International Health Education

Shortly after the earthquake ripped open the heart of Haiti, Physicians for Peace responded with a fundraising drive to support its two partners in Haiti, both of which were reduced to rubble. This week, Physicians of Peace sent checks of almost $27,000 each directly to Healing Hands for Haiti and St. Vincent's School for Handicapped. These funds represented the donations collected by Physicians for Peace in the direct aftermath of the earthquake and were intended for immediate relief operations in Haiti.

Prior to the devastating earthquake, there were an estimated 800,000 disabled people in Haiti. This population was disproportionately underserved and in many cases, shunned as outcasts. To meet the needs of Haiti’s disabled, Physicians for Peace, a Norfolk, VA-based nonprofit that provides medical training for health care providers in the developing world, began working in Haiti in 2005 as part of its Walking Free program—one of a very limited number of agencies with a sustainable track record in Haiti working with amputees. 

Physicians for Peace has now strategically shifted its focus from the initial relief operations to the long term rebuilding effort in support of Haiti's disabled population. All cash and material donations will be used as part of Physicians for Peace’s Walking Free program in Haitito organize, train and supply prosthetic and orthotic production and training facilities.

Walking Free—An Initiative of Hope for Haiti’s Disabled   

Amputee and celebrity Heather Mills publicly launched the campaign on Larry King Live. Physicians for Peace also enlisted the aid of Hanger Orthotics and Prosthetics, the nation’s largest manufacturer, to use its 670+ sites across the nation as collection points. Dozens of cities, agencies and companies are now sponsoring local drives and Physicians for Peace has become the “go to” agency to donate desperately needed mobility equipment. Our 10,000 sq. ft. warehouse is now overflowing, and we have partnered with Arpin Van Linesand  Hampton Roads Moving and Storage for additional storage capacity. These items will be shipped via container to Haiti over the coming weeks.

Physicians for Peace has formed two coalitions to ensure that amputee victims of the earthquake will soon walk again and play an active role in Haiti’s recovery. The first alliance is the Hispaniola Prosthetics and Orthotics Education Coalition with Healing Hands for Haiti and the International Society of Prosthetics and Orthotics-US. Healing Hands for Haiti has been  our long-term partner in the devastated capital city Port-au-Prince and is settin up temporary (and eventually, permanent) work space in the city and will soon be  able to begin prosthetic production. There are vital equipment, medical supplies and professional medical volunteers we need to send. With your generous donations, we can mobilize these efforts quickly.

Second, recognizing that considerable activity is focused in the capital city, Physicians for Peace has joined Hanger Orthopedic Group, Inc., Shepherd Spinal Center, and the Harold & Kayrita Anderson Family Foundation to launch the “Haitian Amputee Coalition” to support the central plateau region. This coalition is creating a long-term prosthetic production center at Hôpital Albert Schweitzer, an undamaged local hospital 60 miles from Port-au-Prince. 

You can help Haiti’s disabled.

Your monetary donations will help restore the production, training and rehabilitation infrastructure for Haiti’s disabled and will give Physicians for Peace the leverage to adequately organize, train and supply our Walking Free program.

 Thank you for all you have already done for the people in Haiti and for supporting our work.

Dr. Lisbet Hanson, an Ob/Gyn who is in Haiti working with Partners In Health, sent this update to Physicians for Peace last night to report on conditions on the ground:
 

"Many many thanks for your help. we are fine, trying to work with PIH to help in any way we can. Cange seems fairly calm and no major destruction here, though a lot of panic initially.  Patients may be mobilized to Cange and Hinche: There is only one general surgeon and the Haitian ob/gyns are anxious to leave to check on their families in Port au Prince as they have had no contact. Sometime today I will have a better idea of what is happening. Thanks for your prayers and all that you do. I hear the devastation in Port au Prince is huge.

Very bizarre, surreal experience sitting here in the Friendship House listening to the ZL (Zanmi Lasante, Partners in Health, Haiti) staff roll out their plan and hear as news trickles in about the airport tower collapse, the palace destruction, the UN destruction with many unaccounted for, the prison collapse, etc. Have heard that Loune and Louise in Port au Prince are OK.  Everyone is very emotional, there is a lot of passion. 23 people from ZL including Paul and Ophelia are having a skype conference trying to figure out how to get in through the Dominican Republic and bring helicopters into Port au Prince to begin triaging patients, then airlifting them to Cange or Hinche where teams of surgeons will be wlling to care for them. Cange is worried that they don't have enough fuel for the generator. The dam is down, there is no power so everything is running off the generator. The water purification system requires electricity to work. And there is only so much fuel. I have offered to scrub, hold retractors, donate blood, help in post op. I think in a few days there will be many people here as volunteers stream in but in the first few days perhaps I can help and not just be in the way. Thinking of you all."
 

Physicians for Peace has set up a special relief fund for the victims of yesterday’s earthquake in Haiti:

 

Click here to make your contribution.

Physicians for Peace has been providing medical education and training in Haiti for several years, particularly in rehabilitation for trauma victims through its internationally recognized Walking Free program.   

Through Physicians for Peace’s partner network of Healing Hands for Haiti and St. Vincent’s School for Handicapped Children (and others), both in the capital city of Port au Prince, donations will go directly to provide immediate trauma relief as well as longer term assistance for amputees.  

Healing Hands for Haiti has been providing Orthotic and Prosthetic services to the people of Haiti since 1998 using both US and Haiti specialists.  St. Vincents School for Handicapped Children is a multi-service facility that provides preschool through high school education, vocational training, physical therapy and medical care. The medical clinic, which includes a small surgical suite, sees over 1000 patients a month for primary care, developmental evaluation and 20-30 corrective surgical procedures. 

“Obviously, such a devastating force of nature has caused incalculable loss of life as well as countless traumatic injuries, particularly amputations,” said Physicians for Peace President and CEO, Brig Gen Ron Sconyers (USAF, Ret.).  “Because of our experience in working with amputees  around the world, and particularly in Haiti, and our close alliances there with highly capable medical partners on the ground, we are in a position to give some immediate medical help.”  

Left to Right: Carolyn Papafil; Brig. Gen. Ron Sconyers (USAF, Ret.) President and CEO
of Physicians for Peace; Elizabeth Woods, President of the Hellenic Women's Club of Norfolk;
Sam Hill, Development Officer, Physicians for Peace. 

For the past few years, Physicians for Peace has been working in partnership with the government of Eritrea and The George Washington University Medical Center to bring post-graduate medical education to Asmara. Last week, a dream was realized for The Partnership for Eritrea, as the Orotta Medical School graduated its first class of doctors and pediatricians, a priceless contribution to the health care system of a country affected by years of conflict. 
President and CEO of Physicians for Peace, Brig. Gen. Ron Sconyers (USAF, Ret.) attended the graduation, which marked an important milestone for medical education in Africa. He shares his thoughts on this experience:

I have just returned from Eritrea…after a most stirring and historical experience. 

When Dr. Horton conceived Physicians for Peace, it was his vision to build international peace and lasting friendships by bringing America’s best medical talent together with the medical talent of the world’s underserved to not only heal and teach, but through “people to people”  outreach, create unwavering friendships, regardless of politics, geography, religion, or other artificial boundaries.  What  transpired this  past weekend sets the standard for Dr. Horton’s vision of medical diplomacy. 

Picture this:  the dais at the graduation ceremony of the first class of Eritrea’s new medical school.  Eight dignitaries prepare to convey degrees on 31 medical doctors and 8 pediatricians.  Four of those about to honor these students are directly affiliated with  Physicians for Peace;  three are from Eritrea, a country with “not so good” relationships with America (but life long friends of PFP);  and one from Cuba (and new PFP friend), who in fact is the Dean of Eritrea’s Orotta School of Medicine…another country with severely strained relationships with its neighbor to the North.  But here they stood, as friends and colleagues, in the name of medicine.   No politics, no animosity. Just a common cause of bringing the best medicine to a nation’s people. 

In 2001, PFP, under the leadership of Dr. Haile Mezghebe, of Howard University (and personally recruited by Dr. Horton)  began a series of medical missions to Eritrea that opened doors and hearts to the way of PFP.  And then in 2005, PFP joined forces with The George Washington University Medical Center to establish the Partnership for Eritrea, bringing the first post graduate medical education to this nation…in the face of severe challenges and uncertainty.

Today, 31 new Eritrean doctors and 8 new Eritrean pediatricians begin their lives anew, fulfilling their aspirations to serve others.  And Physicians for Peace yet again demonstrates that if you heal a man, you heal only one, but if you teach a man to heal, you heal many.  Today, thousands will be healed in Eritrea.   

We can take great pride in our work there!  While it remains unfinished, this is a milestone of watershed proportions. 

As I gather more of my thoughts, more will follow.  But just know that what has been accomplished in Eritrea is game-changing.

Congratulations to all!!!  

Ron 

Find out more about The Partnership for Eritrea at www.partnershipforeritrea.org

The ABIQ training, according to the evaluation of the participants, was very successful and filled all the expectations.  Dr. Quintana and her team want the ABIQ training twice a year and asked to DR. Miranda and I to come on February for other training. The participation of Haitians students was significant and Dr. Miranda is willing to go to Haiti to offer the ABIQ. At the end of the ABIQ, 69 doctors, residents, last year students, and nurses took the exam and were certified with the ABIQ.

During our visit to the Hospital Regional Universitario yesterday, we were welcomed by Dr. Rosa Maria Morel, who is the General Director. She was so excited about the outcome of the ABIQ and also wants us to continue the Physicians for Peace Seeing Clearly mission. In addition, they need urgently some missions for PALS and NALS for both the Hospital and the Burn Unit.

Women helping women: Physicians for Peace volunteers with patients at Segou Hospital.

- Laura Gwathmey
 

Diane Strout (center), Chair of Physicians for Peace's Global Nurse Education Committee, making friends with nurses from Algeria, Philippines, Egypt and Libya during a recent mission to Libya International Medical University in Benghazi.

The first couple of days of our mission to the Philippines focused on the “Walking Free” program and how we could better meet the needs of its patients. We had visited the facilities at PGH (Philippine General Hospital) and Clark Air Field. Today would be different since we would be participating in a relief effort which is something that we normally do not do - Physicians for Peace is an organization that focuses primarily on medical education.

During this part of the mission we were supposed to visit the area of the Philippines called Northern Luzon.  Unfortunately we were not able to do so because of the damage that the area had sustained from typhoons Ondong and Pepeng. Lyne Abanilla, PFP’s representative on the ground in the Philippines, asked our team if we would like to help hand out relief supplies to victims of the recent flooding caused by the typhoons. The effort would be in Pasig which is part of Metro Manila. We jumped at the chance to help.

We meet Lyne at the Manila Bulletin which is where she works. The Manila Bulletin is the nation’s second oldest newspaper and claims the second largest circulation in the Phlippines. The paper is located in the historic Intramuros section of Manila.

When we arrive we are noisily greeted by a room full of volunteers that are busy packing the supplies that will be taken to Pasig. The volunteers include Rotarians, business owners, and doctors. The volunteers are eagerly making and packing peanut butter sandwiches. We quickly pitch in, and in no time everything is finished and ready for transport. Once loaded, we head for the police station to pick up our police escort and the truck that will transport the supplies and the volunteers.

Once we get to Pasig, we are greeted by our security escorts. Our truck that will carry the volunteers and supplies is a standard troop/personnel carrier. There will be seats for 8 people but about a dozen or so of the volunteers will have to stand up during the trip with only the wire from the surrounding cage to hang on to.

We are escorted by two police vehicles as we leave the compound. As we slowly make our way through traffic we notice that we are waved through at every intersection by the local traffic cops. Apparently word has been sent ahead in order to help ease our way through the heavy traffic.

The traffic, which is always backed up, becomes even harder to work our way through. We realize that this is due to the roads being closed due to the flooding and landslides. Then traffic comes to an abrupt halt. Right in front of us is a section of road that is completely submerged. Our escorts slowly ease their way through the water and for a while look as if they are getting ready to float away. We are nervous and are sure that they are not going to make it but eventually they are out of the water. As we inch our way forward, we are greeted by people in boats and tricycles. Some people are actually swimming or wading in the dirty water. To the left of us we notice personnel bridges made of two by fours supported by wooden bases that have been hastily constructed so that people can get in and out of the area. This is a scene that I had never witnessed and am once again awestruck at the ingenuity of the Filipino people.

Once we make it out of the water we arrive at our destination. Suddenly we are greeted by a large crowd that starts cheering and waving. These are the people that we have been sent to help.

Suddenly we are out of the truck and on the ground. The supplies are taken off of the truck and moved to a gymnasium that will be the main distribution point. There are also a large number of people in the gym. We are told that the people outside have suffered some damage to their homes but their homes are still habitable. The people inside the gym have lost most of their possessions and their homes were destroyed or almost completely destroyed.

While everyone is busy getting the supplies ready for distribution I grab my camera and spot a set of stairs inside the gym where I can get a few good pictures of what is going on inside. As soon as I get to the top of the stairs, a door flies open and I am greeted by a young man.  I realize that I am invading someone’s “home”. But instead of being angry, the young man asks if I can take a picture of his family. I agree and suddenly they are all in front of me eagerly posing for the camera. Once again, here is a family that instead of focusing on their terrible loss, are instead trying to have fun by posing for a picture.

I quickly turn around and start snapping pictures of the scene on the gym floor. The sight that appears before me is shocking. These are families that have been dislocated. It looks as if some of them had little or no time to grab anything of value. Dirty blankets and sheets have been erected in an attempt at privacy. Some of the people look as if they do not have any clean clothes. Children are running in and out of the makeshift dwellings playing and laughing. The crowd is starting to murmur with anticipation of a chance to receive some water and a little bit of food.

As I make my way to the floor and start walking in and out of the dwellings, I am greeted by calls of “hello sir”,  “good evening sir”, and “how are you doing sir”.  Everyone has a smile as I greet them.

After taking pictures for a few minutes I notice that Lyne has the volunteers ready to hand out the supplies to the people inside the gym. I run over and grab a big box of bottled water and drag it on the floor as someone else passes out the bottles. We are told to try to limit each family to one bottle. We need to make sure that everyone, including the people outside, receives their fair share of supplies. The first box empties rather quickly and then we start working on a second box of water. Suddenly people start running up to me and asking “tubig please”, water please. Though I know that every family should have received a bottle of water I cannot turn them down. What if their family is very large? How long has it been since they had fresh drinking water? What if they have small children? So I give them some more.  Once again I hear many “thank you sirs” and “salamat po”. Then I spot Doc Montero who is also busy handing out water. Someone is asking him to limit the amount of water that he is giving away. He shouts back that the children keep asking him for water and how can he turn them down. My thoughts exactly.

Eventually mats and blankets are also passed out. A small amount of cooked noodles and bread with peanut butter is given to each family. We are finished handing out supplies to the “residents” of the gym.

Now we shift to the people waiting outside. Everyone is standing in two lines. The supplies start moving down the line but we need to move a little quicker. These people have been waiting for quite some time and we want to make sure that they get their fair share. Lyne is urging everyone to move a little quicker. We certainly don’t want anyone to think that they are going to be left out. It seems that the supplies move a little quicker this time and before we know it we are finished. Through all of the commotion there is no pushing, shoving, fighting or cursing. Everyone is well-behaved and courteous.

Night has come, so we start to gather the few supplies that we have left and put them on the truck. As we make our way to the truck to leave we are greeted with “thank you ate” (older sister), “thank you kuya” (older brother), “thank you sir” or salamat po.  Some of the volunteers are on the truck. As I get ready to climb on I hear a child call out “tanapay sir”, “bread please sir”. I notice a box of bread at the end of the truck. I hand the little boy a roll. Then where there was one hand there are now two. So I hand out two more rolls. Now there are four more hands stretched out toward me, so I give up four more rolls. Now there are six and then eight more hands. So I hand out more bread. The people inside the truck are telling me that we need to leave because it is getting late. Suddenly there is a hand around my right arm and then one on my left. Then there is a hand from behind and then I am in the truck.

As we start to leave we pass by a crowd of people. Some of them are cheering while others are waving. I hear some goodbyes and few more salamats and then we are gone.

Our trip out of the flooded area is a bit quicker since it is late and there is a lot less traffic. Once again we receive a free pass because of our escort and because of our mission.

Once we arrive back at the police station it is decided that we will all meet somewhere to eat. We are all thirsty, hungry, and tired. The restaurant of choice is Jolibees. This is the Philippines version of KFC.

When I receive my order and start to eat, I can’t help but wonder how easy it is for me to take for granted that I have the ability to eat anything that I want at anytime but that there were going to be many mouths tonight that would not be fed. Even though I finish my meal, it seems that it is a little harder to swallow than usual.

P.S. - At some point during the relief mission in Pasig a woman handed me a note. The note had her name and phone number. On it she stated that her daughter had scoliosis (curvature of the spine) and asks for help. When I meet Dr. Pipo Bundoc the next day and ask him if he could help he tells me “I can do this”.  Once again our friends in the Philippines will come through.

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The work of Physicians for Peace to improve third world health care is vital to those in need. Find out more about our medical missions in the Philippines and how you can make a medical donation to support our international health programs there - visit www.physiciansforpeace.org 

Greetings from Pampaida!

Wow! What a week! Monday, a woman came to the office in Zairia. She was introduced to me as a Midwife/Lecturer at the local Training Hospital. Dr. Woje asked that we meet and have open discussions and perhaps I could lecture with the students one day. We traveled over to the teaching hospital, where I was introduced to the Director of Midwifery and the Principal (Dean of Nursing Education). A meeting with the Faculty has been arranged for Friday (tomorrow) morning. I have also requested to spend a day following a midwife. I have drafted a list of questions for discussion. Also, I will ask their help in developing a Safe Childbirth Checklist.

Monday afternoon, in the middle of a rain storm, we headed out to Pampaida Village. There were 17 of us crammed in a small van, plus supplies. I did wear my seatbelt (ALWAYS!) The driving is a bit crazy. They use the horn all the time.

I settled in my room. I have a bed net here. No mosquito buzz attacks in the middle of the night. Banke, one of the nurses, has the other room on the women’s side of the quarters. She also does the cooking. She is an excellent cook. I have had French fries, fried yams, fried plantain, beef stew, spaghetti, rice, beans, greens, and melon and custard. My stomach hasn’t adjusted to the greens just yet. A sauce is made from sun-dried tomatoes and red peppers. It is put on rice, meat, vegetables and spaghetti. I am really enjoying the food. This morning for breakfast I have spaghetti with sardines and hash brown plantain. I was finally able to convince Banke to let me wash dishes. I told her the cook should rest after the meal and allow the ones she served, to serve her.

In clinic at MV1, Maru-a village Health Worker, has learned to do tummy checks. She measures the uterine height and also assesses how the baby is positioned so we know where to listen for the heart beat. She learned very quickly. Next week, I will work with Banke.  The Doppler is a hit with Dr. Oje. He works with the Doppler and I follow with the fetoscope to perfect my newly learned skill.  We have discussed the need to maintain the fetoscope skill as it is not dependant on batteries, nor does it have components that can break. The problems with technology...

In the late afternoons, Banke and I have been strolling through the village. The small children- toddlers are still frightened of the white skinned woman! The rest of the children flock around as they love having pictures snapped. I have to be careful - sometimes there is shoving to get attention and the littler one are pushed to the ground. I took pictures of the settlement-cooking, bedrooms, shops,etc. I have finally learned what millet is. It is a grain that grows on a stalk that looks similar to bamboo.  The grain grows on the top, similar to the tops of the corn stalk. When it is harvested, they beat the stalk to remove and collect the grain.

Today, we had our first training session. We discussed the reproductive system, fertilization and fetal development and prenatal care before the computer died. I have 4 students, one of which is a male. Lots of great questions were asked. We will continue on Monday.

I have enjoyed sleeping with a mosquito net. When I arrived back in Zairia, I was told they are going to put one up here also.  Not sure if it was the open spaces of the village or the net,but I certainly slept well there.

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Monday

Oct. 19, 2009

As another week begins, we will be heading out to Pampaida in the next hour. I will do another lecture today.  We will wrap up prenantal care-maybe even a quiz. Then we will go over the components of labor. Tomorrow, I will be working with Banke in the clinical setting-doing ‘tummy checks’.

This weekend was much better than last weekend. I spoke with Jeff on Friday via Skype, so the feelings of homesickness weren’t so bad.  Saturday, I did some laundry. Boy, did I take my washer and dryer for granted!  I used a bucket and a large bowl to wash the clothes.  I ran out of bottled water so I boiled the municipal water (when it was on). Even after 20 minutes of boiling there was still a dirty looking sediment. I only used it for cooking. I couldn’t bring myself to drink it.

I read 2 books this weekend and did some knitting.  My exercise routine is up to 20 laps around the compound, 30 toe touches, 50 sit-ups and 50 leg lifts a day.

Yesterday, Dr Woje and his family came by to take me to church.  The message was on willingly doing God’s work. Another timely message. The Sunday school lesson was on daily Bible reading and study.  Mrs. Woje (Hannah) was very disturbed that I only brought my little New Testament. She has lent me a Parallel Bible and also given me a Study Booklet.  She has invited me to go to a Revival Convocation in Kaduna the last weekend of the month. She is going to be the boost I need to become more disciplined in reading/studying the Bible!  After church, I was invited to have lunch with the family at their home.  I helped cut up cabbage for cole slaw.  The meal was wonderful-rice with the spicy red sauce, curry, fried plantain, cole slaw (not quite like ours) and paw-paw. It was my first time trying paw-paw.  It is almost like a cross between the mango fruit, papya and cantaloupe. Very good!  Dr Woje extended an invitation that I stay in their guest wing on the weekends. I thanked him, but declined.

His wife has a water filtering business next door to the house.  They take the municipal water and filter it through sand and ultraviolet filtration, then bag it in small bags. People bite a hole in the corner of the bag and can enjoy clean water. Quite impressive!  He dropped off about 50 bags last evening.  I will take about half out to the village with me.

I transferred another 180 pictures from my camera. Maybe Friday, the IT guys can show me how to attach/send them. Or I can figure out Flickr. 

Signing off until Thursday afternoon when I return to the city.

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Friday, Oct 23,2009

Greetings from Nigeria!

This was a very busy week. I taught Monday and Thursday. We covered labor and delivery and complications. They have grasped previous concepts well. I continually quiz them on things we have already covered. Prenatal clinic days  are Tuesday and Wednesday. The male student, Tajudeen, did  "tummy checks" with me on Tuesday. He did a very good job.  He also taught the  pregnant women about condom use. I know...too late to prevent pregnancy, but they are encouraging condom use to cut down on the HIV incidence. He always asks the most questions during class.

We had a little girl that the doctor thinks might have sickle cell disease. She was dehydrated, febrile and didn't make a sound when they put the IV in. By late afternoon, she had perked up and was eating without vomiting. They will send blood for Hgb electrophoresis.

On Wed, at the other clinic, we saw 52 pregnant women! The nurse was gone to a conference so the doctor and I were busy. We took Maru, another nurse, with us. One woman said she was 4 months pregnant, but we couldn't feel anything on palpation. Did a pregnancy test which was a very faint positive. So we will see her back in 4 weeks. Either she is newly pregnant or had a blighted ovum. Another thought she was 6 to 7 months but had no uterine enlargement above the umbilicus. There was a lot below-either twins- I heard heart tones in the right and left quadrants or the baby was transverse. We referred her for an ultrasound.

After clinic, I showed Maru and Tajudeen how to clean up - wash the exam table, doppler, tape measure and scale with alcohol. They are using hand sanitizer between each patient. I have enough to last a couple of months. We had an assistant clean cobwebs, wasp nests and mouse and lizard droppings from the exam room in Saulawa. I wanted to do it, but the doctor vetoed the idea. The clinic is scheduled for a renovation, but we need to have it as clean as we can for the sake of the patients.

I have been doing a lot of walking - through the village or just down the road. It feels good to move. I have watched the men play football a few times. (soccer) They sure are good at heading the ball and also lots of fancy footwork - even barefoot or in flip-flops. There is certainly that sense of competitiveness. I guess that is a universal trait among males!!!

Banke, my housemate in the village, is coming by to take me to the market today. I want to get some material and have an outfit or two made. It will be my first trip out. I need that. The weekends are the worst as far as homesickness goes. Today is the halfway mark. Part of me wants to leave today and the other part knows there is still much to do. 

We have 9 women at term at Saulawa clinic so I am hoping we are around for a couple so the nurses who haven't done deliveries get some experience before I leave. The goal is to have the women come to the clinics to deliver. I warned the doctor that change takes time. If the nurses can train the TBAs (Traditional birth attendants) in warning signs and when transfer to the clinic or hospital is appropriate, they may be more successful with their goals.

I showed my Breech delivery/Shoulder dystocia video yesterday. Dr Woje informed the staff that I would leave the video so they can review it whenever they want. Guess I will get another when I get home! I have been able to utilize my teaching powerpoints from school. Most of the time my computer battery lets me get through the lecture.

Banke has asked me to let her take notes from the powerpoints in the evening when we have generator power.  I will probably download my powerpoints on Dr Woje's computer or a flash drive if he has one. Also, he has asked me to download the soft copy of "A Book for Midwives." I told them we believe in See one, Do one, Teach one - so I expect everyone to pass on the knowledge they are obtaining.

I will talk with Bala today to see if he can arrange a visit with Biya Dogon before I leave. Dr Woje doesn't know the name.

That's about it for now. Have a great weekend!

Robin

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Dr. Ruffin (left) at the APROQUEN Burn Unit in Nicaragua.

Vivian Pellas, burn survivor and founder of the Association for the
Burned Children of Nicaragua.

The Burn Care Program has continued to grow and expand to include not only training and education, but the establishment of an international burn consortium. APROQUEN is now one of 19 equal partner organizations that comprise the Asociación Centroamericana y del Caribe de Quemaduras (Central American and Caribbean Burn Association) in six countries (Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, and Nicaragua.) This Association was formed in 2006 by Physicians for Peace and is dedicated to advancing pediatric burn care in Central America and the Caribbean through training, knowledge exchange, and global collaboration.

You can ensure that this program, started with the compassion and cooperation of Dr. Ruffin and Vivian Pellas, continues to help third world countries treat and prevent burn injuries and help burn victims heal. By contributing to our volunteer medical missions and international health programs, you help bring healing to a suffering world. 

Make your donation today!

"I was excited to be on my first mission since joining Physicians for Peace in May 2005, and looking forward to participating in a medical mission trip to the Philippines. 

Doctor Montero arrived to pick up John Knight, John Knight’s dad, Henry, and myself and then we were off to meet Penny and Pipo Bundoc and Lyne Abanilla at Philippine General Hospital for a guided tour.

While I cannot do justice to what I saw with words or pictures I will do my best to provide an overall sense of what is being accomplished there.

The main focus of the tour was the prosthetics clinic where the bulk of the work for the “Walking Free” program in Manila takes place.  While Penny and Pipo gave me an education as to their primary needs in the shop they also took the time to introduce some of their patients. 

I met  Lea Redreno, who suffers from congenital deformities on every limb.  Lea is working at the “Walking Free” clinic, helping maintain it’s inventory and organization. Lea has a beautiful smile and a great personality even though she has suffered from many personal hardships.

Then I had the pleasure of meeting Herbert Renuda, who at the young age of 15 was being fitted for an above the knee prosthesis at the hip. While being fitted, Herbert displayed maturity beyond his years.

Then I met several young amputees that also had appointments at the clinic who all had positive attitudes and big smiles for everyone they met.

This is proof once again that the Physicians for Peace team and our great volunteers such as Doctor Montero and Lyne Abanilla continue to do great work.

After visiting the “Walking Free” area, Penny and Pipo decided to give us a tour through the rest of the hospital. 

What I saw was something that I have never witnessed. I saw a hospital that is bursting at the seams. Wherever I went there were extremely long lines of sick people waiting for help.  As soon as you walked into the main screening area you could see that the system was overwhelmed. 

One of the scenes was of a woman leaning over her mother who was laying on a cot in pain.  She was busily trying to use a paper fan to try to cool her while her tears were falling as she wondered what illness she was suffering from. I came upon another family that was trying to comfort a young girl that they had barely saved from slipping into a coma. Her supply of insulin had run out, and they were not able to get to Manila in time because of the recent flooding and landslides that had been caused by Typhoons Ondong and Ppepeng. The young physician in training assured me that her patient would probably recover, but that she had suffered a great deal.

Particularly troublesome were the number of very young children that I saw that were waiting for treatment. It is hard to say how many there were but virtually all available space was occupied.  The illnesses of these children could range from the common cold to more serious illnesses. 

Through all of this, the hard working and dedicated medical professionals like Penny and Pipo and our great volunteers Doctor Montero and Lyne Abanilla impressed me with their great attitudes and their hard work. This is the one piece of the thread that keeps things running at this hospital.

Additionally what was perhaps the most inspiring part of what I saw was to witness the strength and courage of the families that stood watch over their loved ones while waiting for help without a single complaint. I will never forget what I saw today, and this experience makes me want to do everything that I can to help the people of the Philippines."

You can join Ken in supporting our medical missions in the Philippines - Donate medical equipment or donate medical supplies to our Gifts in Kind Program, or make a monthly gift by becoming a Partner for Peace... To find out the many ways you can support our medical volunteer work, visit http://www.physiciansforpeace.org/ways-to-give.html 

"The Cambodia School of Prosthetics and Orthotics ( CSPO ) has granted the Philippine Walking Free technicians two (2) full scholarships for its 3 year P & O Category 2 course. Their scholarship covers their $12,000/year tuition fee for 3 years, free board and lodging, allowance, and health insurance. Philippine Airlines has been kind enough to sponsor their roundtrip fares to and from Manila.

The 2 technicians are Edgar Bellosillo and Desiderio Gapasin. Edgar has been the PGH technician (initially for Jaipur and then Physicians for Peace) since 2005... Desiderio is a hip disarticulation prosthesis user who has been a P & O technician since 1990 and is our technician at the Clark Prosthesis Laboratory and Training CEnter.

They are scheduled to leave October 28 for Cambodia and we are truly wishing them all the best in their schooling. May we reap the fruits of their efforts in the P & O school we are trying to establish!"

Congratulations to Edgar and Desiderio, and to all the Walking Free Philippines team for their hard work in continuing to improve care for amputees. If you would like to find out more about our medical missions in the Philippines and other international health programs, visit our web site at www.physiciansforpeace.org.

You can also donate medical equipment or prosthetic devices to the Walking Free Program or make a medical donation to support international health education - Your support changes lives!


Desi at work in the clinic.



Edgar (right) with a patient.

This blog comes from Diane Strout, one of our amazing volunteer nurses who is also a member of the Physicians for Peace Medical Operations Committee and Chair of our Global Nurse Education Committee. She arrived in Libya on October 3rd as part of a medical mission team whose goal is to continue the work begun by Dr. Fred Ward on his trip in July, providing training for local doctors and nurses where needed, as well as making plans for future medical education missions and programs:

Got to Benghazi last night at 9pm.  Met with director of one of the hospitals and the director of the medical school until 11pm...

This morning we met with directors from 2 hospitals at the medical school - Libyan International Medical School - LIMU, toured the medical school and got an overview of the health system here - although I must admit there are still large gaps in my knowledge.  In the afternoon,  one group went to the pediatric hospital, one group to the Jamhouriya (Republic) hospital.  We are warmly welcomed.  The nursing leadership speak some English so we are able to work together without translators.  Plans are made for rounds, case presentations and lectures for the following day.

Will be making daily rounds at the pediatric hospital - challenging cases - presentations from 10:30pm - 2pm at the peds hosp as well. The nursing situation is  very poor - I will be going  back to the peds hospital tomorrow to make rounds and gather additional information

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Greetings!  All is going well! Our group met with the director of the public medical school today, and I have meetings set with the faculty and leadership of the public university nursing schol tomorrow.  The team has continued  to offer education at LIMU - the private medical school -- and the pediatric hospital.  

I will be meeting with nursing leadership at the peds hospital tomorrow to plan our next steps to support the implementation and exection of some basic programs - infection control, process improvement activities and orientation/ nursing internships.  There is an Egyptian nurse charged with this work (she is master's prepared, very rare level of education in Libya) who has asked for support -  she has only been in the country for a month or two.  I hope to be able to connect her with resources at the university as well.  We'll see how it goes.  Everyone acknolwedges the nursing crisis - in one unit there were 2 nurses for 52 patients.  In addition, the nurses that are working function at a very basic level.    

We will be leaving Benghazi on Wed afternoon for Tobruk. There are 2 hospitals where we will consult on Thursday. 

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Good morning!

We had another productive day yesterday - physicians working at 3 different hospitals. I worked with the nursng leadership at the peds hospital and the two nursing schools.  In the afternoon, Dr Ward led our wind-up meeting with LIMU (the private medical school) and then Dr. Dow  conducted a telemedicine conference. Approx 30 physicians were in attendance and 3 cases were reviewed with specialists at VCU/MCV.  It went very well.  In addition, a surgeon from El Jala University hospital, Abdel Karlm Kbaili, will be coming to the States for the American College of Surgeons meeting.  HD put him in contact with a VCU surgeon who will be attending the meeting as well - great networking and support.   Half the team drove to Tobruk last night and the other half is in al Bayda - last day to visit hospitals.

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During the week, Fred Ward was teaching at the medical university, Chris and Joann did case studies and rounds at the Peds hospital, Renee and HD went to the trauma hospital and provided consultations. I was at the Jamahiriya Hospital. They deliver 23,000 babies each year - the hospital is incredibly overcrowded. I see two patients in one bed, babies sharing bassinets. New moms stay in the hospital on average 6 hours after delivery.

Lots of work to be done here. This has been a fantastic trip!
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We look forward to hearing more about the progress our volunteers are making to improve medical education in Libya and address the shortage of nurses there. To find out more about our volunteer medical missions and support our efforts in international nursing education, visit our web site at www.physiciansforpeace.org
 

Day 5 -

Greetings from Nigeria!
 

   The internet was down when I came to the office so I thought I would write as soon as it was available..

The little girl I saw yesterday after having a febrile seizure from malaria is improved today. Praise God!

I have been able to cook the soup mixes I brought.  I cook on top of a gas canister that has a stove grate on top.  It is sufficient. I will take my soups and oatmeal packs to the village, just in case the local food doesn't agree with me. The one local meal this week didn't!

One of the secretaries went shopping for me yesterday. She was able to get me a sheet- I had been using my shawl from my shalwar kamiz (Afghani outfit) to cover up. There was more to be covered than the shawl could accomodate! When the electricity goes out, I have been using a little pen light to get around. Now I can even read! She also got me a case of water.  I drink one bottle during the day, then really load up in the evening. That way I have the western toilet  vs. the squat toilet.  I look forward to my daily splash bath. The cold water feels wonderful.

Today, Dr. Woje and I will choose teaching topics.  He has also asked me to come up with a Safe Childbirth Checklist to post in both delivery rooms. So any of my fellow midwives, please feel free to send me ideas, anything you have used . You,too, can impact birth in Nigeria!

Barbara, another secretary, will take my laundry back to her home in Kaduna and wash things this weekend for me. She has invited me to spend next weekend at her home. We will shop for cloth and have her neighbor, a tailor, make me some clothes. Yeah!  You know how much I love wearing ethnic clothing.

I have been invited to worship with the doctor at his church on Sunday. I am sure it will be very upbeat and exciting. Many of the people here in the office listen to Contemporary music. It is great and makes me feel  like I have a family here.

I am starting to acclimate. I think it is in the high 90s to low 100s each day. Evenings cool off nicely-so the sheet is great to have. I am getting to sleep between 1 and 2 am.  The internal clock has been hard to readjust.

The people have been friendly. The babies are starting to warm up to me a little. They aren't screaming as long when they see "the ghost."

Peace on Earth Begins with Birth,

Robin

Day 6-7

The weekend was rough. I had a major case of homesickness. Everyone cleared out of the office by 3. The office was locked so no internet access. I was alone in the Guest House and there are bars on the window . And everything is inside a guarded, locked compound. Great for safety, but talk about feeling like I was in prison.  I had plenty of opportunity to review the book and outline my lecture for the week. I will actually start on Thursday.

Plenty of time for reading. I read 3 books over the weekend and started knitting a prayer shawl.  I finall broke down Saturday and called my husband, Jeff.  It was so good to hear his voice. Sunday, Dr. Woje and his daughters arrived to take me to church with them.  It was a wonderful time of study, singing and worship. 

This morning, one of the Midwives from the Training Center came by at Dr. Woje's request.  We then went to the University Training Center where I was introduced to the Principal and the Director of  Midwifery Education.  We have arranged a meeting on Friday with all the Midwifery Instructors and myself for some Cultural Collaboration.  I am  hoping to "follow" a midwife for a day or two and actually witness a few births with them.  I have already mentioned that I would love their input on developing a Safe Childbirth Checklist for the delivery rooms at Pampaida.  We talked about all the midwives who are retiring. I suggested, perhaps they would be interested in apprenticing some of the CHEWS and TBA s in the village.  I think involvement of the Nigerian midwives would be a great way to go rather than me coming in and explaining the way I learned.  I am so excited to see what natural birth looks like - wasn't able to do much when working with the physicians!! They like to manage labor and childbirth.

Everyone has been very welcoming. I did give a copy of "The book for Midwives" to the Director and principal with an inscription. "Looking forward to collaboration with you for the health of mothers and babies" signed Physicians for Peace.  We will be tight on books. I have 7 left. I will make sure the nurses who will attend deliveries get one. I have asked Dr Woje to disperse the rest to the CHEWs as he sees fit.

Peace on Earth Begins with Birth,

Robin

Dr. Chris Walters, who specializes in podiatric medicine, is a long time Physicians for Peace volunteer, leading missions to Eritrea since 2004.  Dr. Walters has been the primary fundraiser, collecting over $1 million dollars in original retail value of in-kind donations of orthopedic equipment.  Dr. Walters has also pioneered new surgical techniques for limb reconstruction of severe deformities which are not seen, well-understood, nor treated in the US.  These novel techniques, which are safe, reproducible, and sustainable in the developing world are soon to be published for educational purposes for dissemination to other developing nations.

Dr. Keith Goss, who works closely with Dr. Walters on surgery missions, accepted the award for him at the Gala. (below)


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Health Professional (Non-physician) Category - Gil Mejia, C.P.

Gilberto Mejia, a certified prosthetist, has guided the prosthetists in Dominican Republic towards higher standards of care, embodying the Physicians for Peace philosophy.  When Gil first started providing training the clinic in Dominican Republic was making as few as 7 prosthesis a week, and not making them very well.  Seven years later, the same clinic has a robust staff, is known for their quality of service, and is a self sustaining operation that makes over 30 prosthesis a week.



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Mission Support Category - John Knight, M.P.H.

John Knight has worked with Physicians for Peace for many years and is the founder and champion of the Seeing Clearly Program, one of the many sustainable programs in the Philippines.  The program, first launched in the Philippines, has been a huge success due to John’s leadership and hard work and is now being replicated in Haiti and other countries around the world.  In addition, Mr. Knight serves on the Physicians for Peace Medical Operations Committee and has gone on five PFP missions to the Philippines with his sixth mission scheduled for this October.

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  I finally arrived in Nigeria yesterday at 11 am. We had a 3 1/2 hr drive to Zaria, where the Pampaidas Millenium Project offices are located. I checked into a hotel for 2 nights.  The accomodations are meager but sufficient. Water was off until this morning and electricity is sporadic. The 24 hr internet cafe was locked up. But the office has wireless, so I will be able to keep in touch with those in the States!

I was given an overview of the Millenium Village project this morning, watched a documentary of the project and met with the various directors.

There are roughly 5,000 people in Pampaidas village. Seventy percent of the village are below the poverty level (live on < $1 US/day) The areas being addressed over this 5 year project are
 

    1. Education- the children are educated from grades 1-6. They are working at ensuring the girls, as well as boys, attend school. Each child is given a backpack with books, paper and pencils. School furniture was obtained and they are completing the building of a school kitchen. Each child is guaranteed one meal a day at school.

      Goal: to sensitize parents on the need of school enrollments

    2.  Health- they now have 2 operating clinics.  Last week the clinics saw 221/158 patients.  Total antenatal care was 15/24 with 4/8 new OB patients.   .

       a. Outpatient consultations- provide basic PHC (Public Health Care ) services to all villagers; treatment of common diseases; provide short-term in-patient care.

       b.  Antenatal care - to provide routine prenatal monitoring including interventions such as deworming, IPT  Iron/folate and vitamin A supplementations.

        c.  Child welfare clinic where basic immunizations, growth monitoring, Vit. A supplements are provided. Deworming and treatment of  common nutrition/infection related illnesses are treated. 

       d.  Outreach activities- provision of proximity interventions that target families in their homes, build trust and ownership throughout the communities, and address cultural beliefs and socio-economic and behavioral barriers to care.

     I will tour the village and clinics tomorrow and meet with the clinic staff to formulate the needs/teaching plan.  I am excited to get started.

    3..  Gender and Community Mobilization- to mobilize the community (men and women) for farmer field day and to mobilize community clusters for training in agriculture and business development.

    4.  Water and Sanitation- 23 wells have been dug and capped to provide clean water with easy access, Latrines are being built.

    5.  Agricultural Business development and environment- on-going improvement and training on agriculture and business; develop receipts for repayments of loans; Improve on grains banking; increase fish farming activity and business; encourage home gardening to improve nutrition; start stocking agro input supply centerwithin cluster.

    6.  Infrastructure- receive materials for completion of work on poultry houses and agro processing centers.

   As you can see, a lot is happening here in the Millenium Village Project. I am excited to be a part of helping this village to become healthier, more educated and sustainable. I will try to send frequent updates

Peace on Earth Begins with Birth!

Blessings!

Robin

Day 2 - 
 

My body is still on US time so sleep is quite elusive.  When the electricity is up, I read. Currently I am reading Three Cups of Tea by Greg Mortenson.  It is about an American who decided to build a school in the mountains of Pakistan.  It is amazing what people can do when they put others before their own comfort. When the electricity is down, I have been listening to my IPod- music or audiobooks.

Last night I had my first full “splash bath”. You fill a bucket with water (cold), use a bowl to splash water on yourself, soap up, and then splash to rinse. It felt good to cool off. Much better than the Baby wipe bath the day before!  When finished, you mop the bathroom floor of all the water you splashed!

For breakfast, I had bread with peanut butter. I remembered to take my weekly Malaria Prophylaxis today. Several mosquitoes have already dined on me, so I don’t want to take any chances!

Last night I plugged my phone in at the office to recharge. When I walked in this morning, they turned the generator on. I heard a POP! And saw flames shooting out of my adapter/converter. That is now fried. The phone is OK but didn’t charge. I brought 2 adapters so I was able to get the phone charged. Glad I brought two.  I may have to get another locally!

Today we were at MV2 doing prenatal care. I worked with Hadassah, the midwife. Unfortunately, she said the BP cuff didn’t work. Dr. Oje had the Doppler at the other clinic, so while we waited for him, I did the weights, tummy checks, and improved my skills with the fetoscope.  Dating is difficult as women do not use calendars as we know them and most today had no idea how far along they were. Babies come when they come.  So the pregnancy wheels I made will be of little use.  We just measure the belly and see if there are appropriate changes in size and weight between visits.

I taught Dr. Oje how to use the Doppler. It is just an $80 model off E-Bay but it works well.  He was amazed when we found heart tones on a 14 week fetus.. Yesterday he wore and changed gloves between each woman. I have just used hand sanitizer between patients as we only do external exams.  I will bring extra for the clinics next time. Gloves seem to be a bit much just for measurements!

We had one girl, about 15 or 16 years old here with her first pregnancy.  They explained that she is of Low IQ, as is her husband.  She was very anxious, but we were able to get her calmed down and check the baby.

There is a lot of anemia due to the poor nutritious quality of the diets.  The primary stable is maize (corn) They grind it up and make a cereal or paste.  All the women are given iron supplements and also folate (B vitamin).  I saw several women with Vit B deficiency.  They develop cracks in the corners of their lips.
 

They admitted a young child to the ward who was having a seizure.  They gave her IV medications to stop the seizure.  The doctor felt it was a febrile seizure as a result of malaria. I said a short prayer for her.  

The staff are teaching me short phrases “senu de zwa” means Welcome; “Na Gode” is Thank you,” "Ina quana” is good morning and “Sa hanjuma” means See you later.  I hope to add a phrase or two each day. At my age, I can only retain small amounts with lots of repetition.  I am learning so much from them. I hope when we formally start classes, they will learn from me.

We will have a meeting with the health workers tomorrow to set up a class schedule that won’t interfere with the clinic work. Today, the doctor, midwife and I were a very efficient team. Between 11 and 1:30, we saw around 30 women. The midwife documented while the doctor and I did the exam.  Team work is great.  I will also poll them to see how they want to proceed with the classes. I think we will start with prenatal and move on from there. If a delivery comes in, we will immediately do “on-the-job training.”

Time to go to my room and relax a bit. I hope all is well back in the States.

From Nigeria,

Robin

We look forward to hearing more from Robin as we receive her reports from the field! If you would like to make a donation to help mothers in poverty and support our medical missions in Africa, visit our web site at www.physiciansforpeace.org.

In the 1960s, Dr. Horton embarked on one of his first medical missions – a trip to Haiti as a public service project for his Rotary Club. After the Haiti medical mission, he continued to develop personal contacts in medical schools in many parts of the world, and this network of friends formed the basis for Physicians for Peace. Dr. Horton and his colleagues were a group of humanitarians who believed that sharing their talents with others in order to heal the sick and wounded was more important than political or cultural differences because “when you hold a sick child in your arms, there are no politics involved."  Through Physicians for Peace, Dr. Horton was confident that more doctors and medical professionals would carry on his important work of building peace and international friendships. 
 

In an interview with Horton shortly before his death in 2006, he asked that “…everyone be reminded that Physicians for Peace was founded for one main purpose – the exchange of medical education between Physicians for Peace and the countries hosting our missions.   Networking among medical professionals who became friends as a result of working together was the secret to the early success of PFP and remains my primary vision and goal for Physicians for Peace.” Physicians for Peace has continued to partner with hospitals and global health organizations throughout the world, sending more that 500 medical missions to over 50 countries. 

All of us at Physicians for Peace are proud to be a part of the vision and legacy of Dr. Horton, as we remember him on this special anniversary. Come join us as we honor 20 years of healing work of Physicians for Peace at our "Celebrate the Nations 2009 Gala Reception!" 

For tickets and information, visit the event web site. We look forward to seeing you there! 

This morning we first go to Jamhouriyh (Republic) Hospital. The hospital in Benghazi is a 260 bed facility and the director is Dr. A. F. Zaied, a nephrologist. He was most gracious and made several phone calls to set us up to see others who he thought needed our help. He expressed needs for help in the following areas: pediatric nephrology, emergency medicine, congenital anomalies, and pediatric advanced life support.

Then off to LIMU, Libyan International Medical University.  There we were greeted by Dr. Mohamed Saad Ambarek, an orthopedic surgeon. Dr. Ambarek was trained in England and Scotland.  We have a very detailed tour of the campus.  The organization is a private not-for-profit institution. They have had teachers from Italy, Germany and England.  He says he would be most happy to add the U.S. to their list of those helping them to provide international health education. The school is of the finest quality and has all the basic laboratories, etc.  He admits they have a lot of growing to do.  They are in just their second year.  In talking with Dr Ambarek we concluded that the best way to reach the largest number of physicians would be with a conference.  They have a beautiful space which will accommodate 250 physicians.  Their desires are: general medicine, medical curriculum, advanced life support, and nephrology. He presented me with a medallion for the humanitarian work that Physicians For Peace does.

Our first appointment on Wednesday is at Elfateh Children Hospital.  We are greeted by the Director, Dr. Abdussalam A. Elshakmak. All the departments are well covered, but with minimal equipment.  For instance, in the microbiology laboratory they only have two microscopes. They seem to have a rather high incidence of birth trauma, about 6:300 births.  We saw three children in physical therapy who had upper extremity nerve damage.  Two had had nerve transplant surgery and were doing very well.  The PT people seemed very dedicated to their work. The doctor expressed an urgent need for teaching in genetic defects, especially metabolic defects.  Also, there is a need for pediatric surgery, hematology, and nephrology.

On to Tobruk, our next visit is The Medical Center Batnan, a large complex which incorporates an older unit with a releative new section.  The most impressive thing about the place is how clean it is in every respect.  The medical director is Dr. Saeed H. Ali, a Koln University trained pediatrician and EEG specialist. The staff is very enthusiastic and we had a very long conversation with the head of the department of Obstetrics.  They have about 45,000 births per year, which is astounding.  They have many staff, but not enough and not well enough trained.  We met a pediatrician who is from Egypt, who comes over about one a month for one week. The areas of interest at Medical Center Batnan: hematology, pediatric surgery, nephrology and genetic defects.

Thanks to Dr. Ward's visit, plans are now in the works for future medical mission trips to provide education for medical students, as well as specialized training to help doctors in Libya better care for their patients. 

You can support the medical volunteer work of Physicians for Peace, improving medical care and building friendships around the world... Give today!