After Charlie Hoffmeister had her first baby at age 28, her body changed. She started struggling with her pelvic floor — the muscles spanning between the tail and pubic bones, which cradles the organs above it.

Pelvic floor dysfunction after childbirth is a widespread ailment. In fact, one in three women will be affected by a pelvic floor issue at some point in their life. Symptoms can include loss of bladder or bowel control and pain during intercourse, as well as low back or hip pain. And these frustrating symptoms aren’t just limited to people who have recently given birth: Men and women, young and old, can experience pelvic floor dysfunction, with severity ranging from inconvenient to life-altering.

In Hoffmeister’s case, the time she spent recreating outside dwindled, and she wasn’t as able to join her child in play.

“I was annoyed,” she said. “I felt like it really limited my ability to be the adventurous, rock climbing, running person that I had been.”

Although awareness about pelvic floor dysfunction is becoming more common, it’s still a relatively hushed topic. In part, that’s because it centers around a private area of the body, said Brooke Collins, a pelvic floor and physical therapist who started St. Charles’ pelvic floor therapy program more than a decade ago.

Pelvic floor therapy sessions begin with a thorough consultation, including a physical exam, and then center on the unique needs of a patient’s pelvic floor muscles, which either need to be strengthened or relaxed — or sometimes both. The ultimate goal? For the patient to regain control of their body. Pelvic floor therapy helps 97% of patients with stress urinary incontinence, for example, and cures it for 73% of patients.

“When there's dysfunction there, it can affect every aspect of your life,” Collins said. “We're helping people get control back so that their body is functioning the way they want.”

For patients whose muscles are weakened, a program plan will typically include exercises, not just for the pelvic floor muscles but also for the surrounding hip and core muscles. Patients with overly tight pelvic floor muscles will learn relaxation techniques. In both scenarios, practitioners employ biosensors that reflect muscle activity in real-time on a screen, allowing patients to understand better what is happening in their bodies.

Hoffmeister says she felt more confident after just the first session. After returning for another eight-week round of pelvic floor therapy following the birth of her twins, she could lace up her sneakers and get back into running after only six months postpartum. Now, at 33, she has no remaining symptoms, and she encourages anyone struggling with pelvic floor dysfunction to at least have a consultation, even if they ultimately decide against therapy, because it is empowering to learn about how the body works and what is considered normal, she said.

“You’re not alone; it’s very common,” Collins said. “Don’t put up with it, and don’t give the companies that make pads any more money.”

Learn more about the pelvic floor therapy services, which are offered at St. Charles' clinics in Madras, Prineville and Redmond.

Pictured above are Melissa Chalker, Anthony Mattioda and Dominic Mattioda sitting on Guy's bench. Pictured below are Anthony and Dominic, plus Guy's sister Gina and his parents, Faye and Jerry.

When Melissa Chalker graduated from college and started working at St. Charles Bend 32 years ago, one of her jobs was to deliver paper patient charts from the medical records department to the Emergency Room.

“I would do that 10 or 12, maybe 15 times each day,” she said. “And when I did that, I had to pass the satellite phlebotomy station in the main hallway twice, once on the way and once on the way back.”

One day, she spotted someone new at the station: Guy Mattioda, a phlebotomist who had recently moved from night shift to days. Mattioda was friendly and had a great sense of humor. It wasn’t long before they started dating and were married in 1993.

“If it wasn’t for that job change, I’m not sure we would’ve found each other,” Chalker said.

Eventually, Chalker moved into utilization management and Mattioda became a Registered Nurse, where he earned the nickname “Father Guy” because of his ability to put patients and families at ease. They both got to know many St. Charles caregivers. The couple’s sons, Anthony and Dominic, were both born in the Bend hospital, as well.

“St. Charles has been an important part of our life,” Chalker said.

Life changed, however, in February of 2003, when Mattioda passed away. His funeral was held at the Catholic church in downtown Bend, and it overflowed with people mourning his loss.

“I have always felt like that was a great testament to him. There were tons of people from the hospital: Doctors, nurses, people he knew, people I knew,” Chalker said. “It was really, really heartwarming.”

After the funeral, St. Charles nurses supported the family by delivering food and collecting money to install a memorial bench in Mattioda’s honor. The bench is located just outside the hospital’s main entrance.

“They asked me what the plaque should say, and I thought, ‘What touches people the most?’” Chalker said. “I think it was his smile, because he was always smiling. That’s why we put, ‘Forever smiling, Forever in our hearts.’”

For the past 20 years, Jerry and Faye Mattioda have visited the bench outside St. Charles as a way to remember and honor their son, who grew up in the family’s home just down the road from the Bend hospital. Guy also took religious classes in Sister Catherine’s home when he was a child.

“It was very touching when they placed the bench after he died, and it’s very touching now,” Jerry Mattioda said. “Time goes by, but the memory is always there.”

Over the years, the family had worked with St. Charles’ Facilities crew on upkeep of the bench, but in recent years, Mattioda noticed that it was really starting to show its age. He and Chalker discussed another round of “loving care,” Mattioda said, but word of their concerns got to Derek Miller, director of Facilities for the health system, who had a different idea: To replace the original bench, which was nearing its end of life, and install the new one in the same location.

“I can’t thank Derek enough for how quickly and graciously he responded to our request. I could stand here all day thanking him and his team, because this just means that much to our lives,” Jerry Mattioda said. “St. Charles was a very special place to Guy. He loved his job and he loved what he did here.”

On a sunny Friday afternoon in late September, the family gathered under the trees outside the Bend hospital for a short, simple ceremony, where Jerry said a few words about Guy, then Anthony and Dominic removed the original bench and put the new one in place. There were stories told and photos taken, soft chuckles and tears on cheeks. And now there is a nice, clean, new place for patients, visitors and caregivers at St. Charles Bend to sit and reflect, whether or not they remember the person behind the name on the plaque.

“The real story is kindness: The kindness of Guy and the kindness of our coworkers,” Chalker said, “and the fact that his legacy lives on.”

Fall and winter is a wonderful time in Central Oregon, with plenty of fun stuff to do: Snow sports, sledding with the kids, hanging out by a fire, holiday gatherings and, of course, that much-needed February getaway to warmer climes.

Unfortunately, fall and winter is also respiratory illness season. Influenza, COVID-19 and RSV are all common in the region, and each of them can cause serious illness that will wreck those plans you’ve been looking forward to.

Here’s the best way to protect yourself and your plans: Get vaccinated.

“This season, safe and effective vaccines designed to prevent serious cases of flu, COVID and RSV are available,” said Dr. Cynthia Maree, St. Charles’ infectious disease expert. “Getting sick is no fun, especially when it takes you away from doing the things you love to do. So I want to urge everyone 6 months old and older to get vaccinated against flu and COVID-19, and to talk to their primary care physician about whether they should get the RSV vaccine.”

Vaccines do not always prevent illness, but they can curtail how sick you get if you are infected. It is especially important for people over the age of 65 and people with underlying health conditions such as heart disease, diabetes, obesity or a weakened immune system to protect themselves by getting vaccinated, Maree said. 

“Vaccines remain our best protection against serious respiratory illness,” she said. “Other things you can do to stay healthy include washing your hands, physically distancing, wearing a mask in crowds and staying home if you do get sick.”

• This season’s flu vaccine targets four strains of seasonal influenza and is recommended for everyone 6 months old and older. October is the ideal time to get a flu shot, because protection wanes throughout the season.
• An updated COVID-19 vaccine is available now and is recommended for everyone 6 months old and older. For protection against severe disease, get it now unless you have received a booster within the past two months OR you were infected within the past three to four months.
• There are two RSV vaccines (GSK and Pfizer) that are very similar and recommended for people 60 years old and older, as well as pregnant people. If you’re eligible, talk to your provider about getting the RSV vaccine. Protection is durable throughout the season.

For more information, including where to get vaccines, visit stcharleshealthcare.org/vaccines.

Recently, I had a chance to see firsthand the impact of St. Charles’ Community Benefit program, which gives thousands of dollars in grant funding to community organizations throughout Central Oregon each year.

On a recent Tuesday morning, I had the honor of presenting a $30,000 grant to the La Pine Senior Activity Center to help the facility pay for a much-needed kitchen remodel and new commercial ovens.

This work is vital in La Pine, where the center provides nutritious meals to 60 to 90 community members every week. In a town of a few thousand folks, that is a significant number of people who depend on the center for food.

While I was there, I met a staff member named Barbara, who calls herself “the baker.” She has been putting the new ovens to good use, making treats for patrons of the center.

“There are really no words,” she said. “I love it so much!”

That day, I was reminded of what an important role senior centers play in our communities. By providing a place for seniors to gather, they help to reduce social isolation and give people a place where they belong and can make connections with others.

As you may already know, St. Charles’ Community Benefit program recently announced its grant priority for the next three years: reducing loneliness and increasing belonging in Central Oregon. We’re calling this effort Celebrate, Together; Celebrando Juntos, and the goal is to direct thousands of dollars in grant funding to organizations that are creating opportunities for communities to connect in person.

We’re doing that because we know that isolation, loneliness and depression affect more than just the individual experiencing them. They are root causes of a variety of health problems and societal issues, and we believe that by bringing people together and helping them connect with others, we can make a positive impact on their health and the health of our community.

That’s why we’re here. It’s one reason St. Charles has a Community Benefit program. And it’s why seniors in La Pine will be able to come together and enjoy Barbara’s baked treats for the foreseeable future.

The health system is now accepting grant applications, and community-based groups, nonprofit organizations, education systems and tribal entities that serve youth, older adults and/or vulnerable populations are encouraged to apply. Applications are due Sept. 30. To learn more about the grant requirements and application process, visit our webpage.

Thanks, as always, for reading.
Steve

At St. Charles, one of my responsibilities as president and CEO is to keep our community informed about health care services, access to care and other topics that could impact local residents. That’s why we recently shared the news that St. Charles is reevaluating its participation in all Medicare Advantage plans, which are operated by private insurance companies and are different from traditional Medicare, which is funded and operated by the federal government.

To hopefully alleviate some of the concerns that have been raised, I’d like to share a few facts about why we are evaluating our participation in Medicare Advantage plans and where we are in our negotiations.

Please know that all of us at St. Charles are listening and we understand your concerns about possibly having to change plans or incurring increased costs. We take these concerns seriously and are certainly weighing potential impacts on community members in our decision-making. But we have also seen and felt for years the impact of not publicly acknowledging these problems, and the burden often lands on the shoulders of our sickest patients and our caregivers.

Every day, I hear stories of Medicare Advantage patients who have trouble getting the care they need. Recently, a patient in the St. Charles Cancer Center was diagnosed with prostate cancer. As a routine next step, the treating physician ordered a PET scan to see if the cancer had spread. It was denied by the patient’s Medicare Advantage plan. The patient had to wait and wonder if the cancer was spreading while three different physicians ordered the test and all three times it was denied, even though it is nationally accepted best practice care for this type of case. Eventually, the scan was approved.

As a physician, I have firsthand knowledge of how delays in care can impact a patient both emotionally and physically. I started out in my career when managed care plans were just coming into existence. I’m struck now by how dramatically the administrative burden has piled up on the backs of my colleagues, our caregivers and our patients since those early days.

It is increasingly clear that Medicare Advantage plans do a pretty good job of providing coverage for outpatient visits and procedures, and some plan members rave about their experience. For patients sick enough to need hospitalization or high levels of specialty care, however, the plans too often fall short. Patients on Medicare Advantage plans frequently end up staying in the hospital longer than traditional Medicare patients. In many cases, these patients also wait longer for approval of necessary care and experience a high rate of denials for care that has already happened.

From my perspective, it’s important for people to understand that we do not believe the current system under Medicare Advantage is working effectively for the interests of all patients.

We, like many other health care organizations across the nation, are asking insurance providers to do better through ongoing contract negotiations. Here is where we stand today:

• St. Charles Health System is currently in contract negotiations with four Medicare Advantage plans.
• Contract negotiations between health care providers and insurance companies are routine.
• We are asking for proposals that address our concerns about delays in patient care, denials for treatments that have already been provided and administrative burdens on our care teams.
• Since our recent announcement, we are pleased to share that some insurers have responded with their intention to continue negotiating. We believe some are willing to work with us to find creative solutions to these complex problems.
• Regardless of where we land in negotiations, we anticipate St. Charles will continue participating in some Medicare Advantage plans in Central Oregon in 2024.
• We want people to be aware that these negotiations are taking place so they have plenty of time to research options and consult with insurance experts before the annual open enrollment period for Medicare beings on Oct. 15.

If you have continued concerns, your insurance provider is the best source of information about the plans they will continue to provide to Central Oregonians into the future. We are also committed to providing updates once negotiations are complete.

Sincerely,
Steve

In the hospital, most of a patient's time is spent in bed. And during that time, muscle function can quickly ebb away. That's why movement and mobility are vital to recovery, whether a patient is resting during an extended treatment or recovering from surgery.

But mobility must be maintained in a way that is safe for patients and their providers. That's why St. Charles launched its Mobility is Medicine initiative last year.

"Mobility is part of medicine that you receive in the hospital," said Kelly Plunkett, a nurse manager in St. Charles' Intermediate Care Unit. "That's just as important as the pills and the treatment that you're getting here."

Inspired by a Johns Hopkins Medicine conference about mobility in hospitals, Plunkett and the health system’s injury prevention coordinator, Theresa Kramer, started infusing St. Charles with best practices for safe mobility in the spring of 2022. These practices center around preventing falls, decreasing pressure injuries in patients, and teaching providers how to aid patients' mobility without injuring themselves. (For example, if a nurse lifts a patient without the proper equipment, they can hurt their back.)

Made possible by several generous grants from the St. Charles Foundation, Plunkett and Kramer have secured numerous equipment upgrades that make movement safer and easier, such as bed slings.

“A lot of people think of a hospital stay as bedrest,” Kramer said, “but if you come to stay at St. Charles, you will be asked to move in a way that is safe for you.”

Across the organization, more than 600 nurses have been trained in safe mobility practices so far. In addition to training, the program also introduced a new bedside mobility assessment tool nurses can use to determine patients' mobility needs and the best ways to meet them.

Movement is a vital part of preventing secondary debilities that arise from patients spending more than 97% of their hospital time in bed, Kramer said.

"One of the themes we have been training is, 'Has my patient had their mobility medicine at least three times today?'" she said. "We’re trying to consciously put it in everybody's brain that there is an actual prescription for mobility so they get that it's just as important as a medication."

In the best-case scenario, mobility as medicine might be a patient getting up to walk three times in a day. But that isn't always possible, particularly if a person has suffered an extreme injury or trauma to the spine. In that case, providers may need to manually move patients' limbs to maintain muscles and promote blood flow.

While the training phase of the initiative recently wrapped up, it was just the beginning of the work, Plunkett said. In the coming months, the team will have enough preliminary data to track how effectively the program reduces patient and caregiver harm. Anecdotally, it seems to be making a dent in nurse injuries – a promising trend, given that health care workers are five times more likely to get hurt on the job than other professions.

"If we can get somebody assessed at the beginning and get them mobilized to their full potential every single day, that'll help get them out of the hospital sooner," Kramer said. "It's just so important."

It’s not every day you set out to change a state law and actually succeed. That’s what happened this summer, as caregivers from St. Charles Health System partnered with members of the Confederated Tribes of Warm Springs to advocate for the passage of new state legislation that allows health care organizations to better support patients’ cultural and spiritual beliefs.

The new legislation, SB 189, which passed in July and will be signed into law on Jan. 1, 2024, allows Oregonians to have a say in what happens to their amputated body parts in accordance with their cultural, religious and spiritual beliefs.

“Today, we at St. Charles are celebrating the passage of this legislation along with our friends and partners in the Confederated Tribes of Warm Springs. It’s a great example of listening to our community, hearing a concern, thinking creatively and taking responsive action alongside those who are most impacted to make a difference,” said Dr. Steve Gordon, president and CEO for St. Charles.

For years, caregivers at St. Charles experienced a barrier to care for some patients. Under existing state law, amputated body parts are considered pathological waste and their disposal is required.

“Many of our Native American patients that were in need of medical intervention requiring amputation of a body part didn’t want to seek necessary care if they weren’t able to receive the body part back after surgery,” said Dr. Shilo Tippett, manager of caregiver experience and inclusion for St. Charles. That’s because many members of the Tribe believe they must be buried whole to travel to the spirit world after death.

While the new law will likely only directly impact a handful of individuals each year, its significance is hard to overstate.

Jonathan Smith, Tribal Council Chairman for the Confederated Tribes of Warm Springs, said that the passage of the law as well as the partnership that brought about this change means a great deal to the Tribes.

“We are very happy. We knew it was a concern and it had been on the books for a long time. It was really good to see St. Charles support us in this,” said Smith. “Our continuing partnership is going to be a key for success in the future.”

St. Charles caregivers began the effort to change the law last summer when they surveyed members of the Warm Springs community during a health fair. Overwhelmingly the residents said they wanted the law to change.

“It felt so unfair to our Tribal people and to our staff who wanted to support their patients. It felt morally wrong not to be able to do this,” said Tippett, who is also an enrolled Tribal Member. St. Charles staff worked alongside a lobbyist from the Tribes and collaborated with many groups, including Tribes from across the state, to move the legislation ahead.

“This is huge. For native people, this is removing a barrier to journey into the spirit world and it feels wonderful to know that we at St. Charles had a hand in that,” said Tippett.

In so many ways, I can’t believe one year has gone by since I took on the interim role of president and CEO for St. Charles Health System.

It has been a remarkable 12 months. Before I pause to reflect on all that has happened, it’s worth revisiting my three main goals I shared with you in my July 2022 column:

• Create a better experience for St. Charles patients, caregivers and physicians.
• Improve the health system's financial situation.
• Find and hire an inspiring new president and CEO to lead us forward.

Since then we’ve weathered extraordinary challenges, and we’ve made exceptional progress. We reorganized ourselves around service lines, streamlined decision making and renewed our focus on and investment in our people. Our turnover rate has stabilized at below pre-pandemic levels. Month after month, people are choosing to work for St. Charles and are choosing to stay with us. Financially, we have maintained a positive operating margin for the first half of 2023 at a time when health care finances remain uncertain throughout the state and nation.

I hear regularly from grateful patients about the excellent care they receive at St. Charles. That makes me incredibly proud because I know that excellence happens one patient at a time, but creating conditions for excellence takes perseverance, focus and a continuous improvement mindset. Across the health system, we have maintained a care delivery environment we can be proud of, not just because we provide that care to the communities of Central Oregon, but because it is as good as care delivered anywhere.

Like many of you, I am deeply concerned about the state of health care in America today. I fear that despite our best efforts, St. Charles will continue to face intense external pressures and we will see little in the way of relief from insurers, policy makers and regulators. We are beginning to work on a three-year strategic plan to ensure we are all rowing the boat in the same direction. We are also continuing our focus to reduce administrative burdens through negotiations with insurance companies by evaluating our ongoing participation in Medicare Advantage plans. We hope to share more about both of these important efforts soon.

It’s easy to see how much we’ve accomplished toward the first two goals I outlined one year ago. When I wrote out that third goal, I fully intended that we would find someone other than me to serve permanently as CEO. Instead, working alongside our great caregivers, physicians and providers inspired me to stay on, and I remain energized to keep building upon our recovery and to preserving, strengthening and evolving our services sustainably into the future.

Sincerely,
Steve

Caregivers at St. Charles take organ donation incredibly seriously, treating each donor patient with care and compassion, according to Lori Gaston, Director of Critical Care Services.

“It’s such a gift these donor patients are offering. It’s really powerful to think of the lives that will be saved,” said Gaston. “We have passion around this at St. Charles, around providing excellent care to these critically ill patients. And then ‑ if life is not possible ‑ there’s a drive to say, ‘What other lives can we help save?’ And we find the most comfortable, caring way possible to potentially share organs with others.”

That commitment and dedication was recently recognized, as St. Charles Bend was one of only a handful of hospitals in the Northwest region to earn the Cascade Life Alliance Hope Award. The honor, which was received by teams from St. Charles Bend’s ICU and operating room, is given to hospitals that demonstrate outstanding efforts in support of saving lives through organ donation.

Nikki Ryan, Hospital Development Coordinator for Cascade Life Alliance, said St. Charles was honored specifically for recording a 99 percent timely referral rate and 100 percent conversion rate last year. She explained that these statistics essentially mean that St. Charles “recognizes the importance of these rare opportunities and is able to compassionately support families through these difficult end of life decisions. The topic of organ donation can be incredibly sensitive, especially when a family is unsure of their loved ones wishes and requires a high level of sensitivity to navigate. There is a lot to be proud of.”

In 2022, St. Charles helped facilitate 34 successful organ donations from 13 donor patients. Ryan says organ donation is an incredibly rare opportunity, with less than 1 percent of deaths happening in a way which can allow for organ donation to occur. In order for any life-saving donation to happen, hospital staff must be highly trained to ensure these rare opportunities are not overlooked.

St. Charles partners with Cascade Life Alliance, the federally designated Organ Procurement Organization (OPO) serving the state of Oregon, to facilitate the organ donation process and provide lifesaving organ transplants to those in need.

“This honor shows that our teams are on it. The passion around donation at this organization is palpable and impressive,” said Gaston.

A team of St. Charles caregivers recently returned from the Central American country of Belize, where they provided much-needed medical services free of charge to underserved rural populations.

The group was led by Dr. Les Dixon, a physician at the Madras Emergency Department who first traveled to Belize in 2017 with the Ohio-based nonprofit Partners for Medical Relief at the urging of his oldest daughter Chloe. After hearing her parents’ stories about past medical trips, the then-15-year-old encouraged her dad to take another one…and to bring her along.

“That first trip with Chloe was pretty impactful,” Dixon recalled. “The need for medical resources was huge, but the Belizean peoples’ outlook on life and how happy they were was pretty powerful.”

The father/daughter trip became an annual affair, and Dixon started recruiting his St. Charles colleagues to join them. This year, they brought their largest group yet, a mix of six health care providers and four of their family and friends who joined to help with logistics and support the mission. In February, the team traveled to Corozal, Belize, where health care resources are extremely limited and there is only one doctor for the 50,000 residents in the area.

Along with a larger group from Cincinnati, they were split up into two teams: One that put on clinics in rural villages, and a surgery team that worked out of a local hospital. Both teams did as much as possible to use local staff and to integrate with and support the local health care system.

“At the village clinics, you can come and get your blood pressure and blood sugar checked, get your vitamins, worm pills, get started on medication,” Dixon said. “But a lot of patients just want a provider who has some training who can look at them and go ‘Yeah, you’re doing well.’”

This year’s trip was the first for Matt and Julie Cline, an ER nurse and occupational therapist, respectively, who were part of the village team. Outside their clinics, hundreds of people would line up to wait to be seen, some having traveled for several days to get there.

Diabetes and hypertension were prevalent conditions in the villages, Matt Cline said, but eye problems were also common. “They don’t have much access to glasses there. Unfortunately, we didn’t have an optometrist on the team, but we brought down a lot of prescription glasses, readers (and) sunglasses,” he said. “There were people who had mentioned having headaches for years, and we would give them a pair of $2 reading glasses and it’d be a life-changer for them.”

Julie Cline was the first occupational therapist to join the team, and she immediately saw a huge need for therapy services.

“They hadn’t had much of a therapy focus before, but I felt like therapy was one of the most important services we provided,” she said.

Julie Cline saw an average of 25 to 30 patients a day, including many pediatric cases and children with autism, ADHD and speech and sensory disorders. When seeing adults, many of whom do hard manual labor, she encountered numerous neuropathy and work-related injuries causing chronic aches and pains.

“We talked a lot about positioning while working and sleeping, because many of them sleep on the ground or in hammocks,” she said. “I gave them exercises to do for stretching, flexibility and strengthening, and focused a lot on their posture. Just those little simple things that can make a huge difference in their everyday life.”

Darlene Merlich, a surgical technician based in Prineville, had the critical job of preparing the operating rooms, which due to lack of local staff are not open most of the year. This being her third trip to Belize, she came equipped and prepared to ensure the operating rooms were as close to familiar standards as possible, thanks in part to some donations from St. Charles.

“The surgical equipment they have in Belize is almost always donated and pretty old,” she said. “This year I was able to bring down three full trays of surgical instruments from St. Charles Prineville, and 12 suitcases full of donated surgical supplies. We went from just getting by with what was there to being able to provide a much better patient experience.”

In addition to helping people who need help, the trip provided valuable medical experience for the caregivers, Merlich said.

“It was great for me to get in there and sharpen skills while also learning new ones," she said.

The surgical team primarily did hernia surgeries and gallbladder removals, with the occasional biopsy or mass removal. Dr. David Carne, a general surgeon at St. Charles, said some of the patients had been living with hernias for years and even decades, and the free surgeries made a huge difference in their quality of life.

“It’s amazing what these people can put up with for years, and they've obviously been miserable,” Carne said. “They just don’t have any other alternative. It's hard because we usually have 200 to 300 people waiting to be seen on that first day, but we can only provide treatment to 70 to 80 of them.”

For the future, Dixon and Carne hope to increase surgical capacities on the trips.

“The need for elective surgery is huge,” Dixon said. “If we could find a way to grow our surgical presence to really bring down the sheer load of people who need surgery, that would be a huge service to the people of northwest Belize.”

Carne is fluent in Spanish, so he handled pre-op for patients himself: Meeting them, explaining the procedure, answering their questions, and generally making them more comfortable. This year, for the first time, he was also able to follow up with his surgical patients through WhatsApp after returning to United States.

“Being able to follow up and connect with them afterwards, it’s been a game changer and they’re so grateful,” he said.

All involved said they want to make the journey to Belize as often as possible and bring more providers, support staff and resources in future years. All, too, spoke of the need for more health care providers from any and all specialties.

“If you’re in the medical field, you enjoy helping people and want to give back in this way,” Julie Cline said, “this trip is one of the most rewarding things you can do.”

For more information on Partners for Medical Relief or its upcoming medical mission trips, visit www.partnersformedicalrelief.org.