Author Archives: Children's Surgery International

-Edmonia is a 14-year-old girl who has been incontinent her entire life due to a kidney birth defect. For what could have been a long and complicated surgery, Dr. David Vandersteen and Dr. Janelle Fox were pleased to report the procedure was a success. Now, instead of being ostracized by her peers and feeling ashamed, Edmonia’s quality of life has been transformed, making her one of our biggest successes. Her life was truly changed today.

-Newborn Lucia,  you may recall she had surgery yesterday for omphalocele, is recovering well. She is successfully nursing and bonding with her mother.

-CSI ward nurse Louann Randall and Tetee Urey-Morris, charge nurse for Duside Firestone’s women’s unit, presented washable feminine hygiene kits to about 20 post-natal moms at the hospital and taught them how to use them. The kits were from Days for Girls, an international nonprofit organization that distributes the kits in Third World countries.

-Dr. Phil Chaffin lectured on cleft lip and cleft palate to about 30 Liberian nurses, physicians, nurse practitioners and students.

Amid the successes, all of us see multiple reminders of how much need is here that we cannot attend to, due to limited time, medical personnel and financial resources. Our hearts have been broken by a 1-year-old girl with a large cancerous tumor and a 4-year-old girl hospitalized after being sexually assaulted. But while we are facing the realities of the world, we feel grateful to be here doing what we can.

Sally Lannin and three other CSI team members (Ellen Hoeg, Janet Darden and Zanny Lannin) had the opportunity to visit the West Point area of Monrovia today, ground zero for the Ebola epidemic. This community has 100,000 residents packed into a very small area with one physician. Open sewage, school children with no books, and shacks made of corrugated metal sheets are facts of life in their community. Katie Meyler (featured last November in People magazine’s article 25 Women Who Are Changing The World) was their guide. See morethanme.org to learn more, and understand why she received this honor. Katie’s school, More Than Me Academy, provides high quality education for 180 girls. We were able to donate medications, and we gave them personal hygiene kits made by DaysForGirls.org. These kits are intended to prevent infection, and promote school attendance during menstruation. Thanks to team member, Louann Randall RN, for bringing the kits from the U.S.

We are networking with key community leaders here in Liberia to be sure the neediest kids get connected to us.

Check out more photos

The team got down to work bright and early. Twelve surgeries were on the schedule for children ranging in age from 8 months to 16 years. As always, things changed.

Shortly after we arrived, we learned that a baby girl had been born yesterday with an omphalocele (exposed abdominal cavity). The surgical team examined her and agreed that we could add her to the schedule… today. Liberian babies are not named until they are taken home to their village, so we called her Lucia, her mother’s name. Without surgery, Lucia’s chances of survival were virtually nonexistent. She came through the surgery successfully!

In other happy news, 8-month-old Samuel stole everyone’s hearts as he waited patiently for his surgery. He was soon upstaged by his mother, Lovetee. We wish you could have seen her seemingly never-ending dance, hugging team members and thanking them when she learned that her son’s surgery was successful.

Another patient, Sackie, was born with a cleft lip, just like her grandmother. Sackie’s mother, Mary, cried and lamented when she saw Sackie’s cleft, fearing the family could not afford or find someone with the skills to repair it. They live four hours from Firestone Duside and are farmers who grow rice, peppers and plantains. She heard about CSI on the radio and emotionally shared that despite the fact that she “is scared, she gets her strength through God.”

Mercy, age 9, a cleft lip patient, tried to get into CSI in 2013 but did not qualify for surgery. Rosetta, her mother, received a call from her friend, who had heard on the radio that CSI was returning to Liberia. Rosetta came to screening with Mercy and this year received joyous news. As this post is written, Mercy is coming out of the operating room. Her operating team included Dr. Phil Chaffin, Dr. Jon Robitschek, lead anesthesiologist Craig Smith and nurse Nancy Corcoran.

Late in the day, a mom arrived with her 5-year-old daughter, Miatta. The mother, Annie, had heard about CSI at the weekly market, where she sells peppers and cucumbers. Annie’s first husband died of Ebola, and she and her two older children spent many days in the quarantine center. She is remarried and now has young Miatta with her new husband. Given that the family lives in the furthermost interior part of Liberia, it is a minor miracle that she happened to overhear at the market that CSI was performing free surgeries. She wasn’t sure of the exact days, but she walked three hours carrying Miatta to meet someone she had heard was driving to Firestone Duside Hospital, a place she had never heard of. She found a taxi and asked the driver to follow the other vehicle to Duside. Annie came up to the admitting area, and when we told her the schedule was full, she explained what she had gone through to get here. Clinical lead Lora Koppel consulted with urologist Dr. Janelle Fox and CRNA Lynn Randall to determine if we could fit her on the schedule and if she was fit for surgery. Everyone was thrilled when she was deemed ready for surgery by pediatrician Dr. Tim Wood. Within 20 minutes of walking through the door she was being prepped for surgery to repair a hernia.

Amid it all, Dr. Jon Robitschek gave a lecture on craniofacial surgeries to Duside hospital health professionals, helping fulfill our mission of education. About 25 Duside employees attended his lecture, which focused on trauma and facial defect surgical care.

See more photos here.

Tomorrow, Day 2 of surgeries.

Although it was a scheduled day of rest, the CSI team was still hard at work on Sunday:
-Part of the team toured Monrovia, the capital of Liberia, where they saw the sights, including multiple embassies, and learned about how the country has progressed since the civil war ended.
-As part of a community health initiative some members of the team visited Frances Gaskin Orphanage, where we administered anti-parasitic to approximately 75 children (deworming). Parasitic infections are among the most common infections in developing countries, significantly impairing nutrition – which of course can lead to many other health problems. Thanks to our relationship with Orphan Relief and Rescue, we were able to return to the orphanage again this year, as we do every year. We also delivered supplies, played with the children, observed their musically focused church service and Sunday school for the younger children.
-We visited the village of Cotton-Tree at the request of the village leader to administer anti-parasitic medication to community residents. We had no idea how many people we would be serving; we were enthusiastically welcomed by about 1,500 children and adults eager to see us!
-Tomorrow is Day 1 of surgery, with the first surgeries scheduled for 7:30 a.m.

We are so grateful to Firestone Natural Rubber Company for providing our housing, food, transportation, security and so much more.

Saturday was a busy and exciting screening day for the CSI team at Duside Hospital. Seeing the faces of staff when we pulled up to the hospital was better than any reunion imaginable. They all remembered the names of those of us who were returning and were excited to meet the new among us as we return for the first time since 2013. As we walked down the halls at the hospital, conducting screening, setting up the ORs and sorting supplies, every uniformed staff person greeted us with a gracious, simple, “Thank you.”

The parents and children waited patiently with the hope of receiving good news from our team. We screened 78 patients, and have scheduled surgeries to start on Monday. The team expects to complete 55-60 procedures. One mother stood up and emotionally expressed her gratitude when she learned that her infant daughter would be receiving medical care from CSI.

We especially want to thank Firestone and Don Darden for the many months of planning that has gone into making CSI’s long-awaited return to Liberia a reality. Post-Ebola, the Duside Hospital has been repainted, including every nook and cranny. The hospital literally shines. Firestone’s Guest House, which is where we stay, has also been repainted and replanted, and all repairs glow.

When the  2013 CSI Liberia team prepared to leave the country, they stored supplies in a hospital storeroom. Of course, at the time we had no idea that the Ebola crisis would hit the region, forcing CSI to cancel missions. The hospital staff diligently guarded the supplies until our return this week. We sorted through the supplies today, and were happy to come upon donations from Dollies Making A Difference, a California non-profit group that creates dolls and bears for children around the world in need of something special. We are so grateful to them, and the many other organizations that have helped us get here.

We ended our day with a presentation from Don Darden about Firestone’s history in Liberia and the role it plays in Liberians’ lives, which is significant. We were joined at dinner by a group of Liberian Firestone employees.

Enjoy more photos from the Liberia trip here.

Our Liberia 2017 team are making their way to West Africa today. To say we are excited to return to Liberia and Firestone Duside Hospital to continue our tremendous partnerships and collaborative work, is a bit of an understatement! There are great needs in the country, as they continue to recover from civil war, and most recently, the West African Ebola crisis. We hope our efforts this week will make an impact on individual children, families, and communities.

The full team will assemble Saturday, Jan. 14 to begin their work – a full day of screening, followed by a rest day Sunday, then right back to it – surgeries, education, training and more during the week!

On this trip, our team of 23 includes pediatric urology and ENT surgical teams and support volunteers who will be working closely alongside our Firestone Duside Hospital partners and guests to conduct about 50 surgeries and countless seminars and educational activities to help our partners build their nursing, surgical and anesthesia care skills. Their dedication and passion for touching the lives of children in need, along with their talents as highly skilled pediatric medical and nursing professionals, is remarkable.

A small advance team has been busy the last few days, organizing supplies sent in advance and supplies left behind from our previous trips. The pre-mission visit to the hospital to see our friends – old and new – was like coming home!

Check back for regular Liberia updates, and explore our new website!

As CSI surgical mission volunteers, we are so fortunate to meet many wonderful children and families. I wish we could share all our stories, but here are just a few.

Oscar –
Imagine the desperation of a mother who hitchhiked with her 1-year-old son from their home three hours away to Hermosillo hoping to receive surgery for a cleft lip. Oscar is one of five children whose family lives on a salary of $50/week. Due to a last-minute family emergency, he and his mother missed the CSI screening day. Frantic, but undeterred, she left home with Oscar in her arms. She had no money, and only some juice, water and a small bag. That night the two of them slept outdoors and started hitchhiking toward Hermosillo the next morning. They were picked up by a kindhearted taxi driver took them as far as the bus station. From there another taxi driver brought them to the hospital. We were pleased to be able to put Oscar on our surgery schedule.

Iker –
When Iker arrived last year as a 5-month-old, he was severely malnourished due to feeding challenges as a result of his cleft palate. At that time he weighed about 3 pounds, small enough to fit in a shoebox. Too fragile for surgery at that time, his very survival was questioned by medical staff. At screening during the CSI trip last year he was admitted to a local hospital for care. The St. Andrew’s Children’s Clinic provided the financial and emotional support as he recovered. He arrived back this year for his CSI screening literally transformed, well nourished and ready for his cleft palate surgery. His mother is so very grateful!

Hannah –
Three-year-old Hannah received the best gift ever! Her father promised her that after her cleft lip surgery he would buy her a brand new two-wheel bike. At the end of her bed when she awakened from anesthesia, she found a new pink and purple Peppa Pig bike. Hannah was out in the hallway riding the bike – which was decked out with shiny tassels and training wheels – three hours later under the very careful supervision of her mother and hospital staff.

We wrapped up the surgeries today with a total of 57 children helped in just three days. The team was able to add three children who were on the “maybe” list for surgery as well. One of my favorite things I heard this week was from a St. Andrew’s Children’s Clinic staff member. She quoted the guardian of a young boy that CSI provided surgery a few years ago. “I gave him a home, St. Andrew’s and Hospital CIMA gave him a life, and CSI gave him a smile.”

The generous and hospitable Hospital CIMA volunteers treated our team to a farewell fiesta last night. We enjoyed fabulous Mexican food fit for royalty, in the most lovely historical home in downtown Hermosillo. The evening was filled with music, karaoke and dancing late into the evening. Early this morning the team completed their final rounds, discharging the last 16 of our darling patients. Needless to say, there were smiles all around. Goodbye Hermosillo, until we see you again.

Thanks to our amazing and talented CSI volunteer team, St. Andrew’s Children’s Clinic and Hospital CIMA Hermosillo. Because of great partnerships CSI is able to change many lives, one child at a
time.

Nineteen CSI surgical, medical and nursing volunteers made their way to Hermosillo, Mexico, this weekend from various locations around the U.S. A few flight delays made connections difficult, but the team was grateful that American Airlines was willing to hold a departure so the CSI volunteers (and their vital equipment) could make it to Hermosillo on time.

St. Andrew’s Children’s Clinic in Nogales, Arizona and CIMA Hospital in Hermosillo are important partners for our Mexico surgical missions. The St. Andrew’s Children’s Clinic is involved in critical advance preparation for the CSI team, making certain the children are ready for surgery and that consistent follow-up is maintained. Because of CSI’s long-term partnership with Hermosillo, we have been able to follow some children over several years, making certain they have the ongoing care and subsequent surgical procedures that are sometimes required in these complex cases.

CIMA Hospital in Hermosillo welcomes the CSI and St. Andrew’s Children’s Clinic team with wide open arms each fall. Their staff and volunteers are amazing. Not only are the children and families treated with the utmost care, we are as well. Our welcome included singing, balloons, hugs and even tears of joy.

The team is in the midst of its third day of work already. Our first day on the job was filled with screening 122 children accompanied by very hopeful parents. A team of four specialized ENT, oral and maxillofacial surgeons, pediatricians and pediatric nurses evaluated the children – while the anesthesia team and OR nurses readied the operating rooms for several days of packed surgical schedules ahead. Once all the children had been seen, the surgical schedule for the week could be finalized.

The first day of surgeries was long and productive. Twenty kids had life-changing procedures, which require a team effort. Tasia, our medical records volunteer, has many responsibilities. She manages medical records, directs traffic, translates, dresses kids for surgery, comforts crying babies and supports anxious parents. (and this was all in her first four hours on the job starting at 6 a.m.)

Let me tell you about baby Manuel. At 15 days of age, his family left him a village hospital. Manuel had been born with a bilateral cleft lip. His parents may not have known that a relatively simple surgery could repair the problem. They may not have had the financial resources to pay for care. They may not have understood that there doesn’t need to be any shame in giving birth to a child with a defect. They may have been ostracized by their community. Manuel is now 6 months old and has been living in an orphanage. He is ready to have surgery to repair the birth defect. The CSI team is thrilled to provide the care he needs to thrive and grow. He is pictured with his caregiver, Carolina, who loves him as her own.

Our fall Vietnam mission is complete. With the support of our mission partner IPSAC and the Provincial Hospital leadership and surgical, medical and nursing staff, we were able to successfully perform 24 urologic procedures on children in need. In addition to these surgeries, knowledge was transferred at all points in the continuum of care – from the bedside to the conference room. We collaborated to do screenings, provide pre- and post-op care and family education and, of course, hands-on training in the OR. On our last day, we did a workshop on optimizing surgical outcomes with a multidisciplinary approach. It ended with a good discussion illustrating the differences between our healthcare settings and the impact resources have on patients and teams. We were also supported by a very committed and helpful team of interpreters all along the way.

The children and families we encountered this week were absolutely amazing. It was especially touching to see how children and families supported one another, even though they may not have known one another prior to coming to us for surgical care. One father helped a pregnant mother by carrying her child for her. They supported one another with encouraging words and friendly smiles. They worked together like one big family, challenged while being far from home and stressed by the prospect of their children needing surgery, but all on a similar journey.

Even the children offered encouragement to each other. Our last case of the day on Thursday was the special little boy pictured in the photo. Because eating and drinking prior to surgery isn’t allowed, the other children waiting for their procedures were hungry and thirsty. He helped to calm and distract them by blowing bubbles, offering them toys and playing with them, all with a huge smile.

After leaving Thanh Hoa, most of the CSI team spent an additional day in Hanoi where we visited Blossom House, a foster home for girls aged 5-18 years run by Humanitarian Services for Children of Vietnam. HSCV is a non-profit organization founded by Minnesotans Chuck DeVet and his daughter Annetta. The home provides holistic care for girls from families living in extreme poverty. Learn more about HSCV at www.hscv.org. Our friends at HSCV provided us with critical logistical support and translation services for our medical mission in Thanh Hoa, so we were grateful to be able to, in turn, provide support and information to the girls at Blossom House.

Our team offered a workshop for the girls titled “Take Care of that Temple,” with a focus on positive self-image and self-care. The girls really enjoyed writing positive messages about themselves and their peers. We also discussed and demonstrated the importance of hand hygiene, which was identified as a strong need and was well-received. We hope to continue to partner with HSCV and visit Blossom House on return missions to the region.

Thanks to Dollies Making A Difference, we were able to leave some sweet hand-made dolls with the girls. The girls so appreciated the gifts.

It has been a very, very busy few days for our Vietnam team and local partners! 51 children were evaluated by our surgical, medical and nursing teams during screening. 25 of those children will have surgery this week. Because of the continuity that we are able to provide with return missions, many of these children are returning for planned surgical follow up.

Today was eventful, and ran smoothly thanks to an incredibly flexible team. Our second CSI urologist, Dr. Alonso Carrasco, arrived this morning. Several surgical cases were completed. The most complicated of the day was a 7 month old infant girl who required a partial kidney removal and surgical repair of the ureter. She came through the procedure like a champ! We are grateful for the many opportunities for education and collaboration.

Tonight we attended a hospital celebration of the mid autumn festival (children’s new year). We were asked to do something special for the hundreds of children and parents who attended. CSI volunteer, Leon Randall accepted the challenge to lead our team in a performance. Our rendition of the classic “Heads, shoulders, knees and toes” was a huge hit! The crowd joined in and we had a blast. What a special time to be here working with our partners for the children of Vietnam.

Screening day is complete and the surgery schedule is full for the week! This is the time to meet prospective children for evaluation, review medical records, and assess the children’s current health status and readiness for surgery. As the photos show, the CSI team is partnering with IPSAC and local Vietnamese surgical and medical staff to make the most of our time onsite.

The surgical focus for the week is urological, with an educational focus on evaluating and implementing ways to improve surgical outcomes with a multidisciplinary approach.

The children couldn’t be sweeter, and proud families anxiously await life-changing surgeries. More later…..