Physicians for Peace

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.

Haiti: I Will Never Forget

Thursday, July 29, 2010 by Walking Free

Stories from the Field: Haiti
Sent in by: Maureen Romanow Pascal, PT, DPT, NCS
June‐July 2010

I am a physical therapist and an associate professor in the Physical Therapy Department at Misericordia University. Recently, I had the privilege of volunteering at the Hanger Clinic in Deschapelles, Haiti. I traveled there with my colleague Karen Helfrich, a Physical Therapist Assistant (PTA). In addition to being a PTA, Karen is a student in the Master’s of Physical Therapy program at Misericordia.

As a physical therapist, it was great for me to work in such close collaboration with the prosthetists, and I believe this arrangement really helped the people we worked with learn to use their new prostheses quickly. It was amazing how quickly people learned to tolerate their new prosthesis and to walk on them on all different surfaces. We often had people, who, within a week could easily walk up and down stairs, over rocky terrain and get on and off the floor independently.

We worked with people of all ages, from a 3 years old girl, to women and men in their 60’s. Many of our patients were young adults who lost a limb as a result o f the earthquake. The strength and motivation of these people were incredible. They were so willing to work, and while they were waiting for their turn in therapy, they would cheer on the other patients and offer them advice about how to walk better.

Some great memories were of a young woman named Lovely who had a very high transtibial amputation, also known as an above‐knee amputation. Before patients were discharged, we asked them to try to carry an object such as a jug of water, since this is a task they would need to accomplish at home.

On Lovely’s last day, we jokingly asked her if she could carry something on her head. We were all impressed when she successfully carried a ball – with a cup balanced on top – both on her head – throughout the clinic!

Another young man, Claudy, impressed us by running on his prosthesis on the first day of use, and then walking on his hands, with his new leg up in the air.

Another patient I will never forget was named Modeline. She had both legs amputated as a baby, reportedly after an infection. Her left leg was amputated at the ankle, and her right leg was amputated below the knee. For the past 19 years she had been getting around by knee‐walking, wearing flip‐flops on her knees. Modeline’s story is a great example of collaboration between a patient, prosthetists and physical therapists. The prosthetists had made Modeline 2 prostheses. The one for her left worked well. The one for her right leg needed to have a bent knee, because of the way she’d been getting around for so long. That knee was stiff and Modeline was unable to straighten it. Karen was the therapist who spent the most time working with Modeline. She recognized that Modeline would be more independent if she could get her right knee straighter.

One of the skills I’ve learned as a physical therapist is how to apply a cast to help lengthen muscles. I talked to the prosthetists and Modeline. Modeline was willing to try the casting, and the prosthetists were able to help me obtain all the supplies necessary to apply a cast. Having the cast was not easy for Modeline, as it meant she couldn’t walk on her knees. She had to use a wheelchair to get around, but the area where she was staying had rocky terrain and there were stairs to enter her house. She hung in therewith the cast for 4 days, and then we removed it. Her knee was straighter. Over the next two weeks, she actively worked on getting her knee almost completely straight. She is now able to stand up like everyone else!

This volunteer experience was something I will never forget and hope to repeat. Karen and I had originally planned to stay in Deschapelles for 2 weeks, but there were no physical therapists scheduled to follow us for a couple of days after our departure. Thanks to Physicians for Peace, we were able to extend our stay and help out longer. Karen stayed 5 extra days, and I stayed for two more weeks. Thanks to all who made this possible.

Notes from the Summer Interns

Thursday, July 29, 2010 by Volunteer Conection

Throughout this hot, sunny summer, most young undergrads are hitting up one of the many beaches in the Hampton Roads Area, enjoying the rays and cooling off by catching some waves. On the contrary, Erin Godbout and Grayson Orsini are embracing this heat from within Physicians for Peace’s warehouse in Norfolk. Outfitted in Physicians for Peace T-shirts and plenty of water, these college students are spending their hot summer sorting, counting, and lifting all of the wonderful donations that are sent to locations in need throughout the globe.

Surrounded by prosthetic limbs, wheelchairs and eye glasses, Erin, going into her 2nd year at the University of Virginia explains that she really wanted to volunteer somewhere for the summer. In a roundabout way, she heard that Physicians for Peace was in need for summer warehouse volunteers and as an aspiring pre-med student, she jumped at the opportunity. As did Grayson, an International Relations major at William and Mary, he had previously helped organize several fundraisers for Physicians for Peace within the last year at his college.

After the earthquake in Haiti, he told us several different clubs came together to put on a variety show entitled “Helping Haiti” where they raised a significant amount of money for Physicians for Peace’s program. When asked about his future plans, Grayson explained that he wants to go into non-profit work after college.

A bit cooler perspective from within the air conditioned Physicians for Peace Headquarters, Amy Edler is also volunteering her summer as the Global Health Programs intern. A recent graduate from Old Dominion University with a B.S. in Women’s Studies, Amy is gaining valuable experience as she learns the inner workings of non-profit work. She aids in administrative tasks, researches for country plans and composes manuals for the upcoming missions.

“This entire experience has taught me so much already,” she says. “I will use the skills I learn at PFP throughout my career in non-profit work.”

Overall, Physicians for Peace values everyone from the warehouse volunteers to our devoted physicians. Their ability to donate their time in helping improve health conditions worldwide, solidifies our mission of using medicine as a peace-building tool. We can spread peace as long as there are caring volunteers to help make that message possible.

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.

Farewell to la UNAN Until the Next Mission

Friday, July 23, 2010 by Dental Care

From the Field - Managua, Nicaragua, Dental Care
Sent by Marlee McDonald
Friday, July 9th, 2010

On last day before leaving Nicaragua, Dr. Ever, Sandra, and I (after passing by poet Rubén Darío’s house to take pictures) had a quick walking tour around the quaint and charming city of León to buy gifts to bring home to our loving family members and wonderful supporters. Amidst the poverty, the people of León, with their beautifully colored houses and flourishing patio gardens in every building, find a way to appreciate what they in fact do have in order to express the music and beauty of Nicaragua.

We prepared a few things before the presentation and Sandra went to the nearest copy store to print and make copies of the handouts for the presentation later in the day. We were supposed to give the presentation at the university, but due to rain storms the day before, the power was still out and we moved the event to the conference room in la Casa de Protocolo.

The presentation began a little after 2:00pm. After a short introduction by Decano, Dr. Humberto Altimirano Reyes, Sandra took the microphone, eagerly embracing the moment we have been preparing for the entire week.

After a short introduction about what we had been working on throughout the week and a bit on Physicians for Peace’s mission, Sandra began with the first of three power point presentations, or “DataShow” as they call it in Nicaragua. Sandra started la “Visión General de la Asistente Dental” (A General Overview of the Dental Assistant). This presentation focused on the importance of the dental assistant as a dependable person to which both the dentist and the patient can rely on. Sandra gave certain examples of how to approach the patient depending on age and personality, emphasizing the importance of maintaining a good personal and professional attitude.

The second powerpoint, also accompanied with a note-taking handout of the slides, focused more specifically on the Role of the Dental Assistant. Beginning this presentation with the question, ¿Qué significa para nosotros la palabra, “éxito”?- What does the word “success” mean to us?, Sandra made the presentation very interactive by invoking discussion and causing the women to think about what Success means to them.

Personally, Success for me is when I exceed expectations while inspiring others to work up to their own potential; success is sharing happiness with others. Many of the other dental assistants shared the same personal definitions of success, and we discussed how as a dental assistant, your success starts in the classroom and is transferred to the clinic where your connection between your classmates, professor, and patients plays a very important role. Congruent with every task in life, teamwork in the classroom and in the clinic, a point strongly emphasized in powerpoint number two, reflects success on many levels and remains essential to a productive workplace environment.

Powerpoint number three, “Interacción entre La asistente y el Paciente”-Interaction between the Assistant and the Patient- focused on the proper ways for the Dental Assistant to educate and communicate with the patient. For me, finding the perfect balance between the amount of education the patient needs to understand the procedure and exactly how to communicate it to him remains vital to success in the workplace. In collaboration with Deborah Blythe Bauman, BSDH, MS from Old Dominion University in Virginia, Sandra translated and prepared the third presentation on educating the patient about oral hygiene. Emphasizing that the only way to convey the importance of good oral hygiene to the patient is through effective communication, Sandra incorporated another interactive exercise into the presentation. Inviting two of the women dental assistants to participate, Sandra directed a role play in which the patient and dental assistant held a conversation about finding the balance of finding time to efficiently brush and floss her teeth while at the same time taking care of her family and children. Always addressing the patient in a friendly and caring manner, the dental assistant must always learn from the patient and be flexible to discover which methods work specifically for the patient and his or her lifestyle. As Sandra emphasized during the presentation, this process stems from proper communication and treating the patient with respect and sincerity in order to develop a certain confidence and harmony between the patient and his dental assistant.

The presentation was warmly received by the women dental assistants and la UNAN faculty. I took this opportunity to play my violin as an expression to celebrate the excitement and positive energy for the future of the dental assistant program and la UNAN’s department of odontology in general. Everyone was delighted by the pieces including Ashokan Farewell, Samuel Barber violin concerto no. 1, Compadre Pedro Juan, and Dos Guitarras.

Decano Dr. Humberto Altimirano Reyes presented Sandra and I with certificates recognizing our participation in the elaboration of the “Plan de Estudios de la Carrera Técnica de Asistente Dental”-the Dental Assistant technical career program- throughout the past week. Although the week had passed quickly, it was an amazing experience for both Sandra and I and the faculty and students at la Universidad Autónoma de Nicaragua. We all indeed make up part of the team of people positively changing the future for many.

The dental assistant women were so thankful for our efforts, in fact, that they hosted a party (well, also in part for Sandra’s birthday!) at the house of Nitia, a good friend of Snadra’s from the 2003 Physicians for Peace mission at la UNAN. Complete with music, delicious Nicaraguan food, dancing and joyful people (most of them still dressed in their white dental attire), the fiesta was truly a fantastic way to celebrate the successful events of the week and much hope for the future! It was a great ending to a short but very rewarding journey.

After the party, we headed back to the Vice Dean Dr. Berta Lilliam Orozco’s house to prepare our baggage for our 3am journey to Managua to catch Sandra and my flights to Guatemala and Boston, respectively. As we prepared our bags and reflected on the accomplishments throughout the past short but extremely productive week, we could not help but look forward to our next journey to Nicaragua, a country full of countless beautiful people with so much potential for the future. Thank you Physicians for Peace for making our mission possible! Peace.love.music.healing...Physicians for Peace forever y ever.

Great Strides in Dental Assistant Program at la UNAN

Wednesday, July 21, 2010 by Dental Care

From the Field - Managua, Nicaragua, Dental Care
Sent in by Marlee McDonald
Thursday, July 8th, 2010

Today, the last day before the presentation, was used to finish up all of the small things to get ready for Friday at 2pm. As I worked outside in the beautiful open patio setting of la UNAN on some of the blogs, and sorting through the hundreds of pictures taken throughout the trip, Sandra and Ever finished polishing the “Macro” version of the curriculum which they have been revising throughout the week. They also began working on the “Micro” version, a more specific description of exactly what will be taught in the Dental Assistant program at la UNAN and when and how. The “Micro” version will not be completed by the end of this week, but the goal is to finish it before the final presentation in September 2010 before the semester begins February 2011. Sandra plans to offer her expertise and guidance through Skype if needed! Also, the PFP mission members traveling to León again in August will help to iron out the kinks of the program before it is presented in September.

We discussed the plan for the presentation at 2pm tomorrow. We will present the designed program to the current Dental Assistant students, Dean Dr. Humberto Altimirano Reyes, Vice Dean Dr. Berta Lilliam Orozco, Dr. Ever Jimenez, and Dr. Félix Trujillo. Sandra has prepared some fantastic powerpoint presentations and interactive activities which I’m sure will captivate all the wonderful women of the Dental Assistant department.

I have learned a lot about the workings of the university and the dental department in particular within the city of León and want to place emphasis on the importance of having this program initiated within the university, the city and, in fact, the country.

First of all, the Dental Assistant program is considered a technical skill, requiring only a “bachillerato,” or a high school diploma, in order to enter the program at la UNAN. It is a one-year program designed specifically for women, most of whom already have children and a family. Our program provides these women to learn a technical skill in very little time which in effect opens many doors for these women and their community, providing much hope for the future. Initiating this dental assistant program at la UNAN represents a great stride for Physicians for Peace and for la Universidad Autónoma de Nicaragua and the surrounding community, and I feel very honored to be a part of it.

After working on the curriculum and discussing plans for tomorrow’s presentation, Sandra and I headed to Vice Decana Dr. Berta Lilliam Orozco’s house for dinner with her family and some other friends. Sandra and I even gave a few dance lessons in Salsa, Bachata, and Merengue. We had a very pleasant evening!

$6,485 of Dental Supplies Donated to la UNAN’s Dental Department

Wednesday, July 21, 2010 by Dental Care

From the Field - Managua, Nicaragua
Sent by Marlee McDonald
Wednesday, July 7th, 2010

Today after a beautiful breakfast of fresh eggs, pineapple, and toast with guava jelly in La Casa de Protocolo we arrived at la UNAN a little after 8:00am. Dr. Ever had classes in the morning so Sandra and I worked a little on the curriculum alone and took care of some other emails and phone calls that needed to be done.

One very important phone call that we made was to Mr. Carlos Fernandez-Sera, President of “Bancentro” (Banco Central). Carlos is the cousin of Adriana, a friend of Sandra who lived in Norfolk. When Carlos and Sandra spoke on the phone; Carlos enthusiastically exclaimed he would arrive at la UNAN right away!

He arrived shortly and met with Sandra Mueller, me, and some UNAN faculty members including: Dean Dr. Humberto Altamirano Reyes; Vice Dean Dr. Berta Lilliam Orozco; Dr. Ever Jimenez and two other members of the University Administration. This meeting was one of the most phenomenal meetings of my life. Upon entering the room, after greeting us all with lots of compassion, Carlos, a natural businessman who wastes no time in getting right to the point, exploded with positive enthusiasm, questions, and ideas for the future. The meeting began with an introduction about Physicians for Peace and our mission to initiate the Dental Assistant program here in León. Immediately, Carlos eagerly offered his support from Bancentro and expressed his excitement about forming a partnership between la Universidad Autónoma de Nicaragua, Physicians for Peace, and Bancentro with the likelihood of adding other organizations in the future. He spoke of a children’s foundation here in León that Bancentro also supports with scholarships and was very enthusiastic about involving these children in the dental programs of la UNAN as well. In fact, el Día de los Niños, Children’s Day, here in Nicaragua is Tuesday, July 20th, and Carlos has invited the staff of dental faculty from the UNAN to attend a big event in León for the holiday in order to meet the children foundations that Bancentro supports to further strengthen the partnership.

Beginning this meeting with the intention to possibly form some sort of partnership with Bancentro and Physicians for Peace only, we ended up accomplishing much more than we had ever imagined, receiving the enthusiastic support from Carlos to provide monetary support to the odontology program at la UNAN and possibly later, the entire university, how you may ask....by helping students open “student bank accounts” for their future. Overall, we made some amazing breakthroughs, partnerships, and friendships! Gracias to Sandra and Adrianna for your connections!

As we ended the business portion of the meeting, we sorted through $6,485 value of dental supplies and products that we had brought from the United States to donate to la UNAN’s dental department. It was like Christmas all over again for the dental faculty members as we counted and tallied all of the donations. After taking some photos for the blog, Carlos invited us to his house at the beach where Sandra, Dr.Berta Orozco, and I joined his wife, Carla, and some other family friends and their kids. Luckily, I brought my violin to help celebrate the victory of Spain over Germany in the World Cup semifinal game with a mini concert for the family.

We plan to meet with with Carlos’ wife, Carla, and friends tomorrow for dinner. These are the ladies that make things happen here in town. Overall, we truly had a wonderful day and made great strides for Physicians for Peace and la Universidad Autónoma de Nicaragua in the future!

A Beautiful World from an Amputee's Perspective

Tuesday, July 20, 2010 by Walking Free

From the Field - Manila, Philippines
Sent in by Kelly A.

On my 24 hour plus travel from Manila to Norfolk VA, I have the luxury of time. I hit the random selection on my iTunes, and I am now listening to Colin Hay sing “Beautiful World” on Man At Work. I was privileged to have witnessed a part of this beautiful world this past week while on my first mission with Physicians For Peace (PFP). Beauty was seen in the generosity displayed by our Filipino hosts while taking part of the Walking Free Mission. This magnificence seemed to overtake the spirits of those whom I met along the way, as seen in their ingenuity and drive. I witnessed this in the amputees that were present at the clinics as well as the doctors, Physical Therapists and mental health workers I encountered.

I came along for the week with Physicians for Peace as a guest lecturer on Art Therapy interventions that help those who have suffered traumas as well as a handicap woman. I have known for many years that I was blessed as a below knee amputee and this was reiterated the day I met a man with a wide smile. He is also a below the knee amputee who came to Pampanga for an adjustment on his own creation. He fabricated a leg from wood, steel and what appeared to be barbed wire. We compared legs and he laughed at the Magenta colored toes while I heard a few male on lookers cry “Manicure!”

I know I am supposed to write about my art therapy lectures, however the people I met were more touching to me than hearing my own voice in front of an audience. I will however share a bit of my presentations.

My first presentation was given to approximately 40 mental health workers. This meeting was generously arranged by Dr. Bernie Madrid; the head of the Child Protection Unit. Before my lecture I was given a tour of the CPU facility as well as one of the best home cooked meals while in Manila. Dr. Madrid and I discussed the similarities and differences of the places we work. I was pleased to learn about the team effort by social workers, police, doctors, mental health as well as lawyers to help children in need and to keep them safe from abuse. I was saddened to hear that there is seemingly as much difficulty with conviction rates in the Philippines as in the United States.

At the end of my lecture the CPU participants took part in two different art interventions. They experienced a projective scribble drawing as well as a mandala. With markers and colored pencils provided, participants completed the drawing and writing intervention. They appeared to connect the power that art therapy can provide an individual. Along with my next two lectures, I left four research articles and information on the American Art Therapy Association as I only wet their appetite on art therapy.

The next two lectures were attended mainly by Physical Therapists and Occupational Therapists at Angeles Hospital in Angeles City as well as the Saturday lecture at Philippine General Hospital. While they were unable to participate in the experiential part of the lecture, there was a time for interaction with questions and answers. While my intent was not to turn PT’s and OT”s in to Art Therapists, it was to help bridge the mental health and physical rehabilitation part of recovery. Planting the importance that mentally healing after a trauma is as important as physically healing, it is my hopes that the students will be aware of those patients who could benefit from counseling. As I tell my clients, I believe we are all big puzzles as human beings, and while some parts might be scattered, it is my job to help them find the links to healing. I believe there should be a bridge between mental and physical health and I hope I helped by laying a foundation of knowledge.

“Pensum de Estudio- Carrera Téchnica de Asistente Dental” Ready. Set. Go!

Tuesday, July 20, 2010 by Dental Care

From the Field - Nicaragua
Sent by Marlee McDonald
Tuesday, July 6th, 2010 (day 3):

We arrived today at la UNAN around 8:00am. After meeting up with Dr. “Forever and Ever” Ever Jimenez, we discussed the goals for the day and the rest of the week. Aiming for a final product by Thursday to be ready to present to the board of odontology and dentistry of la Universidad Autónoma de Nicaragua on Friday, we began revising the “Pensum de Estudio- Carrera Téchnica de Asistente Dental.” In collaboration with la UNAN, we will revise the program to have a finalized copy ready to present to the board by September 2010 with the plan being to begin classes in February 2011.

In the morning we spent most of the time going over the “Perfil academico profesional del Asistente Dental” - a description of the certain knowledge, skills and activities that the dental Assistant will be expected to know upon completing the program - and matching it to the certain points of each module of the four trimesters included in the program, to make sure everything is covered. Many changes were made, and we also discussed the content of a few courses such as Consejería I-IV and Informática I and II, which include different techniques on note taking and learning strategies, and information about computer programs and Dental software such as Softdent and Dentrix. Sandra also gave Dr. Ever Jimenez a sample final exam for a Radiology course and one for a Dental Assisting course along with the answers and a review guide which she had brought from home, to help the instructors who will be involved in the program.

We returned to la Casa de Protocolo to eat lunch and... Watch Holland beat Uruguay 3-1 in the semifinal game of the World Cup. With almost half of the guests staying in la Casa from Spain, we anxiously await tomorrows game of Spain versus Germany!!

Around 2pm we returned to la UNAN to continue working on revising the curriculum. Focusing this afternoon mostly on revising the credit hour section of the dental assistant curriculum, this task proved to be a bit of a headache since we had to rework the program designed for one day per week to a full five days per week program...A lot of math!! We will finish the rest of the credit hour revisions tomorrow.

A Little Bit of Música for the Hospitality in Nicaragua

Monday, July 19, 2010 by Dental Care

From the Field - Nicaragua
Monday, July 5th, 2010:

Sent by Marlee McDonald

After waking up around 6am Nicaragua time (which would be 8am in the US) and preparing ourselves for the day and our travel to León, we enjoyed a fantastic "desayuno típico Nicaragüense" (typical breakfast) Nicaraguan style with foods such as eggs with mixed in salchicha, "gallo pinto" (rice and beans) and "queso nacional" (the nation's finest cheese) with of course the best ciabatta bread and marmalade. However, no breakfast is complete without a nice edition of música, so as a way to thank the beautiful couple of Lia and Eduardo, I played a few pieces on my violin including Ashokan Farewell, Barber violin concerto no. 1, and a famous merengue, Compadre Pedro Juan, that Scarlett, my little sister from Santo Domingo, Dominican Republic, had just taught me when she visited us in Virginia. Their parrot, Pepe, even sang along a bit! Eduardo also put on a recording of Yo-Yo Ma’s Bach cello suites which brought peace to the house as we enjoyed our wonderful meal.

Rodrigo, our driver, picked us up in Managua and transported us to León to spend the rest of the week at La Universidad Autónoma de Nicaragua (la UNAN). We arrived at La Casa de Protocolo around noon after about an hour and a half of travel on the newly paved roads, which made the journey Much easier! We were showed to our room- Habitación No. 7- and lunch was served shortly after our arrival, where we met a lot of the fantastic people staying en La Casa de Protocolo as well including many people from Spain, Austria, and Oregon!

After lunch, I played some more violin to express our gratitude for our beautiful welcome to the university's Casa de Protocolo. The sound of the violin was a beautiful addition to the inviting patio decorated with a fountain and many colorful flowers in the middle of the Casa. One of the Spaniards named Juan Diego (Juandi) also plays flamenco guitar and taught me a bit about the semitones used in the the cadencia flamenca, a bit different from the western music that we are used to. There are many other Spaniards staying here from la Universidad Complutense de Madrid (UCM), which partners with la UNAN. Juan Diego is working on a city design project with the patios, giving a flamenco guitar workshop, and helping design the university’s webpage, but many of the other spaniards staying at La Casa de Protocolo are professors giving classes on biology, physics and computer science.

At 2:00pm Rodrigo picked Sandra and I up from La Casa de Protocolo and drove us to la Universidad Autónoma de Nicaragua, la UNAN, where we met with Decano Dr. Humberto Altimirano Reyes and Dr. Berta Lilliam Orozco, Dean and Vice Dean of la UNAN. We discussed plans for the week, the purpose of our mission and key items to focus on. As mentioned before, the main focus of our mission is to edit the Dental Assistant program that we have here at la UNAN. We will give a presentation to the governing board of Odontology on Friday with the goal for the week to have the entire Dental Program curriculum outline revised by Thursday.

Unlike most dental offices in the United States where a dental assistant works side by side with the dentist and gets the patient ready for treatment before the dentist enters the room, and the dental hygienist does all of the cleanings, etc; in the majority of Latin America, the dentist completes all of the tasks. For this reason, in most dental offices in Latin America, neither the position of a dental assistant nor dental hygienist exists. However, we are helping create the program here at la UNAN which will provide academic training for this technical skill with the hope to initiate the position in local dental offices, public health clinics here in León and beyond.

After our meeting with Dr. Reyes, he lead us on a tour of all of the university's dental facilities and Sandra was reunited with many of the staff (dental assistants) which she had trained during her dental mission in 2003. They still even had many of the dental scrubs Sandra had brought for them seven years before! After the tour, we met briefly with Dr. Ever Jimenez, Clinic Director of the department of dentistry here at la UNAN, to further refine the schedule for the week. For Tuesday, Wednesday and Thursday, the plan is to continue revising the dental assistant curriculum in order to prepare for the presentation on Friday. We will be working closely with Dr. Jimenez who was appointed for this task (curriculum revision) during the next few days.

Rodrigo drove us to La Casa de Protocolo where we dined with everyone, relaxed, and connected with family and friends in the US via the free WiFi provided en la Casa. We went to bed early in order to prepare for the big day of work at the university on Tuesday.

A Different 4th of July Celebration for Physicians for Peace Volunteers

Monday, July 19, 2010 by Dental Care

Dental Program - Nicaragua
Sunday, July 4th, 2010

Sent by Marlee McDonald:

Instead of staying in Boston, MA and Norfolk, VA to celebrate this year's US Independence Day, Sandra Mueller and I boarded a plane to Nicaragua. Although, this is of course, always a huge celebration in the United States, we knew that we would have enough time to celebrate after arriving to Nicaragua, especially with the semifinal games of the World Cup taking place! After all, we were on a mission... A Dental Mission, to be more exact, with a non-profit organization called Physicians for Peace.

Sandra Mueller and I have know each other for quite a while. She was my spanish teacher at Blair Middle School in 2003, and we have stayed in touch over the years. She currently teaches spanish classes at St. Patrick’s Catholic school during the day and dental assistant classes at Everett University at night. She traveled to la Universidad Autónoma de Nicaragua (la UNAN) to work at the University for two months in 2003 with Dr. Sacs and faculty. Since then, the dental assistant program (and soon to be added hygienist program) has truly come to life, and our goal on this trip is to make all of the revisions to the current written curriculum so that it may be presented in September 2010 to commence for the February, 2011 semester.

It is a very unique project that we are doing, and I feel very proud to be a part of it, because in almost all of Latin America, much different to the how the tasks are distributed among the dental assistant and hygienist the United States, the dentist does everything, and neither the position of Dental Assistant nor Dental Hygienist exists here in South and Central America. The Dental Assistant and later Hygienist program will be the first of its kind in all of Nicaragua and possibly Latin America, and this is all thanks to Physicians for Peace!

Uniting at the Airport in Atlanta, GA.,

Sandra and I headed to Managua, the capital of Nicaragua, where we would spend the night with Lia and Eduardo, friends of Sandra who used to live in Virginia Beach, VA, but have recently moved back to Nicaragua. Upon arrival at their enchanting home, Sandra and I were greeted with much love and a warm "torta" of chicken and vegetables. After talking for quite a while, we enjoyed a good night's rest which was very welcome after traveling all day, added to the two hour time difference, which had begun to catch up to us as well. As we slept peacefully, we dreamed about all of the exciting events to happen within the coming week...!

So Much Joy and Hope in Spite of Terrible Tragedy

Wednesday, July 14, 2010 by Walking Free

Stories from the Field - Deschapelles, Haiti
Sent by Robin Lam, PT

"I had a wonderful experience in Haiti, and feel privileged to have taken part of the work at HAS. I was continually inspired by the determination and perseverance of the patients that I met.

One of these patients was a young 22 year old named Leon. Unlike most patients that were injured in the earthquake, Leon lost his right leg above the knee due to cancer two years ago. He received a prosthesis for the first time at the Hanger clinic. Leon aspires to be a computer animator, and has a passion and talent for music. His hope is to promote awareness and understanding on behalf of all people that have disabilities through his music.

On June 26th, the Deschapelles community celebrated the 51st anniversary of HAS. The patients at the clinic were the guests of honor at the celebration, and Leon performed two rap songs that he wrote and produced. The performance was awesome! This was just one of many highlights of my two weeks in Haiti. There was so much joy and hope in spite of terrible tragedy. I hope to return very soon."

Stories from the Field - Manila, Philippines

Wednesday, July 14, 2010 by Walking Free

Sent in by Teodoro J. Herbosa MD Philippine General Hospital University of the Philippines, Manila
In response to our request for updates on Physicians for Peace Philippines and our traveling mission team, Ted sent us an update assuring us the group is safe and still forging forward in the midst of this natural disaster.

"The PFP Team from the USA is safe and continue their humanitarian work despite the typhoon. After lunch, the team met with Cabinet Secretary Jesse Robredo of the Department of Interior and Local Government. We will try to collaborate somehow. After that, the team proceeded to the National Childrens' Hospital. We have donated hospital equipment to them and the VP shunts (ventriculoperitoneal shunting is surgery to relieve increased pressure inside the skull due to excess cerebrospinal fluid on the brain) for hydrocephalus.

The hospital had been running on generator power. (I had no electricity in my home from midnight last night until 5pm today) The team distributed sandwiches and juice to the children confined at the hospital. The hospital officials gave us a wish list of their hospital which includes automated external defibrillator for children and ventilators for children.

The team will be free tonight to rest. Early tomorrow, they will proceed to Clark, Pampanga.

Last night, during the height of the typhoon, we were at the Art Exhibit and one man show of painter Ivan Acuna... The sister of President Aquino graced our affair and even handed over some prosthetic limbs to recipients of Walking free and her rotary club funded. In the morning, yesterday, we held a press conference where Kelly amazed the reporters when she removed her artificial limb!

After that press conference, I was interviewed for radio and tv about our Walking Free program. Thank you all so much for your support in all our endeavors.

Typhoon Conson Hits Manila, Philippines - Team Safe and Sound

Wednesday, July 14, 2010 by Walking Free

News Flash

Contrary to predictions, Manila got hit dead on. Lots of flooding and missing fishermen. Typhoon Conson slammed ashore with winds of 75 miles per hour late Tuesday. It weakened into a tropical storm as it crossed the Luzon Island and into the capital, Manila. The storm raged aggressively, leaving downed branches, trees and injured people. 90% of the power is out and may not be restored until Friday.

Heard from Penny and the team is safely tucked in the hotel which is being powered by a generator.