Wednesday, November 25, 2015

Next Stop, Namibia!

It's official. We're in the planning stages of our next mission trip: We'll spend two weeks in Namibia in August 2016.

We're assembling the team, arranging flights, and starting all of the preparation work that a mission involves. August sounds like the distant future -- until you dig into the pre-mission task list.

IEP did an exploratory mission to Namibia in 2012 with a small team of four medical staff. The group worked in the capital city of Windhoek to serve patients while assessing the needs and resources available for future missions. In that trip, the IEP team operated on 18 patients, most with complex foot and ankle deformities. Of the 18 patients, 10 required procedures on both feet.

In addition to the medical care, the team provided educational seminars with the Namibia Medical Society and donated power equipment and bone-fixation devices to the Namibian Ministry of Health.

We're looking forward to returning. This time, we'll have a larger team and spend more time in Namibia, allowing us to greatly increase the number of patients we serve.

It's your support that allows us to build upon our previous missions to help more people.

Wednesday, August 19, 2015

Our 2015 Supporters

The International Extremity Project is grateful for the generosity of the companies, organizations, and individuals that help us to make a difference to the people of Vietnam. Whether through donations of equipment, funding, or other support, these organizations are vital to the success of our missions.

Learn more about these generous organizations on our Supporters page.

Bako Pathology
DARCO International
Footwear Etc.
Hanger, Inc.
Project C.U.R.E.
Rocket Fuel
Santa Clara Valley Podiatric Medical Society

Monday, August 10, 2015

2015 Mission Video: Telling Our Story

It's hard to explain all the sights, sounds, and feelings that you encounter as part of a medical mission. We can use our cameras try to show what we see, but the pictures are never enough. We can write to share our experiences, but our words can never convey the whole of it -- the feelings, emotions, realizations, and all the things that happen in our hearts and minds.

Flecher always manages to bring everything together in the way he tells the story in video. Here's the story of our 2015 mission to Can Tho, Vietnam.

The first time I saw the video, it brought back so many of those feelings of being part of this organization and these trips. I'll admit, I got teary eyed especially about one moment in particular -- one of my favorite of the 2015 trip. I didn't remember Flech being in the operating room when I was interacting with one of the kids. This little guy always had the biggest smile for me whenever I saw him. As they were prepping him, I kept him distracted and amused. It turned out to be a really special moment and it was amazing to see it through Flech's lens.

Thank you for your continued support of IEP! Please share the video to help us tell our story and make a difference.

Sunday, June 28, 2015

Post-Mission Perspective from a Resident Podiatrist

Anna Moore joined the IEP team for the 2015 mission as one of the resident surgeons. Here's her perspective on the experience in Vietnam.

Anna Moore, DPM, at work in the operating room.
Two months ago, I joined the IEP team on the trip of a lifetime to Can Tho, Vietnam. 

IEP facilitates the connection between people who are unable to get the care they need with the hospital and doctors who can provide this to them. The two wonderful weeks I spent working as a resident surgeon with the IEP team and interacting with and caring for the Vietnamese people left me overwhelmed with feelings of awe and gratitude.

It is easy to get caught up in the world right in front of our eyes, but my time in Vietnam broadened my perspective and has made me fall in love with my profession all over again. I gained both a greater appreciation for the world of medicine and for the diversity of patients. 

Monday, May 11, 2015

Personal Perspective on a Medical Mission

I'm not a doctor, a nurse, or any sort of medical professional. Yet, I spent two weeks in full surgical scrubs in a Vietnam hospital, managing patient data, assisting in the operating room, and otherwise doing what's needed on a medical mission with the International Extremity Project. It's physically and emotionally exhausting, the heat and humidity are powerful, and I enjoy every minute of it. 

Until my first IEP mission two years ago, my medical expertise was typically that of a patient -- or a parent's mom. Truth be told, one of the circumstances that got me there is the fact that I'm a klutz. I started working on the IEP website after seeing a photo on my podiatrist's wall. Then in 2012, the team invited me to join a mission trip 
to Vietnam's Mekong Delta to work at Can Tho Central General Hospital.

It's hard to explain the experience because there are so many dimensions to being there. As soon as we landed in Ho Chi Minh City this time, everything felt familiar to me, only better. (Probably because the flights were much smoother and I didn't spend my first several hours in Vietnam throwing up...)

Monday, May 4, 2015

Inspiration for a Future Doctor

Mai, Melissa, and Madison outside the operating room in Can Tho.
Melissa Lipari, who is preparing to attend medical school, joined the IEP team to learn more about a career in medicine. It turns out she's very comfortable in surgical scrubs.

This was my first trip with IEP on their mission to Vietnam. It was also my first excursion to a developing nation. The experience has changed my perspective on life in so many ways.

As an aspiring Orthopedist, I went on this medical mission to confirm my fascination with medicine and my devotion to becoming a doctor. I also wanted to help this amazing organization by raising money for a good cause and contributing a helping hand in the hospital.

The trip was an emotional roller-coaster. The first two days of patient screening were the most emotionally taxing. Tears were shed by both the IEP team and the patients. It was disheartening to look at a full line of people desperately hoping to qualify for surgery and know that we wouldn’t be able to help them all.

Wednesday, April 29, 2015

Q&A with Wing Ip, DPM

This year's mission to Vietnam was Dr. Wing Ip's second with International Extremity Project. As a returning member of the medical team, she had valuable experience from her the 2013 mission. (On a project like this, "valuable experience" translates to "more responsibility.") In addition to evaluating patients for surgery, performing surgeries, and following up with post-surgical patients, she managed the daily surgical schedule and helped to mentor the surgical residents on the team.

Drs. Spanko and Ip work in surgery with
one of the Can Tho Central General
Hospital's orthopedic team members.

Why is participating in a mission like this important to you? People have different ways of giving back to the community, either locally or globally. Some people donate to charities. Others donate their time through volunteerism. But for me, I want to give back by sharing the skills that I have obtained through residency and medical school.

IEP is especially important to me as we all have to work as a team regardless of our roles. No amount of hubris can treat our patients, who have extremely complicated deformities. If anything, this mission demands humility as we need to understand our patients needs in order to provide them with the best care.

How has participating in missions with IEP affected your life/world view?

Wednesday, April 8, 2015

Day 9: 5th Day of Surgeries in Can Tho

complete tibial agenesisThe biggest case of the day was also one of the biggest cases of the mission. The kids are always important because the earlier the medical team can treat their deformities, the more chances they have to be independent, go to school, and grow up with fewer physical challenges to face along the way.

This little girl had complete tibial agenesis, a major deformity of her right knee and ankle joints. She hopped everywhere instead of walking. She is bright, cheerful, and was hoping for a solution that would let her go to school. When she tried, the school sent her home because her deformity was considered a distraction to the other children and too much for the school to manage.

The word amputation is jarring, but this was the solution for this little girl. Dr. Nyska explained that this would bring her to normal. She had no tibia or patella, only a fibula, and her foot was essentially completely upside down from the ankle. Because of the missing bones, it wasn't possible to repair what was there. Instead, they needed to remove her lower leg to allow her to use a prosthesis.

Thursday, April 2, 2015

Day 8: Fourth Day of Surgeries in Can Tho

In 2010, this young man was in a wheelchair
and needed his parents' assistance for nearly
everything. Today, he not only walks -- he runs.
Monday morning brought us back to Can Tho Central General hospital and our patients. It's amazing how quickly the days at the hospital become routine and comfortable despite how different everything is from our lives at home. 

As we start the second week in the operating rooms, our medical team and the local teams have worked with one another in the surgeries, the support teams have figured out their roles, and things run very smoothly. In the second week, our daily surgical cases also increase in number. Instead of six patients a day, we may see seven or eight.

A big bonus of this week is that we have visitors. On Monday, three previous patients came back to Can Tho Central General Hospital to visit and thank the medical team. It's humbling and satisfying to see how patients have responded to the surgery and, in many cases, hear their stories about how IEP's work has changed their lives. More specifics and stories about our return patients in future posts. So much happens that it's hard to keep up with posting (especially with the lack of wireless at the hospital).

Tuesday, March 31, 2015

Flecher's Perspective on Making a Difference

Flecher Fleudujon in the operating room at
Can Tho Central General Hospital.
Flecher has been working with IEP for ten years as our videographer, but he's much more than the guy behind the camera. He's one of the people who keeps coming back to make a difference -- and because of what this experience brings into his life.
He says it much better than I can...

If ten years ago you asked me if I would ever work in a hospital operating room, let alone one in Vietnam, I would have laughed and thought you were kidding. I'm now on my fifth medical mission with the IEP team and spending full days in the O.R. has become second nature. I can even use some surgical terminology. 

I'm the IEP team videographer. I have made a full documentary about IEP as well as numerous shorter videos for the web that not only showcase the incredible transformations that some of our patients experience, but follow the journey that the team endures to make an IEP medical mission happen. 

Looking Back at Week 1 of Our Mission in Vietnam

Stacy Lerner evaluating a pediatric candidate
during screening.
We screened 106 patients in our first two days of our medical mission here in Can Tho. Two years ago, during our 2013 mission, we screened 80 in the same amount of time. The numbers increase each trip as more people hear about us and the hospital advertises the dates we'll be here. The hospital serves the Mekong region of Vietnam, far beyond Can Tho itself. People travel from significant distances. We have a slightly bigger team with us for this mission, but it's always overwhelming to see so many people who have hopes that the IEP team can help them. 

I spend the screening days starting charts with the initial information from the patients or their families. The language barrier definitely adds challenges, but our interpreters help quite a bit. It's very hard to get the patients to admit to pain or difficulty because it's not in their nature to complain. I have discovered that random pantomime is also helpful. Does the knee flex? Does the ankle move? Can the patient climb stairs or walk on uneven ground? I'll never expect an Academy Award nomination, but it helps get the job done. Or makes the patients laugh. Sometimes both.

Saturday, March 28, 2015

Day 5: Third Day of Surgeries in Can Tho

Can Tho Central General Hospital: View of
patient rooms from interior hallways.
Our third day of surgery started with six patients on the schedule, dropped to five midmorning when a patient developed a fever, and settled back to six by the end of the day when a woman came into the hospital with ankle trauma. All our surgical patients today were adults in their 20s and 30s.

During screening, many patients report having had a fever in childhood, followed by an injection that then left them without strength on one side. In most cases, that fever was polio based on the deformities now present. The injection had nothing to do with their current condition, but they commonly attribute it to the shot: the doctor gave them too much, the doctor's wife administered the shot incorrectly, or they received two shots in the same leg instead of one in each.

Friday, March 27, 2015

Extremity Project and the Facebook Kid

Last month, as we were preparing to for our mission to Vietnam, we received a message through our Facebook page from a woman who was conerned about her younger brother.
Dear Mr/ms,

I have a younger brother. His leg was painful. Everything is ok now. Only when he walk he must be on tiptoe. He can not walk as other children.

Doctors from "Cho Ray" hospital told that he is encephalomalacia. Now he is too young to know about that. Please help him!

Thanks for your watching,
I am waiting your feedback.

Best regards,
I looked at her profile and found that she lives in Da Nang, which is 620 miles (1000 km) distance from Can Tho, which translates to 17 hours by car. Dr. Lehnert asked if she could send video of her brother walking, which she quickly did and provided more information.

Thursday, March 26, 2015

Day 4: Second Day of Surgeries

Our first surgery today was a patient the team treated on multiple previous missions. As soon as we saw him in the patient waiting area, Dr. Nyska started his exam since he's been working with him for so long. 

When the team first met him ten years ago, he was four years old and unable to go to school because he couldn't walk due to a significant deformity (tibial agenesis) of his right leg. The doctors performed his first surgery -- a procedure to transfer his fibula to his tibia -- during that mission. By the time they returned two years later, he was speeding around his house with a soccer ball as you can see in the video. 

Wednesday, March 25, 2015

Day 3: Let the Surgeries Begin

The morning started with a bit of frenzy, but the first day of surgery usually does as we get everything organized in the operating rooms and people get accustomed to working together. Although some members of the medical team have worked together for as many as ten IEP missions, others are working together in the operating room for the first time. 

We initially had one operating room with two tables, but were able to get a second down the hall. The team has worked in a single room before, but it's not ideal -- especially for keeping the patients' stress levels down. Surgery isn't a particularly quiet operation, so to speak.

We had six surgeries scheduled, but picked up a seventh by the end of the day when a patient came into the hospital with a badly broken ankle.

Drs. Nyska, Palmanovich, and Lehnert with Mai Phan,
our "imported" translator from California.
Four of today's scheduled patients were kids.

Tuesday, March 24, 2015

Patient Screenings in Can Tho

The patient screening days are always full of activity. The first day is especially busy as we figure out basic things such as where we will meet with patients and how much space we have for examinations. Space is always limited. This time, we ended up screening off an exam space in the hallway so the team could break into smaller groups to evaluate patients more quickly.

Although the hospital pre-screens many patients, our team never knows what to expect -- beyond the fact that it will be a very busy two days. 

The doctors spent Monday and Tuesday screening patients ranging in age from five years old to adults in their sixties. Some cases are fairly straightforward, while others are complex and involve more detailed examinations. 

Monday, March 23, 2015

Day 1: Welcome to the Hospital

Monday was a busy day at Can Tho Central General Hospital for the International Extremity Project team. 

We started with a welcome meeting at the hospital from the hospital's chief doctor, who gave us some of the background about the hospital itself and introduced the team that will work with IEP while we are here. Then Dr. Lehnert from the IEP team talked about our organization, our history in Can Tho, and introduced the mission team to the Can Tho doctors and administrators.

Welcome to the Hospital 
Can Tho Central General Hospital is operated by the government and cares for patients from throughout the Mekong Delta area, which has a population of more than 15 million. The hospital has 40 departments and 1200 staff, of which more than 300 are doctors. The hospital can accomodate 1000 inpatients and sees 1400 outpatients daily.

Sunday, March 15, 2015

Can Tho General Hospital Press Release about IEP

My Vietnamese isn't very good, so Google had to help me translate the hospital's press release about our upcoming trip. English translaion below, original Vietnamese on the hospital's site

The surgical treatment of foot deformities free for poor patients in 2015, is the Central Hospital in collaboration with Can Tho IEP Group (USA).
Time IEP group will work at the hospital from 23-3-2015 to 3-4-2015.
Now the hospital is pleased to announce examination and selected surgical patients in the program are as follows:
Subjects patients: are patients with deformities or congenital deformities, trauma sequelae, polio, or contraction of the neck muscles tendons feet ...
Age   ≥ 5.
Particularly for patients who had surgery prior to the visit to the IEP group on 23 and 24 March 2015.
Registration time from now until March 20, 2015.
All medical information and to register surgery, please contact Surgery Trauma - Burns Hospital Central Tho: clinic No. 3 and No. 7.

Saturday, March 14, 2015

On Our Way to Vietnam in Just One Week!

A week from now, we'll be reading, sleeping, attempting to sleep, calculating how long until we land, shifting in our seats, considering whether now is the right time to extricate ourselves from our seats to visit the lavatory, and all of those things that come with a very long flight.

 We'll have a short layover in Taipei before continuing to Ho Chi Min City. The first challenge upon landing is our passport check, then identifying our luggage from amidst the masses of boxes and such coming down the conveyers.

Here's what I learned last time: More people arrive in Vietnam with large boxes and containers sealed with duct tape than what you'd consider traditional luggage. This time, we'll try to distinguish ours with purple duct tape to speed things along.

Wednesday, March 11, 2015

Supplies and More Supplies!

We have our supplies from MedShare! Jenni went to MedShare to pick up donated medical supplies that we'll take with us to Vietnam.

The supplies we get from MedShare are surplus from hospitals, distributors, and manufacturers. MedShare collects and then redistributes supplies to medical missions like ours, healthcare facilities in developing regions, and clinics in the United States and other countries.

It's amazing what a difference organizations like MedShare can make to support the success of our mission. These aren't all our supplies by a long shot, but what they provide makes a significant difference. Without their assistance, our expenses for basic supplies -- sutures, blades, dressings, bandages -- would be much higher, making it more difficult for us to help the patients in Can Tho.

Jenni filled the car with supplies and had some charming young gentlemen help her unload the boxes when she got home. When it comes to IEP, the whole Lehnert family gets into the action.

Sunday, February 22, 2015

26 Days Until We Leave for Vietnam!

Updates from Bruce and Jenni Lehnert as we prepare for our departure next month.

From Bruce

My tenth medical mission to Vietnam is quickly approaching. It's hard believe that I have been doing this for 17 years. What a long strange trip it's been. Vietnam has grown up so much during this time. The hospital has changed. There so few bicycles and now so many cars and scooters. 

The one constant that does not change is the deformities we correct and the lives we change. The support of our donors and volunteers is amazing and allows our grassroots mission to carry on. Thanks to all the volunteers and donors, both past and present. 

From Jenni

There's so much to do before we take off. Finalizing our inventory and packing supplies is just the beginning. We need to orient and train our new volunteers. In addition to all the medical mission work, there's a lot do with our life here so we can check out for two weeks. But it's all worth it!

Sunday, February 8, 2015

Team Member Bio: Dr. Najwa Javed

Dr. Javed will be joining IEP for her first mission with the team. Like the others on our medical team, she's very accomplished with a wide range of experience and training. 

Doctor Javed grew up in Tulsa, Oklahoma. She attended the University of Oklahoma in Norman and received a Bachelor’s in Biochemistry and a minor in Ethno cultural Anthropology. After graduating from undergrad she moved to Fort Worth, Texas to pursue a Master’s in Clinical Research and Biostatistics at the University of North Texas Health Sciences Center.  

She moved to the San Francisco Bay Area in 2002, where she attended the California School of Podiatric Medicine at Samuel Merritt University in Oakland on a four-year scholarship. She graduated with a Doctorate in Podiatric Medicine and received the Phillip Gardner Award for Excellence in Podiatric Medicine. 

She completed her residency training at the Veterans Affairs Hospital in Palo Alto and Stanford Hospital. During her residency training, she continued to pursue research and particpated in multiple research proposals and a publication. Dr. Javed also focused on diabetic limb salvage and rearfoot reconstruction surgery. Caring for these complex conditions is her specialty and passion. 

She is currently on the team at the Silicon Valley Podiatry Group

Saturday, January 24, 2015

Introducing Dr. Palmanovich

Dr. Ezequiel Palmanovich is joining the International Extremity Project for this first time on this year's mission to Can Tho, Vietnam. 

Born in Argentina, Dr. Palmanovich moved to Israel in 2000. He completed his general orthopedics residency and made the specialization in foot and ankle at the Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore, Maryland. 

He is currently a Consultant of Foot and Ankle Service at the Meir Medical Center in Israel.