MEMORY OF THE CAMPAIGN FOR VARICOSE VEINS AT THE VENTANILLA-LIMA-PERÚ HOSPITAL
The campaign begun with the carrying out of a project for the treatment of venal chronic insufficiency (varicose veins) requested by the Ventanilla Hospital in Callao (Perú) from CA, given that another campaign had taken place in 2017 by lady doctor Bernardos. In 2018 leadership was shared by lady doctors Valderrama and Bernardos with Dr. Bernaola from Ventanilla Hospital.
The project was sent to hospital in July 2018, being accepted by the director Dr. Lenin Paucar Gutierrez, and which included the criteria for including and excluding of patients who would require treatment, the formal consent for surgery and anaesthetics as well as alternative treatments with foam and laser. We mentioned what the contribution we could make with medicines for anaesthetics, gloves, dressings, elastic stockings, foam, laser fivers, medicines for after the operation and heparins, intradural needles, aposits etc. The economic value of all that was calculated as 20.000.00 euros. The hospital gave us 3 surgical theaters (as the fourth did not have the required conditions on account of the bad state of the surgical table) and also gave us help in human resources (nurses, helpers, resident doctors), as in devises, taking care of the analytical ones and of the cardiological study of the patients and leaving an ecograf.
The Spanish voluntary team was made up by 13 professionals who in turn had the cooperation of surgeons, anaesthetists, residents in surgery, infirmary, and auxiliaries of Ventanilla hospital. The surgeons, anaesthetists and infirmariens from Madrid traveled in their regular holidays, and those from Zaragoza on leave granted to them by their hospital (Miguel Servet).
All the traveling expenses, as well as stay and food, were supplied (apart from the share of the Foundation) by the sharings of the voluntaries themselves and the proceedings of the feast organizes by lady doctor Bernardos and Zaragoza companions, which was a success as well as the selling of shirts and raffles.
On 29 September 2018 at 20.30 hours the 13 members of the group (from Zaragoza, Albacete and Madrid) who were going to take part in the varicose veins campaign in the Ventanilla Hospital, Callao Region, Perú between September 30 and October 12 2012 met at the Adolfo Suarez Airport, Madrid, Barajas, together with lady doctor T. Butrón who came to the airport to help in the packing and to see us out.
The group was made up by vascular Surgeons lady doctors Concepción Bernardos Alcalde and Adoración Recio Cabrero from the Miguel Servet Hospital of Zaragoza and Inés Fernández de Valderrama Martinez from the 12 de Octubre Hospital of Madrid and Yolanda Cabrero Rodriguez from the U. Getafe Hospital (Madrid), the angiologist Fr Francisco Javier Perez Monreal from Zaragoza; the Residents Lady doctor Cristina Ruiz from the hospital U. from Albacete (R4) and doctor Alfonso Jiménez Ebaile from the Hospital U. Miguel Servet de Zaragoza (R3); the DUES María Amor Martín from the Gregorio Marañón de Madrid; Sara Luis Lobera from the Miguel Servet Hospital, Zaragoza, and Fatima Martin Fernandez from the U. Hospital 12 de Octubre in Madrid and the logistics in charge Miguel Fausto López Martín (lawyer for the CA Foundation).
Given the amount of medical and surgical material we had (donations of medicines from the 12 de Octubre and Quirónsalud from Zaragoza, and the Pharmacy situated in the “Paseo de las Delicias 5” en Madrid consisting in elastic stockings (Medilast) from the Cinfa Laboratory; heparins with low molecular weight (Hibor) from the Rovi Laboratory; of treatment material from the Logsa Group of Málaga; dressings for treatment of Coloplast, fleboextractors donated by Prim House and a Lasser equipment lent by Dr. Santos Gastón of Zaragoza, Laser Fibers and catheters gifted by Intermedic Arfrán of Cerdanyola Vallés, Barcelona; Lasser fibers and goggles donated by Dr. Vicente Ibañez and an Ecodoppler lent by Mindray España) we first proceeded to the distribution of the same in the different bags and to plastify them to avoid overweight. On the whole we sent 25 bags with a total approximate weight of 500 Kilos.
At 5.30 in the morning, Perú time, after 12 hours travelling, we landed in the Jorge Chávez Lima airport, where the hospital staff was waiting for us, together with Dr. Bernaola (chief of the Surgical Team of the Ventanilla hospital) and surgical residents, and after collecting the luggage we went first to the Betania Casa Retiro, situated in Callao, which was the voluntaries residence, in order to leave their luggage and to take some breakfast. From there we proceeded to the Hospital, where 90 patients were waiting to be evaluated. 414 patients had been inscribed, although only 303 answered the call.
After the official presentation of the team by the Gerente and Dr. Bernaola we began the consult evaluating the previously selected patients by the hospital and we filled up a data base to carry out the surgical program for the next days. The surgeons and anaestetists evaluated all the patients that came that day (about 90), the nurses displayed all the material and medicaments we had brought, and the proper information was included in the basis of data and so to program those the were going to be operated upon the next day Monday October 1st, so that the first work day was finished about 20.30 hours. As not all the patients selected by the Ventanilla Hospital turned up, it was necessary on the next days to have more consults to evaluate those who had not come, always according to need.
The programming of the surgical rooms rotated between all the professionals (surgeons, anaestetists and nurses) sharing work daily with the professionals in each operation theater, the patients to be operated the type of intervention and the estimated time of each intervention.
MONDAY October 1st at 7:00 am, as it would be done every day of the campaign, the microbus sent by the Hospital took the group from the Retiro Betania house to the Ventanilla hospital with arrival about 8:00 am, and work began immediately. 20 patients were treated (16 women and 4 men), with 25 procedures of which 19 were surgical (4 bilateral, 11 unilateral) and 6 with laser (1 bilateral and 4 unilateral). After closing the rooms at 18.30 hours we evaluated the new patients that had been called. The work ended at 21.00 hours.
TUESDAY 2: 21 patients were operated upon (15 women and 6 men) with 24 procedures, 18 surgical (2 bilateral and 14 unilateral) and g trough laser (1 bilateral and 4 unilateral). Given the complexity of the patients we ended work at 21 hours.
WEDNESDAY 3: 15 patients were operated upon (6 men and 9 women), with a total of 21 procedures, of which 16 were surgical (4 bilateral and 8 unilateral) and 5 laser (2 bilateral and 1 unilateral), the work ending at 21:00 hours.
THURSDAY 4: 19 patients were operated upon (4 men and 15 women), with a total of 29 procedures, of which 21 were surgical (7 bilateral and 7 unilateral) and 8 laser (3 bilateral and 2 unilateral), ending up at 21:30 hours.
FRIDAY 5: 12 patients were intervened (4 men and 8 women), with a total of 19 procedures, of which 13 were surgical (5 bilateral and 3 unilateral) and 6 laser (2 bilateral and 2 unilateral). One of the patients, in spite of having been called the previous day to confirm his operation did not turn up, and his placed could not be filled up with another patient. Part of the group, given that they had a programmed flight for 18:00 hours, ended work at 15:00 hours; the rest of the group remained in the “Centro Hospitalario” till 21:00 hours when the programmed time ended. Since it was María Amor Martín’s birthday, and given that on the previous day she had not been well, we had a small celebration in her honor with music and cakes.
The days 6, 7 and 8 being feast in Perú we had no medial or surgical interventions.
TUESDAY 9: 15 patients were operated upon (4 men and 11 women), with 25 procedures, of which 19 were surgical (8 bilateral and 3 unilateral) and 6 laser (2 bilateral and 2 unilateral). After the end of the surgical interventions we had a consult to select new patients for the next days. Work ended at 21:30 hours.
Four of the programmed patients did not come and gave no notice.
WEDNESDAY 10: 12 patients (2 men and 3 women) were intervened, with a total of 21 procedures, of which 15 were surgical (7 bilateral and 8 unilateral) and 6 laser (3 bilateral and 3 unilateral) as in the previous day; at the end of the day and since we had hours to fill up the last days, we took patients who had come to the centre. Work ended at 19:30 hours.
As on previous days there were 2 programmed patients who did not turn up.
THURSDAY 11: 13 patients were operated upon (5 men and 8 women) with a total of 22 procedures, of which 17 where surgical (7 bilateral and 3 unilateral) and 5 laser (2 bilateral and 1 unilateral). One of the programmed patients called on the same day saying that because of his work reasons he could not come. We ended at 19:30. The birthday of Yolanda Cabrero Rodriguez was celebrated with a cake.
FRIDAY 12: The last day of the campaign. 16 patients were treated (5 me and 11 women) with a total of 20 procedures, of which 19 were surgical (4 bilateral and 11 unilateral) and 1 laser (1 unilateral). As there was only one sick man programmed for Laser, we took the operation theater for open surgery, thus allowing that, in spite of work ending at 18:00 hours we used 19 procedures.
One of the patients whose treatment had been postponed twice, and who on that same day morning had said she could not come because of her own work, showed up in the Hospital in the afternoon, although the operation could not take place because the case was very complex.
At the end of work the Hospital put up a detailed report of the cases treated, kind of procedure, pathology by sex, age, number of inscribed patients, together with a photographic presentation by Elena Pastor photographer, thanking the Hospital Director as well as Dr. Luis Bernaola and Dr. Donald in the name of the Residents, the professionality and dedication shown by during the campaign, proceeding then to present us with a commemorative shirt for the varicose campaign with the logo of the Foundation and the Hospital.
On behalf of the group spoke Lady Doctor Inés Fernandez de Valderrama, thanking all the hospital staff, helpers, residents, and even the lady cook for their help and collaboration and inviting them to a farewell dinner.
According to data supplied by the Hospital de Ventanilla 469 patients were inscribed, our of which 152 were directly rejected by the Hospital doctors as not having any vascular pathology; 54 patients were excluded by the vascular surgeons after examination and exploration as without any surgical criteria without any vascular pathology, and other 120 did not show up.
On the whole 14 patients were operated upon (104 women and 40 men), with a total of 208 surgical procedures (80 unilateral and 64 -128- bilateral), of which 40 with Lasser procedure and 159 with surgical procedure. (See the presentation by the team of Dr Bernaola with the data obtained by the same Hospital with the data obtained the Hospital itself and by the person in charge of logistics.
There were 3 biological accidents with negative biological results (2 surgeons and a lady infirmarian.)
The archbishop of Callao, Monseñor José Luis del Palacio, offered the possibility of housing patients who came from faraway places, but it was not necessary to do it.
As agreed between the professional health workers on the Hospital de Ventanilla any postoperation complication referred to the hospital would be shifted to the staff with the name of the patient and photos of the extremities operated upon, thus facilitating the answer through the coordinator Dr. Ronald.
Conclusions:
The project, although meant to carry out between 270 and 300 procedures, we understand that, given the complexity of the pathology, has been highly satisfactory with 208 surgical procedures in spite of a high number of selected patients could not come possibly because of problems with their own work, or communication or displacement (some came from Cuzco or Arequipa with distances of 1000 Km or more.
The material we brought was sufficient for the campaign so that farmacological material like stockings and bandages were gifted to the Ventanilla Hospital.
The fact that Monday October 8th was a holiday also affected the final result of the campaign as on that day no surgical intervention could take place.
The teaching was totally practical for the Spanish residents as for those of the Hospital de Ventanilla, with maximal zest and professionality. Doctors from other Lima hospitals came to see the diagnostic and laser techniques.
The changes were very effective, what allowed us to carry out a great number of procedures, chiefly taking into account that the Laser operation theater was portable, with deficiencies in the light, little space for the ecographer, laser, angiologist, anaestetist and nurse, and in spite of all that we could carry out laser and foam procedures, and in the last day also surgical procedures.
The surgical team improved in the first days, with a great capacity for work in spite of the hard and long work days, some times for more than 12 hours.
The “Cirujanos en Acción Fundación” and the volunteers team want to thank the Ventanilla Hospital, its organization and all the help they gave for this campaign on vein pathology, without whose collaboration it would not have been possible, as well as all the firms that donated surgical and farmacologistic material, stockings, Laser, dressings, ecograph.
Dra. Inés Fernández de Valderrama