Thursday, February 27, 2014
Hello, from Salt Creek on Isla Bastimentos, Panama, in one of the poorest and neglected Ngobe Bugle (pronounced Nobe` Buckle`) communities. The Ngobe people are indigenous to the Bocas del Toro Islands which are some of the last secluded and unspoiled Caribbean Islands untouched by human development. The islands are spread across the North East Panamanian coast and the village of Salt Creek is where we held the extended 2-day clinic in collaboration with Floating Doctors.
In the 21st Century, it was a surprise to find such extreme poverty in these mangrove-filled canal islands on the Atlantic Ocean, which included poor sanitation, no sewer system and zero electricity (some generators).
We met families of 5 to 12 children with numerous unnamed children until age 2 years old, their hesitance to name them due to infant mortality. Happy and playful yet serious, 50% were under the age of 18. The young 15-year old mothers were unprepared and undereducated. My heart goes out to these young moms and families seeing their rotten teeth and desperate living conditions.
With 90% unemployment and little to no government provision, the population suffers from various diseases which are treatable including TB and various parasitic infections.
Most children attend school to age 12 and speak Spanish yet remain less educated than counterparts in Western countries.
A big hit were beanie babies (Dominick's Team) and animal balloons. Thank you sponsoring businesses, Dr. Dell Goodrich and Dr. May Conte for providing much needed toothbrush kits and thank you Mending Kids for offering children life-changing orthopedic surgery. This work has only just begun.
Sunday, January 5, 2014
Call it intuition, stubbornness or the refusal to have so much medical talent stand idle, but we innocently and consistently came upon enough devices and medications and consumables to mend a dozen children.
Just as our last cartridge of blood gas monitors was about to be used up and open-heart surgeries were officially coming to a grinding halt, the call (and the last hurdle we had to clear) to retrieve our goods, came in. The crowning cherry being the need for a surgeon to come pick it up in person. So, as soon as Dr. Sai was done closing his last small chest, we dashed off to Customs Headquarters at the Bole international airport in Addis Ababa.
I anticipated a nondescript government office but what we came upon was a monster warehouse site stretching out for multiple football fields, filled with hordes of governmental men and women, armed soldiers, consumer reps and frustrated procurers, scrambling to get their goods cleared while a choreography of trucks and vans and semi's jockeyed for space on the loading docks. Blue plastic barrels of chemicals, wood crates stamped in Amharic, construction materials, you name it, if it was being imported into Ethiopia, this is where it had to filter through. We got the last signature, presented the surgeon's passport, and then went hunting for a rental truck to help us transport the cargo. I lost it when our tireless interpreter-guide decided that the equivalent of $30 US dollars was too much to pay to the driver. I was not going to haggle over 150k in medical supplies and more than thirty more children waiting for this delivery to have their lives saved!!!
Friday, January 3, 2014
I entered the Cath Lab, to find a 10 year old girl on the operating table. I had met her yesterday as she followed me around and asked for stickers. She was one of the children that was less energized than the others. The Cardiologists performing the surgery were Dr. David Ferry and his partner and assistant, Dr. Tim Casarez, both from Children's Hospital in LA. Also part of the team were Lexi Lee, a Cath Lab X-Ray Tech and Molly Mullaney, a nurse who used to work for the team at Children's. Dr. Tim explained that the procedure involved a pulmonary valvuloplasty. The child's blood pressure was extremely low because the valve in her left ventricle was too small to allow the blood to flow properly. The pig ballon catheter was inserted into the narrowed heart valve, then inflated to stretch the valve open. The progress of the catheter was followed by the doctors on the X-ray screen. Basic algebra was required to determine the exact placement needed for the balloon since the X-ray screen in the operating room did not have the capability that the machines do in the States. As Dr. Tim said on my video: "Kids stay in school, algebra is cool." Another diagnostic procedure used was the angiocardiography involving the injection of a dye into the bloodstream; after injection the X-ray shows the inside dimensions of the heart and the great vessels outlined by the dye. As Dr. Tim said: "Where the dye flows, the blood goes." When the procedure was complete, the balloon was removed. We wore lead gowns to protect us from the X-ray, including one around our thyroid glands. The doctors also wore lead glasses to protect their retinas. I can only imagine the toll it takes upon the doctors and nurses to be suited up with the heavy lead all day long. During the procedure, the power went off once. The patient wasn't intubated but the anesthesiologist quite calmly ensured that the patient continued to breathe by using a hand pump until the generator came on. I took moving pictures of most of the procedure capturing the beating heart, the throbbing lungs and the truly amazing doctors and nurses who worked their miraculous healing.
Thursday, January 2, 2014
When I was told that we were going to the Black Lion Hospital I wasn’t really sure what it was and what was going on within it. We walked down the street to it and as we walked, I saw the top of the building, in which smoke comes out where the dead bodies were being burnt. As we got to the front steps of the building you could smell the burning of skin. We walked through the building where there were hundreds upon hundreds of people either sitting waiting for medicine or for help and others lying in small cots or lying on the ground wounded or sick. We began to walk up the stairs to where the kids were kept and my heart began to sink just a little bit more as my stomach began to knot. The way these people were living was so incredibly sad. This experience made me realize how blessed I was. Before I came to Ethiopia I knew that I wanted to be a doctor but this experience really solidified my want to help other people. This experience also showed me how lucky I was back home.
Never, not even in my nightmares did I ever dream of a place like this. This morning shortly after we had arrived at the cardiac center and made our rounds to see all of the beautiful babies that had just had or were awaiting surgery, we walked across the street for a tour of The Black Lion Hospital, a place that was forbidden for me to visit in years prior. I had only heard stories of the horror that took place inside the walls of this hospital but today I received the opportunity to experience it first hand. Before we left our clean little cardiac center I was told that we were not allowed to take pictures inside the hospital for reasons that I would soon find out. The moment that walked outside I could smell the black smoke hat was rising from the bodies that were burning in the incinerator across the street. As we walked closer and closer to the hospital the streets became more and more crowded with people desperate to find help. My stomach began to twist as soon as we entered the first ward of the hospital, the emergency room. When I walked in it felt as if I was incapable of taking another step. I stopped in my tracts as I looked around in disbelief. There were so many people in need of so much help. I closed my eyes for a minuet hoping that i would wake up from the nightmare i was in only open my eyes to find myself in the same place. There were patients not only in every bed but laying on the dusty floor as well. Every doctor and nurse was hard at work trying to save the lives of these people who were so close to death. As our tour or the hospital continued the conditions seemed to get worse and worse. At that time not only did i understand why there were no pictures allowed nor did I want to take pictures. I could no longer think of a single reason why any one ever would want to see the conditions of the inside of the hospital. When we walked our of the hospital I was walking with my head down only to lift it up to see that I was walking behind a gurney caring a dead body. My heart once again stopped. The worst part was that people didn't even pay attention to it. It was like it was an every day event and it was no big deal.
Tuesday, December 31, 2013
As I sit back and write this, I think back on the last 72 hours and I am truly humbled. This is my best ever mission and I had no idea of what to expect. I knew that it was going to be special from the minute I met everyone back in Burbank at MKI at the pre-mission meeting. Everyone on this mission is so amazing. It has been such an eye-opener as to how much I take for granted back home. Everything from unlimited supplies of EKG patches to warm blankets for the patients... Yet here, we find a solution together and move on. It is about doing all that we can do to help the kids. Everyone is here for the kids. It is amazing and so refreshing. Everyone could use a little dose of this reality to put their lives in perspective. And thanks to MKI, these kids' reality is getting a little bit better. Even though we put in a 12 hour day today, I can't wait to get up in the morning and do it again.
Friday, December 13, 2013
They have signed the medical releases; some using signatures, others thumbprints, and they watch helplessly as we take their children and whisk them off into the OR. It is gut wrenching. Everyone wears a smile on his or her face, on the outside, but on the inside they are terrified. Is this the last time they will see their baby? I mean, we are talking about opening up a malnourished chest cavity, repairing big holes and ventricles and what not, and praying really hard that there will be no complications and that whatever reserves of energy these young patients have, will carry them through a speedy recovery and that parents will see their child in the next 24 hours.
One of these moms, who has become my friend, has been waiting four days now, sleeping on a mat on the first floor landing, and every time she sees me walk by she pleads for a sign from me that her boy will be released from the ICU soon. Everything has been explained to her, and that he is stable, but I don’t have the language skills to tell her that he needs his hemoglobin count to be slightly higher or that he is still on a ventilator. So, with the permission of our cardiologist, I took a photo of him so that she could see for herself that his eyes were open and that he was not in distress. It took me several attempts at careful framing to hide the IVs, transfusion bag, breathing tube and catheters, to make him look the least scary to her and to put her at ease so that she can sit through another day of waiting.
The photo worked. She kissed me and hugged me so tight that it erased all language barriers. She was grateful and I was grateful that this small gift had appeased the torture of waiting, for now. And then we bowed to each other.