Esperança

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Becoming an Esperança Volunteer Surgeon

A surgical team primarily consists of a surgeon (typically the team leader), an anesthesiologist, and an OR nurse tech. The team leader assembles their own team. Missions take place in Nicaragua and Peru. 

We have partnered staff in the host country as well as the assistance of local physicians who volunteer their time to our volunteer surgical mission program. Surgical trips are scheduled anywhere from four months to two years in advance. The team typically operates 5-7 full days and has the option to lead educational presentations to the medical residents and local physicians a few evenings during their stay.  The duration of the trip is dictated by surgical specialty and the lead surgeon’s availability (either one or two weeks of surgery); volunteers should allow for a full day of travel on the outbound and return.

Important Things to Know

General: Hernia repair, cholecystectomy, saphenous vein stripping, appendectomy, thyroid/goiter removal
Gynecology: Incontinence - bladder repair (TVT, TOT) Hysterectomy, cystectomy, herniorrhaphy, colporrhaphy
Ophalmologic: Cataracts and pterygia
Pediatric
Orthopedic: Trauma, fracture repair
Plastic surgery: Burn/ injury reconstruction, cleft lip and palate repair
Urology Prostate resection, radical prostatectomy
Our volunteer surgeons usually recruit their own surgical team. A typical team consists of a surgeon, anesthesiologist, and an operating room tech/nurse. All visiting surgeons are paired with local surgeons from the host country. It is customary for the visiting surgeon to take the lead in the surgery process. Since we utilize local medical volunteers, the visiting team’s surgery tech/OR nurse may have to exercise flexibility in the operating process. This flexibility involves allowing the utilization of local medical volunteers during the operating process. It is possible that a PA or assisting surgeon would be supplanted by a local surgeon at the operating table. Esperança encourages training opportunities for local medical counterparts, especially medical residents. Visiting surgeons are encouraged to teach and train the residents in the operating room. We must balance the quantity of surgical procedures with surgical experiences for local personnel. We are unable to accommodate non-surgical personnel such as students, ancillary staff or family members on our surgical missions. Our resources are limited to licensed surgical volunteers only (MD, OD, DO, DPM, PA, CRNA, RN, BSN) and certified surgical technicians.
Abancay, Peru
Jinotega, Nicaragua
Estelí, Nicaragua
We consider every volunteer an ambassador and representative of our organization. We expect ethical, professional, and considerate behavior from all our volunteers during their entire mission (working and non-working hours). Our volunteers’ positive attitude and flexible behavior impacts the continuation and reputation of our program. Our goal for our surgical volunteers is for them to work in the environment in which they are placed with local physicians, administration and the native people, effectively and harmoniously.
Teams average 25-30 surgeries per 1 week mission (may vary per specialty). Potential complications of schedule can include: reduced operating room access, substitution of local medical staff for team assistants and/or performance of clinical work versus surgery. We believe that our volunteer surgical teams are in place to serve in whatever capacity possible, with graciousness and flexibility. All our volunteers want to be as effective as possible and perform the greatest number of surgeries possible, and meet our expectations for number of patients served through each mission. However, an integral part of our surgical mission program is the impact in training, education and the exchange of information with the local medical professionals. We ask for your assistance in maintaining this delicate balance.
The volunteers are guests in the host country and at their facilities (none of the surgical facilities in which we work are our own). The lead surgeon may be shown deference over other team members, and the same may be true of male versus female team members. This is the impact of their cultural system and ingrained beliefs regarding respect. The locals are a demonstrative people and may hug, kiss, or show other signs of appreciation. Each day will be filled with surgical time, clinical time, and educational time. A lunch hour is observed each afternoon and there may be a scheduled lunch celebration or other small social gatherings or dinners during your visit. These social activities are part of the hospitality the local people extend our volunteers. While most of our volunteers want to schedule as much surgical time as possible during their mission, it is important to engage in festivities organized in appreciation of the surgical team’s efforts as this is the culturally accepted behavior of the host country.
We have several clinics throughout our host countries to work out of. The hospital and administrative staff are supportive of our volunteer teams. During the week, our teams typically have use of a fully-equipped OR in the main hospital and has functioning cardiac monitors, occimeters, anesthesia machine, and a cautery unit.
Our volunteer surgical program is in a developing country where medical care and the transportation to receive care can be insurmountable. We have found that patients that may present for a pre-screening appointment weeks before the surgery visit may not be able to make the long return when the surgical mission team is in residence. Thus, we cannot provide a patient list prior to the team’s departure or specific information as to the types of surgeries that will be performed. Patients are gained through announcements alerting the local people that the visiting US surgeons will be in town. Some of the patients that do show up may be in need of clinical treatment rather than surgery; we ask that volunteers provide as much medical care/assistance as possible. Shortly before the surgeries begin, the visiting surgeon, accompanied by local medical volunteers, will hold a clinic for all patients scheduled for surgery. Lab work and limited diagnostic testing is available. The visiting surgeon reserves the right to refuse surgical procedures for any patient. Our local staff are also very experienced in recruiting patients and selecting appropriate patients for each surgical specialty.

Frequently Asked Questions

Unfortunately, due to the limited size and scope of our program, we are unable to accommodate other non-surgical medical practitioners, residents, lay people, and students at this time. If you wish to travel with us, check out our upcoming travel opportunities !
Unfortunately, we are not able to coordinate individual volunteers.
Esperança is very flexible with dates and times. At this time, Esperança sends 10 teams to Nicaragua and 2 teams to Peru annually. Each mission is usually 1 week. Teams typically leave on a Friday or Saturday from their hometown, start operating on Monday, and return on a Sunday. It is the team leader’s responsibility to coordinate dates for a mission. Once your team dates are finalized, we send your team’s dates to our in-country staff to ensure that local hospitals, staffing, and patients will be available for your mission.
Costs vary depending on the type of mission, duration of stay, travel season, and flight preferences (coach versus business class). Volunteers traveling are asked to cover the cost of their flights, lodging and meals, typically a total $1,000 - $2,500 per person. Additionally, the average mission costs Esperança $9,500 (this includes credentialing, staff time, making arrangements in the host country), to learn more about fundraising for a mission, and supporting Esperança visit our ongoing campaigns
Family members, friends, students, or other individuals who would like to join a volunteer are able to join you on a case-by-case basis. Any individual who joins a surgical mission, but is not a volunteer, must cover 100% of their own expenses.
Esperança will make your flight arrangements. Based on your travel needs, we will provide you with a quote. Once you have approved the itinerary, your flight will be purchased. Esperança will then send you an invoice for the cost of the flight. Your payment to Esperança will be considered a tax-deductible donation. Volunteers can make their own arrangements, if preferred. Should you choose to do so, please send your itinerary to Esperança prior to purchase for review.
Esperança will make your hotel arrangements. We have relationships with in-country hotels that are safe and comfortable. We also have negotiated rates with hotels to keep volunteer costs to a minimum. Each volunteer will have a private room with a private bath, hot water, and cable. There is also wi-fi in all the hotels we use.
Please email Surgical Program Director, Charlie Fulks, discuss the next steps. Once determining qualifications and availability, he will request documentation. Once these documents are submitted to Esperança, they are sent to our host country in order to obtain approval for your mission from the local government. In order to process your application in a timely manner, please send your documents at least eight weeks prior to your mission’s departure.
Teams should bring any supplies and medications that they will need for their mission. A general list of items can be provided to you depending on your surgical specialty. Esperança can also provide you with a solicitation letter for businesses and colleagues. If you are not able to procure all the items, our local team may be able to obtain them prior to your mission. Most general supplies are able to be purchased in-country but supplies required for certain types of surgeries and some medications can be difficult due to cost or limited availability. If you aren't able to find an item, please let us know beforehand.
We ask that each team, prior to their departure, send us a list of supplies with an estimated value. This is very important in helping us request a letter of support from the host country’s Consulate. A letter from the Consulate is given to your team’s leader prior to your departure to help your team pass through Customs. Please complete this list at least four weeks prior to your departure date in order to help us get this letter of support to you on time.
Visas are not required for travel to Nicaragua or Peru.
Typically, our teams do not have any issues passing through customs in our host countries unless they have not submitted a supply list and acquired a letter of support. Host countries are familiar with Esperança’s Surgical Program and are supportive of our work. Esperança obtains permission from the local government for each mission. A letter of support from the Consulate will be provided for each mission prior to your team’s departure date. Should any questions arise, please show the customs official this document. Contact information for our local offices will be provided to you in case local officials request additional information. In order for Esperança to obtain this letter from the Consulate, we must first receive a list of supplies and medications that your team will bring with you and an estimated value.
Yes, our local team will welcome you at the airport of your mission site and provide transportation when you leave.
Our volunteer teams typically work Monday through Friday from morning (8am) till early evening (7pm). Breakfast is usually provided at the hotel. Lunch and dinner plans will be provided for you by our local team. Most hospitals and clinics where Esperança operates are closed on the weekends. During any breaks that your team may have, our local team may plan sight-seeing outings based on your preferences. This may include hiking, driving through villages, visiting a local winery and coffee plantation, or shopping.
Not a problem. Although speaking Spanish is helpful, it is not a requirement for our volunteers. A local bilingual staff member or volunteer will be available to help translate during your mission.

Now What?

Think you're ready for a surgical mission with us?

In order to start the application process, please email Esperança’s Surgical Program Director, Charlie Fulks, to discuss details about your interests and possible dates.  Once your mission dates and team members are finalized, Esperança will provide you with the volunteer application and proceed with processing your documents. The application process includes that each team member send in copies of their license, diploma, CV, etc.

We look forward to building a relationship with you as a member of our Volunteer Surgical Program. Your generous donation of time, talents, and resources is truly appreciated.  We thank you for joining us in this precious life changing work.

5
Million in donated services and materials
49
Surgeries in Peru
315
Surgeries in Nicaragua
11
Total Annual Surgical Teams

Already a Surgeon with us?

See how to prepare for a mission below

Preparing for your mission

A valid U.S. passport is required to enter and exit from Nicaragua and Peru. Passports may be applied for at a local county courthouse or U.S. Government Passport Office. Each volunteer’s passport must have six months validity from their date of entry. No visa is required to travel to Nicaragua or Peru.
Keeping our volunteers safe during a mission is a priority to us. Click the following links for detailed health recommendations by the CDC for travel to Nicaragua or Peru. Any person traveling international should have a physical examination by a doctor before traveling.

If outdoors, prevent mosquito bites by wearing long-sleeved shirts, long pants, and hats; apply DEET insect repellent to exposed skin. Since the same diseases that afflict humans in temperate climates can be magnified in the tropics, all travelers should be in good health. Any person with a chronic ailment should not consider volunteering for work in this remote region.

Most infectious diarrhea is caused by fecal contamination; therefore, it is absolutely necessary that proper hygiene be maintained during a trip to the tropics. Regular hand washing is a must, as are precautions with food and drink, especially in public places. Fresh salads and ice should be avoided when eating in restaurants; if it is not thoroughly cooked, bottled or something that you can peel, do not eat it.
It is best to take an anti-diarrheal drug, effective insect repellent with DEET, SPF35 sunscreen, sunglasses, and a hat. If traveling to Peru, consult with your doctor about Diamox for altitude sickness.
Luggage allowance will depend and vary on the airline. Check the airline’s website for the most updated information. Esperanca typically uses American, Delta or United Airlines for travel to Nicaragua or Peru.
Generally, customs agents are very supportive of Esperança volunteers. Although some travelers have passed through Customs without opening a single suitcase, one should expect a thorough inspection. Please present the paperwork that will be provided to you before your departure. As our ambassador, please be patient with any delays or extra tasks. Should you confront any issues, please do not hesitate to contact our local staff. Their contact information will be provided to you before your departure.
Volunteers should bring cash for spending money, tipping, and airport taxes. A typical volunteer can take $150-$200 in cash and still have money upon their return, depending on individual spending habits. Dollar bills should be in very good condition, without rips, tears, or markings. You should also bring smaller denominations as they are accepted more frequently. Traveler’s checks are not recommended. Many of the larger hotel and restaurant establishments accept credit card. Volunteers will need to pay for their food and lodging for any layovers in transit to their departure/arrival airport.
Nicaragua: U.S. dollars may be exchanged for Cordovas (Nicaraguan currency) upon arrival at the airport or at a Cambio in town, however, most places will accept american currency. Exchange rates vary but you will receive approximately 24 Cordovas for every dollar. There are ATMs available that dispense both U.S. and Nicaraguan currency. There is a $10 entry fee that is paid at the immigration in the airport.
Peru: U.S Dollars may be exchanges for Soles upon arrival at the airport or at the Hotel you stay in. It is always a good idea to contact your banking institutions to let them know of your travel plans. This will help prevent any measures that the bank may take on your behalf, such as freezing your account.
Lodgings are chosen by location and amenities available. Hotels are as close as possible to the hospital or clinic you will be working in. Hotels typically have a restaurant as well as hot water, Wifi, cell phone reception, a and TV in your room. In some of the more remote regions, hot water and wifi may be spotty.
Many volunteers use online email, online chat, Facebook, Skype, FaceTime, and other applications to stay in contact with loved ones during their missions. You can make outgoing phone calls from the hotels. To make the most of your money, you can purchase a calling card. Another option is to bring an unlocked GSM cell phone (T-Mobile or AT&T carriers) and purchase pre-paid minutes for just a few dollars.
We take special care to ensure that our volunteers are well fed during every mission. In fact, most volunteers say that they have gained weight by the time that they return home.
Breakfasts are served at your hotel, lunches are served to you at the hospital, and dinners are at a local restaurant. Snacks, water and coffee are provided to you throughout the day. In Nicaragua, meals typically include a meat, French fries, rice, beans, and plantain. In Peru, meals tend to have a meat, salad, noodles, potatoes, soups, or pizza.
If you have special dietary restrictions or allergies, please let us know beforehand. We will do our best to accommodate your dietary needs. There are vegetarian options at most restaurants although variety may be limited. Feel free to bring snacks from home. You can also stop at the local market or grocery store and buy some snacks.
Your hotels will have Wi-fi and internet access available at no extra charge. Many volunteers use online email, online chat, Facebook, Skype, FaceTime, and other applications to stay in contact with loved ones during their missions.
You can make outgoing phone calls from the hotels. To make the most of your money, you can purchase a calling card. Another option is to bring an unlocked GSM cell phone (T-Mobile or AT&T carriers) and purchase pre-paid minutes for just a few dollars.
Nicaragua: Nicaragua uses the 2 blade American style plug at 120V. If your electronics have 3 prongs, you may need a 3 prong to 2 prong adapter. It is also recommended that you bring a surge protector as both countries have frequent power outages.
Peru uses 220 volt, 60 cycle electricity. Travelers will require a voltage converter for 110 volt devices. Plugs are typically the 2 pronged flat type found in the US, though some facilities have been noted to use the 2 rounded prongs instead.
We take every precaution to ensure that our volunteers are safe. Our local staff are professional and experienced. Volunteers are accompanied at all times. Hotels are reputable and provide 24-hour security.
We stay on top of travel alerts and warnings that are issued by the U.S. Department of State. When a warning is issued for the country we work in, our policy is to cancel the surgical mission. Local staff will also alert us immediately of any unrest.
Click here for general safety tips when traveling abroad.
Nicaragua: Due to the mountainous highlands of the Jinotega region, the weather has relatively moderate temperatures all year round. The rainy season runs from June to November and the dry season from December to May. The most important climatic factor to remember is that it’s generally wet in the summer and dry in the winter. Casual clothes are good and a light jacket and raincoat is always recommended.
Peru: Due to the remote nature of our work in peru, it is best to pack for a wide range of temperatures. You will enter the country and depart from Cusco, which is typically between 30 - 70 degrees F. All of your surgical work will be in Abancay, where it is typically in the upper 70's. Peru's rainy season runs from December - March, and is typically dry otherwise. Dressing in layers is recommended as well as packing a light rain jacket.
Nicaragua: staff will meet you at the airport in Managua and you will then drive in a truck or mini-bus to Jinotega which is a 2-3 hour drive from Managua. Transportation is provided daily between the hotel and hospital. Low fare taxis are always available and walking is another option as both surgical program sites are safe locations.
Peru: After landing in Lima, you will take a smaller plane to Cusco. You will then take a truck or mini-bus to the small town of Abancay where you will be working. Transportation is provided daily between the hotel and hospital. Low fare taxis are always available and walking is another option as both surgical program sites are safe locations.
A week before your departure, you will receive an email with copies of your flight reservations, hotel reservations, and emergency contact information. We encourage you to pass on this information to family and friends.