What to Expect on a Brigade

Brigade Expectations

In order to ensure the safety of brigade participants and the NPH children and to help orient participants to the brigade experience, we have developed a set of brigade expectations. All brigade participants should familiarize themselves with these expectations and must comply with them during the brigade. Failure to comply could result in being sent home prematurely at the participant’s expense, or being prohibited from attending future brigades. Attending a brigade can be an amazing, life-changing experience. Please help us preserve the program for future participants by respecting these rules.

What Participants Can Expect on a Brigade

Surgery Center

  • The surgery center wait list is long, and the need for surgical care in Honduras is great. Above all else, this is a medical mission trip, and our primary objective is to serve as many patients as possible. You will be asked to work hard, perhaps even harder than you do at home, but your efforts will result in the changed lives of dozens of patients.
  • While our goal is to finish cases at 4 pm, there will be days when cases go longer than anticipated. You may be asked to work longer hours or take fewer breaks than you’re used to at home. While the surgery center staff will do their best to give breaks, it is ultimately your responsibility to make sure you have eaten or otherwise rested. If you need a break, please speak up.
  • While we are strong believers in teamwork, it is agreed upon that the US volunteers leave at the end of a day and that the Honduran clinical staff stay overnight, if needed. Our Honduran staff appreciate the opportunity to earn overtime pay to support their families. When released by brigade organizers at the end of your shift, please leave the surgery center so you can rest up for a busy next day.
  • There will be time built into the schedule to spend on the ranch and with the NPH children, but if you are a clinical participant, you can expect to spend the majority of your time in the surgery center.
  • While we will try to utilize your specific expertise as much as possible, we require your flexibility in order to meet patient needs. For example, we sometimes get donations of supplies (i.e. implants) that must be returned to the company if unused during the brigade, requiring us to focus on certain types of cases.
  • Surgeons should be prepared to see patients in clinic (1-3 days) and perform surgeries (2-4 days) during the brigade. Since the surgery center only has one full-time orthopedic surgeon, providing clinic consultations helps line up cases for surgery and provide follow-up care, especially for other specialties. Time spent in clinic is just as important as time in the OR.
  • A large portion of the supplies and equipment at the surgery center has come to us by donation. This means that the surgery center may have older model equipment and a more limited inventory than you’re used to. We appreciate your willingness to problem solve and to work with the equipment and supplies available.
  • Most of the full-time Honduran staff do not speak English fluently. Many of them, however, are very familiar with English medical terminology. The language barrier can be a challenge, but time and time again we’ve seen the American and Honduran staff find ways to communicate and work together as a team.
  • While general volunteers (including students of health professions) will have the opportunity to assist in the surgery center, they should not expect to spend all day, every day in the OR. Those interested in spending time in the surgery center will also assist with room turnover, instrument washing, laundry, general upkeep of the building, and other projects. For the safety of our patients, we may need to limit the number of people in the surgery center at any given time and ask that a general volunteer take a turn in a ranch workstation.

Accommodations

  • You will be staying in a communal living environment. You may be sharing a room with people you don’t know. Based on housing availability, older children may need to stay in a separate room from their parents. We will try our best to make housing assignments according to roommate requests, but it is not possible to accommodate every request. Unmarried couples are not permitted to stay in the same room together.
  • Your accommodations will be safe and clean, but they will be different from your living environment expectations back home. Power outages, spotty internet connectivity, bugs, cold showers, and troublesome toilets are just facts of life in Honduras. Think “summer camp” as one brigade member adequately referenced. As a reminder, all toilet paper goes in the trash bin and cannot be flushed.
  • Visitor housing is located about a ¾ mile from the surgery center, and the principal way of getting around the ranch is by foot. Please be prepared to walk to and from the surgery center every day on dirt roads and uneven sidewalks, sometimes in the dark.
  • There will be plenty of food available during the brigade, and many previous brigade members have remarked about the high quality of the meals. The meals typically accommodate vegetarian and gluten free diets by offering vegetables and rice. If you are a picky eater or have additional dietary restrictions or allergies, please consider bringing some additional food items to supplement.

What We Expect from Brigade Participants

The Holy Family Surgery Center and SCA Medical Missions have worked hard to build a strong relationship with NPH, and the future of the surgery center and brigades depends on this relationship. Please honor this relationship by respecting the rules set by HFSC, SCA Medical Missions, and NPH. Failure to comply with these rules jeopardizes our relationship with NPH and the future of our mission.

General Expectations

  • You and any family members or friends accompanying you are ambassadors of any surgery center or company with which you are affiliated. Remember to represent your surgery center and/or company well.
  • We are glad to host a number of families on our brigades, and your children will have an amazing experience in the surgery center and on the NPH ranch. Parents, please help us set the expectation that this will be a working trip and help us to enforce the expectations set forth in this document. If we approach you with a situation involving your child, please help us resolve the issue.
  • Remember that children under 13 will need adult supervision at all times, and parents should pack a few items to help keep younger kids occupied.

NPH Ranch

  • We will enforce a 10 pm curfew where all brigade participants should be in the housing complex. Roaming around the Ranch past 10 pm is not allowed for your safety and the safety of the NPH children. Armed guards who do not speak English patrol the property 24/7. If they see you wandering around the property in the middle of the night and cannot communicate with you, this could lead to a very confusing situation.
  • For your safety, you must stay on the ranch property for the entire brigade week. Any exploring that you would like to do outside of the ranch must be done before or after the official brigade week.
  • Please dress modestly, as cultural standards in Honduras are different than those in the U.S. Per NPH guidelines, skirts and shorts should come at least to mid-thigh, and tank top or dress straps should be at least 3 inches wide. Please cover tattoos as much as possible, and remove piercings, except for the ears.
  • We will be on the property of a children’s home, and many of the children come from homes where alcohol was abused. Therefore, excessive alcohol consumption is not appropriate in this environment. Beer and wine may only be consumed by adults 21 and over if provided by brigade organizers (i.e. at dinner). Alcoholic drinks cannot be carried around the ranch, and hard liquor is not allowed under any circumstances.
  • For your safety, brigade participants are prohibited from swimming in the dam. Participants may only swim in la poza (swimming hole) if it is a part of an official brigade activity, led by a brigade leader (i.e. Dr. Daly) or NPH leader (i.e. Reinhart or Stefan).
  • Per NPH rules, NPH children are not allowed in volunteer living quarters under any circumstances.
  • Please use your camera only after building a relationship with the people you want to photograph. It is generally a good idea to ask permission before taking photo or video of someone. Per NPH rules, only take photos of the NPH children when they are fully clothed. Photos of children in diapers or swimming attire are not allowed.
  • When posting on social media, be sensitive to each child’s story and don’t share details. Per NPH rules, the use of a minor’s real name is not permitted in any type of posting. If the individual is over 18, you must have his/her personal permission to publish a real name.
  • Per NPH rules, do not exchange email addresses or become Facebook friends with the NPH children.

Accommodations

  • Respect fellow brigade members by moving to the kitchen by 9:30 pm if you wish to stay up later so that others can sleep with minimal noise.
  • Keep common spaces in the surgery center and conference center clean. Throw away your trash and wash your dishes.

Surgery Center

  • Come with a positive attitude, and be prepared to work hard in the service of patients. We know that the surgery center days can be long and difficult, but please remember to treat all fellow participants, staff members, and patients with kindness and respect. If fellow brigade members are not behaving in an acceptable manner, please notify brigade organizers immediately so we can handle the situation.
  • Only the sanctioned brigade photographer, who has been briefed on our photography rules, will be allowed to take photos inside of an operating room.
  • Always obtain a patient’s permission before taking a photo. Patients who do not wish to have their photos taken or to have observers in the OR can indicate this during the intake process. This information will be indicated on the patient file, and the nurses will help to make sure all brigade members respect the patient’s wishes.
  • You may see some really interesting or unusual cases in the surgery center, but before taking a picture, please ask yourself if you would want a similar photo taken of you and/or floating around social media.
  • General volunteers should always obtain permission from the Circulating Nurse before stepping into an OR. The nurse may request that you don’t enter a room if there are already other observers. This is for patient safety, as too many observers in a room can increase the risk of infection.
  • We operate under the “see something, say something” principle. If you see something that you think is unsafe (i.e. sterile technique is broken; there are too many observers in the room), it is your responsibility to say something to others in the room, in that moment, to address the issue.