EP3: ‘Spend a Minute’ with Medical Missions for Children Dentist, Founding Member and Mission Volunteer Charlie Badaoui. Our volunteer team members travel to some of the most remote and underprivileged locations around the world.
March 11th, 2019
Day 3 in Gitwe proved to be our longest one yet. Beginning early in the morning, we started out with the first two surgeries lined up from yesterday. Drs. Dhingra and Sebelik had a particularly tough first case, with a large discontinuous goiter extending into the chest cavity. After nearly a three-hour procedure, it was removed, and both doctors along with Drs. Chandra and DeBiase moved on to complete a total of seven surgeries throughout the day. After completing all our scheduled procedures, there was no time for rest, as prospective patients had been waiting in the Rwandan heat all day outside the hospital, some even refusing to get food because they were afraid to lose their line. We screened as many as possible before night fell, but some patients will no doubt return tomorrow morning to yet again attempt to get seen by the doctors. One of the highlights from the afternoon was seeing the post-op patients return downstairs after their surgeries yesterday to have their IVs and drains removed along with being given an ultrasound by Dr. Sebelik to check their vocal cord motility. Flavia, a memorable patient from yesterday’s surgeries, was particularly happy upon being discharged, whispering thank-yous to everyone in the room and smiling broadly when showing us her neck, now goiter-less and unremarkable except for her scar. One of the difficulties of practicing medicine here in Gitwe is the language barrier, which nearly always necessitates a translator when the doctors and nurses communicate with the patients. However, Flavia’s thank you smile was one of those simple moments where barriers such as those become irrelevant, and was a promising sentiment to end the day on as we continue into the remainder of the week and our trip.
March 10th, 2019
Our second day in Rwanda began more ominously than the first, with thunderclouds rolling into Gitwe’s valley as we walked to the hospital in the early hours of the morning. Similar to yesterday, a queue of prospective patients awaited us outside the hospital, with thyroid goiters ranging in size from a ping pong ball to larger than a human heart. The goiters, which are most often caused by dietary iodine deficiency, can cause issues with swallowing and breathing due to their proximity to the trachea and esophagus, not to mention problems with various thyroid hormones. Our day began with a relatively simply thyroidectomy (the procedure involving taking out the goiter), with Drs. Dhingra and DeBiase completing the surgery. Drs. Sebelik and Chandra completed the second surgery, with the teams then staggering to complete a total of six patients over the course of the day.
One of the most memorable patients of the day was a woman named Donatha, a mother of ten whose goiter crossed over the entire front of her neck. The removal of the mass took a few hours in and of itself, with Drs. Dhingra and Sebelik scrubbing in to carefully transect the muscles of the neck whilst avoiding important vasculature and nerves in the region. The procedure became an anatomy lesson in and of itself, with both doctors getting increasingly excited upon finding neck structures not usually visible with goiter removals. Donatha recovered well from anesthesia, and moved to post-op a few hours later. She smiled softly at us when we visited her later, excited in her own soft way about the removal of the mass that had been a constant obstruction to her daily life. The day ended with the sun setting after beating out the rainclouds that had lingered throughout the afternoon as we finished rounding up the patients and finally left the hospital to walk back to our lodgings, preparing to get some rest before beginning again tomorrow.
March 9th, 2019
This year’s Medical Missions For Children to Gitwe, Rwanda began with a good omen. Just moments after all twenty-one team members arrived at the hospital, a man with a smile as wide as his face came running up to Drs. Dhingra and Sebelik to embrace them. The man, a patient from last year’s successful mission, proudly showed us all his neck, which was goiter-less with just the faintest small scar visible above his clavicle. He wrung everyone’s hands and proudly told us all how he had spent the past nine months travelling around Rwanda spreading word of the prowess of the medical team from MMFC. His mission to spread the word seemed to be a success, as before even unloading the thirty plus bags we had brought from America into the hospital, there was already a long queue of individuals waiting to be screened. After nearly two days of travel, ending with a beautiful (but bumpy) bus ride from Kigali to Gitwe, there was no time to rest up. We began set up in the afternoon, unloading all the medical equipment to set up the pre-op, anesthesia, two operating rooms, and PAC-U. We simultaneously began screening and ultrasounding the patients that had already arrived, getting through nearly a dozen before the sun set. With seven patients lined up for operations tomorrow, and many more will be arriving in the next few days, our work is certainly cut out for us. Despite this, or perhaps because of it, there was an undeniable air of excitement over dinner, and it is clear that the team cannot wait to begin.
The MMFC team comprised of doctors and nurses from Massachusetts, New York, California, Utah, and Hong Kong, arrived at Clark International Airport (formerly Clark AFB) the morning of Saturday February 17, 2018. After a checking into their hotel and a brief rest, they headed to the hospital to start screening the over 100 waiting children. After an afternoon of evaluating the children, a surgery schedule was developed consisting of 48 surgeries over the course of 5 days.
Here are some of the children’s stories.
Matteo is special. He is an 11 month old Aeta. Aetas are indigenous people who live in the scattered, isolated mountainous parts of the island of Luzon. They are thought to be among the earliest inhabitants of the Philippines. They are very small of stature and frame, with curly to kinky hair. We generally never see the Aetas because they don’t believe in doctors (modern medicine) and don’t have the money to travel to Angeles City.Matteo has a cleft lip. His first cousins on both sides of his parents have cleft deformities, but not his but not his 4 year old sister. Matteo’s mother is 26 years old and his father is 30. Both parents are under 4’11”. His mother may only be 4’5″.
Matteo and his family live in village about an hour from Angeles City, but it might as well be hundreds of miles away. They, as most villagers, only have a lightbulb or two and no appliances, running water, or bathrooms. They have communal outhouses, and bathe and wash their clothes in the nearby river. They need to buy drinking water from a tank for 3 pesos. Matteo’s father catches fish, with arrows, in the same river. Meals are cooked over a wood fire. Three rocks surround the fire to hold the pot.
Both parents sell coconut water at the local market. The coconuts are husked and the tops lopped off then a straw inserted to drink the water. These jobs aren’t consistent though and neither are the meals.
Only 3 days a week can they afford to have 3 meals a day and sometimes they have to borrow money to buy milk for Matteo.
I asked if they had any wishes and they replied, “Yes, we would love to have 3 full meals everyday of the week.”
In order to make the trip to Angeles City for Matteo’s surgery, they went up into the mountains to pick Star Apples and sell them in the local market. This enabled them to buy food and milk to bring with them.
Aljun is a 9 month old baby boy with a cleft lip and palate. We will fix his lip this year and next year, when he is older, we will fix his palate. In the meantime, our Speech Language Pathologist meet with Aljun’s mother, MaryAnn, and taught her how to feed Aljun with specialized bottles for cleft palate babies. She had no prenatal care while pregnant with Aljun
MaryAnn, 27, is from the region of Davao on the Island Mindanao. Mindanao and the smaller islands surrounding it make up the island group of the same name. In May 2017, President Rodrigo Duterte declared martial law on the entire island group of Mindanao following the Marawi Siege by the Maute terrorist group.
MaryAnn and her husband had been out of work for over a year and decided to move to Laguna Province about 2 months ago. Laguana is 4 hours from Angeles City and south of Manila. MaryAnn was accompanied by her neighbor, Jackie. Jackie acted as a translator for MaryAnn, who speaks a different language than Tagalog, the most common language in the Philippines.Then I had someone translate Jackie’s Tagalog to English. Good times! Apparently, Jackie convinced MaryAnn to bring Ajun to us for surgery. We are thankful to her.
MaryAnn and her husband now work for her husband’s sister. The sister-in-law raises pigs for roasting on a spit. They sell the roasted meat primarily on weekends, holidays, and special occasions. They rent a house owned by the sister-in-law. It’s a concrete structure with electricity and running water.
MaryAnn is 4 months pregnant with her 2nd child.
Meet Michael V.
Michael is a cute, shy 6 year old in a family of 7 children. He has both a cleft lip and palate. Life hasn’t been easy for Michael. But hopefully it will improve after his surgery and subsequent speech therapy. He is the only sibling to have cleft.
Michael was bullied relentlessly when he started school. Not only does he have cleft deformities, but because of his cleft palate his speech was difficultly to understand. This is typical when children don’t have their palates fixed He would go home crying early everyday and finally he stopped going to school altogether. That was 2 years ago. His mother has been trying to teach him at home. One of our local nurses has been encouraging the family to get the cleft surgery for years. Until now, they haven’t been able to afford for Michael Sr. to take time off from work to accompany his son to the hospital.
His father, Michael Sr., is 39 and a construction laborer who lives on site where he is needed. This might be in Manila or another island in the Philippines. On-site laborers live in barracks provided by the construction company. They must buy their own food though and generally the laborers share
their food with each other (i.e., communal meals). Michael Sr. goes home every two weeks to see his family and give them money.
Michael’s mother, 39, stays at home with the 7 children. The eldest is 19 and is now employed at the local Pepsi plant. The other children are 17, 13, 10, 7, and 4.
Home is about 30 minutes from the hospital. It’s a rented single room structure that has bamboo walls and thatched roofs. These houses, called “Bahay Kubo”, are built on stilts and are indigenous to rural Philippines. There is only an electric fan and no other electricity. There are no appliances. They cook outside on a wood fire. There isn’t any running water, so they use a communal outhouse and buy spring water for drinking.
Hopefully, after surgery and speech therapy, Michael will return to school and live a normal 6 year old’s life.
Mjay is an engaging 10 month old boy with Cleft Lip. His mother and father meet while they were both working in Manila. She worked in a factory that makes baby oil and rubbing alcohol. They moved to an area about 30 – 45 minutes from our hospital.
Mjay has a brother who is 5 and don’t have any cleft deformities. His mother is now a housewife or as they are called in the Philippines, “housekeeper”. His father works in a furniture shop near their home. My understanding is that he is involved in assembling the furniture.
His parents rent an old, one room house. It does have electricity so they have a fan and TV. They also have a propane stove. Unlike many families I have spoken to, they have indoor running water with a tub and toilet. But the water can’t be used for drinking. They still must buy mineral water.
His mother took medication for IBS when she was pregnant and believes this caused the cleft lip.
That is probably not the cause. Since MJay’s cousin has both cleft lip and palate, it is more likely and inherited trait at this point. Either way, we are fixing it!
MJay’s mother wishes for her family to be healthy and happy. She is happy with her life, but would like to be working again. But it isn’t possible with 2 small children.
Meet Prince a 11 month old boy whom we all fell in love with this year. He is an engaging, inquisitive child, who is lucky to have two parents whose lives are better than many people we see at the hospital. Prince was born with a Cleft lip and has 2 siblings ages 9 and 4 years old. None of his siblings have cleft and there is no family history of cleft.
Prince lives with his mother and father about 45 minutes away in Magalang, Pampanga. His father is a plumber and his mother stays home with the children. They own their own home that has electricity and running water.
Prince’s mother tells me that she was sad when Prince was born and is happy that we are able to fix his cleft lip. She told me that they are all happy and that she as a good relationship with her mother-in-law.
Meet Baby Arcel
Baby Arcel is 10 days old and was born with a cleft lip and palate. Her mother brought her to us on our 3rd day of surgeries hoping we could operate. Arcel has extreme difficulty sucking from the breast or bottle and therefor underweight. Although we can’t operate on her this year, because she is too young and small, we will see her next year.
Our Speech Language Pathologist on this mission gave her 2 bottles that are designed for feeding cleft palate babies. These babies need to feed in an upright position so the milk pools in their mouths and then swallowed. The bottles enable the mother to squeeze the milk into the baby’s mouth simulating the sucking action.
Arcel’s mother was taught how to feed her baby and burp her. She was given instructions in her native language as well. Her husband filmed the session on his phone, so they could rewatch at home.
Hopefully, we will see Baby Arcel next year to fix her lip. Depending on her size, we may wait until 2020 to fix her palate.
Meet Newborn Alex
The delivery room here at Mabalacat District Hospital is right across from my working area and between our operating room and post-anesthesia care unit (PACU). Women are wheeled past me and into delivery and shortly later wheeled back out. The baby follows in the arms of the nurse a few minutes later. Mothers are discharged from the hospital the next day.
Imagine my surprise when the delivery nurse came out and beckoned me to come and see the newborn with a cleft lip and palate. I didn’t have my camera only my cell phone, so the first pictures I have of this child is minutes after birth while he was under the heating lamp.
The following morning we were able to talk with Alex’s mother and encourage her to come to us next year’s for Alex’s cleft lip surgery.
In the meantime our Speech Language Pathologist talked to her about feeding a cleft palate baby. Alex’s mother, Ailyn, will be given the special bottles for cleft palate feeding and detailed instructions in her native language.
Ailyn is 22 years old and has 2 other children ages 2 and 1 years old. They have a different father than Alex. Alex’s father left when Ailyn was 7 months pregnant. Her two older children live with other relatives at this time. Since she won’t be able to care for them while she has a newborn.
Ailyn currently lives with her Aunt and Uncle and their 5 children. So there will be 9 people living in a two room house once Ailyn returns from the hospital. The house has a sand floor with some electricity but no plumbing. There are no appliances. An outside communal bath and toilet are used. The toilet is just a hole in the ground covered by a commode. There is a basin for laundry as well.
The family supports themselves by going through garbage and selling the items they find.
Hospital Offers 40 Kids Free Cleft Lip, Palate Surgery—szdaily多媒体数字报刊平台
BY the end of today, 40 children from across the country will have undergone free cleft lip and palate surgeries at the University of Hong Kong-Shenzhen Hospital (HKU-SZH) since Thursday.
It’s the fourth time that the hospital has offered free diagnosis and treatment to children with cleft lip and palate since it launched the program in 2015, which has helped over 100 children — most of them from poor families or welfare centers — repair their cleft lips or palates over the past two years.
At least one 1-year-old boy from a rural village in Jiangxi Province, identified as Tongtong, is benefiting from this program for a second time. This time, to repair his cleft palate. He joined the program late last year when he was 7 months old and his cleft lip was fixed in the first surgery.
“I’m really grateful to the hospital,” said Tongtong’s aunt, surnamed Wei. “We used to avoid bringing Tongtong out in the daytime before he received the surgery because other people might point fingers at him.”
According to Wei, the boy’s family couldn’t afford the medical cost of repairing his cleft lip and palate when he was born. Thankfully Tongtong’s cleft lip has been successfully repaired and the family is glad that the boy has been given another opportunity to repair his cleft palate, Wei said.
“Tongtong has recently been learning to speak, but he couldn’t say words very clearly, probably because of his cleft palate. I think the problem will be solved after the second surgery,” Wei said.
Lo Chung-mau, the hospital’s president, said that the program was not only about doing charity, but also providing a professional exchange and training platform for the hospital’s medical workers by cooperating with other medical institutions, such as Medical Missions for Children (MMFC), an American nonprofit organization that offers free medical services to children across the globe.
According to Lo, the hospital has also set up a charity fund to help patients who are in need of financial support. He said that doctors are prohibited from taking gifts or red envelopes from patients, and when the hospital fails to return gifts or money to the patients, it auctions off the gifts publicly and donates the money to the fund.
The charity fund has collected over 100,000 yuan (US$14,700) since it was launched in 2013. “We don’t want the hospital to be polluted by the stink of money. If the patients really want to show their gratitude to the hospital, they can donate money to the fund and help more patients,” Lo said.
According to the hospital, the program will continue recruiting children with cleft lip and palate from across the country and provide free surgeries to another 50 children at the end of this year. Residents can check the hospital’s official website (www.hku-szh.org) for more information.
Apart from MMFC, the program is also supported by the Rotary Club of Hong Kong Northwest, Hong Kong Association for Cleft Lip and Palate, Lee & Man Paper Manufacturing Ltd., and Hong Kong Society of Plastic, Reconstructive and Aesthetic Surgeons.
Phalodi, India | January 29 – February 4
The MMFC team of surgeons, anesthesiologists, nurses, dentists, and non-medical volunteers from the U.S., Peru and Canada returned to Phalodi once again for its annual week-long surgical mission. The team arrived in Phalodi on Sunday evening, January 29th, and got to work evaluating a few kids preselected by the local hospital staff for surgery the next day.
On Monday, the team began screening all the kids and adults who had come in from the surrounding villages, one from as far as 200km away. The local hospital’s public relations officer Mr. Devi Singh, works diligently to spread the word months in advance so that the families can travel to Phalodi in time for our visit.
The team evaluated 40 already screened patients, and performed 23 surgical procedures. The dental team screened 125 patients and provided Dental Health and Hygiene education to 150 school children.
Every child we see touches our hearts. Shiv is one of them.
Shiv was a little 3 year boy who was found by the Mr. Devi Singh in 2011. The MMFC team evaluation found him to be anemic and unfit for surgery. They did a nutrition consult, instructing the family to follow up with the local hospital, and decided to reevaluate him the next year.
In 2012, Shiv returned to the hospital and underwent surgery to repair his cleft lip and palate. Shiv’s post-op recovery was unusually stressful – he cried for 24hrs straight. Upon further inquiry, the team found out that his parents had been giving him opium to keep him calm. His little body was going through withdrawals. After his surgery, Shiv was lost to follow up for the next 2yrs.
In 2014, after an extensive search by Dr. Jain and Mr. Singh, Shiv returned to the hospital to be evaluated by the MMFC team. They discovered that he had been abandoned by his parents and was being cared for by his maternal grandmother and Uncle. They also saw that his prior cleft repair had fallen apart. Shiv needed to undergo surgery again but was not fit at that time. The team provided a nutritional consult and recommended follow up with the local doctor.
Shiv did not show up at the hospital for the 2015 mission visit. In 2016 once again, the Mr. Singh conducted an extensive search and located him in time for the 2017 mission visit. Shiv was admitted into hospital two weeks prior to the visit. During screening, the team found him in good health and ready for surgery.
His surgery was very complex that it required, not only all entire surgical team on the ground, but it included a live interactive video conference with Dr. Dennis Snyder back in Boston. This is the first time MMFC has use real time, interactive technology to collaborate across continents.
Shiv is now a healthier 8yr old, outgoing, engaging, unafraid of the team doctors, with quite the flare for fashion. Shiv’s success would not have been possible without the generosity of Helpers and Joy Venturini Bianchi.
It is never too late to change one’s look – Meet Kabu Ram
Kabu Ram is a 28 year old father of three. Mr. Sing noticed in him 5 years ago and invited him to visit the hospital for an evaluation during one of the mission visits. Due to family and work commitments, Mr. Ram kept postponing his evaluation.
Mr. Singh’s persistence paid off and this year Mr. Ram took 2 days off work and came into to see the teams. His procedure took 45 minutes and per his wishes, he was able to keep his mustache and tooth.
In the recovery room, when he woke up and saw himself in the mirror for the first time, he cried. In 48 hours he had a new look and we gave him a new smile.
Despite the arduous journey to get to Phalodi, the success of our mission here is due to the stellar team and the very strong 10 year partnership with Dr. Kanti Jain, her family, H.B.S Trust Hospital and all the preparation done by the dedicated local hospital staff.
We look forward to continuing our work with the children of Rajasthan the years to come.
Antigua, Guatemala, 8 Enero (January) 2017
They come from far away, so many of the patients and their families; they are weary and perhaps afraid. They are in line and waiting; for some, perhaps an adventure, for others, undoubtedly a hardship. A few of them we have seen before, but so many this year are first timers. The team screens baby after baby, a few with cleft lip only, likely requiring a single surgery. Many more have complete cleft lip and cleft palate, or microtia (congenital absence of the outer ear), so their surgical journey is just beginning. All of the children are weighed and examined, parents questioned (sometimes requiring multiple translations), team members consulted (surgery, cardiology, anesthesia, primary care nursing, dentistry and speech therapy). Fortunately, almost no one is turned away. The schedule is set; four operating rooms will work non-stop this week, as will the PACU (recovery). The dentists and therapist will have dozens of children to see, procedures to complete and instructions to give. It will be a busy 5 days.
9–13 Enero (January) 2017
Every day is both the same and very different; the patients are brought into pre-op by the very capable and efficient staff of Hermano Perdro hospital. Often, the children are crying from hunger, fear or sheer boredom. The mothers save their tears until one of the MMFC anesthesiology professionals comes to bring their child in to surgery. This is the when the cross cultural barriers break down; a hug, an arm squeeze or a simple “esta bien” (“it’s OK”) coming from a stranger from another land reveals how we are much more alike than different.
What the parents don’t see is the incredible skill of that same anesthesiologist/nurse anesthetist prepping that child for surgery and the finesse of the surgeons’ work to undo the hand that this family has been dealt. They don’t see the efficiency of the operating room nurses to have everything sterile and ready, nor the details in caring for and compassion with which the PACU nurses care while this child is recovering from all of the above. They don’t see the post- op orders written by the MMFC nurse practitioner, nor can they likely absorb the information given to them by the speech therapist until much later. Post-operatively, all this parent sees is that their child is alive and well (albeit not very happy), and that the professionals are smiling. And that their baby’s face looks more “normal” somehow under those steri –strips. And that everything is going to be OK, going to be better. Life is good.
Day 1 – Arrival
The Boston contingency of Charlie Badaoui, Pacifico Tuason, Sandra Klein, Natalie Harris, Roberta Anslow, and Theresa Lynch, met at Logan at 10:30pm 2/10. Our flight to Manila left at 1:30AM 2/11. Smooth travels to Hong Kong (16 hours), then onto Manila (2 hours). After getting thru customs with all the medical bags and pelican cases, we were anxious to get to Angeles City to unpack and shower. What should have been a 2 hour (max) drive out of the city and north to AC, turned out to be a close to 5 hour journey. The traffic was unbelievable.
Day 2 Screening:
Today we head to the hospital and will be screen children for surgery. We’ve been told that there are 40 – 50 children read to be screened. It turns out there were closer to 80 children. Screening is almost a full day event. It’s 20 mins to the hospital and then we need to set up. The children waiting for us and anxious. At the end of the process and the day we have a schedule for surgeries for the following days.
Day 3 Surgery Begins:
Zairone is almost two and has a cleft lip and palate. This year we will repair his lip and next year his palate.
Zairone and his family live near to the hospital. He has a brother who is six. There is a history of cleft lip and palate on his mother side. His parents heard about the surgery from a neighbor whose child we repaired last year.
Even at just 2 years old, Zairone is being bullied by kids in the neighborhood and his brother’s friends. When Zairone drinks milk it comes out his nose because of his cleft palate.
Zairone’s father is a construction worker (day laborer), when there isn’t any construction work, he goes down to the market to see if there is a need for heavy lifting.
His father started to cry, telling me “When there is no work, I can’t feed my family”.
Alfredo is 54 and an unusual case for MMFC. We are an organization dedicated to helping children, but on a rare occasion an adult will reach out to us. Such is the case with Alfredo. He saw our billboards in Angeles City announcing our mission dates and found the courage to come to screening day. You see, Alfredo has had offers to have his cleft lip and palate fixed before, but he has been afraid of the surgery. Why now? He finally got tired of the ridicule that he receives on a daily basis. He is a construction worker and his fellow workers stare at him, then laugh behind his back making rude remarks.
For the first time in many years, Esperance can finally sleep without a large 3.6 pound ball crushing her esophagus. Her goiter has been growing in her neck for over 20 years. This beautiful Wednesday morning in Gitwe, MMFC had the pleasure of checking in with Esperance to see how she was feeling and healing. Many of the patients who come to get thyroid surgery travel over a day by bus and foot to get to the Gitwe hospital for a chance at surgery. The majority of the patients are women, like Esperance, but there are also some men.
When asked how her large growth affected her productivity, she said it made her feel tired and caused her headaches, neck aches, and shoulder aches. She had trouble sleeping at night, since it felt like she was being choked by this massive goiter. The goiter also made her labor much more difficult, having to take many breaks while farming. Since the lifestyle is mainly agriculture for self sustenance as well as trading and selling, being unable to work or having low productivity severely affects the patient’s lives.
Esperance is one of the many whose life has been changed on this trip. She is extremely pleased with the result of her surgery. Take a look for yourself at the before and after images!
Monday was a great day of surgery for the doctors of MMFC. Although the need for cleft surgeries is low, Drs. Aric Park, Merry Sebelik, and Jeremiah Tracy were hard at work with some slightly complicated cleft lip surgeries. Usually, babies with cleft palates have difficulty eating and breastfeeding. They are often malnourished not for lack of food, but rather because the openings in their lips constantly leak food and liquids. This is why often times babies with cleft lips–especially with two openings rather than one–are much slimmer than babies with no clefts. You can imagine the happiness of not only the nurses and doctors, but also the mother when the little babies wake up from their surgery in the recovery room and are able to finally latch on to the breast and feed. This was the case with little 8 month old Lea.
Lea and her mother had been waiting all day through the other cleft lip surgeries. The hallway was filled with the screams and cries of the little girl who was frustrated she was not allowed to eat before her surgery. Her worried mother skeptically followed directions, since she had seen other cases and babies delayed because they had eaten to close to their surgery time and it was unsafe to induce their anesthesia. The surgery went smoothly, and an hour and half later baby was in mom’s arms desperately searching for the comfort and nourishment of her breast. The smile on the mother’s face was priceless, “this is the first time she has been able to latch on”. We were all watching in peaceful attentiveness as the baby settled into a rhythmic suckling, completely forgetting about the pain as she finally satisfied her hunger.
Not all babies latch on so quickly and easily, others have difficulty using their newly sealed lips because they have never had to use the muscle. Eventually, they will learn how to gain control of the muscles around their mouth and have an easier time feeding.
As mentioned in the previous post, most of the patients that made the long journey from their homes miles away were here to get Goiter surgery. As the messages reached further (whether through radio or word of mouth), more and more patients poured into the room. The most remarkable moment is one picture below where women swarmed Dr. Dhingra and Dr. Sebelik asking to feel their necks in the hopes of being one of the lucky ones to be selected to have surgery. Unfortunately, time, supplies and manpower are limits to how many surgeries can be done. No matter how quickly and efficiently the talented surgeons can work, there is no way they can perform over 50 surgeries in a little under three days. For now the goal is to keep working through as many cases as possible… so far we have had 15 successful surgeries! There are still three days left, stay tuned…
Days 1 & 2 – Sat., October 8th and Sun., October 9th:
After almost 24 hours of flying, we finally arrived in Kigali, Rwanda. This would not be our final destination, but for many, our first welcome to Africa. On the ride down to Gitwe, we would hear the happy shouts of the children pointing and screaming “muzungu!!”, meaning “white person” or “wanderer/foreigner”. Never had I seen children with smiles so big, happy to just say hello. Their warm smiles decorated their dark brown faces of the earth, and they, in turn, decorated the brown earth they walked on. They seemed to be one with their surrounding, fluidly strolling between one another on the sides of the dirt roads while cars and motorcycles sped by. Women carried anything on their heads—large pieces of wood, stalks of sugar cane, bags of beans— with their children strapped to their backs. They complemented the warm orange hue of the concrete homes with tin roofs and the lively green of the palm trees, shrubs and bushes all around.
Saturday night was when we first entered the empty rooms that would be our reconstructive and healing spaces for the next 6 days. Immediately, the team began opening the bags and pelicans filled with supplies, medication, and equipment and setting up their stations-P.A.C.U., O.R., Pre-Op, Anesthesia, Thyroid, Cleft. The dusty empty rooms quickly began to fill with noise and movement, starting to resemble the rooms of a hospital. Shortly after, the patients began to arrive. This was the first and only sign of haste in this region where time does not seem to be a part of their lifestyle. We went down to meet the women with enlarged thyroids and children with cleft deformity. Unfortunately, some of the little “umwanas” (babies) were too small or too sick to be seen this time around. We relied on the translators to relay the difficult message to the mothers, who would shoot dissapointed and pleading looks the doctors way, not quite understanding that sometimes rejection for surgery was really for the well being and survival of their child. Giggles and small talk ensued between those who would stay, their smiles a clear sign of the happiness for the victory of all their efforts. Most of the cases done by MMFC in Rwanda, however, are largely thyroidectomies. Many of the patients that filled the waiting rooms were women in their mid twenties to late fifties with enlarged goiters on one side or the other. Each one in their colorful “ibitenges” or traditional dresses and wraps. Their eyes showed a mixture of fear and hope—fearful of what was to come, but hopeful that their lives would return back to normal.
What is a goiter, what causes it, and why do people have it removed? A goiter is a non-cancerous enlargement of the thyroid. Our thyroids play a very important role in our bodies. By using iodine, a trace mineral, the thyroid produces hormones that play an important role in regulating our metabolism, temperature, and heart rate. Goiters are usually cased by lack or deficiency of iodine in a diet or an overactive thyroid (hyperthyroidism). Goiters can obstruct breathing and swallowing and cause shortness of breath, wheezing, hoarseness. If linked with hypo- or hyperthyroid, goiters could cause other health problems. Therefore, a thyroidectomy is an important part of maintaining the health and improving the morbidity of the patient. Not to mention, these ladies will have yet another reason to smile a little bigger each day.
We have a surgery packed day today! So far 3 scheduled cleft lips and 6 scheduled partial thyroidectomies… Let the healing begin!
June 25-July 2, 2016: Our team of volunteer doctors, nurses, and administrators returned to Antigua for another week of cleft surgeries and dental care. By the end of the mission, the MMFC team had completed 39 cleft surgeries and provided dental care to 25 special needs adults.
Meet mi amigo, Abelito:
Douglas Abel Riveria Huit (“Abelito”) is a 2yr old boy who traveled four hours with his mom to be seen by our MMFC team. He needed palate surgery and was very scared.
Abelito had previously had his cleft lip repaired by another team, and was here for a palate repair. His grandmother and 4year old sister were at home eagerly awaiting to see him. They were so pleased with the transformation after his lip surgery, and heard that our team could further improve his life by fixing his palate. While nervous, they also had confidence in our MMFC team. Abelito on the other hand, not so much. He was scared, shy, and didn’t want to talk to anyone. So we played with some toys and drew pictures in the pre-op room. And after coloring for a bit, he called me his amiga and gave me a high-five. His mom told me he likes to be called “Abelito” by friends and family, and I had made it into that circle. The surgeons and nurses took good care of Abelito, just as they did with each and every patient. It’s amazing to watch them work and witness their dedication and care to each child. This is a team that goes over and above to improve the lives of others.
Massachusetts-based nonprofit, Medical Missions for Children, and the San Francisco-based Hellman Foundation have partnered to send Google Chromebooks to medical students at the new Medical College of the Institut Superieur Pedagogique de Gitwe (ISPG) in Rwanda, Africa. For several years, the Hellman Foundation has served as a strategic partner for Medical Missions for Children and the Gitwe Hospital. During the past three years, the Hellman Foundation has expanded its philanthropy to support the new Medical College. The current project will compliment broader initiatives in Gitwe and as Mission Team leader Andrew Patterson explains “The ultimate goal is to empower Rwandan health care workers in providing more effective medical care in a resource-limited environment.”
The Chromebooks being provided will allow medical students at ISPG to access online textbooks, take tests via Google form, and expandtheir resources exponentially. Additionally, the team installed a wireless computer system which allows access to educational content even wheninternet access is disrupted. To further maximize efficiency, the technology director at ISPG, traveled to California to receive training at both Stanford University as well as Google headquarters. The Hellman Foundation The Hellman Foundation is a private foundation established in 2011. Our approach to giving is rooted in the belief that philanthropy has an important role to play in solving problems and improving the well-being of our communities. We also believe that foundations have a responsibility to do their homework, assuming this role with integrity and intelligence. At the Hellman Foundation, we take this responsibility seriously. Since its founding, the Foundation has awarded over $25 million in grants. Medical Missions for Children (MMFC) Founded 24 years ago, MMFC began by traveling to one country and helping a handful of children.
Today, MMFC conducts close to 20 missions a year, operating on over 25,000 children and providing dental care for more than 50,000. Medical Mission’s network of close to 350 volunteer doctors, dentists and nurses travel to hard-to-reach areas, which typically do not have any healthcare infrastructure and perform free medical procedures which resolve health complications, speech impediments, and most importantly brings a better standard of living and happiness to the children and their families. The children who receive these surgeries are given the opportunity to stay in school and become productive members of the community. To learn more about the work that
Medical Missions does visit MMFC.org or call us at (508) 697-5821.
From November 22-December 1, 2013, MMFC’s team of 18 volunteer doctors, nurses, dentists, speech pathologists, and administrators returned to Cajamarca, Peru for a week of cleft surgeries and dental care.
In one week the team completed 46 surgical procedures, including repairs of 14 primary cleft lips, 8 primary cleft palates, and 5 lip revisions. In addition, 145 dental procedures were done, including 11 under general anesthesia. Our speech therapist gave 16 speech therapy sessions as well as 43 consults.
One of the most interesting patient stories from this week was of Maria Angelina and Magali Davila (below). Magali is Maria’s niece, and they are both from Bolivar. It took them four days to travel to Cajamarca, including a day and a half of walking. Maria’s brother (Magali’s father) joined them on the journey to Es Salud hospital in Cajamarca. Magali is in her first year of primary school. Unlike Magali, Maria is mentally challenged, has never gone to school, and does not know how to read or write. They live in a very rural community where outside communication is limited, and even a telephone signal in rare. They found out about MMFC’s mission from a radio broadcast and decided to make the long trek together. Maria and Magali both received surgery to repair their bilateral cleft lips, making the journey to Cajamarca all worth it.
MMFC would like to thank the Helpers of the Mentally Retarded and the Hess Foundation for their donations toward this mission.
From November 1-10, 2013, MMFC sent a 15-person team of volunteers to Tacloban, located on the Leyte island of the Philippines. Working alongside the staff at the Eastern Visayas Regional Medical Center (EVRMC) and the Maharlika Foundation, the team had a full schedule of cleft patients planned for the week.
Led by Drs. Arnold Lee and Pratik Pradhan, the first day of surgeries went off without a hitch, but on Tuesday morning the team learned of a typhoon headed straight for the Philippines. Super Typhoon Haiyan was gaining strength by the hour and the coastal city of Tacloban was expected to be one of the hardest-hit areas. By Tuesday afternoon the tough decision was made to cut the mission short, and tickets were purchased for the next available flight out of Tacloban. MMFC couldn’t take the risk that came with riding out this storm, which was so strong that it didn’t even fall under any of the existing hurricane or typhoon categories.
The MMFC team finished as many surgeries as possible before the end of the day Wednesday, packed up supplies and equipment, and flew out on Thursday morning on the last flight to Manila before all others were cancelled. In three days the team repaired 12 cleft lips and 7 cleft palates – a great accomplishment, especially given the added stress of the typhoon.
MMFC plans to return to Leyte, but it will take time for the needed infrastructure to be rebuilt. The EVRMC was the only functioning medical facility following the typhoon, but it still sustained significant damage.
Our thoughts are with all those who were affected by the typhoon, and we look forward to returning soon.
From October 12th to 20th, MMFC’s 26-person team of surgeons, anesthesiologists, nurses, dentists, nutritionists, and non-medical volunteers from the U.S. and England returned to Quito once again for its annual week-long surgical mission. In five days the team completed 10 cleft palate repairs, 1 cleft lip repair, 7 palate revisions, 2 lip revisions, 4 rhinoplasties, and 26 scar revisions. The dental team also operated on 22 patients.
With such a large team and diverse patient population, our Quito team is able to provide a wide variety of surgeries aside from solely cleft repairs. No matter what kind of surgery the patients received, it will have a profound impact on their lives.
These are just a few examples.
Damiza is a 5 year old girl who came to MMFC with a keloid on her left forearm, which she had as a result of a bad burn. The keloid caused her terrible itching, and removal of the scar tissue would relieve this. During examination on the day before surgery, Damiza was crying and complaining of tooth pain. The dentist discovered a dental abscess, so arrangements were made with the surgery team and on the following day when she went into the OR, the dental team performed a tooth extraction and drainage of the abscess while the surgeons excised the scar. The following morning Damiza was smiling, feeling betting with no tooth pain, and happy to know that the scar was gone and that the surgical incision would heal to a fine line. Her mother was very grateful and appreciative of the care provided as well as the attention she and her daughter received.
Sofia Zoullas is 16 years old and lives in New York City. She attends the Chapin school as an 11th grader, and this past June she got to do something that most teenagers don’t get to experience; She participated in MMFC’s mission to Antigua, Guatemala as a junior volunteer, taking all of the pre-op and post-op photos and collecting stories of some of the children she met.
MMFC sends a mission to Antigua, Guatemala two times each year. On June 22-29, our team of volunteer doctors, nurses, and administrators returned for another week of cleft surgeries and dental care. By the end of the five operating days, the MMFC team had completed 34 cleft surgeries and provided dental care to 21 children.
Thanks to the dedication and generosity of our volunteers, donors, and the Hermano Pedro Hospital in Antigua for opening its doors to us, these children received life-changing operations that they normally would not be able to afford. These are just a few of those children.
Juan Carlos Utuye
Juan Carlos is an 11-month old from Media Luna, about 5 hours away from Antigua. The youngest of four children, he was born with a bilateral cleft lip, and his mother brought him to MMFC’s mission with hopes of having it repaired. Juan Carlos’s mother heard about MMFC through an organization in the region that has an outreach program for children in need of cleft lip and/or cleft palate surgery. With his deformity, Juan Carlos required a lot of extra time and attention from his mother, who has three other children to care for. The surgery that Juan Carlos received was the first stage of his cleft lip repair; when it is complete, it will not only life-changing for him, but also life-changing for his entire family.
Santos Moises Lajpop
Santos is a 1 and a 1/2 year old boy, born with a unilateral cleft lip. He lives with his parents and four siblings in Momostenango, about 5 hours away from Antigua. After learning about MMFC at a local clinic, Santos came with his father to have his cleft lip repaired. Before he received surgery, Santos had a difficult time eating and as a result is malnourished – a common problem among children with cleft deformities. Now, with his lip fixed, he will live a much healthier and happier life.
Sebastian is 6 months old and comes from Rincon de los Leones, about 5 hours away from Antigua. He is the youngest of four children. His mother heard about MMFC through the organization Asociación Compañero para la Cirugia, which advertises for us in local clinics. With his severe deformity, Sebastian would not have been able to live a normal life. He had trouble eating, and the local community blamed his mother for his cleft lip. Now his mother will be able to take better care of him and his siblings.
Esmerelda is 16 years old, and was born with a cleft lip and palate. She is one of ten children and just had her lip repaired two years ago. Her neighbor made the nearly 12-hour journey from Tacana with her this year to have her palate repaired, since her parents had to work and take care of her siblings. For the 14 years before her lip was repaired, Esmerelda never left her house – not even to go to school. She couldn’t speak well and was afraid of being teased for her deformity. Now that her palate has been repaired by the MMFC team, she is another step closer to having a more normal life. She now hopes to improve her speech through therapy.
Cusco, Peru is one of MMFC’s longest-running missions. This year, with Dr. Helen John-Kelly as the team leader, we returned from June 14th to 23rd with a 24 person team of doctors, nurses, speech pathologists, volunteers, and administrative staff, ready for a busy week of cleft, microtia, and dental surgeries.
By Saturday afternoon most of the team had arrived. With Cusco’s elevation being over 11,000 feet, altitude sickness is a big concern, so in order to avoid having any sick team members, Sunday is a day of rest on this mission, a low-key day to acclimate to the altitude. Many team members went to the Sunday market in Pisac to get their souvenir shopping done early. With so many first-timers on this trip, there was a lot of nervousness and plenty of questions, but everyone was excited and anxious to get to work.
The team arrived at the EsSalud hospital on Monday full of energy and focus, and was welcomed by a lobby jam-packed with patients and their families waiting to be screened. This was screening day – always the most hectic day of the week on any mission, but especially so with such a large team. Thanks to careful planning and coordination with local staff, the team screened over 100 cleft, microtia, and dental patients in just a few hours, and by that evening MMFC had all of its cases scheduled for the rest of the week.
Throughout the course of the four operating days, using two operating rooms, the MMFC team completed surgeries on 13 microtia patients, 16 cleft patients, and 25 dental patients. Those numbers did not come easily, though; the days were long (12-16 hours!) and exhausting. But thanks to everyone’s hard work, we were able to help many beautiful and deserving children.
Saul is a 12 year old boy who lives with his parents three hours outside of Cusco. He was born with moebius syndrome, a rare neurological disorder that causes facial paralysis. It’s hard to imagine what it would be like to not be able to form any facial expressions, which play a huge role in our daily interaction with the world around us. This year, our surgical team successfully completed a thigh muscle graft on Saul. This was the first of this type of surgery for MMFC, and the biggest reward is that now Saul can finally smile.
Rommel is two months old and lives with his parents in Anta, a town about an hour away from Cusco. When he was born, the doctor told his parents about MMFC’s annual Cusco mission and suggested they bring Rommel to repair his cleft lip. Our team operated on Rommel on Tuesday, and his parents were so thrilled with the result that they wanted Dr. John-Kelly to be their son’s godmother! Rommel’s father is a driver, and he even offered to drive our team around when we return next year. This is a terrific example of how MMFC’s commitment to its mission sites, and the fact that we return annually, allows local physicians to refer patients to us that could not otherwise afford a cleft surgery. They know from year to year when we will be returning and more important, that we will return.
Sebastian and Luciano Ripa
Sebastian and Luciano are four-year-old twin brothers. They were both born with a cleft lip – one with a bilateral cleft and the other with a unilateral cleft – and they had both come to MMFC’s Cusco mission in prior years to have those repaired. This year, they returned to receive dental care and have palatal obturators fitted. No one likes going to the dentist, especially if it means having teeth pulled, but these two boys seemed to always be smiling. We love to see past patients return – especially when they have a smile on their face!
Cesar celebrated his 18th birthday while recovering from surgery to repair his primary microtia.
Zoraida, three months old, received surgery to repair her unilateral cleft lip.
Our mission to Cusco was a success once again, and it would not have been possible without so many different groups of people working together to make it happen – MMFC is extremely grateful to EsSalud for welcoming us into their facilities, to Edouard Ruelle and the Children of Peru Foundation for their generous sponsorship of the mission, to our wonderful local coordinators Ani Forsyth, Patty Galup, and Susana Mayer, and especially to this year’s team of extremely hard-working and dedicated volunteers.
Mary Beth Hagey is a docent for the Fine Arts Museums of San Francisco and a board member of a private foundation awarding scholarships to students demonstrating outstanding service in their communities and academic excellence. For the past 25 years, Mary Beth has been an active volunteer for the local schools (room mother to PTA President), in her community (scout leader, coach and mentor), as well as on a global level (participated in and organized the AIDS Walk Africa for the Elizabeth Glaser Pediatric AIDS Foundation). The “Greg Feldman, MD, Memorial Surgical Mission to Rwanda” is Mary Beth’s first trip with MMFC.
Sunday, March 10, 2013
“Muraho, Odette. May I take your photo?” all the while pantomiming with my camera. My Kinyarwanda vocabulary is limited to a few pleasantries. I needn’t have worried though. Her infectious smile lights the room; words seem unnecessary. The goiter on Odette’s neck resembles a lumpy grapefruit. With the help of a local interpreter, I come to understand that Odette and her younger sister have walked for 3 days to Gitwe Hospital in hopes that she will be selected to have this life changing surgery performed by American doctors and nurses donating their time and skill with Medical Mission for Children. She made this identical trek last year, but by the time she arrived, the schedule was already filled. Her enthusiasm and gratitude are palpable. Odette recounts her difficulty breathing when she carries her burdens on her head as well as when she sleeps. Odette asks to see her “before” photo as I head for the door. She wants to remember what she used to look like. Somehow I think she will be excited to see the “after” photo as well.