Sunday, February 06, 2011

Epilogue: Help us build a hospital in Coatepeque

Northridge Church has been sending a team yearly for at least the past 9 years. Each year we do something like what I’ve described above. It is a drop in the bucket. King’s Castle (Castillo del Rey) has a beautiful campus. It also has a full-time doctor (Dr. Boris, who comes out with our and other visiting medical teams), and now about 5 nurses, mostly from the U.S. who are full time missionaries there year long.

Here is a photo of Dr. Boris and me (drinking coconut water)

One of the frustrations of our short visits was diagnosing patients with diseases like diabetes, hypertension, hyperthyroidism, chronic medical and surgical problems like cataracts, chronic skin breakdown and infections. It is impossible to treat this with a single doctor’s visit. They need ongoing care. Many of the older population had cataracts, pterigium and other eye problems that are easily corrected surgically. A cataract operation could take as little as 10 minutes in an equipped operation room with appropriate post-operative care. The people that live in the mountainous (altitude of about 600 meters) municipality of Coatepeque (population of 48,544 living in 126.85 km2). To the best of my knowledge, there is no clinic accessible to these people. The closest hospital is in the city of Santa Ana which is about 15 miles away. Since the population is poor, something more accessible is needed. There are concerns regarding parasites (worms and amoebae) in the drinking and bathing water, high levels of arsenic in the water of the lake. There is a great need for treating injuries, infections and acute health problems before they become chronic. There is an inherent mistrust of hospitals. Most people think that if they go to the hospital, they will never come back alive!

We NEED a hospital in this area. Over the past years, Northridge church and other concerned groups have been donating money and bringing down construction teams. The results are what you see below:

The inside looks like this:

Of course, there is no floor and when it gets hot, the horses on campus come and sit inside. $ 16,000 will allow us to put a tiled floor inside, plumbing and doors and windows.
The hospital is about 120 feet long and 60 feet wide. It will have two floors and an access road.

The next step is to raise about $ 20,000. This will give us a floor and plumbing. Once we have these, we can begin to put in windows and doors and set up electricity. With another $ 60,000 we should be able to get the first floor up and running as a functioning hospital. This will include inpatient beds, an operating room and outpatient areas. King’s Castle has housing where visiting medical faculty can stay. We have a number of physicians, surgeons, nurses and therapists willing to come down for periods of time and donate their services. This is, of course, if we have the hospital up and running. I am picking up this vision and shall be working locally (that is, in Marshfield, WI) to raise funds and support for this project. If you would like to help, email me at or ).

The El Salvador 2011 Mission Trip

From January 28 to February 4, 2011, I was part of a mission trip to El Salvador. This is a trip organized yearly by the Northridge Church in Marshfield, WI ( I was excited to go. It was my second trip.

We left on schedule from the church building at about 5 pm on Friday, January 28, 2011, taking a chartered bus to Chicago, IL, from where we were to catch our TACA airlines flight later that night. There were 31 of us, including 5 MDs (a general pediatrician, 2 pediatric neurologists, a plastic surgeon, an ER physician and myself, a combined internal medicine and pediatrics physician) and 2 ER nurses.

When we reached Chicago’s O’Hare airport at about 11 pm, we discovered that there was something wrong with the plane and the only flight that could take all 31 of us was scheduled for Sunday morning, January 30! Oh well, the airline put us at a hotel near the airport until that time and paid for all our meals. It turned out quite nicely actually.

During the next day – Saturday, we got to know each other a little better and had a little R & R.

I think this was the Marriott hotel.
My colleague took a picture of some of our kids holding up their meal vouchers. Don’t they look happy?

On Sunday morning, well rested, we came back to the airport by the hotel’s shuttle bus. Here we are, once again, waiting with our bags in a line to check in to our TACA flight

The El Salvador 2011 Mission Trip - Basics

So first of all, where is El Salvador and how do you get there from Marshfield, WI? The map below, drawn by Google Earth shows Marshfield, WI, Chicago, IL and San Salvador in El Salvador.

This next map shows Central America and locates El Salvador next to Guatemala and Honduras.

The next map shows the enlarged Google Earth map of El Salvador.

And here is a map of El Salvador showing the major cities and routes.

Of course, other than the little nameless location on the coast of Lago Coatepeque, none of the other places we did missions are on this map, so they are shown below.

El Salvador Mission Trip 2011 - Lago Coatepeque

This time things went without a hitch. An uneventful flight of about 4 hours later, we arrived in El Salvador. This is what the airport looks like from the outside.

We arrived by about Sunday afternoon. David Heegeman (our team leader and an ER physician) and myself spent a couple of hours delayed in customs. You see, each member of the team carried two bags – one their personal belongings and the other a bag we had packed at the church a week before. This second bag contained medicines, surgical supplies, toys, shoes, and donated clothing. The customs were not happy with 10 bags of medicines, even though they had all been inventoried and detailed, all were within their expiration period and none were controlled substances. Anyway, after going through some paperwork, we were allowed to leave with out medicines.

Our base for the trip was to be Castillo del Rey or King's Castle ( It is located on the west coast of Lago Coatepeque. This is a volcanic caldera lake about 28 km2 across with a maximum depth of 1400 feet. It is a coatepeque municipality of the Santa Ana department of El Salvador.

We caught a bus from San Salvador (the capital, and where the airport was) and rode about a couple of hours to the west to campus of Castillo del Rey (King’s Castle) on the edge of the Lago Coatepeque. Here are some pictures of this beautiful lake.

A panoramic view:

More views

Day 1 - El Salvador Mission Trip 2011 - Guadalupe

Boys and girls were housed in separate dormitories. We (the boys) slept in a dormitory on the top of a hill with a beautiful view of the lake.

The castle like roof at the bottom of this picture is of of dormitory.

That evening, while the evangelism team learned their skits and dances (that they would perform during the days when we would do our medical work), we packed lots of medicines, counting out 30 day supplies of various pills, dispensing out about 60 cc of various syrups into bottles. (You can see a couple of the bags in which we brought the stuff in the back.

Day 1 - El Salvador Mission Trip 2011 - trip to Guadalupe

Anyway, after a good breakfast, we set out for Guadalupe. We passed some interesting traffic on the way there, like this calf suckling at her mother’s teat in a pickup truck.

The journey to Guadalupe took about 2 and half hours. Guadalupe is a small village.

Where the King’s Castle has a small church community. Once we got there, we began setting up within the church building.

The picture below shows the pharmacy section being set up.

Us doctors set up our section as well and then waiting for our first patient. I’m ready!

Patients would come in and get their vital signs recorded

Once that was done, they would take a seat and pass by to see the doctor in turn.

This picture shows a bunch of girls tickling each other to pass the time while waiting. It was such a cute sight, I had to stop what I was doing and take a picture

Patients would wait their turn and then be seen by the doctors.

I kept track of what I saw and saw about 33 patients that day.

I tapped one swollen knee.

After seeing our patients, they would pass by the ‘pharmacy’ and get their prescriptions.

Both at the beginning and end of each session of seeing patients, we would have to unload and load the bus back up with all our equipment, supplies and medicine. Then there was the long bus ride back to base.

Day 2 – El Salvador Mission Trip 2011 - Dawn and Insect Stories

Day 2 - January 31, 2011

The next morning, we all got up and after a cold shower, were ready to set off for our first field location, Guadalupe. Outside, we could see the beautiful sunrise...

And horses grazing on the field on the campus.

The girls came down from their dormitories with stories of having found a scorpion on the floor...

They also had a huge (about 5 inches long) grasshopper hanging out on their shower curtain.

These guys were all over the place.

Day 2 - El Salvador Mission Trip 2011 - trip to Candalaria

February 1, 2011 - Trip to Candalaria

The next day we were ready to get back to work. Today we were scheduled to go even further, to Candelaria to the location of a second church. On the way there, we saw this cool-looking igunana that was about a couple of feet long.

I saw about 42 patients at Candelia, including 2 cases of a rare skin disorder, epidermolysis bullosa. The first patient, shown in the pictures below was only 29 years old but looked more like 60.

The pictures below show the bullae on her hands and the scars from ruptured bullae and sloughed off skin on her back.

Even if she lived in the States, I doubt we could have done a lot for her.
There was also a lot of bad teeth in El Salvador, probably because of no fluoride in the water.

Here's a funny picture of a little boy that does not want the doc to look in his ears.

Seeing a lot of rashes,

white spots on skin

and fungal infections.

Here's our dentist looking happy, tired and ready to work.

It was a busy day of seeing patients.

By the time we got back to base, we were all pretty tired.

Day 3 – El Salvador Mission trip 2011 – trip to Ayutuxtepeque

Day 3 ; February 2, 2011

On Day 3, we went to the location of the future Dream Center – a project planned by Castillo del Rey. At the moment though, the church has been meeting in a tent for a few years.

On the way to this location, we stopped to the a field of lava rocks. We took some samples as souvenir.

I saw about 41 patients here.

The kids are the most fun to see.

The kids are just the cutest and instead of working, we were tempted to just play.