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.
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.
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.
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.
Nearly a decade ago, MMFC established a relationship with the Kalapurnam General Hospital after meeting its director, Dr. Kanti Jain. Since establishing a cleft lip and palate clinic, MMFC teams have returned to the hospital every year and sometimes twice in a year. To learn more about the extraodinary efforts and life of the hospital’s director Dr. Kanti, please read the featured magazine article below from the February 4, 2007 edition of The Week that highlights her valiant dream of helping the poor and downtrodden of rural Rajasthan.
The Journey Begins, July 30, 2015
Medical teams from the East coast, West coast, Colorado, and Georgia converge in Istanbul and begin the two day journey to Delhi then onto Jodhpur, and finally, a three-hour van ride to Phalodi.
Arrival in Phalodi, August 2, 2015
Check in with patients and meet with local medical professionals.
Surgery & Patient Care, Aug. 3-6, 2015
The team awoke early Monday morning, fueled up with spice-infused masala chai, and headed over to the hospital on foot. We were greeted with a waiting room full of children and vibrant colors. The morning was filled with patient screenings as the doctors checked to see which children were ready for surgery. Nurse Natalie and Doctor Gary prepped the OR while Nurse Terri got to work setting up the PACU. A brief meeting was held to decide the week’s surgery schedule, and then the doctors and nurses were off!
The first surgery began a little after 11AM and involved a toddler who was having a cleft lip repaired. It was followed by two more lip surgeries on a five-month old baby and a six-year old boy. The temperatures here are hot and humid due to it being monsoon season. The operating room started out cool in the morning thanks to a hard-working air conditioner, but the OR’s many machines and devices caused the circuits to trip and the doctors were forced to go without A/C as the day wore on.
By 5:30 the surgeries had wrapped up, and the sweat drenched docs headed to the ward to check on their patients. Relieved moms and dads cuddled with their children and the local night-shift nurses took over care of the patients.
Tuesday in Phalodi, August 4, 2015
Lots of little ones in the OR today—some were there for the first time and others, like Jagdish, were returning from previous years for follow-up surgeries. Despite the stifling heat, the recovery ward was full of content children and parents.
An interesting practice here at the hospital is how they distinguish between male and female patients. The title “Baby” is used to designate female pediatric patients, and the title “Master” is used to designate male pediatric patients.
Master Chandaveer’s parents were especially grateful for his care. While in the recovery ward, his father called me to his son’s bedside and requested that his picture be taken with a thumbs up. The family traveled from a village over two hours away using a variety of transportation modes including auto rickshaws and busses packed with passengers. In this sweltering heat, the journey is even more taxing.
The patients will stay in the ward all week so the nurses and doctors can continue monitoring their recovery. The children sleep on the hospital beds, and their parents sleep on the cool marble floor on either side of the bed—they use no mats or sheets. The nurses report that these children are amazingly easy going and are a delight to work with!
Farwell Assembly, Aug. 7, 2015
Hospital Director, Dr. Kanti Jain holds a ceremony to honor the patients, families, doctors, nurses, and hopsital employees who made the week a success. The MMFC team returns to Jodphur.
A group of nine team members traveled on a long 24 hour journey to Rwanda, Africa. The group spent the next morning setting up the operating and recovery rooms while simultaneously triaging patients. By the early afternoon, the Kibagabaga Hospital was set up and the teams had screened numerous potential patients for the early part of the week.In total, we screened about 15 individuals in the morning. Two were unfortunately turned away, one for a pregnancy and one for high blood pressure, but they remain strong candidates for surgery next year. After a few hours working through the language barrier with the aid of interpreters and local patients with English understanding, we narrowed down a list of patients for the next few days.The afternoon’s agenda consisted of two surgeries. The first patient, a beautiful young 22 year old woman from Kigali, named Patricia, got the group off to a great start with a very successful surgery.
Surgery Day Two Sunday March 16, 2015
Day two started with a beautiful sunrise and a jog around Kigali for a couple members of the team. With the patients already screened the night before, the team got right into pre-op procedures upon entry into the hospital.
A group of residents followed the team around today, learning and actively participating in the surgeries. These people proved very valuable, especially in dealing with the language barrier between our group and the locals. The team was able to perform five surgeries, although delayed throughout the day by instrument sterilization.
Each patient carries their own unique backstory and personality. Nyiraregwa is the mother of eleven children and has worked on a farm her entire life. This was her first time going to the doctors. Her positive energy filled the hospital and she soon gathered and entertained a group of women around her in the pre-op room.
Surgery Day Three Sunday March 17, 2015
Day three proved to be very busy here for the team. With a schedule full of patients, we grabbed an early breakfast at 6 and went straight to the hospital to start work.More residents and local nurses came to observe and learn in the OR today. A Swedish medical school student and a Swedish doctor, conducting research in Kigali for a few months, joined us to observe surgeries in the morning. In addition, the two residents from yesterday remained with us along with local two anesthesia techs, and a nursing student.
As word spread about our procedures here, more potential patients journeyed to the hospital to be examined. Madaline and I continued to triage individuals, with the help of Dr. Nkurunziza. In total, another twenty potential surgical patients remain on the waiting list for the remainder of the week, with more expected to come in tomorrow. Madaline joked as we screened these patients, asking if we could stay three more weeks instead of just three more days. That’s one of the hardest parts of the trip, not being able to perform surgeries on all of the well-deserving people that come here. We’re just touching the surface on the people we can help here
Surgery Day Four and Five Sunday March 18-19, 2015
Finally settling in to a consistent sleep schedule, the team arrived at breakfast well rested and ready to go. The local media joined us today, interested in seeing our work here and the great results from yesterday’s surgeries. The news coverage brought in a flow of more people interested in receiving the medical treatment so many desperately need.
A boy named Christian and his mother arrived today, the youngest boy we’ve seen by far at just four years-old.
After another long day of operating the team had conducted 19 surgeries thus far, and headed home to enjoy some native dancing and food.
A driver of wheat from Tanzania to Rwanda, David was one of the kindest and most professional patients we dealt with. After about an hour and a half in the operating room, he emerged with rest results. Hours later, after he woke up from the anesthesia and felt strong enough to return to his family, I stopped over to visit him one last time. With tears in his eyes, he grabbed my hand and muttered a humble ‘thank you.’ Little moments like those almost brought me to my knees at the work we were doing here. In just a short time, we were able to change the lives of so many deserving people and their families, and it was humbling to see how much it meant to them.
While the last few surgeries went on, Vianney and I continued to screen more and more patients. Another 20 people showed up on our last day of surgery, all unable to receive our help until next year. This was one of the hardest and heartbreaking things to do. It was hard to believe the full week had gone by and I would have to leave these amazing people and beautiful country.
Overall, the team blew me away with all of their work and selflessness throughout the trip. Each person gave up vacation time to travel across the world, working extremely hard in tough conditions to make a difference in other people’s lives. I’m humbled to be part of such an incredibly gifted and caring team. When asked about my favorite or most memorable part of the trip, I respond without question that it was the people. From the doctors and nurses on our team, to the staff at our hotel, to the patients and their families, I was in constant awe of how truly amazing these people are.
This year marked the sixteenth mission in Quito, Ecuador. During the “sweet 16” mission, the MMFC team saw a number of new and repeat patients for follow up surgeries. They screened over 145 medical and 50 dental patients, conducted 72 surgeries, provided dental care to 36 special needs patients, and fitted 3 children with hearing aids. It’s amazing to see the impact MMFC has over the course of the week, let alone sixteen years. The children and families of Ecuador along with MMFC doctors, nurses, volunteers, and staff are grateful to the Alvarez, Dassum, and Barrera families for their continued support of the Quito mission since 1998.
Meet some of this year’s patients…
Jefferson Parco Guadalupe (12 yr) & Keila Valeria Alvarado Guadalupe (4 yr)
A brother and sister returned to MMFC this year, both for lip surgery. Over the years, Jefferson has had 5 surgeries and Keila has had 3. They traveled over 5 hours from their home town of Napo to be seen by the MMFC doctors. After seeing how the MMFC team was able to help Jefferson, their mother was not worried once Keila was born with the same deformities as her brother. Jefferson, Keila and their family are grateful for the care provided by MMFC which has allowed them to be accepted within their society. Without MMFC, neither child would have received the surgeries they needed.
Esteban Issac Quimbita Pucha (2 yr)
During this mission, Esteban had surgery to repair his lip. MMFC had also operated on his palate during a previous mission. When Esteban was born, his mom was scared when she first saw his cleft lip and palate deformities. It was something she had never experienced before with her other child. After seeing that MMFC could treat his condition, his mother was relieved. She and her family are grateful to MMFC for bringing a smile to Esteban’s face. They are thankful to the team of doctors and nurses for returning each year to provide care for her son and many other children in Ecuador.
Robert Alexander Tipan Masabanda (9 yr)
Robert is another patient that has received various care from MMFC over the years. This year, Robert had another surgery to repair his lip along with a tooth extraction. He was also one of the children who was fitted with hearing adds during this mission. Robert and his mother have gotten to know the doctors and nurses over the years and are appreciative for the consistent and quality care they’ve received.
On July 18th the MMFC team of volunteer surgeons, anesthesiologists, dentist, and nurses headed to Tanzania for another two-week mission providing free cleft surgeries and dental care, working alongside the wonderful staff at the CCBRT hospital in Dar Es Salaam.
Thanks to the generosity of 14 year old Tori Cargill of Beverly Farms, MA, the biggest winner of all at MMFC’s 17thannual charity golf tournament turned out to be a young girl who has never once in her life seen a golf course.
But 12 year old Jackline Lukinga, who lives in a small and impoverished village some 8,000 miles away in a remote corner of Tanzania, knows just how lucky she is.
And so does her family.
Two years ago, in the summer of July 2012, Tori spent two weeks with MMFC’s surgical team in Dar Es Salaam, Tanzania, and during that time Tori bonded with over 40 children who where in desperate need of medical care. For long hours every day, Tori taught the children about music, art and dancing — and perhaps most of all, she comforted these frightened and terribly sick children both before and after their surgeries.
One of those children she comforted and cared for was Jackline, who was ten years old at the time.
However, when Jackline was admitted to the hospital two summers ago, a bronchial infection forced the cancellation of her planned cleft lip surgery. Jackline was treated with antibiotics and sent home four days later, her family heartbroken and despondent.
But now fast forward to June 23 of this year, when over 600 golf balls were dropped from a helicopter and onto the 18th fairway at Marshfield Country Club in MMFC’s first ever ‘golf ball drop’ contest. The numbered golf ball nearest the marker belonged to Tori Cargill, who was about to make Jackline one very lucky girl.
Now what would you do if you were 14 years old, your pocket suddenly several hundred dollars heavier?
Spend a day shopping for clothes, perhaps?
Find a jewel or two to sparkle around your neck or wrist?
Maybe even a watch for all to envy.
Would you be tempted?
Tori was tempted alright…tempted to do exactly one thing: to donate her winnings towards the 2014 Tanzania mission so she could sponsor Jackline’s cleft lip surgery.
You can see the difference this surgery has made, and will continue to make, in Jackline’s life. When she first saw herself after surgery was complete, she couldn’t stop looking at her new smile in the mirror and saying how happy she was. This will, in many ways, be life changing for her.
Jackline wasn’t the only one to receive life-changing surgery — there were many other just like her, ranging from babies to adults who had lived with their deformity for far too long.
The team is now back home in the US, but there will be many more stories like this when we return to Tanzania next year. Thanks to MMFC”s many supporters, the CCBRT hospital for welcoming us, and mission sponsor Margie Rotchford of Saratoga, NY for making this mission a huge success.
Roberta Anslow is an artist and professional photographer who has been volunteering with MMFC for several years now. She designs MMFC’s print and web based marketing materials, and coordinates our annual Marshfield Charity Golf Tournament. This year Roberta went on her first MMFC mission as the trip administrator, where she put her artistic skills to work by documenting the week’s surgeries with a blog and some beautiful photos.
This past February, Medical Missions for Children returned to Angeles City, Philippines for a week of free cleft lip and palate repair surgeries. Thanks to the entire team of volunteer doctors and nurses, Holy Family Academy Batch ’83 (our host organization), and the Mabalakat District Hospital, 15 cleft lip repairs, 7 cleft palate repairs, and 2 lip revisions were completed in just four days. In addition, 10 patients were fitted for obturators.
Meet John Paulo
This is the story of John Paulo, one of many children Medical Missions for Children helped in Angeles City, Philippines. He is 8 years old and suffers from untreated asthma. John Paul0 was born with a cleft lip and cleft palate. His lip was repaired at some point during his 8 years, but it was not done well and he was left with a very noticeable scar. Because of his cleft palate he doesn’t speak like other children and is bullied at school. When he eats, some of the food will come out his nose. A beautiful, sad, shy boy.
When he and his mother arrived for screening on Sunday, he was wheezing quite badly. We scheduled his surgery for Wednesday. The surgery he needed to correct the lip and close the cleft palate was estimated to be 2 1/2 hours long.
John Paulo arrived Wednesday morning for surgery, but his asthma was still bad. Our PACU team spent time treating him with a nebulizer filled with Albuterol, and after a couple of treatments, our Anesthesia team decided he was ready to go into surgery. During the almost 3 hours of surgery his mother huddled just outside of the operating room area. She did not want to be too far from her son.
Immediately after coming out of surgery, once in the PACU, he was again given Albuterol, and again the next morning. His lip and palate are fixed and now he will need to learn to speak all over again. Our local hosts, HFA Batch 83, will try to find and fund a pediatrician to treat his asthma.
Andrei is 6 years old and was born with a cleft lip. His two brothers don’t have any facial deformities, but a cousin on his father’s side does. Either the mother or the father can pass on genes that cause clefting. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol and take certain medications.
Andrei is in kindergarten and so far has not been bullied, and his cleft lip doesn’t affect how he eats. He has lots of friends, loves basketball, singing, and learning English. This is often not the case, however. Left unrepaired, cleft lips can unfortunately result in people being ostracized from their community, making it difficult to make friends and find work.
His mother found out about MMFC from her neighbor. The surgery was quick and successful, and both Andrei and his mother were excited about the changes this would bring about in him and the effect it would forever have on his life.
Angelique is 2 years old. She was born with a cleft lip, and at some time during her short life there was an attempt to repair it. As you can see, it wasn’t a very good job. Angelique was a team favorite, in part because she is a stunning child, but primarily because of her sassy attitude. You see that reflected in her photos.
The MMFC surgeons performed a lip revision on Angelique — an improvement from her initial surgery.
Angelique and her mother came back to the hospital 3 days later on our final day for her checkup. She was dressed up in her fancy headband.
Danica is 7 months old and was born with a cleft lip and palate. When she eats, food comes out her nose. Since she is so young she has not been bullied yet; nor does she get many strange looks. This would change as she gets older, though. Her mother was excited but also very worried about the surgery. Sometimes parents are so worried about the surgery that they never return with their children on the scheduled surgery day.
Thankfully, the team was able to schedule Danica for surgery despite her history of chronic coughs. She returned with her mother on the day of her surgery, and left with a repaired cleft lip.
Next year Danica will return to MMFC’s mission to have her cleft palate repaired. The earlier we can fix their palates, the easier it will be for these children to learn to speak and eat normally. Danica’s mother feels the surgery will make life easier for both herself and Danica.
For over a decade MMFC has been sending cleft, microtia, and dental teams to the Obras Sociales Hermano Pedro hospital in Antigua, Guatemala. The high demand for cleft surgeries in Guatemala has generated the need for MMFC to return not once, but twice a year. The January mission is the first of the two, and also MMFC’s largest team. With 26 volunteers – cleft and microtia surgeons, anesthesiologists, OR and PACU nurses, dentists, speech therapists, and administrators – coming from all over the United States, the team was prepared for a busy week.
On Sunday, screening day, over 100 patients were screened by the surgical and dental teams, including 16 handicapped residents of the Hermano Pedro Orphanage.
By the end of the day Friday, MMFC had completed 70 cleft and microtia surgeries, provided dental care to 82 patients, and given 62 speech therapy sessions. Many residents were away with family for the holidays; they will be eligible to receive free dental care when Dr. Charles Badaoui returns with MMFC’s second Guatemala team in June of this year.
Here are just a few of those who received life-changing surgeries this time…
MMFC thanks the Lefkofsky Family Foundation for its generous sponsorship of this mission.
Paul Christian Barrera is a writer and editor based in Oakland, California, currently at work on his first collection of prose. His creative work has been selected for publication by the conservation blog Nature Bats Last. He is employed as a Course Writer and Editor at Academy of Art University in San Francisco, working with instructors and professors to develop web-based learning modules targeted at the school’s large population of foreign and overseas students. He graduated from the University of California, Riverside with a B.A. in English Composition in 2008. The 2014 MMFC mission to Rwanda is Paul’s first trip with Medical Missions for Children.
Saturday March 15, 2014
Patients queued outside the Medical Mission for Children team’s makeshift office in the late afternoon, seeking evaluation and treatment for their thyroid conditions. Rain clouds filled the sky and began to shower just as screening began. Many patients were local, from Gitwe and other nearby communities, but others journeyed several hours by foot, car, and motorcycle taxi to Hôpital Gitwe, with some persons traveling from as far away as Uganda.
Despite their difficult voyages, the patients’ high spirits and hopefulness were as refreshing as the day’s early evening rain, energizing an MMFC team that had spent the last three days traveling from the States to Amsterdam to the Rwandan capital Kigali before finally reaching the mission site at Gitwe.
After setting up their equipment and settling into their accommodations for the week, several members of the team joined the local children in a game of pickup football that attracted more and more smiling, curious kids as the game progressed down the road, back toward Hôpital Gitwe. Many of the children had trailed the team since their mid-morning arrival in Gitwe, sharing their beautiful smiles and offering lessons in Kinyarwanda, teaching the team basic phrases like “muraho” (hello), “amakuru” (how are you?), and “meza” (I’m fine, thank you). Inspired by the gregariousness of the Gitwe community and its wonderful youth, the team screened more than 32 patients and scheduled 27 surgeries for the first four days of the mission, with more openings planned as the week progresses.
Surgery Day One
Sunday March 16, 2014
MMFC’s first day of surgeries began with foggy skies and dark clouds that threatened a second consecutive day of showers, with Sunday’s work slated to begin at 7:15 a.m. Just 90 minutes later, the day’s first operation was completed. The once-ominous rain clouds gave way to Rwanda’s unrivaled sunshine, and the local Gitwe community woke to its daily routine of conversation, travel, and hard-scrabble work.
Six surgeries were scheduled for Sunday, a majority of which were the most severe cases of goiter that the MMFC surgery team planned to treat during their mission. These cases were tabbed for the beginning of the week’s work in order to allow patients maximum recovery time and ensure their comfort. In spite of the challenges of performing surgery with just a single operating room, the team’s work is best described as both organized and efficient, rotating patients in and out of the OR and dynamically adjusting their workflow to counter unforeseen obstacles in unfamiliar surroundings.
Between cases, doctors also took time out of their breaks to consult with a handful of non-thyroid cases. A specifically touching instance: a young local girl from just down the street in Gitwe, with beautiful orange-brown hair and a soft smile, gently padded into the MMFC office, backlit by the early morning sun. Her shy, discreet demeanor did little to mask her immense courage and admirable frankness, as she quietly pulled down the neckline of her crisp maroon tanktop to reveal an enormous butterfly-shaped burn across her sternum, just below her clavicles. The staff immediately set down their morning coffee and directed their attention to the girl, concluding that the burn likely occurred during infancy and thus had afflicted the girl for the duration of her life. Due to the difficult nature of her condition, the doctors directed her to a trusted plastic surgeon, making room even during their down time to offer their services to this brave young lady and those like her. This case is just one example of the compassion and gentleness that MMFC hopes to spread with their mission in Rwanda.
It is the team’s sincere hope that their efforts—both in and out of the OR at Hôpital Gitwe—will enable each patient to lead a more active, enriching life and enjoy Rwanda’s immense beauty and warmth, despite some of the country’s more difficult realities. Indeed, it is this sort of consideration and concern that, in the face of fatigue, has fueled the team’s efforts to assist a staggering turnout of afflicted patients seeking aid. Certainly, MMFC’s near-incessant work since their arrival on Saturday morning has proved taxing and strenuous, but their desire to help each person that crosses their path is palpable in the gratitude and relief smiled by the patients and their loved ones.
Surgery Day Two
Monday March 17, 2014
With Sunday’s surgeries under their belts, the members of MMFC’s Rwanda mission entered their second day of operating with six patients scheduled for treatment of goiter. Monday’s weather was marked by bright heat and near-cloudless skies. During the morning walk to the hospital, the team encountered a young boy driving a team of cows back toward his family’s homestead. In town, schoolchildren filled Gitwe’s main road in navy blue and sea green uniforms, holding hands as they made their way to the local academies for daily instruction. Meanwhile, the patients slated for Monday’s operations began filing into Hôpital Gitwe as MMFC’s surgery team scrubbed in, wearing lucky green caps and undershirts to celebrate St. Patrick’s Day.
The first two cases of the day resulted in the removal of a 10 cm goiter and a 35 cm goiter, respectively. These cases represented some of the team’s largest goiter removals of the week, and were thus planned for early in the day to give each patient ample time to recover and rest before their long journeys home. The patients, still groggy from anesthesia, nonetheless expressed immense gratitude to the team. Their huge smiles belied each woman’s desire to return home and begin their new lives without the pain and disfigurement caused by their thyroid conditions.
Rwanda is known as “the land of a thousand hillsides and a million smiles,” and this sense of community and cooperation has been unmistakable since the team arrived in Gitwe. The day’s schedule originally included one of the few male patients to visit Hôpital Gitwe for thyroid surgery, a gentle, unassuming man named Evaliste who hails from Gitwe. However, the team became aware of a woman named Lydia, who had driven four hours from Kabale, Uganda with her cousins to seek surgery from the MMFC team. One of the original 32 patients screened on Saturday evening, Lydia was slated to receive her surgery on Thursday, for which she expressed deep gratitude. But she also indicated that she needed to be back in Uganda no later than Saturday morning in order to make it to her job as a social worker. Wanting to ensure an on-time recovery for Lydia, the team consulted with Evaliste, who was gracious enough to switch his spot on Monday’s schedule for Lydia’s original time slot on Thursday morning. Both were satisfied with the outcome, and Evaliste seemed especially pleased that he was able to help a fellow patient. With this sort of friendly, flexible collaboration from the patients, the MMFC team has had no trouble adjusting their workload to accommodate each person’s special needs and limited travel schedules.
Dr. Stephanie Jones Returns Home
March 18, 2014
MMFC’s thyroid mission to Gitwe was launched in 2006 through the tremendous joint efforts of Rwanda native Vianney Ruhumuliza and Dr. Denny Snyder, with the goal of spreading aid and benevolence via top-class medical treatment and gentle goodwill. Understandably, Vianney was deeply moved by what he describes as “the trouble” that tore through his homeland in 1994. He had since envisioned a program like MMFC’s mission to Rwanda; in his words, he wished to “give thanks for the gift of life” in response to the atrocities visited upon his countrymen.
Fortuitously, Vianney and Dr. Snyder met during Vianney’s tenure as a travel nurse at Brockton Hospital in Boston in 2003. Linked by their humanitarian goals, Denny and Vianney began developing the plan for an aid-based mission to Vianney’s homeland. Three years later, after much struggle and red tape, Denny and Vianney organized the first thyroid mission to Gitwe. It is a mission that continues to this day, with yearly trips for brave and kind-hearted doctors wishing to share their skills with the rest of the world.
Denny and Vianney’s fight to create this mission is the lynchpin to a most incredible coincidence that occurred during this year’s mission, in which a descendant of a native Rwandese man was able to return to the land of her ancestors on a mission of peace and aid.
Meanwhile in 2006, as Vianney and Denny embarked on the first-ever MMFC mission to Gitwe, a young anesthesiologist named Stephanie Jones was beginning her career in medicine at Loma Linda University—a fourth-generation physician, and the first woman in her family to hold the title.
Stephanie’s history of medical aid in Africa, however, began long before this year’s mission to Gitwe. It is a story that stretches into pre-War Rwanda, encompassing three generations of Stephanie’s family: a story that fits hand-in-glove with Vianney Ruhumuliza’s own history of travel medicine.
Robert Llewelyn Jones and his wife Charlotte were missionaries for the Seventh-Day Adventist Church, and in the late 1920s began a religious mission in Gitwe, a small rural village south of the Rwandese capital of Kigali City.
In 1931, Donald Jones was born to Charlotte and Robert in nearby Ngoma, the only appropriately equipped hospital in the area at the time. Donald, a precocious and sharp-minded youth, attended La College Adventiste de Gitwe, just steps from the current Hôpital Gitwe site—the same place where Donald’s third grandchild, Stephanie Jones, would work on her first medical mission more than 70 years later.
“When I first signed up for the trip, I didn’t make the connection. But after talking to Dr. Jeremy Collins, leader of the Gitwe anesthesia team, and looking at his photos from previous missions, I started to put the pieces together,” Stephanie said. “To be able to come back to where my lineage began, in the capacity of a medical mission, it’s very powerful for me.”
Robert and Charlotte were cornerstones of the community in Gitwe. Robert was the regional secretary for the Seventh-day Adventist church and a teacher at the local primary school. They were leaders of the local faith community, and their five children were regular playmates of the native kids.
In 1940, as World War II raged across Europe and the African continent, Robert was approached via letter by a Belgian mission in the Congo, which asked him to stand in for the local missionaries during a planned absence. Robert graciously agreed and set off for the Congo, leaving his wife and young children behind to look over the family’s work in Gitwe.
Upon his arrival in the Congo, a Belgian merchant came into the mission and reported that he’d just shot and wounded a Cape Buffalo.
“These animals are very dangerous. They will attack if wounded, and have a reputation for waiting in the bush to kill their attackers, or the next innocent humans that wander along,” Stephanie said.
The Belgian asked Robert for assistance in tracking and killing the buffalo before it harmed anyone else.
“Bwana Jones, don’t go,” the natives told him. “These animals are dangerous, and will kill someone,”
A skilled hunter and marksman, their warnings only served to fuel Robert’s sense of duty. He thus undertook a hunting expedition with a small party comprised of the Belgian merchant and some local natives from the Congo. The party found the track of the Cape Buffalo and followed it most of the day, until they lost the trail early in the afternoon. Determined to quell the threat for good, Robert and his team set up camp, hoping to starve out their quarry and line up a finishing shot.
“They sat down in a clearing under a tree to eat their lunch and nap. While standing in the clearing, the buffalo appeared and charged my great-grandfather and knocked him to the ground. He held the beast by the horns while it pushed him around in the dirt until the others finally shot the buffalo,” Stephanie said.
“He was taken to a primitive field hospital nearby with broken ribs and severe internal organ damage. He died two days later complaining of horrible abdominal pain.”
Two weeks after the incident, in the middle of the night, Charlotte received correspondence from the Congo, informing her that Robert, the father of her five children, was dead.
“She cried all night. My grandpa, Don, was eight or nine,” Stephanie said. “He remembers asking her what was wrong, and that she kept telling him that she couldn’t yet say. Two days later, she sat down with her children and told them their father was dead. And that they were returning to America.”
The Jones family’s return path to the states would be far from a tranquil homecoming. Leaving behind the mission she’d built with her husband, Charlotte booked a steamer trip from South Africa to Brazil, despite the constant threat of Nazi submarines.
“They were told by the captain that no lights were allowed at night,” Stephanie said. “They had to dodge U-Boats all the way across the Atlantic until they got to Brazil.”
Bravely, Charlotte and her entire brood arrived unscathed via train, settling in the northern California community of Angwin, where Stephanie’s father, Steve, was born.
Steve would preserve his family’s proud legacy of aid, embarking on a mission to Burundi in the late 70s. His father, Don, would make the trek back to his native Africa to meet his son, and together they returned to Gitwe, the place of Don’s childhood—continuing the family’s legacy of service that Stephanie proudly carries on as part of the 2014 MMFC thyroid mission to Rwanda.
“To walk the same streets, to see my great-grandfather’s school, it’s a surreal feeling to represent my family and help the same families that my great-grandfather helped,” Stephanie said. “To connect so directly to my personal past while having a real role to fulfill, after all my studies, it just makes me feel like I have something meaningful to do, and that all this hard work has paid off.”
MMFC’s Goodwill in Gitwe
March 19, 2014
MMFC’s thyroid mission to Gitwe, Rwanda is a complex global health project that requires the cooperation and charity of both skilled physicians and generous benefactors. The Rwanda mission in particular is a bi-coastal effort, assembling surgical and anesthesia teams from such reputable medical centers as Tufts and Stanford. Through the efforts of the MMFC thyroid team, Rwandese men, women, and children receive highly specialized surgical services with a specific focus on excision of large goiters.
The mission is also an opportunity for young residents and medical students to develop critical operating room techniques and instincts, all within the context of donated care and medical philanthropy. Designed as an enriching experience for both the locals as well as the mission team, it comprises the tireless efforts of a multi-faceted set of professionals that includes doctors, nurses, business specialists, and writers, all of whom volunteer their services with the goal of enhancing the lives of patients that might otherwise never receive quality treatment.
“The mission has come a long way since it began in 2006,” said Otolaryngological Surgeon Dr. Jagdish Dhingra. “The conditions under which we operate are a big challenge, but as the mission has evolved, we have been able to take on more and more challenging cases.”
Dr. Dhingra is a veteran of the MMFC thyroid mission, having made seven trips to Gitwe since the inception of the program. He and his team have helped countless goiter-afflicted Rwandese lead more active, happy, and social lives as a direct result of his surgical expertise. In turn, each resident and medical student that has accompanied Dr. Dhingra has walked away from the Gitwe experience with the deep satisfaction that can only come from sharing one’s gifts with the developing world.
This mission would not be possible without the philanthropy of multiple donors, especially major contributions by the Downs Family and the Aiyer Family. Ethicon Endosurgery has also been a wonderful partner to MMFC, donating crucial operating equipment and implements to ensure the consistently high level of quality surgery that has defined the Gitwe mission since its inception nearly a decade ago.
Thanks to the kind efforts of the donors, Tufts resident Jeremiah Tracey was able to join the ranks of the Gitwe team, contributing his skills and experience to what’s proven to be a most impactful medical mission, aiding the continued recovery of post-genocide Rwanda. Also joining the east coast team was third-year Weill Cornell medical student Andrew Gregg.
“It’s been an incredible opportunity to learn,” said Andrew Gregg. “I’ve had a lot of fun with the patients and the surgical team, but the biggest highlight for me is working alongside my father, Dr. David Gregg, with the specific aim of helping the less fortunate.”
Meanwhile, the west coast contingent of the MMFC thyroid team—led by Dr. Jeremy Collins and Dr. Kevin Malott of Stanford’s Anesthesia department, as well as General Surgeon Dr. David Gregg—also received tremendous gifts from several donors. Significant among these contributions were the Hellman Family Foundation’s grants, which supported the team’s procurement of essential operating equipment and other resources . Another, anonymous donation, directly allowed Anesthesia residents Stephanie Jones and Natacha Telusca, as well as General Surgery resident Geoff Krampitz, to be a part of the 2014 Rwanda mission.
“Seeing the smiles of the community has reaffirmed my calling to medicine,” said Natacha Telusca. “I am grateful to the donors who have supported me, and it has been a pleasure to make a difference in this wonderful community.”
The donors’ substantial gifts, combined with the surgical team’s tireless work, have made the thyroid mission to Rwanda a dependably resounding success. Indeed, the team has been warmly welcomed back time and again by the community at Hôpital Gitwe, returning each year determined to build upon the previous years’ successes.
With its skilled team of surgeons, anesthesiologists, and talented young residents, the Gitwe mission has become a remarkable example of the spirit of international goodwill that is the ultimate goal of Medical Missions for Children—a globally meaningful endeavor that patrons of MMFC can feel proud to assist.
Rwandese Hospitality for MMFC Team
March 20, 2014
Wednesday the 19th—day four of surgery—began with the successful excision of the largest goiter of the mission—nearly 700 grams in weight. The surgery was a multi-hour affair and required the assistance and expertise of every surgeon, anesthesiologist, and resident on the MMFC Gitwe team. Despite the long duration of the first case, the surgery team still managed to operate on all scheduled patients, forgoing their lunch breaks in favor of providing the care that was promised.
At day’s end, the team was exhausted but in good spirits after continuous sessions in the operating room. For dinner, site host Vianney Ruhumuliza invited the MMFC Gitwe team to his family’s home in the nearby village of Mbuye. Per tradition, the team made the trek by foot. The 90-minute sunset hike from Gitwe to Mbuye began with thick rainclouds overhead, and a brief shower threatened to wash out the team’s hopes of a scenic and relaxing walk in the countryside. However, the weather cleared just in time for sundown, and team was rewarded with a truly remarkable experience: dusk atop a Rwandese ridge, surrounded on all sides by lush valleys dotted with evening fires, the pleasant odor of wood smoke filling the air as the sun descended behind the country’s legendary collines, or hillsides.
The welcome at the Ruhumuliza residence was expectedly warm and gracious. A large fire had been constructed in the center of a dirt courtyard, flanked by holding pens for farm animals and knee-high benched filled with local children and generations of the Ruhumuliza family. After handshakes and mutual thanks were exchanged, the team was invited to the living room in keeping with Rwandese traditions, meeting with Vianney’s parents and siblings before receiving a customary pre-meal blessing. Served a kingly spread of beef stew, roasted potatoes, whole leg of lamb, broiled cauliflower, and traditional imyumbati—a dish of ground cassava leaves—the team joined the locals and family members in the courtyard to eat, laugh, and share stories of travel.
With dinner complete, the local kids lined up in the courtyard for a recital of some of their favorite songs, all in Kinyarwanda. Lit by the smoldering fire, the children’s bright smiles seemed to dance alongside their singing, and there was barely a word from the MMFC team during the performance—only applause and cheers and looks of enraptured appreciation for the children’s incredible gift of authentic Rwandese hospitality.
As the performance ended, Vianney’s father, Mr. Mdandi Ruhumuliza, stepped to the center of the courtyard and delivered a final blessing before the team was driven back to their accommodations in Gitwe for a good night’s sleep ahead of the final planned day of surgery. With another five operations slated for Thursday’s schedule, the positive energy gleaned from their experience in Mbuye was an essential restorative for the team after a long week of treating thyroid afflictions at Hôpital Gitwe.
A Letter of Thanks to MMFC Gitwe
March 20, 2014
Lydia is a Ugandan woman from Kabale who received surgery from the MMFC team to excise an apple-sized goiter on the front of her neck. She is a social worker and teacher, earning her B.A. in Eduction from Makerere University in 2011. A mother of two, she made the trek across the Uganda-Rwanda border with her cousin, Musinga, as the driver. Lydia was originally scheduled to be operated on later in the week, but she needed to be back in Uganda before Saturday morning in order to make it back to her job at the Compassion International children’s home. Wanting to accommodate her tight work schedule, the MMFC team made every effort to move her procedure to earlier in the week, and Lydia received her surgery on Monday afternoon. Before departing back for Uganda on Thursday evening, Lydia wrote a tremendous letter of thanks to the MMFC team, the transcript and photos of which can be found below.
RE: Appreciation of Good Medical Services
I take this pleasure to appreciate the opportunity rendered to all patients who visit this hospital. I appreciate the Ministry of Health in the Republic of Rwanda for their great work to improve the health of the people not only in Rwanda, but to the neighboring countries.
I am grateful to the work done by the doctors, nurses, and the entire staff. I do appreciate the team of professional doctors that traveled from U.S.A. to operate [on] patients with goiters. I Lydia, from Kabale, Uganda, heard about the team of doctors that were traveling from USA — United States of America — to Gitwe Hospital over the radio, and then we called some people in Rwanda to confirm the announcements, and they said it was true.
I have benefitted personally. I travelled from Uganda to Rwanda on Friday, 14th of March 2014. I was operated on Monday, 17th of March and was discharged on 20th of March 2014, in a very good condition.
I am grateful for all the services done here in Gitwe Hospital, where patients are given food freely, the rooms are very clean. The entire environment is clean, all the staff you meet greet you with a smile, people here are very friendly. We really appreciate the Republic of Rwanda for all that made our visit a success, our words cannot express the way we feel at heart. The free medical services that people receive makes the whole thing amazing. All in all, I am grateful to all. God bless you.
Another Successful Year for MMFC Gitwe
March 21, 2014
With just one surgery scheduled for Friday morning, the MMFC Gitwe team celebrated another year of successful thyroid operations, providing nearly 30 patients afflicted with long-term thyroid conditions with surgical procedures that they might otherwise not have been able to access. In spire of their mood of relief, the surgeons and anesthesiologists maintained an attitude of professional focus, operating on a young girl’s groin to relieve her of discomfort that has prevented her from walking without pain for the duration of her young life. This surgery is just one example of the special cases that the team undertook this week, making room between thyroid-specific cases to operate on needy children with conditions that could otherwise be inoperable without the MMFC team’s help.
The 2014 mission’s tremendous success is due in no small part to the tireless work of everyone involved, from the donors to the doctors and nurses to the support staff. MMFC’s thyroid team would especially like to thank the nurses and doctors of Hôpital Gitwe for their incredible warmth and invaluable assistance in unfamiliar surroundings: the mission would never have gotten off the ground without their willingness to help in the operating room, the PACU, the recovery room, and everywhere else in between. Their brilliant energy truly inspired the entire team and made each day’s surgeries that much easier to complete, in turn allowing more patients to be screened and assessed—the ultimate goal of the MMFC thyroid mission to Gitwe.
In addition to the efforts of the Hôpital Gitwe team, the MMFC surgical team would also like to recognize the efforts of them team’s nurses. Tanya Lashchuk, Ashley Richards, Shannon O’Keeffe, and Jana Barkman were consistently positive presences in the operating room and the PACU, providing crucial service to the patients that eased their experience of the thyroid procedures. In the OR, Tanya and Ashley were on their feet for more than 10 hours a day, helping to maintain the smooth pace of operations that marked the week’s work in Gitwe. In the PACU, Shannon and Jana were unshakable, managing a dynamic operating schedule, providing essential pre- and post-op care, acting on shifts in patients’ conditions and, most importantly, keeping up patients’ spirits with their gentle, warm attitudes.
Also of massive help during the week was administrative lead Leslie Collins, who single-handedly tracked the week’s operations, handled all photography responsibilities, controlled the team’s finances, and served as the team’s project manager, ensuring that all equipment and resources were in place and responding to any and all project-based issues that arose during the week. Her gregarious energy was palpable the entire trip, and the whole team came to rely on Leslie not only for her administrative efficiency, but for her unceasing effusiveness that was a critical source of positivity in the face of marathon surgeries performed in the Rwandese heat.
Finally, the writer would like to express his tremendous gratitude to the MMFC team, as well as the Gitwe community. He has been genuinely touched by everything he’s experienced during his week-plus with this team and this community: the doctors’ happily selfless work, the nurses’ unbelievable friendliness, the villagers’ beautiful smiles and profound hospitality. The locals are easily the proudest, kindest people that the writer has been fortunate to encounter in his young life, and the warmth they’ve shown him and his team will not fade in memory or effect. The MMFC’s doctors, residents, and nurses are people to be admired and emulated. Indeed, the lessons learned here are of a weight and importance that cannot, unfortunately, be put into words as of yet. But the writer is confident that, as he processes the immense power of this life-altering trip to Rwanda, he will be able to iterate and more truly understand the complex nature of our world, and more accurately represent the irrefutable significance of compassionate love in his own work as a writer.
Thank you to Leslie, Jeremy, David, Andrew, Jeremiah, Tanya, Ashley, Jag, Jana, Shannon, Geoff, Vianney, Stephanie, Natacha, and Kevin, and especially ALL of the patients and staff at Hôpital Gitwe for teaching me what has already proven to be one of the most important lessons of my life.