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Robin Pawlikowski’s eyewear reflects surgery as she assists with an abdominal hysterectomy at the Good Samaritan Medical Center in Catacamas, Honduras.
International
Photo by Audrey Jackson

Foreign operations: health care in Honduras

Long-awaited surgical team returns to Predisan Health Ministries despite pandemic.

CATACAMAS, Honduras — Metallic clanging echoed through the surgical ward as Dr. Chad Eustis hammered the arm of the operating table against the floor to loosen a stuck mechanism. The first step to practicing surgery in a developing nation is to operate on the equipment. 

Eustis, who started leading surgical trips to this Central American city in 2007, was unfazed. 

Within an hour, his team would be treating patients in both operating rooms at the Good Samaritan Medical Center, owned by Predisan Health Ministries, which is associated with Churches of Christ. 

Dr. Chad Eustis, left, points to the overhead surgical lighting, which went out mid-surgery, while Lesa Dale, middle, and Dr. Damon Simpson, right, focus on the patient undergoing a laparoscopic gallbladder removal. Adaptation in the operating room is just part of practicing medicine in developing nations, Eustis said.

Dr. Chad Eustis, left, points to the overhead surgical lighting, which went out mid-surgery, while Lesa Dale, middle, and Dr. Damon Simpson, right, focus on the patient undergoing a laparoscopic gallbladder removal.

This surgical team from Atlanta-based Jackson Healthcare was the last to visit before the COVID-19 pandemic and the first to return in a year and a half. 

Arriving as the delta variant surged across the U.S. and Honduras, the 11 team members had to show proof of vaccination as they entered the country. Before leaving for home, they would have to get a nasal swab test for COVID-19. A positive result could confine them to Honduras for two weeks or more.

Dr. Amanda Madrid, CEO of Predisan, thanked them for taking the risk. Many patients had been anticipating the team’s return, she said. Others had died awaiting treatment. 

Alejandrina Castillo had waited 15 years.

Alejandrina Castillo smiles while resting in the post-op recovery room.

Alejandrina Castillo smiles while resting in the post-op recovery room.

Her home in the mountains of Honduras made access to health care difficult, and a failed surgery made her wary. A doctor at a private clinic told her the surgery would cost 50,000 lempira, or around $2,100 U.S. —  money that she did not have, Castillo said. 

“Money here is very scarce,” said Castillo, who required treatment for a pelvic organ prolapse. “We don’t have a lot of resources to go and pay for private clinics.”

Her only option was to seek care from a clinic that would perform the surgery pro bono. 


Related: Compassion at capacity


Dr. Nadia Reyes at the Culmí Clinic, a health care center that Predisan oversees, encouraged her to seek the help of the surgical team at the Good Samaritan Medical Center. 

Despite living five hours from the center in Catacamas by car — or nine hours if she had to travel part of the journey by horseback due to road conditions — Castillo resolved to be treated by the visiting North American surgeons. 

“I used to pray a lot to God to give me a solution,” Castillo said. “I felt this was the time when God gave me the answer.” 

Dr. Chad Eustis, far right, prays in English with patients while Carlos Ponce, right, translates the prayer into Spanish at the Good Samaritan Medical Center owned by Predisan Health Ministries.

Dr. Chad Eustis, far right, prays in English with patients while Carlos Ponce, right, translates the prayer into Spanish at the Good Samaritan Medical Center owned by Predisan Health Ministries.

The surgical team gathered for a devotional at the beginning of the day in the medical center’s chapel. 

Afterward, Eustis led a prayer with the patients before the group changed into surgical gowns and prepped the operating rooms. 

Castillo was the first patient of the day. 

From a wheelchair to walking

With 45 patients scheduled across four days of surgery, team members made the most of their time at the clinic, working 12 hours one day to stay on schedule.

It was after dark when they arrived back at Hotel Plaza Maria on the third day. Despite the long hours in surgery, Eustis climbed back into a Predisan van after dinner with a translator, intent on visiting a former patient. 

He leaned forward in anticipation as the van rolled down the dimly lit streets of Catacamas before turning into a narrow side road. 

“This is it,” Eustis said.

Stepping out of the vehicle, he embraced Oscar Enrique Pagoada Bonilla and clapped him on the back before they walked inside together. 

Health care professionals listen with patients to a devotional led by Julio Benitez, a chaplain and staff psychologist at the Good Samaritan Medical Center.

Health care professionals listen with patients to a devotional led by Julio Benitez, a chaplain and staff psychologist at the Good Samaritan Medical Center.

The first time Bonilla saw Eustis was in 2008, when his father helped him into a wheelchair outside the gates of the Good Samaritan center. 

“It was the exact time when the bus stopped and all the Americans were coming by,” Bonilla said. 

Little did he know then that Eustis, a general surgeon who practices trauma and acute care in South Carolina, would play a critical role in his life. 

A truck had hit Bonilla earlier that year while he rode a motorcycle, breaking his left leg in two places. His family pooled their finances to send him four hours away to a hospital in Tegucigalpa, where surgeons amputated his leg below the knee. But the procedure left him with chronic infections and pain. 


Related: Covering COVID: Inside an ICU


The problem, Eustis said, was that the Honduran doctors kept cleaning out the infection and resealing the wound without treating the cause of the infection: a metal rod known as an intramedullary nail inserted alongside the bone. 

Though the rod is the golden standard for stabilizing closed femur fractures, it is only recommended for open fractures if the wound is cleaned within eight hours of injury, Eustis said. Bonilla’s open fracture was not. 

While the team from Jackson Healthcare in 2008 was able to treat the infection, Bonilla needed to see an orthopedic surgeon. 

Since Eustis lacked the specialization to correct the prior procedure, Madrid had one request: Take Bonilla to the U.S. where there are surgeons who can.

Eustis, a nondenominational Christian, described the following events as nothing less than miraculous. 

Oscar Enrique Pagoada Bonilla shows off his prosthesis.

Oscar Enrique Pagoada Bonilla shows off his prosthesis.

Connections through one of Eustis’ patients in the U.S. helped secure a visa for Bonilla. A donor in Texas bought Bonilla’s plane ticket. The CEOs of both hospitals where Bonilla received treatment — the Oak Tree Hospital and the Baptist Health Hospital in Corbin, Ky. — donated their care.

Twelve years later, Bonilla’s injury is undetectable with the aid of a prosthesis. But to Bonilla’s family, the miracle was their introduction to the visiting surgeon. 

“For us, the biggest miracle was actually meeting him,” said José de Jesús Pagoada, Bonilla’s father. “It is also a miracle that my son can walk. He has a family. He has a wife. He has kids. He has a job. He doesn’t need help from anybody else.”

An answer to prayer

Back at the medical center, Castillo proclaimed the surgical team’s presence in Honduras as a blessing. She recounted the medical challenges she had faced for years while lying in the postoperative recovery room that workers finished renovating mere days before the surgical team arrived.

Ryan Dadds, left, and Dr. Chad Eustis, right, lean against a monumental cross in Catacamas, Honduras.

Ryan Dadds, left, and Dr. Chad Eustis, right, lean against a monumental cross in Catacamas, Honduras.

“I have no way to pay, but I know God will be able to,” Castillo said. “God is going to bless them. I pray that the North American teams keep coming here, to bless people and solve problems like mine.”

Despite the long recovery that lay ahead of her, Castillo said she was hopeful that this surgery would allow her to lead a more active lifestyle with her grandchildren and church.

“There is not one single patient who could have had the surgeries they had without your presence here,” Madrid said to the surgical team on the final day at the center. “Those were people who were really waiting for you.”

Tears ran down Castillo’s cheeks. The visiting doctors and nurses, she said, were an answer to prayer.

“God has not abandoned me.”

AUDREY JACKSON is associate editor of The Christian Chronicle. Contact [email protected].

Filed under: Features health care Honduras International international news News Predisan surgeons surgical team Top Stories

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