Ayacucho Mission 2017

By Shannon Abi Mora

This past June my father and I went on a Medical Mission to Peru. It was the best father daughter experience ever.  We met up with a group of other medical providers who were also volunteering in the Ayacucho Mission – PAMS. We were part of a multi specialty team that provided medical care for hundreds of impoverished patients. We met up with volunteers from all over the United States.  The volunteers we met were some of the most caring and giving people that you will ever meet.  We educated, treated, operated and supported wonderful and kind people from this beautiful city. We did the best we could with the limited resources that we had available. By the end of each day we were hungry, fatigued, and mentally drained. But, in the end, we felt like we made a significant difference in peoples lives. In the process we saved a leg, operated on numerous hand deformities, referred complicated patients to our network of medical colleagues in Lima, taught patients how to care for their joint pain, taught rehabilitation exercises, taught wellness, provided braces and exercise aids.   Most importantly we treated the poorest of the poor with dignity, professionalism and kindness.

I believe that we left Peru better human beings than when we arrived.

Standing just outside of our clinic trailers.  This is a sign which announces our medical mission to the community.
Our mission provided free specialized medical care. Some of the other team members included a plastic surgeon, ear nose throat specialist, general surgeon, pediatrics, internal medicine specialist, and anesthesiologist. We also had a large number of ancillary support including nurses and interpreters.

My father is an orthopedic surgeon in Orange, California. His family heritage is Peruvian.  My father lived in Peru until age 7.  When he was 5 years old he was hit by a bus and suffered major injuries to his legs resulting in growth arrest and deformities of his legs.  He was able to receive free treatment at Shriners Hospital for Crippled Children, Los Angeles California.  He has taught me the true meaning of giving back.  It has been my dream to be able to help him on his medical missions.

Here are two pictures of the city of Ayacucho where we were located.  We arrived here on a Friday and left the following Saturday.

Ayacucho is known as the home to some of the most beautiful Cathedrals in Peru.  We were fortunate enough to wake up and hear the bells ring every morning.

Every city in Peru is represented by a different hat which the  women wear everyday.  It is a way for each individual to recognize each other.  The city of Ayacucho is represented by a hat with a circular bottom and a square top with a black center.

Here is one of the clinic trailers where patients would be seen everyday. It looked like a small metal container. We had a desk, two chairs, and a small exam table.

These patients waited to greet us outside every morning at 6:30 AM.  We worked until 9 PM daily.

We saw approximately 40-50 patients a day in our little trailers. Whether a patient was alone or accompanied by family members, waiting time did not matter.  Their sense of despair and need for treatment did not deter them from waiting up to 8 hours or longer.   We would examine and diagnose patients who came in complaining of various types of pain.   At the end of our clinic day we would go to the operating room and help out the other team members.

Here is my main work area.  I was responsible for setting up all the medication and supplies that were brought to Peru.   Being highly organized was essential for efficiency.   My other duties included preparing injections, transcribing for the doctors, patient charting, fitting braces and providing my willing help wherever I was needed.

We saw many patients with knee pain due to arthritis. It only took a simple injection for them to feel relief and regain hope.  Because they do not have access to doctors to continue to inject them we taught them simple stretches they could do everyday to prevent future pain.

Several patients had complaints of foot pain.  These problems were related to poor shoe quality.  These people walked on dirt moutanous roads with shoes that had zero cushion.  A simple solution to their pain was giving them a soft heel pad.

This mission also allowed my father to work with the local Peruvian doctors.  These interactions allowed for a respectful interchange of medical information and ideas.

Here is an image of a 16 year old boy’s legs who had been hit by a car.  Due to unfortunate circumstances the patient developed complications which led to a severe deformity in his right leg.  Fortunately we were able to refer him to my fathers colleague, an Orthopedic specialist in Lima, who agreed to perform the complicated sugery for him free of charge.

We saw many patients come in with congenital and environmental deformities of their hands. Some due to malnutrition or genetic defects.  Some of the problems included fused fingers, scarred hands and extra digits.  These people, who were mostly children, were restricted to full motion and functions of their hands.

Here are some of the patients waiting in the hallway of the hospital to be operated on.  Every morning seemed more and more chaotic around the operating room. With the fear that they would not be seen, patients were constantly asking if it was their turn.  I was often times moved to tears after being asked these questions.  The patients waiting knew that this opportunity to have surgery only comes around every few years.  There was a quite sense of desperation.  Unfortunately our reality was that our mission was short.  Some of the hardest conversations I witnessed were between the doctors who had to inform the patients that they could not be seen or treated.   All we could do is network with the local doctor to see if they could possibly perform the surgery but in some cases the local doctors were not experienced enough.  We gave the patients hope by telling them that we would be back next year.

Here is an image of a room inside the hospital. The operating room and post operative rooms were poorly equipped. The team brought most of the equipment required to do surgeries and once we completed our work, we gave it to the Peruvian surgeons and nurses to utilize.

Here are some images of surgeries being performed inside of the operating rooms.  I was fortunate enough to be given the opportunity to watch these amazing doctors do their work and I was, and still am, in awe of their talents.  My responsibility was to take down vitals, assist the nurses, help prepare the patient for surgery and help in the recovery room.   It is clear that operating in a third world country is much different than operating in North America.  But the shortages of supplies and lack of x-ray machines did not deter the doctors and nurses from doing their job.

In all the running around, we still managed to fit in a selfie before surgery. No matter how busy, it was important for me to document these special moments with my dad.  We worked hard everyday together and I wanted to remember these moments for the rest of my life.

This is an image of a deep infection with a necrotic wound on the right leg a 21 year old man. He had been in a motorcycle accident and his wound never healed. Once we saw his leg, it was of high importance to get him into an operating room as quick as possible because we knew that if the wound got any deeper, amputation would be necessary.

We performed the operation using local anesthesia.  General anesthesia would have been optimal however there were no resources for this option.  The doctor used lidocaine to numb up the surrounding area before cleaning out the deep infected wound.  We created a mixture of bedadyne and saline to wash out all the dead tissue during the procedure.  A tool was used to scrape the skin edges and muscle.   In all honesty, helping out in this procedure was not easy for me.  I had never been in a situation where I watched a patient, a human being, receiving surgery care and I was a participant.  I had to take a moment to sit.  It took about an hour to complete the procedure but we were able to successfully clean out the wound and free the leg of infection.

3 days after the procedure.

By the time we left Peru the wound was clean and was healing very nicely. We provided the patient antibiotics from the U.S. and arranged to have the local doctor provide post operative care.    This final picture of the wound is 7 days after surgery. The infection was gone, the deep wound had closed, and the tissue was healthy. I was happy to see these pictures because it proved that our hard work was making a difference in someone’s life, in this case, saving a leg.

Here is our surgical team.  I was fortunate to have met wonderful nurses who told me about their education and how they became nurses. Through them, I learned more about the universities which I am very interested in applying to.  It was really nice to see how their college experience shaped them and helped them be the great people who they are.

On our last day in the surgery center, the team took some final pictures in the operating room.

This is the patient who’s leg we operating on.  We had already left for the United States. The local orthopedic surgeon did a follow up. The patient wrote on the piece of paper “thank you Mission USA and thank you Dr Mora”.

Another one of our patients who sent us this message after we left.  “Thank you Mission USA and thank you Dr Mora”.

After our clinical work we also visited the local orphanage.  Although, it was very sad knowing that these children were abandoned soon after birth, I was given the opportunity to comfort and make the kids smile.  Visiting the orphanage had a life changing effect on me.  It made me realize how important it is for everyone to feel loved and cared for.  I am specially grateful to have family that cares for me.  I now understand how unfair life can be especially for these kids who’s chances of having an education and a safe home is almost none.  My plan is to go back again and help even more in the future.

It was great to see how passionate everyone was about helping those in need.  There was not a moment were we weren’t doing something.  There was always a patient who needed assisting or a doctor who needed support. I formed relationships with these people that I will never forget.  We all had one common goal and understanding: we were here to help.

Coming home felt great. There’s nothing like coming back home to the United States of America. My Ayacucho Peru mission was an amazing experience.

I’m very thankful to have been able to go on the mission with my father. It was a great experience for me. It was an experience that I will never forget.

About Dr. Mora

Dr. Mora is a native of Orange County. He graduated from Anaheim High School in Orange County CA. He received his medical education at UC Irvine College of Medicine where he finished at the top of his class earning the coveted AOA Medical Society honors. He completed his Orthopedic Surgery training LAC+USC Medical Center and then completed a Sports Medicine Fellowship where he focused on sports medicine, shoulder, knee, hip arthroscopy. He has published numerous book chapters on the topics of ACL injuries in soccer players, cartilage restoration, and athletic hip injuries. He is currently practicing Orthopedic Surgery in the City of Orange Orange County. He is a founding partner at Restore Orthopedics and Spine Center (www.restoreorthopedics.com). Dr. Mora’s specializes in regenerative medicine,  sports related trauma, MMA injury treatment, arthroscopy of the shoulder, knee and elbow.   He sees athletes of all levels including professional soccer and UFC/MMA patients.
Dr. Mora’s family heritage is Peruvian. He speaks fluent Spanish.

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Restore Orthopedics and Spine Center
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Orange CA 92868
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