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November of 2020, Hospital Mission Tarahumara

The past 21 days have forced us to come face-to-face with a pandemic that we had only read about on the news. Our state of Chihuahua, Mexico is currently experiencing a COVID-19 outbreak that is completely overwhelming the medical system. The headlines are heartbreaking: government hospitals are at 100% capacity. Men and women are dying in ambulances waiting to be seen. Private hospitals are requiring $30,000 USD upfront to admit a patient with COVID. Families are scrambling to locate oxygen tanks for loved ones who can no longer breathe.

In October, the governor of Chihuahua placed the state on “red light” status and ordered mandatory closings of restaurants, businesses, and churches.

Earlier this year, we had seen cases of COVID trickle into the Copper Canyon but had not it yet arrived in full force. The Tarahumara people’s attitude toward “el virus” varied from fear to ambivalence. In March, rumors circulated that those with COVID who sought care at any hospital would be tracked down, their homes burned, and fluid removed from their right knees. Others believed it to be a hoax and a disease of the “chabochi” or white man. Due to widespread misinformation and lack of testing, it was difficult to determine the true number of COVID cases in our region.

Two young Tarahumara girls during the pandemic

In October, our little town of Samachique hosted a large quinceañera for a community leader’s daughter. Several cows were slaughtered, and over 500 unmasked attendees celebrated until the early morning hours. Around that time, we began seeing an influx of patients with respiratory symptoms. Despite our best efforts to adhere to strict PPE (personal protective equipment) guidelines, a large percentage of our hospital staff developed suspicious COVID-like symptoms.

Our family started getting sick too. Ten-month-old Caroline began vomiting and spiking fevers. Lucy lay on the couch coughing and didn’t want to play outside. At first, Willy and I thought our headaches and muscle pain were the result of a hectic week at the hospital. But by Friday I woke up with the sensation of knives stabbing my throat. I grabbed my cellphone flashlight to find patches of pus on my tonsils. We knew it was time to test. The mission hospital had eight COVID PCR testing swabs available. Those of us who met Mexican government criteria for testing filled out long forms in Spanish. We were swabbed in the hospital lab, then our mission pilot flew the specimens in a cooler to the city lab.

The missionary bush plane prior to departure

In the meantime, those of us with symptoms of COVID were placed under a 14-day-quarantine. As we lacked the manpower to staff the entire mission hospital, the administration decided to downsize operations to respond to emergencies only. Overnight, the usual bustle of the mission hospital came to a standstill. The surrounding community seemed to sense it too. Fruit vendors no longer stopped by; empty playground swings creaked quietly in the wind.

On the morning of October 27th, Willy and I were notified that we were both COVID positive. Of the eight doctors at our hospital, five of us had been infected. As he had already tested positive and had largely recovered, Willy volunteered to round on the affected staff members in their homes. Every morning, he donned full body personal protective equipment, completing a meticulous sanitizing routine at each home he visited. Logs were kept of patients, symptoms, oxygen levels, x-ray results, and any medications given. In between home visits, we spent our time reading treatment protocols, journal articles, and “phoning friends” internationally who had experience treating patients with COVID.

Willy preparing to care for patients with COVID-19

The week that followed was harrowing to say the least. Two of our staff doctors with COVID began to deteriorate. The first, Dr. David, was an outstanding general practitioner with a special interest in OB-GYN. He and his wife Alejandra (a nurse) met at Hospital Misión Tarahumara, then were married in 2016. Dr. David was not only an excellent clinician, but he knew how to keep his cool under pressure. So much so that in 2019 on his first day as an attending physician at the hospital, he developed intense abdominal pain but continued seeing patients. Later that evening, Willy operated on Dr. David for a perforated appendicitis.

Dr. David being transported to the city hospital

By the afternoon of October 30th, Dr. David was requiring 8 liters of oxygen per minute and was extremely weak and struggling to breathe. His chest x-ray showed multi-lobar pneumonia. Willy quickly arranged to transport him by ambulance to a nearby government hospital. The next morning, thanks to coordination made by our hospital director Dr. Mike Berkeley, a bed became available for him in the capital city. We praise God that within several days he began to show improvement. David and Alejandra were in tears with gratitude for the care they had received. In Alejandra’s words “I felt like David was given back to me from the dead.”

Dr. David and Alejandra feeling much better

Our missionary community breathed a collective sigh of relief. But that feeling was short-lived. Two days later, Dr. Pedro, a dear 70-year-old staff physician also became critically ill. Dr. Pedro and his wife Dr. Rosi had faithfully served the Tarahumara people for 20 years, behind the scenes, with extremely limited resources. Whenever we saw him in the hospital, he would break out into a gigantic smile and modestly offer an amazing tidbit on the management of tuberculosis or some other tropical disease. By November 1st, we were running out of key medications used in COVID treatment protocols. Dr. Pedro was requiring 10 liters of oxygen per minute and Willy was proning him (positioning him face down) in his bedroom to try to improve his oxygen levels as we prayed that an ICU bed would become available.

The staircase

Drs. Pedro and Rosi lived in a tiny apartment above the labor and delivery unit of the hospital. A steep, rickety metal staircase led up to his front door. That night, Willy and I had some difficult conversations. “If we have to intubate Dr. Pedro in his bedroom, how will we transport him down the steep staircase from his apartment?” “What if there is no hospital bed for him?” “If we fly him out, how will he tolerate the change in altitude?”

After a full night of monitoring, we were relieved that in the morning, Dr. Pedro was still alive. Then we waited for a call to see if an ICU bed would be available. At 10 am, news arrived that a patient in the COVID unit had died and there was a possible vacancy. Then that plan fell through. By the afternoon, a hospital bed miraculously became available an hour away by plane. The hospital staff jumped into action. Willy and fellow missionary Walt cautiously lowered Dr. Pedro down the steep staircase on a backboard to the waiting ambulance. I waved goodbye and forced out a word of encouragement to Dr. Pedro as he was loaded into a long plastic tube for transport. His grey, wrinkled lips broke out into a weak smile. Inwardly, I worried that this would be the last time I would see his face.

The team evacuating Dr. Pedro

Evacuating an unstable COVID patient in a 3-seater Cessna plane was no small feat. The back seat had been removed to fit the foot of Pedro’s stretcher in the cramped tail portion of the plane. A special aeronautical oxygen tank was positioned next to him with each liter carefully calculated to ensure it would last the flight. Our pilot Brent flew as low as possible to avoid further oxygen issues and left the plane’s windows open. Willy balanced a portable crash cart on his knees in the event of an emergency intubation. Thankfully, the flight went smoothly and the team landed safely in the neighboring city. After a short ambulance ride, Dr. Pedro arrived at the government hospital and was admitted to the COVID unit.

Our dear friends Dr. Pedro (left) and Dr. David (right) team up to practice neonatal resuscitation at Hospital Misión Tarahumara last year

Over the past week, people from all over the world heard about the outbreak in our community and began to pray for Drs. David and Pedro. We witnessed the power of those prayers as both of our friends began to slowly recover. Dr. David was discharged home on November 6th and remains on 4 liters of oxygen. Willy visited him this morning and reported that he was smiling, joking, and enjoying a homemade stew with Alejandra. Dr. Pedro remains hospitalized in serious condition, but he is stable. He and Dr. Rosi want to express their immense gratitude to those of you who are praying for his recovery.

Willy recently told me that leaving two of his close friends in COVID units has been one of the most emotionally draining experiences he’s ever faced. Though this past month has challenged us in many ways, we feel certain that we are in the right place at the right time. Thank you for your support which helps provide care for these incredible health care workers who are laying down their lives to serve the Tarahumara. Thank you for bringing hope to our friends in Mexico at this critical moment when they need it most.

Perhaps the heavy headlines of today’s world have left you wondering how you can make a meaningful difference. Know that God has strategically positioned you in the “mission field” you find yourself in, right now. Whether it’s by giving, praying, calling to check on someone, or just being present in their moment of need, God can use you as a vessel of hope to a hurting world.

PRAY WITH US!

Thank you for your prayers and support that allows our family to serve in Mexico!

Please pray:
-For the complete recovery of Drs. David and Pedro and for peace and strength for their families during this difficult time.

-For wisdom for our hospital administration as they develop a strategy to receive an increasing number of Tarahumara patients with COVID, and for the resources needed to treat them.

-For endurance and protection for our family and other health care workers at Hospital Misión Tarahumara during the COVID pandemic.

 Let us know how we can be praying for you and your family!

The Bustinzas
Willy, Jessee, Lucy & Caroline

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