Saturday, February 1, 2003

2003 Epilogue: Ponce Gonzalez

This will be my last journal entry for the trip. I thought that I'd pull together some thoughts and fill in some holes here and there. First, I'm glad that I had a chance to experience the trip. I know that other vets have made the trip to come home again. Now I know why.

I'm glad that I was able to witness the good that the doctors of Mission Peace have done.

I am glad that I could sit down with a doctor and former VC and speak of our shared goal to help heal. I was glad to  hear him say, "I like Americans!" and genuinely mean it. He spoke of the war and the times that he had to take cover under his desk during the bombings and that he survived to complete medical school. He gave me a bear hug and laughed when I told him that I was never a good shot anyway. (Only something a vet would probably understand.)

I met a lot of neat people during my stay. Many people were curious enough to touch me and inquire where I was from. Now there's something that wouldn't happen in the States. The students at the high schools we visited were interested in what we did for a living, why we had come to Vietnam, and about our families. Questions we ask others when we meet them for the first time.

The staff at the hospital was happy to see the medical instruments, medicine, etc. that the doctors brought with them. They asked us if we could leave some of the instruments behind for their use, which we did.
I think that this is the fourth year that the doctors have made the trip to Vietnam. You can see the progress that has been made during that time. Not only have the doctors provided excellent care, they've also provided training and books to help the Vietnamese doctors.

The hotel staff for both the Can Tho and Saigon units took care of making us feel welcome. As I was boarding the bus to leave Can Tho, the head receptionist told me that the staff wanted me to know that they liked me very much and that I was very funny. (I think that this was a veiled reference to cyclo disaster I described one of my earlier journals.)  Two of the students from the high school for "gifted" students also came by to say goodbye. It's interesting that we'd only known them for such a short time, but I felt that I was leaving a bit of family behind.

In retrospect, I'm not really sure of all that I've learned.
  • I know that it reinforced my conviction that people are basically friendly and that they have the same day-to-day struggles that we have and they want the best for their kids too.
  • I've learned more about the doctors, nurses, and their commitment to help others.
  • I've learned that people can come together from other parts of the U.S. to focus their energy to teach hands-on and through lectures the latest techniques in physical therapy.
  • I've learned that one man's idea to help others that started out as conversation over beers can turn into reality.
 Which brings me to the conversation we had as we winged our way to Vietnam: He wondered if he could convert a  Boeing 747 into many operating rooms with even more doctors. . .   Hold on!

2003 Epilogue: Bruce Lehnert

Mission Peace 2003 was our smoothest and most successful mission to date. Vietnam is, at best, a difficult country with which to establish clear and efficient communication. The Mission Peace team has finally crossed that bridge with our Vietnamese counterparts. In fact, we did not have a translator the first three days, yet we managed to see more than 50 patients and operate on 8. I feel like our Vietnamese team members have become our brothers.

One of the highlights of the mission was seeing and examining patients who underwent operations in 2000 and 2002.  There is a certain anxiety about leaving people for whom we have performed major operations for one year. That anxiety builds until we see them the following year. Being less than an optimist I always assume the worst.

Every year, including this one,I have been more than pleased with the technical outcome of the procedures.Our complication rate has been amazingly low, and more important, the satisfaction of our patients has been high. Seeing people whose lives have changed because of our help is at the heart of practicing medicine. Some of our patients lived on the fringe of society because of their deformities. To see them walk without crutches and assume a new level of confidence and function is truly amazing. It is what keeps me coming back again and again.

As our skill level of treating the Mekong people develops, we have a better understanding of our patient’s cultural and physical needs. It has been professionally fulfilling to see our team grow in its breadth of skills and abilities. Our technical capacity has also grown due to the generous donations of power equipment and fixation devices. Because the MP team acquired more instrumentation we were able to run two operating rooms at the same time.

Another highlight of the mission was the addition of my fellowship mentor Dr. Meir Nyska. I have always looked to him as a source of inspiration and knowledge and regard him as my foot-and-ankle surgery mentor. It was special to have him see, first hand, how I have turned out and to work side by side with him again.

My wife joined us for a second tour of duty this year. Jenni has carved out a niche as our team's surgical nurse. She efficiently runs the operating room and irons out all the wrinkles that inevitably develop in any operating theater setting. I am proud that the team finds her invaluable.

In addition to Dr. Nyska and my wife, I had the benefit of another family member joining us this year--my Dad. Poppa, as he likes to be called, was a wonderful addition to our team. He was our backup man and in charge of taking surgical and clinical photographs, troubleshooting our equipment failures, and helping with the humanitarian portion of the mission. He was the one team member who was universally loved by all.

I am already thinking about MP2004. The more I go,  the more I want to go again.

Tuesday, January 28, 2003

Day 10: Our Last Day in Can Tho

After a nice breakfast of bananas, yogurt, and coffee, Steve and I met with the "Mom" of the street kids so that we could take them to the local market to buy them some new clothes for Tet. Somewhere we got an extra kid, but the more the merrier! She had them spruced up as much as she could for our morning excursion.

We loaded up on one of the "Cyclos" that are ubiquitous in Vietnam and headed for our shopping adventure. The kids knew exactly what they wanted and where to find it. Steve and I thought two shirts, two pair of pants, two pairs of shoes, and a backpack for each would do them fine. Can you believe that this set us back a whole US$30.00?

After getting the kids fixed up, we stopped for something cool to drink and the kids opened their bags and began to sort out whose stuff belonged to who. After all that was done we flagged down another Cyclo to head back to the hotel.

Traveling the streets of Can Tho in one of these Cyclos is a real treat. Everything was great until we turned into the hotel driveway as van was slowly pulling out. Since no one actually gives way here, the van and Cyclo came very close. The Cyclo driver made a sharp turn to get around the van and hit the curb just enough to make the trailer portion (read: passenger section) unstable.

There’s not much room in these things. I was sitting in the cab portion with our backpacks and a little girl on my lap. Steve and the two other kids were in the forward portion. We s-l-o-o-o-w-w-w-l-l-l-y-y tipped over. It seemed to me that it must have taken a long time because I could see my life flash before me. I thought of all the money I owed friends, the promises I made to quit having Snickers bars for lunch, and I wondered if God really did have a sense of humor.

I held on tightly to the little girl and took one for the team.

We all tumbled out on to the driveway. Almost instantly there were people all around shouting excitedly and offering various concoctions to dress our wounds. I can't wait to see us on the 11 o'clock news. This story will run in parallel to the great bus burnout when we arrived. Everybody was fine except for a few scrapes and bruises for Steve and me.  After all of this we took the kids to the barber for trims. This was a real experience, Steve got a haircut, beard trim, and a manicure; the Mama and two girls had perms, and the got boy a haircut – all for about US$10.

In the afternoon we had our debrief with the hospital staff to review what went well and where we wanted to improve.  Mostly it came down to communications (sound familiar?) and how to improve it so that the surgical teams can work smarter. We established additional lines of communications to get this started for next year. Tomorrow we're off to Saigon to meet up with the other part of our team. Tonight they're having a dinner for us and a little celebration to send us off.

I've had a great visit in Can Tho.

Thursday, January 23, 2003

Day 5: Ponce Gonzalez

One of the schools we visited was for "special students," or the best in the Mekong region. They spoke English very well and asked some tough questions. These kids are the generation that will make things happen.

We had a chance to share our story about helping the Vietnamese people by showing them a PhotoJam video about Mission Peace. This short video had pictures of the doctors and others doing their jobs of healing and showing them that even a few people can make a difference.

Today, we moved a little closer to that difference. This student (Hikki N) was the most vocal of the group. She reminded me of my daughters and I told her that she was my daughter in Vietnam. As you will see in her e-mail to me she has incredible insight for an 18-year-old kid.

Was my trip worth it? Yes it was . . .

Hikki N wrote:
Date: Wed, 22 Jan 2003 12:43:46 +0000 (GMT)
Subject: hey! it's me!
Hi Ponce Gonzalez!
Your daughter in Vietnam is here! So can you recognize me now? The first time you have come to Vietnam you put your first foot on the land of the Vietnamese with the feeling of confusion, but then you feeling has changed to much better, is it right? I'm quite sure that most Vietnamese are very friendly and hospitable. We now learn to forget our "yesterday" filled of great pain of loss in the war. We are now trying to build a better "tomorrow" where there are people holding hands and making this world as small as it is in your hand. My grandfather also died in a bombing by Americans, so my dad was an orphan when he was just 8 years old. He used to suffer from many difficulties. It's my great loss not to have a grandfather.
But time has erased the pain and it is okie now for all of us to hold hands in order to make a happy world with no revenge. You can close the door of your history from now on. Be happy and have good sleep every night!
Vo Hoan Nguyen

Day 5: Physical Therapy Team

We made it here safely and smoothly after a VERY LONNNNNNNNNGGGGGGGG trip. We have been very busy since the first day at the hospital. The children's hospital is much bigger than we expected. They have 850 or so inpatient beds and 2000-3000 patients come every single day as outpatients to see the doctors.

The rehab clinic is nice and has more things than we expected, but has no resources to get more things. They have been so excited about all of the "gifts" that we brought. We still do not know about the container with all of the large items. The shipper at home says it will arrive at the end of the week but the shipper here has another story. Please pray for us and them that we can get it when it does  arrive. The hospital had a container that sat at the airport for over six months before they got it. They have some OLD computers and printers. We will buy them a new printer and several cartridges. If a child needs a picture book to communicate, the family has to pay money for each picture. We still have money to spend to buy more things that the clinic cannot afford. We take so much for granted.

The PT and OT in my group presented on Cerebral Palsy yesterday. We totally revamped what we originally planned because of limited time. We have interpreters repeat each and every sentence. It is also difficult to convey some of the technical terms and philosophies, but we're managing. We have also been interpreting for each other to help each other find easier words ... we call it the "easy thesaurus". Several therapists came in from the provinces to also learn.

I presented today on feeding disorders in children with Cerebral Palsy. I think it went very well. They had me demonstrate treatment in the afternoon; it was very challenging to have 40 people watch you with a small child.

The children love us but are often not sure what to think. They also seem to not have seen many toys before and are mesmerized by something as simple as a popup toy or the donut stacker. I was treating a small baby who was very involved neurologically and he started to have a seizure during my session... a little scary but was okay. The children are beautiful and the parents sweet. Worried faces look the same in all cultures.
I think as people are finding out we are here, more are coming. So much to do, not enough time. Tomorrow we will present on autism. Psychology is a new field here and they are very interested in learning. I will probably treat more kids then.

We go to the orphanages in Can Tho and Vinh Tanh this weekend and then back to the hospital on Monday. I hope to work with many children and the therapists more 1:1 then. I feel like we have all helped in many ways, but know that there are a thousand more things we can do. (The temptation to keep coming back is very tempting…)

The heads of the hospital departments invited us to a TET party today at lunch. It started with them boiling LIVE shrimp in front of us. They looked like they were "dancing". IT WAS DELICIOUS. They taught us how to peel it -- and pull off the "legs" and all. Who knew I would ever be able to do that. It has been strange eating food that looks back at me. They leave EVERYTHING on. No eyes for me thanks.

The food kept on coming and coming at lunch. Fresh seafood RULES. I had a food coma from eating so much. I have realized I have to be careful what I eat because of the MSG. I have had two migraines already. It's a crapshoot knowing what food has MSG.

Next week I will get a tour of their natal unit. They are hoping to build a neonatal unit someday. Right now if a child weighs 1000 grams or less at birth, they do not try to help it because they don't have the resources to care for it. I sometimes wonder after seeing the severely premature kids at home that we "save" whether we have the right idea.I will also get a tour of the burn unit. They have about 30-40 children in it right now. Most of the burns are scald burns from the families having boiling water on the kitchen floors because their homes are so small. It was very sad the first day when we visited the ER. A young girl had been brought in with burns over 80% of her body and I believe she passed away as we were leaving. Eighty percent is severe at home. It was a very surreal experience to be in the ER like it was no big deal.

The ICU was next door. They don't have enough ventilators so families have to pump a breathing bag by hand, sometimes for several months. They have a craniofacial unit that I hope to work in a little bit next week. They see about 10,000 children with cleft lip and palate every year. They are not sure why, but believe it may be from chemicals from the war. Operation Smile, another organization, has visited but they need more help.

The families are like CNAs [certified nursing assistants] in United States hospitals. The families have to do all the daily care like washing, feeding, and cleaning the clothes and they never leave the child's side. Although they have so little in many ways they also have some fun things. In the outside "waiting" area there are vendors or cafes and toy stands. I guess like a gift shop. They have little jungle gyms and rides like they do in front of some grocery stores.

We have survived our long days by treating ourselves to a little shopping. For those of you who know me well, it is my natural "high." I have had four outfits made already. Souvenir shopping is also good. I may need my own shipping freight to get everything home.

We have been invited to one of the therapist’s homes for a day during Tet, which should be very exciting. There is so much to see and do. So far we have seen only the city (dirty and crowded) but hope to see the more traditional green Vietnam.

We have been busy as you can see. I average about four hours of sleep each night. We have a driver who picks us up each morning at 7:30 and brings us home at 4:30 or so. I figure I will adjust to the time change by the time we go home.

Thank you again to everybody for this opportunity. You will never know how much it means to the therapists and the children here.

It is actually very easy to find an Internet café. They are everywhere and very cheap. (And Dad, it's faster than your connection at home.)

Monday, January 20, 2003

Day 2: Unpacking & Organizing

Sheesh! 1:30 a.m. and the phone is ringing.

I am sleeping like a rock and it takes about 10 rings to wake me.

My mind finally lets me know that someone is speaking Vietnamese to me.

Still not quite sure where I am or who I am speaking to, I do my best to respond.

I finally realize it is Dr. Duong, one of the doctors at the hospital. After a couple of minutes my mind starts to clear and I realize he thought it would be a nice time to chat. I said a polite hello and we talked about tomorrow’s plans. I don’t remember much about the conversation. Morpheus had such a strong grip on me that I am surprised I could speak at all, let alone in Vietnamese.

I think we have the day set up. Maybe.

Up at 6 a.m. and breakfast at 7 a.m. The hotel puts on a very nice breakfast buffet like home, but a bit smaller. Everyone is fat, happy, and ready to start our first day at the hospital. The hospital had a van waiting to transport us right at 8:30 a.m. -- just the way we planned it last night (I think).

We had a short meeting with the Vice Director and the doctors began unpacking and organizing all the cartons of supplies we brought. They will have everything organized and be ready to start surgery tomorrow morning. This afternoon the doctors will check on some of last year's patients and see as many new surgery candidates as they can. Our turnout is expected to be a bit light: The Vietnamese don’t want to have a patient around the house during the Tet holiday. Kind of like being in the hospital during Christmas back home. Can’t blame them. We will see who turns out for examinations.

Cam Hoa, Ponce, and I are off to meet with our friend Philip Phuc at the local shipping company who has been helping us with our cargo container. I dashed out of the house in such a hurry on Friday night that I forgot the documents I need to receive the container. Philip let me use his computer and fax machine to contact our agent in America. I hope to have the paperwork by Wednesday. Stupid mistake on my part.

The doctors completed their setup and examined several of the last year's patients, all of whom are doing just fine.  One of the men they worked on last year needs some minor corrections. The doctors hope to take care of him while here. Barry and Annamarie made it to the hotel around 10:30 p.m., which was about 6 or 7 hours later than expected.  Not bad for Viet Nam.

Sunday, January 19, 2003

Day 1: We Have Arrived

Well, we made it! It wasn’t easy. Something always seems to go wrong no matter how well we try to plan and arrange our trip. First a big thank you to Merri, Larry, and Shel, too. Without your pickup truck and van we would never have been able to make it to the airport with all of our supplies.

We arrived at SFO a little later than planned. No problem, EVA was ready for us, as usual. We checked our personal luggage and proceeded to the VIP lounge and left the cargo for them to take care of. It was very nice of them to let us go and not wait around for them to check through all of the stuff. And, there was lots of stuff… 30 cartons in all.

We all retired to the lounge and spent the time there getting to know each other better. Great group this trip!

The flight to Taipei was uneventful and long, as usual. Most of us spent a good portion of the time sleeping. We landed in Taipe on time and began our two-hour layover. We got to the gate in time only to find that there was going to be a delay. We were delayed about an hour and a half. No big deal. The people waiting for us in Saigon would just have to be patient. We arrived in Saigon late as expected. The baggage game was a zoo as expected. We finally rounded up all of the luggage and cartons and proceeded, en masse, to the customs check out.

This is one of the times I worry about most on our trips. But, this time we had them! The hospital wrote a great letter for us to present at the customs desk. It took them about ten minutes to check the letter and get approval. We breezed right through. I was amazed!

Cam Hoa was there with a bus ready to take us to Can Tho and the hospital in Saigon was there with a van for our Physical Therapy Team. Minh Tu, our PT team's interpreter, was there to accompany the Team to their hotel and get them settled in. Barry and Annamarie went with the PT Team and will spend the night in Saigon and get the PT Team settled into the hospital tomorrow, then join us in Can Tho. Everything was going just great!  I should have known better…

Everything was going along just great! No snags, no hang ups… We were a bit tired, but spirits were high. We fought through the Saigon traffic and made it to the open road in good shape. Just a couple of more hours and we would be in Can Tho. Never had a trip gone so smoothly.

We took a short rest stop about a third of the way to Can Tho. Just time enough for a coke, ice cream, and personal breaks. Back on the road refreshed, we were on the final leg. About halfway to Can Tho, people in passing cars and trucks started waving frantically as they passed us. Finally the driver pulled over and a huge cloud of smoke overtook us. The driver opened the engine compartment and the smoke poured into the bus -- nothing like a lung full of burning oil! Damn, and we were almost there.

The driver took off back down the road looking for oil for the ailing bus. We knew the poor bus was ill, but we expected to be back on the road soon… Luckily, we pulled over near a café and spent our time waiting for the driver to return sipping a cold beer and joking about our minor delay. The driver returned in a few minutes with about five gallons of oil and transfused our ailing bus. He somehow got the bus restarted and we were again off toward Can Tho. Only 55 kilometers to go. We can make it easy!

About another 10 minutes down the road, we again had passing travelers waving and shouting at us like crazy. This time the throttle on the bus stuck and the engine went crazy. I think the bus was dying before our eyes. Again to the side of the road and again a lung full of smoke. This time it was serious. The patient was dying and we didn’t want go down with the ship. Stumbling and choking we poured off the bus and onto the roadside. Immediately a large crowd of people gathered to get in on the excitement. We looked back up the road and it was a sight to behold. We laid a smoke screen that couldn’t be believed. It looked like a forest fire was burning behind us. There was smoke as far as we could see. I amazed there wasn’t a 50-car pileup behind us!

I started getting nervous that all of our supplies and luggage would go up in smoke on the bus’s death pyre. Luckily there was no fire. The driver got on the phone and had another bus sent to take us on the rest of our journey. We must have made the six o’clock news! People came from everywhere to see what the crazy Americans were up to this time. I think we must have provided more excitement than they had in months. Glad we made someone happy…LOL.

Our relief bus arrived in pretty short order and we formed a bucket brigade to transfer all our baggage to the new transport. The drivers decided to tow the dead horse in with us. After being pounded in the behind by our dead friend several times and breaking two chains, we left the dead levitation floundering by the side of the road. Good riddance!

Finally, off again. Tired and about three hours late, we checked into our rooms. The Golf Hotel was ready for us and all were off to the comfort of their rooms in no time. I think our total travel time from SFO to Can Tho worked out to be something like 29 hours. Some of us went out for a quick meal while others just wanted to go to bed.
Tomorrow will be a better day, I hope.  At least we are laughing about our woes this trip.

Wednesday, January 1, 2003

Preparing for Our 2003 Trip

We are preparing for our upcoming trip to Viet Nam.

We packed a 20-foot container to the brim with supplies to support our mission. The container is on the way and should be waiting for us when we arrive in Viet Nam.

This trip our Physical Therapy team will be working with handicapped children at Children’s Hospital #1 in Saigon. Our team of Podiatrists will be again working in Can Tho. Joining our team in Can Tho this year is Dr. Meir Nyska from Israel, an orthopedic surgeon who be able to work on knee and hip problems that we may encounter. Dr. Nyska is an important and much-welcomed addition to the Mission Peace Team.

We will be throwing two super parties at the Hoa Mai Orphanages in Vi Thanh and Can Tho. We are planning to show the kids the time of their lives. Annamarie has reworked the pen pal program and we will be linking as many Vietnamese students as possible with students in America.

There is much, much more happening this trip. It will be our best yet.