Gynecologic oncologist’s passion brings needed care to women in Guatemala
Key takeaways:
- Mission work centers you, keeps you grounded and lets you know you are in medicine for the right reason.
- Seek out your passion and be a leader in that passion.
Monica Avila, MD, MPH, became involved in mission work through a program during medical school that brought her to Peru for nearly 2 months.
In that setting, Avila, gynecologic oncologist at Moffitt Cancer Center, went out to local communities with other medical students to screen women for cervical cancer and referred those with any abnormalities to the central clinic to seek medical care.
Fast forward several years, and Avila is now involved in mission trips to Guatemala through the Faith in Practice organization.
“Faith in Practice is an organization specifically seeded in Guatemala. One of two hospitals is located in Retalhuleu, which is about 6 hours from Guatemala City by bus, and is where I go to volunteer,” Avila told Healio. “At the hospital, there are four operating rooms set up with all types of medical equipment that people have brought from other missions over time and we also bring medical equipment every time we go.”
For many women, seeing Avila is the first experience they have ever encountered with women’s care. In fact, she performed the first-ever laparoscopic hysterectomy at the hospital.
“I am responsible for all gynecologic surgeries in the hospital, and there’s a lot of ‘MacGyvering’ that goes on because the equipment is either sparse or semi-functional,” she said. “As surgeons, we have to be creative in what we put together and how to get the operation done, especially for minimally invasive surgeries.”
Back to center
After many years of medical training and working long-hour days, Avila said that mission work is what helps to bring her back to center.
“Providing care for these women reinforces the reasons why I went into medicine. In a way, it takes me back in time,” she said. “There is no centralized charting system. Instead, everything is done on paper. We actually get the time to spend with our patients. Even the way we do morning rounds brings me back in time. The next day after performing surgery, it’s really old school where they have a long ward where all patient beds are lined up and separated by curtains and we get to talk with them one at a time and hear their stories.”
For some, the procedure is their miracle surgery, Avila continued.
“They walked for miles and waited for months, and they’re just so grateful, loving and excited that they’ve had access to medical and surgical care. It melts your heart and really centers you, keeps you grounded and lets you know that we’re in it for the right reason. There’s hope, and every little bit that we do counts,” she said.
Since her first trip to Guatemala last year, Avila said the number of resources has increased.
“Every time we go, there’s more Guatemalan medical staff that have been trained,” she said. “Everything grows little by little, even if we cannot see the entire picture, we certainly see the little bits at a time and it’s very rewarding.”
Project ECHO
Avila has also become involved in Project ECHO through her connection with Kathleen M. Schmeler, MD, gynecologic oncologist in the department of gynecologic oncology and reproductive medicine at University of Texas MD Anderson Cancer Center.
“Project ECHO is a telehealth program spearheaded out of the University of New Mexico, which is where I graduated and completed a combined degree program, both bachelors and medical school,” Avila said. “At the time, it was mostly used as a means of communication for the liver surgeons to communicate between the University of New Mexico and the local clinics because it is a very rural state. Since then, it has grown and now has an oncology portion that is headed by Dr. Schmeler. I learned about the expansion of the program through her and started participating in the Latin American project.”
Avila’s goal is to expand the project and provide more than educational offerings.
“The project links providers all over Latin America and involves case reviews and case studies that are done on a monthly basis for providers to log in and learn from,” she said. “One of the eventual goals is to not only use the telehealth program to discuss pathology and/or difficult cases but to actually give treatment recommendations specific to each patient. The hope is to get that started in Guatemala and get ongoing feedback on how to treat patients after surgery because it’s not just about the surgery but about staying in contact with each patient and continuing treatment even when not physically there.”
Get involved
Avila said that one of the biggest lessons that she learned during fellowship is to seek out your passion and be a leader in that passion.
“While women are highly represented across U.S. medical schools, they very rarely go into oncology and even less go into surgical oncology,” Avila said. “Women are a huge necessity in female-driven specialties in general and all over the world. When you go to these rural communities and realize that no one is there providing any sort of female care, it is eye-opening.”
To get involved in mission work, Avila recommends reaching out to colleagues who have served in the past. Faith in Practice is also always looking for more physicians to join.
“If I can do anything, even if it’s planting a small seed in somebody to get the itch to provide care in areas of need, even if it’s only once or a handful of times, then I have done my job in spreading the word and have hopefully made a difference,” she said.
For more information:
Monica Avila, MD, MPH, can be reached at monica.avila@moffitt.org.
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