The World Surgical Foundation team that volunteered on the Honduran medical mission is pictured.

Ashley Koppenhaver holds a baby girl that was admitted for cleft palate reconstruction surgery..

(Editor’s Note: The Sentinel, this week, presents photos and a narrative from Heidi Koppenhaver of Berrysburg regarding a medical mission trip in which she and her oldest daughter, Ashley, participated in earlier  this year in the Central American country of Honduras.

The trip was sponsored and organized by the Camp Hill-based World Surgical Foundation Inc. The WSF’s goal is to ‘‘serve people in impoverished or developing countries where health care is not available or is too costly.”

The Koppenhavers became familiar with WSF in 2003 after conducting a toy drive for hospitalized children. Through that drive, they met the organization’s founder, Dr. Domingo T. Alvear, MD. Alvear is currently Chief of the Division of Pediatric Surgery for Harrisburg-based Pinnacle Health Systems Inc. and has earned national recognition as a pediatric surgeon.

An edited version of Heidi Koppenhaver’s narrative follows. NOTE: The narrative includes descriptions of surgical procedures that may be unsettling to some readers.)

My family became involved with the WSF back in 2003 after my children ran their first toy drive.  It was at that time that Dr. Alvear told us about his medical mission work via the World Surgical Foundation in Third World countries and he told us of the children he helps. 

Hearing about his missions really struck me. I recall driving home from work one evening after learning about these medical missions and it brought me to tears. The mothers and fathers in these impoverished countries often have no choice but to sit and watch as their child dies. Why, you ask?  Be-cause they have no medical facility within many miles – and even if they did, most can not afford the luxury of healthcare. 

To me, as a parent,  this is just unfathomable and so completely unfair. No parent in this world should ever have to endure the loss of a child when it could be prevented with medical care. It made me realize probably for the first time in my life how very fortunate I am to be living here in the United States of America. It also made me realize that I wanted to do more for these people. In fact, helping people in poverty stricken countries has been a desire of mine since I was a child, so this just added to my longing of helping these people.

For my girls (Ashley and Amber; her son, Mason, was only two years old), this was the first time they had ever heard of other children not having any toys at all. They couldn’t comprehend this, being only 6 and 8 years old at the time – what do you mean, there are children who have no toys? How could a child have no toys at all when so many children here in the USA have more toys than they can even count? 

We had long discussions on this, but I don’t think they really understood, until Dr. Alvear shared some pictures with them. The pictures were taken in one of the Third World countries in which he had recently done mission work. Being able to see the children’s faces as they received these toys was all that my girls had to see  they truly understood.

In October 2009, Dr. Alvear asked me if I wanted to become a board member for the WSF. I felt quite honored in his request, and so I joined the Board of Directors.

During a Foundation picnic earlier that year, we had the opportunity of meeting a doctor from Ethiopia. It was at that moment my oldest daughter, Ashley, expressed the desire to go on a medical mission. 

Since that time, things went into overdrive.  Because Ashley has a serious auto-immune disease, we had to seek approval from her various doctors, which we did right away.  After a little resistance from one doctor,  we were given the go ahead! So we began preparing for our journey.

A ‘‘fairytale’’ becomes something different. The week-long trip to Olanchito, Honduras was amazing, to say the least. After taking two flights to get to Honduras, we finally arrived in San Pedro Sula at around noon. We were greeted by six armed Honduran Navy guards. They would be our protection as we traveled through their country.

Initially seeing that we had to have armed guards made us feel a little uneasy, but that soon dissipated and we were grateful for their presence.

Then began our long six-hour drive through their mountainous regions in a Navy bus. Our medical team of volunteers were in one bus and all of our medical supplies were in a second bus (both protected by guards during this trip). 

The mountains were beautiful. Everything was so green, like something out of a fairytale. It was very surreal.

Then we saw the homes in which the Honduran people live. It was the complete opposite of the landscape.  The homes were so tiny and run down. Most were about the same size or smaller than a single-wide trailer.  Their homes had no windows or doors, and some didn’t even have floors.  All of the side roads were unpaved. 

Due to lack of plumbing in the homes, we saw many people doing their laundry in nearby creeks. 

There were very few vehicles on their roads, because gas prices in Honduras is equivalent to about $3.54 in American money. Even though their gas prices are slightly lower than ours, you have to keep in mind that the average annual income for a person in Honduras is $1,190 in American money. So for them, $3.54 is worth far more. We would see people pull into gas stations and only purchase one gallon of gas. This was difficult to watch, because it was difficult to comprehend how incredibly poor they were that they could only buy one gallon of gas at a time.  Honduras is the third poorest country in the western hemisphere, behind Haiti and Nicaragua.

As we drove through the mountains, we could not believe the number of people we saw. Many people were walking, or there would be two people per bicycle or on motorcycles driving along the road side.  If we did see a pickup truck it was packed; people would sit in the open cab part in the back. Even school buses appeared to be overfilled with the number of passengers it really should carry.  We also would see donkeys pulling carts which would either be filled with people or produce.

We saw people out and about like this during our entire journey and at all hours of the day and night.

There were fields of banana trees and pineapples everywhere you looked.  And from what we were told, this is how the people make their money, by selling their produce; that is, if they have more produce than what it takes to feed their own family.

The six-hour bus ride through their countryside seemed to take so much longer than that – not because the temperatures were over 100 degrees and we all were sweaty and hungry and cramped into a bus,  but because it was so difficult digesting everything we were seeing. 

I had thought I was mentally prepared for this trip, for the poverty I had heard that I would see – but I wasn’t close to being prepared for this. I don’t think anyone can prepare to see such extreme poverty as we were seeing.  Being able to see all of this first-hand was so humbling. 

The poverty touched me so deeply,  that at one point I had to close my eyes to everything because it was just too much to take in. I felt like crying. There was so much I had taken for granted in the USA and I wished that it was possible to now give my family  back home some more hugs. 

Ashley and I talked about all we were seeing. We just couldn’t quite believe the extreme poverty in this country. And yet, the one thing that stood out among all this poverty were the people; they were smiling, there were children outside playing in the dirt and creeks, neighbors were communing with neighbors. They had so incredibly little as far as worldly goods, and yet it seemed as though they had so much more than we have here in the USA. Again, this just added to the large amount of information both Ashley and I were processing during this trip.

The hotel we stayed in was comparable to many Americans’ deer camps. It had running water, but most nights the water barely trickled out and was cold.  We only had hot water on one evening. The water came out via a pipe that stuck out of a hole in the wall. The toilets were relatively normal, except that you were not allowed to flush the paper (we found this out after ours clogged),   so you would place your used toilet paper into a trash can. Ashley and I would remind each other of this every time we’d use the restroom. Also, you carried toilet paper with you, because most public rest-rooms did not have toilet paper (again, this is a luxury item which most Honduran people can’t afford.)

We also lost electricity several times during our stay; the city just shuts all of it down. It was all so incredibly different from being here in the USA. Some nights, there was  no electricity for hours at a time. One night, we were given candles to use so we could see in our hotel rooms.

In five days, 140 surgeries. We went to the Hospital Anibal Murillo Escobar in Olanchito the following day, and again, we saw that much of the facility was run down. They had a few pieces of more modern equipment in the recovery room – which was probably donated to them by Americans – but much of the hospital was in need of renovations. The ceilings were falling in, some places didn’t have ceiling tiles, and you could see up to the roof.  (We saw a gecko run up into the one ceiling tile.  I believe it lived there.)

Many windows did not open or were broken, and the hospital did not have air conditioning, except for the two operating rooms and the one recovery room we used during our mission.  Considering temperatures can top 100 degrees Fahrenheit, it would get very hot inside the hospital and the air became stale quickly and was almost unbearable on most days.

Four American surgeons traveled with our World Surgical Foundation team during this medical mission – a pediatric surgeon, general surgeon, plastic surgeon, and an OB/GYN.  We also had two anesthesiologists, a nurse anesthetist and a variety of specialty nurses, along with a few laymen (non-medical persons) such as ourselves. 

Hundreds of Honduran people showed up to be evaluated for surgeries during our first day there.  Many of these people spent all the money they had just to get there to see us on this day, as the cost of a bus was $8 (American money).  Unfortunately many Honduran people also had to be turned away. The team always feels badly about this. These impoverished people look at the WSF team as possibly being their last hope of getting the help they so desperately need.  But we don’t have the time to help everyone, and this particular hospital also did not have the resources or expertise to care for the patients who required more extensive surgeries.  So our surgeons had to figure out which patients they could help, in the time we had and with the resources we had available to these people post-operatively.

During the course of five days, our team of Doctors performed more than 140 surgeries.  We all worked 12-hour days. We were given two operating rooms to work from, with two doctors performing surgeries in each room. This made for very tight quarters,  but the team members were able to work in that tight space. 

We were also given one recovery room which had four beds. Sometimes one bed would be shared by up to three children.  

Some of the surgeries performed included thyroidectomies, cleft lip/palate, burn/scar tissue removal, gall bladder removal, hernia repairs, appendectomies, and circumcisions, among others.

Some of our doctors performed corrective surgeries on people who had underwent botched surgeries by Honduran doctors. One young boy was called ‘‘monkey’’ by his peers after an incorrect procedure was performed on him. Our plastic surgeon fixed him all up, and he will now only have a tiny scar and hopefully lose that nickname.

We also were able to witness four emergency Caesarean sections. These births brought many of us to tears. In such poverty, and yet there was new life.

Many lives changed. One thing that really struck both Ashley and I was the age of the young mothers. Most were Ashley’s age (17) and many were even younger, some toting more than one child.  One young mother really pulled at my heart when she was brought in with a septic abortion. She had apparently gone to a street doctor to seek an abortion, and the surgery was not performed properly. She was in very serious condition and it was life-threatening. I don’t know whether or not she survived the operation, as she never regained consciousness while we were there.  Like I said, it was very difficult seeing this type of case.  She was a beautiful young teen with her whole life ahead of her.

Our doctors changed many lives during our one week medical mission. Dr. Alvear, our pediatric surgeon, removed what was believed to be a fetus in fetu from two different patients.  This is a rare medical condition in which the host carries their ‘‘twin’’ – which  is more or less a tumor – inside their bodies. If this tumor is not removed, eventually the host will die. Dr. Alvear removed one such tumor from a young girl’s head, and another from a 19-month old boy.

These surgeries were probably the two that fascinated us the most, because fetus in fetu only happens in 1 of every 500,000 births and we were there to witness two such removals in one afternoon. These cases actually brought about much excitement in our group, as we realized what we was unfolding in front of us. Truly he saved these two children’s lives! 

After both surgeries,  the mothers of the respective children took the tumors home to bury them.

During the trip, Ashley and I assisted in any non-medical way we could.  Our duties ranged from unpacking our medical equipment and supplies, to taking photos and video footage of what our team was doing to help these people. We also were able to comfort some of the children who were awaiting their surgeries, or we’d sit and color pictures with them.

Ashley also typed up all the cases of surgeries our doctors performed.

My main task was the cleaning of the dirty medical tools after each surgery.  I would clean them and then give them to a Nurse who would then sterilize and prep them for the next surgery. The hospital only had cold water, so that’s what was used to clean the tools before sterilization took place.

We constantly were on the move from sun up to sun down.

Ashley’s greatest enjoyment came from being able to witness our doctors performing the surgeries. This is a passion of hers, as someday she plans on becoming a doctor herself, and this trip gave her the opportunity of seeing so many things relating to medicine – things that the average U.S. medical student would not be seeing until their seventh year of medical school. 

Our surgeons also enjoyed telling Ashley what types of surgeries they would be doing, with some even explaining to her how they would be fixing the problem. As one C-section birth was being done by a Honduran doctor, our own OB/GYN stood beside Ashley and explained everything she was witnessing, and she was even allowed to video tape it.  She was in awe!  This trip has definitely given her much insight into the medical world.

For many children, their very first toy. We also made sure to take along a lot of stuffed animals and dolls collected by our toy drives during the past few years.  As we would see children or mothers with babies, we eagerly handed them a stuffed toy.  It didn’t matter whether they were there for surgery or just someone we’d see in passing – if it was a child, they received a toy! The smile we would received in return was worth more than anything we’ve ever experienced and brought tears to our eyes. These children have no toys;  many were receiving their very first toy as we handed it to them. 

One young girl to whom I had handed a doll had stared at that doll for several minutes in awe I got a great picture of her mesmerized by the doll;  it could melt your heart. She then looked up at me and smiled, and I almost broke down into tears. Her young mother of around 15 years old was so excited for her young daughter and kept saying ‘‘thank you’’ to us in Spanish. Something so simple as a doll, but it means the world to a little girl and her mother.

This was probably the best feeling in the world for us; we loved handing out these stuffed toys. And we must give so much thanks to the people in our local communities for assisting us with the collection of these stuffed toys – they mean the world to a child!

We also had one young man, 8 years old, rather an artist, create pictures for several members of our team.  He drew an ocean scene for me, and I’ve framed it since returning home and it is now a part of my living room. Elvin, this young artist, was such a special young man who had come in for surgery to get rid of his ‘‘sleepy eye,’’ as he called it. He is one of the children I will never forget.  He was so sweet and loved talking to us.

Another item we handed out to the patients were personal hygiene bags. We filled all of them with donated items such as combs, shampoo, soap, toothpaste and toothbrushes. We gave these to children and adults alike. You  would have thought these people won the lottery when we handed them these tiny bags of hygiene items. They held onto them tightly and kept thanking our staff for helping them and for these bags.

We also were able to give many of the children a special card created just for them by the fourth grade class at Upper Dauphin Area Elementary School.  Ann Bonwit, the Art Teacher, was so happy to be able to have the kids do this and Mason was thrilled to at least be a part of what we were doing.  The class made so many cards that the WSF team has many more to take along to Honduras later this year!

A mission trip such as this costs the World Surgical Foundation thousands of dollars.  It takes approximately $10,000 for the WSF to send the larger items of supplies to the country we are helping.  The team will also take along extra baggage on our flights with even more medical supplies.  We take along all the supplies we use to treat their people, and we then give the hospital all the supplies we have left over so they are able to continue helping their people for months after our departure. 

In addition, the WSF’s doctors will teach the local physicians new techniques because our doctors are much further advanced than those in Third World Countries. The knowledge we provide to these countries will then enable these doctors to continue helping their own people, long after we leave. 

During this particular mission trip, the WSF also had donated a pediatric ventilator and electrocautery machine, as well as vaporizers. Items such as these are always needed greatly in these countries.

A feeling of humility. The feeling Ashley and I left with was one of humility. This journey we had taken was far beyond what our words can come close to expressing. It is one of those experiences I would recommend to everyone in our country. We learned that we must count our blessings every day, because there are so many people out there with so much less than we have.

In Honduras, a middle-class American family would be considered quite wealthy;  even the poorest families in America would be wealthy in Honduras). 

And yet, we also learned that having more doesn’t equal more happiness either; we saw this first-hand. 

We are overjoyed we were given this opportunity and that it was such an incredible life-changing experience.  And, we’d like to recommend to everyone to take time to volunteer locally or abroad; no matter your profession, there is something you can be doing to make this world in which we live a better place.

Even for a healthy person such as myself, this trip was physically challenging due to the long hours we put in and the different diet, as well as the extreme heat and humidity during our trip.  With her health issues, Ashley did fine under the circumstances.  When we first arrived at the airport, the heat quickly overtook her and she came very close to passing out (I caught her as she dropped), and we quickly got her onto the bus to rest and drink. After that, she made sure to drink plenty of fluids.  She also was very exhausted till the end of the week and ended up coming home with an intestinal infection for which she  received medication.

But would she do this trip again?  She would definitely say ‘‘yes’’ in a heartbeat.

I also anticipate doing more medical missions in my future, with Amber and Mason, both of whom have already expressed a great desire to help on a medical mission.  So probably in another three years, Amber and I will be headed to Honduras and then a few years after that, I will be doing a trip with Mason.

We’ve been told such mission trips become “addictive.’’  My thoughts – what better addiction to have than one in which helps other less fortunate people!  I look forward to many more years of helping on such mission trips.

To Donate to the WSF

The World Surgical Foundation accepts donations from the public towards financing future medical mission trips.

Donations are tax-deductible and can be made through the Foundation’s official Web site: www.worldsurgicalfoundation.org

In addition to its Web site, the WSF also has a Facebook page and a You Tube channel that includes several videos of recent mission trips.

‘‘We really need the public’s help to continue helping those less fortunate,’’ said Berrysburg resident Heidi Koppenhaver, a WSF board member and contributor of the narrative in this week’s issue.

For information on holding fund-raisers to aid the WSF, contact Heidi Koppenhaver by e-mail at

heidikopp@frontier.com

WSF founder to speak locally

Dr. Domingo Alvear, MD, founder of the World Surgical Foundation Inc., will be the guest speaker Sunday, Nov. 6 at the churches of the Lykens Valley Charge, United Church of Christ.

Alvear will speak at the 9 a.m. service of Peace UCC, Berrysburg; and at the 10:30 a.m. service of St. Peter’s UCC, Lykens Twp.  (located near the  Crossroads  Auction). He will speak about the WSF’ medical mission trips.

The public is invited to these services.