MEXICO CITY—Ask physician's assistant Eileen Mackey about the most fun she's ever had in the medical profession. Her answer will take you far from her clean and orderly office in Ponca City, Okla., where she has been in practice with her husband, a family doctor, for 12 years.

Picture her instead with 11 doctors and nurses in the back of a weathered Volkswagen van, traveling along unpaved roads in the mountains of rural Mexico, and setting up simple clinics in tiny, stucco homes with dirt floors. Part of a larger team based at a hospital in the town of Cotija, Mackey spent a week in November ministering to the poorest of the poor in a “hands-on” environment devoid of impersonal technology and paperwork-laden managed care.

“We had the time of our lives,” Mackey recalled. “We even ran out of gas. It was a blast.”

Mackey is one of 200 Catholic health professionals who, in the past two years through an organization called Helping Hand Medical Missions, have provided more than 3,000 needy patients in Mexico with everything from routine checkups to hip replacements.

Doctors, physician's assistants, nurses, and others volunteer their skills, a week or two from their busy practices, and boxes of donated medicine and supplies. In exchange they receive spiritual support from priests who accompany them and an opportunity to use their expertise in a meaningful way most have only dreamed of since medical school.

Mackey saw from 60 to 80 patients a day in the remote villages. Without the normal supports of lab tests, X-rays, or other high-tech diagnostic tools, the missionaries rely on the basics.

Picture her with 11 doctors and nurses in the back of a weathered Volkswagen van bouncing along unpaved roads in the mountains of rural Mexico.

“It really hones your diagnostic skills,” said Mackey, who acts as a “junior practitioner” able to conduct routine exams, order tests, and prescribe medicine under the supervision of a physician. “It brings back medicine to where it started, one-on-one.”

A particular woman approached the missionaries, depressed and crying, Mackey remembered. “She thought her sister was dying of cancer.”

“We said, ‘Bring her in, let us take a look at her.’”

After taking a history, the missionary team suspected something much less serious. They gave the woman money for the three-hour bus drive to the hospital in Cotija, where she could be examined by the obstetrics-gynecology doctor based there.

The next day she came back to the clinic and joyfully reported that all she had needed was a minor surgical procedure.

“It was something so simple. She wasn't going to die,” Mackey said.

The people who came for care, in many cases lining up at the door, were simple, uneducated, hard-working, and full of an almost inexplicable faith, say the medical missionaries.

“I saw a lot of depression, but also a lot of joy,” said Mackey. “It was an eye-opening experience. These people have nothing. (But) they have faith. There's no blaming God for anything. They are staunch. If you asked them about their faith, they were very vocal about it.”

In fact, Mackey, who has long recognized that faith is part of a person's wellness, said in some cases she had to resort to spiritual prescriptions — such as prayer as an antidote to depression — because the missionaries are not able to provide enough medicine to stock the shelves indefinitely.

Also, she said, “We're not just there for medicine,” but for spiritual encouragement. “Medicine is a perfect vehicle for that, because you see people at their worst.”

The Mackeys participated in the most recent mission at Cotija, three hours south of Guadalajara, after learning about the outreach through Mackey's sister in Dallas.

“You hear about people going on medical missions, and I would always think, ‘Yeah, I need to do that someday,’” said Mackey, who said she ended up putting it off, imagining a lot of administrative hassles.

“It was surprisingly easy, a matter of a phone call,” followed by filling out a few forms and updating her passport, she said.

Helping Hand Medical Mission is an apostolate of the ecclesial movement Regnum Christi. It is coordinated by is an outwardly shy but inwardly steely 43-year-old nurse, Guadalupe “Lupita” Assad of Irving, Texas. A devout Catholic born in Mexico, Assad has raised her four children on her own since her husband abandoned the family years ago. Three of the four children, now young adults, are pursuing religious vocations.

Assad's modest home not far from the Dallas Cowboys' Texas Stadium serves as the headquarters for the mission, with office equipment in her dining room and boxes of medical and religious materials filling her garage and occupying part of her front entry-way.

A full-time nurse at Parkland Hospital in Dallas and volunteer administrator for Helping Hand, Assad moved her family from Los Angeles to Irving in 1991 to send her children to the Highlands School, run by the Legionaries of Christ.

At the same time, a Legionary priest and acquaintance of Assad was assigned as a chaplain to a medical mission in rural Mexico, where only two of the 20 doctors were Catholic. The idea of a Catholic medical mission was born as a way to reach people with spiritual as well as physical aid, and to promote the culture of life among U.S. doctors increasingly faced with pressures to hasten death rather than heal or comfort.

Assad became involved in 1993, and built the present program. “I was so happy,” she recalled. “I had no idea I would eventually take over this.”

She has coordinated a total of six missions, and four are planned for 1999, including one in Honduras. She has only praise for the doctors who give of their time.

Among the physicians volunteering is Karl Beer, an orthopedic surgeon from Ohio. He has gone on three missions to Cotija and performed between 30 and 36 hip and knee replacements. For each mission he arranged transportation for 40 boxes of donated equipment and supplies worth about $100,000.

“The first time I went I was pretty leery about it. I was worried about infection,” said Beer. “But the hospital there in Cotija is very clean. There was a clean operating room and they had old-fashioned but very adequate sterilization.”

Beer, who does some 300 surgeries a year at Toledo Hospital in Ohio, said he has grown more confident in sharing his faith with his regular patients because of the “intermingling” of faith and work at the mission.

“That's what I like about it. The [Mexican] people are Catholic, the faith is all part of it. You pray with the patients before and after [surgery]. There wasn't any barrier there like we have with the secular world. And the people are so grateful.”

One patient, Israel Contreras, invited the entire missionary team to his home for dinner two years in a row as a way of saying thanks for his successful surgery in 1996, Beer said. Another patient the doctor recalled warmly was a 39-year-old mother who had both hips replaced last year; this year Beer watched her volunteering at the hospital with all six of her children.

Assad said the difference between Helping Hand and other medical missions is the spiritual framework; the day begins with morning prayer and daily Mass, and ends with a talk on bioethics or spirituality in the evening. Throughout the day the chaplain is available to hear confessions. “Some doctors come with us because we have a priest. That makes so much difference,” she said.

Mackey added that she “can't imagine” a medical mission without that spiritual support.

In remarks to U.S. bishops during their ad limina visit to Rome on Oct. 2, Pope John Paul II stressed that, “meeting the physical and spiritual needs of the sick is a form of imitation of Christ. … Doctors, nurses and other medical personnel deal with people in their time of trial, when they have an acute sense of life's fragility and precariousness, just when they most resemble the suffering Jesus in Gethsemane and on Calvary. Health care professionals should always bear in mind that their work is directed to individuals, unique persons in whom God's image is present in a singular way and in whom he has invested his infinite love.”

Assad said her faith, too, has been challenged and grown, not only in the workplace — where she sometimes locks horns with doctors over life issues — but also in the administrative challenges of Helping Hand, through which she has had to deal with major last-minute schedule changes, the need for financial and secretarial support, and the challenge of recruiting doctors.

“The grace of God is so amazing,” she said, recalling her days in nursing school, when she struggled with English and wondered if she would graduate. “Everything fell in place. I just think about it, and I say, ‘How did I do it?’ I don't know. It seems that nursing was just for the medical missions.”

Although the setting for the Mexican mission is rustic, the medical volunteers were provided with good meals, a clean bed, and showers, Mackey said. Volunteer translators help the non-Spanish speakers communicate with their patients.

Mackey is already planning to attend another mission next fall, the one in Honduras, where she expects even a more primitive environment than in Cotija. She is currently taking a course in Spanish and “recruiting like crazy.” So far she is planning to bring along on the mission nurses from her clinic, an orthopedist friend, and two of her four children, one a respiratory therapist and the other a college student.

Her advice to anyone in the medical field thinking about going on a mission? “It's worth it. Just do it.”

Ellen Rossini writes from Dallas.