Today started early with breakfast at 6, the bus at 7 and evaluations at 8.  Last minute instructions were delivered on the bus and we were ready to hit the ground running.

Upon arriving at the hospital we find it unusually quiet.  Rotaplast veterans tell me that patients, many having traveled long distances, are normally lined up at the door with the hope of clearing the many hurdles of candidacy for surgical repair.  Today it was quiet.

We prepared, tested our systems and readied ourselves for the many who surely wanted our help.  They weren't there at 8, or at 8:30, but near 9 they began to trickle in.  This is our first mission to the Dominican Republic so maybe the message didn't reach the right ears?

In time the patient flow increased but we didn't see the cleft lips and palates that are the specialty of our team.  There are very significant needs here but we suspect that they may be different from the services Rotaplast teams typically provide.  We're living our motto of "Be Flexible", "Tenga Flexibilidad!"

 There were a few who can and will be helped, but the patients who came to us today had more scarring from burns, most by fire, a few by other means.

We worked through the people as they arrived, creating patient records, taking vitals and meeting with physicians. 

Quite a few were turned away because of health conditions, or due to the type and complexity of surgery and follow up required. Some hopes were dashed but also some patients realized that their conditions weren't serious enough to require this level of treatment.

And then there are some for whom a prayer and a miracle wouldn't be enough.  We had two today, a man and a boy, who were burned in different ways and in different events but whose physical damage and scarring are so severe that whatever repair we can do here will be far less than what they need.  The man, a policeman, had very significant chemical burns over his head, face and arms in an acid attack.  The boy suffered burns in a house fire as an infant.  Our sympathy for them is deep but what they need is our help.  The surgeons will do what they can.  Dr. Fred Tomlinson is optimistic that the policeman's face can be more functional even if little can be done for him cosmetically.

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Our scarred policeman discusses surgical options with his wife.

After seeing over 60 patients today we still have fewer than 20 scheduled for surgery by the end of the day.  The hospital arranged for a late afternoon press conference with the local media and hopefully, we'll see if we have more patients later in the week.

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Dr. Maria Jaramillo discusses surgery with the selected patients.

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Nan Madden, PHP, pauses after a full day of screening patients.
 
Carl Cilker
Photojournalist