Santiago Dominican Republic ILAC Trip, November 2023

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November 2023 Santiago Dominican Republic ILAC Trip

Our first set back was encountered before the trip when it became apparent that the container would not clear customs in time.  However, Mary Lou Collins, our equipment coordinator came to our rescue by reminding us that all sent in this year’s container was for next year.  This year we did encounter a shortage of patients performing only 67 hernia operations as opposed to 100 more or less in past years.  Much discussion ensued as to reasons for the shortage.

Chuck has decided to step down as the team leader and in his place will be a core group consisting of Pat Gude, – general logistics, Vinayak Kottoor – pre-op, Theresa Keefe – anesthesia and Mike Sarr – surgery.  All agreed to assume responsibility and they will make decisions about future trips to ILAC.

The surgical mission went very well with plenty of staff including 6 wonderful Peace Corp volunteers for translation.  In addition, Dr. Alvaro Torres, an ILAC employee, did an extremely good job in the pre-op area with patients that could not have surgery or needed surgery to be delayed.  Mary Lou and Robin Vineyard were excellent OR leaders and the team in general functioned very well.

Sixty seven operations were performed with one take back for a scrotal hematoma.  All patients made a good recovery including the take back patient.  Team members afterward sent inspiring notes stating that the weeklong experience inspired them to pursue future humanitarian surgical work.  Pat Gude said “I think the outstanding care we once again provided is a testament to the work of so many good people”.   Please see the photos below.

Mike Sarr with OR team

  Bob Fitzgibbons with team
The 2023 team with Peace Corp volunteers

Santo Domingo Dominican Republic Trip, November 2022

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November 2022 Santo Domingo Dominican Republic Trip

This was our first trip to Santo Domingo.  It was conducted with the Foundation for Peace, a well-established large non-profit based in the Dominican Republic and Haiti.   They are focused primarily on health care, education and community partnerships.  A small US team arrived but there were some authorization paperwork difficulties that delayed surgery for one and half days.  This was rectified and one operating room was used in the Hospital Regional Doctor Marcelino Velez Santana. Dr. Michael Sarr and Dr. Alejandro Serrano were the operating surgeons and Dr. Jennifer Huerta, Dr. Serrano’s wife provided excellent anesthesia.

Twenty one operations were performed without complications.  Many of the patients had a short recovery because local anesthesia and sedation was used.  More work will be done to improve the logistics for next year.

 

Part of the Teamwith Dr. Sarr in the upper middle and Dr. Serrano in the maroon shirt
Dr. Huerta administering anesthesia
The operating team

Santiago Dominican Republic ILAC Trip, November 2022

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November 2022 Santiago Dominican Republic ILAC Trip

This was our first trip back to ILAC since 2019.  An entire team was recruited and all three operating rooms were used.  One for pediatric hernia surgery, another for the more complicated adult patients requiring a general anesthetic and the third for hernia patients requiring only local anesthesia with intravenous sedation.  Dr. Michael Sarr, Dr. David Chen, Dr. Robert Cusick, Dr. Alex Schroeder and Dr. Conrad Ballecer were all surgeons with several spending two days of the five.  Dr. Chen also gave a hernia lecture one evening to the Northern Dominican Republic chapter of the American Board of Surgery.

Eighty one operations were performed and many large inguinoscrotal hernias were repaired.  One patient experienced an intraoperative bradycardia during that was rectified pharmacologically.  No other complications were encountered.

 

The pre-operative staff with patient

An expert selfie of the entire team taken by Dr. Chen in the left foreground

Santiago Dominican Republic ILAC Trip, April 2022

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April 2022 Santiago Dominican Republic ILAC Trip

After a pandemic hernia trip hiatus, the first Hernia Help US staff based trip was to the Dominican Republic.  Covid 19 restrictions were in place with staff having a preliminary Covid test, all staff were fully vaccinated and patients all had a rapid test the day before surgery.  Only two operating rooms out of three were utilized as we wanted to start conservatively.  A full staff was recruited and Dr. Robert Fitzgibbons and Dr. Michael Sarr were the operating surgeons.  The World Foundation Peace brought patients from Santo Domingo and the rest of the patients were from the ILAC catchment area.

Seventy one operations were performed and there was one complication when a patient had to be brought back for an additional hernia.  No other postoperative problems were encountered. 

 

Pre-operative patients waiting outside the clinic
Patient with Mother
Part of the Team including Dr. Sarr on the left Corey Lawson in the middle and Dr. Hauscar Rodriguez on the right.

Dominican Republic, November 2017

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HRFU ILAC 2017 Mission trip

The team functioned well in the outstanding ILAC facility.  New surgeons included Dr. Rigoberto Alvarez, and Dr. Alejandro Pena from Guadalajara Mexico.  Dr. Larry Raynor was the new head of anesthesia and did an excellent job.  Many team members returned and we performed 105 hernia operations.  One patient with a large inguinal scrotal hernia did have an early postoperative hematoma and required re-operation.  There were challenging new customs equipment restrictions that were surmounted at the last minute with much effort.

The entire 2017 team

The Pre Op Team with Sylvia the cooperadora

One of our classic Dominican older patients

Mao Salcedo, Dominican Republic, 2016

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Mao, Dominican Republic, November 2015

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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

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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

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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

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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.