Wednesday, 25 March 2015

Can Tho, Vietnam Day 2-- hospital screenings and more

We've had a busy 24 hours since I blogged you last!

We returned from the first day of screenings and the medical residents and attending surgeons worked together to organize all the patient data and start scheduling the surgeries they will do over the next 2 weeks. 


Drs. Najwa and Ta

Drs. Anna and Wing

blue folders are patients' xrays



My good friend Stacy is a physical therapist in Omaha, and she and I have worked in the International Extremity Project together for the last 11 years. I can't imagine making the trip without her! In our time working in the hospitals in Vietnam, we have made some strong connections with translators and medical professionals from the area. 

Stacy and I worked for the first 3 trips to Vietnam with Phuong as our translator. We got to have dinner last night with her and her son, Phuc. It was great to catch up and enjoy watching her son be a cute little toddler. 








We were up at 6 this morning for our second day of hospital screenings. We screening 50 patients yesterday in around 8 hours, and the hospital director mentioned that there would likely be more today. 
The Mekong River outside my room

Early morning hazy view from my room. 
Early morning Mekong River traffic

The view from my breakfast table! Includes small sweet bananas, dragonfruit (white fruit with black seeds), and salt-pickled eggs. 

Hoa picked me up this morning to go to the hospital, which was a terrific start to the day.
Hoa and Melissa, an IEP volunteer







Here's some video from the morning commute

 






Heading to Can Tho General Hospital
Banh mi sandwich shop outside the hospital

Outside the hospital entrance. 

Hospital entrance. On the left are pharmacies and medical supply shops- families are usually responsible for supplying medicine, medical supplies, food, and daily care for the patients in the hospital.


There was a great turn-out from prospective patients today. We registered 56 additional adult and pediatric patients. Out of the 106 patients screening, the surgeons are planning to do 40 surgeries over the next week. 

I am always interested in the pediatric patients (you know me) and their stories. These first two children came to be evaluated by the team because they have not been permitted to enroll in school because of their limb deformities. The time that the surgeons and physical therapist took to consult with the children and the families was invaluable in making plans for surgical intervention and rehabilitation. 





These 2 days of surgical intake coordination really let my inner (and outer?) bossiness shine


Adaptive equipment-- this chair is operated by moving the steering column back and forth.

Adaptive equipment for this little girl's leg length discrepancy

IEP surgeons help to train the Vietnamese surgeons (in white coats)

Dr. Meir Nyska, IEP orthopedic surgeon from Israel


Consulting



Family members and other interested bystanders watching a screening

On the pediatric side, many potential patients have cerebral palsy, other neurological issues, post-polio syndromes, and foot and leg deformities. On the adult side, post-polio syndromes and mobility issues due to brain injuries and/or limb injuries (congenital and accidents) seemed to predominate this year. Please check on the International Extremity Project Facebook page and website for more photos of the screening day!

I got back from the hospital in a non-scooter way (just a boring old taxi), with just 2 things left on my list for the very brief working time in Can Tho: eat my favorite "sweet rice" dish, xoi ngot, and get a reminder of the relative quiet of Can Tho before heading to the sensory assault of Ho Chi Minh City tomorrow. 

Mission accomplished!

View of city park along the Mekong River

Setting up the Can Tho night market

Can Tho's Ho Chi Minh statue and park along the Mekong River

Nighttime = major outdoor socialization time. Vietnamese homes are not large and so many daily activities are conducted outside, including haircuts, meetings, group exercise sessions...
Dinnertime banh mi chay (vegetarian banh mi, hold the duck liver)

Ahhhh, my nighttime dessert highlight! This is a delicious xoi ngot-- 2 different kinds of  warm glutinous sticky rice (yellow and black), shredded fresh coconut, chopped peanuts, sprinkling of salt and sugar, wrapped in a thin waffle, then wrapped in a layer of edible rice paper. Just about the most delicious thing you can imagine. 

Next to the xoi ngot are roasted potatoes. Also yummy, but they pale in comparison to the rice treat. 


Now I get to take off my administrative assistant hat and get to some serious pediatric speech and language therapy in the next few days (this may be one of the nerdier things you will hear me say)! 

Tomorrow morning, Stacy and I head back to Ho Chi Minh City (Saigon) for 2 days of working at the Pediatric Hospital #1. We will each see patients (physical therapy for Stacy, speech and language therapy for me) side-by-side with their Vietnamese therapists, do some specialized training with the hospital's physiotherapists in different domains, and each give a lecture for area physicians and therapists. 

Just as in Can Tho, Stacy and I have worked with the HCMC Pediatric Hospital for the last 11 years. I'm looking forward to getting back there to see old friends. 








Monday, 23 March 2015

First day in Can Tho, and all is well.

Hi everyone!
We made it to the Mekong Delta. For the next 2 days, I will be working with the larger International Extremity Project (IEP) surgical team in the city of Can Tho. 

The IEP group this year consists of 20+ people, including podiatric and orthopedic surgeons, medical residents and students, nurses, pediatric therapists, medical assistants, and a couple of kids (the organizers' sons).
Carrying medical supply boxes in SFO Airport

We travel to Vietnam through Taiwan. In the 90 minute layover between the 15 hour US-> Taiwan flight and the 4 hour Taiwan-> Vietnam flight, I try to do a lot of walking. This means I get to visit all the different-themed gates in the International Terminal, including the Hello Kitty departure gate


and the Taiwanese Ceremonial Waiting Lounge.


After almost 24 hours of travel, we land in Ho Chi Minh City, where we find our bags and multiple boxes of medical supplies. 


Stacy and my traditional "I just landed in Ho Chi Minh City and have already sweated out a week's worth of fluid" photo

Can Tho is almost 4 hours by van south of Ho Chi Minh City-- we are all officially exhausted by the time we get in. I managed to shower before collapsing into bed. Not even the rollicking karaoke boat that docks on the Mekong River across from our rooms managed to keep me awake. 

This morning was our first day at Can Tho General Hospital. I work for 2 days as the administrative assistant for the IEP surgical team. I set up a medical records system for the 100+ potential Vietnamese patients that have to get screened to determine if they are eligible for lower extremity surgeries from the IEP team. 

With the help of an interpreter, I take brief histories of the potential patients, photograph the patient, and take a short video of their walking. This information helps the surgical team make decisions about whether a patient will benefit from surgery, and to make some before and after comparisons. 

Potential surgical patients are kids and adults with some varied histories; some of the issues are familiar to us in the US, but others are seen much less frequently. Polio is still a concern in Vietnam-- today we saw 8 year olds with lower extremity deformities and impairments due to polio. Cerebral palsy is a common issue in this patient group, as well as other types of brain injuries that have affected the way a person can walk and move. We see some potential patients who had significant motor vehicle or work-related accidents that did not have good initial treatment. There are also developmental and physical problems related to environmental toxins, traceable to Agent Orange used heavily in this area during the Vietnam War. 

Children and adults are typically very interested in learning whether they would benefit from surgery. The big questions are always whether surgery would provide a functional and realistic change for a patient, and whether surgery would help to change something that is an impairment for the patient. That often means that a child would be able to begin to attend school because she could now walk there, that a young woman could now look for a job because she could fit her foot into a "regular" shoe, or that a man could regain the ability to bear weight on his foot and leg. 

Stacy, the team's physical therapist, can often develop a rehab plan on the spot for someone who does not qualify for surgery. It's a great team, I'm happy to support them in this part of the mission. 

Here are some of the people we got to see today. If you'd like to see more photos, please check the International Extremity Project Facebook page and website. 


















I call the patients into see the teams of doctors using my rudimentary knowledge of the numbers 1-10 in Vietnamese (very thankful for the interpreters we have!!), and the doctors get to work:










The hospital is very welcoming to us, and we have a great lunch in the can tin ("canteen"). I'm able to get my 2nd coconut in as many days-- I start to get worried when I don't get a coconut!


When in doubt, always drink a coconut. 



We will be heading back to the General Hospital tomorrow for the 2nd day of screenings. We saw 50 patients today and expect at least that many tomorrow. Did I mention that it was a super-humid 93 degrees here today, and the hospital wing is not air-conditioned? I definitely need some more coconuts. 

I got a ride "home" today from one of our interpreters, Hoa, a university student. Here's the hospital parking lot. 



I'll post some video of my xe om (scooter) ride back tomorrow. 














Sunday, 22 February 2015

Amy's heading back to work in Vietnam-- March 2015! Can you help?

Dear Friends and Family:

We’d like to let you know that we are returning to Vietnam in March 2015 to continue our partnership with the US-based International Extremity Project (IEP), the Can Tho General Hospital, and the Children’s Hospital 1 in Ho Chi Minh City, Vietnam. As you may know, we’ve been working with these organizations since 2004, and we are thrilled to be working with them all again.

This year, we will be working in Vietnam for a short time due to our work schedules in the US. It will be an intensive week of work! First, we will work in the Mekong Delta city of Can Tho at their General Hospital with the team of IEP nurses and surgeons to assess patients for foot and ankle surgeries planned for later that week. We will then go north to Ho Chi Minh City to Children’s Hospital 1 to again work with the pediatric physical therapy and speech therapy teams in hands-on open clinic with patients and to provide training lectures to area therapists and physicians.

You have been very generous in the past in helping to support our participation in the IEP mission. If you are able to contribute to the mission again, we would be very grateful. Any donation that you make is tax-deductible.  This year, your donations will be used to defray the $3000 in travel costs that I will personally incur to make the trip, with any additional money going to support the surgery team.

Here’s how you can contribute:
Online (credit card): https://donatenow.networkforgood.org/1441540. Designate “IEP- International Extremity Project” in the “I want my donation to be designated toward” pull-down menu, and designate “Amy Levin and Stacy Lerner” in the “I want my donation to be dedicated” field.
By mail (checks only):
International Extremity Project
1874 Great Highway
San Francisco, CA 94122
designate “Amy Levin and Stacy Lerner” in the subject line

LINKS
-Check out our blogs about our past work in Vietnam:
Amy: http://amyinvietnam.blogspot.com/
Stacy: http://vietnammissiontrip2013.blogspot.com/ 

-Some other photos of us in action: http://www.donatevietnam2013.org/history-of-our-work-in-vietnam-so-far/
-You can also follow the International Extremity Project on Facebook and Twitter (@extremityproj)
-On YouTube:
https://www.youtube.com/watch?v=OGuVGb8jzDg&feature=youtu.be
https://www.youtube.com/watch?v=CWOjfSBrTfk


We’d love to talk with you more about our plans—please ask us!

Thank you again for your interest and all your forms of support,

Amy Levin alevin330@yahoo.com
Stacy Lerner stacyllerner123@yahoo.com