GUAYAQUIL, Ecuador – As word trickled out that an American medical team was traveling to their country to offer free surgeries, people grabbed their children and flocked to the large port city of Guayaquil any way they could.

Some arrived on horseback. Some traveled great distances by canoe.

And some, upon reaching the hospital, shed their clothing right in the hallways because they were so eager for doctors and nurses to examine their wounds.

For the medical team, which included seven people from Carle Foundation Hospital and Carle Clinic, it was a glaring contrast to what they typically see on the job.

"It puts everything in perspective," said Jeanne Murray, a Carle hospital nurse. "We have too much."

This trip to Ecuador in March was Murray's third mission with Operation Rainbow, a San Francisco-based organization that sends medical volunteers around the world to provide free plastic and orthopedic surgeries for needy children. The organization says it has treated more than 7,000 children since its start in 1978.

Dr. Michael Goldwasser, a Carle Clinic oral and maxillofacial surgeon, is a longtime Operation Rainbow volunteer who has been involved in 20 such trips – the first one to the Philippines when he was in college.

"Everyone who goes on this is in the health care profession for the right reason: to try and help others," he said. "Without the bureaucracy in America, they get to go somewhere and experience the pure pleasure of helping others."

One volunteer on the Ecuador trip, Nissa Habaradas, is a Carle hospital nurse who remembers such medical missions coming to her native Philippines. Habaradas said she vowed, if she ever became a nurse one day, that she would return the favor.

"It was my dream," she said.

Murray said she used a week of her vacation time for this trip and would do the same thing a fourth time because the kind of care she gets to deliver puts the rest of her daily life in perspective.

"You get addicted," she said.

She and others said they found extreme poverty and an overwhelming need for medical care among the people who came to them for help in Ecuador.

"They'd be stripping in the hallway to show you," Murray said.

"We had people showing up that came by canoe. They came by horse. They live way out in the country. These people have nothing," said Glenn Huff, a nurse manager at Carle hospital.

And though the doctors and nurses on the trip worked for free and there was no charge for the surgeries, some people still had to go back home without being helped because they couldn't pay the hospital's $15 charge.

"Even that ruled out some people," Murray said.

Huff said he saw the mission as both a challenge and a chance to help.

"I knew people in those countries didn't have an opportunity to have medical care and have very disfiguring problems," he said. "Some walk around with bandanas on their faces."

Young Moore, a Carle hospital nurse manager, said one woman told them she had to first earn money to rent a canoe to get to Guayaquil – and then make a three-hour trip in the canoe to get to that city. Another told them she had no money to buy a bottle to feed her crying baby.

Many of the children brought in by their parents for surgery were born with cleft lips or cleft palates, which cause difficulty speaking and eating as well as facial disfigurements.

When babies have such birth defects in the United States, plans are made from their birth to take care of the problem, Murray said. In Ecuador, such deformities are associated with folklore and the children's faces are covered up.

For Moore and Murray, one of the most memorable patients was a man who came in with a disfigured face and neck and was barely able to breathe because his mother-in-law had poured acid on him.

He'll need more surgeries, Moore said, adding, "We helped him a little."

One of the most stark contrasts she and others on the trip noticed was in hospital conditions. Even the poorest hospitals in the United States have better equipment and supplies, they said.

"Compared to here, it's minimum. We used supplies we'd never think of using here," Moore said. "I really had to utilize my nursing skills. Here we have equipment. There I had to go back to basics."

Moore also remembers how parents would cry and hug the doctors and nurses when they saw their children after the surgeries.

"They are constantly hugging you ... so grateful," she said.

Goldwasser said volunteers generally take a week of their vacation time or give up a week's pay to go on these missions, but the Carle Development Foundation's William S. Johnson Fund covers their travel and living expenses for the week.

Goldwasser said there's a steep learning curve for this kind of volunteer work, so he always mixes experienced volunteers with new ones on each trip he plans. He also offers the experience to medical people outside Carle, with the most recent trip including a doctor and a nurse from the Chicago area.

Goldwasser already is planning his next trip, which will be to Honduras in the fall, and, as always, expects he'll have more than enough volunteers.

"I could fill trips for the rest of my career. We have 50 people apply for every trip, and we take seven or eight," he said.

And many want to go back and help again.

"The rewards aren't financial," Huff said. "They're better."