Missions of Mercy

The Baltimore Sun

This is the last in a series of weekly articles highlighting people in the Baltimore area who exemplify the "Spirit of Sharing," The Sun's annual holiday campaign.

Mercy Medical Center nurse Gisella Alvarez was told last July that she had breast cancer. Her reaction was typically selfless.

"When I was diagnosed, my first concern was 'Will I be able to do my mission work?' "

Answer: Yes.

Alvarez, 44, underwent a double mastectomy and, come October, used two weeks of vacation to go serve as a volunteer on a medical aide project in Peru - for the ninth consecutive year.

"I don't know how she touches so many people. It's a talent," says Vince Fitzgerald, a physician's assistant at Mercy who was a first-time volunteer on that trip. "She has a passion for doing this stuff."

The annual Peru mission brings First-World surgical skills and medical care to a remote area of the Andes Mountains. During their 14-day stay, 40 volunteer doctors, nurses and support crew set up shop inside a Spartan hospital that has outdated equipment, no blood bank and no telephones.

Yet they managed to perform 186 operations (everything from hernia repairs to skin grafts) and attend to 800 other patients.

"We get more out of it than what we give them," says Alvarez. "They think of you as gods. They have this incredible appreciation for anything you do. It's a very humbling experience."

Launched in 1989, the Peru program is run by Pennsylvania-based Global Health Ministry, a member of Catholic Health East, one of the country's largest nonprofit hospital networks.

The Sisters of Mercy, founder of Baltimore's Mercy Medical Center, is one of the religious communities that make up GHM. In 1998, Alvarez responded to a general e-mail request seeking mission volunteers and was selected to participate.

In everyday life, she's a patient-care coordinator for the medical surgical unit at Mercy. That initial trip to Peru suddenly thrust her into an operating room that tries to function under combatlike conditions.

"Completely out of my comfort zone," acknowledges Alvarez. "I was nervous."

But she performed so coolly under pressure that the next year Alvarez was asked to be the mission's team leader. That has been her role ever since.

"She's basically running an OR [operating room] and a primary-care physicians' office in two weeks," says Kathryn Ries, an administrator at the Johns Hopkins University School of Medicine and a GHM volunteer. "She's an incredibly organized person."

Proof can usually be found in Alvarez's arms: the three-ring binder labeled "G's Brain" that she carries clutched to her chest like a jewel box. It contains surgical schedules, copies of volunteers' passports, emergency contacts, medical forms, lists of medical suppliers and more. NFL coaches have thinner playbooks.

Alvarez - who is single and lives in Pasadena - came to Baltimore in 1981 to live with two aunts. She graduated from the University of Maryland and immediately went to work at Mercy Medical Center.

But she grew up in the mountains of Colombia, never forgetting that life can be blisteringly hard and good health often a luxury. That's part of the attraction of taking a GHM "vacation"; that and the brothers-and-sisters-in-arms camaraderie of the medical teams.

As Alvarez says, "Prima donnas are not going to volunteer to do mission work."

Supervising the Peru mission is like having an unpaid part-time job. Right now, Alvarez is writing her 2006 post-trip reports. Next she'll hold a bake sale at Mercy to help fund the "side projects" she does on every mission. Last year she raised $3,057, most of which went toward buying school supplies and food for needy families.

March will be an off month because Alvarez is taking a week's vacation to travel to her native Colombia - on another medical-relief mission for another nonprofit. (That trip is less pressure, however: She'll be a nonsupervisory volunteer nurse.)

In April, the 2007 crop of Peru volunteers will meet outside Philadelphia for a weekend of team-building and preparation sessions. Shortly after that, Alvarez will start coordinating overtures to hospitals and drug companies, soliciting all the medications expected to be needed on next October's mission. Teams have to take their own supplies with them, from sutures to an anesthesia machine.

"We don't get one cent of corporate support," says Sister Mary Jo McGinley, executive director of GHM, noting that she relies on individual contributions, plus the $2.5 million of in-kind donations rounded up this year.

Alvarez does some procuring of her own. She started a "Global Outreach Donation Center" at Mercy, a fancy name for the 14th-floor closet where she stores unwanted medical supplies.

By law, a still-packaged catheter with a broken seal can't be used in a U.S. hospital. But why toss it away when other countries need them? Same goes for perfectly good towels, surgical blades or crutches all headed for a landfill.

Several times a year, Alvarez ships a few boxes of that surplus bounty to a medical-products recycler in Atlanta that services nonprofits. Some of those items find their way to her Peruvian mission.

The city of Chulucanas is about a 14-hour drive from Lima, up in the clouds where health care is spread as thin as the air. There are 250,000 people in Chulucanas proper; 500,000 if you include outlying areas. They're served by one 50-bed hospital.

That's where the GHM team takes up temporary residence, assisted by a few local doctors and nurses, plus a host of villagers who cook, wash laundry and run errands.

There are 18 Catholic parishes in and around Chulucanas. Church officials screen prospective patients, deciding whose condition demands immediate attention. The wait for a surgery slot can be several years.

The poorest of the poor come from high in the hills. Some travel as long as nine hours by bus, mule and foot to get to the hospital.

These are leathery men and women who lead tough lives. Their pain thresholds are above the norm. Alvarez notes that the average post-operative patient in Chulucanas requires 1 to 2 milligrams of morphine. Back home, it's 6 to 8 milligrams.

"They're stoic," she says. "Women have a hysterectomy today, they'll be leaving the next day. That would never happen here in Baltimore."

The level of treatment in Chulucanas is getting better with each GHM visit. Volunteers spread the gospel of preventive medicine, particularly to pregnant women (an important message since half of all babies are born without even a midwife in attendance). They also keep stocking the hospital with quality hand-me-down equipment from America; the theory being, a used incubator is better than no incubator.

But, in many ways, Peru remains the dark side of the medical moon. Volunteer ophthalmologists, for example, must get down to speed on cataract surgery, boning up on techniques from 30 years ago: The nearest laser machine is hundreds of miles away. In October a woman had a 30-pound benign tumor removed from her uterus. Doctors and nurses don't encounter asteroid-size growths like that at Mercy Medical Center.

That's why Gisella Alvarez takes more than her "G's Brain" binder and stethoscope to Chulucanas. She packs her faith too.

"When I'm in Peru," says Alvarez, "there's not one day I don't start the day with a prayer."

tom.dunkel@baltsun.com

global health ministry

Global Health Ministry dispatches medical mission teams to Guatemala, Haiti and Jamaica, in addition to Chulucanas, Peru.

This year, 101 volunteers went abroad. You don't need to be a doctor or nurse, or even Catholic in order to participate.

"Our volunteers come from all walks of life, all faiths," says Sister Mary Jo McGinley, GHM's executive director. "This is not an evangelical organization. Our mission is to bring health and health education to communities."

Volunteers not only donate their time, they pay $500 apiece to support the mission. Most trips last two weeks.

The hours are long, the living and working conditions austere. But team members say the experience of bonding with fellow volunteers and local residents can be as rewarding as helping patients. The first few days back home are often emotional.

GHM relies on private contributions, many quite modest. As McGinley notes, "We're as grateful for the $2 that comes in an envelope without any name on it as for the $1,000 we get from a former volunteer."

Donations may be sent to Global Health Ministry, 14 Campus Blvd., Suite 300, Newtown Square, PA 19073. Phone: 610-355-2003. E-mail: info@globalhealthministry.org.

For ground-level information about the Peru mission, contact Gisella Alvarez . Her e-mail address is gialga@hotmail.com.

Spirit of Sharing

The Sun's annual Spirit of Sharing Holiday Campaign raises money to help needy families in the Baltimore area during the holidays. The campaign, administered by Baltimore Sun Charities, a fund of the McCormick Tribune Foundation, runs through January. For every $1 contributed, the foundation will contribute 50 cents (up to $100,000). Administrative costs are covered by Baltimore Sun Charities, so all money raised will be distributed locally to those in need. Donations are tax-deductible. Contributions may be made online at baltimoresun.com/spiritofsharing, by phone by calling 888-683-4483 or by sending a check to Baltimore Sun Holiday Campaign, 501 N. Calvert St., Baltimore 21278-0001.

The agencies featured in the Spirit of Sharing articles are not necessarily past or future grantees of the Baltimore Sun Charities Spirit of Sharing campaign.

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