Medical Missions Foundation

October 23, 2009

Dave Brinkerhoff and I went to Benjie’s house to check on him today. I also wanted to see where he lived to learn more about him and his family. One of our post-op nurses, Ed Ayaquil, lives in Manila so he went with us to interpret in case we needed assistance. Benjie’s mom, Gina, met us at the hospital so she could navigate our way. They live just a couple of blocks off the coast about 20 miles from the Tagbilaran City.

Gina is 31 years old and was born just outside of Manila in a small town called Iloilo City. She and her husband, Sabino, met in Manila and have been married for nine years. Sabino was born in Tagbilaran City so they moved to town to take care of his parents. They live in a very small three room house that was built by his parents. His father passed away a couple of years ago so they still take care his ailing mother and their two children, Benjie, and his 3-year-old brother, Vincent.

Sabino had a job working as a fisherman until about four years ago. Because of the poor economic conditions in Tagbilaran City, he hasn’t had a job since then. As with most citizens of this community, they work for themselves fishing or farming. They either sell their goods to others in the neighborhood or they trade things in order to take care of their families. Gina and Sabino have a small row boat so they started their own fishing business. They earn about 350 pesos a day ($7.50 USD). Benjie is not too happy today - mostly because he’s hungry. Because he cannot yet hold food down, he is not allowed to eat anything but clear liquids. His mother tried to give him some chocolate milk when we were there, but that didn’t settle too well.

The good news is that he looked good! Benjie’s life will now change for the better. Until the surgery, he couldn’t eat normally. Gina explained to me the stages of how she used to have to feed him. Because of that and some other birth defects Benjie had, he was often sick. But what struck me as the most interesting part of our trip to their house is that even with the health concerns of their family, their economic situation and living conditions, they are basically happy. This is their life the way they know it. Their faith keeps them going every day. It was a pleasure to get to know our new friends. I look forward to coming back to see Benjie and his family on another mission some day.

Back at Ramiro Community Hospital, Dr. Milton Grin and his team were preparing to perform cataract surgery on brothers Jason and Jolbar, 5 and 7 years old. They had congenital cataracts in both eyes. Cataracts typically occurs as a result of aging. That’s why you mostly hear about elderly people needing surgery. When you see it in children, they are usually are born with it. Dr. Milton rarely sees bilateral cataracts in children and certainly this is the first time he’s seen it in two brothers so young.

Cataract comes from the Latin word "cataracta" meaning "waterfall.” The term is believed to  be used metaphorically to describe the clouding that develops in the eye - just as rapidly running water turns white. Cataracts develop from a variety of reasons, such as long-term exposure to ultraviolet (UV) light, exposure to radiation or secondary effects of high blood pressure or diabetes. It typically progresses slowly causing vision loss over time, but can be potentially blinding if untreated.

Jason and Jolbar could see when they were babies, but their sight has deteriorated over the past few years. With surgery, Dr. Milton was pretty confident he will be able to give them clear vision. In today’s procedure, Dr. Milton will remove the damaged “lenses” from their eyes with an instrument that vibrates 10,000 times a second to remove the old lens material. That, along with a high powered microscope and a steady hand, Dr. Milton can usually get each eye done in about 30 minutes or less. Both procedures went well and the boys woke up easily in recovery. Adults are typically are operated on only using a topical anesthetic. It’s more uncomfortable for children and they don’t sit still, so they are usually put to sleep. I know you’re waiting to hear what it was like for them when they took off their eye patches. We won’t know until tomorrow when they come back for their check-up. Stay tuned!

Many thanks to Dr. Grin and his team, Kristen Jones, Mona Warren, Sue Dahn, Marilyn Moyo and Jannette Marshall. This team had long days and some unexpected challenges that delayed getting started the first couple of days.

We were up early today as the mission teams got on their way. I started at Galleres Memorial so I could see Benjie before his surgery. The operating rooms at both hospitals took a little longer than planned to set-up because of several reasons, such as power failures and a last minute surgery that took priority. Just imagine the detail that goes into totally furnishing three operating rooms with all the necessary supplies, all  shipped from Kansas City from the Medical Missions Foundation. It requires months of planning and anticipating every need. (Some of these supplies are donated, but many times, must be purchased. There is also great expense incurred in shipping which is why fundraising is an on-going effort for the Foundation.)

Benjie’s surgery was a success! Dr. Cusick said he was a little tougher case because of the way his body had developed. For those of you who don’t know, cleft palates occur during pregnancy and is a condition in which the two plates of the skull that form the hard palate (the roof of the mouth) are not completely joined. The soft palate is “cleft” as well. In most cases, a cleft lip is also present. Cleft palate occurs in about one in 800 births in this region. Benjie surgery went well and his mother couldn’t be happier.

Cristina was next in line and her surgery also went very well. Thank you Dr. Cusick, Doug, Becky, Joyce, Marlene, Kay, Vonnie, Leila, Cora and Ed!

Each mission’s medical director has the task of putting together the surgical teams. That’s not easy considering everyone’s busy schedules at home, time off from their real jobs and trying to match-up the different skills needed. In most cases, these are new teams that might not have had the opportunity of working together before. I couldn’t believe how quickly everyone got along so well. It takes patience, understanding and, of course, big hearts. I’m very lucky to have made some great new friends!  Dr. Cusick’s plastic surgery team includes Doug Cowan, Becky Quesenberry, Joyce Sheehan and Vonnie Kane. Marlene Bailey is the team’s nurse anesthetist. The pre-and post-op nurses are Kay Johnston, Cora Zamora, Leila Busch and Ed Ayaquil.

The Medical Missions Foundation has been working with Galleres Memorial Hospital for several years now. We have a very good working relationship with them and our surgeons take every opportunity they can to help train their medical teams in order to help expand their capabilities. In 1997, MMF brought and left for them a Laparoscopic machine to be able to use for many surgeries that with it don’t require an invasive approach. These machines are very expensive and would unlikely be able to afford to get one themselves even now, twelve years later. Through donations MMF was able to give them the new scopes they needed for other operations. Chief of Surgery, Dr. Zaldy Boac was very grateful. I spent the rest of the day at Ramiro Community Hospital with Dr. Trudi and her team. Jerome had his surgery today and all went well. After his surgery his eyes were pretty red but Dr. Trudi said they would clear up after a couple of weeks. She added that surgeries like these are great for the kids and their families because you can see the positive results almost immediately.

Strabismus (also called cross-eyed or crossed eye) is a condition where the eyes are not able to properly align. Both eyes are not able to focus in the same direction, at the same point and at the same time. In most of the cases on this mission, these children we born this way. So, aside from the obvious cosmetic reasons to do these surgeries, it’s important to get to them as young as possible because if left untreated, the eye that is not aligned tells the brain to ignore what it sees.

Paul is another patient Dr. Grin operated on today. His surgery was a success and he’s coming back to see Dr. Grin for a follow-up visit on Wednesday. He and his mother were quite happy as they left the hospital in a taxi. Here in Bohol taxis are the way most everyone gets around. You can get just about anywhere for 25 pesos (50 cents)! Special thanks to Dr. TrudiGrin’s surgical team, headed by Phyliss VanHorn and the local Ramiro Hospital staff, Agnes, Gloria and our mission coo rdinator Cora’s nephew, Ryan, who lives here. Today had its challenges. There was a power failure during one of the procedures, but all went well thanks to the handy pen light Dr. Trudi had in her pocket.

As I mentioned on the first blog, I had been told many times about the Filipino culture and how friendly  everyone is here. Well, that’s an understatement. We’ve been treated like kings and queens by every person we’ve come in contact with – from the people at our hotel to the medical staff teams we work with at both hospitals. But mostly, the patients. The children are so sweet, brave and amazingly patient even after having to wait for hours to see our team. I was talking with another teammate about why, in general, these kids are so different from most of the kids in the U.S. Even with the conditions they have, their demeanors are peaceful and calm and they are very well behaved. Might make a good dinner conversation anyway... 

What a team!

Our mission teams spent the day getting ready for four days of surgery.  We are going to be working with patients at Gallares Memorial and Ramiro Community Hospitals.  We are also setting up a medical clinic in the large central courtyard of Tagbilaran’s city hall.  Everyone will be welcome.  Here, we’ll be checking vital signs, like their temperature and blood pressure.  We will also be checking their cholesterol and blood sugar levels.  And for those in need, MMF sent a lot of commonly used medications we’ll be giving away at the clinic.  We’ll also have an arts & crafts station set-up complete with crayons, markers, coloring books, stickers and other things to keep them busy while the families wait in the long lines.

  I’d like to tell you a little about the physicians on this mission.  

Dr. Trudi Grin is our Medical Director.  She and her husband, Dr. Milton Grin, are ophthalmologists in Olathe and Leawood.  Between the two of them, they’ve been on 16 MMF missions.  They will be running the eye team at Ramiro Hospital.  Dr. Trudi will be performing surgeries on children with eye misalignments (strabismus or crossed eyes).    Dr. Milton will be performing cataract surgeries.  The Foundation is so grateful to the Grins not only for the hundreds and hundreds of surgeries they’ve performed throughout the years, but for their leadership helping to guide the growth as MMF goes to other developing countries.  The Grins are amazing examples of the true meaning of giving back, and have the unique ability to teach others - like their three children.  By exposing them to this kind of mission work so young, it became second nature to them and part of their lives as adults.  Their daughter, Cara and their new son-in-law, Doug Cowan, is with us on this mission.  They met on an MMF mission in Romania several years ago.  Their oldest son, Ben, used his only vacation time this year for a mission trip on his own.   

 

Dr. Doug Cusick is our mission’s plastic surgeon.  Dr. Doug has a private practice in Leawood and this is his 21^th mission and 4^th time to the Philippines.  He and his wife, Barbara began going on missions even before he became a physician in 1982.  He and the plastic surgery team will be working at Galleras Memorial and primarily operating on children and young adults with cleft palates & lips and scar  deformities.  Dr. Cusick works in conjunction with the plastic surgery society and this is the second time we’ve been able to use grant money due to his relationship with Smile Train.  Dr. Cusick is a natural teacher and is actually using this mission as an opportunity to mentor Doug Cowan, who is in third year of his ENT residency at KU.  

Dr. John Hubbard is our mission’s anesthesiologist.  Dr. John practices at Truman Medical Center.   He has been on numerous MMF missions and he is the co-president of the Medical Missions Foundation board.  He is here with his wife, Cindy, who is a nurse anesthetist.  Together, they work as a team to make sure our patients are safely put to sleep for their procedures.   Today was also the day to screen all the surgery patients to make sure they are physically able to withstand the procedures and that our medical teams have all the necessary equipment to perform them successfully.   

Here are a few of today’s patient stories to share with you:  

Benjie was our favorite from the day at Galleres Memorial.  Aside from being adorable, he’s five years old and in real need of both cleft palate and lip repair.  He has other birth defects that he will struggle with so we’re hoping that the surgery Dr. Cusick will be performing on him will help give him an early start building his confidence by being able to speak clearly and smile brightly.   

Roy is 29 years old.  One of the tools that was used during his birth damaged one of his eyelids. Dr. Cusick will be repairing his eyelid.  Dave Brinkerhoff and I were talking with the administrator of the hospital today and she said one of the things they love about our mission is that we bring surgeons and surgical teams that do the types of procedures their doctors can’t perform.  And, they don’t have plastic surgeons in Bohol.  So Roy is very excited about getting Dr. Cusick’s help. 

Jerome is seven years old.  Just before his first birthday, his mother noticed his left eye crossing significantly.  I asked his mom what it’s been like for Jerome to live with his eye that way it is.  She put her hand on her heart and with an interpreter’s help, told me that it hurts her to see the other kids make fun of Jerome.  She is so excited to be able to give her son this gift.  

Cristina is 20 years old and as you can see, is in need of both a palate and lip repair.  I had the chance to talk quite a while with Cristina.  She’s a very sweet and polite girl, but you can tell how embarrassed she is to have had to live with her situation her whole life.  It’s a real joy to see how excited (and a little nervous) she is for her operation tomorrow.  Cristina also has two thumbs on her right hand.  Dr. Cusick offered to repair it, but she decided to leave it alone because ever since she was a little girl, her grandfather told her it was god’s way of giving her good luck.

I’ll give you updates on these surgeries later in the week!  

Tomorrow, the mission teams begin to change the lives of some very special people here in Bohol.  Each one has their own story, but what they all have in common is that they’ve had to live with their deformities in a society that is not much different than ours when it comes to how it makes them feel about themselves and what it does to their self confidence.  The difference is that they don’t have access to the medical care they need to fix it. 

A Warm Welcome

  We have good news!  We all got to Bohol safely and ready to make a difference here.  We were completely overwhelmed with the most amazing rock star arrival ceremony.  The mayor of Tagbilaran, Dan Lim had organized a welcome team of about 100 adults and children with banners, a band playing and with just about every kind of handmade necklaces you can imagine.  For some of us on our first mission, you can imagine how it gave us the sense of security we needed and the love the community has for this mission as we get started.

Here’s a little more information about Bohol.  Bohol is an island province of the Philippines located in the Central Visayas region, consisting of Bohol Island and 75 minor surrounding islands.  You can see many of  the smaller islands from the plane on our final approach.  Its capital is Tagbilaran City  - where we’ll be stationed.  With a land area is about  1,500 square miles with a coastline 162 miles long, Bohol is the tenth largest island of the Philippines.  Bohol is a popular tourist destination with many beach resorts.  The Chocolate Hills, numerous mounds of limestone formation, is the most popular attraction. The island of Panglao, located just southwest of Tagbilaran City, is famous for diving and is often listed as one of the top ten diving spots in the world.  We are hoping to be able to spend a little time in the water towards the end of the week.
Here are some other interesting facts about Bohol:

• The population of Bohol is 1.3 million.
• They have a high literacy rate – 93%.  They say it’s primarily because most of the children attend Catholic schools.
• The poverty incidence rate here is about 40%, higher than the national average.  The average family annual income is P57,000 (pesos -- approx. $1,200 USD)
• The average size of a household is 5.41, also higher than the national average.
• Temp right now – high’s in the low 90s, lows in high 70s – and humid, 66%
• Limestone tops their list of exported commodities, followed by rice, bananas, mangoes and cattle.

Last night’s welcome reception was spent on board a large covered river raft.  We were served traditional Filipino foods as we floated down Loboc River.  That was just the beginning.  After we finished dinner, we stopped at one of the “ports” on the side of the river and about 50 kids entertained us.  They danced, they played instruments and they sang songs -- with perfection.  Many of our mission team members took part in the performances. After we docked the raft, they took us to a local performance center, called the Bohol Children’s Palace.  A 45-piece middle school brass and rhythm band, the Youth Ambassadors, performed some great American classics for us and and their families.  It’s hard to describe this experience.  It was tough for all of us to hold back the tears seeing the enthusiasm these kids had wanting to play for us. It’s 9:00 am and we’re about to leave for Governor Celestino Gallares Memorial Hospital, Ramiro Community Hospital and Tagbilaran City Health Clinic. 

Today is going to be spent meeting with all the patients and their families and also setting up the operating rooms and clinics.  Recently, we found out that we qualified for a grant from an organization called The Smile Train.  Smile Train is an organization that provides funding for cleft lip & palate surgeries all over the world.  In order to receive the grant, it requires a great deal of documentation.  We’ll be doing that today as well. 

Philippines Mission: October 15 - 25, 2009

We’re on our way to the Philippines for the Medical Mission Foundation’s (MMF) 50^th medical mission – and the 12^th trip to the Philippines.  For the next ten days or so, I have the honor of being able to tell you all about what this amazing team of volunteers is going to be doing.

 

We just finished an eleven hour flight to Tokyo.  We’re about to board a 3-hour flight to Manila, stay the night there and then on to a one-hour flight to a small island in south central Philippines called Bohol.  Our medical teams will be working in two hospitals and one medical clinic in Tagbilaran City.   We have 27 volunteers on this mission, including Plastic Surgeons, Ear, Nose & Throat (ENT) specialists and Ophthalmologists.  They are planning to mostly perform surgeries on kids with cleft palates & lips, misalignment of the eyes for children and adults, cataracts and ENT procedures.  Our mission’s Medical Director is Dr. Trudi Grin and our mission Coordinator is Cora Zamora.  Cora was born in Bohol so we are very lucky to have her as our fearless leader.  Through Cora’s family and their friendships and the MMF’s past experiences in Bohol, we are looking forward to being received with open arms by the mayor of Tagbilaran City, Dan Lim (or as everyone calls him, Mayor Dan).  They are planning a welcome dinner at our hotel with entertainment.  As some of you might already know, the Filipino culture is known for its graciousness and hospitality.  Those with us that have been on previous missions here before cannot say enough good things about the wonderful people there.  So, for those of you wondering about our safely, thank you!  But please rest assured that we are in good hands.

 

In addition to the medical staff on this mission, we have community volunteers that will be so important to the success of this mission.  They will spend time organizing the many boxes of medical supplies that were shipped months ago.  We also packed hundreds of toys and beanie babies – and candy for the patients and their brothers and sisters.  A great deal of time is spent making sure the families feel like they are in a safe environment and that their child is getting the best care.  I’ll spend more time telling you about the families for sure.

 

I’ve only had a little time to spend with the others traveling with me, but it’s already so obvious why they are here…to make a real difference in the lives of these children – to be able to perform surgeries and other procedures that would never be done if it weren’t for the work of this mission.  I am very excited to be able to take part in this life changing experience.

 

We’re about to board our flight.  Stay tuned!

 

Post by Dan Nilsen