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.