Opal House-Rotary Orthopedics & Podiatric Surgery, 2025
San Lucas Toliman, Guatemala
Dates: March 14-22, 2025. 49 surgery cases in 5 OR days
The Opal House-Rotary Medical Mission team has conducted its eleventh surgical mission trip to the Hospital Obras Sociales de Monsignor Gregorio Schaffer (HOSMOGRESCH) in San Lucas Toliman, Guatemala. The mission or “jornada” was again sponsored by the Fidalgo Island Rotary Club of Anacortes, Washington (www.fidalgorotary.org) and co-hosted by Opal House (www.opalhouseguatemala.com) with additional logistics support from the Podiatry Institute (www.podiatryinstitute.com) and private donors.
The mission’s primary focus is surgical reconstructive surgery of pediatric limb deformities, primarily of the lower extremity. Surgeries were performed by podiatric surgeons and pediatric orthopedic surgeons. This year we had an orthopedic hand surgeon to meet those special needs as well. Our veteran team of volunteers also included anesthesiologists, nurse anesthetists, a team of skilled nurses, a pediatrician, an orthopedic surgical assistant, surgical techs, an electronics engineer, administrative organizers and support staff. We also had two physical therapists from Comayagua, Honduras who volunteered and drove to San Lucas Toliman to serve on this mission, a service for which we have been searching.
One of the highlights of the trip is always to reevaluate patients from prior years. The structural and functional improvement of our past clubfoot reconstruction patients is again astonishing. As podiatrists, mission work is very rewarding. In twisting around a poor child’s clubfoot, we help give them a chance at a normal life. Seeing patients through this life-changing transformation is special. Five of our patients had surgery on their second foot after having surgery on their first foot last year.
This surgical mission evolved out of the efforts of volunteers Will and Diane Boegel who
were called back to Guatemala after a medical mission. Their life mission has become service of
the poor (especially the women and children), the indigent, the sick and the forgotten. Amongst
the natural beauty of the land and Lake Atilan, the local people face many hardships, particularly
the Maya community, emerging from a 36 year civil war. Dr. Boegel selflessly serves and devotes his life toward the treatment of the pediatric population in this area. He and Diane also have a school for up to 100 students on the farm property that educates local poor children using the Montessori method.
The HOSMOGRESCH serves more than 34,000 people locally, mostly who are Mayan,
without discrimination of any sort. Patients were procured via the local clinics and networks of
Dr. Tun and Dr. Boegel. As our former patients have spread the word and informed others in
their communities about our mission, more distant patients seem to find us each year.
well with minimal or no pain.
Pathology encountered included torsional extremity disorders, nonunions, malunions, external fixation, hip dislocation, osteomyelitis, hardware for removal, tumors, cerebral palsy, clubfeet (virgin, rigid, neglected, residual and partially corrected), isolated equinus, and amniotic bands (Streeters). Hand surgeries included polydactyly, plastic scar release, wrist fusion, and emergency repair of a serious machete laceration. In 5 OR days, the team performed over 100 surgical procedures on 49 patients. Ponseti casting was again performed and bracing done and taught by the physical therapists. Several patients had an Achilles tenotomy in conjunction with casting.
Our team was a bit handicapped by the unfinished remodel of the surgical facilities within the hospital: no in-wall oxygen or suction; only two surgical lights for 4 operating tables, no mini C-arm as purchased, and limited anesthesia machines and patient monitors. Still, we were able to conduct surgeries safely and no patients were turned away. The need for surgical treatment remains great in this somewhat remote region of Guatemala.
We appreciate the hospital expansion and complete remodel of the surgery area with the goal of expanding Pre-Op and PACU wards and OR capacity. We provided surgeon input to help with the expansion plans. We remain devoted to the patients in Guatemala and the efforts of Drs. Rafael Tun and William Boegel.
Many of these patients present with very complex problems requiring judicious evaluations and customized surgical plans plus skilled anesthesia, PACU and short-term hospital care. The safety of the patients and their welfare are our highest priorities, while respecting their dignity. In the end, many lives are changed, the ultimate goals being to improve the health and to expand the opportunities for each individual. Every year we come to the same hospital and treat the indigent, we feel we can migrate slowly toward the goal of making the hospital more self-sufficient and attracting other healthcare providers to the area.
Stephen Miller, DPM
Team Leader
2025