Friday evening the team arrived on schedule in Guatemala City - 29 members with their carry-on baggage and to great consternation... none of the 50 checked bins with our medical supplies.
Having a full plane the airline decided to send our bins on a "future" flight.
Following an uneventful hour long bus ride to Antigua Guatemala, pizza, cervezas and a good night's sleep the team was treated to a relaxing breakfast at our hotel, the beautiful Quinta de Las Flores.

Saturday breakfast was followed by orientation by our team leader Cindy and a tour of Las Obras guided by Padre Jose.
Seeing the undernourished children with cleft lips and palates and the mentally handicapped children and adult resident impressed on us why we were here.
The day ended with a collective sigh of relief as the bins arrived intact with thanks to the generous volunteers who returned to Guatemala City to collect them.

Sunday was the day to triage the waiting patients, unpack the supplies and set up the OR.
Most of the patients travel many hours on foot and then by bus from their remote villages with the hope of being seen by the doctors and accepted for surgery.
Sixty plastic surgery, general surgery and gynecology cases were booked with only a very few turned away. As an added bonus several patients from previous years missions visit giving rewarding feedback on their progress.

Monday we got down to the work at hand. Two OR's were run with one doing plastics and the other a mix of general and gynecologic surgeries. A cleft palate and lip repair in an adult, a cleft lip repair in a 1 year old and repair of burn contractures of the hands of a 2 year old fill the day for the plastics team. The general surgeons help out 3 patients with hernias and our gynecologist performs 2 hysterectomies.

Tuesday is a national holiday for All Saints Day but it's business as usual at Las Obras. Cleft lips in a 7 month old boy and 3 year old girl are repaired, correction of a thumb syndactyly (a duplication of the thumb) in an 11 year old boy and removal of a 33 year old women's facial tumor keep the plasticos busy. The Generalisimos perform 5 more hernia repairs.

Wednesday there is one six month old boy with a cleft lip and a fourteen month old girl with a cleft palate to repair and correction of a three year old girl's polydactyly of the foot (congenital extra toes). Dr. Gordon Graham, a Canadian gynecologists who now works in Texas has joined the team for the first time this year. He performed 3 hysterectomies and a prolapse repair today.

Thursday the general surgeons perform one open and two laparascopic gall bladder removals and an incarcerated hernia repair. Gordon performs a vaginal hyserectomy, ovarian cystectomy and repair of a rectocele. The plasticos have a day off to play in the sun.

Friday the general surgeons perform 3 more laparoscopic cholecystectomies plus inguinal and umbilical hernia repairs. The plastic surgeons have two of a previous year's children with successful cleft lip repairs returning for completion of their cleft palate repairs. They also have a one year old with a sixth toe on each foot to be removed. The incidence of these sort of genetically related abnormalities is higher in Guatemala.

The middle weekend is an opportunity to refresh, recharge and see some of the country.

On Saturday nearly half the team travelled to Lake Atitlán to view the destruction from the recent mudslides.
A colleague of Cindy's had visited the hospital in Panabaj earlier in the year and raised some money to aid in its re-location after it was severely damaged in the slide.
Cindy led a group to the slide site to deliver their donation.
Also we bid adieu to RoseAnne, Jim and Gordon who return to Texas early Sunday morning.

On Sunday there was relaxing and sightseeing capped with an impromptu dinner with a wonderful fish stew courtesy of Gordon's, Mike's and Peter's Saturday fishing trip to the Pacific.

Monday it's back to work with Pamy carrying on in the general surgery line after the departure of Gordon and Jim.
Today the general surgery team performed one bilateral inguinal hernia repair, a laparoscopic cholecystectomy an incisional hernia repair and another inguinal hernia repair.

The plastics team performed a dressing change, release of tongure tie, reduction of an acute nasal fracture, cleft palate repair and the reconstruction of a nose cut off by a machete.

Also, the Canadian Ambassador to Guatemala, Kenneth Cook, visited Las Obras to view the team's activities.

Tuesday, the general surery team with the addition of Dr. Elsa Sen, a Guatemalan surgeon, performed a removal of breast mass and two laparoscopic and one open cholecystectomies.

The plastics team perform the repair of two more cleft lips in a 5 month old and 18 month old, repair of finger syndactyly in an 2 year old and a five year old and a heel spur excision in a 32 year old.

Wednesday, the general surery team performed two laparoscopic cholecystectomies and two hernia repairs.

The plastics perform another cleft lip repair in an 11 month old and a reconstruction of a congenitally malformed ear. They also close two fistulae (abnormal connections) between the nose and mouth in two patients who previously had their cleft palates repaired.

Thursday was the last day of surgery and two plastics rooms were run.
In one there was a repair of a hole remaining from a previous cleft palate repair, a revision of a scarred ear, a septoplasty (straightening of the wall separating the two insides of the nose) and correction of a malformed ear.
In the other there was a final cleft lip repair in a 17 month old, dressing changes on the young boy with scar revisions to his hands from the first day and revision of scars on the abdomen, shoulder and arms of three other patients.

Thursday evening there is a farewell get together at La Quinta and the team traditionally supplies a pot-luck dinner for Las Obras staff.

Friday is left open for dealing with any emergencies and ensuring we don't leave Las Obras staff with any complications.
It is a time for most team members to do some last touring.