January 17, 2003 - Blairsville Dispatch: Honduras RPCV Kathryn Tschiegg founded Central American Medical Outreach

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Honduras RPCV Kathryn Tschiegg founded Central American Medical Outreach

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Saltsburg Missionaries Help In Honduras*

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Saltsburg Missionaries Help In Honduras

By Jeff Himler
Staff writer
Friday, January 17, 2003

SALTSBURG--On a typical weekday, one nine-month-old girl was saved while three other young children died.

It was a grim ratio for Saltsburg respiratory therapist Susan Shetter to grasp as she worked to improve the equipment and medical training available in the pediatric ward of a hospital in western Honduras.

That was nearly two years ago--during one of the now annual mission trips Shetter and her husband, Harold, have made to the struggling Third World country with Central American Medical Outreach Inc. (CAMO).

A non-profit, non-denominational Christian organization based in Ohio, CAMO provides medical education, supplies and equipment to impoverished communities in Honduras.

The program has allowed Susan to volunteer her medical experience and Harold his versatile construction skills to improve conditions at the Public Hospital Regional de Occidente in the western Honduran town of Santa Rosa de Copan.

Said Susan, "We keep coming back because we love the people. We feel so sad when we see what they don't have."

During her visits to the hospital she's observed a ratio of just one nurse for about 30 pediatric patients. Also, "There is no running water in the afternoon and the power goes out all the time."

With the hospital serving a regional population of 600,000, two people typically share each of its 200 some beds. And, Harold noted, "If you're in a hospital bed, you have to have someone from your family assist in your care."

Given a national infant mortality rate of 39.79 per 1,000 live births in 2000 (compared to a U.S. figure of 6.67), there is much room for improvement in Honduras' public health system.

But CAMO Founder and Executive Director Kathryn Tschiegg, a registered nurse and former Peace Corps worker from Ohio, reminds herself and the group's volunteers that they are making a steady, important difference in the lives of ailing Hondurans.

During CAMO's 10 years of operation, it has installed a total of 12 ventilators at the hospital in Santa Rosa de Capon. Tschiegg credits the devices with saving 184 lives this past year.

And, in 2001, if not for the pediatric ventilators supplied in the nick of time by CAMO and the guidance Susan Shetter provided to Honduran doctors and nurses using them, one more infant would have been added to the death toll, Tschiegg noted.

"One machine can be very vital in a country as poor as Honduras," she said.

Susan Shetter was still in the process of training Honduran physicians and nurses in use of the new ventilators when she became aware of a recent arrival at the hospital, nine-month-old pneumonia sufferer Doris Ramirez.

Said Susan, "I knew she was going to be dead in an hour and a half" without help from the ventilator. It only took 10 minutes for the hospital staff to reach the same conclusion.

While supervising placement of the infant on the respirator, Susan was "sad yet hopeful. She was a beautiful child."

Though she was not able to stay for the youngster's complete recovery, Shetter learned through Tschiegg that her prayers had been answered and the girl survived.

Both women were impressed by the resolve of the child's mother, who learned to help with her daughter's therapy--bathing the girl and stretching her stiff muscles for more than a week, until mother and child were able to return to their remote farming village.

Just to bring her daughter in for treatment, Susan noted, "The mother had to ride eight hours on the bus" over poorly surfaced roads.

According to Susan, pneumonia is one of three major contributing factors in cases of pediatric respiratory failure seen at the Santa Rosa hospital. Asthma and neuromuscular disease also are cited.

Unfortunately, she noted, many Honduran villagers actually harm rather than help those with pneumonia by having them drink an oil-based folk remedy.

She explained, "You don't want any petroleum-based products near (the patient's) airways. It encapsulates the bacteria in the lungs," making it more difficult for medicine to attack the infection.

CAMO's ventilators arrived in Santa Rosa just in time to snatch Doris Ramirez from the brink of death.

But three other youngsters who were admitted to the hospital that same day weren't as lucky: an infant boy expired from a bowel obstruction before surgeons were able to attend to him; two other small children also expired, from pneumonia and malnutrition.

There was a similar mix of fulfillment and frustration for the Shetters during their first trip to Honduras, in 2000.

That year, CAMO's success stories included an eight-year-old boy with a chest ailment who was spared unnecessary surgery when Susan Shetter taught his mother how to perform physical therapy on her son.

Before that alternative treatment proved helpful, Harold Shetter said, "They were ready to cut the boy open and drain him."

Still, during the same trip, his wife recalled, "A six-year-old girl died of malnutrition, dehydration and worms."

Tschiegg initially served at the Santa Rosa hospital in 1979-81 as a Peace Corps nurse. She returned in 1993 with her newly founded group, CAMO, and a new goal of effecting permanent change in health care at the hospital and in communities throughout the region.

During its initial year, CAMO provided $37,000 worth of services and since 1998 that figure has risen to $2 million annually, benefiting about 35,000 people each year.

In 1996, Tschiegg quit her nursing job to operate CAMO full-time. With an annual budget of less than $150,000, it now sends 21 volunteer teams to Honduras during three annual mission trips, has 10 employees and processes donated medical items at two plants, in Ohio and Honduras.

In the process, Tschiegg said, "We feed a whole orphanage," which provides a home for up to 30 infants and children in Santa Rosa.

The Shetters are in their fourth year of involvement with CAMO, making annual trips to Santa Rosa in late winter.

Susan got wind of the organization when she was working as the director of a long-term care center for patients requiring ventilators.

She found several older ventilator units at the facility which were no longer being used but were still functional.

"I couldn't throw them away," she said, "so I put them in my office, and they sat there for months."

Finally, she figured there ought to be a need for such equipment in some of the globe's third world countries and, inquiring around, she was referred to an area man who had been working with CAMO in Honduras.

He put her in touch with Tschiegg and, after they met, Susan agreed not only to donate the equipment to the organization but to come along on the next trip and teach the Honduran hospital staff how to use it.

Said Susan, "We taught basic respiratory therapy for the first year, and this little nurse came to me and said, 'I need a ventilator for my ward (for pediatric patients two years old and younger).' It took me a year to get one back to her."

Among the challenges Susan and her CAMO teammates faced was adapting ventilators which had been used by older patients in a home environment so they would work for the very young in a hospital setting.

That required tinkering with the apparatus to reduce air volumes to amounts appropriate for infants and toddlers.

Since Susan was not well versed in pediatric critical care, she spent three days huddling with a specialist at Children's Hospital while drafting a series of written protocols to guide Honduran medical professionals in adjusting the ventilator settings for children of various ages and weights.

Finally, language instructors at Saltsburg High School and the Kiski School, a nearby boys' prep school, helped her translate the guidelines into Spanish, the official Honduran language.

Susan noted the project was one example of how Tschiegg "pushes you to the limits of what you think you can do, and you do it anyway."

"I expect my volunteers to believe in themselves," Tschiegg noted.

During each trip to Honduras, Harold Shetter also has faced and overcome different situations which challenged his logistical skills.

"I go with my tools packed, and I always get surprised," he said. "Last year it was a dental van that was broken down outside of town."

On the first visit, Tschiegg asked Harold to oversee hauling of some Bobcat vehicles from a remote location to help with repair of an area road.

In the end, the vehicles were delivered and the job was accomplished. But, along the way, Harold learned a thing or two about the unique perils of travel on the Honduran "highways."

No matter how narrow or uneven the road, speed limits were non-existent. Noted Harold, "It was a five and a half hour drive, and our trucker got us there in four hours."

That included a stop to inspect a snake in the road, which the driver was eyeing as a likely menu item.

Harold explained, given the country's depressed economy ($1 U.S. is equal to more than a dozen of the Honduran lempira), many people supplement their pantry with whatever wild animals they can find, including lizards.

"You won't see a fish left in any of the streams," he said. "They eat anything that's a source of protein."

At Santa Rosa, Harold helped with a $100,000 project which moved the hospital laundry from the basement of an abandoned building to a new facility about 400 yards away.

Previously, he noted, the women in the laundry hand-washed 800 pounds of linen per day, stretching it out on the lawn to dry.

Twenty Honduran paratroopers were recruited to help move heavy Japanese industrial washer and dryer units on pipe rollers to the new laundry. To install the machines, Harold handled the plumbing and another volunteer completed the electrical wiring.

Previously, CAMO constructed a new kitchen for the hospital.

Harold, who is a union sheet metal worker in Pittsburgh, applied his additional carpentry skills to build "crash carts" to house hospital ventilators, heart monitors and related medical accessories.

"It's everything you need to open an airway and start a heart," Tschiegg said.

Harold also used the project to pass along his handy know-how to two assistants--teen-age boys who were referred by the local orphanage.

He found the Honduran youths were quick studies: "They're used to doing things with their hands."

Each year, Harold also collects as many baseball caps as he can to distribute to youngsters in Honduras.

"The people are so grateful for whatever we do," Susan noted.

Her goal for this year's mission trip, which will get under way Feb. 16, is to augment staff training at the Santa Rosa hospital, focusing on use of ventilators for adult critical care patients.

Each time the Shetters return to Honduras, they are once more impressed by the dignity, intelligence and perseverance of its people, despite the severe economic disadvantages they face.

No matter how many miles of muddy roads they must walk to reach the nearest medical clinic or hospital, "Their shoes always shine," Harold said.

A nation of mostly devout Catholics, he noted the Hondurans take great care to maintain a neat appearance and clean home as a sign of respect for their creator.

Still, Tschiegg said, "Our indigent people in the United States live better than (the Honduran) middle class. We have the social services, they don't."

Tschiegg noted Honduras has 5,000 trained physicians but can afford to employ only 2,800 of them. "The need is for more financial backing so these doctors can afford to take care of people in the villages," she said.

Through CAMO, Tschiegg, the Shetters and their fellow volunteers continue working to bridge the gap in Honduras' basic medical services.

Tschiegg demands a lot from her volunteers so they'll be able to make a lasting impact on the lives of their Honduran hosts.

She noted all volunteers must be able to teach some beneficial skill to Hondurans and they must commit to participating for multiple years so the projects they work on can come to fruition.

Tschiegg explained CAMO partners with native professionals and organizations in Honduras so its resources can be applied where they will be most useful and new medical programs it launches can be sustained during the months between visits by the volunteer teams.

Efforts it has developed include: a dental program with three mobile units treating more than 6,000 people per year; an audiometry program which provides hearing aids and the services of a speech pathologist; a fully-equipped clinic for eye exams and surgery;

Also, a breast clinic offering diagnosis and treatment; a wheelchair distribution and repair workshop; a medical teaching library; a prosthetic limb workshop; a CPR training program.

In addition, CAMO has helped with repairs at seven rural health clinics, and is promoting medical research into the high incidence of stomach cancer in western Honduras.

CAMO relies on funding from foundations, churches, civic groups, corporations, fundraisers and tax-deductible donations from individuals.

Each volunteer team member must raise about $1,000 per week to pay for his annual trip to Honduras.

The Shetters take vacation time off work in order to make the one- to two-week trip and have received donations for their charitable work from relatives, friends and churches in the Saltsburg area.

To get more information about CAMO or to make a donation, call 330-683-5956 or log on to the organization's website: www.camo.org.

Jeff Himler can be reached at jhimler@tribweb.com or (724) 459-6100, ext. 13.

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