Daily Diary of Lisa Robertson

HMO Clinic Trip to Asuncion Paraguay,
August, 2013
By: Lisa Robertson

This Asuncion Paraguay Mission was a nine-day trip serving the less fortunate people within Asuncion and its surrounding flood prone areas including the garbage dump communities and a men’s and women’s penitentiary.

A special thank you to Mrs. Mari Carmen Schaerer along with the assistance of the Paraguayan association, “Fey Alegria.” (Faith and Happiness) Without their support the mission would not have been possible.

Wednesday August 21st, 2013
A group of volunteers met at Pearson International airport for our 11:40pm departure to a final destination of Asuncion Paraguay.  The group consisted of 4 enthusiastic general volunteer teenagers, 5 dentists, 3 hygienists, one medical doctor and one general volunteer adult. (Paraguayan born and raised translator)  Some of our group had already flown in from Calgary and Edmonton on earlier flights and were now joining us for our journey on to South America.  Our original departure time had now been delayed until 1:40am.  The high energy of the evening, of meeting and getting acquainted, turned into a quiet slumber as our plane took flight at 2 am.

Day 1 – Thursday Aug 22nd
We arrived in Asuncion Paraguay at 5:30 pm after a transfer in  Sao Paulo Brazil and a stop in Ciudad Del Este, Paraguay.

We arrived at our hotel and were greeted by Natalia De Silva and Megan Turner, two nurses that were joining our group.  These nurses, originally from Port Diana Paraguay, from previous missions had completed their education with the help of Health Missions Outreach through a scholarship program.  They will now be joining our group for the remainder of the trip. It was wonderful to watch the reunion between the dentists that return yearly to Paraguay and the two nurses they had not seen since last year’s mission.

That evening we had dinner at the hotel and held a debriefing meeting with Mrs. Mari Carmen Schaerer (the Ambassador’s aunt) who was hosting us.

Day 2 – Friday August 23rd, San Alfonso
With an early wake up and arrival at our first clinic on the outskirts of Asuncion, we were greeted by translators, a local doctor, local dentist and more volunteer members of the “Fe Alegria” Association.  We had been aware of our itinerary for the week and we knew we were going to be faced with new challenges as the week had been arranged with us in a new clinic setting every day.  That meant our temporary set ups were to be set up and taken down daily which was going to be time consuming.  Our team however, with their experience, high energy and shear drive worked symbiotically with the volunteers within the community to have everything up and running within a few hours.  Although all of our luggage was present (none lost this trip) we had some equipment glitches and electrical issues and were not able to set up as many units as once hoped despite all the pre-planning and maintenance.  The working areas were small rooms fitting usually 3 providers with  make shift chairs and provider stools.  The closeness in proximity to each other contributed to a very high energy and supportive relationship amongst us.  One dental operatory already existed as it was already a local medical clinic which one of our dentist took to and got busy with surgeries right away.

With the locals arriving and filling the hallways, the medical clinic was occluded with anxious and excited villagers.  Late afternoon, having seen all patients that arrived and with the first of many days of sore backs due to improper postures, we closed the clinic around 6:00, shutting down and re-packing all equipment to move on to the next location the following day.  At the same time, an impromptu basketball game had begun outside between our 19 year old volunteer and one of the local men.

Day 3 – Saturday, Aug 24th San Cayetano
Again, we had an early wake up and arrival to Banado Sur for set up.  This location is in one of the flooded villages from the Paraguay River outside of Asuncion. These villagers live off the recycled garbage within the dump.  Upon arrival, the smell in the air was overpowering. The air was thick with the stench of waste byproducts. The temperature was extremely cold and each room was exposed to the elements outdoors. We all wore jackets to work in, and although the volunteers had set up heaters in a few of the rooms to deal with the frigid temperatures, we were not able to run the heaters due to blowing fuses due to all the electrical equipment we needed to have running.  It was too much for the building.

We set up again in shared spaces and set to work. Today, our teenage volunteers within our group were full on assisting in surgeries and restorative with dentists.  They were supporting the medical clinic and were active photographers.  They even helped making bracelets for the happy yet anxious children.

In this clinic setting, although we had thought we had seen a lot of tooth loss the day before, we found this village seemed to be abundant in “bombed out” teeth.   Several power outages were experienced throughout the day, however, it was a rewarding day working on the villagers, meeting new people and working with that community.

Day 4 Sunday Aug. 25th THE WOMEN’S PENITENTIARY (Visitors day)

We arrived early and were greeted by heavily armed, serious security where we gave our passports as proof of identification and were then patted down and searched individually in a closed room.  As we awaited entry into the jail we could hear howls and screams, which of course led to the anxiety of the unknown that some of us were already feeling.

As we entered the jail we were led through a courtyard as a parade of volunteers in front of a courtyard of viewing inmates.  The middle of the courtyard was exposed to the elements and hosted a volleyball net.  As it was raining and cold, the center of this courtyard was vacant of people.  However, they huddled in groups around tables surrounding the building and waited under roofed areas for the upcoming clinic.

We were quickly separated into 3 groups where we were to work for the day and we were told NOT to move from the room we were in without being escorted.  We were now well practiced at setting up only what we needed as fast as possible and we got underway.  Once again we had the use of one dental chair that already existed in the jail and the rest were to be temporarily set up.  Unfortunately the dental chairs that already existed never seemed to be working to their full capacity with the high speed not working on this unit.

The prisons had been a highly discussed topic amongst our volunteers and some of us went with reluctance.  However, as the day moved forward it turned to be our most fulfilling yet emotional day thus far.  With translators present we worked with the female inmates and got to talk to them about their lives.  The dental experience was one of many missing teeth and dentures, bombed out teeth and the need for extractions.  Their children were present as it was visitor’s day and this proved to be a rather emotional day for many of us. The children had come the night before and stayed with their mothers and were to leave again that night.  We discovered that mothers that were convicted of crimes and had children under the age of 3 were allowed to keep the children with them until they turned 3.  Once they turned 3, the children were removed from their mothers. It was heartbreaking to hear their stories.

We treated both mothers and children that day with the group being very strong and stoic.  Not a lot of tears from the inmates or their children that day.

Day 5 – Monday August 26th (The Men’s Penitentiary)-TACUMBA

The men’s high security jail is the largest in South America and is called Tacumba. 

The teenage volunteers in our group were not allowed to attend the jail and there was much debate as to whether the women should attend. Two women volunteers chose to work in the end.  The volunteers that attended the men’s jail felt it was a highlight of the trip, as what they witnessed, their experiences and the communication they had with the inmates were measurable.

The jail is so rundown and over crowded that the living conditions are devastating.  Many inmates have to sleep outside with only a blanket or sleeping bag on cold concrete huddled together due to the freezing conditions and rain. There were makeshift shelters to protect some from the environmental elements.

The stories were abundant. There was one offer of gratitude to one of the male dentists upon completion of work to use the inmates name within Paraguay if the doctor needed “ABSOLUTELY ANYTHING.”

The gratitude the inmates showed in thanks for the help given to them, was often shown with tears of emotion which was heart wrenching coming from men living in these intolerable conditions.

Our Medical Doctor spent the entire day with a medical doctor in the prison working on patients only to find out at the end of the day that he was actually a prisoner himself serving time.

The day ended for the medical staff by quickly being escorted out of the clinic because of an emergency situation. A prisoner had been bludgeoned in the back of the head. 

Day 6 – final Day of Clinic “SANTANA” August 27th
We returned for a second day to one of the communities we had been in earlier but to a different clinic. This day we were changing things up by moving clinicians around to work alongside others they had not worked with all week and it led to some very unique experiences. The energy was high. The locals were arriving early and kept coming as they told two friends and so on.  The corridors were over crowded and the patients kept arriving. The local doctor and 2 local dentists were back with us.  In the afternoon, we were greeted by two nurses, originally from Canada that had been residing in Paraguay for over 52 years working with the locals. They had just heard of the clinic and wished they had heard of us earlier in the week as they would have liked to have spent some time with us.  They were very appreciative and interested in the work we were doing.  They were definitely great contacts for a future mission.

It was our longest day yet finishing up the waiting patients and closing up around 7:00 for the last of us.

Day 7 – Iguassu Falls for some us.  August 28th
With an extremely early start, a 1:30 am wake up call from Lun, we left at 2 am for a 6-hour drive to Iguassu Falls. With 8 volunteers crammed into a van plus 2 drivers, we were transported in the cold uncomfortable vehicle in the night with the unknown of where we might awake.  With a few adventures along the way with VISA’S, we arrived safely at the infamous Iguassu Falls and spent the early part of the day viewing the over 200 different water falls and enjoying the scenery.  Our 6-hour ride back to Asuncion was filled with slumber and a few stories.

Day 8 – Departure  August 29th
An enthusiastic and possibly psychotic driver raced, chased, waved, taunted and blasted his car stereo while escorting us rather unsafely to the airport.

With some confusion and re-directing of bags we finally checked in.  As we waited for our departure, we reflected on the week.

We initially choose a mission based on our own personal and possibly professional reasons.  Serving a mission is an excellent way to see what life is like in another country. We do it for the sense of adventure, a chance to see another country up close and personal and have a meaningful vacation at the same time.

At the end of the week we realize what a life-changing experience it can be. We are touched and changed by the experience far more than the people that we are there to help.

Through this mission we saw approximately 500 patients in dental and provided about $100,000 worth in free dental services. 

We would like to extend our extreme gratitude to the doctors, dentists, general volunteers and the Paraguayan Association of volunteers that helped make this mission  a success.

We would like to thank the Paraguay Ambassador and all that assisted him in making this mission possible.