Health Care Charity

Day 6: Exploration Time

Thursday, August 19, 2010 by Maternal and Child Health

From the Field: Dominican Republic (PALS)
Sent in by: Achal Patel

With the medical training portion of the trip complete we were fortunate enough to use our free time to explore the area nearby Santiago. We revisited the family with whom we had dinner a couple of nights ago. Today we had a trip planned to the Dominican jungle out to a local river in the foothills of the mountains surrounding the valley within which Santiago lies. The trip took us through small villages and gave us a much different perspective on Dominican life as compared to the city. We reached the river, basking in the sunlight and enjoying the water while awaiting the completion of a lunch cooked by means of a campfire. Abruptly a tropical rainstorm was upon us, with the small 30 feet wide river we crossed to reach our campsite turning into a mini-torrent of fast moving water. After retreating to the shelter of a local shop we managed to consume our lunch covered from the rainstorm.

It continues to amaze me the hospitality shown to complete strangers in this country, with the owner of the store welcoming us in and providing us with shelter, while expecting nothing in return. Furthermore, he offered us seating and an area to stay until whenever needed. After the rains lifted, me made our way home, stopping to drop of the family we spent time with. As we were saying our goodbyes I realized that it was probably the last time in my life I would see the family. Even though both parties realized its unlikelihood, they insisted upon us revisiting them at a later date, telling of both their personalities and optimism. However, after spending only two days with them it was similar to saying goodbye to friends I had known for years. It’s amazing to see how well humans from completely different backgrounds, with different languages and cultures, can get along with the aid of a few words, openness, and laughter.

As we drove home, appropriately enough the clouds lifted enough to set the stage for a beautiful sunset behind the mountains of the Dominican Republic. With an early morning departure planned for tomorrow morning, I am becoming increasingly aware of how much I will miss the country that offered me so much in return for practically nothing. After visiting the Dominican Republic it is difficult to not have faith in the goodness of the human heart, when they can impress such a positive attitude of their population upon others without the use of money alone. I am happy to say that I can return home with clichéd phrases possessing new meaning; understanding that the free and simple things in humanity can lead to the greatest happiness.

Day 5: PALS Course Part 2, Last Day of Training

Thursday, August 19, 2010 by Maternal and Child Health

From the Field: Dominican Republic (PALS)
Sent in by: Achal Patel

Without regard to the rain from last night, typically enough the sun came out again this morning for another warm and bright day in the city. We once again made the trip to Moca for Dr. Shaw to finish his training session. The second day consisted of information on identification and treatment for patients in shock as well as the practical and written examinations. The use of a couple of different defibrillators was also demonstrated, a major accomplishment for the training program. Once again the physicians conveyed an attitude of enthusiasm and appreciation over the course. Many of the physicians constantly had to answer their phones, presumably from work related calls. Nevertheless they still continued the training regardless of how much extra work they’d have piled up when returning to their jobs. The result of such gusto was evident when they worked successfully through the practical examinations while smoothly functioning as a team. The class went by today without any points regarding Dominican healthcare that I have not previously covered and thus this post will be shorter than previous days. Overall we left Moca understanding the strides that had been made over the two-day course, but also realizing the need for more basic medical resources in the country such as defibrillators in order to maximize the effectiveness of the training given by Dr. Shaw.

Day 4: PALS Training of Local Physicians

Tuesday, August 17, 2010 by Maternal and Child Health

From the Field: Dominican Republic - Pediatric Advanced Life Support (PALS)
Sent by: Achal Patel

We awoke yet again to a warm, sunny, and vibrant day in Santiago: conditions that seemed to be a recurring theme in the city. Day 4 would mark the separation of the team with Dr. Karotkin presenting three lectures at the Children’s Hospital in Santiago with Dr. Lopez and Dr. Shaw making the trip to Moca to present the PALS course to local physicians. I joined the later group to learn about a different constituency of trainees. Today I shed my cell phone, my only indicator of time, and adopted a mindset of ‘Dominican time.’ Rather than obsessing over regularity and quenching my need for a constant time check as I would at home, I enjoyed the events of the day as they progressed and let them arrive with a more relaxed mindset. While I was trying to go through my day limiting my use of technology, Dr. Lopez seemed set on maximizing its use, skillfully answering calls on his two Blackberry’s at once and always having them both easily accessible. I soon learned how this mastery is part of the reason for our success thus far on the mission.

After breakfast we made the trip to Moca, a much smaller city than Santiago. We made the trip, which was anywhere between 20 and 30 minutes, and arrived at a private Catholic school, our headquarters for the day. Along the way we passed an interesting juxtaposition of man and jungle with buildings and roads surrounded by lush greenery in seemingly flawless harmony. Upon arrival we were greeted by friendly local physicians, many of who traveled from the mountains surrounding the valley to take part in the training.

When these physicians arrived from all around the city of Moca, it became clear that our in country contact Dr. Ramon Lopez had undertaken preparations before our arrival that were both extensive and time-consuming. Without exaggeration, he seemed to know practically everyone everywhere we went, and if he did not he was quick to make local contacts. If it were not for his help the reach of the program would surely not be as significant. In addition, the universal warmth of both the people and weather in the Dominican is clear and outwardly reverberating, welcoming the curiosity of travelers with great kindheartedness making the arrangement of training sessions easier for the entire team.

After setting up and awaiting the arrival of the remaining participants, Dr. Shaw gave an overview of the course to probe the knowledge already possessed by the physicians. Among the questions he asked was whether the physicians had defibrillators in their hospitals or any experience in using them. Thereafter, one of the participants remarked: “we have a defibrillator in our hospital, but we don’t know how to use it.” The lack of training on the use of defibrillators has become a persistent theme throughout this trip and is reason for concern, more alarmingly so when stated by an experienced physician. While the hospitals may have equipment that can be upwards of tens of thousands of U.S. dollars, they obviously will not do patients any good if the majority of the healthcare providers in the hospitals cannot use them. The prevalence of defibrillators in the United States is often taken for granted, with AED’s at hand in a multitude of public areas, such as airports where they are every few hundred feet. The lack of such equipment in hospitals would almost be unimaginable at this point in American healthcare. Yet, in countries such as the Dominican Republic physicians are making do working without such equipment.

The proper training required for the use of a defibrillator is relatively simple and if incorporated into the curriculum of medical schools within the nation it is evident that great progress can be made in the way of resuscitation techniques. We are hoping that the training provided by Dr. Shaw over the course of the two-day training will provide these physicians with enough information to allow them to properly use their equipment at hand. The enthusiasm shown by these doctors was quite evident through both their mannerisms and the questions that they asked throughout the session. Being experienced and having worked in hospitals, the physicians seem to realize the importance of the PALS course and I have confidence that they will pass on the training on to their colleagues as well as students. If Physicians for Peace and other similar organizations can continue their training programs until there are enough in-country physicians who can provide similar classes or until such material is incorporated into medical schools, there is great promise for the future of Dominican emergency care, both pediatric and general. As for the class itself, Dr. Shaw covered a very similar material set as he did on days 2 and 3 of the trip. He also demonstrated nasal intubation techniques and provided a review of the proper form of CPR and general intubation in addition to the more advanced topics in regards to PALS. Some of the physicians seemed to have never been taught the correct methods of performing CPR and have never needed to utilize CPR as general physicians; however, it was apparent that they were more than capable of performing it after being shown the correct approach. The interest level from the practicing physicians on such topics was noticeably higher than the medical students, with Dr. Shaw fielding many more questions than on days 2 and 3, once again indicating the real-world importance of the material covered in the training.

As we made our way back to the hotel after the day of classes, I left with my thoughts on the current medical situation in the Dominican Republic being confirmed. While there are ample enthusiastic and adept physicians present to provide care, many have never received the training necessary to perform proper pediatric advanced life support. However, as demonstrated by the classes, this issue can be easily solved. As I stated earlier, if physicians who currently have the proper training in the country spread the knowledge they have acquired and if there is a desire from local physicians to continue to improve their training, then pediatric as well as general emergency care can be significantly improved. Thus, an internal support and knowledge-sharing network will be vital for the future success of the Dominican Republic’s healthcare system.

Day 3: Children’s Hospital (Neonatal Resuscitation Program: Dr. Karotkin)

Tuesday, August 17, 2010 by Maternal and Child Health

From the field: Dominican Republic - Pediatric Advanced Life Support (PALS)
Sent by: Achal Patel

We awoke to another picturesque day in Santiago anticipating the completion of the two-day classes in the Children’s Hospital. As we walked through the hospital today I noticed each ward had around ten beds in them each. While the wards were congested, I observed a significant number of doctors and nurses present to care for the patients, certainly a reason for optimism, as it was evident that there is not a lack of human capital in the hospital. Unfortunately but understandably so, due to hospital regulations I was unable to document any of my observations through photographs. But, it is clear that these doctors and nurses work everyday through improvisation and do an excellent job at it.

With the enthusiasm and hands-on skill possessed by these healthcare providers one can only imagine the strides they can make in the healthcare sector of the country with just a few more resources and proper training on the utilization of these resources. While I have been previously aware of the tremendous medical resources available to us in the United States, I am only beginning to realize that even this acknowledgement cannot lead to me accurately comprehend the advancement of medicine in the States compared to the majority of the world’s countries. If these countries possessed even a small fraction of the medical resources available to physicians in the United States the possibilities for medical advancement are tremendous and exponential.

While missions aimed at clinical work can provide short-term alleviations to medical issues and may perhaps even be glorified, I have come to the realization that it is further training that will provide the basis for medical advancement and self-sustainability in many countries, including the Dominican Republic. After setting up for the day the students trickled in after completing their morning hospital duties and training resumed shortly after 10:00 a.m.

Today I sat in on Dr. Karotkin’s Neonatal Resuscitation class with the second session being the more interactive and examination day of the class. Dr. Karotkin would use the second day to build upon the topics covered in the previous day, which consisted of the overview and principles of resuscitation, initial steps of resuscitation, use of resuscitation devices for positive-pressure ventilation, and chest compressions. He began the second day by covering the procedures of endotracheal intubation, the utilization of medications for neonatal resuscitation, and actions taken during special cases. Afterwards lessons on resuscitation of babies born preterm and ethics and care at the end of life were covered. Right before the lunch break I learned that the majority of the students in the class were on call the previous night and had not properly rested for upwards of 30 hours. Yet, impressively enough they continued to pay attention throughout the presentation with many students simultaneously studying the material covered the previous day and absorbing the new information provided. After the conclusion of the lessons and the lunch break, the students practiced intubating a ‘dummy’ baby; for many this was their first time.

Thereafter, an 89-question test evaluating them on the material covered was administered. With the aid of a couple medical students fluent in English the class was able to take the test printed in English smoothly. While the tests have not been graded yet, I have faith that all of the students will pass and receive their Neonatal Resuscitation Program certificate. Meanwhile, in the PALS class Dr. Shaw is finishing up giving the practical exams to the students after the written versions were taken this morning. All of the students who were administered this test passed and were given their certificates today. Afterwards, we bid farewell to the students who helped to make the two-day programs a success hoping that they will eventually be able to utilize the materials they learned over the past couple of days in a clinical setting. Departing the Children’s Hospital, we entered the Santiago rush hour traffic and made the short trip back to the hotel after what we considered another successful day in Santiago.

The Children's Hospital

Wednesday, August 11, 2010 by Maternal and Child Health

From the Field: Santiago/Moca Dominican Republic
Sent by: Achal Patel Mission Program: PALS

Day 2:

After awaking at 6:30 A.M. on a sunny and beautiful day in Santiago the team met for breakfast and discussed the events to follow throughout the day. Shortly after Dr. Karotkin, Dr. Lopez, Dr. Shaw, and myself made the short trip to the Children’s Hospital via the bustling and lively maze of Santiago’s morning traffic. Upon arriving we received a warm welcome from a variety of physicians, residents, and medical students excited to help the team in whatever way possible. As I walked through the hospital the differences between Dominican and American hospitals were not as evident as I expected them to be. At first glance I noticed that the hospital was fairly clean and well organized and while it looked slightly dated compared to its American counterparts it seemed to have all of the resources to provide patients with the proper care. With the proper training, there was certainly the ability to provide medical care similar to that of the United States, providing reason for great optimism. We soon set up in two classrooms with all the resources necessary for an effective educational program to be conducted such as projectors, speakers, and dry-erase boards. Most importantly, we were fortunate to have a few medical students fluent in English who were able to translate the presentations given by Dr. Karotkin and Dr. Shaw, an invaluable resource. After a slight delay in setting up and organizing the participants, Dr. Lopez introduced Dr. Karotkin, Dr. Shaw, and myself to the students and the classes were underway.

Today I observed Dr. Shaw’s class on Pediatric Advanced Life Support (PALS). Through the use of a translator, video, and handbooks in Spanish the class went smoothly as the students dedicated their full attention to the topic. Dr. Shaw did an excellent job of modifying the materials he had to better suit the conditions the students would be practicing advanced life support under. It was clear that the participants realized the value of the material they were being taught and the long-term effects simple intervention can have on decreasing infant mortality rates in the Dominican Republic. While the students were attentive during the video and speech presentations, it was the hands on demonstrations that truly captivated their attention. As Dr. Shaw emphasized the importance of CPR as the basis of PALS, demonstrations on adult, adolescent, and infant CPR were shown as the students quickly adopted the correct pace and form when performing the CPR on the manikins. Dr. Shaw continued his presentation while outlining the basics of PALS, covering the evaluation of patients in distress and the utilization of AED’s and medicine to provide life support. Class was then adjourned for a lunch break over which I spoke with a few of the medical students about their futures.

The conversations I had confirmed my previous speculation that many of the medical students in the Dominican Republic had a wanting to go to the United States for their residency and post-medical school training. While this phenomenon is a common one throughout the world today, it provides reason for concern that some of the Dominican’s brightest medical talent is emigrating from the country post-medical school. Whether the students will return after spending a few years in the United States during residency is unclear; however, it is clear that in order to promote the highest level of healthcare within the Dominican Republic the country must create methods to retain bright students. In no way am I disregarding the talent possessed by students who do remain in the Dominican Republic, but it is common knowledge that the most apt students often translate into being the most gifted physicians. As a resident of the United States and not the Dominican Republic, I can only observe this issue and speculate on ways for the Dominican to keep their talented individuals within in the country, but it is apparent that by retaining such talent the country can provide an almost instantaneous boost to their healthcare system. Conjectures aside, the class continued after the break.

Dr. Shaw continued his presentation by illustrating methods of IV placement in infants when the primary locations such as the veins in the arm are inaccessible. In addition, he covered the use of a defibrillator. This aspect of the presentation seemed to field many more questions than earlier parts of the training, indicating that the participants had not received as much training in such methods. With the interest level suddenly spiking, the energy in the room as a result of learning new material was quite apparent. This point in the demonstration was the first time that I could see that the students acquired newfound knowledge that can truly play a significant effect in an emergency situation. However, it was disheartening to learn from the Chief Attending physician of 4 years that in her time at the hospital she had only used the defibrillator twice. Even more concerning is the fact that the majority of the students and physicians in the hospital do not even have the training to operate the equipment. But, if basic training on the use of defibrillators and AED’s is provided to the medical staff, countless lives can undoubtedly be spared. Perhaps a future goal for Physicians for Peace can be to provide the hospital with the resources to provide this training. Moving on with the class itself, Dr. Shaw introduced a variety of real-life case studies testing the students on the material learned throughout the day, providing an interactive environment for the students. As the participants engaged in the presentation it was clear that they absorbed much of the information presented to them throughout the day, ending the academic day on a very positive note and providing hope for the training possibilities of the future.

Pediatric Advanced Life Support and Neonatal Resuscitation Program: Santiago, Dominican Republic

Wednesday, August 11, 2010 by Maternal and Child Health

From the Field: Santiago/Moca Dominican Republic
Sent by: Achal Patel
Mission Program: PALS

Hi!, I'm Achal Patel and a rising 2nd-Year Undergraduate at the University of Virginia on a Pre-Medicine track pursuing a degree in Politics. I am on a trip with Physicians for Peace in Santiago, Dominican Republic providing Pediatric Advanced Life Support and Neonatal Resuscitation Program training to medical students in the country. The courses are taught by Doctors Eric Shaw and Edward Karotkin, respectively; the mission will last from August 8th, 2010-August 14th.

Day 1:

As the aircraft descended into the Dominican Republic the natural splendor of the island was undeniable. The clear blue waters contrasted the dark green and prospering jungles, the two separated by only a narrow, bright white beach. Adding to the scenery were the mountains ascending from the ocean that we would soon be acquainted with. The natural beauty of the island seemed to rub off on the personalities of the citizens of the country, who appeared eternally joyous.

Early morning flight changes and altered departures left the team consisting of Dr. Edward Karotkin, Mrs. Betsy Karotkin, Dr. Eric Shaw, and myself, weary as we arrived in Puerto Plata around noon on August 8, 2010. However, our excitement was difficult to hide even beneath the cloak of exhaustion that was upon us. The cordiality with which Dr. Ramon Lopez greeted us at the airport foreshadowed the warmth, hospitality, and gratitude that would be shown to us by the Dominican people throughout our trip.

We began our journey towards Santiago on the warm, sunny day taking twisting mountain roads with stunning views into the valleys below. As we passed towns it was difficult to find residents who were not jubilant on this Sunday afternoon, the traditional Dominican day of rest and celebration. We stopped about halfway through our journey to enjoy a delicious lunch at a restaurant overlooking the beautiful valley within which Moca and Santiago reside. As we finally made it into the town of Santiago the streets were calm and quiet on the Sunday afternoon, echoing our need for rest and providing time for preparation for the days to come. After a late dinner we resigned to our rooms to get some much needed rest for the week to come.

While our introduction to the Dominican Republic conveyed a façade of flawlessness, we fell asleep understanding the fundamental medical issues in the country, something that would slowly begin to be addressed the following day. However, the positive attitudes of the general Dominican population and their previous triumphs over challenges, whether they be political or otherwise, brought on optimism over the effect the next week of training can have on the future of the countries medical care.

Malawi: A Fact Finding Mission Turns a Maternal & Child Health Program into a Reality

Thursday, July 29, 2010 by Ellen Libby

Program Update: Malawi, Maternal & Child Health
Sent in by: Laura B. Gwathmey (Director, Global Health Programs)
Mission date: March 2010

We are excited to report the news of a Maternal & Child Health program development in Malawi. As part of our philosophy, Physicians for Peace will only work to develop a new program at the invitation from a host-country partner. This has been the case in Malawi, where we will be replicating our Maternal and Child Health program to this rural area.

Physicians for Peace was introduced to Adventist Health Services by a local supporter who had visited Malawi with his church. At the invitation of AHS, Physicians for Peace sent a fact find team this past March to assess their needs and determine areas of potential collaboration. The team visited 6 of the 17 rural clinics AHS operates, witnessing first-hand the need for ongoing training and support in isolated areas. Incredibly dedicated to their work, AHS clinicians work under stark conditions, often living on-site at the clinic to provide round the clock care for villagers, leaving only occasionally for provisions. This means they don’t receive ongoing medical training, so their skills quickly become dated.

In August, Physicians for Peace will send a nurse to Malawi for 11 weeks to provide refresher training and education for these clinicians. She’ll split her time between 6 clinics, living and working with them as they improve their skills in family planning, counseling and testing for STDs, and prenatal care. Because of this partnership, Physicians for Peace will be working to improve the health of rural Malawians, working alongside them to truly build peace and international friendships through medicine.

Laura B. Gwathmey has joined Physicians for Peace after many months of volunteering while finishing her graduate program at Old Dominion University. She is now the Director, Global Health Programs, focusing on medical missions in the African region.

Cardiac Specialists Team Makes Progress in Dhaka, Bangladesh

Friday, July 23, 2010 by Specialized Surgery

From the Field - Dhaka, Bangladesh, Specialized Surgery

Written by M. Abidur Rahman. MD. FACS

Vascular Surgeon, Team Leader

A surgical team:

M. Abidur Rahman, M.D., vascular surgeon
Kim F. Duncan, M.D., pediatric cardiac surgeon
Jobey Varghese, M.D., pediatric cardiac anesthesiologist
Jayesh Thakker, pediatric intensivist
Tara L. Goesch, pediatric ICU nurse
Angela Messerich, pediatric ICU nurse
Joseph Deptula, pediatric cardiac perfusionist

The team left Chicago on February 17th and reached Dhaka in the early morning of February 19, 2010. On their arrival, the entire team was invited to attend the 10th Annual Celebration of Rokhsana Memorial Hospital at Manikgng, which is 46 kilometer from Dhaka. This facility provides free pre-, postpartum, ante- and neonatal care to mothers and children.

The next day, the pediatric team was invited to visit Pediatric Cardiology Department, where Dr. Duncan and the rest of the members were introduced to the pediatric cardiac surgeons and adult cardiac surgeons, as well as the staff of Pediatric Cardiology. Dr. Rahman visited the Vascular Surgery Clinic, where he reviewed the angiograms and diagnostic workup of 15 pre-selected patients. Of those, some of the patients were selected for additional workup and surgical intervention over the next few days.

Dr. Duncan reviewed 10-12 echocardiograms of pediatric cardiac patients and selected the patients for surgical intervention over next few days. Many suggestion and recommendation were made to NICVD cardiologists, as well as surgeons, in order to proceed with planned surgery for the selected patients.

On February 22nd, Dr. Duncan presented “What’s new in congenital cardiac surgery”. He also performed two pediatric procedures which included one VSD closure and a repair of the Tetralogy of Fallot. Dr. Rahman performed two procedures which included Juxtarenal abdominal aortic aneurysm resections and a carotid endarterectomy. In between the surgical procedure both Dr. Rahman and Dr Duncan attended vascular and pediatric cardiac clinic and offered consultations to many patients.

There was extensive discussion amongst the Ministers Director of Health, Dr. Rahman and Dr. Duncan regarding the prospect of improving the pediatric cardiac care services in Bangladesh in general. The Director General of Health asked for assistance and suggestions in this regard. Dr. Duncan and Dr. Rahman have offered assistance arranging fellowship for pediatric cardiac team from Bangladesh at Children’s Hospital of Omaha, Nebraska, with the possibility of sponsoring this program through Physicians for Peace in collaboration with University of Nebraska, and the Government of Bangladesh. In conclusion, we assured that we would explore the possibility of this fellowship for a pediatric cardiac team in the United States.

On the evening of February 24th, Dr. Kim Duncan had a local television interview regarding the pediatric cardiac care services in Bangladesh and the future of pediatric cardiac services. The TV interview was much appreciated by the Ministry of Health, as well as the staff at the National Institute of Cardiovascular Disease.

On February 25th, Dr. Varghese offered lectures at the National Institute of Cardiovascular Disease. The topic was “neuroprotective technique of pediatric cardiac anesthesia”. Joseph Deptula also presented the topic of “myocardial protection of neonates during cardiac perfusion”. Dr. Rahman performed an abdominal aortic aneurysm resection, as well as performed a femoral angioplasty with placement of multiple stents for occlusive disease of the femoral arteries.

On February 28th, Dr. Duncan performed an LMBT shunt, and Dr. Rahman performed two abdominal aortic aneurysm resections. On the evening of the 28th, Dr. Rahman had a television interview regarding present status and future of vascular surgery and care in Bangladesh.

On March 1st, Dr. Duncan presented "Techniques for repair of TGA and a functional single ventricle". Dr. Duncan also performed a Rastelli procedure for a patient, and Dr. Rahman performed two procedures with a femoropopliteal angioplasty and placement of a stented graft. That evening, a reception was held by Bangladesh Association of Physicians for Peace. The Director of Health expressed his appreciation for the visit of the team and engaged in a discussion on how to proceed with a fellowship for the pediatric cardiac team in the United States. Team offered several suggestions to the Department of Health for implementation to improve present health care delivery to pediatric cardiac patient and for early recognition of congenital heart disease in Bangladesh for better out of medical and surgical treatment.

On March 2nd, Dr. Duncan presented "Congenital Heart Surgey in Omaha". He also performed bi-directional Glenn anastomosis, and Dr. Rahman performed procedures on two patients with a femoropopliteal angioplasty and placement of stented grafts.

Entire team would like to thank Physicians for Peace for organizing the mission. Special thanks to Mary for co-ordinating different itinerary for few team members and getting visas and passport back in time for the trip.
______________________________________________________________

Did You Know?
February 21st is a national holiday for National Language Day. On this day in 1952, there was a protest against Pakistan Government not recognizing Bangla language as one of the national languages . Pakistan authority opened fire on the mass protestors and five people were killed. Ultimately Bangla was recognized as one of the two national language. The whole nation celebrates the day in memory of the martyrs of the National Language Day. It is worthwhile to mention February 21st was also recognized as a mother language day by the United Nations in 2000.

Physicians for Peace Mission

at National Institute of Cardiovascular Disease

Dhaka, Bangladesh from February 19th through March 3rd, 2010.

From the Field - Manila, Philippines

Wednesday, July 14, 2010 by Walking Free

Day 2

On our second morning, Kelly, Penny Bundoc and Physicians for Peace Philippines Board Chair Dr. Ted Herbosa were tapped to be part of a press conference panel on disabilities, along with a blind architect who has been advocating for accessibility codes for housing and public spaces. Penny and Ted spoke eloquently about the Walking Free program in the Philippines and Kelly spoke about using art therapy to get trauma victims to work through their experience.

The media seemed quite interested in the topic and asked many questions, but they really became animated when Kelly came around to the front, sat down and took off her prosthesis for the cameras. Everyone was fascinated, and loved the magenta toe nail polish on the prosthesis foot. Kelly was interviewed by a local TV station as well. Later that night, both Penny and Kelly went to the Philippines cable station, which airs via radio and TV in the Philippines and around the world. They sat for make-up and hair and were interviewed for 45 minutes. Kelly once again removed her prosthesis for the cameras. (Note: 3 days later, we heard that the station is still talking about Kelly. A star is born!!)

Back at the P&O workshop, Dave and Mike were busy with patient fittings and fabrications. We met a 23 yr old named Kharisma. She has a hemi pelvectomy due to cancer that her doctor neglected to diagnose as malignant after she fractured femur. Kharisma had just passed her nursing final exams when she learned she would have an amputation, so she was never able to work as a nurse. In fact, she does not think there is any work she can do. She lives a 2-hr drive outside of Manila, and her mother has no money to send her back to school to study another subject (a benefactor had put her through nursing school). Kharisma’s twin sister, Karina, is finishing her nursing degree as well, and has hopes of finding a job soon. Gail worked with Kharisma to try to get her walking without a crutch. She is so sweet, but is feeling very unlucky. She tells us that her mother misnamed her, that she has never been charismatic, and now will never be without her leg or real prospects for a future.

In the afternoon, Kelly went to the Child Protection Unit to speak to 50 social workers about art therapy. The social workers were very interested in the topic and asked a lot of questions. While Kelly was giving her presentation, the rest of us went to Tondo, where there was an amputee screening. We were told that morning that there would be 18 amputees, but when we arrived, we learned that there were 75! The screening was especially noteworthy because SMART, the local cell phone company, has developed an application for patient screenings. SMART will donate 39 cell phones and train health care workers to go into more remote areas of the country and capture all the necessary information and even take pictures of the patients. This will be kept on a central data base. This is an exciting pilot program and marks a new era of corporate social responsibility in the Philippines.

Went to an art auction tonight at Rob Lane's store. Most Philippines - Physicians for Peace Board members attended plus President Aquino's sister. Mike and Cindy won the raffle for a $1300 painting. It is beautiful.

Today we go to Quezon City where Gail and Joseph are speaking at one venue and Mike and Dave are training at another.

Tomorrow - we are off to Clark Pampanga to

see the P&O shop there.

Building Relationships with Niger State for Future Missions

Tuesday, July 13, 2010 by Ellen Libby

Today we welcomed dignitaries from Niger State - Nigeria's largest state - at our headquarter office in Norfolk who came to visit with the leadership team at Physicians for Peace to discuss future medical education and training opportunities in Niger. The Nigerian delegation was sent by Executive Governor, Dr Muazu Babangida Aliyu OON and included the Governor's Chief of Staff, Yusuf Garba, Ms. Aisha Aliyu of Zamfara State (a long time friend of Physicians for Peace in Nigeria) and Nigerian expatriates Prince Clement and Frances Tagwai, both living in the United States.

Physicians for Peace has worked in Zamfara State, Kaduna State and Rivers State in Nigeria. This will be their first time in Niger State.

2nd Quarter Updates - Physicians for Peace

Wednesday, July 7, 2010 by Ellen Libby

FINANCIAL STEWARDSHIP
Goodman & Co. just completed the audit for our 2009 Fiscal Year - marking another successful “unqualified audit”, the best type of report an organization can receive from an external auditor, for Physicians for Peace. You can find our audited financial statements and our 2009 annual report on our website at www.physiciansforpeace.org/about_financials.html.

MEDICAL MISSIONS
Spring was a busy quarter for our medical operations team as they managed complex logistics, diplomatically coordinated with host country partners, and prepared our eager volunteers for missions. The completed second quarter missions were:

Destination	Program
Asmara, Eritrea	Specialized Surgery
Deschapelles, Haiti	Walking Free - multiple missions
Fes, Morocco	Specialized Surgery
Leipzip, Germany	Walking Free - international conference
Diyarbakir, Turkey	Walking Free
Santiago, Dominican Republic	Maternal & Child Health - Resource Mothers
Santo Domingo, Dominican Republic	Walking Free
San Salvador, El Salvador	Burn Care
Monrovia, Liberia	Maternal & Child Health

Mission highlights include:

The first off-pump open heart surgery was performed by the Morocco mission team
Our Burn Consortium partner inaugurated a new burn clinic in El Salvador
Our Walking Free Philippines Director, Dr. Josephine Bundoc, was asked by the WHO to speak about the challenge of meeting the needs of amputees in developing countries at the International Society of Prosthetics and Orthotics (ISPO) conference in Germany
Julie Philips, MPH, presented her evaluation of the Walking Free program at the ISPO conference as well

MEDICAL SUPPLIES
We have received significant donations of medical supplies and equipment during the 2nd quarter to help our Walking Free, Seeing Clearly, Burn Care and Specialty Surgery programs. As a result of our highly-publicized collection drive for Haiti’s disabled, we have to date received over 1,000 boxes (about 25,000 lbs.) of high quality prosthetic components from 244 Hanger Prosthetic offices in 44 states. Many other organizations continue to donate items for our Walking Free program.

HAITI
Our efforts in Haiti continue as we meet the current rehabilitation needs of the amputees through an amputee clinic being managed at the Albert Schweitzer Hospital in the Central Plateau by Hanger Orthopedics, Christian Medical Mission Board, and other founding members of the Haitian Amputee Coalition, including Physicians for Peace. Physicians for Peace has sent numerous physical therapists and shipments of crutches and high quality prosthetic components to the clinic. The clinic has produced over 450 prostheses for amputee victims, more than any other site in Haiti. In fact, the donations have been so generous that we have now actually received more donations than Haiti can use. As a result, these donations will be directed to other developing countries where we have ongoing relationships and programs that can utilize them effectively.

Physicians for Peace continues to stay true to our mission of improving healthcare capacity through education and partnerships with local organizations to increase impact. Nowhere is this more important than in Haiti, where the needs of this “generation of amputees” will continue into the foreseeable future. To this end, Physicians for Peace is embarking on the following strategies:

- Physicians for Peace partnered with two universities in the Dominican Republic to bring together rehabilitation specialists, students, NGOs and Ministry of Health representatives from both Haiti and the Dominican Republic for a conference designed to identify best practices for sharing skills and knowledge across the island of Hispaniola (Haiti and the Dominican Republic).

- Our Prosthetist Certification program in partnership with Don Bosco University in El Salvador will begin this fall. The plan combines distance learning with hands-on training by Physicians for Peace medical teams over a 3 yr period to become a certified prosthetics specialist. Physicians for Peace is awarding scholarships to those Haitians wishing to participate who are currently in training at the Amputee Clinic at Albert Schweitzer Hospital and other locations.

- Physicians for Peace has also partnered with Catholic Medical Mission Board (CMMB) and the Hanger Ivan Sabel Foundation to provide a comprehensive rehabilitation plan for Haiti. Under this partnership, Physicians for Peace would provide the training and education of physical therapists in Haiti.

We are proud to announce that Hanger Orthopedic Group, co-founder of the Haitian Amputee Coalition and our long-term partner in our Walking Free program, was honored for its charitable relief efforts in Haiti by InterAction, the largest alliance of U.S.-based international development and humanitarian nongovernmental organizations.

Physicians for Peace is a member of InterAction, and nominated Hanger Orthopedic Group for the Corporate Recognition for Humanitarian Assistance award for their outstanding work in spearheading the Haitian Amputee Coalition. They were in good company with the other honorees, which included JPMorgan Chase, Toys“R”Us, Inc., Whole Foods Markets, and American Express.

STRATEGIC PARTNERSHIPS
Brighton – Physicians for Peace received a donation of $58,000 from highly regarded women’s fashion designer Brighton as a result of their “Peace Charming” winter campaign. Customers were given the chance to vote for one of four charities for a Brighton donation, and Physicians for Peace received the most votes nationwide of the 4 charities selected this year.

Eastern Virginia Medical School – 4th year students medical students Ketzela Marsh and Brad Holbrook completed their 4th year rotation with a Physicians for Peace internship, including a mission to Eritrea. This is part of an on-going partnership with EVMS, including a scholarship opportunity.

George Washington University – our partnership with GWU medical faculty to provide specialty post-graduate medical education in Eritrea has officially ended. We are exploring other possibilities for joint ventures.

Old Dominion University – our on-going partnership with ODU includes a strong relationship with the College of Health Sciences, whose faculty and students have been very involved in our Walking Free program and now the Dental Care program. We are currently exploring a partnership among Physicians for Peace, ODU and the Universidad Autónoma de Nicaragua in Leon to develop a dental hygiene curriculum, which would be the first in Latin America.

American Red Cross – Physicians for Peace held a successful meeting recently to discuss partnering on a blood banking initiative in Mali.

International Society of Ultrasound Obstetrics and Gynecology (ISUOG) and the Millennium Cities Initiative (MCI) – in our quest to most effectively bring together the resources needed to create positive health outcomes, Physicians for Peace is facilitating a partnership between ISUOG and MCI for potential projects in Ghana.

Family Health International – a fall return mission to Ethiopia is planned for our on-going partnership.

RECENT EVENTS

April 12 – Haiti Day at GWU. Physicians for Peace President and CEO Ron Sconyers was asked to address the needs of the disabled in Haiti as part of a panel discussion hosted by The George Washington University Medical Center. The guest of honor for the Forum was Haiti’s first lady.

April 25 - Taste of India in Norfolk. Physicians for Peace information booth at the event. Physicians for Peace has received generous support for our medical mission work from the local Indian community.

May 15 – Zach Collett’ s began his ambitious Walk for Haiti at the US Capitol in Washington DC on April 12th, and ended at Bicentennial Park in Miami on May 15, where he addressed a crowd of 15,000 Haitians at their Compas Festival. Zach, , a student at Southern Virginia University, chose Physicians for Peace as his charity of choice for his Walk.

June 9 – Dr. Jyoti Upadhyay, a volunteer pediatric urologist on the Morocco mission presented a Mission Debrief in Norfolk.

June 11- our June Board of Trustees Dinner featured:
- a touching SKYPE presentation about her Haiti mission from physical therapist Mary Anne Kramer-Urner,
- an overview of the recent Walking Free conference in the Dominican Republic aimed at identifying best practices in sharing rehabilitation skills and knowledge across Hispaniola (Haiti and the Dominican Republic) by Dr. Gail Grisetti,
- a heartfelt appeal for funding by local Norfolk restaurateur and Moroccan native Omar Boukhriss, - and a husband and wife tag team presentation about the Morocco Surgical mission by anesthesiologist Dr. Dean Giacobbe and photographer Kris Giacobbe.

June 12 – Physicians for Peace Board of Trustees meeting. We are pleased to announce that new trustees elected to the board, effective October 2, include:
- Lawrence B. Colen M.D., F.A.C.S. - Norfolk Plastic Surgery, P.C. and Associate Professor of Plastic Surgery (Plastic & Reconstructive) at Eastern Virginia Medical School
- Maurice Jones - President and Publisher of The Virginian-Pilot
- Carmen Hooker Odom - President of the Milbank Memorial Fund
- Ivan Sable - Chairman of the Hanger/Ivan R. Sabel Foundation and Chairman of the Board of Directors of Hanger Orthopedic Group

We are also pleased that Eid B. Mustafa, M.D., F.A.C.S. has agreed to serve once again as a Trustee.

SNEAK PEEK – UPCOMING EVENTS
Physicians for Peace is moving its headquarters on West Bute Street to 500 East Main Street on the 9th Floor. The move will be completed on July 31. All phone and fax numbers will remain the same.

The 5th annual Physicians for Peace Gala Reception will be held on Saturday October 2, 2010. President Bill Clinton is the recipient of this year’s Charles E. Horton Humanitarian Award for his international work, especially in Haiti and in Asia after the Tsunami. Please reserve the date and contact Sallie Ray at sray@physiciansforpeace.org for corporate sponsorship opportunities or live auction donations.

APROQUEN (Asociación Pro-niños Quemados de Nicaragua) in Managua, Nicaragua will host the Burn Care Consortium’s annual meeting in August. The Consortium includes burn clinics in eight Caribbean and Latin American countries and was formed as the successful next step in the Burn Care program established by Physicians for Peace in the region.

Fun{run}RAISER will be a combination 8K, half marathon, and full marathon Physicians for Peace team racing in the Outer Banks of North Carolina. The team has a set a fundraising goal of $50K to support the medical missions for Physicians for Peace volunteers. Click here if you would like to support our race for health.

Our Medical Operations team is busy planning (and our development department is identifying donations to fund) upcoming missions to:

Upcoming Destination	Program
Guayaquil, Ecuador	Specialized Surgery
Leon, Nicaragua	Dental Program
Manila, Philippines	Walking Free
Dilla and Adigrat, Ethiopia	Specialized Surgery
Manila/Zamboanga, Philippines	Seeing Clearly
Managua, Nicaragua	Burn Care
Lilongwe/Blantyre, Malawi	Maternal & Child Health
San Salvador, El Salvador	Burn Care
Ramallah, West Bank	Specialized Surgery
Nagpur, India	Maternal & Child Health
Santa Cruz, Bolivia	Specialized Surgery

Gifts in Kind Keep the Programs Running

Friday, July 2, 2010 by Gifts Kind

Where Do the Eyeglasses, Prosthetics, and Surgical Equipment Go?

Over the last few months, we have received significant donations of medical supplies and equipment to help our Walking Free, Seeing Clearly, Burn Care and Specialty Surgery programs. Our warehouse and overflow storage spaces were bursting at the seams with donations of crutches, walkers, canes, wheelchairs, and prosthetic limbs from groups in Virginia, Indiana, North Carolina, Massachusetts, Illinois, California, Alabama, New York, Arkansas, Pennsylvania, New Jersey, Idaho, Montana, Florida, and Nebraska just to name a few. All of these donations are in short supply in many places where we work and will be shipped wherever they are needed the most.

While we continue preparing shipments for Haiti during the second quarter, we also were able to send additional shipments to the Dominican Republic and the Philippines. We shipped a large amount of quality-certified prosthetic components to Haiti through Southern Prosthetic Supply. The components will be used to build new limbs for individuals that lost their limbs as a result of the earthquake in January. The Stryker hospital beds and mattresses have also been shipped to Haiti for the Hospital Albert Schweitzer.

As a result of our highly-publicized collection drive for Haiti’s disabled, we have to date received over 1,000 boxes (about 25,000 lbs.) of high quality prosthetic components from 244 Hanger Prosthetic offices in 44 states. Other especially noteworthy donations include:

Burn garment materials, compression gloves and UVEX sheets to help support our June El Salvador mission and an upcoming Guatemala mission.

Bone graft supplies from Ortho-vita, Inc. to be used by our physicians for an upcoming surgical mission to Ecuador on July 3-July 10.

Over 70 prosthetic limbs from Ability Prosthetics and Orthotics that will be used to help support our “Walking Free” program in Haiti.

30 hospital beds and 18 mattresses from Stryker Medical Products for delivery to Hospital Albert Schweitzer in Haiti.

Over $100,000.00 worth of medical supplies were donated by State of the Art Medical Products and will be used during upcoming surgical missions.

$25,000.00 worth of endoscopy equipment (video colonoscopies, video gastroscopes, and video processors) from The Endoscopy Center of Connecticut. This donation is currently headed to Philippine General Hospital, where it is sorely needed.

An opthamology chair, slit lamp, tonometers, phoropter, keratometer, and many other supplies to support our Seeing Clearly program in the Philippines were donated by Dr. Gene Grace, an optometrist in Durham, NC.

Shipments

On June 21, we shipped a forty foot long container to the Philippines that will be used to support the Walking Free, Seeing Clearly and Specialty Surgery programs. Supplies included eyeglasses, ophthalmology equipment, prosthetic components, wheelchairs, canes, crutches, and walkers, and endoscopy equipment. Paincare infusion pumps, accessory kits, and catheters are on their way to the Dominican Republic, where they will be used by patients for the management of post-operative pain.

During the next few months we are planning to ship containers to the Philippines, Haiti, the Dominican Republic, and El Salvador.

These medical programs are highly successful due to these generous gifts. If your organization would like to contribute to our gifts-in-kind program, please contact our gifts-in-kind manager at khudson@physiciansforpeace.org.

Celebrate Independence Day!

Thursday, July 1, 2010 by Ellen Libby

More than two decades ago, Physicians for Peace began an important journey to declare “independence” for those around the world who did not have “freedom” because they did not have access to adquate health care. When Physicians for Peace was launched, and every day since then, we have been another kind of force for freedom, freedom from suffering and disability as we mobilize volunteers to help those who can’t help themselves.

As we celebrate our freedoms this weekend, let’s remember all those Physicians for Peace “freedom fighters” who served and are serving on the front lines where poverty and disease make life unbearable for so many…giving them independence, friendship and peace through medicine.

Have an enjoyable and safe 4th of July holiday!

Train & Heels – the Physicians for Peace FUN{run}RAISER Team

Tuesday, June 29, 2010 by Volunteer Conection

Celebration RUN
Friday, July 9, 2010 by Ellen Libby

“Running is my personal time. I run as fast as I want. I run where my feet lead me. I run to clear my head. But, running for a cause gives extra motivation, even on the hottest of days." – Anne Klinkhammer, Team Physicians for Peace

Super turn out yesterday for our FUN{run}RAISER. The four runners from the previous training day were joined by three additional Physicians for Peace staff, a staff daughter, and a friend! The team split into two groups; one led by Mary for the team run/walkers and the other led by Laura for the “hard core” runners. Mary did ask Laura if she had her map of the route. Laura, pointing to her head, claimed she didn’t need it. Needless to say, we got off track in the twisting roads of Ghent. Luckily, two “Ghentinites” – both runners – were able to lead the team back on track.

This particular run marked a special day for our “flip-flop” runner, Anne, who enjoyed celebrating her birthday with the ladies on a particularly hot and humid day. Arriving fully prepped in socks and sneakers today, she was grinning to herself during the entire run. I think she was thinking flip flops would have been a bit cooler.

Hope to see you on our heels for the next run, September 7th at 5:00pm.

Hitting the Pavement for Charity with Team Physicians for Peace

"This is a great way to motivate myself, while at the same time remind me that running long distances requires a certain type of discipline. This race also gives me a chance to raise money for my favorite charity. Although I am not guaranteeing to finish in [my] record time, I wan

t people to know that I am serious about my challenge, more importantly I want to raise awareness for those who haven't even heard about the amazing work we do at Physicians for Peace." - Ellen Libby, Runner, Team Physicians for Peace

Just trying to get out of the office is pretty tough. But this 105 degree weather is making it tougher to get the motivation to run this evening. Mary was able to convince four out of the eight runners/walkers to join the run today. Eventually, we will get a day when the entire running team can meet and take over an entire lane... just kidding commuters.

You may notice in the photo below, Anne (Director of Global Health Programs) is running in a pair of flip flops. Talk about dedication...her feet are in pain from an old injury and wearing sneakers seems to aggravate the flair ups. Will she be running in flip flops for the half marathon? You'll have to come to the Outer Banks to find out.

As you know, Physicians for Peace not only provides primary and specialty patient care, but promotes sustainable health programs in our partner countries through education and training. Our hope to continue developing these programs in need can be met through your support. Click here to help us meet our FUN{run}RAISER goal today.

Team Run Schedule:

Tuesday, June 22nd: 5pm- 2 mile run/walk here in downtown Norfolk. Leaving from the office and ending at Baxters. (completed)

Thursday, July 8th: 5pm- 3 mile run/walk here in downtown Norfolk. Leaving from the office and ending at Baxters.

Monday, September 7th: 5pm - run/walk downtown Norfolk. Leaving from the office and ending at Baxters.

Sunday, October 10th: 1pm- 7mile run – Cape Henry Trail (Meet at First Landing Park)

Care for Salvadoran Children Burn Victims Has United Organizations

Monday, June 28, 2010 by Ellen Libby

Celebrating the Inauguration of a New Burn Clinic

June 24th, 2010 marked a very important day for the lives of Salvadoran children. A project that had begun in 2004 was brought to fruition at the inauguration of the Unidad de Ninos Quemados “Familia Meehan” (The “Meehan Family” Children’s Burn Unit). Speeches were given by representatives of each organization whose financial contribution made the burn unit a possibility: the Meehan Family Foundation, the Ministry of Health, the Benjamín Bloom Hospital, the Benjamín Bloom Foundation and APROQUEMES (the Association for Burned Children in El Salvador).

Those gathered recognized that “burn injuries are amongst the most painful that a person can endure" and thus “it was the very courage and faith shown by those children who had been treated in the main hospital building in past years that motivated the efforts to provide better treatment. Despite their pain, these children inspired all around them to recognize that many times, life’s barriers are nothing other than walls we ourselves create in our imagination.” said Dr. Antonio Bonilla-President of APROQUEMES.

Expressions of appreciation were made evident in the fact that walls mean nothing when collaboration amongst many people and organizations unite for a cause. In this case, the cause of providing care for Salvadoran children who have suffered from burn injuries has united many in the construction of the burn unit and, even more importantly, in the long term commitment to enhancing that care.

Physicians for Peace has been partnered with APROQUEMES since facilitating a Central American and Caribbean burn care association in 2006. As the new building begins to function, Dr. Bonilla and the staff of the burn unit will continue to be supported as Physicians for Peace supports their equipment, materials and training needs. The upcoming August 29-September 2 burn nurse and rehabilitation training mission will provide practical educational experiences as Physicians for Peace volunteers collaborate with seventeen Salvadoran nurses and seven therapists.

Please consider supporting this mission as we respond to requests from our partners to be one partner in a united front to help construct medical facilities around the globe.

The Husband - Wife Tag Team to Haiti

Thursday, June 24, 2010 by Walking Free

We've been mesmerized and brimming with tears listening to Mary Kramer Urner share her volunteer stories of Haiti. At our recent Board of Trustees event, she captured the hearts of Physicians for Peace staff and friends through our pilot videoconferencing on Skype - a big success! Mary has brought to us, through her power of words, the understanding of volunteers' yearning to continue their work through our medical missions. In the whirlwind of her trip to Haiti and barely enough time to get back into her regular routine, she spins around to wave good bye to her husband, Dave, who is off to Haiti to continue the Physical Therapy work.

Here is a brief update from Mary:

I spoke with Dave tonight. He sounded really good; exhausted and invigorated, all at the same time. He saw about 18 patients at the clinic on the first day, and really felt like he’d hit the ground running–it was all pretty much a blur. It was him and one other PT from Boston trying to manage a busload of people from Port-au-Prince. But, by today, they’d figured out some organizational methods that helped rein in the chaos a bit, and he felt much better about how the flow went.

He’s in awe of all the beautiful people he’s encountered. Their resilience and positive attitudes have been infectious. His patient handling skills have come right back to him which allows him to feel that his presence there is meaningful and effective (I knew that would happen!) He also said that he can really picture me, Sage [their daughter] and him there someday (so can I).

The tent hand-off went well at the airport, once Dave finally arrived there. The tent is still in Port-au-Prince, but hopefully it will get up to the mountain community of Duval this weekend (the thunderstorms have prevented travel there so far). Regardless of when the tent actually makes it up there, I’m happy to know that it’s in Haiti and that it will make it to Aunt Margaret and her family very soon.

Update: Day 3
Dave called from the clinic this morning just before the morning busload of folks arrived for prosthetic fitting and training. He told me something that happened yesterday. He worked with a 12 year-old girl who had lost her leg above the knee, and both of her parents, in the earthquake. He said that she mainly just stared out ahead of her, not really focused or engaged. As he described it, he started to choke up. That’s when it really hit me that he was describing someone Sage’s age. We were both just silent for a moment, feeling the deep sadness of that thought. I thought about her being in a deep state of shock. Broke my heart. Each story of loss and sadness is unique, yet all are so much alike. I’m glad that Dave is there, sharing his very big heart. He is doing really important work.

Update: Father's Day

Sage and I were able to speak to Dave yesterday for Fathers’ Day. He sounded great, having had his first day off since his arrival. He and some others took a 3 hour hike (all uphill!) to a place called Verrette Falls yesterday. It was hot, hot, hot—requiring lots of water—but the water fall was lovely.

He told me that the 12 year-old girl (Nahomi) I wrote about last week was better on Saturday when he worked with her. She’d begun to make eye contact, smile and even laugh a little. It seems like a bit of hope is seeping in.

He was gearing up for another busy Monday when a busload of people are brought in from Port-au-Prince for limb casting. That and the group of people who are staying at L’Escale (the nearby hospital housing for people training to use their limbs). There are now 2-3 P.T.s and a P.T. Assistant, so the clinic is well staffed with a great group of folks. He’s taking lots of pictures, so I’m looking forward to seeing how things have changed (and how some things have stayed the same!) since my time there.

Update: I'm Back!

Well, I’ve returned from Haiti and am safely and comfortably back home. What an amazing 2 weeks I have had, and I will have many stories to share once I start to process all I’ve experienced. Very short, simple version: I had an excellent time working with some great PTs, with quite remarkable patients--people who have so much life in them, in the midst of a devastated country, that you can’t help but admire and love them. I feel like I brought so much good will, from you all, and did some good things there, helped a lot of people. But it’s hard to escape the fact that there is still such overwhelming need. As a PT who was in Haiti some years ago said, “It is the most hopeless country, with the most hopeful people.” I think she got it right.

Thanks for all of your support through this. I am very glad to be back with Mary Anne and Sage in my most fortunate life. More later!

At the heart of this experience, it was awesome and very inspiring.

Friday, May 21, 2010 by Walking Free

Tom Meenzhuber is a Physical Therapist from Arroyo Grande, CA who specializes in Orthopedics. The following is his account of his first mission with Physicians for Peace a few months after the dust has settled and the rain season has hit. He was amazed at how positive and hope-filled the Haitian people were, including his amputee patient. Tom looks forward to returning to Haiti to continue his work at the Deschappelles Hôpital Albert Schweitzer clinic soon.

Sunday: May 2
After arriving in Haiti, it didn’t take long for me to get a taste of their culture. I was immediately engulfed in a celebration to witness a local marriage vow renewal. A voodoo priest and nun ran the ceremony. The large crowd, drinks, really great food, laughing and partying - I can't explain it all, but it was just a wild party with everyone singing and dancing kept in time by an African band providing the music.

No real problems other than the heat, the physical work in the clinic, and the language barrier. I really have to pace myself and drink a ton of water when working. Next week is going to be really rough as we will be down to two therapists instead of three. We don't know when another one will come; a big problem.

I am going to be able to discharge several of my patients tomorrow! One of them is from Port-au-Prince, an above knee amputee and he is so happy that he was shaking my hand and smiling so much it just warmed my heart and soul. Another 10-year-old orphan who is a below knee amputee is so excited to have a leg and be able to walk. He high fives me and we do the fist bump, say respect and put our fists to our hearts .The patients work so hard in rehab and very few ever complain.

My heart is a little weary today but we will just keep punching the bag as Jim says.

Wednesday: May 5
I am working in an outpatient amputee clinic near the hospital and it has been quite an experience. The number of young and multiple amputees makes it look like a war zone. We treat patients from Port-au-Prince and from the surrounding countryside. I am in DesChappelles about 60 miles from Port-au-Prince out in the country and they send bus-loads of people from the city every Monday to be rehabbed in our clinic. They have housing for people who stay here, a mile or two away on dusty dirt roads, but it’s not really what we would call housing. These are open-air buildings with no screens on the windows and no doors. Very basic living quarters with about eight units which house somewhere around 50 people.

Unbelievable conditions. No electricity or running water, one community kitchen in which the hospital provides two meals a day, and the families cook while the rest of the family brings items. Other patients come from the surrounding areas and some ride a bus (called a tap-tap) for three hours which is really just a truck where the people sit on benches in the back. Most can't afford to come more than one or two times a week or maybe once a month if they aren't staying here at the clinic. Some live up in the mountains and hills in the middle of nowhere. The hospital is whole other story.

Thursday: May 6
I am staying at one of the Hospital houses they have for volunteer doctors, nurses, therapists, and other people involved in different relief projects in Haiti. They have electricity and usually cold running water. Some days, water is only available two hours a day. There are five rooms with two beds to a room and a ceiling fan, each bed with mosquito net. It thunders with rain and lightening almost every afternoon.

There are three bathrooms with no hot water but a toilet that flushes. However no paper goes in the toilet. We have about five or six ladies that take care of us and speak only Creole. They like me and are always trying to get me to speak Creole and correct me when I am not speaking it right. Two or three work at the same time, feed us three meals a day, and wash our clothes if we need it done. Meals are at 6:30 am, 12:30 pm, and 6:30 pm. They leave for the day at about 7-8 at night and then we are on our own. Runners come at all times of the night to get the doctors on call; however, there is a guard at the gate 24/7. There really are no bad guys, just a few hungry people begging for money or tying to make money selling things.

Our clinic treats about 30-40 amputees a day. No air conditioning - just fans. The only place that has air conditioning is the operating room and hospital library. It is extremely physical work and very, very hot and humid; I’m dripping sweat all day. However, our patient population is great; very fine, hard working people. If someone whines the rest get on them. When someone needs encouragement or does really well, everyone gets involved. These are just very fine, loving, friendly people. I have gotten many hugs, kisses, and hand-shakes with a big, “MERCI.”

My heart is heavy with what I have seen but also warm with the love of these hard working people.

Saturday: May 8
I have a few last thoughts to share on my last night in Haiti. My first few e-mails probably sounded pretty depressing as I was just starting to get acclimated and I was sharing with you all my initial impressions. Those impressions were accurate as this is a desperately poor country with many people needing medical and financial assistance.

However there are many Haitian people who are, or appear to be, healthy, happy, and hardworking. Port-au-Prince is like no place I've ever seen or imagined; dirty, crowded, hectic, wall-to-wall people, and traffic. Surprisingly, the downtown area appeared to be unscathed for the most part from the destruction of the earthquake. A few for sure were impacted, but most were up in the hills or other areas I didn't see. However, I did see a lot of tent cities.

The country is beautiful and the people live as they did 100 years ago; carrying loads on their heads or on their horses, wash clothes in the river, and people out on the street selling produce and everything else. Simple living with no running water or electricity, no TV (which was awesome), and close family ties. When someone gets sick and goes to the hospital, the family cooks for them, feeds them, bathes them, and washes their linen and clothes.

At the heart of this experience, it was awesome and very inspiring. I really felt like I was here for a reason and definitely was able to help people and see the results of all the hard work; theirs and mine. I am so happy that I came; however, I know that there is so much more work to be done.

An Emotional Goodbye to Eritrea

Friday, May 14, 2010 by Ellen Libby

Physicians for Peace and The George Washington University Medical Center have announced the final days of the Partnership for Eritrea program. Although we knew this day would eventually arrive, it was sad to say good bye to the students, faculty, and staff of the Orotta School of Medicine.

Our joint involvement in Eritrea through medical missions and the Partnership for Eritrea is a model for future program implementation and goal achievement. We are pleased with the program development progress and the following highlights:

Within a relatively short time, we were able to triple the number of trained pediatricians in the country;
We developed a successful model of partnering with academic institutions, both in the United States and outside of the country, which can be replicated;
We were able to introduce many new medical volunteers to the Physicians for Peace model of education and training to build sustainable health care systems;
Rather than being only a one-way transfer of knowledge, US and Eritrean medical professionals developed an ongoing exchange of experience and ideas;
Through millions of dollars of donated medical supplies and equipment, we have had an additional significant impact on the ability of Eritrea to meet the health care needs of its citizens.

The mutual professional respect established when we first began our medical missions in Eritrea 8 years ago has deepened into strong bonds of friendship. Physicians for Peace wishes our partners and friends at the Orotta School of Medicine all the best and hopes that there will be opportunities for further partnerships in future.

Final Days in Morocco

Monday, May 10, 2010 by Specialized Surgery

Omar Boukriss shares his thoughts on his recent experience traveling with the Physicians for Peace medical mission team to Fes, Morocco.

Omar Boukhriss Expressing His Passion for Physicians for Peace

Wednesday May 5, 2010

Fes, Morocco

Another busy day of surgeries began with Dr. Khoury's second open heart Coronary Artery Bypass Graft (CABG) operation in two consecutive days - this time a double bypass. Having successfully completed the surgery and with only short break, Dr. Khaury performed a very difficult and unusual aortic aneurysm repair.

Drs. Tawil and Heart led the Physicians for Peace team in a Urethral-Vaginal Fistula repair on a woman in her 30’s who had been unable to afford the surgery until now. Coming from a small town outside of Fes, she had been plagued with urinary incontinence for the past seven years after her first birth resulted in a still-born child. This condition typically creates a social problem for women because they are oftentimes ostracized by their villages for their uncontrollable hygiene problem. However in this case, the patient’s husband has been extremely supportive in finding treatment and getting her well again.

In one of the pediatric ORs, Dr. Upadhyay performed two cases involving bladder exstrophy and proximal penile-scrotal hypospadias. Bladder exstrophy is a complicated congenital condition in which the bladder and penis do not form correctly and are left open to the lower abdomen. It usually requires several surgeries to complete the repair. The bladder exstrophy patient is a 3 year old child who had his original 1st stage repair fail as a newborn. Dr. Upadhyay corrected the failed repair and stage the proximal penile-scrotal hypospadias procedure as a case study operation for a buccal oral mucosa graft harvest. Buccal mucosa has received increased attention in the field of urological reconstructive surgery because it is readily available, is easily harvested from the cheek or lip, and it leaves concealed donor site scar. The 2nd stage for both of the surgeries will be performed in later in the year by the Moroccan pediatric surgery team.

The Physicians for Peace Lecture series continued today with a second lecture by Dr. Giacobbe. This one centered around using a ultrasound machines to assist in locating major vessels for central venus lines or nerves for local anesthesia nerve blocks.

Thursday May 6, 2010

Fes, Morocco

The final day of surgeries once again proved to be incredible with several fascinating cases. The first case of the day, Dr. Khoury repaired a 6 cm abdominal aortic aneurysm on the same patient from which he did a four vessel Coronary Artery Bypass Graft (CABG) on Tuesday. This was the patient who had endured chest pains for 8 years and now has finally received the essential treatment necessary for a healthier life.

The second case involved a collaborative effort beween Drs. Mustafa and Upadhyay for a 24 year old gentlemen who had a severe penile contracture/deformity after a circumcision at birth with an incidental identified distal hypospadias. The repair required combined effort from both Plastic Surgery and Reconstructive Urology.

Dr. Bevivino performed the final case involving a young child with both a cleft palate and nose. This case offered an opportunity to teach the Moroccan pediatric surgeon a new technique in not only repairing the cleft palate but also the nose for which the Moroccan surgeons previously were finding difficult to accomplish.

As a result of the work and education provided by the Physicians for Peace team, the local radio station, SAISS, interviewed Drs. Mustafa and Khoury in describing their experiences at CHU Hassan II Hospital. They not only highlighted the new relationships that have been established in working with the local Moroccan physicians but also the success of the first off-pump CABG to be performed at that hospital. Drs. Khoury and Giacobbe were also interviewed by a local TV station emphasizing their collaborative efforts in Cardiothoracic Surgery and Anesthesia during their visit.

To conclude their work at the CHU, members of the Physicians for Peace team spent Thursday afternoon making post-op rounds on the pediatric floor and giving small gifts to each of the children.

Our final evening in Fes was spent as the guests of the city, when Dr. Ammraouie in his position of Assistant Mayor of the city hosted a reception and dinner for the team at a restaurant just outside the city wall.

Leaving is always difficult. The volunteer doctors have forged new friendships while old friendships are made stronger. For some, the mission in Morocco is just the beginning of their journey with Physicians for Peace. For the "veteran" mission volunteers, they are already putting their heads together for the next mission.

Quadruple Open Heart Surgery Made Moroccan News

Friday, May 7, 2010 by Specialized Surgery

Tuesday May 4, 2010 - Fes, Morocco

A busy schedule of operations today with a quadruple CABG open heart surgery by Dr. Khaury made the local headline news. This was especially significant because it was the first off pump CABG to ever be performed in Fes, Morocco. The patient was a 67 year old male who had chest pain for the past 8 years but was not able to receive appropriate treatment due to a lack of insurance. The Physicians for Peace medical team took him in and further diagnosed him with a 6 cm symptomatic abdominal aortic aneurysm for which he will have his repair on Thursday. In addition, the medical team also presided on two more burn scar repairs, a cleft lip and a cleft palate, and a cystocele repair with mesh.

On the pediatric side, little Boubid Fatima who was just 14 months of age, endured the 12 hours of travel with her mother to reach the hospital. She had been plagued with frequent urinary tract infections for the past several months and was diagnosed with a UPJ obstruction. Dr. Upadhyay performed an open pyeloplasty to correct the problem and two other Posterior Urethral Value Resection cases. Meanwhile in the adjacent OR, Dr. Bevivino operated on a pediatric cleft palate and a bilateral lip revision.

The Physicians for Pease Lecture series was started today with an excellent presentation on local anesthesia nerve blocks by Dr. Giacobbe. It involved a live presentation on cervical and brachial nerve blocks. Several other lectures are planned by the various physicians on the team later in the week.