Dr. Brad Pasternak is a pediatric gastroenterologist from Arizona who recently went on a trip across the border and shared what seemed to be a life-changing experience on social media. We reached out to him and he was thrilled to share details of the experience with us.
So we’re sharing them with you!
(We will be discussing other life-changing experiences inside our new private, interactive FB group called Doctor Side Ventures. Doctors, join us here).
Can you give us an overview of the event you proudly shared?
Yes. A recent article about it titles it: 50 Mexican & American Health Care Professionals Working Together to Make Our World a Better Place
On Saturday, May 20th, 25 USA doctors, nurses, health care professionals, medical translators and support staff met at Agua Prieta, Sonora, MX, at a Pediatric Health Care Clinic for the underserved children of the community. This unique bi-national effort saw professional Mexican and American doctors, nurses and medical support volunteers come together. The health examinations included issuing vaccines, vision and audio testing, dental exams and procedures, growth and hemoglobin screening and overall health analysis. 127 underprivileged children ages 13 days to 12 years were screened, including 8 from the local orphanage. 90% had previously undetected health issues with 9 of the children having complex medical problems. These children are now registered in the health system for follow-up care.
The following morning, volunteers packaged and distributed food enough to feed 1,300 people. The American volunteers stayed and had their meals in Mexico at Rancho Feliz’s, new La Hacienda Feliz volunteer dormitory.
1. What was your exact role in this event?
My role was pivotal in this event. I actually came up with the idea of creating this pediatric clinic in Agua Prieta, Mexico (1 mile across the US border from Douglas, AZ).
I assembled a team that made this inaugural cross-border collaborative effort a success. I was involved in all stages of planning and execution.
During the actual clinic day, I oversaw the entire running of the clinic, precepted residents involved in patient care, and provided gastroenterology expertise for those patients that specifically required my assistance.
2. What pushed you to do this, or become involved?
This is actually a great story.
In college, I was a member of Sigma Alpha Epsilon (SAE) fraternity.
Post undergraduate years I was not very involved in the alumni scene, as most of us are aware of the rigors of medical education and demands on time.
At a holiday party for my current department, I learned that the husband of one of my nurses was a SAE brother and ran the alumni association for the state of Arizona.
He later informed me I was going to be honored with an award for my contributions to the field of pediatric gastroenterology and invited me to that years award dinner.
That was where I met Gil Gillenwater.
He was the recipient of the distinguished alumni award for philanthropy.
He stood at the podium in his signature cowboy hat and gave the most passionate, awe-inspiring speech about his story, the act of philanthropy, and what he has done for this impoverished border town of Agua Prieta through his charity Rancho Feliz (www.ranchofeliz.com). He described his experience walking the migrant trail coming across skulls, skeletons, medication, identification, etc.
He collected many of these items and pictures and currently houses them in a museum he created at the dormitory used for volunteers. When he finished his acceptance speech, I was captivated and wanted to be involved.
I approached him and said “You build houses, dog shelters, do food distributions and have established yourself in the community, but what about medicine?”
He immediately agreed it was an unmet need and set up a meeting between myself and Michael Blaczyk, one of the board members of the charity (Former Senior Executive Vice President, Chief Financial Officer and Chief Corporate Officer for Dignity Health and Senior Vice President and CFO for University Hospitals, Cleveland).
Clearly, Michael had the administrative experience of running hospitals and what needs to take place to make it successful. The three of us travelled to Agua Prieta to meet the local pediatricians and government officials to inform them of this idea- of a cross-border collaborative clinic.
Upon arrival, we stopped at the migrant center where we heard horrific stories of failed attempts to cross the border to avoid gangs, violence and death from their country of origin (Mexico, central and south America). Following this, we settled at “La Hacienda”. This is a beautifully designed dormitory built by Gil and his charity to attract volunteers- to provide safe and comfortable shelter, authentic cuisine and security.
The meeting was exciting and the energy was extremely positive.
“Volunteers packaged and distributed food enough to feed 1,300 people.”
The Mexican contingency was open and eager for collaboration. We toured the hospital to assess the scarcity of resources.
This hospital was equipped with only a single antiquated x-ray machine (that still used film and light box for interpretation) that was broken at the time, and no other imaging modalities. A laboratory that was only capable of the basic tests (CBC, BMP) – not blood cultures, blood gas, or any disease specific specialty labs. There was no possibility for endoscopy or interventional procedures and there was no pathology available. Samples would need to be sent to Hermosillo (4 hours away) and took weeks for results. This was the definition of third world medicine- and only a mile from the US border.
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The hospital offers no subspecialty care and complex patients need to drive those 4 hours to Hermosillo for consultations. There was a small 4-bed NICU without CPAP machines, but ventilators without the ability to measure capillary gases. This was a place where the art of physical exam and diagnostic prowess was essential. After that successful trip I was put in touch with Dr. Lara Yoblonsky, from my institution, who happens to run the global health program. She was enthusiastic about participating and, in my opinion, was the key to bringing this idea to fruition (having no experience myself). Lara, two global health residents, and myself made another trip down to hash out specific details such as equipment needs, medication needs and clinic flow.
We were extremely fortunate to have a wonderful pediatric partner in Agua Prieta, Mitzy Aragon, who did some training in the US, to serve as our main liaison. Our contingency toured the hospital again with the medical director and he graciously offered use of their outpatient space to for the clinic. Thus, we had exam rooms and basic equipment already provided, which was a blessing! Lastly, A nurse practitioner, Gail Peterson Hock, joined the team and utilized her expertise and leadership skills to assist in the final planning details. “Plan down to the pencils you will use” is a quote not lost on me.
3. Tell us what went down. Lay out the event through the eyes of a pediatric gastroenterologist.
We were able to assemble an incredible team of 3 attending physicians from Phoenix, 3 physicians from Mexico, 7 residents from Phoenix, 4 nurses from the US and 3 from Mexico, in addition to 3 medical translators, 4 phlebotomists, an audiologist (from Hermosillo), a dental team (from Agua Prieta), and pharmacists.
We all drove to Douglas, AZ the day before the clinic and parked our car.
We proceeded to walk across the border stopping briefly to stare at “the wall” that divides us knowing our mission was communal. We were met by the Rancho Feliz vans and taken to the migrant center to hear more inhumane stories of despair and desires to cross the border and work in America. We returned to the dormitory, had an authentic Mexican meal (that immediately made the trip worth it) and debriefing.
We described the flow of the clinic to the team and the roles of each volunteer. Prior to the clinic day, we created tickets for the event to prevent true potential chaos of the entire town trying to be seen at that clinic. The charity perfected this process with their food drive and we mimicked the concept, having the Mexican physicians and staff deliver 150 tickets, separated by time frames, to prevent a bottleneck.
We were aware families would try to have siblings, cousins, friends try to be seen and had a strict policy against this. Interestingly, we only encountered this issue twice.
The plan for the day was the families would enter, get registered into the hospital system, get a number to be called to have vitals taken, followed by vision screening and audiology. Following this, they proceeded to phlebotomy to assess for anemia, see the physician and then dental (if needed) and given immunizations (if needed). If subspecialty care was required, their names were collected at check out to follow up the following week for arrangement for care in Hermosillo.
Upon check-out, they stopped at a desk where a Mexican physician would write a prescription if needed and send them to the pharmacy. We saw patients for a total of 4 hours in the morning and an additional 4 hours in the afternoon. Ultimately, 130 children were provided care.
While this was intended to be a general pediatric clinic, seeing a truly healthy child without comorbidities was rare. In fact, the residents were exposed to fascinating cases.
For instance, a child presenting with clear signs of leptin deficiency (with no access to therapy). In this particular case, the family had a visa to cross the border and we were able to establish care for them in Phoenix. There was another child with short stature, failure to thrive and renal failure awaiting transplant, as well as a severe fecal impaction requiring disimpaction in the ER that day (my specialty).
“Seeing a truly healthy child without comorbidities was rare.”
The residents were truly autonomous and able to hone their skills and gain confidence and an unparalleled experience. The families were beyond appreciative. It was amazing to see the children and parents show up dressed to the nines for their visit. It highlighted the cultural difference as far as respect for providers is concerned. The clinic day went as smoothly as possible.
The ultimate feeling of satisfaction and accomplishment was immeasurable. We ended the night with a fiesta complete with mariachi band to celebrate the success. The next morning concluded the weekend with a food drive to continue to provide for this community. As Gil always likes to say, “we feed their bellies and they feed our souls”.
4. What stood out to you most from this experience?
So many things stood out to me from the experience.
Overall, the camaraderie between the Mexican team and our team was instant. They immediately became colleagues and friends.
It truly was a collaborative effort. In addition, the respect the families gave our team was completely unexpected. The fact they were dressed up for the appointment as if they were attending church mass made us realize feel grateful and highlighted the importance of the work we were doing. Lastly, the ultimate feeling of satisfaction and fulfillment, in addition to being overwhelmingly proud over how we were able to successfully bring this clinic to fruition with plans in effect to increase the amount of clinics the following year.
5. Was there anything that was particularly difficult to see?
The complete lack of resources was eye-opening.
It was amazing to see how they have to practice the true art of medicine without the tools and benefits so easily accessible to physicians in the states.
While not without faults and issues, this experience made me appreciate what we have in the US at our disposal to assist in diagnosis and treatment. In addition, the city itself was difficult to see- hundreds of houses made of cardboard, stray dogs roaming the streets, and extreme poverty around every corner.
It was amazing to see how they have to practice the true art of medicine without the tools and benefits so easily accessible to physicians in the states. Click To Tweet
6. Have you discovered anything new through this experience?
I discovered that many people in impoverished nations continue to practice the true art of medicine where reliance on history and physical exam is paramount.
In addition, I discovered the true desire for collaboration on a global scale for the betterment of humanity.
Lastly, I discovered the satisfaction of having my soul fed.
SoMeDocs End Note:
We thank Dr. Pasternak for sharing this experience with us.
Who else has participated in a life-changing experience that others could find fascinating, too? We’d love to discuss it, inside our newest interactive space for doctors, on Facebook, called Doctor Side Ventures. Request to join here.
If you’d like to be featured in a spotlight, pitch us via email, here.