface of the eye and checks for astigmatism. An A-Scan measures how long the eye is. It cuts down on the time needed for these evaluations. Zury is a great help for the team.

Interesting pathology found this year includes basal cell carcinoma and corneal problems. The latter cannot be repaired here. There are disappointments, too. Juan came in for a cataract repair that caused blindness. But, the vision loss was due to glaucoma, not cataract. Neal B had to report that this was not reversible.

Out of the cave and into the light…fitting for reading glasses now has a bright room with great lights. Most persons are so thankful to get glasses, but some style mavens are looking for different colors or designs.

At the Hospital General many patients arrived bright and early to wait for their scheduled surgical appointments. Day one of surgery began as nurses, surgeons, and anesthesiologist formed teams to help patients with a plethora of symptoms.

Joel and his brother came from a small village two hours outside of Mante to receive treatment in tandem. Joel had an obstruction in his nasal passage and was receiving a third and hopefully final surgery. In good spirits his brother patiently waited, looking forward to his appointment at Cruz Roja on Wednesday to remove his cataract.

In the waiting room (or hall), Perla awaited a routine gal bladder surgery. However during triage, the nurse identified a small kidney stone. Perla decided to go forward with the arthroscopic surgery to remover her gall bladder immediately, during which Dr. Charlie would also try to identify if the kidney stone could also be removed with a minimally invasive procedure.

A small five year old boy was born with hemi facial microsomal, a malformed jaw and earlobe. Although he was too young to receive surgery this year, his face needed matured, his family was educated about the jaw expansion surgery that will happen next year, and the three ear reconstruction surgeries to follow.

Oh, my. Why so many referrals from GYN to PT at the Clinic? It seems as if many women have leakin’ bladders. PT instructs them in the famous Kegel maneuver. A comment was made that if you are in the line at the supermarket in Boulder and there are many women over 40, they are all doing Kegel!

There are angels in our midst. These include Sr Karim y Sra Nora. As their mission, each day they provide breads and coffee at Cruz Roja for any hungry folk. 80-100 people come for this feast.

Gracias from your reporters Jean and Abby

Medical Mission Personel Fly to Mexico by Rich Lopez

Flying during the Super Bowl in a commercial jet with only 14 passengers is peaceful.  One can only imagine what is taking place in bars, homes throughout the world.  I’m arriving late to El Mante, Boulder’s Sister City in the State of Taumaulipas Mexico. [Pilot: we’ll be taking off in a few minutes, score is 3 to 0 Pittsburgh].  Nearly 100 medical personnel from Boulder Community Hospital are here for the 19th Medical Mission.  The Advance Team arrived on Wednesday to begin the hard work of setting up clinics to treat patients, some who have been waiting a year to see a doctor.   All but 7 of us are medical personnel. [The score is now 10- 0 Pittsburgh]. We are administrative persons or in my case, a member of the Boulder Community Hospital Board of Directors.  What will I do there?  Help.  Help in any way I can.

A few years ago I spent several days trying to arrange for a young girl and her mother to fly to Colorado where a Loveland surgeon volunteered to perform a delicate surgery on her face to remove a large growth.  Visas, paperwork, calls to the US Embassy and then calls to representative Mark Udall’s office consumed my time.  Ultimately, the girl’s family decided against traveling to the US, but we learned that a relative living and working in the US had sent money to the family to pay a local surgeon to perform the operation.  Seem unusual to forego a free operation and free trip for two to Colorado?  The girl and her family are indigenous Indians who live in the mountains, miles from Mante.  She came to the clinic with an uncle who spoke Spanish.  Her language was spoken only in the villages. [Flight attendant: the score is now 10-7 Pittsburgh]

I don’t know what to expect when I land.  There was one email from friends in Mante, who were going to try and have a car and driver meet me at the Tampico Airport and drive me the 90 kilometers to Mante.  But, it is Super Bowl Sunday and many of our friends South of the Board do enjoy football too.  I’m prepared to take a taxi to the bus station and catch a bus to Mante.  I wonder what the score is now?   It’s 6:30 PM Boulder time.  Looks like we’re getting ready to land.

THE FULL MANTE Vol 11, No 2 – All the News To Print That Fits – February 1, 2001

There is always hub-bub on Saturday morning. The dignitaries, the press, the DIF persons all gather near the podium on the lawns of the “La Escuela Enfermeria” or the Nursing Schoo1. We celebrated the opening of Brigada Medica XIX…our 19th year in Cd. Mante. At 10:15, the procession started down the center aisle. It included the Dr. Davkd Rodriquez, Mante Presidente, Hector Lopez, Secretary of Health Juan Guillermo Manzur Arzola from Tamp State, Mayors from five near-by referral cities, Dr Silvia Elena de la Garza de Lopez president of DIF, and, of course Sr. Mike Moran.

Speeches ranged from 2 to 15 minutes, and included warm words of welcome with the belief that “Gratitude is a Memory of the Heart” and that “Languages nor distances can support this humanistic bond.” More than 5,000 patients have already signed in. Each message was easily understood with the simultaneous translation to English.


Since he lost both legs in an accident, Manuel uses a wheelchair. Today he came not for himself, but for his father. His father may have had a stroke and now has balance problems. But here’s what is amazing. Manuel supports himself repairing computers. But, he is on a Handicap Basketball team which came in second place for the national competition for all of Mexico! What an achievement.

Dave in GYN commented that as a first-timer, there is no one here to show him the ropes. The good side of this is, anything he does is OK. At 4:00 he still had a line of women waiting. This year there is only one exam table instead of two, which obviously slows the process of seeing women.

Can it be a new epidemic? I don’t think so, but peds is seeing a lot of ventral hernias.

What a blessing it is to have Dra. Moreno Bringas here from Tampico. An oncologist, she works with women with breast cancer. She is unhurried and thorough seeing and talking with women and examining them. A group of women watched the video she showed about self-examination and early diagnosis of breast cancer. She will be here tomorrow (Sunday) and has also been an inspiration for the formation of a breast cancer support group here.

Each year, Magda an OR Nurse, and I have fitted 10-12 women with prostheses. During the year, Magda works with an additional 10-12 women. My source for donated prostheses has gone. Women we saw today are using rolled up socks or plastic cups. Here’s great news: DIF has offered to pay for prostheses (about $30-$50 each) for women living in Mante who cannot afford to buy their own.

Before and after visits to the general physicians, many families and children stopped to learn from our dietician Elizabeth and student nurses about daily habits to help reduce the likelihood and effects of diabetes. With children running around the nursing school grounds, every bit of education will help reduce the likelihood of more diabetes cases.

Hasta manana from your reporters, Abigale Stangl and Jean Bedell

THE FULL MANTE Vol 11, No 1 – All the News To Print That Fits – January 31, 2009

Once again The Full Mante is in publication…the eleventh year of facts and figures of interest and amazement.  Our team members number slightly less than last year..just under 100.  But,bour national scope has broadened to include folks from California, Florida, Illinois, Oregon, Texas, Wisconsin, and Wyoming,  Oh yes, and from Colorado, too.  Word must be spreading that this is a great mission and team to of which to tbe a member.

Transportation:  there was one flight that turned around mid-air and returned to Houston.  It was just a two-hour delay.  Word has it the pilot was not looking for the Hudson River

Here’s the Thought of the Week.  It was posted on the wall of one of the clinic rooms.  It reads:  “IT IS NOT A MIRACLE…I JUST DECIDED TO DO IT.”    And that has been the image of Day-Two-Of-Set-Up.  There are boxes to be located and unpacked, dirty tables and chairs to be cleaned, medicines to be shelved, laboratory equipment organized,  pediatric scales to be calibrated, six towels to be wrapped per bundle for autoclave, physical therapy equipment to be put in place (how many pair of shoes are there?

A trip to Soriana bought a huge amount of rice for audiology.  Curious, you may think.  They pour some into dozens of baggies to give to patients.  With the humidity here, hearing aids and batteries are kept in rice to keep the equipment dry.  And, the other shopping purchase was jars of baby food bananas and pears to evaluate speech mechanics in children

We are recognized and watched over here.  Last night, Becky was walking home alone in the dark.  A vehicle began to follow her.  She speeded up, and so did the driver. Finally he pulled up, stopped and called out “Boulder?”  Yes, she replied.  He was a security officer just providing her with protection.  Memo to folks:  don’t walk alone at night

And, another hint when walking along, day or night.  One of our folks was walking and taking lots of great photos.  Suddenly, her foot stepped on something soft and squishy.  You just have to look down, as well as looking up.  There were several folks watching this event and laughing a lot.

Lunch today was provided generously, again by DIF.  DIF is the Mexican equivalent to our Department of Social Services.  The wife of the Mayor/Presidente is automatically the President of DIF.  They provide many services for children, older adults, persons with special needs.  And while we are here, they often provide lunch for us

In 2008, two Mante sisters who have helped us for years, were both diagnosed with breast cancer.  They are completing treatments.  During this time, they have also established a Breast Cancer Support Group.  It will meet on Monday, 2 February.  They have also arranged for Dr. Moreno, an oncologist from Tampico to come and consult with this group

The autoclave team has a varied background.  Sue works in imaging/mammography at BCH
(She says she doesn’t recognize women with their clothes on.), Sharon has retired from OR nursing.  Leah is  Customer Service Rep who will begin nursing school soon.  Leah was here six years ago for the summer and thinks Mante seems cleaner than before.

Maureen…how do you speak Spanish?  Just take any word and add ‘o’ or ‘a’ at the end.

The Full Mante may add some class.  Abby Stangl might do some photo-shop work

Best news of a person coming:  Rocky will join us this week.  It is her second trip here, and she will be an extra bright member of our team.

It is wicked-good to be back here as your roving Mante-lady.  Keep them stories comin’.

Jean Bedell

Medical Mission (Jan. 31 through Feb. 9)

120 doctors will be traveling to Mante January 31 through February 9 for this year’s medical mission.

Log in here for pictures, updates, and to read the Full Mante, the Medical Mission newsletter from Jean Bedell.

Parade of Lights

We have agreed to participate in this Saturday’s Parade of Lights in downtown Boulder along with Boulder’s other Sister City committees. Please come out and support us.

Participants gather for the parade at 6 p.m, with the parade starting at 7 for a walk around the Pearl Street Mall. This is the big kick-off for celebrating Boulder’s 150th anniversary. The weather promises to be much warmer than it is today!