Rotaplast Missions

New Delhi, India 2014 - A Day for Thanks

Four-thirty am: The hotel room is quiet except for the whir of the ceiling fan and an occasional horn honk from the Delhi-Agra Road. Within an hour the melodic morning call-to-prayer will float in from the nearby mosque.

The usual mix of cars, motorcycles, moto-taxies, bicycles, bicycle rickshaws, pedestrians, dogs and Brahma cattle will compete for their place on the pavement, regardless of lane markings.

At this hour in the post-op ward, children that we treated yesterday are becoming acquainted with new sensations in their lips or palates. Parents are struggling to find a comfortable spot between the hospital beds for a few last minutes of sleep.

Today is our last day of surgery and we have a full schedule. One of today’s patients, Ganesh, just arrived to our clinic yesterday. He is a 35 year-old rickshaw driver with an untreated cleft lip and palate.

Lata, a local Rotarian volunteer, translated our conversation between English and Hindi. Ganesh’s wife was the supplemental interpreter since she was familiar with the nearly unintelligible sound of his nasal speech due to his cleft palate.

Ganesh was born in the economically depressed state of Bihar in eastern India. His father was a farmer and Ganesh didn’t attend school. After his marriage he and his wife came to Delhi to find work.

However, due to the high cost of living in the city, they ended up in Faridabad, 50 km from Delhi. Ganesh consulted doctors and hospitals in the past but was never able to afford the cost of surgery.

With Rotaplast coming to Faridabad there was renewed hope. Although his condition undoubtedly brings unwanted attention, he was fearful to come on the first day.

His sister’s son was treated at our clinic last week. Ganesh was impressed by the bravery of the boy and the results of the surgery. He has a very supportive family, including two sons and a daughter.

It all combined to give him the courage to seek help for himself and show up yesterday. His joyful personality was infectious and he immediately had our team smiling and cheering for him.

He is in the pre-op ward at the hospital this morning awaiting our 6:45 am arrival. I can only imagine his thoughts of apprehension and hope.

Simran’s story is a one-in-a-million win. Simran’s father is a quality control manager in a garment factory and her mother is school teacher.

They had planned to visit the Lotus Temple on Monday but because of mom’s teaching schedule, they went on Sunday.

On our team’s day off last Sunday we also visited the popular site along with thousands of local residents. Mission director Brian Walker spotted Simran, a five-year old girl with a cleft lip.

He excitedly turned to Guarav, our local host, and said, “here’s another patient for us!”

In 2011 Simran had her lip repaired but was in need of a revision for additional correction.

 

Simran’s parents were all smiles today at their good fortune for getting connected to Rotaplast. They are hoping to return next year so Simran can have her cleft palate repaired.

Three days into the mission, Anshika’s father heard about Rotaplast from his brother-in-law. The family, who live in a neighboring state, took a bus for the 70km ride to Faridabad.

Fourteen-month old Anshika had a beautiful result on the repair of her cleft lip, a procedure that took only about an hour. The “after” photo was taken a short time later.

The clean appearance of the children's lips immediately following surgery is the result of a newer method. Subsurface layers of the lip are stitched as before, but the outer layer of skin in now fused with Dermabond, a super glue.

In another year, she’ll be old enough for repair of her cleft palate.

Today is Thanksgiving Day in the US. Although not a national holiday in India, there are dozens of families who are giving thanks to Rotaplast for the gift of a beautiful new smile or the ability for better speech. Gifts that will provide the opportunity for a more productive, fulfilling life.

I’m thankful that I was able to participate and share some the stories with you.

Jerry Meshulam, Photojournalist

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - This is Thanksgiving

When I woke up this morning, I realized  with dismay, that I had only 3 antimalarial pills left:  my trip was almost over! A trip to India was not in my plans this year. However, when the opportunity presented itself to travel abroad as an anesthesiologist with Rotoplast, I couldn’t say no. 

I am currently an anesthesiology and critical care fellow at Stanford University Hospital.  I am fortunate that my mentor, Fred Mihm, invited me to come along on this mission. It has been eye opening, exhausting, fun, and most definitely rewarding. Everyday I am  part of changing lives. 

The surgeries take only around an hour or so, on average.  The cases, from a medical standpoint, are not dangerous, nor complex, but they are significant. They are life-changing. One hour of our time spares a child from constant ridicule and  a lifetime of feeling isolated and less-than. It affords them the opportunity to function normally within society, to go to school, to get married, to have children and to live life with their heads held high. I feel privileged to be able to use my training to give so many kids a chance at life.

It has also amazed me how gracious our hosts from the Rotary have been. We are so well taken care of. We are never without (great!) food, fresh water, and a clean and comfortable place to sleep at the end of a long day.  

Tomorrow is Thanksgiving, our last operating day of the mission. We have 10 cases scheduled. Instead of eating  turkey, I will be eating curry. Instead of lounging on the couch and watching football,  I will be in the operating room. Ten lives will be changed tomorrow. For that I am thankful.

 Leslie Hall, MD, Anesthesiologist

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New Delhi, India 2014 - Crafted with love

PACU nurses Ellen Adams and Marilyn Perkins monitor a patient following surgery and comfort him with a hand-crafted quilt.

As children are admitted for surgery, they are each given a lovingly handcrafted, colorful quilt. It will comfort them from pre-op, into the operating room and recovery, then home. Quilters around the US and Canada donate them through Rotaplast. Organizations include the Santa Clara Valley Quilt Association, Wrap-a-Smile by International Quilters, a project of the Rotary Club of Wells, Maine and quilters and Rotarians of Washington, Idaho and British Columbia.

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Comments from the Quartermaster, Part III

Through the course of each day, I develop a list of items that the team medical staff needs…or individual team members require. This usually means an adventure into the local markets to acquire theses treasures and I love the challenge scouring the nooks and crannies to find them.

Delhi; a continent I had never been to before…and a culture I had never experienced. As I had imagined, the streets of Faridabad, (the actual suburb of New Delhi where we are located.), are a combination of broad avenues and a twisted labyrinth of ancient dusty alleys. 

Tuk Tuks, three wheeled motorized taxis crammed with upwards of seven people, scooters, bicycles, cars, cargo trucks and pedestrians all weave a tapestry of high speed chicken in either lane horns blaring.

The orange red sun casts a crimson Maxfield Parrish glow on the market walls as I explore them. 

Amongst the teaming knotted humanity, it would be easy to take on a mantle of sadness after witnessing such poverty and heartbreaking tragedy on the crowded streets. Missing limbs, eyes, and the occasional cities of tents….but there is such a surprising deep-seated joy in the eyes of the Indian people. Their smiles radiate a humble happiness that seems to transcend all manner of adversity.

Cement and brick stacked buildings stacked haphazardly at odd angles right next to structures of beautiful architectural beauty generate a sense of historical encampment….that humans have lived on these sacred plains for tens of thousands of years.

The gentle sideways bob of the Indian head during conversation is endearing. Since I am not currently fluent in any foreign language, I depend on mannerisms, gestures and sign language to try to explain what I am looking for and why I am looking for it.  The differences between cultural mannerisms are vast and I am sure that some of my gyrations are quite humorous to the locals as I am explaining my situation.  Fortunately, Gaurav Ahuja our Rotary contact and past president has been at my side most of the time to assist in translation.

As I walk through the endless shops in search of elusive items, I notice how reflective the people can be.  If I imagine I am too busy or in too much of a hurry to make eye contact the locals do not see me at all….two travelers that pass in proximity but pass unseen.  However, a smile, a wink, a nod, or a verbal pleasantry given….opens a door of beautiful communication.

Every situation, every conversation, really every moment on the vibrant streets is a personal test of one’s patience….one’s personal commitment to a positive cooperative attitude. 

Chris Brannan, Quartermaster

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Day 6

Krishna is a 22-month-old beauty with big, expressive eyes. Her family lives only a few kilometers away from the hospital where her father works as a motorcycle mechanic. Krishna is their only child.

They heard about Rotaplast from a friend who had seen the advertisement. Mom and dad commented that they are feeling really good about the outcome of the surgery and thank Rotaplast for their good service.

 

One of the hallmarks of a Rotaplast mission is the collaboration and continuing education among the medical professionals. With decades of experience to share, they work together to provide the optimum outcome for each patient. When unique and rare malformations present, the learning continues.

Here, team medical director Dr. Dennis Dundas explains to surgeon Dr. Gagan Sabharwal and Pediatric Nurse Practitioner Nan Madden how he reconstructed a portion of the patient’s nose.

 

 

Another educational opportunity is the inclusion of medical residents on the team. Dr. Mary Lyn Stein is seen here working with lead anesthesiologist Dr. Fred Mihm. He is ICU Director and professor of anesthesia at Stanford. This is Dr. Stein’s first mission and she shares these observations…

Hi! My name is Mary Lyn. I'm thrilled to be a part of this mission as one of three anesthesiologist. I have done 4 years of training in pediatrics and anesthesiology since graduating from medical school, and at home in California I am a resident physician in both pediatrics and anesthesiology.

My role on this mission is to provide anesthesia to the patients undergoing  surgery.  In addition to ensuring that the patients are safe and comfortable during the procedure, I am involved in their preoperative evaluation and their postoperative care along with the rest of our fantastic team. 

One of the most striking features of working here has been the trust that the patients and their families place in us.  When it is time for each child's operation, he or she, along with a few family members, is brought to a preoperative holding area where we do one last check that we have the correct patient and surgery and that the patient is ready to proceed.

Then one of my colleagues or I take the child from her family and carry her into the operating theater (OT). The families encourage their children along, never once expressing fear or anxiety about the procedure.   Many of the children will walk or be carried happily into the OT and arrange themselves helpfully on the surgical bed - and this is without any sort of medication to ease the fears that are natural in this sort of setting! 

To me this signifies an incredible amount of trust in us and in our work! I am grateful for the opportunity to serve these families and we are working hard to earn the trust that they place in us.

Mary Lyn Stein, MD, Anesthesiologist

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New Delhi, India 2014 - Meet the Team

Our New Delhi team is an awesome group of 13 top notch medical professionals and 8 eager non-medical volunteers. We're an international blend with many seasoned Rotaplast masters, some with over 20 missions logged.

From the first meeting through the last surgery, there is constant collaboration and cooperation. We are all here to provide the best possible outcome for our patients. Here in random order is our crew...

(left) Chris Brannan, Quartermaster; Garberville, CA - (right) Brian Walker, Mission Director; Garberville, CA

Pamela Dundas, RN, Head Nurse and Dennis Dundas, MD, Medical Director; Sequim, WA - Fred Mihm, MD, Lead Anesthesiologist; Mountain View, CA

Ellen Adams, RN, Lead PACU Nurse; Sequim, WA - Jean Roberts, Medical Records; Olympia, WA

Erin Dunn, Ward Coordinator; Fortuna, CA - R.K. Chetty, DDS, Orthodontist; Granada Hills, CA

Jerry Meshulam, Photojournalist; Sebastopol, CA - Mary Stein, MD, Anesthesiologist; Menlo Park, CA

Jogi Chungath, MD, Surgeon; Abudhabi, UAE - Gagan Sabharwal, MD, Surgeon; New Delhi, India

John Kaufmann, Patient Transporter; Tiburon, CA - Lois Borie, RN, OR Nurse; Ocala, FL

Leslie Hale, MD, Anesthesiologist; Redwood City, CA - Marcus DeRanieri, Sterilizer; Burlingame, CA

Marilyn Perkins, RN PACU Nurse; Port Angeles, WA - Helene "Bo" Morse, PACU Assistant; Brisbane, AU

Nan Madden, NP, Pediatrician; Oakland, CA - Deborah Miller, MD, Lead Pediatrician; Mill Valley, CA

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Comments from the Quartermaster, Part II

After the initial mad rush at the hospital to move, store, and organize our equipment….set up the operating rooms, and prepare for the opening screening clinic….the days settle into the surgery schedule. After making sure the doctors and staff have what equipment and supplies they require, the Quartermaster is usually tasked with running errands, delivering messages and keeping everybody happy. 

If there is downtime…I love to go to the recovery room or PACU. Often the nurses there need someone to hold the children after surgery while they take all of their vital signs and comfort them as they awake from anesthesia. Holding these precious infants after their miraculous transformation is magical. Some awake gently and dream-like amazed to see some strange person in medical scrubs holding them….they stare in wonder. Others awake in a writhing fury….squirming in every way possible…making the tasks at hand challenging at best. But every now and then….something happens that puts everything in perspective…if the timing is just right…you get to be the one that is given the gift of placing the child back in the arms of their mother.

As you can imagine, the frightened families have gathered the courage to bring their children to a large hospital and put their hopes and dreams in the care of the Rotaplast team. They have waited for hours through the multistage clinic screening process,  awaited their appointed surgery day….then the longest wait of all…surgery.  Then….all of a sudden, someone summons mom from the waiting room…she is dressed in a gown and brought into PACU.  She is seated in a chair…then her beautiful darling is placed in her arms. Invariably, there is a hushed amazement….and emotional release…and tears. 

When the tears of joy start flowing, they are contagious. There are very few experiences that can compare to this moment. 

Chris Brannan, Quartermaster

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Day 4, More beautiful results

At this point in the mission we are concentrating on young children with previously untreated cleft lips. The results are incredible. Immediately following surgery, their repaired lips are unswollen and clean. Moms are brought into the recovery room; they're the best remedy to ease their child out of anesthesia. The joyous, tearful reactions upon seeing their children are the best reward for our effort.

The dark eye make-up Sahir is a local tradition for superstitious and asthetic reasons.

Jerry Meshulam, Photojournalist

 

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Our first new smiles

Gunnu was awake this morning and was understandably a bit sore but ready to show off the results of her surgery. By the closing clinic next Friday, the swelling will be down and the blood will be cleaned up. Children heal very quickly.

Sumit awoke while still in post-op and was joyfully greeted by his mother and her sister. Just one hour following surgery, he already looks nearly healed.

Jerry Meshulam, Photojournalist

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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New Delhi, India 2014 - Comments from the Quartermaster, Part I

It is indeed an honor to once again return to Rotaplast after an absence of several years. I am truly in awe of the amazing level of dedication each and every team member exhibits on a daily basis. 

I must say that the Quartermaster position is my favorite job. I guess technically, I am supposed to shepherd the two tons of equipment from San Francisco through Dubai, on to New Delhi…navigate the mysteries of customs and get those same twenty seven boxes…..and our team safely to the hospital. In reality, it is a team effort. Everyone pitches in and lugs, pushes, scoots and drags the boxes at the airports.  Mission Director Brian Walker is a master of figuring out just what to do and not do to get our entire caravan through customs. 

Our plane at SFO was loaded and ready to depart exactly on time at 3:30 Sunday afternoon. Then the U.S. border security decided to thoroughly run every square inch of the baggage compartment and each passenger through a special unannounced screening; this, despite the fact that we were departing the country, not entering the country.  This scrutiny took an additional one hour and twenty minutes…while we sat. 

Eventually, we did leave California and took off on our circum-polar route to Dubai, a fifteen and a half hour flight. I was thrilled to see that our fight path took us just short of the North Pole, north of Greenland, over Scandinavia, East of Moscow, and threaded down between Iran and Iraq to Dubai. Somewhere over Greenland I peered out the window and was pleased to watch the pale green aurora borealis for an hour or so.

At the short layover in Dubai, our team was joined by RN Lois Borie and PACU assistant Bo Morse.  We were now complete except for the two surgeons who would join us in New Delhi. 

We arrived in Delhi at about four in the morning on Tuesday.  After Brian Walker got all our equipment and us through customs, we were met by the Rotarians of the Delhi Vasant Valley Club. They had our bus ready and an ambulance to carry our equipment. We checked into our hotel at 6:00am, exhausted but excited. Our mission was beginning!

Chris Brannan, Quartermaster

Are you interested in donating to Rotaplast to support volunteer medical missions and change lives?  You can donate online via Rotaplast's secure payment system. You can also call the Rotaplast office at (415) 252-1111.

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