Category Archives: Vietnam
The team has finished up the final day of surgeries. In our short time here, the CSI team performed 56 surgeries. This morning the surgeons made their final rounds and signed off to the local Urology and ENT Departments who will follow the children In the hospital for a few additional days, as is their typical protocol here.
A few CSI team members toured different areas of the hospital during the course of the week, including the NICU, pediatric ICU and the emergency department.
The CSI team has been honored to care for the families and children of the Thanh Hoa region this week. The children’s sweet smiles and the grateful eyes of the parents make the work a pleasure.
Adminstrators, surgeons, physicians and nurses from Thanh Hoa pediatric hospital invited the CSI team and our translators to a farewell gala to celebrate the week of collaborative work on behalf of the children. It was a festive night filled with friendship, laughter, toasting, speeches and, of course, Vietnamese karaoke!
Here’s a fine example of the karaoke, performed by Dr. David Vandersteen, urologist, left, and Leon Randall, biomedical support.
A special shout out goes to a very enthusiastic and dedicated team of translators who have been with us the entire week.
Today was spent visiting a floating river village and Trang An, a national heritage park. Three generations live on this floating home.
The team will disperse tomorrow. Some head home to the U.S. while others extend their stay to explore Vietnam and Thailand.
Jet lag, 12-hour workdays, exhaustion, and sometimes a rumbling stomach are “part of the deal” on a surgical mission. But what is so very wonderful is that every morning I wake up thinking about the kids we cared for yesterday, and remembering the smiles, the tears, the parents’ expressions of hope, worry, and ultimately gratitude. I can’t wait to get back to the hospital to see how the kids fared during the night. Did her labored breathing settle down, did he drink some fluids, did the bleeding stop, is her pain under control, did the parents get some rest?
The weather has been beautiful this week, sunny and 75 degrees. The morning walk to the hospital is filled with the sights and sounds of the city. Walking into the bustling Thanh Hoa Pediatric Hospital gives us renewed energy. It’s a large and very busy regional pediatric center, with 500 beds and currently about 800 patients.
Today, the rhythm and flow of the CSI surgical day in Thanh Hoa were nice. The team members are all settling into their roles, finding their way around their work areas and the rest of the hospital, and getting to know their Vietnamese colleagues better. We are becoming more efficient and synchronized every day.
The urology and ENT patients that are assigned to the CSI team stay with us in the Anesthesia Department for the first day and overnight. At that time they are transferred to their respective ENT and Urology Departments where they will be in the hospital for several more days.
The surgeons, anesthesia and OR nurses (CSI and Vietnamese) have two cases going simultaneously in each room. With two ENT and two Urology surgeons with us, we are performing cleft lip and palate repairs, as well as the repair of a variety of urological abnormalities. Some of these can be quite complicated and may require additional procedures in the future.
Off to the last day of surgery. Stay tuned!
~ Linda Sedgwick
Tuesday, March 1 – A beautiful morning to start the day in Thanh Hoa. The teams are starting to hit their stride. We are seeing great collaboration and information sharing among our surgeons, pediatricians, anesthesiologists and nurses as they work a busy slate of urological and maxillofacial cases. The ENT team has been working through seven cases today, mostly cleft palates, and there has been an opportunity to work side-by-side sharing ideas and procedures with our Vietnam colleagues.
The urological team had a rare epispadias case this afternoon, something which our surgeons had only seen five times in their 50 years of combined experience. It’s estimated to occur at a rate of 1 in 250,000. We were well-equipped, and working with our Vietnamese colleagues, the repair procedure went very well. During the day, anesthesiologists shared techniques on airway management and regional blocks. Pre-op and post-op nurses worked together on procedures and kept the whole system operating smoothly. The days are long, wrapping up around 8 p.m., but there has been strong engagement and support across the teams.
By Tom Fansler, CSI Board Chairman
After a meeting with our partners at Thanh Hoa pediatric hospital, we began evaluating the many patients waiting to be seen by urology and ENT surgeons. Many patients and hopeful families had traveled long distances to see CSI.
Because we had a team here six months ago, we have the ability to see some children in follow-up who weren’t ready for surgery at that time. Returning after just six months also allows for more continuity in our education and training models, as well as streamlining and improving our processes with the hospital staff and administration.
It was a very busy but interesting and successful day. More than 100 children were evaluated for potential surgery. Some will be ready for surgery this week, while others may need further testing and diagnostic work. To a few families’ joyful surprise, their children had normal examinations and did not require a procedure.
While the children were being evaluated, our OR anesthesia and nursing teams spent the day setting up the operating rooms, assuring they had all the necessary equipment ready to provide safe and comprehensive pediatric surgical care, and meeting with their Vietnamese colleagues.
Our team is enthusiastic, resourceful, committed, hardworking and fun! CSI is thrilled to have a few nurses and physicians with us in Vietnam who are new to CSI. It really doesn’t take long for a group of passionate people to become a cohesive team. The children and families waiting for us here give us the energy and focus to give them our best.
As always, our focus is on education for local health professionals. We will be working alongside Thanh Hoa hospital surgeons, physicians, nurses and administrators every step of the way this week.
Long travel days were the norm for the team traveling to Thanh Hoa. The journey included 28 hours+ flight times, an overnight in Hanoi and a bus ride to Thanh Hoa on Saturday. We enjoyed a welcome dinner with hospital physicians and administrators. Everyone is enthusiastic about getting started. Sunday will be spent screening children at the hospital in preparation for a full schedule of ENT and urology surgeries this week.
The CSI team in Vietnam includes 26 members from Minnesota, Virginia, California, North Dakota, Tennessee and Maryland.
A special thank you shout out to our guide Frederick, Father Joseph and our Vietnamese interpreters.
Docs are making rounds on the final patients. The rest of the CSI team members are packing up, counting charts, paying bills and blogging. After evaluating many more potential patients than we imagined this week, the team was able to perform surgery on 28 urology and 31 ENT patients. So many grateful families; so many changed lives!
Our team was also able to incorporate an educational curriculum into the busy week, which was an important goal for the mission.
The week’s finale last night was a team-building dinner with our Vietnamese counterparts at a restaurant of their choosing, complete with karaoke, an essential part of Vietnamese entertaining. Very, very funny!! It’s been a memorable, successful week in Thanh Hoa. Here are few final photos before we start our long trek home.
As I write this, only three patients are still in pre-op, waiting for today’s surgical cases. One is a little fellow named Van, who is ONE UNHAPPY DUDE because he hasn’t had anything to eat or drink since midnight in preparation for surgery. It is 4 p.m., and he’d give anything for a little something to nibble on. We’ve tried music, coloring and puzzles, but he just wants food! It won’t be long now, and he’ll be off to sleep and ready for his surgical repair.
The second fellow is Tam, a 17 year old who nicely borrowed my computer and immediately tried to sign on to Facebook, but alas no Wi-Fii at the hospital. How can we be in the middle of nowhere in the north of Vietnam and he wants the same entertainment as our 17-year-old kids at home? The world is definitely growing smaller.
Last in the room is a wonderful 42-year-old woman named Thuong, whom we squeezed onto the surgical schedule. Thuong has had a disfiguring cleft lip that led kids in school to mock her. She stopped attending school in the 2nd grade. With the hands of a 70-year-old woman, she gestures that she worked in the rice fields since she was 3 feet tall. Thuong is envious of the white skin of one of our nurses of Swedish heritage, and we tell her that we try to get our skin the color of her brownness by lying in the sun. Her sister tells us that she is able to read only five or six words, but can write her name, albeit very slowly. Thuong’s smile is utterly beautiful, and her personality, with plenty of giggles, shines through. She will continue to be followed by local health professionals after CSI leaves for continued care and support.
We officially screened 74 urology patients and 65 craniofacial patients. We evaluated an additional 150 patients, but for a variety of reasons we were not able offer surgery at this time. We have collected names and contact information for this group. They will either be seen by our Vietnamese medical colleagues, or we will contact them when our CSI team returns in 2016.
Our logistics head, Con Nguyen, had a very productive meeting with a group of local physicians as we fine-tune our process on our first visit. We have drained the team of translators, as one of us always seems to be calling out “may we have a translator in here”? There are very specific processes in the hospital that we are learning as we mesh how we manage pain, communicate with families and provide care for patients. Of course we have the same goals, and there are many great learning opportunities for both our team and for the people here.
Posted Wednesday by Sally Lannin
It is Tuesday afternoon here in Thanh Hoa, Vietnam. When we arrived at Thanh Hoa Pediatric Hospital (THP) for screening on Sunday three times as many patients were waiting to be screened as we had anticipated. Our partners here in Vietnam, specifically Father Joseph, who is a Jesuit priest affiliated with IPSAC in Peoria (www.ipsacvietnam.org), and THP, did a wonderful job of getting the word out that the team from CSI was arriving so that parents could bring their children to be considered for surgery. And come they did, from all over the country, many traveling very long distances to be evaluated.
Patients and their families were standing 20 feet deep waiting to be evaluated by the team. Logistics head/CSI Board member and Vietnamese-American Con Nguyen was flying from room to room managing the translators, patient flow and answering hundreds of questions. Nurses were preparing children for evaluation. At the end of screening day, surgeons Dr. Dave Vandersteen (Urology) and Drs. Rajanya Petersson and Christopher Discolo (ENT) had the difficult task of prioritizing and creating four very full surgical days. Many of these decisions were heartwrenching, considering so many families were hoping their children would be included.
It was a late night for the medical records team of CSI Partners Cindy Halverson, Johnine Adomitis and Kaitlin Nelson. They needed to create schedules, assemble charts and have everything organized for surgery in the morning. We brought medical record supplies for 60 patients, and ultimately screened more than 100 children, piecing together pages wherever we could get them. Thank goodness for that printer Johnine carried in her luggage all the way from the U.S.
Monday, Day 1 of surgery, started bright and early. Volunteer videographer Nolan Morice is recording, interviewing and snapping great photos of these children. Team members scavenged for sterilization supplies, gauze, gloves and other necessary supplies. Logistics co-lead Stacey Brown even got stuck in the elevator while transporting a giant cart of IV fluids. (No harm done.) Lora Koppel and Sally Lannin carried a solid steel fan up five flights of stairs to try to get some air circulation. Thankfully, Leon Randall was able to get the fan to work. Leon’s helpful can-do attitude is spectacular!
Pediatrician Erin Novak started having gripping stomach pain and was sent back to the hotel to rest. The crack PACU team of Dr. Bruce Ferrara, Anna Koppel and Mary Bye rose to the occasion and handled the post op/PACU patient situation, despite being one team member short. We scavenged empty offices, storage closets or restrooms looking for underutilized fans in an effort to get air circulating in the PACU. Bruce gave a big thumbs up once the air started to move.
The pre-op team of Nikki Lavin and Katie Houle readied patients for the handoff to anesthesiologists Drs. Raj Sarpal and Craig Smith, and CRNAs Lynn Randall, Monica Bultena and Michael Gotzsche. We had three or four operating tables going simultaneously. The OR wonder nurses Charlee Kimmes, Nancy Corcoran and Jessica Driscoll (on her first trip ever outside of the United States — what a way to get the passport stamps started!) are keeping things moving and sterile.
By early afternoon as patients came out of PACU, things started hopping in the ward. There is very little space in this area. Children are three and four to a bed with no air conditioning, and parents primarily are responsible for the patient aftercare. Floor nurse team of Patience Kankeh and Patrick Faunillan have their hands very full not only looking after our patients, but also using every opportunity possible to provide theVietnamese nurses with aftercare training.
Late in the day, team member Dr. Erin Novak returned to the hospital with severe abdominal pain. After evaluation and ultrasound, she was headed to the OR to have her appendix removed! Thankfully, our IPSAC partner Dr. Holterman (a general surgeon in Peoria) happened to be onsite and was able to perform the surgery within an hour. She very thoughtfully called Erin’s husband in the U.S. to let him know the surgery went well, and the outcome looked excellent. Erin rested at the hospital for an hour and walked back in the front door of the hotel just as 200+ Communist Party members in evening dress were gathering for a large regional meeting. The juxtaposition was almost humorous. This was a first for a CSI mission — we’ve never had a team member on the OR table. When Erin Skyped her practice partner Dr. Dave Tetzlaff, CSI Medical Director, the first thing he said was “did you take the appendix out yourself?”
Tuesday, Day 2 of surgery, we were ready at the crack of dawn as a complete team! Yes, even Erin was up and at ’em after a great night’s sleep under the care of nurse Anna Koppel, who stayed with Erin to monitor her medications and vital signs. Patients were gathered from various locations in the hospital and the process began again. Bubbles were flowing to entertain anxious children in pre-op. Grateful families were cradling their children. Wonderful handmade dolls and teddy bears donated by the volunteers of Dollies Making a Difference were distributed to patients in post-op as well as donated beautiful fleece blankets. Nurses Patience and Patrick are doing everything possible to teach, train and care for these precious children after they come out of surgery.
More tomorrow on some of the individual stories of the patients and the families we have had the privilege to meet.
The CSI 2015 Vietnam team has made it safe and sound to Thanh Hoa City, Vietnam without a hitch. We kicked off the trip by breaking bread in a seaside dinner with Bien Vien Nhi’s doctors and local charity members. We discussed the weeks’ agenda, collaboration and patient load. Patient screening will begin tomorrow morning – stay tuned!
Screening Day is summed up with one word – WOW! It is amazing the lengths people will go to for family. Some waited all day and traveled even longer to be seen. All patients who showed up were evaluated for surgery. Thanks to a great group of flexible volunteers and hospital staff, we have a full week of facial and urological surgeries ahead!