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Bamako, Mali - Bonnie MacEvoy, anesthesiologist: This little boy came back for a dressing change, and it was determined that he had to come back for a cleaning and some repair under anesthesia. He had not eaten or had anything to drink, so he was ready to go. Unfortunately, a break in cases did not come for him for about five more hours. During this time, his father sat in the entryway with his son on his lap. His son fell asleep, and the man did not move, not taking a break or getting water.
A while later, after a few hours had passed and the little boy had wakened, the boy was sitting on the floor coloring and the father still waited. I offered to sit with the boy if the father would take a break and go for a walk to get a drink and a rest. He reluctantly agreed, saying the boy did not like to be with anyone else. I insisted, sat down with the crayons and the boy, and the father finally ambled off.
After about five minutes, the jig was up and the boy began to look around and started to cry. I tried and tried to distract him, make faces, and get him to smile, but only made things worse. Luckily, at about this time, Oumar walked in and saved the day. He scooped the boy up, swung him around, and made little noises that comforted the boy. As I caught this photo, Oumar looked askance at me as if to say, "How am I doing?" Great, Oumar, perfect.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: We have all noticed how stoic and brave these children are. They do not seem any less afraid than other children, and some do throw a total fit when we take them back (all done without sedation), but many others swallow their fear and hold it in, possibly betrayed only by a small tear, a trembling lip, or a shake. Imagine how it must feel to be taken away from one's family by people you have never met, can't understand, and all you may know is that something is going to be done that will probably hurt.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Looking closely at this child as he had his dressing changed, I noticed the buttonholes were tied with string. Can you imagine being too poor to afford buttons? We had one earlier during the first week with string on the belt loops of his pants; he had no belt
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: This little baby had amniotic bands, which constrict a limb from birth and prevent normal growth. Only a few months old, hopefully she can catch up on some of her growth and lose the swelling in the left foot. She was crying and fussing, so our coordinator Manon wrapped her up on her back like the locals do and the baby quieted right down. Nice and close!
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: A little girl was to have her hand fixed, and she was so cute. Many of the hand problems that we repair change a hand from non-functional to useful. Not all end up looking like a normal hand, but thumb function in opposition to the fingers and the grasping function of the fingers might be provided. Suddenly they have the potential to function with two hands, which may mean they can work, provide basic functions at home for themselves, and embrace their world.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: One day the phone rang and the lady at the desk said there was a man here to see me. I went downstairs to the lobby, and it was a patient from two years ago. He had a photo of him after his operation, and asked me about each care-giver in the photo. He had had his lip repaired by Roberto and was quite happy with the result. I think he had a tumor on his lip, was a professor of history, and a very sweet middle-aged man. Anyway, he got to see myself, Scott and Jacques, and I told him the rest of the team was not here this year. But we will let them know! It's always nice to be able to receive a patient's gratitude.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Congratulations to Dr. Oumar Coulibaly, Interplast's partner in training and his bride Massaran! They got married during the weekend between the two weeks we were performing surgery in Mali. He was kind enough to invite us to his wedding. Everyone at Interplast is very fond of Oumar and we wish him all the best in his marriage.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: These kids are amazing. They spend most of their early life wrapped close on their mothers' backs, and have such a close sense of personal space. When we hold them in our lap to breathe them to sleep, rather than kick, push away, or have a tantrum, they give in and lean into us much sooner and closer than I am used to back home. They wander all over the neighborhoods as soon as they can walk, and have large extended families that include neighbors and friends. Very different sense of trust and community. There really have been very few children who have fought us, and it humbles me to watch them be so stoic through this experience.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Verathon was kind enough to let us use a Glidescope Ranger. This is a very portable video scope that allows us to place tubes in people that otherwise might be too difficult to do. We have used it many times, but three times it proved to be critical. I think we all have used it now and are very thankful to have it.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist:
Our day was long, but many medical visitors came and went. We had several of the surgical trainees working with us. To see them learn and work side by side with like professionals who do not always speak the same language is gratifying. Everyone gets along, finds a way to communicate, and works together on the common goal of patient care.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: On our second day, a little boy wandered into the operating area and was giving out handshakes and hugs. He was not due to have surgery, just curious and friendly. His visit set us up for a great day.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: The last patient of the day was met by his mother, who appeared to have a sibling on her back. However, the baby on her back actually belonged to the mother of another patient. This woman was comforting the baby simply to help the other mother. It was such a loving thing to do, even though the two women had never met. Both had children who were post-operative, but this sweet lady took on the baby to give the other mother a break. It's nice to end a long and hard day of work with a scene like this.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: The recovery room nurses have adopted several nursing students to come and work and learn with them. These lucky students have two very capable and dedicated nurses to teach them. Here is Vickie at work, doing well with lecturing in French.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: What probably made today a relatively stressful day was the fact that clinics, (where we see patients to screen and schedule for surgery), were advertised as happening today as well as yesterday. So not only did we have to go through our list of mock emergencies and situations, gear up for our first cases, and work through the glitches, but we also had to run back and forth to another building to get these other expectant patients seen. One little boy could not be calmed but he let me put my hat on him. He still wasn't happy, but re-focused his energy from crying to problem-solving: "Who ARE these people?"
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: As the days go on, more of the local medical workers start to show up wanting to participate in the day's procedures. Today, we anesthesiologists got to meet two of our local colleagues and share some ideas about how we do things. Always very interesting for all parties involved.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Today was a long day for everyone. We started with an early breakfast and then made rounds to see a few more patients who might need procedures. Visiting the wards is always very colorful. The families practically move in⎯mats on the floor with cooking pots, covers and various items to care for thier sick family member. Sometimes we see them praying and paying respects. No need for nurse call buttons; plenty of advocates all around the bed.
Next we all made our way to the OR and met with the medical director of the hospital. He helps host us each year and expresses many thanks. As our team leader Dr. Steve Parker said, "Dr. Keita always welcomes us with his big arms."
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: To share all of this with such a capable team of dedicated, like-minded, interesting and delightful professionals is itself a gift. Where do they get these people?!! I always come home from these trips a bit changed, with more knowledge and experience learned from my colleagues. I also feel restored and appreciative of the work that we get to do.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: I would be remiss if I did not mention the adorable children and older patients. They come with such hope and high expectations and it is a privilege to be able to offer them some help. It is the least we can do in exchange for the humbling experience of knowing them and understanding their lives and struggles. They are incredibly brave to hand themselves over to total strangers from an alien culture. This simple element of trust is something that bridges many boundaries.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: To help bridge the linguistic divide, we have translators who translate between English to French, French to Bambara and back again. I did some translating and other than telling one patient to open his leg and another to give me his teeth, was able to make some headway.
I noticed that when Zacharia (one of the translators) went from French to Bambara, he retained the word "minuit" (midnight). I asked him if there was not a word in Bambara for midnight, and he said that before "outsiders" came, the locals only referred to early night (just after sunset), middle night (while sleeping), and end of night, (just before dawn). So they simply adopted the new word for the new concept of specific time. This gentleman is a local doctor and he also explained to me that after the third year of medical training, all training is conducted in French. There were no Bambara words to cover subjects at the end of training. He proudly said that he has been the first person in Mali to complete his medical training in Bambara, that he helped pioneer the necessary words and teachings to keep the local language alive in the medical profession.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Some of us went to tackle the task of building an OR suite from the ground up (except for the walls, which were already there) - recovery area, clinical office, supply room, sterile processing, cleaning and sink area, OR with tables, vaporizor manifolds, airway/IV/surgical supplies, suction, waste gas scavenge and record keeping. Interplast does a great job of imploding all these items into the boxes we bring and we must rehydrate them all to life.
Patients come from all over to be seen and hopefully selected for surgery. Some do not have a problem that is surgical (one girl had not spoken in her life), others cannot be safely done with the equipment we have and the time to do it in (extensive burn grafting) and yet others are not things we can deal with at all (club feet).
Patients are first seen by the surgeons: the senior staff, second attending and the Interplast Webster Fellow. Consideration is given first as to whether the case ought to be done at all (technically) and if so, a plan is devised. We also have along a nursing professor who is teaching local nurses and is in charge of dressing changes and wound care and a hand therapist extraordinaire who treats some post-operative patients and takes others for hand therapy only. One of our translators is a very organized engineer and keeps all our needs and details running smoothly. Everyone has his/her own niche and essential roles.
Those who are chosen to be scheduled are then funneled to the next room where they are seen by two nurses for hemoglobin, weight, height, vital signs, and photographs for identification on the day of surgery and then to the pediatrician and anesthesiologist for the final screen and clearance.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: First full day in Mali and as always we hold a clinic day.
We got up early for a group meeting before seeing patients and had breakfast in the dining room. I needed to ask for another blanket and some other things for our room. The night shift guy was asleep, or as they say, "on Mali time."
We all marched to the hospital, about two blocks away. We were met with a very loud and chaotic crowd, packed into two long hallways. Of course, if one child comes in to be seen, he or she arrives with his or her mother, siblings, uncle, grandfather, blankets and food for the day.
Bamako, Mali - Bonnie MacEvoy, anesthesiologist: I am at SFO now, waiting for my Air France flight to Paris. Everyone starts to show up about three hours early to load the 30 or so boxes of equipment and supplies, plus our own personal stuff. How will the plane get off the ground?!!
**UPDATE: Here's the photo of the man with his sister.** As our volunteer medical team headed home after two weeks in Dehradun, India, we in Mountain View, California (where Interplast is headquartered) received the following email from a patient’s brother. Reading his note made us all a little extra proud to be working at Interplast.
I've already met your team members here in Dehradun. In fact it was a chance meeting at the Dehradun Airport where I had gone to see some of my family members off to Kolkata. Because of the inclement weather, their flight was not being confirmed. And I was quite worked up since cancellation of the flight meant missing the connecting flight from Delhi to Kolkata. Many such weird thoughts were crossing my mind when I received a phone call from my sister who had also come to the airport and was sitting at the other end of the lounge, she wanted me to come over to her. On reaching there I found her talking to a gentleman. She introduced the gentleman to me as one Dr. Kush. In turn I also introduced myself. Dr Kush informed me that a team of specialists were reaching Dehradun just then and he was at the Airport to receive them. He told me that a camp was being organized by an NGO called Interplast. Seeing my sister with burn contractures on her neck and lower lip, Dr. Kush wanted me to bring her to the camp the following morning for a possible corrective surgery.
And thus began my introduction with Interplast. Today, I'm immensely pleased to tell you that my sister was operated upon last Thursday and has since been discharged from the hospital and is recuperating fast. I am really touched by the love and care with which they treated one and all alike without distinction.
I wish to place on record my profound sense of gratitude to the each and every member of the Interplast team for the love and care showered on one and all.
Thank You, Interplast!!
Dehradun, India - Nicole Friedland, Interplast chief development officer.
Big improvements for the patients and the team this year! Dr. Kush Aeron, Interplast's international partner in Dehradun, has arranged for the team to perform surgeries in the state hospital where he works. The chief minister of the state of Uttarakhand authorized the use after a recent meeting with Dr. Kush, Dr. Scott Corlew, Interplast chief medical officer and Susan Hayes, Interplast president and CEO.
Previously, surgeries have taken place at New Disha Hospital, a small two-bed clinic run by Dr. Kush and Dr. Yogi Aeron, Interplast surgical outreach director. We feel fortunate to stretch out in the safe and large space of this impressive hospital.
Dr. Kush and Dr. Yogi have done an amazing job of preparing for the team, as always.
Dehradun, India - Wai-Ling Eng, Ronald McDonald House Charities (RMHC) board member.
It was very gratifying to return to Dehradun, India and see the progress that has occurred since my visit last year. The two-bedroom house that used to be the surgical site is now the clinic where dressing changes and minor procedures are performed (a much better use for the space). The area provided by the state hospital is so much better—I can already see the possibilities of expanding this location for more work. The future of this program looks bright.
The people in this region have been relying on these services for years. Many of them have been returning yearly to have much needed work done; what would they do if we were not here? That's why I am proud that RMHC (Ronald McDonald House Charities) has been a consistent, multi-year supporter of this program that has impacted so many lives and in such significant ways.
It will be interesting to proceed to Nepal and see the possibilities there.
Dehradun, India-Nicole Friedland, Interplast chief development officer.
First-up for surgery this morning is Riya, an adorable little girl who fell into a pot of boiling water at the age of two. After the accident, Riya’s elbow began contracting, as most unattended burn wounds tend to do so. With the surgery provided by the Interplast team, Riya will have full use of her arm and hand. Both Riya and her mother were in happy moods this morning, seemingly not nervous at all about the surgery to come.
All scrubbed-up and ready to get to work, our medical volunteer team has begun its first day of operations in Dehradun.
Regional collaboration and partnerships are important aspects of how we work. Both Dr. Hien Thi Nguyen, anesthesiologist and Interplast’s surgical outreach director in Vietnam, and Dr. Shankar Man Rai, surgeon and surgical outreach director in Nepal, have joined the team to India. Additionally, Lekharaj Niroula, a hand therapist at the outreach center in Nepal, is participating on an Interplast volunteer team for the first time.
Some paced the hallways of San Francisco International Airport, just hours before their flight’s departure. Others intently discussed survival strategies for their upcoming 18-hour flight. Regardless of how they chose to pass the time between boarding and the plane’s departure, Interplast’s medical volunteers all shared the same excitement.
The team is headed to Dehradun, India, where they will work alongside their local medical colleagues to provide free reconstructive surgery to those in need. Accompanying the medical team are Emil Wang, Interplast board member, and Wai-Ling Eng, a board member of Ronald McDonald House Charities, a key partner and sponsor of Interplast’s work.
Through this blog, we will bring you updates on the team and stories of the patients they meet during their time there.
To our volunteers, thank you and have a safe flight!
Read stories from our 2009 Dehradun team trip here.
Visiting from Los Angeles, California, actress Micky Hoogen (Raising Helen) and former MTV VJ/serial entrepreneur Adam Curry, arrived at the Interplast office last week. After meeting the staff, Micky and Adam were given a behind-the-scenes tour of how Interplast is run.
As this year’s masters of ceremony for Interplast’s popular Transformations Gala, Micky and Adam came to discuss their role at the event and gain an in-depth understanding of Interplast’s work.
After a fruitful day of meetings and discussions, it was the staff’s turn to ask questions. Susan Hayes, Interplast president and CEO, asked, “Of all the worthy causes, Interplast’s included, you’ve chosen to support ours, why Interplast?“ Watch their response.
When she’s not busy working one of her two jobs---completing her medical school application and volunteering at Lucile Packard Children’s Hospital---Holly Cooper, Los Altos, California, spends her time (about 12 hours a week) interning with Interplast!
Holly recently received her master’s degree in biology from Stanford University. She told us that she has wanted to be a doctor for as long as she can remember, and hopes to begin medical school in August 2011.
After nearly fainting on her first day working at an out-patient surgical facility, Holly started to doubt if it was really the right profession for her. At that time, she took a brief detour into animal care, retail and research, but she returned to her original choice of medicine. “Soon I realized that the aspects of those jobs that I liked, the sense of accomplishment of working with my own hands, the joy of meeting and helping new people every day, and the constant quest for discovery and answers, all intersect in medicine,” Holly recalls.
Her compassionate nature and commitment to improving the world around her are the driving forces behind the time she spends volunteering. In the past, Holly has volunteered at the Palo Alto Junior Museum & Zoo and completed internships in dolphin acoustics at Southwest Fisheries Science Center and in animal care at the Monterey Bay Aquarium, Oakland Zoo, and US Navy Marine Mammal Program.
As Holly reflects on her decision to apply to medical school she shares, “I would like to feel as though I am bettering humanity and making an impact during my lifetime.”Today, we feel privileged to have her as part of our summer internship program. In the time Holly has spent with us, she has contributed greatly to the staff, our programs and most importantly to Interplast’s mission. We’d like to give a big thank you to Holly and to all our summer interns for helping, energizing and inspiring us.
Disabled people are the world’s largest minority. Today marks the 20th anniversary of the Americans with Disabilities Act. That law has improved the lives of the disabled in the United States and brought greater awareness to the issues they face. But more needs to be done here and in developing countries, where 80 percent of the world’s disabled live.At Interplast, we treat a hidden minority within the disabled community: those who have become needlessly disabled because of burn injuries. Few realize the scope and impact of disabling burn injuries in the developing world, but every 5 seconds someone is severely burned in a developing country---more than 6 million people annually. That is 1.5 times more than the number of women worldwide who are diagnosed with HIV/AIDS each year.
In 2009, the U.S. took a step toward advancing the rights of the disabled worldwide by signing of the U.N. Convention on the Rights of Persons with Disabilities. However, the task of actually improving these conditions is daunting. Moreover, before such measures will help the millions with debilitating burn injuries, burns first must be acknowledged as a neglected global health problem and a significant cause of disability in developing countries. Please help us spread the word. http://bit.ly/cxnEtAPhoto by John Urban.
“We are passionate about Interplast because of my step-mother’s commitment to the organization and because of how it helps so many children around the world,” continued Stephanie. “Asking guests to honor my parents and our celebration by donating to Interplast was a great way to give back---and it meant a lot to us to do it.”
Interplast is deeply grateful to the Bush-Pecci family for their support and generosity. We send them our best wishes for a wonderful life together. They were married on May 29, 2010 in Salt Lake City, Utah.Photo: (from left to right) Juan Pablo Pecci, Stephanie Bush, Steven Bush and Lori Bush, Interplast board member; by Jason + Anna Photography.
Interplast repaired Shu Zhi’s cleft lip and by doing so started a new chapter in her life, one that she never dreamed was possible.Recently, Shu Zhi asked her children, who, like so many others in rural China, have left their family’s small farm to work in the city, to send us a picture of her now. Sporting a beautiful new red shirt, she wanted to once again thank Interplast and to share her and her family’s happiness.
We here at Interplast hope that you can share in their happiness, too. Thank you for helping us give patients like Shu Zhi a second chance at life.
At the Miraflores Central Military Hospital in La Paz, Bolivia, our host surgeon Dr. Jorge Terrazas enthusiastically pointed to one of the many brightly colored posters he posted over the past month, advertising the free reconstructive hand surgery that our Interplast team will provide to both pediatric and adult patients. In preparation for this trip, Dr. Terrazas, who is an orthopedic trained hand surgeon, tirelessly screened over 700 patients prior to our arrival and selected more than 100 patients to be seen by our team. Interplast has successfully partnered with Dr. Terrazas for the past eight years in La Paz; together we have operated and taken care of hundreds of patients.
Today we set up shop at el Hospital Militar Central. Our host, Dr. Jorge Terrazas, is great. He not only prescreened 700 patients prior to our arrival, but he also facilitated setting up our operating site and getting local nurses, residents, and other hospital workers to help out. The clinic itself was captivating; there were so many people in need of correction of hand problems including congenital defects, burns, work-related injuries and accidents. Dr. Kyle Bickel, Dr. David Kim, and Dr. Joyce Chen along with Dr. Jorge Terrazas helped evaluate all patients to determine if an operation could improve function and form of their hands. Witnessing their collaboration with decision making was phenomenal. Everyone on the team was working hard. The pediatricians and anesthesiologists were thoroughly evaluating patients and the team nurses were setting up the quirófanos (ORs) and seeing patients as well. Given that we were starting up quirófanos from scratch, the anesthesiologists worked closely with the local physicians and nurses to ensure that we had everything we needed. Amazing day really, many patients in true need of help and great people working together to make it happen.
We arrived a day before beginning clinic day in La Paz, Bolivia. This place is breathtaking (literally at times); it has blue skies over a huge valley with amazing Mt. Illimani in the background. Everyone on the team feels well today. Besides the slight time change, most team members are worried about "soroche" or altitude sickness, considering last year’s team was significantly affected by it. Most of us are on Diamox (altitude medication) and some have tried “mate de coca” or coca tea, a local alternative. We walked around today to acclimate and went to see our operating site to evaluate and deliver our crates of equipment. Tomorrow is clinic day, where we evaluate potential patients and determine if we can help them during our trip and/or offer physical therapy.
Last week, 15 employees of Acclarent volunteered at Interplast headquarters. Acclarent is a business unit of Ethicon—and Ethicon is one of our major in-kind donors.
The employees prepared approximately 700 oral health speech therapy kits for our Nepal speech therapy program. (Speech therapy is often needed after surgery for repairing a cleft palate.) These kits include small items like tongue depressors and dental mirrors for the therapist to evaluate and work with patients to improve their speech, as well as toothbrushes and toothpaste for dental hygiene.
“Having the Acclarent volunteers in the office was fantastic,” said Teresa Olson, Interplast development coordinator. “Seeing Ethicon again lend it's strong support to our program—and the employees of Acclarent give up their time to help supply our Nepal speech therapy camps—was such an inspiration. I can't imagine how we could have made all of those kits without them…plus, they were a total blast!”
Interplast is grateful to the Acclarent volunteers and for Ethicon’s long-term and continuing support.