Zambia 2011

In April 2011, I traveled to Lusaka, Zambia, with Dr. Joe Clawson, a wonderful surgeon and mentor. He has taken medical mission trips for over 20 years and has performed more than 2400 cleft lip and palate operations. His travels have taken him to Mexico, Ecuador, Jamaica, the Dominican Republic, Honduras and Zimbabwe. This was the first trip to Zambia for both of us. We had a wonderful experience at the Beit Cure Hospital in Lusaka. The Staff at the hospital were very professional and very dedicated to the care of these children.   
To Africa! | 4.10.2011
One of my significant  professional goals has been to serve on medical mission trips. In 2008, I celebrated my 20th anniversary of graduating from medical school by taking my first mission trip–to Mexico. I was “hooked” and I’ve been dreaming and scheming  about taking another trip ever since. As a single parent in private medical practice, it has been challenging to coordinate the next Mission trip, but here it is! I leave for Zambia later this week!

I will travel with Dr. Joe Clawson, a wonderful surgeon and mentor. He has  taken medical mission trips for over 20 years and has performed more than 2400 cleft lip and palate operations. His travels have taken him to Mexico, Ecuador, Jamaica, the Dominican Republic, Honduras and Zimbabwe. He and I  will travel together to Lusaka, Zambia, where we will perform cleft lip and palate surgery at Beit Cure Hospital.

I plan to blog about our trip so friends and family can “go along” with us. Whenever I talk about my plans, people say “I’d like to go” and so I invite you to come with us through this blog.

If you’d like to support our work, click here for the address and tax id number for his foundation.

Please keep us, the medical staff in Lusaka and, most of all, the children we will serve in your prayers.

4.14.2011
We are packed and ready to go at the Seatac airport. Luggage is filled with surgical instruments, medications, sutures and supplies. Dr. Clawson and I have discovered that we are each half Italian and we wonder if this is a good thing or not. Two surgeons talking with their hands at the same time might be interesting…
Thanks for all of the well wishes and prayers as we embark on this journey!

Sunrise in Zambia | 4.16.2011 
We landed in Lusaka, Zambia early this morning and were greeted by a beautiful sunrise. I spent a couple of hours during the flight chatting with the gentleman seated beside me, Michael, who was born in Zambia and has a farm near Lusaka. During the flight I also spent time reading “In My Family Tree”, a book by Shaila Siddle and co-authored by my good friend Doug Cress. I learned a lot about the country and the wildlife through my conversation and my reading. I’m excited to finally arrive!
Unpacking in the OR | 4.16.2011
Upon arriving in Lusaka, we were greeted at the airport by a delightful fellow named Daniel. Daniel works for CURE and took us directly to the Beit CURE hospital. We were warmly greeted by Sister Irene, the head Theater (operating room) nurse. After changing into scrubs, Dr. Clawson is seen here unpacking our surgical supplies. The OR looks well-equipped as does the clinic and hospital ward. Clinic starts tomorrow morning. I’m praying that the word is out that we are here so these babies can be taken care of…time for a shower and a nap.

Parents are a wonderful blessing | 4.17.2011

I’ve been thinking a lot about parents today, and the unconditional love that so many parents bestow upon their children. We saw patients this morning in screening clinic. This meant that parents of children with cleft deformities had packed up their children and driven, walked, bused, or hitched a ride to reach the clinic. Both mothers and fathers were there today, and even an aunt/uncle pair (who had arranged for their thirteen year old niece to be brought from 9 hours away!). A local church had collected enough money for her uncle and the girl to travel to Lusaka for this clinic. All of these parents (and the aunt and uncle) demonstrated unconditional love for their children. One poor mother was not only drooled upon, spit up on, but her baby boy proceeeded to urinate on her during our exam. She didn’t complain or even try to clean herself during the exam. She merely tended to the needs of this sweet child with a severe cleft lip deformity. When I looked out into the waiting room, full of parents and their children, my eyes teared up. Daily life is so hard for these people, and added to that, they have the extra challenges of feeding a child with a cleft lip, and the added expense of traveling to Lusaka on the hope that we will be able to help. The good news is, we can help. And we have eleven operations scheduled for this week already! if you’d like to help offset the cost of care for one of these children, please consider a donation to Dr. Clawson’s foundation by following this link:http://jpclawsonmedicalmissionsfoundation.org/contact.html or by donating to the Beit Cure Hospital here in Lusaka by following this link http://cure.org/hospitals/zambia/

And, by the way, I’m thinking also about my own parents, who flew to Oregon to care for my children so that I could go on this mission trip. Aren’t parents a wonderful invention and certainly a wonderful blessing? Thanks Mom and Dad…

Today we did three cleft lip operations. This darling little girl is three years old and was our last patient of the day (we schedule the infants first and had a 7 month old and a nine month old earlier). This photo is immediately post op, so she still has sutures in place and some swelling, but you can see that she looks just beautiful and her mother was moved to tears when she saw her baby after surgery. To tell the truth, I was also. I just think about my own daughters and the impossibility of  watching them endure this hardship for three years. She will now be able to eat more easily, speak normally and radiate her beautiful smile with no inhibitions. This can even make a grown man cry. That is another story…but I have to share it anyway…Last night Dr. Clawson and I had dinner with a friend that he met (really long story that I won’t go into) via email. Victor is Zambian, living in Zambia, but also has a position in Portland as a fellow with the World Forestry Center and a surrogate mother(Mama JJ) in Longview, Washington (Dr. Clawson’s home town). Victor walks the walk of his Christian faith through his many adopted children, his support of a local orphanage (which we visited this evening) and his invaluable assistance with this trip–obtaining a cell phone, transportation, outreach and marketing and his genuine heart of gold. Last night, Victor invited his friend George Mubanga, a famous Zambian newsman, to join us for dinner.  Mr. Mubanga was so moved by our work and photos of previous patients that he came into the operating room today with a camera crew and did a news story for ZNBC (Zambia National Broadcasting Company). We are told it will air tomorrow, but more telling than that is the heartfelt “thank yous” that he repeated to “Dr. Joseph” and “Dr. Michelle” for helping his fellow Zambians and the telltale redness of his eyes as he walked away from the interview. I continue to see God in the details of this trip as relationships develop, people are changed and more children have access to this procedure as the news spreads…What an incredible blessing for all.

One Day After | 4.19.2011
…this little girl was playing outside with this huge ball wearing what looked like tiny blue surgical scrubs. She was so happy and cute and had not a care in the world. Once the swelling subsides and the sutures dissolve, there won’t be much evidence left of the large cleft that caused her so much difficulty for the first three years of her life. I can’t help but smile as I look at her and I feel so grateful that I have been allowed to participate in this transformation.
I am learning so much from Dr. Clawson– not only picking up surgical pearls, but learning the logistics of planning and executing a medical mission trip. He plans each trip well in advance, collecting donations of suture, antibiotics, anesthetic gases, syringes, needles, pediatric medications and, of course money to purchase what can’t be donated. His system of cataloging all of the surgical instruments and supplies needed for the anticipated number of patients to be treated is amazing. The preprinted pre and post operative orders, clinic records, operative notes, and bedside charting is not only helpful but downright critical to make sure each patient receives the highest quality of care, in sometimes challenging situations. This trip, he tells me, is as close to perfect as they get. Our anesthesiologist, Dr. Tshoma is so gifted that I would entrust him to anesthetize my own children if they required surgery (and you can imagine how picky doctor-mom’s can be). I have long planned to do medical mission work, and couldn’t have dreamt up a better way to learn what I need to know as the next chapter of my life unfolds…

This little baby is about the right age for a cleft lip repair. Even a bit younger is really ideal. If treated while still an infant, there is a better outcome for development of the upper jaw and dentition as well as speech. Here you see the child at 48 hours post surgery, with some swelling and sutures still in place. We use absorbable sutures on the skin for two reasons–one, the babies typically live a long way from the hospital and won’t have to return for suture removal, and two, have you ever tried to remove tiny sutures from a tiny, crying, moving target? Another great invention is tissue glue, called Dermabond, which we apply over the suture line. This seals the wound and helps prevent infection, makes it water tight, and means no dressing, wound care or antibiotic ointment is necessary. These babies can breast feed in the recovery room and feeding and nutrition is greatly improved after repair of the cleft lip.
Today we had a special guest in the operating room–the President of Zambia! I will have some photos to share later. He came to see Dr. Clawson and it was great PR for this wonderful charity hospital. The employees haven’t had a salary increase in 3 years (due to a severely decreased budget due to the economic downturn and reduction in donations) and the President indicated today that he would help fund the hospital. One of the orthopedists shared with us that he worked without salary for the entire first year of his time at Beit Cure hospital. And, we stayed late today and were joking about overtime when the nurses told us they never ask for overtime. These nurses work without a break and the OR turnover time is better than any US hospital I’ve worked in. I’m going to brag about our anesthesiologist again today–Dr. Tshoma is incredibly talented. These children may be very disadvantaged, but I am pleased to report that they receive excellent care when they reach this facility. Check out www.cure.org to read about other services for children (hydrocephalus, club foot…).

The President Joins Us For Surgery | 4.21.2011
Wow, this trip has been amazing in so many ways. I’ll be telling stories for months before I cover everything. Yesterday, President Banda came to Beit Cure hospital to visit Dr. Clawson. (This photo was on the front page of the newspaper today. Dr. Clawson and I are seated in scrubs, President Banda is on the right in a gown and surgical mask. Tshoma, our favorite anesthesiologist is on the left in the green srubs). The two met last year when President Banda saw Dr. Clawson on CNN, featured for his work in Zimbabwe, and called Dr. Clawson to invite him to Zambia. Dr. Clawson and his daughter spent a day with the President and his wife last year and hence we are here in Zambia doing this cleft lip and palate work. President Banda came to the hospital and spent time touring the facilities, meeting the staff and patients and capped off his visit with a stop in the operating room where he and Dr. Clawson rekindled their friendship. Well, that was all fun and good, but here is the best part. President Banda announced during his visit to the Beit Cure hospital that the Zambian government would take over paying the salaries for the doctors and nurses at the hospital! You can’t imagine the excitement and joy that this brought to the staff. Now the charitable donations given to Beit Cure will help even more children as these wages are covered by the government and donation money can go towards equipment, outreach cinics, transportation for patients from distant villages, etc.

So, aside from surgery, we have been part of a huge improvement in the financial situation at this hospital. And, tomorrow, we go to the State House (think White House) for a banquet with the President and several staff from Beit Cure. We believe that when we return next year, we will find that more patients have been able to travel to the hospital for cleft lip and palate surgery. And our dear friends (doctors, nurses and other staff) will have salary increases that they really need. There is a “brain drain” in Zambia as the few well trained doctors and nurses are tempted to leave the country for better paying jobs. Thankfully there are some who stay, work at this hospital and care for the poor.

Thanks for reading, for the supportive words and messages and for your prayers for our work and safety. There is so much more to tell.

Suzan | 4.22.2011
Suzan broke my heart when I met her at the screening clinic last Sunday. She is thirteen years old, as is my oldest daughter. I wrote about her a few days ago–her Uncle/guardian traveled with her 600km to come to our clinic. A local church raised money for the bus fare. He told me that they didn’t know that there is a procedure that can repair this problem until he heard of our clinic. He knows of four or five other children that he will try to bring next year. He said “when they see Suzan, they will want to come”.
This is Suzan’s preoperative photo. Just before surgery, she gave a flower to President Banda to greet him on behalf of all the other children. He later joined us in the operating “theater” and we were starting Suzan’s operation.
Suzan Immediately Post-Op | 4.22.2011
I hesitated to show this photo, as Suzan is just waking up here and is still a little bloody from surgery. She has a pack in her mouth from a tooth extraction also. But, I think you can still see how much better things will be once she is healed and her swelling is gone and the sutures are gone.I think she probably wonders why I smile so much each time I see her. I wish I could speak easily with her, but we don’t share a language. I would tell her about my daughters and how much we have been praying for her and all the other patients this week. Her Uncle speaks English and did tell me that the first thing she did when she woke up was to reach up and feel her lip. She was pleased. Later we showed her a photo of herself on a digital camera. She is very happy…and so am I.

In my next story, I’ll tell you who else now has a special place in his heart for Suzan…

Lunch With the President | 4.22.2011
Each day I have spent in Zambia brings a new surprise, or several new surprises. We found out yesterday that there would be a luncheon banquet today at the State House with President Banda and his wife! Pictured here are Judith (matron or head of nursing at Beit Cure hospital), me, President Banda, and Dr. Joe Clawson. We spent several hours eating delicious Zambian food, including Nshima (?spelling), listening to and dancing to Zambian music and visiting with one another. President and Mrs. Banda were very personable and gracious. The President asked how Suzan is doing after surgery and would like to see her again to thank her for the flower and to see how she is doing. His children and grandchildren were there and it was very enjoyable. There are monkeys and peacocks on the grounds and it was quite lovely. Several members of the Cure team were there and we are all so pleased that the hospital is being recognized for it’s good work. This is Good Friday and although Dr Clawson and I understand the importance of the day, we were initially disappointed that the staff did not want to schedule surgery today. As is always the case, we didn’t understand the bigger plan. This luncheon and the new relationship with President Banda and Beit Cure hospital will allow many more children to be helped over the years than the several that we might have helped today. Like the many we hope to serve when we return next April.
And, then there is tomorrow…when President Banda will have his helicopter fly us to see wild life and a bird sanctuary! I have been a little sad that I have traveled all the way to Africa and would not have time to see the spectacular wildlife. But, I reconciled myself to that fact as I am here to help the patients first and foremost, and I hope to return many times in the future. I’m still planning to return again next year, but couldn’t possibly say no to this invitation. My oh my, what will tomorrow bring?

Helicopter Safari | 4.24.2011
As I said, each day in Zambia has brought surprise. Saturday, we boarded the presidents’ helicopter for a helicopter safari and headed west. Seeing the city of Lusaka and the countryside from this vantage point was breathtaking. Here you see zebra running and lechwe (impala-like animals). We saw many birds and beautiful wetlands. The pilots made a courtesy flight over the Beit Cure hospital and the children were having an Easter egg hunt. They waved to us and one of the nurses who was flying with us had tears in her eyes as she waved to her own children, who were visiting the hospital for the Easter egg hunt.

President Promises Ambulance | 4.24.2011
After we landed, we had tea with President Banda. We discussed a strategy to allow more children with cleft lip and palate to come for surgery when we return next April. He asked if Beit Cure has an ambulance, and was told by the director that the hospital cannot afford one at present. The president said that he would get one for them the following week! So many unexpected blessings have come our way this week.

Sunset | 4.24.2011
The sun is setting for my time in Zambia. It has been a wonderful 8 days, and I am returning home feeling that I have been well blessed. Any of us who do mission trips will tell you that you go with the intention of serving and blessing others, but you return feeling that you were the one blessed instead. It has been such a privilege to work with Dr. Clawson this week, and to see him honored by President Banda personally as well as in newspapers and on television. He was referred to as “the doctor of the poor”, which he modestly shrugs off. But it is so true. The wheels are already turning as he plans to travel to Niger in December and April, to Ecuador in January and back to Zambia next April. I plan to accompany him to Zambia in April and possibly to Niger. I’ll have to dust off my French language skills for Niger…au revoir mes amis!