by Courtney Nachlas

The Filipino girl had never taken a breath out of her nose. She looked up, with hopeful eyes, at the American surgeons. Their scope to provide light in the third-world hospital had about 25 percent battery left. She was 13 years old.

“I’m not sure we could ever really forgive ourselves if we left this girl with a tumor in her nose,” Dr. Nathan Nachlas said. “There’s no one really else that‘s going to take it out for her.”

Photo by Nathan Nachlas

Dr. Nachlas along with Dr. Michael Aronson and Patty Wilder, their surgical technician, traveled over 30 hours to preform surgical procedures for The Bicol Clinic. The clinic, founded by Dr. Mitchell Schuster, serves as a medical provider over the summer to individuals who have never received proper health care. The clinic works all year to raise the funds for both medical supplies and accommodations for the medical students who spend their summers there. At first glance, it may seem like just a typical medical mission trip, but I can assure you it is far from it.

Dr. Schuster started providing medical care with his wife on her family’s plantation, the Bicol province, back in 1982. Over time, the clinic has stood in a variety of shapes and sizes, yet it always had the same goal: To provide optimal health care to those who cannot achieve it. They’ve now established clinics in The Philippines, Nepal and Haiti.

Photo by Nathan Nachlas

Dr. Schuster: “I was not expecting us to become a referral center for wide and far. I thought with certain amount of financing we would be able to take care of the cases. We get a lot of hardship cases that come from wide distances. The difficult part is having the burden of people coming to you. In their eyes is hope and sadness. They know they have a child with a terminal illness, if untreated, and the pressures that that brings upon the Bicol clinic, realizing that the funds are such a difficult process, especially for people around the world. It’s hard for donors to gain that sympathy and empathy for those around the world who are suffering. It’s one thing where there may be an earthquake in Haiti and everyone’s emotions are aroused and suddenly people dig deep into their pocketbooks and come up with funds. But, on a day-to-day basis it is hard to evoke empathy from donors to care about a child on the other side of the world when America and Americans have their own problems. So, the difficulty in my opinion is realizing the hopelessness that there so many people that I cannot help.”

As I slowly made my way up the hill from my dormitory quarters to The Bicol clinic an hour before its doors were to open, I expected a few early risers to be waiting outside. As I approached, the number of people waiting outside the clinic in the 100-degree weather was closer to 200. Many were my age, smiling back at me with a beacon of hope that they may receive a pack of vitamins after waiting for hours to be seen.

Photo by Nathan Nachlas

Jaclyn Alycia, one of the medical students working with the clinic this past summer put it perfectly: “You have to see it to actually believe it, you can hear about things that are going on in the world, you can hear about the poverty but until you’re actually experiencing it, it is unlike any other. We were talking about how the Filipino people have little to nothing… They’re very much impoverished and in the United States you see poverty as people who still have food stamps, who can go to an ER and get treated, people aren’t denied. Here they are and seeing it, seeing people so ill and not able to get treatment, seeing that they’re actually very happy, they’re just such happy people. Even we had a patient yesterday who was acutely ill and she was just so appreciative to just get care, I don’t think that’s some- thing you see everyday in the U.S. and it’s actually very refreshing.

It puts my life in a little bit more of a perspective, I think, just to see that as Americans we’re always kind of searching for happiness. When I got here and saw our living conditions, my first thought was that I gave up everything, nice running showers to take bucket showers and come to a place where they don’t have internet or connections to technology or whatnot and I gave up all of that to what? Find something that would make me happy, these people live in the moment are happy and it kind of changes your perspective.”

When I first arrived in the Philippines, the idea of pouring a scoop of cold bucket water onto my head to take a shower seemed unbearable. The thought that I would walk outside and be drenched in heat seemed disgusting. Yet, as I dove into my trip more and more, I started to notice a smile on my face as I entered the bucket shower, opposed to dread. I didn’t mind the heat, because I realized that unlike these hundreds of people near me without fans, I had access to them. I started to realize and appreciate where I was.

Dr. Schuster: “As one gets through life one can [create] hierarchy to the things that are important and I think comfort rates some- where in the top ten but certainly not in the top eight.” The greatest thing about the Shuster family is that everyone pitches in to help the cause they’re so passionate about. Dr. Shuster’s wife cooks phenomenal meals three times a day that were both locally grown and far surpassed the meals I eat in the states. As a vegetarian, I was accommodated at every meal to ensure that I felt welcomed and loved. Dr. Schuster’s daughters Jessica and Jennifer have dedicated their lives, it seems, to the Filipino people.

Jessica manages the infrastructure of the clinic. She also organizes all of the medical students coming in, guest doctors staying and works to raise money. Jennifer works with both the clinic and with the local schools in Sorsogon. I had the privilege of shadowing Jennifer as she taught reading comprehension of “The Hunger Games” to her class.

Photo by Nathan Nachlas

Jennifer:  “It has sort of been just a mentality that I carry with me. It has sort of been my whole life. And that is something my

dad taught me, which is: We are all citizens of this world and it is our duty to leave it a better place than when we entered it. So, on my spare time I’m constantly working for The Bicol Clinic to get us organized for these trips, but at the same time I use that mentality with everything I do.”

The trip isn’t just a way to help those without proper health care. The clinic also serves as a teaching center for med- students. Medical students from all over spent their summer working under both American and Nepalese doctors. 

Photo by Nathan Nachlas

Dr. Schuster: “The students feel empowered when they’re next to the surgeons, because they feel that confidence that they’re learn- ing a correct technique. They’re enhancing their education. And, in addition, the surgeons that come are enthralled so much with the trip as well that there’s a sense of joy that goes back and forth. It also is more of an even level of education. It is not a hierarchical thing where the professors look down upon or condescend to the students back home. Here everyone is almost on the same equal footing. It is almost of a friendship.”

Rob: “We get greet hands-on experience here that medical students have been kind of run out of in the past in hospitals. Like, we go to Tulane and we hear stories all the time about Charity hospital and how it was the wild wild west and there was barely any nurses so the med students got to do everything hands on, like running IV’s and giving injections, minor surgeries, treating abscesses. And we got great teachers here and we got to do it ourselves, which is huge. And the people are very grateful for it and we haven’t had any complications knock-on-wood. You know its been great training and I think we’re giving great care and we’re under good supervision. But, we get to do it physically where as in med school it has kind of diluted your education…You don’t get trained like this in the states. “

Photo by Nathan Nachlas

Sean Evans: “We ended up seeing like 3,200 patients in 19 days. From day one we hit the ground running I was doing surgery I mean things I’d never fathomed and the people were impossible to imagine how happy and thankful they actually were. We are very well taken care of as students our accommodations our food and everything else. It really kind of surpassed my expectations at every turn.”

As much as hands-on medical experience helps medical students, inside the clinic was not the only teaching center. The students, doctors and I learned to submerge ourselves into a new culture. Submerging to make friends, to make memories and most importantly, to make a difference.

The American surgeons’ scope went from about 25 percent brightness to about 0 percent brightness by the end of the13-year-old’s case. They successfully removed the tumor. The girl woke up after surgery and was able to take her first breath through her nose.

As Dr. Nachlas completed telling his story he stared into the distance as if recalling that memory. “That was the highlight of my trip,” he said with a smile.