Saddest case of the mission so far

During a very busy clinic day, this Father approached our intake station with his daughter in a wheel chair. He provided no invitation letter but just pleaded for his daughter just to be seen by our medical team. As we would never turn down someone in need, we accepted this patient and started the initial work-up. She is a pleasant 14-year old girl, who is very much like any adolescent from the neck up. But thats where the similarities and normalities for this child ends.
She was born normal, however, when she was 3 years old, she had some difficulty walking and her parents brought her to a doctor. The doctor injected something into her lower back and within days, she lost all function of her lower extremities. Over time she has been confined to a wheelchair. With the combination of no motor function and very poor posture in the chair, her body has grown into a dramatic shape.
Her spine is so distorted that while sitting in the wheelchair, one can barely make out the natural direction of her spinal column. She has lost most of her motor function from waist to feet, although she can still wiggle her toes and partially move her arms. Her torso is so compressed that if she continues down this path, dangerous complications such as collapsed lungs and dysfunctional gastrointestinal system will eventually develop.
Our plan is to manipulate her spine to physically attempt to straighten her. We will assist to develop a brace so when she sits in her wheelchair, she can be held up more straight. There is no chance for recovery, but without attempting to fix her posture, she will certainly die an early death.
As everyone filed into the room to watch this girl get treated, taking pictures etc... I looked into her eyes and saw fear and embarrassment. At that point I stopped with the medical assistance and just bent down and held her hand. I hoped that by holding her hand and looking into her eyes with care and compassion, that she would feel less fear, less embarrassed, and more human.
I watched as her tears fell, then dried up, and a slight smile of thank you for just being there to make her feel safe come across her face.
Allowing my tears to flow would have not helped the situation at all, thus I fought hard to hold back my emotions. It wasn't until her treatment was over that I removed myself from clinic and found a quiet alone place to reflect.
Even with our help, she will never live a normal young girls life. All I hope is that she can live knowing that people care about her, no matter what we look like or where we come from.

Real hands on training

Purposes and objectives for this Vietnam Pharmacy Mission are many. One of which is to provide our students an opportunity to provide clinical pharmacy services and many other medical/physical therapy/ and prosthetic fitting assistance. The best way to remove fears/obstacles about practicing pharmacy after graduation is to get real hands on experience doing what the profession will expect them to be proficient at: Giving injections of vaccines etc...
After much proper pre-mission training, during which most of the students had needle phobia, either to give or receive, they were ready to provide injections in the medical clinic.
After dozens of injections, hopefully the team will be well prepared to practice at the expected level post-graduation!!!

Fix what was "broken"

This boy's mother brought him to clinic with little to no use of his left arm. He is 11 years old and broke his arm a few months ago playing with his friends. The local physician and hospital provided care for him, resetting his bones and casting him. The follow-up x-ray, in the cast, shows the quality of the resetting. The bones reset crooked, causing the nerves to be damaged, pain, and little to no movement. What occurred next would seem barbaric to some, but life changing to others. Bac Si Ha decided he would have to re-break the arm at the place where it healed inappropriately. After he would reset it straight, make a splint to stabilize it and confirm with another x-ray.
I was expecting loud yelling, crying pain, and screaming during this procedure.
After injecting about 20 ml of lidocaine 1% into the surrounding tissue and muscles, Bac Si Ha starting to manipulate the boys arm. A few winces, but not a single tear fell from his eyes as the manipulation became more rigorous. Finally, and suddenly, I heard a pop. Bone re-broken. I assisted in the splinting of the newly reset arm with four random bars of metal from our prosthetics supply and tightly wrapped medical gauze and bandages. All the while, the team watching the procedure looked more uncomfortable that our brave young man!!!
A reconfirmation x-ray showed a better reset. We provided the local clinic instructions for follow-up in the next few days. Our hope is that this will set normally, providing the patient with better range of motion, less pain, and proper use of his arm.
Your stronger than most ban toi!! (my friend).

Did it for grandchildren

This so far is the most emotional patient we have treated during this mission. We are now treating patients in Phong Dien, a small suburb 40 minutes from our hotel in Can Tho. About half way through the day, this patient arrived at our intake station being carried by her daughter and accompanied by a young boy. When they placed her carefully in a seat, she was missing both arms below the elbow and both legs below the near. A quad amputee. Here is her story:

A few years ago while baby sitting her grandchildren, she developed chest pain. Her family took her to a local hospital where it was discovered she was having a heart attack. Her hear rate slowed dramatically, which caused acute kidney damage. Her heart stopped beating and a code was called. The medical team tried to revive her heart with two different medications which failed to bring her back to life. The doctors told her family that they have one other medication they can use to attempt to revive her, and there is a good chance it will work. They also discussed the dangers if the medication saying there is also a strong possibility that it will cause her to develop multiple clots in her body. The family decided to accept the treatment in order for her to watch her grandchildren grow up.
The treatment worked and her heart started beating. Within 2 days, she developed clots in all 4 extremities. The doctors said that, now the best way to keep her alive is to perform quad amputation.
After the surgery, they attempted to fit her for prosthetic limbs, however, she told them it was too painful to walk and she stopped trying to use them. For years she has to have family take care of her for everything.
Today, our team was able to fit her with two properly fitting prosthetic legs and cast her to make 2 prosthetic arms that will be sent to her in December.

As they were interviewing her, she said that "she is so happy to now be able to start to walk again. She can now start to do things on her own. She can not wait to get home and set up a pratice area where she can get stronger and more independent. She is overwhelmed with joy, love and affection for our team for helping to give her her life back!!!"

Our teammate Molly, who assisted with the fitting told her that today was her birthday and that seeing her happy and able to walk is the best gift she could ever receive. With no prompting the woman teared, hugged Molly, and sang Happy Birthday in English.

At this point, all team members present broke into tears!!!

This is what selfless charity work is all about. Seeing the work we do, change lives forever!!!!

PAIN: Relieved

All day during clinic we attempt to provide treatment for orthopedic conditions and pain relief. Sometimes the outcome seems subtle, but other times it is visibly dramatic. No pain, no gain they say and the physical reaction by this patient says it all!!
Status-post motor vehicle accident months ago, this patient has not been able to move his shoulder. His range of motion was very much decreased and he has suffered in pain, not being able to work to support his family. Upon physical examination, it was discovered that his shoulder was dislocated. After multiple injections and painful manipulation, we were able to pop the shoulder back in place allowing for almost full range of motion. He walked into the clinic with a painful grimace, but walked out of the clinic with a joyful, grateful smile!!!

Patients of all ages

The majority of the patients we see and treat are adults with chronic pain and orthopedic illnesses. They develop These conditions due to poor nutrition and extremely hard labor. They presents with severe sciatica, lumbar bone spurs, cervical compression, disabling osteoarthritis etc..
But every now again we treat children with childhood disease such as post-polio syndrome, neurologic complications from fevers etc...
This child presented with severe contractions of the lower extremities, particularly his achilles tendons which prohibited him from walking normal. The thought of this child not being able to walk and play with friends brought tears to my eyes. After physical examination by Bac Si Ha, we injected the affected area, which brought crying from him, and broke my heart. However, We were able manually manipulate his lower extremities relieving the tension and pressure in his legs. His ears stopped, and he was a very brave and strong boy. In the end he endured the pain which led to him being able to flex and extend about 50% better then pre treatment. The plan is now to build a brace that will help strengthen and decrease the tension so he can grow up with a normal quality of life!!!

Life changing prosthetic fitting

Our mission is composed of 2 major components. First is the orthopedic medical clinic and second is is the prosthetics clinic. Our partnering team from Mercer University is trained well and supplies all the materials needed to successfully fit prosthetic legs. Patients in Vietnam have lower extremity amputations for a variety of reasons including silent land mines, trauma, diabetic complications etc...
Many of them go years without having the ability to walk on 2 legs, while others get very creative with their home made prosthetics. We see patients who make limbs out of wood, tree stumps, and even sheet metal. These legs typically are heavy and do not properly fit for a correct walking gait leading to pain, sores and infections. Our team develops and makes universally fitting prosthetic legs that are able to be custom made to fit each and every amputee. They are strong, durable, lightweight and most importantly properly fit.
This fitting process can take up to 8-10 hours of hard labor, which the patients gladly endure for the chance to have a normal life once more. From the intake process you can hear the stories of the cause of the amputation which is always emotional. Once taken into the fitting area, their stumps are tested for strength, range of motion, and measured. After hours of very detailed and accurate variations, the patient is finally ft to a custom made new leg.
When they arrive back at checkout, the overwhelming joy, smiles, and sometimes tears barely can describe the way they feel. There is something very rewarding, gratifying and life altering for our team members, that help to improve a life one leg at a time!!!

Bustling clinic

Daily we arrive at clinic at 7:00 am to approximately 50 medical orthopedic patients for the morning session, and 35-40 amputees for the day.  They wait patiently the heat and humidity for our bus to pull up. The greeting we get is warm and welcoming. You can see the anticipation on the face of each patient. Today they will feel less pain. Today they will receive a new leg. Today they will walk without pain or discomfort.

Each member of our team digs in right away, first performing amputee and medical intake including interviews, chief complaints, blood pressures, pulse, glucose readings, height and weight. The light blue scrubs quickly turn dark blue with perspiration. A sign that the team is working extremely hard every minute to help these needy patients. I have been so impressed with the energy and initiative of our team, independently triaging and managing the chaotic work flow. 

On day one we treated 115 medical/orthopedic patients, and fit 23 amputees. Not a bad first day!!!

2015 treated 2016 cured

In 2015, we treated this cute 3 year old. She presented with LLD (Limb Length Discrepency), due to abnormal pelvic anatomy. Her left leg was 1.5 inches shorter than her right leg, causing severe gait abnormalities and pain. During of mission last year we treated her and designed a brace to help correct the pelvic anatomy. I recall her crying a lot, very scared of us in blue scrubs and in a lot of pain.
This year she presented for a follow-up visit with a dramatic improvement, close to a cure. Her left leg is now almost the same length as her right, she walks normal, and she has no more pain.
The cure of her LLD did not cure her fear of blue scrubs.... Every time one of us walked into the clinic room, she would start crying. This occurred for a few minutes until Bac Si Ha start his examination. Once we saw her new X-ray and watched her walk, she became the cute and happy 4 year old again. In fact, she was so cute and happy that she personally thanked all of us with the sweetest and most precious voice to saying " Cam on Bac Si"!!!   It brought such joy to me to hear that and to see such a success from our past treatments. This young girl can now actively play and live a normal life.

105 blessed years

In 2013, we had the honor of traveling to DaNang, home town of one of our team members. Prior to visiting, she told us that her Grandfather was 102 years old, thus I had to meet this man.
Part of our journey this year was to revisit Chi's Grandfather who is now 105 years old. Needless to say, it was again such an honor to spend some time, albeit short, with a man who has lived and seen over a century of lifes beauty.
An additional blessing this year is that he got a chance to meet his great great grandsons for the first time. Kevin is 20 and Chris is 19, both of who have never visited Vietnam nor met their great grandfather. Seeing this interaction was truly amazing.

Thank you Chi for once again sharing your family with ours!!

It made all of our team reflect on our ancestry. Some never knew their grandparents, some only when they were barely old enough to recall, and others, like me, and very fortunate to have known all 4 for many years.

Today I send warm, loving, respectful, and thankful thoughts to my own Grandfather, Charles, who will be 96 this year. He has taught me about life, respect and honor. His presence in all of our lives made us a better, stronger family.

Hoi Yen church visit

We took half a day to travel to a the Hoi Yen church outside of DaNang. This poarish has been in existence for over 400 years and once was the place of pray for over 4000 people. It is located in a very rural and poor region of the country. During winter season, the area is affected by numerous typhoons every year. Over the course of many years of weather destruction, along with poor construction, the church was damaged beyond repair. When you pull up the path, all you see is the original foundation for the church, about 2 feet above ground level. The community assisted with the salvage of any materials and the building of a small shed to house any of the original artifcacts from the church. Today, mass is held in a temporary building until funds and supplies can be obtained to construct a new church. 

We met the current priest, who has been at this parish since 2008. His congregation is now at 400 people.

His hope and prayers are that his community will overcome this hardship and rebuild the church within 5 years. 

Charity work in Quang Ngai

Our team traveled from DaNang down the coast approximately 2.5 hours last night and arrived in the city of Quang Ngai. Prior to the  mission, our team was in contact with a local University, Middle School and Orphanage. It is here where we begin our charity work. It consisted of two events, first visiting children and giving gifts to the orphans, and second, visiting families homes to provide scholarships to 10 outstanding middle school students.

First, the orphanage:

The Phu Hoa orphanage has been in existence since 1963 and is currently run by 1 nun and 4 lay people. It is the home to 25 children who have been abandoned and left at the doorstep of the building. The government assists the facility to the amount of $20 USD per child per month. Some charity organizations send funds or supplies, but it is rare for an International Charity team to visit the children to show the love and care and compassion they truly deserve. As soon as our team van pulled into the parking area, wide eyed and beautiful children began to appear. It wasn't long before each member of our team was surrounded by children who craved hugs and love. We provided each child a gift package pre-ordered through our contacts in Vietnam, containing books, crayons, pens/pencils, and toothpaste/toothbrushes. The joy on their little faces was priceless.

Second, the home visits to the scholars:

As a team from Temple University School of Pharmacy, we know the daily struggles that many students from our own area endure and have been fortunate enough to provide many of them scholarships for outstanding academic and leadership activities. With this in mind, our charity team decided to use a portion of our funds raised to provide scholarships to 10 outstanding middle school students. The scholarship consists of 1,500,000 VND ($75  equivalent) which will pay for 1 year tuition, academic books and school uniforms for the child. The children were selected based on outstanding academic achievements and need. The professor at the local University gave a presentation the day before to the Scholars describing our intention saying " you have earned this honor through daily hard-work and dedication. It is the hope of our team for this to continue so they can become leaders in their community and provide a better life to those around them". Most of the recipients of these scholarships have lost either one or both of their parents and are being raised by grandparents. Each student was genuinely grateful and displayed shy, yet, sincere gratitude for this amazing honor. Almost all of them promised to study hard and do well in school so as not to disappoint our team!!!