BajaNomad

Heartfelt journey

BajaNews - 8-20-2006 at 07:09 AM

http://www.sacbee.com/content/news/story/14302764p-15175053c...

A young woman takes her first plane ride and her first trip beyond the Mexican border for life-preserving surgery in Sacramento

By Dorsey Griffith
August 20, 2006

San Quintin, Mexico -- Yoana Gonzalez, looking much younger than her 21 years, stood on a remote dirt airstrip with a brave face and a yellow Winnie the Pooh bear held tight to her chest.

It would be her first ride on an airplane and her first trip beyond the Mexican border. But more than that, it would be a journey that could give her a more certain future.

Within 24 hours, she would be flown 700 miles away, to an operating table at Mercy General Hospital in Sacramento. A medical team would work to improve blood flow from her pulmonary artery to her heart -- and give her the energy most young people take for granted.

Yoana was offered a chance for the life-preserving procedure by the Mother Lode chapter of the Flying Samaritans, a group of doctors and other health professionals who fly into San Quintin on private planes once a month and provide free medical care to the impoverished Baja California community.
For Yoana's family, it was a leap of faith. As the volunteer pilots readied their small aircraft for takeoff last Sunday, Yoana's sister and her mother quietly sobbed.

Her father, Ismael Gonzalez, joked that his daughter would be fine on the six-seat Cessna 205, since she'd already been on "La Rueda de la Fortuna," a Ferris wheel.

Still, the jocularity belied some fatherly anxiety. "Of course we want to do everything we can for her," Gonzalez said. "The only problem is that I can't be there with her."

The Gonzalez family watched Yoana climb aboard the tiny plane, then stayed behind, waving goodbye until the last of four private aircraft was out of sight.

The first signs that something was wrong with Yoana emerged when she was about 2 years old. Her mother, Laura Melgoza de Gonzalez, said her rebellious daughter couldn't chase her big brother, Ismael Jr., without breathing hard. Too hard.

But in their hometown of Punta Colonet, a desolate dot of a place along Highway 1, getting medical assistance would prove elusive, time and again.

Without local expertise or health insurance to pay for surgery at an urban hospital, Yoana's dangerous heart defect would continue to plague her into early adulthood.

A doctor confirmed a congenital heart problem when Yoana was 7. But when the family sought a doctor at a Tijuana hospital, they were turned away.

The problem didn't go away. "One time, when she was 13, we were on the beach," Ismael Gonzalez recalled. "She was running and she passed out. She was unconscious for about 15 minutes. It scared us to death."

Yoana, who dropped out of high school five years ago and returned last fall as a sophomore, has never been able to take part in physical education classes or play basketball with her brother and sister. She's tried to work as a farmworker, but had to quit.

When her symptoms worsened this past year, her family again sought help, this time at an Ensenada hospital. "A doctor did tests," Yoana said. "He said I had to have the surgery."

She never got it in Ensenada. "It cost 75,000 pesos," an amount equal to $7,000 in U.S. dollars. "My parents don't have the means to pay for this. We couldn't do anything."

Ismael Gonzalez is a self-employed fisherman and doesn't have health insurance and doesn't qualify for government benefits.

Yoana's condition, pulmonary stenosis, occurs in about one in 10,000 people and kills one in 100 every year. It's dangerous because when the blood flow is obstructed, pressure builds in the right ventricle, making it hard to push blood out to the lungs. The problem is typically detected and corrected early in life. But for Yoana, it seemed like a life sentence; one doctor told her to forget about ever having children.

Yoana was years past due for a balloon pulmonary valvuloplasty, a catheterization procedure to open the blocked valve so blood can flow normally.

Ismael Gonzalez heard about the Samaritans' clinic three months ago, and drove to San Quintin, an hour and a half from their home, for the scheduled clinic in May.

When they arrived, Gonzalez recounted his daughter's story to Dr. Bill McDavid, one of a handful of doctors who had made the monthly trip to San Quintin. The doctor held his stethoscope to Yoana's chest.

"I listened, and she had a very loud heart murmur over the left side," said McDavid, a retired doctor from Placerville. "I had her jump up and down for 30 seconds and she almost passed out."

McDavid asked Yoana's father to send him the test results from the Ensenada hospital and to get Yoana a Mexican passport.

Gonzalez sent the results, and McDavid quickly sought expert opinions -- and a doctor and hospital willing to carry out the procedure.

Sacramento cardiologists Arvin Arthur and Jeff Van Gundy agreed to operate without charge, and Mercy General Hospital would absorb the hospital costs. More calls secured a "humanitarian relief" document from U.S. Citizenship and Immigration Services allowing Yoana a temporary stay in the United States.

On Aug. 12, Yoana and her parents returned to the clinic, a pair of shabby buildings on land owned by a private tomato-growing operation on the outskirts of San Quintin.

By 10 a.m. long lines of hopefuls had formed outside. In one, families waited to learn whether they would receive one of 24 coveted Flying Samaritans scholarships awarded annually to high-achieving students to cover the cost of a year in Mexican public junior high and high school -- worth between $150 and $250.

"The government doesn't help us," explained Adalberta N??ez, mother of a 13-year-old boy. "I want my kids to go to school, so they don't have to work in the fields like we do."

Another line formed at the clinic door, which was covered with a gauze sheet in a futile attempt to keep clouds of flies outside.

Among those waiting: a diabetic man with a foot lesion, a woman with advanced ovarian cancer and a newborn with an extra pinky and toe.

In eight hours, the volunteer staff, including four doctors, saw 101 patients.

While the Samaritans offer basic drugs, routine care and medical counsel, many patients leave empty-handed.

"We can't fix everything," said Dr. Bob Haining, a pediatric rehabilitation specialist at Children's Hospital Oakland. "Lots of times I see someone with something I know they will die from, but we can't do anything. You just have to walk away."

This time, no one walked away from Yoana and her parents. McDavid reported she could fly back to Sacramento with the Samaritans the following day.

Pilot Joel Prosser and his wife, Heidi, brought Yoana to Mercy General early Monday morning for blood tests, an echocardiogram and some medicine to make her sleepy for the operation.

As she was wheeled to the hospital's catheterization laboratory, a volunteer with the Flying Samaritans showed her photos of her family taken the day before. Tears pooled in her sleepy eyes.

Yoana was informed that in rare circumstances these operations -- designed to prevent early death -- go awry. She felt afraid.

"She is at substantial risk," Van Gundy emphasized before the procedure. "She needs this."

When the 90-minute catheterization was complete, Arthur and Van Gundy looked pleased. The frighteningly high pressures in her right ventricle had been reduced by half. And yes, she would be able to have children some day, after all.

On Saturday, as she prepared to climb back aboard Prosser's Cessna for the flight home, she said she knew the procedure was a success because she'd climbed stairs without struggling for a breath. In a half day she'd be back home in Punta Colonet, ready for another year of school and maybe even a rugged game of hoops with her big brother.

elgatoloco - 8-20-2006 at 06:18 PM

bump
:yes:

Diver - 8-20-2006 at 07:01 PM

One of many wonderful stories made possible by the generosity of american doctors, pilots and others. Good for them all !!

The other side of Baja

Baja Bernie - 8-20-2006 at 09:50 PM

While we are talking about violent acts we should keep this type of action in mind. This helping each other has been going on far longer than the violence stuff. And, hopefully, it will continue after the violence has played itself out.