Thursday, September 27, 2007

Healing the Children

Our first day began bright and early at 7am. We arrived at the hospital, again by military escort, and came to see the entire courtyard filled with families, children, grandparents, anyone and everyone that could come to see the 'American Doctors'. By the end of the day, we had evaluated over 150 patients and selected 65 to perform restorative cleft palate procedures on. UNIMA had spread the word of our arrival to outlying villages through radio, flyers, and word of mouth. Each family spent great time, effort, and monies to reach us. One particular child, Anibal Jose, and his family were so desperate to seek our medical services, that they walked over two hours from their remote village to the nearest town, then travelled 7 hours by bus, only to manage making it to the hospital a whole day after all of the prospective surgical candidates had already been selected. Not only did his story warm our hearts, but also his cleft defect was very significant, so we had to add him onto our OR schedule.

The operative days have been long and gruelling--7am to 10 pm but very rewarding. Danilo is a high school student who has a severe cleft defect that has affected his speech. He is a very bright student, which has earned him high honors. However, his applications to local universities have been met with disdain--his speech impairment is viewed as a cognitive defect--admission deans see him as mentally slow and he is denied admission to every college in his town. Yet his ambition prevails. He vows that he will pursue his dream of higher education--and comes to us for surgical correction of his physically limiting cleft palate--to show the world that he will be able to speak normally, communicate effectively, and gain entrance into a premier university. Yesterday, on post-op rounds, the team is elated to see Danilo doing well and able to speak like he has never spoken before--he, his mother, and the surgeons exchange tears and hugs and hope for his future.

Santa Marta

The mountain ranges and the ocean--sheer beauty. The weather is a hot humid 90. Daily there have been brief mid-day tropical showers. And the people--wonderful, genuine, hospitable, and grateful.

Our hosts, UNIMA (United today for a healthier future) is a grassroots nonprofit organization that has spent months coordinating the local efforts in recruiting patients, getting the hospital and supplies ready, and funding our lodging and meals. UNIMA dates back to 12 years ago when a Floridian Heal the Children representative moved back to her local Santa Marta. She wanted to create an organization that would help sponsor foreign medical teams to provide care to her own people, and deliver care that was not accessible to local residents. Twelve years later, we are the sixth team that they have sponsored. We have not seen such a group of dedicated, hospitable, and altruistic women before.

The Journey

So, we've made it to Santa Marta, Colombia safe and sound. The Journey was not without its exciting moments: between Manoj leaving his wallet behind, delays at the George Washington Bridge, making it to the gate just before the doors were being closed, 2 medical emergencies on the plane (although one ended up just being a female passenger experiencing menstrual cramps), careful scrutiny of our belongings at customs in Bogota (after realizing our purpose for bringing a curious variety of items such as tongue blade depressors, clorox wipes, and anesthesia equipment, the airport personnel were very thankful that we came to help their people), 6 very loooonnnnggg hours there waiting for our connecting flight, and a military escort to our military barracks (well equipped with highly visible rifles), it was certainly a memorable trip here.

Wednesday, September 19, 2007

Angels along the way

Coming from a country where medical access is limited, this surgical mission means a lot to me. In very poor areas of the Philippines, children born with deformities are assumed to just live life the way they were born. There are no second chances. They are isolated and made fun of. I have always dreamed of doing something for kids like these. When asked to be a part of this mission, I said yes without hesitation. I knew that this would be my chance to give back to the world.

There have been some ups and downs getting us to this day but we made it. I would like to especially thank our nurse manager in Vassar Pediatrics, Sue Albertson, for her total support. Thanks Sue for your flexibility with our requests. I also would like to thank Apria Healthcare Inc. through Katie Rapp for donating nebulizers, Bill Brown for more nebulizers and some respiratory supplies, Ramona Trever for other supplies. For all the staff in Pediatrics who have helped us in so many ways. Our sincerest gratitude to our donors who have generously given financial support. Last but not the least, our families, for their love and sacrifice (taking care of the kids while we are gone). You are all instrumental in making this trip possible. From our hearts, thank you.

Sunday, September 16, 2007

Little helpers

Meds courtesy of Priti Shah at the Kingston Hospital Pharmacy.

The boxes were large enough to fit Minali (left) and Kiran (right)!

An overflowing bounty of supplies from New Century Medical Associates and some from TLC.

Kiran helping mom, Kavita, remove packaging from medications to get everything to fit into the suitcase.

Minali helping count :)

Packing Party

Those who could, gathered for a "packing party" at Debbie Fritz's house and also at Vassar Brothers Medical Center. Given the sheer volume of equipment, supplies and medications that we had gathered, and now needed to be carefully itemized and packed into individual suitcases, the task seemed daunting. Once again, I was impressed by the hard work, dedication and coordination of team members, as it all came together. Not only did we get the work done, but it was a great bonding experience - laughter and good conversation abounded as we looked forward to the upcoming trip.

There was barely any floor showing in Debbie's living room! It was a rainy Saturday evening, the perfect time for a packing party. Pictured above from left to right are Terri, Byron, Nick and Debbie.

Tamara (in the back) and Elaine meticulously inventorying medications.

Terri (at left) and Amy (Steve Nargiso's wife) sorting through sutures. Elaine is in the background.

Paul Fritz (Debbie's husband) did a fantastic job itemizing our master packing list, precisely noting where each item was packed.

Nick organizing anesthesia supplies - his help has been crucial.

The satisfaction of a late night, but a job well done! Kneeling in front, me and Debbie. Back row from left to right, Terri, Steve, Elaine, Tamara, Paul and Nick.

Debbie, Paul and their two lovely dogs, behind a sea of packed suitcases. Thanks again for hosting the event and letting us take over your house!

Late evening, packing after hours - team members have given up their weekends and stayed until late at night to make this happen. Bibi (back to wall), Mary (in the back), and Chicky (pointing) organizing supplies for the trip in the hallway outside of the Operating Room at Vassar Brothers Medical Center. Chicky has led the effort at Vassar.

Lee and Mary sorting through boxes stacked up high in the ladies locker room (anywhere space could be found to store supplies needed for the mission!)

Thank you for your generosity

I am always amazed by the generosity in peoples' hearts. From the moment I took on the responsibility of putting together this team, nearly everyone and anyone I have asked to help has responded without hesitation. There have been tons of obstacles, and times when it appeared there was no chance this mission was going to come together. But with everyone pitching in, perseverance, and faith, here we are! It is for this reason, I am grateful to have the opportunity to recognize those who have contributed to making this mission happen.

First, and foremost, the team members, who are donating their expertise, their time (both for the mission and the endless preparation), supplies, and paying their way. For many on the team, this is their first mission - I know the gratitude on the faces of the kids we help will be more then ample reward. Thanks for putting up with me and the never ending e-mails, phone calls and tasks! Please refer to my last post for the list of team members and a partial team photo - there will be lots more photos of the team during the mission.

The hardworking staff of Healing the Children all deserve recognition We could not have done without their contacts and organizing help. Specifically, I'd like to personally thank executive director Dana Buffin for negotiating through the changing dates and locations, and board member Steve Nargiso who graciously adjusted his schedule and volunteered to join our team at the last minute. I'd also like to thank Missy Law, Lisa Cohen, Phyllis Amdurer, and travel agent Ann St Hilaire for making arrangements and putting up with all the last minute changes.

In advance, I'd like to thank our hosts in Santa Marta, UNIMA under the direction of Cecilia Santos de Cely, and the Hospital Fernando Troconis. Our hosts are arranging local transportation, accommodations, and space in the hospital to screen, operate and recover patients. They have sent out word of our mission to the surrounding areas, and we are expecting more then a hundred patients.

Locally, I am indebted to those at the Vassar Brothers Medical Center and the Fishkill Ambulatory Surgery Center who have gone out of their way to facilitate this mission.

Dr. Daniel Aronzon, CEO of the Medical Center (pictured above with me at a recent fund raising event), has made an effort to champion humanitarian efforts, and this mission was no exception. Bill Silta, head of pharmacy (seen below with Gail Kennedy) has supported our effort to gather needed medications.

Greg Bishop, Paul Corish, and Joanne Ritschdorff of the Surgical Services at Vassar, and Nancy Fitzgibbons at the Fishkill Surgery Center, have been more then giving in allowing us to borrow needed surgical instruments, donating excess supplies and equipment, and adjusting staff schedules so that they can participate in the mission (Joanne and Paul are shown below). The same is true of the nurses on the Pediatric Floor.
Dr. Tim Dowd, head of North American Partners in Anesthesia, and Dr. Richard Goldmann, based at Vassar Brothers Medical Center, have been supportive of anesthetist Nick Schewtschenko's participation and efforts to gather much needed anesthesia supplies. Nick is pictured below, flanked on the left by Dr. Dowd and on the right by Dr. Goldmann.

Priti Shah, director of the pharmacy at Kingston Hospital, and inventory coordinator Deb Reed, came through again with much needed medications for another of my humanitarian missions. The physicians and staff in the Fishkill offices of New Century Medical Associates and TLC pediatrics also opened their hearts (see Kavita's post below). I would be remiss if I omitted the contribution of the staff at my office, especially Judy Fallon and Kathryn Alexander, who are true as ever

A few other notes:
-- Team member anesthesiologist Dr. Pat Escandon, originally from South America and a seasoned veteran of Healing the Children missions, has helped immeasurably by coordinating communication with our hosts in Colombia. In addition, team member nurse Terri Daly's good friend Alma Santana (who teaches Spanish) has helped me with translation of e-mails to and from Colombia.
-- My wife and team member, Dr. Kavita Aggarwal has arranged for a bus (I'm told its a big yellow school bus :) to transport us to the airport (we have to leave at 3:45AM), and bring us back (flight gets in to JFK just past midnight, and lots of us are working the next day!).
-- Roberta Green and Bess Rodgers at the Dutchess County Medical Society offered ready support by reaching out to all our local physician members for needed supplies and medications.
-- Anesthesiologist Dr. Basil Abeysekera of St. Francis Hospital was initially scheduled to go on this mission and provided me great assistance formulating the list of anesthesia supplies. However, with the change of dates for the mission, he is not able to go. Anesthesiologist Drs. Mike Simon and Matt Klein at Vassar and Kalpana Modi at St. Francis were likewise very interested in participating, but had scheduling conflicts. I am sure they will all join us on future missions.
-- Ray Norat of the Arlington Rotary Club made a sincere effort to arrange shipment of our medical supplies. However, given the late date, advance shipment was not possible, and the team will hand carry everything. Thanks for trying, Ray, and I would appreciate your help in the future.
-- I also have to thank my resident, Dr. Anand Patel, without whose help we would not have been able to locate the anesthesiologists needed for this trip

Finally, I would like to acknowledge Dr. Minas Constantinides and Ann Holton of the American Academy of Facial Plastic and Reconstructive Surgery for sanctioning this trip as a Face to Face medical mission Through them, I was introduced to Dr. Carlos Pedroza of the International Federation of Facial Plastic Surgery Societies, and have been in touch with Dr. Alba Betancort, a physician based in Santa Marta, who has graciously offered to provide her assistance and any necessary post operative care.

Manoj T. Abraham, M.D.

Behind the Scenes Team Support - by Debbie Fritz, R.N.

The planning and preparation stage for our mission involved months of effort and support from a large number of volunteers and recruits. When I originally asked Dr Abraham if he would be interested in doing a medical mission with HTNCE, I had no idea that he would take this idea and run with it- I was thinking as a team member, not a team leader! Organizing and leading a mission can be extremely fulfilling, but it is impossible to know the effort that goes into making this a reality. Helping Dr. Abraham to make this mission successful has been a long process of collecting, organizing and then begging for more supplies. We started actively collecting supplies and garnering support from our friends, coworkers and contacts many months in advance of our trip.

We began by contacting our supply representatives and asking if their companies donated to humanitarian missions and when we found these generous companies; we began asking for donations, and when required we went through the process of writing grant letters and proposals to these companies. Companies like Ethicon and their Medical Mission Program, who donated almost all of the suture we needed; and Schering-Plough Physician Asst. Program (Map International) who generously donated two large boxes of medications appropriate for our trip. Other companies like Cardinal Health who donated packs and drapes; Medtronic who donated surgical supplies for the heath care of patients; our 3M representative who gave us a book of supplies to look through and then provided everything we asked for.

Of course none of this would have been possible without the endless help and support of my coworkers, but most of all friends, at Fishkill Ambulatory Surgical Center. Many thanks to Ann Conboy, PACU Coordinator and Nancy Fitzgibbons, OR Coordinator for their flexibility and thoughtful help with my work schedule, helping to attain supplies, and allowing us to borrow surgical instruments. Ann is shown on the left below, and Nancy on the right.
Maureen Merchant, Head of CSP and Purchasing (seen on the right below) who would always make sure to ask the reps if they could donate any supplies towards our mission. Because of her efforts we procured many of the supplies needed for surgery. Debbie Vasquez (on the left), Anesthesia Tech, was instrumental for many of the anesthesia supplies attained through her contacts. And, Daisy Gotay of CSP (on the right above) and Dawn Marie Pries-Ogden, Perioperative Tech, (on the left) for all their time spent taping all instruments and sterilizing supplies. The children who’s lives that will be touched by our mission will only be meeting half of the team because the other half will still be at home, behind the scene. Thank you all from the bottom of my heart!

Debbie Fritz, R,N.

Thursday, September 13, 2007

Thank you for the prep work!

To Manoj, the team, and other contributors,
I'd like to say a giant Thank You for all that you have done thus far. Having been on such trips (to Ecuador, Nicaragua, and Panama) for plastic and cardiac surgery, I know how much time (and sweat!) goes into getting everything ready. The coordination factor is not minor. Thanks to those who donated funds. Thanks to those that packed. Thanks to those that got things together to pack. I'm sorry that I cannot be there with you to help with the preparations. I so look forward to meeting those of you that will be traveling to Santa Marta.
Be well!

Wednesday, September 12, 2007

New Century Medical Associates-Fishkill group comes together to help a good cause!

I want to thank the staff, nurses and my partners at New Century Medical Associates, Fishkill office for coming together not only as a team, but also as a family to help out with our upcoming mission to Colombia. I didn't even have to ask, and everyone lent a helping hand for such a good cause. Notably, Lisa Patterson, office manager, coordinated providing vaccinations at no charge to several of the volunteers. Thanks also to my partners including Dr. Jose Fontanez and Dr. Patricia Shannon for providing the funds for this donation! and nurses June Brown and Melania Fontanez for staying after-hours to administer these vaccines.

Melania and June also did a lot of leg work to collect medications and supplies from our office and pharmaceutical representatives. The front reception staff: Joanne Thyne, Janet Bernabe, and Amy Litcofsky, helped to get the word out to the pharmaceutical reps of our need of medications. The reps that donated medications included: Ellen Carr-Fenner of Schering-Plough, Lisa Marsella-Joyce of Sanofi-Aventis, Christine Honig of Glasko Smith Klein, Mare Falker-Corwin and Alan Allard of Astra Zeneca, Beth Toth of Tap Pharmaceuticals. Several nurses have even loaned or donated their own personal suitcases to pack ALL of the supplies in, including June, Melania, and Wendy Gerbes. Let's not forget our Physician's Assistant Dave Haldeman, nurses Wendy & June, and Dr. Shannon who purchased several 'must need' items, and PA Lorry Martin for the bags of suture sets. Melania's spanish translation services were really appreciated when corresponding back and forth with the Hospital Fernando Troconis.

I wanted to also give special mention to Michelle Stevens, Joanne Thyne, June Brown, and Lisa Patterson for getting the whole staff involved in getting together care packages for each and every team member--what a special, thoughtful, and beautiful gift! Each package had wooden bead bracelets from Bethlehem, symbolizing healing and spirituality, hand made earrings (made by Lisa's mother), bath and body works lotions, and loads of other necessities. Every NCMA staff member that contributed should know that your thoughtfulness is truly appreciated--the team loves them!!

Special note of thanks also to TLC Pediatrics physicians Dr. Parveh Borojeni and Dr. Christian Hietanan for their generous donation of medical supplies as well!!!

The Colombian children and their families will be very thankful for everyone's time, generosity, and caring. Thank you!

--Kavita Aggarwal, M.D.

List of Team Members, Team Meeting

Pictured at the team meeting on Monday (starting with back row):
Dr. Manoj Abraham - Facial Plastic Surgeon/Team Leader
Terri Daly - Nurse at St. Francis Hospital
Dr. Byron Fernandez - Pediatrician, Poughkeepsie Medical Group
Dr. Cliff Mihail - ENT Surgeon with the Mid-Hudson Medical Group
Debbie Fritz - Nurse, Fishkill Ambulatory Surgery Center/
Operating Room Supervisor
Steve Nargiso - Healing The Children Board Member/Administrator
Lee Gerspach - CT Nurse at Vassar Brothers Medical Center
Elaine Suderio-Tirone - Peds Nurse, Vassar Brothers Medical Center
Dr. Arthur Menken - ENT/Otolaryngologist
Dr. Kavita Aggarwal - Internist, New Century Medical Associates
Kiran Abraham-Aggarwal - Honorary Team Member
Mary Hayden - Recovery Nurse at Vassar Brothers Medical Center
Not Pictured
Nick Schewtschenko, RN - North American Partners in Anesthesia
Patricio Escandon, MD - Anesthesiologist from Yale
Veronica Swanson, MD - Pediatric Anesthesiologist from Oregon
Chikela Cody - OR Technician, Vassar Brothers Medical Center
Bibi Yasim - OR Nurse at Vassar Brothers Medical Center
Tamara Faublas-Joseph - Peds Nurse, Vassar Brothers Med Ctr
Joel Seligman - CEO N Westchester Hospital/Admin Training
Annabel Clark - Healing The Children Photographer

How This Began

Growing up in Sri Lanka and Nigeria, I have witnessed the worst in humanity. I became a Facial Plastic Surgeon to help heal. With my training and experience, I can restore function, enhance appearance, and turn back the clock. There is no greater sense of satisfaction then making people feel better about themselves.

Because of my experiences, I have been driven to give back and have been involved in several humanitarian efforts, including with the CRISP foundation led by Dr. Ronald Strahan at UCLA.

Earlier this year, Debbie Fritz, a nurse at the Fishkill Ambulatory Surgery Center asked me if I wanted to go on a mission with Healing The Children, a humanitarian organization run by her good friend Dana Buffin.

I jumped at the opportunity. Since so many of those in the local area had generously donated supplies and expressed interest in my previous trips, I offered to put together a team. We decided this would be an ENT/Facial Plastic Surgery mission, and picked the Hospital Fernando Troconis in Santa Marta, Colombia since a team has not visited in several years. Santa Marta is a large port city located on the coast of Colombia. It serves a large indigenous population, many of them with scant access to health care. On my previous trips, parents would often trek for days to reach us, hoping their children would get care.

Six months, three date and location changes, several hundred phone calls and e-mails later, we are finally on the verge of departing. Trying to juggle 20 team members with their own schedules and obligations, and who are voluntarily donating their time and paying their way is certainly no picnic (similar to herding cats, I've been told :) Soliciting all of the equipment, medications, and supplies needed for this type of surgical mission has also been a challenge (though I am once again overwhelmed by the generosity of those in our community - more on this later). Debbie and I are planing on popping a bottle of champagne when we get back from Santa Marta!

The best part will be providing care for hundreds of patients, mostly kids, who would otherwise go untreated. We will perform 50-60 surgical procedures, many of these cleft lip and palate repair - this congenital deformity makes it difficult to eat and to speak, and is terribly disfiguring leaving those afflicted ostracized from their community. A photograph of a child before and after surgical correction is shown below.