ReSurge International Blog

Clinic Day in Cox's Bazar

Cox's Bazar, Bangladesh -- Eileen Sheldon, ReSurge volunteer and trip supporter

We made it to Cox's Bazar after our journey that included a sunny afternoon in Singapore during our layover, an overnight stay in Dhaka and an introduction to the current political affairs in Bangladesh.

Our final destination, The Hope Foundation Hospital for women and children, is located off of a narrow but busy village street and is an impressive facility among its surroundings. Our first morning at the hospital started with a greeting and introduction by its director. Immediately afterwards, we set up our clinic to screen patients while several team members began assembling the operating room. We were off the ground and running.

The clinic was abuzz within moments of our set up. We were greeted with quietly eager and obviously nervous patients and family members. Within a few hours we completed the screenings needed to determine the appropriate procedure for each patient. Thanks to some glittery stickers and coloring books, we produced quite a few smiles and hopefully some comfort.

I was moved by the stories of all the patients -- a 16 year old girl who journeyed on her own to have a facial contraction improved with the hopes of obtaining a job; the petite 2-year-old who spoke of having the doctors fix her syndactyly (fused) fingers; the wide-eyed young boy who loves playing football but limped severely. I could go on.

Before we left for the day, we spent time in the ward where the families gathered to wait until their scheduled procedure. It was quiet and calm. Some napped, curled up on the bare mattresses. Others sat quietly still, like the father-daughter pair who picked a lone corner and fixed their eyes in stoic gazes across the room. For some the humid, dimly-lit room would be there home for the coming week or more. And I selfishly hope that will give me an opportunity to get to know them.

What a day.

 

The Incredible Impact of Reconstructive Surgery in India

Earlier this year, ReSurge sent a team trip to Dehradun, India, where we have a Surgical Outreach Program run by Drs. Yogi and Kush Aeron. One of our former patients who visited the team in Dehradun during clinic day was Punkaj, and his story truly highlights the impact of reconstructive surgery on a patient’s life.

Punkaj was burned when he was 10 years old, after the gas stove he was using to heat up tea exploded. In 2007, ReSurge performed surgery on him to release the burn contracture on his neck. In 2009, Punkaj returned to have the contractures on his arms released. Punkaj wanted to be able to ride his bike to attend school and the contractures on his arms made it impossible for him to lift his arms high enough to reach the handlebars. 

And in January, Punkaj returned to welcome our team and thank them for their help throughout the years. During his visit, our surgeons offered to do some revision work on his neck. Punkaj turned down this offer because he has school exams coming up.

When he was 14, Punkaj asked for surgery that would allow him to attend school like most boys his age. Now, because he is able to attend school, he has turned down surgery—a true testament of how Punkaj’s life and functionality have been restored. Punkaj’s priorities have shifted, and our surgeons were more than happy to oblige. Punkaj is currently in college and hopes to become an elementary school teacher one day. Thanks to the surgical care he received, he is very well on his way to a brighter future.  

Punkaj is just one of many children and adults in India whose life has been transformed by the surgical care provided by our partners Dr. Yogi and Kush Aeron. We are thrilled that this father-son duo will join us on November 9 at our Transformations Gala in San Francisco to accept an award in recognition of their incredible work.

To hear more stories of inspiration and transformation from the Aerons themselves, be sure to get your tickets to the gala today!

 

Center photo by John Urban; right photo by Liliana Vazquez Giffen

ReSurge Team has Arrived in Cox's Bazar, Bangladesh

The team at the San Francisco airport ready to depart

ReSurge’s Surgical Team made it safely to Cox’s Bazar, Bangladesh, despite a few brief delays due to the political unrest there last week.

Our international partners from Dhaka, Dr. Shafquat Khundhar, Dr. Farzana Ibrahim and Dr. Iftekhar Mannan, have joined our medical volunteers to perform surgery for the poor in the Cox’s Bazar region. 

ReSurge’s medical volunteers are: Myles Standish, Kathy Gallagher, Celeste McCartney, Elise Gettings and Karen Pitbladdo. They are joined by volunteers and trip sponsors Rob Williams and Eileen Sheldon, who will serve as documentarians on the trip.

The focus of the American and Bangladesh team will be educational medical exchange and training -- of doctors, nurses and therapists on burn treatment to frontline community health workers on burn first aid.

More updates on this amazing team will be posted throughout the next couple of weeks.  Stay tuned!

Creatively Treating Acute Burns

By Nancy Chee, ReSurge volunteer occupational therapist

The most common causes of burn injuries in Nepal include open cooking fires where women catch their scarves on fire, flame burns from hot oils and children who play too close to a pot of water while mom is cooking or just being too curious. Burns can also occur when people sleep too close to fires to stay warm and may accidently pitch or roll onto fires.  

One of the most severe burns I have helped treat on this trip is of a 4-month-old infant girl named Astha. She was in a traditional ritual at two months of age for newborns where they are anointed with oil. She was lying on her mother’s lap and keeping warm close to an open fire. Her mother leaned forward and Astha accidently fell into the fire, sustaining severe burns to her face and right hand. 

Due to the limited understanding of treatment of acute burns early, she developed the tightness of scars over her face to where her mouth almost completely closed to almost less than a 0.5cm diameter opening. She was limited to getting her nutrition through a small eyedropper and unable to suck. 

Astha was brought to the burn hospital just before we arrived. The therapist, Mohan, remembered a plastic splint that I had shown him years ago and made one that hooked onto the corners of Astha’s mouth and stretched it apart with a rubber band extended behind her head. 

It may look like something from “Silence of the Lambs,” but it worked! Within one day of wearing it, the mouth opening expanded to just larger than 0.5cm. With some suggestions for modification to Mohan, we changed the splint each day and Astha’s mouth opening is almost 1.5 cm. 

Her mother is ecstatic to be able to feed her more easily with the eyedropper, and Astha is even sucking now. With her mother’s persistence and dedication, I know Astha will survive and thrive.

The Global Health Crisis You've Never Heard Of

The following blog post was published today on InterAction.org as part of a blog series in recognition of the International Day for the Eradication of Poverty earlier this week. See the original post here.

 

When we talk about global health challenges, we often cite the ones that receive the most attention or funding. AIDS and malaria come to mind. You probably don’t think about injuries sustained from cooking fires or acid attacks. But the truth is, severe burns are a leading cause of mortality and morbidity in developing countries – a crisis afflicting the poor that hardly anyone is talking about.

In resource-strained parts of the world, open fires and kerosene cookstoves are relied upon for cooking, heating and lighting. Add in to the mix overcrowded living conditions, lack of proper fire safety measures, loose clothing worn by women and insufficient supervision of children. Suddenly, it’s not hard to see why someone is severely burned every three seconds in a developing country.

That’s more than 10 million people each year. For those burn survivors around the world who do not have access to basic medical care, burns are left to heal by themselves, creating a permanent tightening of the skin as the burn wound heals. As a result, even a minor burn can restrict one’s ability to walk or cause a working hand to become an unusable fist.

In our 44 years of providing reconstructive surgery for the poor, ReSurge International has seen too many children come to us with debilitating burn injuries – with arms fused to their torso or hands unable to hold a pencil – because the straw mat they were sleeping on as an infant caught fire or the cookstove they were playing beside suddenly exploded. We’ve seen too many adults who can’t work and provide for their family because a burn injury prevents them from straightening a leg or moving their neck.

These are the cases that Dr. Goran Jovic, the only reconstructive surgeon working in Zambia, sees every day. Jovic, who directs ReSurge’s Surgical Outreach Program in Zambia, accepts patients with all sorts of reconstructive surgical needs, but about 75 percent of the procedures he performs are to correct burn injuries.

In sub-Saharan Africa, burns are the 16th leading cause of death for people ages 15-49. Infants in this region have three times the incidence of burn deaths than infants worldwide. Through the Surgical Outreach Program, Jovic and his team treat burn survivors both in the capital of Lusaka and in outlying areas. Jovic pilots a small plane to reach patients in rural areas who are not able to make the trip in to the city.

Jovic has treated more than 1,100 burn patients. These patients typically undergo multiple procedures to release burn contractures, and they often need physical therapy afterward. Many of the burn patients who Jovic takes on through the Surgical Outreach Program have lived for years with disabilities caused by burns. But we have learned through our work in the field that just with simple and affordable treatment provided soon after a burn, 50 to 60 percent of burn disabilities are preventable.

Burns are acutely tied to poverty, according to Jovic, who says that in his experience, the people most susceptible to burn injury in the developing world are poor people. Women and children are also disproportionally affected by burn injuries, the poorest of whom are typically the ones with little to no access to that basic medical care that can prevent burn injuries from creating a disability.

“The beauty of plastic surgery is to return the patient as a productive member of society,” says Jovic. “If a person has both hands burned and can’t even feed himself, and you open up those hands, that person gets his life back.”

ReSurge International provides nearly 5,000 free surgeries each year through Surgical Outreach Programs like the one that Jovic heads up. These surgeries enable the developing countries where we work to recover more than $75 million in lost wages over the lifetimes of those patients, who will now be able to work.

The work we are doing to address the global burns crisis is as much about eradicating extreme poverty as it is about restoring the health and dreams of our patients. Severe burns leave their victims with disabilities that cost more than $80.2 billion a year in lost productivity alone; 95 percent of that economic burden falls on developing countries.

By supporting the prevention and correction of debilitating burn disabilities through projects like the Surgical Outreach Program in Zambia, we will continue making progress against poverty for those who need it most.

 

Photo: Phil Borges

Long-Time Volunteer to Speak at Gala

 

We are thrilled to announce that Nisha Chaudry, a long-time ReSurge volunteer and supporter, will be one of the speakers at our Transformations Gala coming up on November 9 at the Ritz-Carlton in San Francisco.

Nisha, a volunteer since 2008, was born in India and grew up in nearby San Mateo County from age 11. Despite a demanding work schedule as CFO of Crown Electric, Inc., in San Francisco, and as a part-time customer service supervisor for Alaska Airlines, Nisha has remained firmly committed to ReSurge over the last five years.

After her most recent trip to India with ReSurge earlier this year, Nisha wrote an article for Alaska Airlines' employee newsletter about the experience. Read an excerpt of the story below to learn more about this valued ReSurge supporter. 

And if you haven't gotten tickets yet for the Transformations Gala, be sure to register today. You won't want to miss it!

 

As a customer service agent for Alaska Airlines, I’m used to being the person who issues plane tickets to nervous and excited travelers. Yet, there I was, on the opposite side of the counter, having my ticket issued as I tightly gripped my carry-on bag and prepared to embark on my second humanitarian journey.

When I first visited Dehradun, India, in 2009 as a volunteer for ReSurge, the experience changed my life.

Dehradun is a beautiful city, tucked away in the base of the Himalaya Mountains. The need for medical care for burn survivors there is tremendous. In India, poor families use open fires to cook, heat and light their homes; unfortunately, accidents are commonplace. Burns are the third leading cause of death for young women and girls (15-49) in India.

My job as the coordinator/translator for the team was to facilitate communication between the medical personnel and the patients. In my role, I learned their stories and developed a deep bond with our patients and their families.

Since then, I ad been looking forward to volunteering in Dehradun again because I wanted the opportunity to revisit the patients our team treated. I had often wondered how our former patients’ lives had changed since our initial visit. So, as my flight towards Dehradun took off, I could hardly wait to be reunited with our former patients.

Once in Dehradun, my wishes became a reality as many of our former patients returned to share how they were doing. After talking to a few of them, I couldn’t help but notice how much happier they all appear. It was wonderful to see how they are all looking forward to living out their lives.

After my first trip to Dehradun, I did not fully understand how the surgeries our team provided would make a difference. Four years later, seeing the impact of those surgeries was immensely gratifying.

 

Pediatric Anesthesiologist Dr. George Gregory to Receive Prestigious Humanitarian Award

George Gregory, anesthesia director for ReSurge, with a young patient on a ReSurge trip

ReSurge's anesthesia director and world leader in pediatric anesthesia, Dr. George Gregory, will be recognized as this year's recipient of the Nicholas M. Greene Outstanding Humanitarian Contribution Award from the American Society of Anesthesiologists (ASA).

The award is given to an individual for his or her humanitarian contributions and outstanding volunteer service. It will be presented at the 2013 annual meeting of the ASA in San Francisco beginning this weekend. A long-time volunteer with ReSurge, George leads our anesthesia education and training for international medical partners and has recruited volunteer anesthesiologists for years. He has also led volunteer surgical teams to a variety of sites. 

George founded the pediatric anesthesiology program at the University of California, San Francisco (UCSF) in the 1960s and is the author and editor of hundreds of medical articles and books, including Pediatric Anesthesia, the leading textbook on the subject. 

We are thrilled that George is being recognized for his incredible contributions to the humanitarian field. Please join us in congratulating him!

Welcome, Marcella and Jennifer

ReSurge has been fortunate to recently add two new members to our staff in California:

Marcella Di Sciullo, Assistant Director, Annual Giving

Born and raised in the Bay Area and with a background in East Asian international relations, Marcella joined ReSurge's development team in August. For the last five years, Marcella has combined her passion for international affairs, humanitarian work and fundraising in a nonprofit setting. She has lived and worked in China and is proficient in Mandarin, French and Italian. Marcella received her bachelor's degree from Hawaii Pacific University and her master's from the University of San Francisco. She comes to us most recently from the American Red Cross Silicon Valley Chapter.  As the new assistant director of annual giving, Marcella is excited to collaborate with her team in raising funds to support the mission of ReSurge.

 

Jennifer Wilmore, Assistant Director of Communications and Advocacy

Jennifer joins ReSurge with more than five years of experience coordinating communications and advocacy work for international organizations in Uganda, Sierra Leone, New York City and Washington, D.C. Born and raised in Tennessee, Jennifer earned a bachelor's degree in political science from Samford University and a master's degree in international affairs from Columbia University's School of International and Public Affairs. She also has experience conducting field research in numerous countries in East Africa and Latin America. Jennifer enjoys exploring her new home in the Bay Area, eating tacos and making music.

 

Please join us in welcoming Marcella and Jennifer!

Images from the Field

Thanks to Joe Lippi, Associate Director of Medical Education and Outreach, for sending these excellent photos from the visiting educator trip in Nepal:

Nancy Chee (ReSurge volunteer occupational therapist) and Mohan Dangol (local occupational therapist and longtime friend and partner of ReSurge) assess the progress on a 4-month old child with serious burns across her entire face and arm.

PACU Nurse/Educator Sandy Dore-Harris talks with nurses Kirtipur Hospital about key principles of the post-op recovery room.

Occupational therapist Nancy Chee works with local occupational therapist and long time ReSurge friend and partner Mohan Dangol on a case at Kirtipur Hospital.

Nancy and Mohan assess range of motion of a patient.

Operating Room Nurse/Educator Anne Dinsmore delivers a lecture on appropriate sterile technique to room of physicians and new nurses at Kirtipur Hospital.

View from the operating room of Kirtipur Hospital

Inspiring Patients and Volunteers

       

Kathmandu, Nepal -- Joe Lippi, Director of Medical Programs and Impact

This is my first trip as an employee of ReSurge. Though I have been fortunate enough to travel to some developing countries for school or previous work, there is something profoundly different about this trip. 

First, the team and their level of dedication to this work and to these patients is truly an inspiration. This is hard work. The days are long and exhausting, and every volunteer is using two weeks of precious vacation time to work as hard or harder than they do during their usual jobs. It takes a special breed of human being to do that, and clearly these ReSurge volunteers are of that breed. 

I’ve also had the opportunity to observe the treatment experience of several patients from end to end. I’ve been able to spend time with patients with burn scar contractures as they awaited their surgery; I’ve observed the fascinating surgeries take place; I’ve watched the recovery process and the dressings, splinting and occupational therapy of patients post-operatively. Burn surgeries are truly a life-changing intervention, and I’ve been lucky enough to see that first hand. 

To treat the wounds and design a device to open up the nearly burned shut mouth of a four month old child with burns throughout her face and body is to give her a chance to eat, to breathe, to survive.  

To operate on a young boy’s arm to return the extension of his fingers and arm is to allow him to not only play with his friends but to hold a pencil. To raise his hand fully in class.

To release the burn scar contractures on both arms of a grandfather and give him the proper splint and exercises to ensure that function is truly restored is to enable him to care for his grandchild and to return to work—to keep his family together.

The patients here are an inspiration. They are strong, brave, and resilient. The ReSurge volunteers who have traveled across the world to offer up their experiences, ideas and wisdom are helping the talented staff of Kirtipur Hospital expand its knowledge and improve patient care. This hospital is a special place with endless potential to be a world-class center for reconstructive surgery. 

The work being done by Dr. Shankar Rai and his staff of physicians, nurses and support personnel is a model for how the highest quality, dignified care can be provided to some of the poorest people on earth. It’s been an amazing trip so far, and I’m honored to be part of an organization that works with such dedicated humanitarians to deliver care to those who need it most.  

 

A Young Girl's Determination to Walk Again

Kathmandu, Nepal -- Dr. Hien Nguyen, ReSurge partner anesthesiologist

I met a beautiful 11-year-old girl in Kirtipur, Nepal. Her home land is in a village high on a hill.

One day over 6 months ago, she got a burn accident from a slip on a pan of boiling oil when she went to the market. I could not imagine how hard and how painful it has been since that time, but it's not finished yet because her knee has been bent so she cannot walk.

She came to the hospital this morning for surgery to release the scar at her knee.  I think that she has been waiting for this surgery for a long time because I saw in her eyes the willingness to walk normally after surgery.

She was offered the option of spinal anesthesia if she would be ok to be awake during surgery. I thought that she must be sedated. But after a little bit of tears because of the needle of spinal she smiled and cooperated very well. She speaks a little bit of English so she asked me my name and she said she was ok every time I asked her how did she feel.

I took a picture of me and her and she wanted me to take the pictures of her surgery that was happening behind the barrier of the surgical area. I did one.

She asked more and she was very brave to overcome her fear of this surgery. She was very happy to see the pictures of her knee straight.

The surgery was done and I was so happy to have the picture of her before leaving the OR with her thumb raised up. I told her, "you are number one."

Teaching Eager New Nurses

Kathmandu, Nepal – Joe Lippi, Associate Director of Medical Education and Outreach

The team has now been in Kathmandu for over one week. It’s funny how quickly a place can feel like home. 

After spending a weekend in the beautiful town of Pokhara, we all found ourselves asking things like “what time is our flight home [to Kathmandu]?”  

Kathmandu is a dusty maze of semi-paved, pothole-filled narrow streets that meander around beautiful pagodas and temples, up hills and over rivers. The air is thick—both with a warm, damp humidity and the smell of burning incense, simmering curry, and steaming "mo-mos" (Nepali dumplings).  

Looking out at the horizon you see Kathmandu’s low colorful skyline near and beautiful mountain ranges in the distance that are hidden and revealed over and over as the clouds drift in and out of view.  It’s a magnificent place.  

The members of this team—Nancy Chee, Bonnie MacEvoy, Anne Dinsmore, Vickie Van Fechtmann, Sandy Dore-Harris and Len Sterling—are pros. Not simply because they all have a history of volunteering with ReSurge and are talented in their own professions, but rather because every morning they are up early and are anxious to get to work.

Every evening they debrief the day—discussing what worked and what didn’t and how to make the next one better. And every day they work relentlessly hard to deliver informative, relevant, and thoughtful lectures and workshops to a room full of nurses and physicians. It’s hard work to educate for hours on end in this context, and it’s even harder when those lectures and workshops are redesigned almost every night to respond to the observed needs of the students and the hospital.  But this team does it, and they do it remarkably well. 

The majority of the participants in the lectures and workshops are new nurses who graduated and passed their qualifying examinations only very recently. They are 15 sharp, eager young women. The ReSurge team has been working closely with them to augment their skill sets, present materials and topics in novel ways, and to expose them to nursing techniques in the care of patients with burn injuries, in particular—the thematic focus of this trip. 

Nurse educator Len Sterling delivers a lecture on burn care to a room of new nurses at Kirtipur Hospital.

Days when our Nepali colleagues are doing operations, our volunteer nurses and anesthesiologist observe the work, take notes on what systems or practices might be improved, and engage in real time dialogue with the medical team. Nancy, the trip’s occupational therapist, is working side by side with Mohan Dangol, her longtime Nepali counterpart whom she helped train (this is her fifth time working with him). 

The two of them do amazing things with simple materials—creating life-changing (and perhaps life-saving) braces, splints and other tools to dramatically improve the healing and restoration of function for the patients with burn injuries.  It’s an amazing thing to observe.