Monday 4-8-2024 A day in Porto Velho post mission

I have an hour before we leave for the airport, so I decided to try & complete this blog post now as when I get back I have work and travel to Utah next week. While it is fresh in my mind I wanted to finish up. Yumi & I slept in until 8:40  -it was glorious! We went to breakfast at 9 am & for the first time I notices a “Panini maker” that they use to make toast – and they serve ham & cheese in addition to ALL the Brazilian fare that I did not eat. So, I decided to make a panini breakfast sandwich & mix it up a bit 😊 We saw the team who was still here for the day & who all fly out tonight. Different people were making plans for the day. Yumi headed out to go shopping with a group . I made my 2^nd trip across the street to get some Coke Zero & get Yumi a Moster as she manages her travel tonight. I was happy to come back to the room, put on some music and catch up on my blog and begin packing.

I am on GOL Airlines for my return flight & go from PVH to BSB (Brasilia where I have a 4 hour layover them from BSB to Orlando where I have about 2 hours to get thru customs & catch my flight to LAX returning there at 10 pm tomorrow night. GOL has a bad reputation in airflight, poor reviews and are trying to file for Chapter 11 – not too encouraging. Last night I was able to find my reservation & see that I have assigned seats but it was too early to check in. Today I get to the same place & then they cannot locate my reservation & I can’t check in. It is the same for the majority of people flying on GOL…and I have tried multiple times today so I am counting on it all being fine when I get to the airport. Several others are on my same flight to BSB & 3 or 4 others are on my next flight to Orlando so I will be nice to have company as I travel.

At 1 pm Sister Rosemary picked me up on her lunch break. She works very close to the hotel & is in finance for car companies? After she got me we picked up the sister missionaries & then drove about 20 min out of town to a grocery store that she said had good prices. Sis. Gabriella & her 16 year old son met us there & we ended up buying 200 1Liter boxes of milk so that each food basket will get 4 liters. I asked if there was anything else & they said: “the children love chocolate” so we ended up buying 50 containers of “chocolate” to go in the milk – like Nestle Quik. The 16 year old was the muscle to load the car - we took a few photos said our good byes. Sister Rosemary dropped me at the hotel – we took a few more photos & hugs & then she was taking the sisters back & going back to work. She text me later “Again sister please share our deep gratitude for everything you and your wonderful friends are doing for the families of Porto Velho -Rodonia -Brazil”. They plan to put all the baskets together this Saturday & deliver them over the next week :) I had an hour to finish packing before we needed to meet in the lobby for our boat ride on the Rio Madre de Dios – River of the Mother of God. The river was pretty brown & I am sad to say there were exactly zero pink dolphins spotted. It was a nice lil cruise though with music and a snack bar & visiting. The captain even let me drive for at least 2 minutes – for a photo op at his insistence! There was a beautiful sunset over the river as we docked.

After the cruise we went to a place called Barto for hamburgers-they were actually quite good! And I visited with Carlos a plastic surgeon who I have probably been on 4 or 5 South American missions with. He is a nice man. We just got back to the hotel  -showered to be fresh & clean for our flights & are finishing things up (like my blog) before we leave for the airport.

It was a lot of travel & I have just as much in front of me but even with all the travel if asked I would do it all over again. The ability to meet faithful members of the church & see them volunteer with the  same “Helping Hands” vests that we wear at home helping our friends and neighbors was touching, the miracle of the 50 food baskets and the generosity of my friends is something I will never forget. The sweet children and their families reminds me why I became a nurse & the opportunity I am given to use my talents for good. My connecting with the 10 missionaries in this zone reminded me there are AMAZING young people in the church willing to serve & parent who have prepared them (I forgot to mention that the one elder from Spain was a professional soccer player there & made a decision to give that up & come  on his mission) He was great & would find me every day & say “Sister Nancy are you okay”. Understanding the commitment of and feeling the love that these stake leaders have for all people who are in their boundaries was touching & recognizing the environment that they serve in is so challenging – reminded me how grateful I am for all who serve in church callings.  Meeting people like Yumi I also know was also not happenstance…I was scheduled to be with a different person but the debacle of the room assignment when I arrived turned out to be something wonderful. Doug & my family support of these endeavors is so important to my ability to make these trips & my team at work who know that these trips fill my bucket & touch my core. So as the mission comes to an end I am simply GRATEFUL for the uncountable blessings that have come my way over the past 8 days. I am so blessed. Ready to head home first flight in 4 hours at 1:15 am. Praying the travel angels accompany me!

Surgery Day 2 – All Lips – Cute Babies to Snuggle but an unexpected end to the day!

 Since we (the PACU team was at the hospital so late they told us we could leave at 8 am instead of 7:40; basically the time for the bus to go to the hospital & come back. I stepped out of the hotel at 8 am exactly only to see the bus drive away…typically buses are sort of on time but this was a first???        No problem I am resourceful so I called an Uber & for $1.50 American I got there at about the same time as the bus.

We were doing all lips today so I assumed the day would go faster & the patients would come back sooner – it sort of went that way…we had a 2^nd translator in the PACU in addition to Sis Wright – her name was Amanda & she is 24 & a schoolteacher at an Portuguese/English private school. She is one of the “LDS Church Helping Hands Volunteers”. Her sister in law is Carlos’ daughter & Carlos was asking for all members who spoke English to help and Carlos daughter planned to come but was unwell so Amanda came in her place & was so sweet. She shared lots of cultural information about Brazil. She has lived in PV for a year & moved from the center of the country where there was more crime. The other Sister Missionary Sis Rueda  has been the full time translator for the Psychologist from Honduras who speaks Spanish as Sis Rueda speaks Spanish, English & Portuguese, Sis Rueda has the most amazing countenance – she is 28, is so gracious and kind and has a calming sense of maturity and life experiences. I am certain she brings so much to her missionary service. She taught English in Mexico prior to deciding to come on a mission.

We have a total of 16 patients again & 3 age deviations meaning we are doing lip repairs on 3 babies <6 months old (which is the OSI criteria) but we can do younger if they are well nourished & meet other criteria. They are all on Yumi’s table so I told her to look for me when she brings them to to the PACU. I went into the patient holding area & saw the cutest lil 9 year old Greciane who has had an “unrepaired primary lip” her entire life. She is Autistic and they have not been able to have it repaired. She had a play stethoscope in her ears & a pretend microphone & was singing her little heart out 😊

I really thought we would have the first round of lip patients out sooner but I guess they were doing a lot of teaching? The first baby came in at 11:15 & the next 3 within 15 minutes so it got a bit busy in our area. My fist patient was Giovnna & she was a sweet little girl that took awhile to wake up. I snuggled her for quite some time & later in the day the Op smile photographer sent me a photo of us that he took. It encapsulates so much of my love for these babies & this  work. I had to pass her off to a volunteer when the 4^th patient came in as Norina & Allyson were also busy with patients.

My next patient was Petyro and he was a bit more fussy & harder to calm but settled if I was standing him rocking him..like all babies. The team dentist Flor came in & wanted to hold him & she sang some Brazilian songs & did some dancing with him in her arms & he loved that! I guess I didn’t have the right moves or language 😊 After that it got loud with 4 moms & 4 patients crying & my friend Greciane came back & literally was screaming for at least 30 min – I cannot imagine coming out of anesthesia not knowing what is happening. It was rough but I am so glad she got her lip repaired – the mom said because of both eh autism & her lip she has been ostracized most all her life ☹

I got “shamed” into trying the local lunch which today for the Brazilians was a plate of rice, beans on top of the rice, lasagna on top of that & shoestring fried potatoes on top of that for texture (they really seem to care a lot about texture?). I opted to try the lasagna only 0 it had both diced ham & ground beef in it – wasn’t bad…

My next to last patient had a crazy backstory the entire surgical team was surprised about.  Her name was Kabatchogue & she was one of the babies from the indigenous tribes in the area. She was 9 months old & 6 mos ago came to a local mission in another area. She had a large bilateral cleft lip plus a palate. The chief in their town believed she would bring a bad spirit to their tribe & banished the mom & baby. At 4 mos of age Op Smile did not feel they could repair the full lip but were concerned for her safety so they repaired one side of the lip. AT this point the story gets a bit unclear because I don’t know if she was able to go back to her tribe or has stayed away the past 5 months? On this mission she came & we repaired the other part of her cleft lip & I believe she will return to her tribe now? The baby will still need palate surgery. Mom & baby were accompanied by an aide worker who could translate her dialect to Portuguese – such  sweet person.  

Mid-day we got a text that there would be a tam dinner at a “Pizza-Pasta Buffet” with buses leaving at 7:30. Sounded fine to n=me but my last patient REALLY needed the extended stay at the end of his time in the PACU & I then became doubtful if our team would attend (but don’t worry we did!). Anyway my lil guy was only 4 months old & had both a nose & lip deformity. They did a 3 ½ hour surgery ti repair the lip & tried to do some reconstruction on the nose. He came to the PACU with a clear tube coming out of each side of his nose – & had a bit of oozing around it but nothing too concerning aside from the fact that the surgeon expected it to stay in for 14 days & the mom would clean it each day??? News Flash she lives in a rural part of Brazil. He really was doing ok in PACU. I syringe fed him some juice when he was awake & he settled ok for me & mom. Mom was uncomfortable though as she only breastfed & was engorged & the baby could not latch on…so the local PACU RN & I “played McGyver” & made abreast pump from a 50 cc syringe. We cut off the syringe tip, I covered the raw edge with tape stripes  & we put it on her breast using the syringe phalange to pull the breast milk out – WaaaLaaa it worked & once the baby was crying the milk flowed freely into the big syringe & I fed him from a small syringe. It’s all about innovation at the smallest level! Our PACU MD is on the nutrition council for Op Smile & took photos of our “creation” haha. Unfortunately about 30 min later – not certain of the reason his oozing of blood around that tube increased. I applied pressure which made him more upset & ooze more, so Teresa the PACU Dr sedated him & we applied more pressure & ice. Since he was the last patient the majority of the team had left – I was literally ready for him to go to the post op ward when this started. We out him on some oxygen continues to control the oozing & called the surgeon on call who came about 30 min later. In the PACU we all believed the tube was irritating his nose, causing more swelling & more oozing – we were right. The on call surgeon came in, removed the sutures keeping the tubes in place, I applied more pressure while the surgeon created nasal packing with Vaseline & gauze, Packed the side of the nose that was bleeding &  then we put on a moustache dressing – it was now 7 pm & he looked okay but they wanted to watch him for 30 more minutes. The local Dr had to stay & Allyson offered to stay so I got an Uber for Norina & me& we go to the hotel at 7:25 truly did a 5 min change & made it on the bus to the dinner.

There was some VERY INTERESTING pizza combinations – dry beef & cheese, carrot & cheese, banana & meat, shrimp, chicken & corn, one with lots of meats  & fortunately marinara & pepperoni which I ate. They were also serving all sorts of pastas I passed on & french fries? Then they had dessert pizzas that still had a base of crust & cheese on them plus either lots of chocolate & chocolate sprinkles, chocolate & strawberries, one with flan on top & lots of caramel & another with all sort of m&m’s sprinkles & a scoop of ice cream & chocolate syrup. We got one of each at our table & all tried a bite. Very sweet!

They showed the traditional video – highlighting that this is the 10^th mission in PV & they have now done 400 surgeries here so I don’t think they have ever done a big 90 patient mission here. Christina the Local Executive Director Volunteer has been a part of the entire 10 year history. It is always nice to se the mission from our 1^st gathering thru the training days screening, surgeries, recovery & post op. It encapsulates the entire experience so well.  I was in the video with one of my sweet babies from today 😊 The event finished at 10 pm & we were back at the hotel at 10:30 & some people were leaving for the airport at 11:30.As much as I typically am ready to head home right after the mission I am actually grateful that I am not leaving tonight; for a few reasons. I am tired & looking forward to a good nights sleep with no alarm to be set so maybe I will come home rested – perhaps jet lagged a bit but rested. Tomorrow I will get to make some other need purchases with Sis Rosemary the Relief Society President. Also for those of us here all day tomorrow Nipson is arranging a 2 hour boat trip on the local river (not the Amazon River) to hopefully see the “Pink dolphins” that are unique to this area of the world?

I am writing this post Monday morning so happy to report a good nights sleep – Yumi & I slept in until 8:30 & it was wonderful! I will make my last blog post likely after I return. If you have been following along – THANK YOU for the love support & prayers during these missions. I am so blessed & grateful to be able to use my skills for good all over the world with Operation Smile & have these opportunities & I believe I have been where I was meant to be this week in PV Brazil

Teaser – Ambra came to me yesterday asking If I knew some of the plastic surgeons at CHOC who I do (Dr Jaffurs & Dr Elyas) as their group & CHOC? would like to sponsor a mission in the DRC in about a year & she wondered if I would be interested…

Day #1 of Surgery 16 Palates!!!

It was a “typical first day mission morning 😊, UP at 6:30, breakfast at 7, team mtg at 7:20, bus leaves at 7:45. Last night they gave us Op Smile Brazil scrubs that they wanted everyone to wear today once we get to the hospital but they are made of really heavy materiel & oddly sized so I was going to wear the Op Smile Scrub top & my own pants only to see about 25% of the team didn’t wear them?!?!  But by then I was not going to change clothes. While viral season in the US just ended & we lifted our masking requirements for RSV etc, the seasons are opposite here so it is just starting & they just began masking at the hospital.

Also a normal morning at the hospital to start the mission. We finished setting up the PACU & our supplies remain sparse. We checked the crash box, had the mock code and then we wait….our PACU intensivist is Teresa a native of Brazil, who is fluent in English & has done numerous missions. Allisson (male) is the local nurse who has worked with Teresa on many missions so he is our leader in the PACU. We do not have anyone we are training so there are just 3 experienced PACU RN’s Norina is on her 5^th mission from Canada. I guess that PACU RN’s or PICU R’s functioning on a mission as a PACU RN are hard to find??? IN this country there is usually only 1 RN and then the rest are “technicians” caring for the patients and PICU’s are limited & PICU nurses rare. Since this is my 2^nd “Champion Mission” w/o any “trainees”.

Today we have 4 operating table & each table will do 4 palate surgeries so I am anticipating a LONG day 😊 Since we have only 2 days of surgery it is the opposite of what is “typical”. On most missions the 1^st day’s schedule is filled with lips & then they start on palates. We got our first patient at 12:10 so I used the morning to type up my blog on a word doc so I could post it last night.

Davi was my 1^st patient & came in at 12:30 – he was such a sweet boy & I remembered him from screening but he came in to the PACU a little wild & we needed to give him some Nubain to help him go back to sleep. That provided him with the 3 hour “extended stay” in the PACU and when he woke up like a little angel. He had chubby thighs & a sweet mom and his palate repair was great. By about 2 pm the 2^nd round of cases were on the table & the 4^th & last round were started at about 6 pm so I knew then it would be a late night.

A few “oddities” about this mission – it is the first one that they have not had water bottles at the hospital – they had large water coolers in 2 areas with little 4 oz cups so I was not hydrating well at all & will bring my water bottle tomorrow. Lunch had a slight variety today it was self serve on a hot plate – rice, beef in a sauce & a root vegetable of some sort. I was completely happy with my PB sandwich, and a protein bar and snacks! Another odd thing is that the pre/post op ward is “on this street” but ½ mile away so the patients go from the PACU to the post op area via ambulance – never had that before. So no visiting the Pre/Post area for me. It does seem like an added risk to be an ambulance ride away if there was a problem but fortunately that will likely not be an issue. One nice thing here is that they let the parents go into the operating room for their child initial induction to sleep before the surgery & they also bring them in to the PACU once we have them settled.

My VERY LAST patient Andre was 2 years old & his cute mom was 6 months pregnant and so grateful & tearful when she came in to see him in PACU. He had his lip surgery about a 16 month ago & had been waiting for another mission to have the palate repair & traveled 36 hours from the southern part of the country. Thru the translator she said she was so grateful I came to her country and that her mothers heart was swelling with love for having surgery for her little boy because it will change his life. I replied that “I know a mother’s heart with my own children & grandchildren and am happy I was here with this team to help” We shared a long HUG!!! He was another that got Nubain on arrival to make him comfortable & had the “extended stay”. After about an hour I did a little face wash to see if he would wake up a bit & he did but was fussy. His mom held him & sang him lullabies until he calmed down it was so precious to observe. He was finally sent to the post op area at about 9:45 & we closed up the PACU at 10 pm & I was back at the hotel at 10:20 to shower & get ready for bed. Yumi & I shared our days, I called Doug & went to bed at 11:15. Unfortunately, for some reason I was awake until about 12:30 – just could not “turn off my brain” even though I was tired. Tomorrow is he same schedule but all lip patients so it should be a shorter day * about half of the team leaves tomorrow night & the other half (like me) Monday night  

 

Friday An Unexpected Half Day Off – Being a Tourist! Then PACU Set Up

The team met for breakfast & then were given the agenda for the “Training Day” Originally some of us were assigned to help with BLS but then they decided they were only going to do “re-evaluation” not a full course and would not need all of us so Linda & Patty (OR Nurses), and I were excused. Patty REALLY wanted to get out to a National Park & Linda & I were open to going with her – Patty’s enthusiasm was so contagious. We got an Uber & drove about 40 min to the Parque Natural Municipal de Porto Velho that was opened in 1989. Our Uber driver waited for us to be sure it was open as NO-ONE was there & in fact it was closed for refurbishments thru the end of this year!!! BUT….Linda explained to them we were here as volunteers for Operation Smile for the Mission in Porto Velho & they were SO NICE and said they would take us on a private tour for 90 minutes or so😊 Manuel who works there & is in charge of the “Seedling Garden” was our guide as he is still working on site growing the seedlings. He has a degree in Biology and was passionate about the rainforest & the park. He did not speak English at all so we used Google translate off line to communicate thru the tour.

There was no wifi at the park – of course it was in the Amazon Forest,,,so we prearranged for our Uber Driver to return to get us in 90 min (Brazilian time we knew that would be 2 hours). The park includes part of the Amazon Forest & was so so green and lush. You are told to “take a forest bath” by breathing in all of the air and beauty – so we did. Manuel first took us to the “museum” in the park where basically there were LOTS of preserved animals, birds, fish, rodents, insects, snakes etc that are found in the Amazon & the majority of them were from this park & a few that Manuel had caught! There was a HUGE Anaconda skin, monkeys, sloths, an armadillo, kookaburra (basically a giant rodent) The spiders were HUGE & Patty has a bit of arachnophobia so that freaked her out – especially when Manuel pulled one out for us to hold! There were also really large butterflies & lots of big bugs and fish from the Amazon River.

It was quite humid & for part of the time actually raining in the rain forest. So my hair down quickly became hair up in a pony tail The trees were so tall & I now understood the concept of the “canopy” of the forest. Some of the frauns (sp?) on the plant were huge! They have demolished the rotting wood walkway thru the park & are rebuilding it so Manuel took us on the 1000 meters that were completed – it was lush, green, beautiful & peaceful. We did hear some birds but did not see any animals. He did take us to a marsh area where there are alligators & the large freshwater turtles (we had seen skeletons & shells of them in the museum) but none of them showed up t visit us today in the marsh.  IN the park he pointed out a “Golden Chain Tree” and the wasp hives in the trees. We were so fortunate to get this private tour &  Manuel was so generous with his time. He took us to “his seedling garden” last it was a bit of a walk yet lovely & then introduced us to all of his gardening team. SO amazing that they are doing this work to “replant” the Rainforest.

Our Uber driver was bout 25 min later than we asked but it all worked out. We had him take us to the Casa de Cultura where other team member had gone on Monday – it was a place where local artists were featured and displayed their art in numerous mediums – paint, sculpture, wood, metal, string, pottery and other traditional crafts. I did find a beautiful, nicely made crocheted doll for Navy and met the woman who made it 😊 Right across the street from there were the 3 Caixas de Agua (3 water tanks) which are a famous “photo op” in Porto Velho. There is also a famous train but it too is under renovations so we did not go there.

It was again really humid so we got an Uber back to the hotel (4 miles away). I requested the Uber for us & FYI here for a lower fee you can get an Uber motorcycle. The car was only $3 US and we doubled that with a $3 tip! The education was over by the time we got back & some people were going to a seafood buffet near the river but I opted to shower & then fell asleep on my bed for about 45 min until Yumi returned to our room. She is 38 & single, has a brother & sister & her mom was a pediatrician & dad a civil engineer. She recognizes that she is so blessed as only about 10% of people in Paraguay go to college & she was fortunate to be born in a family that could afford that & that she had the aptitude for school. Her mom is Japanese & her dad is from Paraguay, so part of her family is Buddhist, some catholic & she has an uncle & his family & those cousins belong to the LDS church. She said that in her family you do not talk about politics or religion 0 & I said that is similar in some families in the USA – we simply love each other even with our differences. She had many questions about the Church of Jesus Christ of Latter-Day Saints & how it differs from the Catholic church – fortunately I have experience in both 😊 

We talked of God & Yumi believes that everyone needs a “higher power” in their life to rely on & it is missing in today’s world. She sees it in the “younger generation” & the residents she teaches that they are so overwhelmed & not grounded or centered & they seek for happiness in external things & when they are not happy ask for medications or use alcohol. She was in an accident after her residency & was unable to walk for 6 months & knew if she could not walk she could never be a practicing Anesthesiologist. She promised God if he would allow her to recover & walk she would live a good life  and use her skills for good & service – she recovered miraculously & that is why she volunteers for Op Smile & does many missions in Paraguay, she works at 4 different hospitals & says when she is asked to go on a mission it is often hard to get her work covered “ but it always works out” It was really a sweet conversation & I am so glad we had all the room “mix-ups” on that first night so I ended up as her roommate & she said the same😊

At 5 pm we went to setup the OR’s & PACU – I have never seen such a paucity of supplies. Alyyson (the local male nurse) seemed fine with it & encouraged us to not open up the things I would normally open & have at each bed spot. Many of our medications were expired so we removed them from our drug box & he was going to get them replaced tomorrow. I will just “go with the flow” & it will all work out. However I am reminded that if we were not in a 3^rd world country this set up for patients after surgery would be much different…and here they are just simply grateful for the opportunity to have the surgery completed. Since we will only have 2 days of surgery tomorrow we will do all palates (about 20) so they can we watched for 2 days & then Friday will be all lips. Backwards of most missions where we start w/ lips.

It was 8:30 by the time we got back & some were going out to dinner but Yumi & I were not up for a 2-3hour event so we struggled a bit but the front desk helped us order pizza that would be delivered via motorcycle (their version of Uber eats). It was actually delicious & the first real food” I think I have had since I got here aside from all my packed snacks & PB sandwiches! I was in bed by 10 & asleep before Yumi was out of the shower & went to bed!

April 4 - PART 2 - Because of others 50 families will be helped - The Miracle that's happening in Porto Velho

 We had a plan for the sister missionaries to pick me up about 6:45 in their Uber & go to the church to meet w/ Pres Rocha. Most of the team members were going out to a steak restaurant for dinner & if I got back early enough, I intended to meet them. But…I got back about 9:30 pm and had just enough energy to post my Part #1 blog for the day & send a few texts & go to bed 😊

The Ubers were running slow, so we got to the church about 7:15 & as we arrived, we were greeted by a woman who does the cleaning there. The sisters chatted w/ her & introduced me & she got very emotional sharing with me (since I was from the US) that her son from here in Brazil served a mission in Salt Lake City & while he was there had a terrible accident & for some time his mobility was limited. She said it was hard as she could not get him back to Brazil & care for him and when she told his mission president that he said “your son is now my son” & the mission president cared for him for months until he could walk & return home…he is now doing well and working in Sao Paulo. It was a very emotional memory for her and such a sweet story about a SLC Mission President.

We were then greeted by Lucas who is the Stake Clerk & speaks good English. He took us to Pres. Rocha's office where I met him & his wife. I was also introduced to Sister Nacimiento the Stake Relief Society President who is in a “high position” at a finance company & was just released from the hospital on Sunday, Sister Gabriella who is an attorney & the stake 1^st counselor and a Stake Communications person. After the emails & video call meeting Pres Rocha was like meeting an old friend – he is very energetic and so positive!

He started by asking me if “I had a plan” for the sacred funds. I explained that typically I do not as is the case here – that my generous friends & I simply want to help wherever is needed & I gave him examples of how we have helped in various ways in other countries. Then he said, “after hearing from you we have been praying and we have a plan”. There are many families in the boundaries of our stake (which is very big) who struggle to have enough food every day. Even last week a ward Relief Society President who is a single mother with two children called to see if there was any help for her family as they had run out of food. While Sis. Nacimiento was in the hospital Sis Gabriella called all the ward Relief society presidents to ask about needs and food was the highest need for church members and others they know in the area. As they gathered up the names and total number of families Sis Gabriella priced out how much money for food was needed to give families “the basics” that would last one month. The basics included: rice, beans, spaghetti pasta, flour, oil and lard. It would be about $30 per family & they were concerned as when they totaled up all the struggling families in their boundaries it would be 50 families & that amount would be R$6550. Well, that is when my tears started flowing abundantly & I knew that is why God sent me to Porto Velho to help feed his children 50 families here specifically.

You see at the Sao Paulo airport I had exchanged $1500 in US dollars & with the exchange rate of R$ 4.4 to 1 US dollar & the associated fees I had received from the exchange & had in my envelope from the exchange bank R$6525 the R$25 difference was equal to about $6 US. As I pulled out the money & gave it to him there were many more emotions and tears of gratitude in that room. Pres. Rocha stopped us then to offer a prayer of thanks for this “miracle” and when he said that prayer it was a very long prayer of expressing gratitude….that I was sent to this country and the state of Rondônia and the area of Porto Velho specifically. He expressed gratitude for the generosity of the individuals who selflessly gave money to help people they do not know and will never meet, gratitude for their pure hearts, that by doing this they will be feeding the hungry and blessing the sick there will be tears of gratitude from these families.  

After the rest of that prayer – I don’t remember all of it just the beautiful spirit of it & we all were emotional I told them we all needed to pause to remember this moment and recognize the many steps we were all a part of in this miracle-

1.      I was asked to come to Porto Velho by Op Smile

2.      I said YES to the mission despite some rough travel.

3.      My stake leaders got me Pres. Rocha’s email.

4.      I have generous friends who care about their brothers & sisters in Porto Velho & I was given these sacred funds – the most I have ever brought on a mission.

5.      I contacted Pres. Rocha 2 weeks ago & he replied.

6.      When I had some anxiety over the travel, I reached to make flight changes & Op Smile made the changes.

7.      Pres. Rocha brought his leaders together & they talked about these sacred funds.

8.      I exchanged my cash in Sao Paulo

9.      The church leaders together decided on providing food-then prayed over the list of families to find the 50 families.

10.  The amount of money needed was almost the EXACT amount I had exchanged.

11.  To me it is clear the Lord is in the details of our lives and in this work

I also said this is a lot of work for them to do all the shopping & out together all the items. They plan to get baskets for the food & wanted to know if we wanted to have a message of who it was from…I was a little unsure about that & then said to just tell them it is from their brothers & sisters in Southern California who care about them and love them. They liked that idea because the farthest point in their stake in Nueva California – (New California)

They continued to share some of the unique situations people were in…widows who were older women, single mothers trying to work and care for their children, families with significant health conditions prohibiting them from working, and a myriad of other struggles. He said the poverty rate is high in this area and this will make such a difference in so many lives and it will be delivered as if it came from the hands of the Savior. I did mention that I received another $200 I did not bring in cash but could use a credit card if they needed to buy the baskets other items.

Pres. Rocha again said he was so touched to know there are other people far away worried about his people – in a time in the world when most people only think of themselves, He also said that for weeks and months there will be many prayers that those who gave so generously will be blessed for their kindness and will feel and know that they are literally saving lives and spirits in Porto Velho.

Pres Rocha concluded by reading Helaman 10:4-5 where in verse 4 the Lord points out the qualities of Nephi - that he was not thinking of himself, he was taking care of people he did not know he was not worrying about his own life  and because of that in verse 5 those traits were identified – kindness/goodness/loving and he was promised many blessings and that I and my friends have these qualities – worrying about people we do not know, seeing that there are children of God with needs blessing other people and will receive the same blessings that were promised to Nephi.

He then handed the envelope of money to the Stake RS President and said my contact would now be with her, based on my weekend mission schedule & her schedule she said she would come for me at my hotel at 1 pm on Monday (I am just here that day waiting to fly out that night). so, I will see her then with the sister missionaries too so we can get any other items to “package or prepare the food”. They will get together with the ward Bishops and Relief Society Presidents next Saturday to assemble these “gifts from God – like manna from heaven”.

When we finished at 9 pm I felt soooo drained because of this experience and also soooo overjoyed. I could visualize & hoped that these people who will receive food will feel the love and support with which it is sent. That hunger will be relieved for 50 families, the hope and joy they perhaps will feel. These faithful leaders in Porto Velho (some of whom themselves struggle)  are being our  “long distance hands” from California.

I am still processing all of this but one thing I am certain of is….GOD OUR FATHER AND JESUS CHRIST ARE IN THE DETAILS OF ALL HIS CHILDREN'S LIVES! That does not mean we always get our miracles or life is easy, that we don’t experience grief, heartache, loneliness pain, or sickness, It just reminds me we are never alone & they are always there…I am so very humbled to simply play one small part and be the conduit thru which this miracle in Porto Velho has happened.   

April 4, 2024 - Part #1 SCREENING DAY - I LOVED IT

 I got a good nights sleep last night, had packed my backpack before bed & that set me up for a GREAT DAY & WONDERFUL NIGHT 😊

A few “catch up things from yesterday – I also met Brother “Carlos” who is in charge of LDs Helping Hands in Northern Brazil – such a nice man & he was also on the video call the other night. We took a photo together that I posted on social media. Also I did not give the “Acai” it’s full credit..I didn’t realize that it is grown here in Brazil & actually in this Northern part of the country (or so I am told).

Breakfast was at 7 & the bus was to leave at 7:45. There is mostly very Brazilian breakfast options but I am good with my “mission standard breakfast of scrambled eggs on a piece of toast with a slice of cheese on it – perfect for me. They do have some fruit – bananas & apples and also a jar of….BRAZIL NUTS!!! So I put a few of those in a baggie for an afternoon snack.

The drive to the hospital was uneventful however they parked the bus in the opposite side of the street that the hospital is on & as I went to the front of the bus this sweet Brazilian team member grabbed my arm to be sure I crossed the street with her safely dodging the cars & motorcycles 😊 Screening was all set up & organized which was wonderful. I went into the “Nursing Room” to do vital signs & heights & weight on all the kids. It was fun to “be in the thick of it” because often I get other assignment on screening day so I enjoyed this one & seeing all the cute kids coming thru. It also helped me get to know the other nurses who will be in surgery & pre-op/post-op. S far I have not met the PACU person I will be training but I have met my other international volunteer Norina who is from Toronto Canada & very nice.     

We saw our first patient at 10 am & I was AMAZED at how well these first 10 kids all did, very few tears, sweet moms & the local nurses would sing or get them laughing to keep them distracted. I took a few photos – one with Jovanna a cute lil girl who needs a lip repair with a sweet mama. They had traveled 28 hours by bus from a state in south Brazil just hoping she could get a lip repair. She is staying with the friend of a cousin here. I could tell the mama was tired & she said that they had gone to that house to change their clothes & “get dressed up for the doctors” – melted my heart. I just wanted to bring them back to the hotel with me. 28 hours on a bus is like driving to the Midwest from California. I will be praying she will be on Saturdays surgery schedule – I am pretty confident she will.

As time went on even the toddler kids were good  -they would put their hand out for the oximeter after I showed it to them on my finger & were pretty good with the “hug” of the blood pressure cuff. BY 11:30 we had screened 26 patients which I thought was a good pace & we had a good system. One  of the missionaries was outside our door & would receive the patients to be screened & let us know someone was waiting & we rotated them in. We had 2 Vital Sign stations plus a weighing station & moved them all thru quite nicely. Yassmin was a little one that stols my heart…her 5^th birthday is tomorrow & she was in a cute teal dress. She needs a palate repair as it had opened up impacting her speech & eating. She was SOOOOO CUTE & reminded me of my Charlotte.

We actually had all 10 of the local missionaries helping today so I met the other 3 young men who are all native Brazilians & equally as nice. It was warm in the screening area so each time I went to get a water & grabbed a bunch to keep them all hydrated as well. We also has 6 helping hands volunteers -both men & women her to help their “neighbors” as they said. I had Sis Wright put some basic phrases on a piece of paper for me so I can at least communicate “good morning, introduce myself etc”

By 12:30 we had screened 43 kiddos so 17 more in an hour; which seemed like a really good pace to me. It was energizing teamwork between all of us in the room. Everyone is her for the same reason – to help these kids & families get care. By noon some people were breaking for lunch & the patient flow slowed a little. I am told that the food they are bringing in for us to eat is a very standard “main meal” here…a bowl with rice, spaghetti noodle & beans (yep lots of carbs) and then either some beef in sauce or chicken in a sauce & they have a veggie option too. It was offered yesterday & today & will be every day I am here I assume. It did not look bad but I happily packed my peanut butter sandwich & ate that; which made me realize I pretty much only eat PB Sandwiches (no jelly) on mission trips!

Aside from the 28 hours bus ride patient we also saw 3 patients from Bolivia (which is a close neighboring country) and one from Venezuela which is FAR away & someone said they may have been sponsored on a flight to get here? We also had several Indigenous families from communities along the Amazon river.

Our education yesterday & todays screening is at a private jr high/high school & yesterday I thought maybe it was a “school for athletes” cause all the kids were in red sweat pants & a white shirt w/ the school logo & their name. Come to find out today those our “typical school uniforms” and it is a private military school. My hot tip & how I connected the dots was seeing one of the students arriving and then “saluting” his teacher while standing at attention. Plus the teacher had his name Sargent….on his shirt. Bad guess yesterday!

One of the OP Smile directors from Brazil came in during a time when we had a “lull” & shared some really interesting info with us…Brazil actually has 7000 plastic surgeons in the country which is the 2^nd highest # of Plastic Surgeons in  a country after the USA – however they are all in the ‘Southern states” of Brazil like Rio de Janeiro & Sao Paulo doing Botox & cosmetic surgery with patients lining up to get in. Only 0.4% are in the northern states =28 for a huge geography & they all have successful private practices & make good $$$. So recruiting them to learn and do “volunteer palate work” is tough. Op Smile looks for & recruits that “diamond in the rough” plastic surgeon & essentially “courts them “ to take on this opportunity & work in this environment. She said it is a great opportunity for them to learn from world class surgeons from other countries & those who do come for this type of training return to their work after the mission training experience “changed” it elevates them as people-which I think it does for all of us here. It also makes sense why here we are doing our days of surgery Sat & Sun so that these surgeons are away from their practices a minimal number of days. She also said in this state of Rodonia 200 km is “your neighbor” and just the state of Rondônia top to bottom is 1000 km or about 620 miles. It was a very interesting lesson…

We finished screening at 3:30 pm & saw 72 pts total. It makes me a lil sad because I think we are only expecting to do 35-40 cases in the 2 days – so some of these little ones will have to wait ☹.We got back to the hotel & some of us went over to a nearby grocery store – they were getting beer & going to enjoy the pool. I got myself some Coke Zero & came back to the room to empty my backpack, have a snack, start this blogpost so maybe I could get caught up and get ready to meet the sister missionaries to go meet Pres. Rocha.

I just returned from our time at the church & will make a separate entry for that time & experience

Wednesday in Porto Velho -An Education Day

 Well it was a short night – 4 hours of sleep was about all I got so I was a little jet lagged today. Lipson (from last night’s video call) did come find me at breakfast – he’s energetic & an Op Smile Volunteer in another “state” in Brazil & came here to facilitate the church’s involvement in this mission. He only speaks Portuguese, so we did a lot of “google translate” on our phones to “talk”.

The “school” where we were doing the education sessions & screening is only about a 10 min bus drive away & imagine my surprise & excitement when I got off the bus & saw 3 young men – missionaries walking into the school. I walked in with them & got their names & where they were from & they said just last night they were asked to come & help translate the educational sessions today! I was even more excited & surprised when I walked inro the education session room & saw Sister Wright from the video call last night – here to be my “personal translator” – never had that before!!!

I got the update on the church’s involvement here – the Church Humanitarian Dept is helping to fund several Op Smile missions in Brazil to help the infrastructure of surgeries in this country-which is so wonderful. It reminded me of my first mission that the church also supported in Kenya. Sis Wright (from SLC) & her sweet companion of 5 days Sis Rueda (from Mexico) said they were only asked last night to change their schedule to help this week 😊 and that they are also asking for members to help volunteer tomorrow at screening. In the morning we started w/ 3 Elders two from Utah (Kamas by us in Midway & Syracuse), the 3^rd was from Spain plus the 2 sisters. Mid-day we got 2 more Elders – Elder Chase from Logan – Doug’s hometown & the other from Texas. There are 170 missionaries in this mission which includes a large area of the Amazon & the mission headquarters are 10 hours away in Manaus. This mission is going to be split July 1^st simply because of the large geographical area it covers. They have 10 missionaries in Porto Velho & we had 7 of them helping us. They were all so helpful & nice. Sis Wright told me that the church is struggling in this area with member engagement and activity often because of peoples need to work. There are 6 congregations in this stake(diocese) and each has attendance of 30-50 members who attend regularly, There have been conversations of changing it from a “Stake” to a district” which has caused a bit of a “call to action” for church members to increase their participation. They are hoping that helping their neighbors and volunteering with this mission will spark some enthusiasm for service. 

Sis. Wright sat by me as my Translator for the opening meetings which was an explanation of the Champion program (which I was already familiar with from Guatemala). Ambra did part of the presentation, so it was in English translated to Portuguese. The program intro was really well done & explained the need for programs like these as in most areas of Brazil patients & their families live in remote areas & have to travel by walking, crossing rivers, and riding buses for many hours to get to the “larger cities” for care. Training teams in smaller areas multiplies the access – after training one trained plastic surgeon can potentially perform 200-300 surgeries a  year in the right environment & with the  support of anesthesia, nursing etc. The videos of patients in this area needing help were very moving reminding me of the original Op Smile tag line “Changing Lives One Smile at a Time” & here they say “A SMILE makes all the difference.”   We were trained on the new electronic healthcare record and training principles & evaluation. Later in the day we had MANY classes – on occasion it felt like “powerpoint overload” & some were in Portuguese so Sis Wright was translating ALL DAY! The difficult Airway Management presentation was in Portuguese & I was surprised that with my limited Spanish but strong knowledge of the content I was able to understand some of it & anticipate what he was talking about – my own version of “predictive English translation “simply because I know the steps of intubation, chest tube placement etc. We also had a PALS review that I was very familiar & comfortable with and understood the principles he was speaking about despite the language difference 😊

 News to me…or maybe I didn’t pay attention in the emails but I guess I am now part of the Brazil Champion Program??? And committed to coming here once a year – the travel certainly is not as convenient as Guatemala was but the needs are the same & the people here are lovely,

We finished about 6 pm & were to have a Team meeting at 8. The missionaries would also be attending that so  I offered to take them all out to dinner nearby in the 90 min or so we had. They could pick the spot & we ended up at a hamburger place withing walking distance so I took the 7 of them plus Lipson out to eat. After our burgers we got Acai at another place on the walk back. They were a really great group of young adults here as missionaries to “just serve” & teach people about Jesus.  They jokingly said “so this is what it is like to be on a mission in the states where there are members who treat you to dinner”. I was so happy I could do that! During dinner Pres. Rocha sent me a message & wants me to meet him at the Church building tomorrow with the sister missionaries as my translators to talk about the humanitarian needs of people in his area. I am SO EXCITED to meet him & hear about the people in this are that “we”(my generous friends) can help <3 . We got back to the hotel by 7:40 & the Team mtg didn’t start until 8:30 & it was 10:30 when it ended after everyone introduced themselves & they went over the “preliminary” schedule for the week. We also got our team shirts one for screening & another for the last day.

By that time I was REALLY TIRED & as I was going to my room a group invited me to join them for dinner but I politely declined…all I could imagine was my pillow & my bed & I knew as is Latin American style they would be out until after midnight. My roomie Jumi, who is an Anesthesiologist, on the mission & from Paraguay joined them.  I showered, talked to Doug & am headed to bed for a real full nights sleep. I am really feeling like I “belong” on this mission and am so glad I am here – It’s Screening Day tomorrow….often chaotic & always uplifting to see the sweet families & kids. Good Night!