Rotaplast Missions

Tenth day - Clinic

Our last day, clinic day, the day when our patients come for their follow up visit before our departure. The time when we are able the see the results of the 81 surgeries performed these past days.

  And last but not least a little more about our team members:

The three youngest members of the medical team have a lot in common.  They're all men in their early 30's, living in Northern California.  They're on their first Rotaplast mission and eager to serve on a second one.  And they all have friendly, open smiles underlying a somewhat reserved demeanor.  

Phat (pronounced "Pat") Tuan Giang and Danilo (Dan) Ramos are anesthesiologists living in the Sacramento area and working at U.C. Davis.  Phat is a member of the U.C. Davis Medical School faculty.  Dan is finishing his residency in June, after which he'll be working at U.C. Davis.  Both were recommended for Rotaplast work by U.C. Davis Dr. Neal Fleming, a Rotaplast Board Member with 15 missions under his medical belt.

Kenny Liu is a dentist and currently lives in Daly City near San Francisco.  He graduated from the University of the Pacific (UOP) Dental School and practiced pediatric dentistry for 4 1/2 years.  He is currently a craniofacial genetics research fellow with Dr. Marie Tolarova, a Rotaplast Board Member who has been on 42 missions.  Kenny plans to do an orthodontics residency and ultimately treat underserved children with cleft lips and palates in his hometown of Bakersfield.

Ted Daley and Stella Kenya both O.R. nurses are on their 4th mission with Rotaplast.  Stella is from Colorado and has been a nurse for 41 years.  Ted originally from Wisconsin, changed careers at age 42 from being a manufacturers rep in sporting goods to nursing. Recently he moved to Fresno after meeting Speech Pathologist Kelly Cahill on a Rotaplast mission 5 years ago in Vietnam.

 

I, (Linda Bullard Stoich) would like to thank Sallie Weissinger, not only is she a beautiful friend, 

patient intrepreter, and loving human being.  She is a talented writer and editor, contributing many stories to this blog.

And then there is Roger Schulte, the Big Teddy Bear, oozing with love and kindness. Even with the language barrier, Roger's big bright smile could calm even the most frightened child.  Many of Roger's beautiful photographs graced this blog.  Thank you Roger for sharing your photographs with such class.  Sallie and Roger's contributions have been invaluable to this Tacna 2010 blog.  Thank you!

Mission Director Ken Funk, is very pleased that we were able to improve the quality of life of so many people in Tanca.  And is extremely proud of the the Rotaplast Team for all that they have accomplished. Ken commented,  "Humanity has been well served by Rotaplast and this team."

 After a joyful day in clinic our team said goodbye to our Peruvian friends and headed home.

Ninth day - Surgery - The Earthquake the Night Before

We started our day with "the Jaguars",  little Andy and Margoth Escamilla and Recovery Room Nurse from Levittown, New York, also named Margoth.  She is always seen with a beaming smile and positive outlook.  Andy was happy to receive the gift of the jaguar, a Pre-Colombia symbol of strength and power.

 

 

  

The earthquake produced significant tremors, yet all the patients remained calm and there were no injuries.  The hospital only suffered minor damage when a 300 lb. oxygen tank fell over breaking a suction motor and other equipment in the recovery room.  Volunteers pitched into to clean up and everyone was ready to work in no time.

 

When we got to the hospital this morning, we asked the staff how our patients and the hospital had fared during the two quakes. They said there was very strong shaking on our floor, but no one panicked, and there were no injuries or significant damage.  Our biggest problem was with a 300-pound oxygen tank that fell over, breaking a suction motor and equipment in the Recovery Room.  With a bit of clean-up, everyone was back to work in no time.

Cesar charmed us all. He is a dancer and actor and entertained us with an old Peruvian story. Twelve-year old Cesar has had 3 palate repairs and they have all failed, so he has been visiting Rotaplast's dental clinic during our visit in Tacna.  Dr. Rosario Mayro, Dr. Margot Escobedo and Dr. Kenny Liu have been working all week to build him an obturator to improve his speech.  His family also received suggestions on how to get speech therapy now that the obturator will decrease nasal airflow that inhibits optimum speech.

Patience was truly exhibited by the family of Massie while waiting for her surgery.  Massie's operation to release a contracting scar on her finger was cancelled two times last week due to illness, according to Head Nurse Carolyn Walchak.  Finally, on the third try, our last day of surgery, Massie had her surgery.

 

Lead Anesthesiologist Leigh Pederson, travelled the furthest to join our mission, meeting up with us in Tacna from New Zealand.  This is Leigh's third mission with Rotaplast, although she has been on several other missions with other organizations.  Leigh said that she particularly enjoys working with the Walchaks, and looks forward to future Rotaplast missions with them. 
 

Eighth day - Surgery

Among the 10 doctors on the Tacna team are two who grew up together in  Ahmedabad, Gujarat (near Mumbai), India.  Falguni Patel, anesthesiologist, and Divya Joshi, pediatrician, have been friends for 30 years.  They met in their first year of high school, rode bikes together, and studied for their medical school admission tests together.  Falguni was the captain of the school basketball team and Divya was the team's best player.

When Falguni moved to the States in 1991, she encouraged Divya to come and sponsored her in 1995.  Both are married to doctors, both have children and both are on their first Rotaplast missions.  Falguni and her family live in Sugar Land (near Houston), Texas.  Divya lives with her family outside Atlanta, Georgia.  Both are making friends and winning hearts in Tacna.

Dr. Rod Simonds, plastic surgeon from San Francisco, and Medical Director, Dr. Frank Walchak, performed surgery on calm, quiet, 7-month old Abigal to separate her fingers that were fused at birth.  Dr. Angelo Capozzi one of Rotaplast's, co-founders, said that Dr. Simonds was a resident under him at St. Francis Hospital in San Francisco.  Dr. Capozzi brought Dr. Simonds on his first international mission to Argentina. 

Alison James, our patient transport volunteer, said that Abigal didn't cry one bit.  The nurses on the ward also commented that she was the one of their gentlest babies all week

Six-year old Yennifer came into the clinic engaging us with her coy smile.  When the time came to take her patient photograph, she was a reluctant to remove her hat.  

Yennifer was burned by hot oil from the stove when she was 18 months old, leaving a huge scar on the back of her scalp.  Dr. Farnworth removed the scar tissue and performed a skin graft.  

Always learning, always researching, Dr. Gaby Doumit, Rotaplast Surgeon and Dr. Hugo Sanchez take a rare moment, to escape to quiet of the computer room to share surgical techniques.

Seventh day - Surgery

Maria (R) spent the night waiting for surgery for her congentially malformed ear. She met Agueda (L) when we moved her from a stuffy, isolated room where she had been recuperating from a skin graft, for 5 days.  As soon as we moved Agueda, Maria was sitting on Agueda's bed making friends. The next thing we knew they were working together creating beautiful story books with their Mrs. Grossman's stickers.  

Percy, who had a surgery similar to Agueda, a skin graft to revise a burn scar on his neck to help increase his mobility, used stickers to write a story about an evil magician.

When Mike Farnworth, our youngest team member, accompanied 7-year old Aracely to the pre-op waiting area, she was nervous and teary.  It got worse: the anesthesiologist said it was time for her operation, a complex pharyngeal flap, to start.  Aracely began crying and clinging to Mike.  Mike carried her into the O.R. and stayed with her, hunched over the operating table, as the anesthesia took effect.  This 22-year old pre-med student's calming words were invaluable. 

Mike has become our "hacelotodo" ("he does it all"), serving as patient transport aide, circulating nurse, scrub nurse, and translator. His Spanish is great after a two-year mission in Mexico. Mike (whose father Todd is a plastic surgeon on our mission) says his experience here in Tacna has solidified his resolve to become a doctor, either in cardiology or reconstructive surgery.  He definitely wants to serve on future Rotoplast missions. 

  

Sixth day - Surgery

Fernando charmed us with his gentle nature.  He told Dr. Farnworth he already had lots of toys, but that his mother had bought him a special new one for after his surgery.  Dr. Farnworth performed an operation to remove one of his two thumbs.

Oscar came to us for a palate repair. Nothing was going to keep this little guy down.  He wasn't a bit scared and kept the pre-op room busy with his clowning.

 As soon as his operation was over and Oscar was moved into his room, he was sitting up, and ready to work with his Mrs. Grossman's stickers.

Rotary volunteer Shirley Dean found a special way to celebrate her husband Paul Dean's birthday today.  Shirley engaged the help of Tacna Hospital Nurse Mirta and Rotary President Nora Vela Paz de Cordova's son Jhon to find a rocking chair for the Pediatric Ward. Shirley wanted to do something special for the mamas on the ward. They don't have anywhere to rock their little ones after surgery.  Shirley took care of that and donated the much-needed rocking chair in Paul's name for his birthday.

Paul is our medical sterilizer and spends each day sterilizing medical equipment.  Shirley works as our kind-hearted Pediatric Ward coordinator.

One of the last patients of the day was our brave patient Pamela.  Not a complaint from 8 year old Pamela she could not eat or drink all day.  She checked in the night before and wasn't called for surgery until 3:30 in the afternoon.  Pamela was having burns removed from her face.  She had been burned last August in an accident in school. 

Pamela kept herself busy all day working with Mrs. Grossman's sticker's, she loved the letters and demonstrated for us some of her English language skills.  She is such a pretty girl.

 Kelly Cahill spent some time with Ariana and her mother training Mom on speech techniques that she can work on at home.  

 And as every surgery day ends Kimberly Vellekamp, Medical Records Keeper and Carolyn Walchak, Head Nurse get to work planning the surgery schedule for the next day.

Fifth day - Surgery

Percy Jesus came to us on clinic day with a burn scar on his neck.  He had traveled with his family from the mountain city of Ariquipa, 8 hours from Tacna.  His surgery was initially scheduled for the next day.  Because of scheduling problems, we changed his surgery date to the following week, thinking the family lived in Tacna.  Our communication was a bit flawed, obviously. 

 

Fortunately, someone realized they were returning to Ariquipa, not Tacna, and we caught them just as they were leaving the building.  It was arranged for the family to stay at the home of the Tacna Rotary president in preparation for Percy Jesus' surgery 3 days later.  The surgeons would revise the burn scar to release contraction and increase mobility in his neck.  The surgery was performed by Rotaplast Surgeon, Dr. Rod Simonds, and Tacna Surgeon, Dr. Santos Condori.

 

Noemi Princesa's middle name Princess fits her perfectly.  Two years ago this beautiful dark-eyed pre-schooler knocked a boiling pot of water off the top of the stove in her kitchen.  The accident left her with a 5" scar on the side and back of her right leg.

Her parents made sure they understood how her surgeon, our mission Medical Director Dr. Frank Walchak, was going to remove the huge keloid scar from her small leg.  They wanted to know where the cuts would be, whether there'd be a skin graft (there wouldn't be), and what the healing process would entail.  Her father asked questions until he felt he had the full picture.  Bravo for being a proactive parent. And bravo for our mission interpreter.

After the operation, Noemi's father told us that his active, extroverted daughter loves to play at the park and draw pictures at home, but has always insisted on wearing pants so no one can see her "ugly place" - her keloid.  She knew the day would come that she would have to wear a skirt when she's old enough to go to school.  And now Noemi Princesa can show her legs!

Jose Alfredo wanted Dr. Frank Walchak, group Medical Director and plastic surgeon, to know how much he appreciated his working on Peru's Day of Work,their labor day.  So he made him a colorful drawing in the post-op ward.  Dr. Frank says the drawing will grace his refrigerator as soon as he gets home. 

Jose Alfredo had three operations on his palate and lip prior to coming to our mission.  Dr. Frank lengthened his columella (the strip between our nostrils).

Jose loves to play soccer and basketball, but he also loves to read, study (his favorite subject is math) and draw.  His 17-year old sister has taught him to dance, and he likes to dance at home, alone or preferably with her.  When asked what else he is interested in, he said he wanted to work and is planning to be a civil engineer.  So here in Tacna we found our future renaissance man; an artist/dancer/athlete/student/engineer-to-be.

 

Fourth day - Surgery

Jean Pierre, a little cutie, came in today for hand surgery.   He certainly kept us entertained with his charisma.

Dr. Doumit and Dr. Walchak performed our only primary lip surgery on Jhon Bradley.  He was our floor sweetie.  Mama and Papa were so relieved to see him when he finally arrived back at his room.

 Later in the afternoon we set up an impromptu clinic and saw 4 potential new surgical patients.

"This is the reason I'm a doctor," Bryan Stamm said after saying good-bye to Franklin's parents.  They brought him to us at the end of a busy operating day. 

Eight-year old Franklin fell on a cement surface two years ago, leaving him with a huge hematoma.  He still has a small hardened bump on his left cheek. His teary mother asked Dr. Bryan if it was a cancerous tumor and if it was going to get worse.  Family doctor Bryan examined the healthy, wiggly boy and assured her it was a retraction of a calcified hematoma that was not a medical problem at all.  He said it would most likely look like a dimple by the time Franklin was 18, making him even cuter than he already was.  Then Dr. Bryan and Franklin started tickling each other.  

A good end to a busy day in Tacna.

Third day - Surgery

Dr. Hugo Sanchez, head of Tacna Hospital, said that Rotaplast is engraved in his heart. With the help and coordination of the local Rotary Club of Tacna on our first day of surgery we were off and running.

Our first patients were three young women, Irma who has had 2 other surgeries in Tacna with Rotaplast, Fifteen year old Agueda and Thirteen year old  Johanan with burn scar revisions. Through the generosity of our Rotary Districts each of our patients receive a beautiful handmade quilt that will see them from pre-op to recovery, to their hospital room and on to their homes.

Irma Gladys, first came to Rotaplast - Tacna for an inital Cleft Palate Repair in June of 2003.  She had already had her lip repaired at age six. Again Irma returned a year later in June 2004 to Rotaplast - Tacna for a follow-up surgery and had a lip revision. Today Irma is having a surgery for a repair to her palate (fistula).

Another of our first patients of the day was sweet  Johanna.  Johanna and her mother were burned in a car accident and are here with Rotaplast having scar revision surgeries.

Sweet little 7 year old Daniela was a favorite of many.  She was so shy and but yet eager to be our friend.  She was very anxious to have her hemangioma removed.  She told many of us that she was ugly.  Oh but no, she is the sweetest little girl and how much cuter can a little girl get?

Down on the second floor Dr. Rosario Mayro and her team of doctors Dr. Kenny Liu and Dr. Margot Escabedo, a volunteer orthodontist and Rotarian from Lima were busy making palatal expanders and obturators for placement after cleft palate repair surgeries. 

The day ended well, we performed ten surgeries.  And we are ready for a fresh start tomorrow!

Clinic Day - our second

Clinic day, the day before our first surgeries, the day we screen potential patients for surgery the day of organized chaos.  

 This is when those with the mission experience take charge and it shows.  To an outsider it may seem like chaos but as a team member assigned a position it runs like a well oiled machine.  Carolyn Walchak, RN and Head Nurse on this Tacna mission and with 10 Rotaplast missions behind her surely knows how to run this ship.

 We met at 7:00 a.m. at the hospital passing a long line of patients that looked as if they had been waiting for a long time.  We spent an hour setting up our stations and next thing we knew we were on our way taking pictures of potential patients, moving them through to pediatrics for physicals and then on to specialty doctors for a consultation depending on their medical circumstances.

We screened  113 children and adults.  Saw a lot of children that needed lip and palate revisions and approximately 1/3 of the people we saw were burn patients. 

 

We also saw people with an assortment of deformities.  We only saw one primary cleft lip.

 
 Rotaplast has been to Tacna 4 times, it will be interesting to see if any children are returning for revisions from any of our previous missions.

 The initial schedule is set and we’re ready to go.

 

 

Our First Day in Tacna, Peru

Ken Funk, our mission director proclaimed upon our arrival in Tacna that this had to be one of his smoothest trips and check-ins in his career as Mission Director with Rotaplast.  With six stints as Mission Director under his belt that must be a good omen.

 

Although Clayton Lee, Assistant Mission Director and his wife Lorrie might not agree, they were the only team members to miss our flight to Tacna due to a flight delay in Sacramento.  In the end it all worked out, there just happened to be another flight out of LAX to Lima twenty minutes later,. We were able to meet up in customs in Lima.  Just in time for their much needed helping hands in transporting our 32 boxes that made it seamlessly through customs.

 

A member of the Rotary Club of Lima meet us at the Lima airport at midnight and helped us through customs.  How impressive the bond of Rotary Club throughout the world. 

Upon our arrival in Tacna, again another outpouring of comradeship of the Rotarians.  Their must have been over 20 Rotarians from the local Tacna Rotary Club at the airport at 6:00 a.m. waiting for our arrival.  The Rotarians were there with a truck to haul our boxes and equipment and a beautiful bus to transport us to our lovely lodgings, The Meson Hotel. 

 

After our team who comes from Spokane, Philadelphia, Boston, Phoenix, California, Texas and Atlanta and even as far away as New Zealand got a few hours of sleep we walked just a few blocks to the Tacna Hospital.   We were treated to lunch and a tour of the hospital and developed a strategic plan for the following clinic day.  What a group; the local medical team, headed by Dr. Hugo Sanchez; the local Tacna Rotarians and of course our wonderful, enthusastic and loving Rotaplast team with dozens and dozens of mission trips worth of experience under their belt.

 

I think Ken Funk’s prophecy might be right this just might be a real smooth trip.