On a Mission – #9

Beauty Within

(This is my travel journal that I kept during a medical mission to Paraguay; part one can be found here)

October 1, 2015. 15:30

Havana Café, ASU Gate 2 / TAM JJ8141, Seat 24A

Recollected from September 29th & 30th surgery day.

There is a nervous excitement in the breakfast room. Even though we have all had breakfast here for the past few days, collectively we are clueless and tentative with our selections. Not quite aphasic, but not decisive either. It is an early start, despite recovery from jet lag, six thirty feels too soon to rise. Clive and I stand at the toaster conveyor, flipping bread, several times without toasting it. Our attempts prove useless; we settle for disappointing warmth. The fruit looks great, but the thought of diarrhea does not. Instead I see a few biscuit treats next to the coffee. They are calling for me.


Darcy, Bernie, Mafe, Vivi, Nina and I (part of the J&J team) decide to walk to the hospital. It is quite straight forward now, and even though the streets do not look like home, the area has been safe to us. The pavement, when present, is musically uneven, undulating and pitching. Where patches are neglected, the missing layer reveals a past of tiled or cobble stone craftsmanship; evidence that the city has been neglected for some time. Dirt, stained by oil and excrement, among other municipal secretions, tend to fill the patchwork and add a red brown hue to the ground.

Twisted metallic shards and rebar, rounded from years of traffic, project out of the pavement. Maybe a railing once stood here containing a sidewalk café. Contrasting is the oblong holes into the ground revealing knobs recessed in the depths. Comparisons are inevitable as I remember from my days living in Philadelphia; certain objects are coveted and stolen for metal recycling and the cash prize which comes with it. Such objects made from brass or copper, like flashing, rain gutters, and grounding wire, and the Iron, mainly castings for covering holes in the ground like the one missing from the oblong hole. I Read more

On a Mission – #8

History in the Making

(This is my travel journal that I kept during a medical mission to Paraguay; part one can be found here)

September 27, 2015. 09:45

Hotel Internacional, Room 1004

An unknown Paraguayan number vibrates on my phone; it was four fifteen in the morning. I think I managed to sleep a little after that but finally rolled out of bed but with a deep, soar and gravelly voice. I was able to call home. We had not spoken in what seemed like days, and traveling here seemed to screw up all forms of communication. Melinda didn’t have the chance to read my email which contained two images of this journal, recounting the day of screening.

As I re-described the stories like that of Wilma’s, I became choked up and had to pause to compose myself. The work here is powerful stuff in many ways. Today they announce the patients who will receive surgery in the coming days. Of the two hundred and seventy-eight, they will schedule one hundred and twenty, with five on standby.


Arriving at the hospital, we tour the wards to see the flow from preparation, to operating room, recovery, and post-op. The local student volunteers had decorated each area with cartoons, streamers and animals including the arrows from the front entrance to the waiting areas. In operating room #2 or #3, the decorations included an underwater theme with fish. Outside the preparatory hallway we spot the bees, some of them were dead on the floor. About five to eight of them swoop in and out of the neon light fixture at the end of the hall.


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On a Mission – #7

Into the Falls

(This is my travel journal that I kept during a medical mission to Paraguay; part one can be found here)

September 27, 2015. 05:50

Tadeo’s Van, Row 3

It is Sunday; a free day. Dinner on Saturday night began after ten o’clock. Someone suggested a visit to the waterfalls of Iguaçu. Before I left for this trip to Paraguay, I spoke with a family friend who lived in Paraguay for a number of years, and she suggested that if I had the chance, I should go. I wrote this off when I looked up to see how far it was from Asunción; it is about a six hour drive and I had no idea how to get there.

There were some discussions about the purpose of us being in Paraguay, and the extraneous journey to Iguaçu. From my perspective, we were afforded a day off which could have been spent at a resort on the river; I wanted to see more of the country, to get a feel for life outside of a large city, and embrace an opportunity to see a part of the world I may not have the opportunity to visit again.

I joined a group of four others and we hired a van to drive us, the only problem was that we had to leave a few hours after diner at two in the morning. The five of us packed into a van with our driver, Tadeo, and headed out. I tried to sleep, and was jealous of the ones I could hear snoring.


Our driver stopped at the Chiperia Maria Ana. From the looks of things we were perhaps the first customers of the day. Later I found out this is perhaps one of the best places in Paraguay to eat Chipa, and Tadeo appeared to be one of the first customers.

A little less than half way, the morning light slowly illuminated the environment around us, farms and trees, roadside huts selling fruit, queso and asado. The bare earth has a red tint to it, something of a rouge mahogany of which I have never seen before; it looks so rich and full of nutrients.

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On a Mission – #6

Patients and Patience

(This is my travel journal that I kept during a medical mission to Paraguay; part one can be found here)

September 26, 2015. 19:15

Hotel Internacional, Room 1004

Last evening, I almost overslept the team meeting at 18:30. The jet-lag was actually worse after I had napped. The meeting room was swamped with about fifty various local and international surgical staff. Pre-op, Surgical, Post-op, Records, Laboratory, Anesthesia, Dentistry, and Speech Pathology are all represented, to name a few.   Of the fifty, eight of us are from J&J. They cover a lot of things, do’s and don’ts, changes to the policies and documentation, forms, workflow, team introductions, and more.


We ate empanadas and shared stories and expectations. We will be working out of the Paraguay Military Hospital down the street from the hotel. There was some work being performed, facility upgrades to the electrical system, but while this had been taking place, there was a bee infestation. I was still very tired from traveling and can’t remember falling asleep.

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On a Mission – #5


(This is my travel journal that I kept during a medical mission to Paraguay; part one can be found here)

September 25, 2015. 14:00

Hotel Internacional, Room 1004

I arrived. I recognized two “Operation Smile” t-shirts on the way off the plane; Andrea and Clive. A Colombian Dentist from New York and a Londoner who no longer lives there. I introduce myself as the American living in Switzerland. We walk to and through Customs, but I was stopped and waved to turn back for a Visa.

I had passed the Plexiglas encased booth which was around the corner as I walked into the Customs hall. “18ºC” is displayed on the air-conditioner behind a man who is intensely looking at his phone. Tenuously, I wait; unsure how to approach a man who governs my only possibility for entry into a country. I begin to sway, moving slightly. I approach and step back. Several times I hope that my motion will trigger something in his peripheral view. I quietly clear my throat, several times. Already smiling, he looks up in a blank, yet happy stare.


“You’ve got a customer,” I think as I smiled. I slipped him my passport and disembarkation paper through the slot beneath the glass. His heavy, nearly exophthalmic eyes stare back at me. Same smile. He reviews my papers and begins to scan and type and photograph me, twice.

“How long can this possibly take?” I am the only one here I wonder.

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