Diary: Trip to Guatemala, by Anna Murchison, MD, MPH

Guatemala, June 20 – 24, 2010
Anna Murchison, MD, MPH
Wills Eye Institute

Early departure flight with an eight-hour layover. Guatemala arrival was easy and facilitated by Drs. Mariano and Nico Yee waiting at the gate and having special customs connections. After a quick dinner we arrived at the hotel. The hotel was clean and safe with friendly staff.

Monday

8:00-9:30: Visualiza Eye Clinic tour.

9:30-14:00: Clinic of new residency program (Pan American University, Dr. Rudy Gutierez). One private patient and 4 service patients. The residents were very interested in evaluations, review of CT scans and active in teaching discussions. One surgery (private) with the new oculoplastics staff member. Dr. Gutierez was very welcoming.

14:00-18:00: Due to our early completion time Dr. Nico Yee took me to Antigua with his wife, Wanda. We were able to walk and explore the historic city and had lunch before returning.

19:30: Lecture on Orbital Emergencies. Attended by Dr. Gutierez, Pan American University residents, other residents, private practitioners, oculoplastics specialists, the Yee’s and miscellaneous others for a total of about 40. Nico and Mariano suspect the good turn out was in part due to announcements by the Asociación de Oftalmología de Guatemala. After a 30 min delay to start, the power was restored the lecture went well. Several physicians brought cases for review after the lecture. The lectures were at the medical society building and there were not any of the nearby celebrations to distract that Dr. Levin encountered.

Tuesday

8:00-10:00: Visualiza Eye Clinic private patients. Mostly lids, including unilateral and bilateral ptosis, brow ptosis, and lower lid fat prolapse. One orbital case.

10:30-15:30: Six surgeries. With both Drs. Yee this went very quickly. We were able to perform the orbital case in their operating room and spent some time reviewing internal lower lid blepharoplasty techniques. After surgery further discussion with Nico about surgical techniques, in particular tarsal strip techniques with which he had questions/problems.

Wednesday

8:00: Visualiza Eye Clinic post-ops.

8:30: Visualiza Eye Clinic social patients. This is very well organized and all patients are pre-screened. Additionally a local oculoplastics specialist was there.

11:00-15:00: Surgeries. Eight patients were signed up, unfortunately not all were performed due to financial problems and two failed medical clearance. All lid/socket cases with one cicatricial lower lid retraction and several anopthalmic sockets. We put to use the tarsal strip technique we had reviewed and Nico and I did several.

19:30: Two lectures (Dangerous Ptosis and Lower Lid Blepharoplasties) with similar audience and overall attendance. No power issues this time. Again several physicians brought cases for review after the lecture and several others expressed interest in spending time learning further with me. The interested doctors were welcomed to come to Wills to observe and given my contact information.

Thursday

8:00: Visualiza Eye Clinic post-ops

9:00-11:00: Surgical observation with Mariano. Demonstrated access to the new Wills Eye Knowledge Portal to Nico for he, and anyone else interested, to be able to see lectures, surgical videos and other educational opportunities from Wills (http://willseyeonline.org/), most of which is free.

14:00: Departing flight

Overall this was a very good first visit. The Pan American University program, with Dr. Rudy Gutierez, was very welcoming and the staff and residents seemed very interested in clinical and didactic educational opportunities. This is well worth a day and will hopefully grow in volume. The Visualiza Eye Clinic is busier and more time there is productive. A visit to the Peten clinic in the future may be worthwhile, depending on what the Yee’s feel the plastics needs are there. Given their volume of oculoplastics setting up a lecture series and return visits would seem to be of interest to them.

Additionally, we would welcome them to come and observe at Wills, in oculoplastics or other services, and encourage the use of our online education between other opportunities. The accommodations were fine with friendly staff and very safe. I would recommend getting a room not overlooking the nightclub for future visits. I was very well looked after and felt as though I had known the Yees for sometime and enjoyed being welcomed to Nico’s home for dinner. They were incredibly gracious, but wouldn’t let me pay for anything.