Going the Distance for Women`s Health

VOLUME 2, SUMMER/FALL 2011
IMPROVING LIVES THROUGH MEDICAL MISSIONS
Going the Distance for Women’s Health
Medicine in
Motion: Make a
difference in your
community
BY CARLA CARWILE
Banepa, Nepal, sits high
in Asia’s Himalayas.
Mugonero, Rwanda,
nestles near placid
Lake Kivu in
central Africa.
BY DAVID EHRENBERGER, MD
Iquitos, Peru, is a
beyond-roads jungle
capital on the
Amazon River.
A triangle connecting the three
destinations would
stretch more than
22,000 miles,
which makes the
DRS CAROLE CHRISTENSEN AND LUNG HUYNH WORKING IN NEPAL
volunteer health
effort connecting
ond to Nepal. In terms of distance, the
them most remarkable and the care
two sites were 11 time zones apart. The
it’s providing the regions’ women
span was equally significant in terms of the
cause for celebration.
types of patient problems encountered.
Long Huynh, MD, and
Carole Christensen, MD
In August 2010, OB/GYN Long Huynh,
MD, made her first CGHI mission trip to
Peru. Six months later, she made her sec-
“At the clinic in Peru, we saw a high
incidence of uterine fibroid tumors that
required hysterectomies,” Dr. Huynh
explains. “The condition definitely runs
in families there, with women developing
Medicine in Motion, a volunteer
“clinic on wheels,” meant a lot to
Tony. As a father he found himself
and his family without housing and
in need of both shelter and medical
services. However, what was bothering him was not initially obvious
to the “CareVan” physician until
Tony lifted up his long beard—an
enormous goiter (large thyroid) had
been growing for several years and
LYNN EHRENBERGER (RIGHT) WITH PATIENT
Continued on page 4
Continued on page 2
TABLE OF CONTENTS
1
> Go the
Distance
Changing
lives around
the world
Medicine
in Motion
Right in our
own backyard
2
> Greg’s
Jungle
Notes
5
> You Can Help
Making a contribution keeps the
work going
6
> News & Notes
A birdseye view of
what’s going on
in each country
8
> Upcoming trips
Sign up today for
lifetime memories
Medicine in Motion Continued from page 1
was pressing on his trachea. The Medicine in Motion
team arranged for Tony to have his thyroid tumor
removed by ENT specialist, Dr. David Morrissey,
at Avista Adventist Hospital with anesthesia provided
by Dr. Darrell Nivens – all generously donated and at
no cost to Tony.
Jungle notes
And then there was Mike, a 14 year old with
persistent asthma who was awakening every night
with wheezing and trouble breathing. Amy Kinsey, a
Rwanda is well known for the 1994 genocide, but
few know of the tremendous progress the country
has made since then. Rwanda is now one of the
safest and cleanest countries in Africa. President
Paul Kagame has a vision to create a center of
commerce, education, telecommunications, and
healthcare…to become a new “Singapore” for
East Africa. These are worthwhile goals, and ones
that will help the country move forward. Yet, there
is such a long way to go! Once you leave the
hustle and bustle of the capital city Kigali, you
enter a largely rural environment where things
still haven’t changed very much. Normal citizens
AMY KINSEY, PA, AND PATIENT, MIKE
like you and me still face enormous challenges to
obtain a quality education, access professional
physician assistant working on the CareVan, responded quickly, getting him back on his steroid inhaler and
updating his immunizations, including the flu vaccine.
medical services,
or improve their
financial situation.
Several new
CGHI initiatives in
Photo by Greg Hodgson
Rwanda are featured in the News
& Notes section
found on pages
6 and 7 of this
newsletter. Check
YOUNG PATIENT AT MUGONERO
HOSPITAL IN RWANDA
them out, and, if possible, support these efforts
with a financial contribution. In these small but
important steps, we can help make a better future
for the people of Rwanda.
Volunteering at Medicine in Motion means a lot
to nursing coordinator Lynn Ehrenberger, RN, and
to Kathy Johannes, RN: "We enjoy our work and role
as nurses at Avista Hospital and were thrilled to learn
of the volunteer opportunity with the CareVan at
Growing Home. The families are committed to a
brighter future, and basic healthcare is an important
part of their needs."
Since 2008, volunteer nurses, medical assistants,
physicians and physician assistants, and non-medical
personnel have provided care for people of all ages,
ranging from infants to great-grandparents at a north
Denver homeless shelter for families called Growing
Home. With evening clinics twice a month, services
range from well child visits to care of chronic illnesses
and include free medications, lab studies, imaging
and vaccinations.
Greg Hodgson
Director, Global Health Initiatives
www.centuraglobalhealth.org
2
2
Growing Home, a Westminster-based organization led by
Kathleen Drozda, RN, provides a variety of support services to
families that are low income and/or homeless. These services
include subsidized and affordable housing, food and clothing,
a youth program, case management, financial assistance, and
a homelessness prevention program. Growing Home owns
a 20-unit apartment building (the Westchester Apartments) in
Westminster for both
permanent and “transformational” housing
and supportive services.
Rent is based on the
families’ income. In
collaboration with the
Adventist Community
Services Care Van, basic
healthcare services are
provided on a weekly
or biweekly basis.
At the heart of the
Medicine in Motion
program is the CareVan
clinic on wheels, a customized 34-foot long
THE COOL CAREVAN
Winnebago owned and
operated by Adventist Community Services (ACS) of Denver.
Under the leadership of Michael Bright, ACS donates medical
services to the homeless and the uninsured residents of
Colorado. The CareVan has medical supplies and pharmaceuticals provided by Porter and Avista Adventist Hospitals. There
are four blood pressure chairs and a waiting area toward the
front. An examination room is located in the rear of the vehicle
and includes a medical exam table, running water, pharmaceuticals, splints, an AED, and some basic diagnostic tests. Finally,
medications are dispensed from an extensive "on-van pharmacy"
and, through the Medicine in Motion electronic health record,
a wide variety of generics can be ordered and sent by secure
internet to our local pharmacy partner at Walmart in
Westminster. All medications are provided at no cost to
Growing Home patients.
A key commitment of our CareVan volunteer program is that
healthcare provided is not limited to the several hours we
are in clinic per week. The sophisticated Electronic Health
Record also allows providers to securely access care records
between visits for lab report notification, responding to patient
questions and for management of medication refills. If patients
require hospital-based services (e.g., lab work, imaging), these
services can be provided at Avista Adventist Hospital; furthermore, what fees remain after the hospital's Charity Care matrix
is applied, are covered by donated funds and grant monies
supporting the Medicine in Motion program. Women who are
pregnant and without an obstetric provider are referred to
Clinical Family Health Services' excellent prenatal care program.
Grant funding and other donations
have been generous to the Medicine
in Motion program and benefactors
have included the Avista Adventist
Hospital Foundation, the Denver Post's
Season to Share program (grants in
2009-2010 and in 2010-2011),
Adventist Community Services and the
Ronald McDonald House Charities.
As volunteer, Sheila Harrington, RN,
says, “No matter what your specialty,
your skills as a healthcare professional
CAREVAN COORDINATOR, RICHARD SOCIEWICZ
are invaluable, bringing basic yet vital primary care services to
those most in need…Medicine in Motion meets those needs at
Growing Home.”
3
Womens’ Health Continued from page 1
lapse and those seeking help from the
Nepal Women’s Health Initiative is striking,”
she explains. “Here, most women have far
fewer pregnancies, so the incidence is
much lower. And if it is a problem, most
can have it taken care of surgically before it
progresses to the severe state of the women
we’re seeing there. We operated on 18
women over the course of five days, and
many are waiting.”
huge masses—frequently the size of a four
or five-month pregnancy.” Extremely heavy
bleeding often accompanies the condition,
making severe anemia a related concern.
In Nepal, the majority of patients seen by
the women’s health team had come for
uterine prolapse correction. Recent surveys
suggest that from 10 to 43 percent of
reproductive-age women in Nepalese villages are affected, often with devastating
physical and social repercussions. (See sidebar: Nepal Women’s Health Initiative).
When their surgical schedule wraps, Dr.
Christiansen and her colleagues welcome
the opportunity to explore their exotic
surroundings. “Visiting Pokhara, trekking around Annapurna—
this allows me to see parts of the world I wouldn’t otherwise.
It’s a great opportunity.”
DR. LONG HUYNH WITH RECOVERING PATIENT
“Genetics can play a role in this condition,” Dr. Huynh continues, “but most often it is the result of
the harsh lifestyle Nepalese women endure. These women do
everything,” she adds, “walking for miles for water, constantly
working, having many pregnancies with virtually no chance for
their bodies to recover between.”
Providing the surgery that would change each woman’s life
so dramatically was “…one of the most rewarding experiences
I can imagine,” recaps Dr. Huynh. So was the opportunity to
serve as a role model for younger Nepalese women. “I’m
Asian,” she says. “For them to see a woman of color doing
things to help them have a better life, and to be able to share
this with their daughters, is a very good thing.”
Having the opportunity to work alongside Dr. Huynh was a
highlight of Dr. Carole Christensen’s most recent CGHI journey
to Nepal. Also an OB/GYN with close ties to Avista Hospital, Dr.
Christensen is a five-year mission veteran, having served in
Peru and
Rwanda, as
well.
“The contrast
between care
available to
women in the
United States
experiencing
uterine pro-
Michael Gavigan, MD
For Parker Adventist Hospital physician Michael Gavigan, MD,
a recent CGHI mission trip to Peru meant “…fulfilling a dream
20 years in the making. I lived in Mexico while going to college and have done some community development work in
Latin America, and I love the people. So being able to go as an
OB/GYN to Clinica Adventista Ana Stahl was great.
“Performing surgeries
there puts things in perspective. I do a lot of
robotic GYN surgery at
Parker, and it’s amazing.
But mission service is
going back to basics.
You don’t need all the
bells and whistles to
make a difference.”
More than 20 women
DR. GAVIGAN WITH DR. EULER PORTOCARRERO,
received much-needed
OB/GYN IN IQUITOS, PERU
surgical procedures—
ovarian cyst removals,
hysterectomies, pelvic prolapse correction and more—during
the five days Dr. Gavigan and his team were on site. He praises
his CGHI surgical colleagues: “Lynda Kithil, our scrub
nurse, and Mark Baller, our anesthetist, were fantastic.”
Is another mission trip on his horizon?
ABOVE: NEPALESE WOMEN
CARRYING HEAVY LOADS.
BELOW: DR. LONG HUYNH
WITH NEPALESE CHILDREN
“I definitely will do it again,” Dr. Gavigan responds.
“CGHI has designed this so it’s beneficial to those who
need the care most and to those of us who go as care
professionals. I think, with each trip, the process gets
more efficient.
“It gets better and better each time.”
4
NEPAL WOMEN’S
HEALTH
INITIATIVE
Working in partnership with
Scheer Memorial Hospital and
ADRA-Nepal, Centura Global
Health Initiatives has undertaken
an ambitious project: the Nepal
Women's Health Initiative. The
shared focus is to provide corrective surgery for women who suffer
from severe uterine prolapse, and
the need is great. According to
UN studies, an estimated 600,000
Nepalese women have uterine
prolapse, with 186,000 needing
surgical procedures. Poverty
causes many to suffer in silence,
seeking help only when symptoms
become so severe they risk losing
their families and lives.
Gretchen Heinrichs, MD
Photo by Lisa Marshall
It seems symbolic that Journeys caught up with Gretchen Heinrichs, MD, between
sessions of an international health conference on the East Coast. For while the OB/GYN
is based in Denver—serving on the faculty of the University of Colorado/Denver (UCD)
and practicing at Denver Health
Hospital—her commitment to improving world health regularly takes her
beyond Colorado’s borders.
UNIVERSITY OF COLORADO/DENVER ASSOCIATE PROFESSOR GRETCHEN HEINRICHS, MD, JOURNEYS TO RWANDA
TO HELP TRAIN MEDICAL RESIDENTS IN OB/GYN CARE.
DEVELOPING RWANDA’S NEXT GENERATION OF SKILLED
MEDICAL PROFESSIONALS IS A PRIORITY SHE SHARES WITH
CENTURA GLOBAL HEALTH INITIATIVES.
“My first experience was as a medical
student,” Heinrichs begins. “I traveled
to southern India with a small health
NGO (non-governmental organization)
and taught community health worker
nurses about women’s health,
everything from physical exam skills
to training on domestic violence
recognition and prevention.”
This is an expensive undertaking
That experience sparked more. During
for CGHI. Even though the medher residency, she traveled to Baja Sur,
ical teams volunteer their time
Mexico, where she worked with a family
and pay for their own expenses
planning NGO on breast and cervical
to travel to Nepal, there are still
cancer screening and domestic
the costs for screening patients in
violence. When she became part of the UCD faculty, she journeyed to
the villages, transporting women
Rwanda, where she taught Family Practice and OB/GYN
nization
lth Orga
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Thank you!
isks for w
health r
You can help.
Your tax-deductible donation to
Centura Global Health Initiatives can
help fund a life-changing surgery for a
Nepali woman. The cost of providing
one surgery is approximately $600.
Make your gift to the Nepal Women’s
Health Initiative Fund today and
change a life.
NAME
ADDRESS
EMAIL
CITY
STATE
Enclosed is my tax-deductible gift of:
❏ $1,200 ❏ $600 ❏ $300 ❏ $100
ZIP
PHONE
❏ $50 ❏ Other $_______
Please make checks payable to “Nepal Women’s Health Initiative.”
To make a gift online using American Express, Discover, Visa, and MasterCard:
visit www.centuraglobalhealth.org and click on “Make a Donation.”
To send by mail: International Medical Missions, 7995 E. Prentice Ave., Suite 204,
Greenwood Village, CO 80111
5
N E W S
:PLACES:
PERU
A medical team coming primarily from
Parker Adventist Hospital traveled to
Iquitos in April. A GYN surgical team led
by Dr. Michael Gavigan performed 18
cases at Clinica Adventista Ana Stahl,
while the community health team led by
Drs. Todd Mydler and Richard Anstett
saw 524 patients. Two Centura Health
OLINDA SPITZER WITH PATIENT IN PERU
associates from Colorado Springs,
Olinda Spitzer and Ashley Anderson,
joined the team from Penrose-St. Francis
Health Services. Jan Lovelady and
Debbie Bennett, representing the
Rotary Club of Denver Southeast, also
joined the team, and made arrangements
&
N O T E S
to create a clean
water system for
the village of
Gran Peru along
the Amazon River
in cooperation
with the Rotary
Club of Iquitos.
Dr. David
Ehrenberger, CMO
at Avista Adventist STUDENTS FROM THE UNIVERSITY OF COLORADO SPENT SEVERAL WEEKS IN PERU
THIS SUMMER. THEY CONDUCTED TRAINING SEMINARS IN PRIMARY HEALTHCARE
Hospital, led a
FOR THE VILLAGE PROMOTORES ON THE RIO NAPO.
large group to
Fourteen students from the University
Peru in June. The team consisted of a
surgery team, a community health team, of Colorado’s Anschutz Medical Campus
worked in the District of Mazan togethan education team, and a dental team.
er with mentor Dr. Richard Anstett.
Orthopedic surgeons Jordan Stoll and
The students came from the School of
Jim Pettey led the team at Clinica
Medicine,
School of Pharmacy and the
Adventista Ana Stahl, along with anesthesiologist Dr. Deepika Aluru, while Drs. Child Health Associate Physician’s
Assistant Program. Training seminars
Susan Robertson, Brad Fanestil, and
were organized for the promotores in
Richard Anstett led the primary healthvillages throughout the district and were
care clinics where 729 patients were
held in Mazan and Llachapa. Dr. Karen
seen. A group from LifeSource Adventist
Gieseker, who holds positions at the
Fellowship in south Denver, led by Gale
School of Medicine and the Center for
Hendrick and Peter Casillas, worked at a
dental clinic, participated in the commu- Global Health in the Colorado School of
Public Health at CU, also visited Iquitos
nity health and education teams, and
during
the CU and CGHI projects, looksponsored a project at the Jerusalem
ing at potential partnerships that could
School in Iquitos and a clean water
be developed for future projects.
project in the village of Llachapa on
the Rio Napo.
THE COMMUNITY HEALTH TEAM SETS UP A PRIMARY HEALTH CLINIC IN A PRIMARY SCHOOL ALONG THE AMAZON RIVER.
4
6
N E W S
&
N O T E S
RWANDA
A NEW WATER
DISTRIBUTION
SYSTEM UNDER
CONSTRUCTION IS BEING
SPONOSORED
BY THE ROTARY
CLUB OF
DENVER
SOUTHEAST
AND WILL
PROVIDE
GREATER
WATER
SECURITY FOR
MUGONERO
HOSPITAL.
A $30,000 grant was received from
the Versacare Foundation to sponsor
children in Rwanda who need surgery
to correct severe cases of club foot.
Donors to CGHI have already sponsored
four children for this type of surgery.
This new grant will provide funds for
another 15 children to receive this
life-changing surgery.
The CGHI Board, one of the sponsors of
Centura Health, approved a $57,000
grant to provide training and supplies in
an effort to correct club feet in newborns through serial casting. These
training events will be held in Rwanda
and will include surgical and family
practice residents from the University of
Rwanda along with physical therapists
located at district hospitals throughout
the country.
Construction began on improvements
to the water distribution system at
Mugonero Hospital in western Rwanda.
This project will help to provide better
water security for the hospital, as well as
replacing old and leaking pipes, which
distribute water to buildings throughout
the facility. The Rotary
Club of Denver Southeast
sponsored this project and
plans to raise additional
funds this fall through their
Race Across
Africa, which will
enable further
improvements
in 2012.
ALICE IS THE FOURTH
CHILD IN RWANDA
WHO HAS BEEN
SPONSORED BY CGHI TO RECEIVE CORRECTIVE SURGERY FOR
CLUB FEET. NOW ABLE TO WEAR SHOES, ALICE AND HER
FRIENDS ARE BEING TREATED AT THE RILIMA ORTHOPEDIC
HOSPITAL IN SOUTHERN RWANDA.
been in need of improvements for many
years. Construction of a new laundry
facility began in June, thanks to generous donations from CGHI supporters
who are interested in improving the
sanitary conditions for patients and
employees of the hospital.
The laundry facilities at Mugonero
Hospital have
How to submit: Send items of interest and high-res photos
to [email protected]. Submission deadline for
Winter 2011: September 31.
FINANCIAL SPONSORS TO CGHI HAVE
ENABLED THE CONSTRUCTION OF A
NEW LAUNDRY FACILITY AT
MUGONERO HOSPITAL.
We are grateful for the
continued contributions
of these companies:
Ethicon Suture
Plaza Medical
Covidien/ValleyLab
Neomedic, Inc.
7
7995 E. Prentice Ave., Suite 204, Greenwood Village, CO 80111
Live the mission. Change a life. Change yourself.
2011/2012 Global Health Initiative Projects
MISSIONS & COMMUNITY HEALTH
Compassionate Care
Dr. Susan Robertson with
patient in Peru
Contact Information
Greg Hodgson, Director, Centura Global Health Initiatives
Phone: 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]
DATE
LOCATION
PROJECT
OCT. 7-17, 2011
Peru
Porter Group
Cataract Surgery Team
Community Health Team
NOV. 2-13, 2011
Nepal
GYN Surgery Team
Community Health Team
JAN. 4-16, 2012
Rwanda
Orthopedic Surgery Team
FEB. 8-20, 2012
Nepal
GYN Surgery Team
Community Health Team
APRIL 13-20, 2012
Peru
Avista Group
Orthopedic 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
Orthopedic Surgery Team
Family Trip
JULY 27 - AUG. 6, 2012
Peru
Porter Group
Cataract and Orthopedic 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.