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Right Place, Right Time

Trisha Combs and Annie Hahn: right place, right time

Sometimes life puts you exactly where you need to be at precisely the moment you are most needed. For Annie Hahn and Trisha Combs the where and when was San Pedro Sula, Honduras in September 2012. Hahn and Combs were volunteers for Operation Walk Pittsburgh, a medical service organization that provides free hip and knee replacements for patients in developing countries and parts of the United States. How they got there and what they did there make a wonderful story.

Hahn, a Delaware native, came to Duquesne University on a swimming scholarship. She graduated with a degree in physical therapy and went to work for the UPMC Outpatient Physical Therapy Center where she met Dr Anthony Michael Gioia. Dr. Gioia, the medical director at Magee in charge of the UPMC Orthopedic Program,  also has a foundation, AMD3, which sponsors Operation Walk Pittsburgh. When Hahn learned about the program, she put her name on the waiting list to volunteer her Physical Therapy services.

Hahn was on the waiting list for three years before the call finally came. By that time, she had left UPMC to open her own business, Restoration Physical Therapy at Route 19 and Boyce Road in Upper St. Clair.

Same work, better weather

Trisha Combs grew up in Indiana, attended Purdue University majoring in office management. After completing her degree, she moved to the Pittsburgh area and worked in her field. After ten years, Combs made a life changing decision and enrolled in Nursing School at CCAC. She earned her Associate’s degree in Nursing and worked for five years at Allegheny General Hospital in the trauma unit, followed by a stint in the operating room at St Clair Hospital. In the OR, Combs injured her back while transferring a patient from a gurney to the operating table. She needed physical therapy and went to see Hahn.

Hahn and Combs hit it off immediately and became friends during the course of Comb’s physical therapy. Combs left the hospital and went to work for South Hills Orthopedic Surgical Associates on Vanadium Road in Bridgeville. She also enrolled in Slippery Rock University to obtain her Bachelor of Science for Nursing.

After a spot opened up for Hahn on the Operation Walk Pittsburgh team, one of the nurse volunteers had to drop out. Hahn immediately submitted Combs’ name as her replacement.

“I wanted to share this experience with my friend, and I didn’t want to be stuck rooming with just anyone,” laughs Hahn, “so I told Trisha she had to go!”

Trish screens OR candidates

“We each had to raise $1,000.00 of the cost of our trip,” Combs says. “Plus, we had to have a complete physical and make sure our immunizations were up to date.”

“We also had to take malaria medication as a precaution,” adds Hahn. “We were so excited to go and try to make a difference in these people’s lives that we didn’t mind the shots and the medicine.”

San Pedro Sula is the world’s most dangerous city. Hahn and Combs were cautioned repeatedly not to leave the hotel or the hospital without an armed escort. As we started talking about their trip, Hahn’s and Comb’s eyes lit up, and they became animated gesturing with their hands and finishing each other’s sentences.

“It was strange at first seeing the armed guards everywhere, but once we got to the hospital the guards became part of the background.  I was so impressed by the people we met. From the moment we got off the plane, the people of Honduras were welcoming, gracious, and incredibly thankful for our presence, said Hahn and Combs.”

It's not the Ritz....

“San Pedro Sula was a lesson in extremes. People there were either very wealthy or very poor. There was a middle class, but it was small in comparison to what we think of in the States.”

“The first day we did patient evaluations at Hospital Bendana, the facility we would be using during our stay. It was small, but very efficient. There are many hospitals in Honduras, but they are all small, more like clinics than the large hospitals we have in the States. The medical director, Dr. Luis Boquin had already completed much of the screening process, which made it possible to start the surgeries much sooner. There were numerous translators, many of them medical students in Honduras, ready to assist us.  We prescreened 70 patients that day and selected 54 candidates for various surgeries. One man was bitten by a dog and because of his fresh wound, we couldn’t do his procedure. We had to put him on the list for next year.”

...but these women are grateful!

“Because the hospital was so small, Honduran volunteers constructed a platform tent with a wooden floor, similar to a MASH Unit, to accommodate the extra patients. Patients spent the night before surgery there.  They spent the first day and night post op inside the hospital then moved back into the tent.  We had one side designated for women and the other side for men. A large curtain divided the room, but it was so hot that we had to keep it open so the cool air from the portable air conditioning units could circulate.”

We would be drenched in sweat, but the patients never complained,” says Combs.

“At first there wasn’t much for me to do as a physical therapist,” says Hahn.  “My work started the day after the first surgeries. Trisha was busy every minute putting in fifteen hour days.”

A different kind of OR for Trish

“The operating room looked just like any operating room in the States,” says Combs, “but the hospital had older sterilization equipment that couldn’t sterilize instruments as quickly as we needed them. We experienced delays waiting for sterile equipment, and once we overtaxed the energy supply so severely that we had a power failure during surgery. One of the other nurses and I had flashlight apps on our iPhones. We had to hold them up over the patient so the surgeon could finish the procedure. Neighboring hospitals shared their emergency generators, and we got back on schedule performing 59 procedures on 53 patients during our week-long stay.”

“Another time, we had to surrender one of our operating rooms, so surgeons could perform an emergency C-section. We all huddled around the observation window watching this new little life come into the world. Though we’d seen hundreds of births between us as medical professionals we all cried when the baby was delivered safely. The father brought her out, so we could see her.”

Hector walks....

“The patients didn’t have access to the level of pain medication we have in the States. Most of them received only Tylenol, but they never complained. I quickly learned the Spanish word for pain is “dolor” and “mareado/mareada” means dizzy. They were anxious to stand for the first time after surgery. Honduran volunteers built special stairs for the patients to climb as part of their rehab. I was impressed by how quickly the stairs were completed and how well they were constructed. The hospital’s physical therapist didn’t speak English, so it was a challenge to communicate, but he was very committed to learning how to help the patients,” says Hahn.

“I only had one patient who gave me a problem. He was a middle aged man who tried to be macho and refuse help getting up to go to the bathroom. He stood up and passed out. Luckily, he fell into the wheelchair, but I thought I killed him. Luckily, Trisha was there and she revived him.”

“One patient, Hector, was probably our favorite. He worked as a concierge at a hotel that did not have elevators. At 36, he lived with constant pain in both hips. It was amazing to watch him take his first steps without pain in seven years. He wanted the surgery so that he could accept a job promotion. Most of our patients just wanted to be able to work and take care of their families; they were so grateful for our help.”

... gets the reward!

“Many of the problems we dealt with were caused because the patient had been born with some sort of defect that could have been easily treated at birth. But, because this level of care was not available, they grow up with physical limitations and often severe pain. Part of what we do is exchange ideas with the medical team of the host country. We try to help them provide follow-up care for the patients, and we receive updates on patients. One of our patients recently fell, and Dr. Boquin was able to repair the damage to her hip.”

Non-medical volunteers visited a local orphanage for girls who had been abandoned or abused. They painted and spruced up the facility, returning the next day with gifts for all of the girls which they purchased with their own funds. Another group visited the Pediatric cancer unit presenting toys to all the patients.

Some rare downtime on their last day.

There were so many random events that had to combine to create this opportunity, but Hahn and Combs’ next trip to Honduras with Operation Walk Pittsburgh is deliberate.

“We’re going again, and we will keep going as long as there is a need,” says Hahn as Combs nods her head in agreement. “It was so gratifying to help improve the quality of these people’s lives. There is no sense of entitlement there, and the people are so grateful. They made us little thank you gifts.”

“I love my job here, but our trip to Honduras helped me realize why I changed careers to become a nurse,” says Combs.

Hahn and Combs will be raising money for their 2013 trip.  For more information about Operation Walk Pittsburgh and how to donate to this cause please visit http://www.operationwalkpgh.org/.

One Response to Right Place, Right Time

  1. Congratulations to you Trish and Annie you are so generous with your time and your talents.
    I realy like reading this article it is well written and so interesting till the end.

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