Finding the Universal in the Particular

VOLUME 3, WINTER 2011
IMPROVING LIVES THROUGH MEDICAL MISSIONS
Finding the Universal in the Particular
BY PETE VAN DEVENTER
AND KATIE AMMONS
The day starts with
the rumble of one
motocarro among
hundreds weaving its
way through the
streets of downtown
Iquitos, Peru. We are
headed for Clinica
Adventista Ana Stahl,
where over 30 patients
are already waiting.
Before we proceed
ROOSEVELT AWAITING EYE SURGERY TO CORRECT A CHILDHOOD INJURY
with the new surgery
cases lined up for the
bandage underneath. Dr. Stewart steps
day, we spend the first hour and a half
in with a slit lamp to check that there are
seeing yesterday’s patients for their postno signs of swelling and that the new lens
operative appointments.
is still properly placed. Then he pulls
The morning post-op appointments are
back, holds up two fingers and asks,
where the magic happens for the eye
“How many?” Almost every patient
surgery team. Each patient, wearing a
answers correctly!
stiff, blue eye patch with perforated holes
Blindness is a universal issue. Thirty-nine
over their surgical eye, enters a small
million people are legally blind throughroom. Bonnie, one of the scrub nurses,
out
the world. Ninety percent of these
greets them warmly, has them sit down,
people live in the developing world, and
and takes off the tape, eye patch, and
Continued on page 2
A Step in a New
Direction
BY GREG HODGSON
CGHI Develops Clubfoot
Treatment Program in
Rwanda
I was shocked when I first saw
Emmanuel’s feet. Emmanuel suffers
from a severe form of bilateral clubfoot that has never been treated or
corrected – only endured. During
my many years of living and working in Colorado and overseas, I had
never seen a condition progress to
a point like this before. I have been
sheltered, though. Soon, several
other cases
Continued on page 4
EXTREME CLUBFOOT CASES LIKE EMMANUEL.S
ARE NOT SEEN OFTEN IN THE DEVELOPED
WORLD.
TABLE OF CONTENTS
1
> Finding the
Universal
Eye surgery
changes lives
A Step in a
New Direction
Clubfoot
treatment success
in Rwanda
2
> Greg’s
Jungle
Notes
5
> Photo
Album
Kids step forward
into new lives
6
> News & Notes
A bird’s eye view of
what’s going on in
each country
8
> Upcoming trips
Sign up today for
lifetime memories
finding the Universal Continued from page 1
cataracts are the main cause of visual impairment in these
cases.1 There were a reported 83,000 untreated cataract
cases in Peru alone in 2007.2 Yet, we cannot attempt to
Jungle notes
I recently returned from Iquitos, Peru, after celebrating the fifth anniversary of the partnership
between Centura Health and Clinica Adventista
Ana Stahl in Iquitos. Since the first Centura team
went to Peru in February 2006, we have treated
approximately 25,000 outpatients and provided
nearly 800 surgeries…all free of charge to
patients who otherwise would have no access
to healthcare. The cost of these services would
be in the millions of dollars here in the U.S.
Thanks to the many volunteers who have
participated in these trips and for all the loving
care you have provided.
2012 should be a year of growth in the Peru project. We are working with the Center for Global
Health and the School of Medicine at the University
of Colorado to find ways to better document our
interventions and also to further engage students
from across the Health Sciences campus in research
and training projects. We also have a team from
the south state group of hospitals within Centura
Health – Penrose, St. Francis, and St.Thomas More –
who will be forming a team that will travel to
Iquitos in March 2012. This will be the first organized team from the CHI hospitals within Centura
to join ranks with Avista, Littleton, Parker and
Porter Adventist Hospitals. This is an exciting and
long-awaited development! We are also looking
forward to a joint project with the South Metro
Denver Chamber of Commerce to improve the
health centers in Mazan and the village of Indiana.
DR. AMMONS, DOING A POST-OP CHECK ON ROOSEVELT, USING A SLIT
LAMP TO CHECK THAT THE LENS IS STILL IN PLACE AND LOOKING FOR
ABNORMAL SWELLING
If you haven’t yet joined a medical mission project,
I assure you --it will be a great experience and
a life-changing event. We welcome you to join
us in 2012!
Greg Hodgson
Director, Global Health Initiatives
EYE SURGERY TEAM
www.centuraglobalhealth.org
2
2
cure blindness through generalities and numbers. It is a struggle
one eye at a time.
Roosevelt was nervous. He walked
stiffly into the operating room on
Thursday, our last day of surgery.
Yet he was a bright faced 36-yearold, one of the youngest patients
we had seen all week. His eye was
a cloudy black, through which he
was only able to discern light and
a trace of hand movements in front of his face. His eye was not
unlike most the surgical team had seen and treated all week; however, most patients were 30 years older. He had sustained a traumatic injury as a child. He couldn’t remember the event, but his
mother had told him he was stung in the eye by a fire ant when he
was very young. The trauma led to the development of a cataract
that by age 12 completely obscured the vision in his left eye.
Cataract surgery in the United States is a quick and relatively
non-invasive procedure. Two small incisions allow the surgeon
access to the lens and cataract with the phaco machine, the
cataract is fragmented and removed, a new lens inserted and
unrolled, and the patient is done. A patient walks out after ten
minutes with no bandage, no sutures, and vision that is already
dramatically improved. In Iquitos, lacking
a phaco machine, surgeons Dr. Richard
Stewart and Dr. Tim Ammons resort to
ECCE procedures (Extra Capsular Cataract
Extraction with manual cortical removal, or
“Simcoe”), which requires the doctors to
make larger incisions, remove the lens
and cataract intact, insert a solid lens,
and then suture the incision closed.
In addition to the more difficult
procedure, the cataracts encountered
in Peru are much more developed,
further complicating the challenge of
each eye. An hour or an hour and a
half later, patients leave the operating
room with a patch and protective
cover over their eye and instructions
WALTER WENT FROM ONLY BEING
to return in the morning for their
ABLE TO SEE LIGHT IN HIS LEFT
post-op.
EYE TO HAVING VERY GOOD EYESIGHT THE NEXT DAY AND ABLE
Though his lens and cataract were
TO COUNT FINGERS FROM OVER
10 FEET AWAY. HE WAS PERHAPS
large and difficult to remove,
ONE OF THE MOST SUCCESSFUL
Roosevelt’s surgery went well. The
AND ONE OF THE HAPPIEST
PATIENTS WE SAW.
cataract stubbornly held its place in
the eye, and scarred fragments of the
lens adhered to the capsule. The surgery did all we could hope it
to do. There was a good chance the retina had also been damaged
during his injury, so although he was not seeing as clearly as we
hoped the next day, he could see more than he ever had since he
was 10. He explained he works construction in Iquitos, so the more
his left eye improves, the more he will be able to do for his job.
At the end of the week, the surgery team had operated on
57 different cataract cases, with all of them showing varying levels
of success. The team had really just hit its stride, but with all the
prescreened patients treated, the job was done for this trip. It was
frustrating for the team to have to stop for lack of patients when
the numbers show there are so many more in need. However,
that’s the nature of the problem; one can’t cure large numbers of
cataracts in a fell swoop as one might parasites or other maladies.
Cataracts are an individual problem requiring specific attention
for each case, and the only way to make an impact on the grand
number is to plug away, one case at a time. In the end, the team
was very successful, and all members look forward to another
opportunity to return to Iquitos and continue the work they
started this trip.
According to the World Health Organization Fact Sheet no.282, October 2011.
The Clinton Giustra Sustainable Growth Initiative has committed to deliver 50,000 cataract surgeries in Peru, and since the launch of the project in 2007,
they have helped complete thousands, including the ones done during our GHI mission to Iquitos.
1
2
3
Clubfoot Continued from page 1
of clubfoot just as severe as Emmanuel’s began to appear at the
orthopaedic clinic where we were working.
be corrected but through a more difficult surgical procedure
that requires patients to spend several months at the hospital.
I was part of a team of volunteers working at Mugonero Hospital
in Rwanda when I first met Emmanuel. The surgical team from
Centura Health was providing free orthopaedic surgery to
patients in the western region of the country. Orthopaedics has
been identified by Centura Global Health Initiatives (CGHI) as a
priority for Rwanda. Currently, there are no orthopaedic training
programs in Rwanda, and only six
surgeons perform orthopaedic
surgery for the entire country of
approximately 10 million people.
All six surgeons are located in the
capital city of Kigali.
CGHI has made a commitment to help children with clubfoot in Rwanda. Until now, funds raised through private
donations have enabled four children with severe clubfoot
to receive surgery at the Pediatric Orthopaedic Surgery
and Rehabilitation Center located in Rilima, southern
Rwanda. The Versacare Foundation recently made a
grant of $30,000 to CGHI,
which will enable 15 additional
children to receive surgery during
the next several months.
In addition to providing surgery, the
important task of training physicians
Clubfoot is a birth defect that occurs
and physical therapists to treat clubin about one in every l,000 births
foot soon after birth is a top priority
in this country. The foot generally
for CGHI. Initial training and supplies
turns inward and points downward,
have been given to some district
and it often appears the patient
hospitals in Rwanda through another
is walking on his or her ankle.
DR. PETER JANES, FROM ST. ANTHONY SUMMIT MEDICAL CENTER, HAS non-profit organization, but
Approximately 50 percent of
PERFORMED ORTHOPEDIC SURGERIES IN RWANDA IN 2010 AND 2011. Mugonero and many other hospitals
clubfoot cases are bilateral, and the
were not included. A $57,000 grant
condition occurs in males almost twice as often as in females.
made by Catholic Health Initiatives (CHI) to organize training
There are some genetic causes for clubfoot, but in general the
activities and provide instructional materials, casting supplies,
cause is unknown.
and braces will go a long way in supporting that goal. The grant
will be administered by the St. Anthony Summit Medical Center
Babies in the United States with clubfoot are normally treated
Health Foundation under the direction of orthopaedic surgeon
soon after birth when the tendons and ligaments are still very
Peter Janes and Foundation President Deb Edwards. Dr. Janes
flexible. The Ponseti method, developed by Dr. Ignacio Ponseti
traveled to Rwanda in 2010 and 2011 as part of the CGHI
of the University of Iowa, is a technique that has gained widemedical mission program and plans to return in 2012 to provide
spread acceptance around the world. The method involves
additional orthopaedic surgery and training to residents at the
manipulating the foot by stretching, serial casting, and/or use
University of Rwanda as well as training in the Ponseti method.
of braces. Clubfoot can often be corrected within two to six
months of treatment. The key to this method’s success is that
It is estimated that nearly 400 children with clubfoot are born
it starts in infancy.
in Rwanda each year. Additional funding is still required to
provide help for these children. Perhaps you or someone you
Unfortunately for Emmanuel and many other children in Rwanda,
know would like to help provide this life-changing surgery.
treatment for clubfoot was not available following birth. After
Costs average $1,500 per child; however, donations of any
living with this condition for several years, the deformity can still
amount are welcome and appreciated!
You can help.
Your tax-deductible donation to
Centura Global Health Initiatives can
help fund a life-changing surgery to
treat a congenital deformity known
as clubfoot in children and young
adults in Rwanda. The cost of
providing one surgery is approximately $1,500. Make your gift to
the “Step in a New Direction” fund
and change a life.
4
NAME
ADDRESS
EMAIL
CITY
STATE
Enclosed is my tax-deductible gift of:
❏ $1,500 ❏ $750 ❏ $500 ❏ $100
ZIP
PHONE
❏ $50 ❏ Other $_______
Please make checks payable to “Rwanda: Step in a New Direction”
To make a gift online, visit: www.centuraglobalhealth.org
and click on “Make a Donation.”
To send by mail: Centura Global Health Initiatives, 7995 E. Prentice Ave., Suite 204,
Greenwood Village, CO 80111
!
d
n
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b
a
s
e
i
r
o
t
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i
Success
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E ug
Alice
Emmanuel
Josienne
AWAITING SURGERY – LEFT TO RIGHT: ALEXIS (BOY, 2), ALPHONSE (BOY, 2), D’AMOUR (BOY, 14), ESPERANCE (GIRL, 2), ZACHEE (BOY, 12)
5
N E W S
:PLACES:
PERU
&
N O T E S
anesthesia along with former Medical
Director of Clinica Adventista Ana Stahl,
Dr. Daniel Huaman, who currently
works at Clinica Good Hope in Lima.
Derek Ortner
(Admin-LAH) provided administrative
support for the
team. A community
health team under
the leadership of
Nancy Griffith
ABOVE: LAH TEAM IN LORETO
RIGHT: DR. TORI KING WITH A YOUNG CLEFT
LIP PATIENT AT CLINICA ADVENTISTA ANA
STAHL IN IQUITOS
BELOW: TESSA MALMGREN LEADS OUT IN A
PRIMARY HEALTH EDUCATION SESSION WITH
THE KIDS IN THE SAN LUIS RIVER COMMUNITY.
A 32-member team sponsored by
Littleton Adventist Hospital traveled
to Iquitos the end of July. Two surgical
teams led by Drs. Victoria King
(ENT-STM) and Charles Giarratana
(OB/GYN-LAH) performed 31 surgeries
free of charge for the people of Loreto.
Dr. Oksana Bantley (SAH) provided
4
6
(RN-LAH) and Dr.
Marlana Mun-Yun
Li (SAN) saw 1,219
patients in five
villages during the
week, including one
hectic day in Belen.
Dr. Paul Bahlinger
(Colorado Springs)
also joined the team
to provide dental
services to the people of San Juan.
A large health education team under
the leadership of David Meza (AAH)
traveled to several river villages to
present a program in the elementary
schools about primary health.
In October, another team, this time
sponsored by Porter Adventist
Hospital, went to Peru to provide additional medical services. Dr. Timothy
Ammons (PAH), who went to Iquitos in
2010, returned to Peru along with team
leaders Dr. Richard Stewart (AAH) and
Diane Nelson (RN-PAH), to perform
57 cataract surgeries. The Community
Health Team, under the leadership of
Karen Aubrecht (RN-PAH) and Dr. Lisa
Hastie (SAN), saw 575 patients in the
river villages. Oz Muller (HR-PAH) provided overall leadership for the project.
During the week the Centura Health
team was in Iquitos in October, two
important milestones were celebrated.
Clinica Adventista Ana Stahl completed
85 years of service to the community of
Iquitos, and Centura Health and Clinica
Ana Stahl completed five years of
partnership in providing surgical and
primary health services to thousands of
people in the Region of Loreto. Various
community, military and political leaders
attended a celebration of these two
milestones, along with Gary and Barbara
Campbell (CEO-Centura Health),
Stephen King (Senior VP for Mission &
ANNIVERSARY CELEBRATION AT CLINICA ADVENTISTA ANA
STAHL – FROM LEFT TO RIGHT: STEPHEN KING, GREG
HODGSON, DR. ROBERTO LUNA VICTORIA, GARY CAMPBELL
N E W S
Ministry), and Greg
Hodgson (Director,
CGHI). Additional
guests from Colorado
included John
Brackney (CEO-South
Metro Denver
Chamber of
Commerce) and
Dr. Karen Gieseker
(University of
Colorado).
&
N O T E S
provided assistance
to the technicians at the
dental clinic at
Mugonero
Hospital. Kris
Ordelheide
(General CounselCentura Health)
and his family
also joined the
team, including
regular Todd Rapp
(PAH) to help in
several facility
improvements.
RWANDA
The largest Centura
Health team to date
traveled to Rwanda in TAYLOR FINN WITH
YOUNG GIRL AT
August. The surgical
THE L’ESPERANCE
team was led by
ORPHANAGE IN
Dr. Peter Janes
RWANDA
(SASMC). Several
team members, including Matt Cowell
(CRNA-SASMC), Patti Janes (RNSASMC), and Lynda Kithil (RNAAH/CGHI), also returned to Rwanda
after being there in 2010 as part of the
same team. Team leader Jeff Wagnaar
(Director of Physical Medicine- AAH)
helped to coordinate a Community
Health Team under the leadership of
Dr. Ken Finn (Colorado Springs) and a
team working at the nearby l’Esperance
Orphanage. Dr. Andy Ashby (dentist)
Following the week at Mugonero
Hospital, Peter & Patti Janes and Kay
Roth (SASMC) stayed in Kigali and
worked at CHUK (Central University
Hospital of Kigali). Dr. Janes worked
with the physicians and general surgery
residents from the University of Rwanda
School of Medicine in order to advance
their understanding of orthopaedic
surgery. During the entire time in Africa,
Dr. Janes performed 20 surgical cases.
Dr. David Schneider (AAH) also
performed 6 surgical cases with the staff
and residents at King Faisal Hospital in
Kigali during the same week. Both Drs.
Schneider and Janes, Centura-affiliated
orthopaedic
surgeons, were
in Kigali to help
train a future
generation of
surgeons in
Rwanda.
CENTURA HEALTH
TEAM OUTSIDE THE
SURGICAL BUILDING
AT THE CENTRAL
UNIVERSITY
HOSPITAL OF
KIGALI – FROM LEFT
TO RIGHT: KAY
ROTH, PETER JANES,
PATTI JANES
and is leading out as
CGHI’s Development
Officer. Dr. Paula
Enrietto, a volunteer
who has joined the
Centura Health team
working in Rwanda
:PEOPLE:
Two talented individuals recently joined
the staff of CGHI. Richard Laub started
working at the Rocky Mountain Adventist
Healthcare Foundation earlier this year
RICK LAUB
the last four
years, has joined
CGHI as the
Coordinator
of Board and
Academic
Affairs.
DR. PAULA ENRIETTO
How to submit: Send items of interest and high-res photos
to [email protected]. Submission deadline for
Spring 2012: January 31.
7
7995 E. Prentice Ave., Suite 204, Greenwood Village, CO 80111
Live the mission. Change a life. Change yourself.
MISSIONS & COMMUNITY HEALTH
Considerate Care
Community care in Peru includes
teaching kids to wash their hands.
Contact Information
Greg Hodgson, Director, Centura Global Health Initiatives
Office: 303-661-4138
Email: [email protected]
www.centuraglobalhealth.org
To make a donation
Rick Laub, Development Officer
Cell: 720-560-4764
Office: 303-715-7605
Email: [email protected]
2012 Centura Global Health Initiatives Projects
DATE
LOCATION
PROJECT
JAN. 4-16, 2012
Rwanda
Orthopaedic Surgery Team
FEB. 8-20, 2012
Nepal
GYN Surgery Team
Community Health Team
MAR. 16-26, 2012
Peru
CHI Group
ENT Surgery Team
Community Health Team
APR. 13-23, 2012
Peru
Avista Group
Orthopaedic Surgery Team
Community Health Team
JUNE 8-18, 2012
Peru
Littleton Group
General and GYN Surgery Teams
Community Health Team, Family Trip
JULY 25 AUG. 5, 2012
Rwanda
Orthopaedic Surgery Team
Family Trip
JULY 27 AUG. 6, 2012
Peru
Porter Group
Cataract and Orthopaedic Surgery Teams
Community Health Team, Family Trip
OCT. 3-15, 2012
Nepal
GYN Surgery Team
Community Health Team
OCT. 5-15, 2012
Peru
Parker Group
General Surgery Team
Community Health Team
Newsletter questions and comments
This newsletter is a publication of Centura Global Health Initiatives, a 501(c)(3) non-profit organization.
Anne Kemp, Editor
Phone: 303-775-7324 or email: [email protected]
To unsubscribe, please call Rhonda Cooperman at 303-715-7607.