By Kimberly Sherman

Instant gratification so often outweighs delayed reward in today’s world. While giving a man a fish is a feel-good act, teaching that man to fish takes patience and endurance that can stretch the limits of our shortened attention spans.

But the mission work of a pair of Visalia physicians reminds us that dedication to helping the world’s needy by encouraging them to participate in the betterment of their own lives pays rich dividends to everyone involved.

An early sense of mission

David Sine first traveled to Haiti in 1989 while enrolled in nursing school. During subsequent trips to the Dominican Republic and Ecuador, he realized that practicing medicine in developing countries was his true passion. Young and single, David continued his love for medical missions with trips to Cuba, Tobago, and Trinidad while studying pediatric medicine in San Diego.

His close proximity to Tijuana gave him the opportunity to hone his Spanish-speaking skills, and in 1997, his last year of residency, he went to Honduras on yet another medical mission.

Then David met Kealani, a young woman from Hawaii who was also studying pediatric medicine in San Diego. She graduated in 1999, and the two married. Dreams of hopping on a plane to serve in a giving capacity waned; David’s new passion was the need to nurture a blossoming family.

In 2002, while discussing the desire to raise their young daughters in a less urban environment, the Sines were given the opportunity to start a pediatric program for Kaweah Delta Hospital, smack dab in the middle of rural California. They packed up dreams and babies and moved to what seemed the perfect solution: Visalia, the Gateway to the Sequoias.

“We’ve made wonderful friends here,” says Kealani. “We started a program here that wasn’t in existence; the pediatric program has grown by leaps and bounds and now includes a neonatal ICU.” Thanks to the Sines’ efforts, Kaweah Delta now boasts a 25-bed intensive care unit for newborns and is equipped to provide care to babies born 3 ½ months premature and weighing as little as 2 pounds, 3 ounces. Pediatricians are available in the hospital around the clock.

Three years into the fledgling program, the Sines recruited Dr. Anna Coll, a Stanford-trained pediatric cardiologist, and her husband, Dr. Roberto Gugig, a pediatric gastroenterologist. Another addition was Dr. Francesca Geertsma, a pediatric infectious disease specialist.

Raising the bar on quality of care

“Our philosophy is: What would we want done if it was our child?” says David. Bringing in renowned doctors with specialized areas of training helped ensure local patients receive the highest quality of pediatric medicine. Says David, “We have really changed the level of care at Kaweah Delta.”

While Visalia’s pediatric services were improving, the longing to serve on another medical mission to a Third World country was building inside David. Then, while befriending the parents of a patient, he was introduced to Students International (stint.com). “I always saw myself doing Third World stuff, but with my wife and family I was nervous about bringing it up,” David admits. “It was divine intervention that I happened to work on that kid that day. The parents were comfortable taking their kid (on a mission) to the Dominican Republic.

“I’ve worked with a lot of medical mission groups, but never saw eye to eye. Most of the time you just come back feeling better about yourself,” says David. “I wanted to get involved with an organization that would have a long-term effect for the people there.” Students International turned out to be exactly what he’d been looking for.

Once Kealani was convinced, the Sines scooped up their young daughters and, with a total of 20 families from Visalia and the East Coast, headed to the Dominican Republic for a life-altering experience that they would repeat several times over—each mission designed to bring lasting change to the people they helped.

“We can treat an ear infection for a couple of weeks,” says David, “but that doesn’t change the fact that they have dirty water. The concept is that we’re here to help. We have staff who are nationals; that way it’s a team approach and not just foreigners telling them what to do. It empowers them to do things themselves.”

Going the extra mile to help

While touring the municipal hospital on their first trip together, the Sines noticed a baby in respiratory distress. No services would be rendered unless the parents paid, and the mother had no money. After much negotiating of language and cultural barriers, the Sines were allowed to provide the needed care to the child around the clock. Then the baby was abruptly discharged without the Sines’ knowledge and with nearly a week’s worth of oral antibiotics left to administer.

Kealani drove from village to village in search of the baby and her mother so that she could administer the final doses of much needed medicine. “It was serendipity that put us there to see that baby in distress,” says Kealani.

Since their first medical mission as a family, the Sines have traveled to Guatemala, both as a family trip and a women’s mission for Kealani and her daughter, and to Costa Rica on a men’s mission for David.

Of their Guatemala experience, Kealani recalls, “It’s a little squatter village where homes are made of sticks and cinder blocks with dirt floors. The school was made into a rough clinic; patients came through in a line and we’d treat them.”

In developing countries, well-child visits are an unheard of luxury. “We have such a short period of time to try and triage what’s going on,” says Kealani. “We treat a lot of intestinal parasites and anemia, and other things like ear infections and orthopedic issues.” Asthma and pneumonia are also common due to poor ventilation. The residents cook on open fires and, in turn, breathe in smoky air.

There are a variety of outreach groups within Students International that serve the needs of the developing countries’ residents, including medical, dental, construction, social work, sports, special education, and even art. “My daughters have been involved with the dental and construction groups,” says Kealani. “They can see the Third World and learn how to help.”

WORD MISSING? David says that, while providing basic needs is not as glamorous as going in to help someone with a machete laceration across their belly, he did help save a critically ill 12-year-old who had been carried on his mother’s shoulders for four hours in search of the Students International mobile clinic.

“I provided him with IV fluid and antibiotics, and that wilted flower slowly came back to life,” David recalls. “He came in dehydrated and walked home six hours later wearing my Goofy hat. He may have succumbed if we hadn’t been there that day.”

Getting priorities straight

David says the saddest sight he’s seen on a mission is a piece of highly sophisticated equipment sitting in a room that’s never going to be used due to lack of knowledge or lack of repair know-how, or both.

The critical need, as overwhelmingly determined by locals, is as fundamental as air to breathe and food to eat: clean water. It’s been a struggle, but the Sines are working consistently to help the Guatemalans achieve a dependable water source.

With an innate desire to help people prosper, the Sines have taken the same approach to their work in the Valley. “We were with Kaweah Delta, but we’re moving on,” says David.

They joined the board of CASA (Court Appointed Special Advocates) of Tulare County and spearheaded efforts to establish a federally funded rural clinic in Exeter run by the hospital. Next, they hope to focus on child abuse prevention. David also specializes in end-of-life care and serves as the Medical Director of Pediatrics for the Tulare Hospice Program, an extension of his work for the San Diego Hospital Hospice program that earned him the Circle of Life award back in 2000.

“In the late 1990s, studies showed that of kids who needed hospice, only 2% actually received it,” David says. “I enjoy helping with comfort and I have the skills to help someone be comfortable in death. I felt it was a calling.”

The Sines have harnessed a truly altruistic way of life that will be passed on to their children. “It really gives you perspective,” says Kealani of their medical mission work. “Everyday problems are nothing in the scheme of life.”

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