Mao, Dominican Republic, November 2015

2015 HRFU Dominican Republic Mao Trip Summary

The trip was held in Mao at the Luis L. Bogaert Hospital for a second straight year. This repeat site for HRFU in the Dominican Republic trip once again was truly a tremendous success.  During 5 consecutive days in November we performed approximately 72 hernia operations on 66 individual patients of which 25 were pediatric hernias.

Aside from the operations that were performed numerous other patients were examined and benefited by being referred for additional medical, cardiac and even oncologic workups as a result of items identified pre­operatively and intraoperatively while we were at the site.

As always our team members were grateful for the experience. We had team members representing Jersey Shore University Hospital (Neptune, NJ) , Lankenau Medical Center ( Wynnewood, PA) , Centrastate ( Freehold, NJ) , Swedish (Seattle), CHOP (Philadelphia) Hospitals as well as an Italian team from Milan Istituto Clinico Sant’Ambrogio ­ Milan & Multimedica Hospital, University of Insubria­Varese.

Drs. Jarrod Kaufman, Giampiero Campanelli and Marta Cavalli were the adult surgeons and Dr. Robert L. Weinsheimer was our pediatric surgeon. Dr. Kaufman acted as team leader for the second year and brought many new first time physicians. Dr. Kari Palmer an Internal Medicine physician facilitated the pre­op and post op evaluations. Dr. Michelle Barnes joined to help provide high level anesthesia for the pediatric patients.

The anesthesia team consisted of Drs. Michelle Barnes (peds) and Dr. Anthony Fugaro.

The entire team of nurses, scrub technicians, sterile processing and translators performed well under more predictable, but less than perfect conditions. As this was our second time returning to the site we tried to help correct some of the needs and as a result we donated 2 new electrosurgical units and had 2 new sterilizers also donated which greatly facilitated the operative flow and instrument sterilization.

There is continued enthusiasm on the part of the team members and local hospital staff members to continue our work at this Mao based hospital. The Timmy Foundation, Banelino and the HRFU Local staff truly helped round out the team for our second successful mission at this location.

There were many good moments and below are but a few.

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Below two of our pre-operative patients are waiting for their procedures.

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Surgeon Training:  Two fully trained local surgeons were trained by Drs. Campanelli on the Lichtenstein repair.  Both surgeons did very well and were awarded 10 pieces of donated mesh for future Lichtenstein repairs on poor patients.  This was done after watching the trainer operating on one patient and then after completion of 5 other groin hernia operations performed by the doctors with Dr. Campanelli first assisting each of them for the remaining cases.  After each of the 5 operations a written rating form was used to assess surgical performance and has been standardized by HRFU.

Training has become an important part of the HRFU mission.  Many additional successful hernia repairs will need to be performed by these surgeon we have trained. We believe that this training will eventually lead to the training of these surgeons to become trainers for hernia repair in their local area.

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Dominican Republic, November 2015

HRFU ILAC 2015 Mission trip

The team functioned well in the outstanding ILAC facility.  New surgeons included Dr. Brian Jacobs, a Pediatric surgeon, Dr. John Murphy, Dr. Alex Schroeder from Hamburg Germany and Dr. Kal Nandipati.  Many team members returned and we performed 88 hernia operations.  One patient with a very large hydrocele was challenging but had no complications after the hydrocelectomy.

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The entire 2015 team

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Jim and Pat on the left in front of the Manion room

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At the Wednesday night fiesta

Salcedo, Dominican Republic, May 2015

2015 HRFU Dominican Republic Salcedo Trip Summary

The week of May 24th, 2015 was the first HRFU trip to Salcedo, DR.  A team of 16 volunteers from the USA, 3 volunteers from the Peace Corps, and Dr. Lesly Manigat our on-site coordinator, descended upon Hospital Regional Dr. Pascasio Toribio Piantini.  This trip would not have been possible without the interpreter and logistic support provided by the regional branch of the Lions Club, and by generous supply donations from Direct Relief and Fundacion Solidaria.  With this help, the team was able to operate on 42 patients despite disruptions related to an unexpected regional physicians strike – a tremendous success.  Surgery was provided completely free of charge to all patients, with small and large hernias of the abdomen and groin repaired.  All operations were successful, and there were no complications.

The team was incredibly well received by the community and the hospital and its staff.  Many fond memories and new friendships created, with the community and the team looking forward to an even more successful mission next year.

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The team. From L to R: Mike Elliot, Barb Elliot, Nathanial Misra, Katie Clampitt, Krista Hinman, Dwijen Misra, Chris Hanson, Jessica Porritt, Rebecca Paskiet, Lesly Manigat, Tommy Lee, Amy Vinton, Julia Field, Victoria Conforte, Lisa Lugo, Dawn Porritt, Anna Disque, Fritz Disque, Jeanie Fry, Ron Oconer

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This trip would not have been possible without supplies from our generous donors.

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Many new friends were made. Here, Victoria Conforte, Barb Elliot, and Dr. Lesly Manigat pose with some the local nurses and technicians.

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Patients in the pre-op area.

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Jeanie Fry and Katie Clampitt working the recovery room.  There were no complications.

 

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Drs. Misra, Dr. Manigat with Dr. Pedro Hildalgo hospital chief of surgery

Dominican Republic, November 2014

HRFU Dominican Republic Trip Summary

The most recent HRFU Dominican Republic was a huge success!  A team of 50 US volunteers plus 7 Institute of Latin American Concerns health care providers (cooperadores) and 2 Peace Corp volunteers provided care for over 250 patients and two potential HRFU team leaders, Dr. Mark Reiner and Dr. Antoine Lofti were trained – see below about team leader training.  One hundred three hernia operations were performed without complication and numerous other patients were examined and treated medically. As always the team members were grateful for the experience.  The patients and their families touch your heart in ways unanticipated.

Pictures below show Dr. Guy Giroux of Anesthesia and our Pediatric surgeon Dr. Robert Cusick on the right, a child patient in her mothers’ arms – another beautiful child patient, and Dr. Jim Manion our chief of Anesthesia sitting with one of his adult patients.

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HRFU Team Leader Training:  We use a team leading manual and Dr. Reiner and Dr. Lofti were given a copy by e-mail prior to their arrival with the understanding that they were coming to learn about but not necessarily volunteer to be a team leader.   The manual includes the HRFU mission statement and goals, our code of conduct, the way HRFU supports teams, our surgical policies, team leader qualifications, how to plan a trip, assemble a team, fund raise, the expected OR routine, surgical complication local physician backup, in kind donation procurement, a description of our surgeon training model, the responsibilities of specific team members, information about liability and sterility practices, a sample equipment and medication list for a  80 patient trip, information about the Peace Corp and attachments of a variety of HRFU policies and chart forms.

After reviewing the manual materials with the surgeons they performed hernia operations and Dr. Filipi assisted/observed and explained the Lichtenstein repair as we train it.  Dr. Lofti and Reiner will then decide about their further involvement.  Yearly team leader training will continue to build the reach of our program.

Mao, Dominican Republic, November 2014

2014 HRFU Dominican Republic Mao Trip Summary

The trip to Mao as a new site for HRFU in the Dominican Republic trip was truly a success.  From November 17th-21st; 66 hernia operations were performed and numerous other patients were examined and referred for additional medical and cardiac workups pre-operatively. As always the team members were grateful for the experience. We had team members from Centrastate , Jersey Shore , Lankenau and CHOP Hospitals.

Drs. Jarrod Kaufman, Giampero Campanelli, Robert Fitzgibbons were the surgeons. Dr. Kaufman led the team and brought many new first time physicians. Dr. Sandra Abramson a Cardiologist facilitated the pre-op and post op evaluations. The anesthesia team consisted of Drs. Charles Farrell, Anthony Fugaro, and Nancy Moyer CRNA.  There were no operative complications during the mission and none reported postoperatively to date.

The entire team performed well under less than predictable conditions, as this was our first time at the site.  There is continued enthusiasm on the part of the team members and local hospital staff members to continue our work at the Mao hospital. The Timmy Foundation and Banelino and HRFU Local staff truly helped round out the team for a successful mission.

There were many good moments and below are but a few.

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                              Below two of our post operative patients are ready to go home.

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 Surgeon Training:  One fully trained local surgeon, Dr. Fausto Rodriguez-Perez, a Mao surgeon was trained by Drs. Campanelli and Fitgibbons on the Lichtenstein repair.  Dr. Fausto did very well and was awarded pieces of donated mesh for future Lichtenstein repairs on poor patients.  Below are pictures showing the beginning of training with Drs. Campanelli and Fitzgibbons . After operating and after completion of 5 other groin hernia operations performed by Dr. Fausto  with Drs. Campanelli  and  Fitzbibbons first assisting him.  After each of the 5 operations a written rating form was used to assess surgical performance by Dr. Fausto.

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Training has become an important part of the HRFU mission.  Many hernia repairs need to be performed but surgeon training and eventually if protocols are followed, training of those surgeons to be trainers will occur.

Dominican Republic, November 2013

2013 Dominican Republic ILAC Trip Summary

The most recent Dominican Republic trip was a success.  One hundred and eight hernia operations were performed and numerous other patients were examined and treated medically. As always the team members were grateful for the experience.

Dr. Robert Cusick and Dr. Lao were the Pediatric surgeons, Dr. Campanelli and Dr. Fitzgibbons plus Dr. Ed Buckley, Dr. Steve Kerns and Dr. Jarrod Kaufman were the adult surgeons.  The later three were there for Hernia Repair for the Underserved (HRFU) team leader training.  Dr. Manion led the anesthesia team followed by Dr. Guy Giroux, Theresa Keefe CRNA and Dr. Carl Heine.

The entire team performed well under Barb Elliott’s leadership.  Welcome back Barb.  There is continued enthusiasm on the part of the team members and ILAC staff members to continue our work at the ILAC surgical center.

There were many good moments and below are but a

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Below one of our post operative patients going into her home.

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Surgeon Training:  One fully trained surgeon, Dr. Jean Fritz Jacques from Port au Prince Haiti was trained by Dr. Cusick on pediatric hernia repair and Dr. Campanelli on the Lichtenstein repair.  Dr. Jacque did well and was awarded 20 pieces of donated mesh for future Lichtenstein repairs on poor patients.  Below are pictures showing the beginning of training with Dr. Campanelli operating and the two surgeons after completion of 5 other groin hernia operations performed by Dr. Jacque with Dr. Campanelli first assisting.  After each of the 5 operations a written rating form was used to assess surgical performance by Dr. Jacques.

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Training has become an important part of the HRFU mission.  Many hernia repairs need to be performed but surgeon training and eventually if protocols are followed, training of those surgeons to be trainers will occur.

Dominican Republic, November 2012

The most recent HRFU Dominican Republic trip was a huge success! Forty two US volunteers and many Institute of Latin American Concerns health care providers (cooperadores) and 4 Peace Corp volunteers cared for more than 200 patients. Two Dominican surgeons were trained as described below. One hundred and fourteen hernia operations and 18 lumpectomies were performed without complication and numerous other patients were examined and treated medically.

Surgeon Training

Two fully trained Dominican Republic surgeons were chosen–a Pediatric surgeon for Pediatric hernia training, and a general surgeon for Lichtenstein hernia repair training. Dr. Robert Cusick trained the Pediatric surgeon and Dr. Wolfgang Reinpold trained the adult surgeon. Both trainers used a validated surgical technique rating form designed by the University of Southern Illinois surgical department education division (with input from Dr. Filipi, Dr. Cusick, and Dr. David Chen of the UCLA department of surgery). The rating form is now being implemented in the U.S. for surgical residency training. The hernia rating forms are available upon request.

The rating form was reviewed and then the trainer performed the first operation and the trainee assisted. The trainee and trainer reversed their roles with following operations. The trainer then filled out the rating form in privacy then immediately reviewed it with the trainee giving him a numerical score and explanation for all of the step ratings. This was repeated immediately for four subsequent operation. Both surgeons passed with flying colors and Dr. Ramirez was given free mesh on condition that he would use it only on poor patients and that he would monthly fill out a spreadsheet on the patients receiving the mesh and send the spreadsheet electronically to Dr Filipi. Photographs below show the process.