FEBRUARY 15 THROUGH FEBRUARY 23, 2008
ANNUAL REPORT

We are dedicating this mission
to Tom Jernigan
(Please Click here)

CENTRO NACIONAL DE OFTALMOLOGIA (CENAO), MANAGUA, NICARAGUA

OPHTHALMOLOGY

USE OF VITRECTOMY MACHINE AND SUPPLIES WERE DONATED BY

ALCON MEDICAL MISSION PROGRAM

RICHARD MINTON FEIST, MD

            TAREK O.  PERSAUD, MD

FRANCISCA RIVAS, MD

ABRAHAM DELGADO, MD

Drs. Feist and Persaud screened 70 patients.  They performed 21 vitrectomies and had use of fifty (50) doses of Avastin. 

CENTRO NACIONAL DE CARDIOLOGI,  MANAGUA

NELSON SALAZAR, MD.  DIRECTOR

ILANA KUTINSKY, MD

DAVID PARR, TECHNOLGIST

20 PACEMAKERS WERE DONATED BY ST. JUDE

TWENTY TWO SURGERIES WERE PERFORMED.

All twenty pacemakers were placed in indigent patients.  We also did 1 ICD (implantable cardiac defibrillator) and one pacemaker/lead revision.

I discovered several children who needed rhythm restored.  We began a project called Restore the Rhythm  (Salvando Corazones) Saving Hearts.  We have gotten preliminary OK from Beaumont Hospital in  Michigan to proceed with Restore the Rhythm.  Beaumont wants to support bringing the kids to Michigan for the procedures, as well as, establishing a lab in Nicaragua for future use. 

HOSPITAL AMISTAD JAPON- NICARAGUA, GRANADA, NICARAGUA

JUAN BARRIOS, MD, DIRECTOR  and YELBA BROWN, MD,  DEPUTY DIRECTOR

OPHTHALMOLOGY 

MICHAEL ALSTON CALLAHAN, MD.  JOHN STEVEN PARKER, MD.  AND

MARK DRABKIN, MD.

ANESTHESIA

JERALD CLANTON, MD, JAMES RUDULPH, MD, JOE STOWELL, CRNA

BIOMETRY

LYNN GUZMAN,  KEITH HODGE

TRANSLATOR KOULA CALLAHAN

VOLUNTEERS ASSISTING:  JACK PARKER,  BONNIE PARKER

5 CORNEAL TRANSPLANTS, 6 STRABISMUS, 38 CATARACTS, 11 YAG LASERS ,

1 DCR, AND 1 PTOSIS.

SUPPLIES AND EQUIPMENT WERE DONATED BY

ALCON MEDICAL MISSION PROGRAM

We arrived in Granada on Friday, February 15, 2008, and began clinic early Saturday morning.  We were able to set clinic up and process approximately 74 patients. In so doing, virtually filled the operating schedule for the entire week.  Mr. Jack Parker and Rosita helped manage the patients while Koula Callahan translated.  Dr. Mark Drabkin’s bilingualism was and always is crucial to the success of the mission.  Saturday morning clinic presented an unusual number of complex pediatric strabismus disorders, quite time consuming.  We also received quite a number of consultations of patients with cataracts and other disorders from Nicaraguan ophthalmologist.  As always, there was nearly a 100% pathology rate in terms of the number of patients examined versus the number of patients scheduled for surgery.  A few patients had undergone previously unsuccessful cataract procedures elsewhere, or had terminal absolute glaucoma, for which we had nothing to recommend as they were inoperably blind. The patients receive our prayers.

Saturday morning  Drs. Vargas and Drabkin designed an orderly numbers system to screen the patients systematically. Drs. Parker and Callahan examined them and scheduled the surgery.  Mr. Keith Hodge and Ms. Lynn Guzman were unable to perform biometry on Saturday because the clinic was so busy. They prepared to do this on Monday morning.

Clinic began at 8:00 AM and began to wind down about 4:00 PM.  Monday we had one operating room.  The rest of the week we had two OR’s.

We had no surgical complications the entire week due to the good anesthesia work of Dr. James Rudolph and Dr. Jerry Clanton with Joe Stowell, CRNA helping to organize surgical supplies and keep the line moving, a major help. 

Dr. Johanna Ramirez, the new, young ophthalmologist who trained in Leon, is also a new mother.  She is now our contact person.  Although she is not bilingual, she will be able to follow up on our post-operative patients.  We hope her youthful love of ophthalmology, will enable her to take a more active role in our mission and benefit from the teaching that we do as well.  She will need our support to “get up to speed” for our annual medical mission.

GASTROENTEROLOGY

TIMOTHY DENTON, MD

GUILLERMO GOMEZ, MD 

BECKY COOK, RN

We scoped or helped to scope 35 patients - the majority of those were upper endoscopy - with significant finds of chronic gastritis. This became a big draw for the staff as well as the patients.  Many had never seen first-hand what the physician was seeing.  We believe a clearer understanding was achieved. The techs in the room were very receptive once they understood that the equipment would now be theirs, very durable equipment but fragile with mismanagement -   Great emphasis was placed on handling, cleaning and disinfection with each procedure. Initially they felt it would slow them down but the Dr's became patient and the desired outcome worked out well for all the physicians.  Dr. Denton bonded with ease when they were able to place their training in actual visual finds with hard copy pictures if desired.
 
Volunteers, pitched in to work on equipment that was out of order.  With skilled hands, these now work.  Other volunteers aided in cleaning the area.  We believe this has given the other staff the courage and pride to keep it clean or at least cleaner
 
Three  scopes were identified in poor condition and brought back for evaluation and hopefully repair.  These will be returned to the hospital in Granada ASAP. These scopes
at the moment are at IMS under the umbrella of Scopes of Mercy.  Two other scopes for Upper endoscopy are in process of donation for them
 
The  physicians discussed wants and identified needs.  Dr. Denton is currently in the process of trying to make these needs a reality.

Dr. Denton spent time with the Hospital Administrator discussing his belief that the level of care had jumped 25 years with the arrival of the new equipment. Dr. Denton will work to help Granada have perhaps the best Endoscopy Unit in the country including Managua.
 
Dr. Denton extended an invitation to Dr. Gomez to come to Birmingham, as his guest, to observe the practice of GI medicine and help identify what would be of use in his area.

SOME EQUIPMENT REQUESTED -
Varic Banding
Endoscopic Atlas in Spanish
Guide wire Dilators
ESU with ground pads and appropriate active cords
TRI forceps

ORTHOPEDICS

MIKE BRAGER, MD.

JUAN BARBERENA, MD

Dr.  Brager reports 8 surgical procedures and multiple patients seen:

3 hip fractures, 2 tibia fracture non-unions, 1 elbow fracture, 1 ankle fracture-gunshot wound,  1 knee arthroscopy.  He saw multiple patients with various orthopaedic problems in clinic on Friday, since his specialty is Sports medicine. 

OBSTETRICS/ GYNECOLOGY

DANIELLE PATTERSON, MD

YELKA MARTINEZ, MD, MARBELY RODRIGUEZ, MD,

CARLOS ERNESTO QUIJANO, MD

TRANSLATOR: NILSA OCASIO, RN

Dr. Patterson reported treating 55 patients in Ob/Gyn Clinic.  On Friday she assisted the local doctors with 4 sterilizations and one Caesarian section. Dr. Patterson left OR supplies including sutures, bovies, suction tubing and various other helpful items. 

PEDIATRICS

BONNIE MATTHEWS, MD. 

  BRYANT E. BENSON, MD.

VOLUNTEERS: LAVERNE RAMSEY, JOY FERRELL, WILLIAM DEXHEIMER

ALLISON, MELISSA AND REBECCA PARKER

TRANSLATORS:  ADELA LACAYO AND THELMA LACAYO

Two hundred-fifty three pediatric patients were seen and treated.  Meds were prescribed and  toys were given.

With the help of Keith Hodge, we were able to repair a ventilator in the NICU.  Instead of one, they now have two.  We also provided a pulse oximiter, and several glucometers to the unit (they previously had none ). 

DENTAL CLINIC

Erica Barba, DDS.  Iradj Sooudi, DMD.

Myyoska Payan G. DMD. from Managua

assisted by Dr. Ivania Mendez Bermudez, Granada

Dental assistant Delmis Murillo Acevedo, Granada 

SERVICE PROVIDED BY DENTISTS:

•         9 extractions and surgical procedures

•         28 patients received fillings.

•         20 patients received oral pro prophylaxis.

•         09 patients visited us for dental consultations.

•         We performed multiple extractions as well as multiple teeth restorations.

ALABAMA GRANADA CLINIC

NICHOLAS LOON, MD. NEPHROLOGIST/ENDOCRINOLOGIST TRANSLATOR: LOWELL SMITH, RN

CLINIC DOCTOR, RENE CASTILLO,   MD

WEILY SOONG, MD. ALLERGIST

VOLUNTEERS TRANSLATING:  JANET SANDINO

 CECILIA BURGOS and REESE FEIST

JON VACIK, MD. EMERGENCY MEDICINE PHYSICIAN

VOLUNTEER TRANSLATING: MYRNA HORN

CLINIC DOCTOR  CESAR SEQUEIRA, MD

VOLUNTEERS ASSISTING:  ABBOTT WILLIAMS, CHERYL WILLIAMS, LORI FEIST, RN., LAURI SOONG, JANE FEIST, JACK FEIST, BARRATT RUDULPH, BONNIE PARKER

439 patients were examined and appropriate treatment administered. 

Of  439:  96 were diabetic patients. Fourteen were new to our clinic where we already have over 350 registered diabetics.

Dr. Nick Loon works with the diabetic patients, his specialty.  He closely examines and, in his teaching mode, shares his knowledge and techniques of treating  diabetes with Dr. Castillo, one of our Alabama Granada Clinica doctors. 

Missing this year was Judy Loon, RN who is advancing her career in study at home.  We missed her work preparing and triaging patients with diabetes.  She has also conducted classes instructing diabetic patients in nutrition and proper technique of administering their insulin.

Besides seeing and treating patients, one of our goals is to share knowledge of new technology with the Nicaraguan doctors.  Drs. Vacik and Soong have also taught through the years.  As an allergist, patients exhibiting these symptoms are referred to Dr. Soong.  As an emergency medicine physician, Dr. Vacik treats a variety of  ailments.  He says he has seen extreme cases in Nicaragua that he has never seen in the ER at the hospital where he works in the US.