Nurse anesthetist Bill Swartley's winter trip to the Caribbean is no vacation

By Mary Pannabecker Steiner
As a nurse anesthetist for the past 30 years, Bill Swartley of Bluffton, has spent countless hours as a member of surgical teams in sterile environments, backed up by the latest in medical equipment and supplies.

Clearly, he has a passion for his career, which he describes somewhat tongue-in-cheek as "putting people to sleep for surgery and waking them up."

Yet once or twice a year, Swartley leaves the comfort of Blanchard Valley Hospital in Findlay to spend two weeks working in hospitals with less than ideal conditions where there are often no charts, no X-ray machines, and medications and blood for transfusions can be in short supply.

Since 1998, Swartley has participated in 17 trips as a member of a surgical team with Medical Ministry International, an "evangelical but not denominational" organization based in Texas. The mission trips have taken him to countries such as Ecuador and Dominican Republic.

During the most recent trip to the DR, he and his surgical team completed 135 cases, performing procedures involving hernias, gall bladders, C-sections, hysterectomies and circumcisions.

"The things we see are the same as we see here, but are often more advanced," said Swartley, citing the case of one man with a large hernia who continued to work the fields because "he has to support his family."

Soon after arriving at the hospital, they begin seeing patients. Usually, there are 100 or more individuals already in line. All are extremely poor, but each patient is expected to pay some part of the cost, however small.

For example, having a skin tag removed costs about 100 pesos, or $3.
"The philosophy is that they're going to appreciate it a lot more if they participate (in the cost)," said Swartley. Although wealthy individuals often attempt to be seen, they're always turned away because they can afford the Dominican hospitals and private clinics.

Swartley first became involved with MMI while living in Hesston, Kan. A doctor friend invited him to join the next trip.

"I'd always wanted to go, but was nervous," he said. As it turned out, that first trip was truly a "life-changing experience."

Each trip, of course, is a new experience with new patients. This time Swartley's favorite patient was a tiny 8-year-old girl named Peggy Lee.

Asking her if she knew there was an American singer named Peggy Lee, the little girl grinned and said "I was named after her."

Little Peggy Lee with the cheerful personality won the hearts of the whole team. She arrived in a dress and when asked why she was there, pulled up the dress to reveal an umbilical hernia. The hernia was repaired and the child left the hospital before the day was over.

This tendency to undergo surgery and leave as soon as possible is very typical of the Dominican patients. One man had gall bladder surgery on Monday and when Swartley returned to his room on Tuesday, the man was dressed and ready to leave. Although he was encouraged to rest a bit longer before leaving, he refused.

Most patients take just a minimum of antibiotics, according to Swartley, who explained that "they're exposed to so much harshness that we don't see a lot of infection there."

After 17 trips, Swartley has learned how best to prepare for each trip. Because each member must take along his or her own medical supplies, Swartley collects items throughout the year, often spending his own money on meds and drugs necessary for anesthesia. Likewise, the surgeons take their own suture equipment.

Fortunately, some of the costs of supplies are lessened by donations from organizations such as AmeriCares, a nonprofit disaster relief and humanitarian aid organization which supports long-term humanitarian assistance programs. For example, Swartley says that Abbott Labs sent two semi-loads of millions of dollars' worth of medical supplies to Americares, which then distributes items to organizations such as Medical Mission International.

Swartley is always grateful for items donated by surgical patients who find themselves left with medical supplies not used in their recovery periods at home.

Despite the cost and work involved, Swartley continues to look forward to each trip.

"We get so much more than we give. I've had tremendous opportunities, a wonderful life here. If I can share a little of that," he said. "It's terribly fulfilling."

This year, two other Blufftonites joined Swartley and his team. Glen and Judy Buller made their first mission trip with MMI. Glen is a nurse anesthetist who works at Institute of Orthopaedic Surgery, Lima, and Judy is a registered nurse at Bluffton Medical Center.