We are back from a wonderful trip to Gracias. Over the course of a week, we met about 90 children and their families. With help from our incredible donors and the team at CRILE, especially Dr. Carlos Mazier, Oti Matteo and Dora Maldonado, we were able provide care and counseling to some new kids and some familiar faces.
Every day children would line up at with their families at CRILE to see Dr. Ben Klein and Dr. Angie Ip and our team of therapists, Ashley Jakovljevic, Bernette Kay, Laura Bradley and Christine Veldhuis. Many of them had cerebral palsy, hydrocephalus, and other developmental challenges. We worked with parents to teach them skills for caring for their kids and help them understand their conditions.
This year’s trip was a big success. The donated supplies and braces made a big difference for kids who otherwise wouldn’t have access to these essential devices. Thank you to everyone who supported us, and we can’t wait for next year!
It’s been too long since we’ve updated you on the latest news. Our 2018 trip was cancelled at the last minute because of local political unrest in Honduras. We were very disappointed after all the progress we made in 2017.
We are thrilled to say that we are moving full steam ahead planning this year’s clinic, which will take place March 24th to April 1st. We are really looking forward to seeing our old friends at CRILE and the kids.
More to come soon…
Another very successful day at CRILE in Gracias. We saw 16 new patients!
On Day 2, our whole team was featured on the evening news in Gracias. You can watch the video here at this link. We are at minute 28 of the video, so fast forward and see all of the amazing things we are doing here.
As on other days, people came from all around Gracias to have consults with Ben, Ashley, Melanie, and Kristie. We distributed 5 more chairs to children who need support to sit up and engage in daily activities.
We also met with a carpenter who is going to build even more little chairs for us here in Gracias. One of our goals for this trip was to develop a relationship with someone in Gracias who can build these chairs for us in the future. This way, we can support a local craftsperson and help kids in need.
We made many new friends yesterday, and explained to many parents the complicated care their children need. For many, this was the first time a doctor or therapist had explained the reasons for a child's special needs. Often the children see Ben and then the therapists, but sometimes they work together to diagnose a child and advise the parents.
Here, Ben is examining a very young baby. We see children of all ages at CRILE.
We are looking forward to several more days at CRILE.
We made it to Gracias, and our first day was a great success. We started at the Centro de Rehabiltacion Integral de Lempira (CRILE) bright and early. By the end of the day, our team (with some assistance from the CRILE team) treated 24 children who came from all around to see Dr. Klein and our amazing specialists, Ashley, Melanie, and Kristie.
We fit so many children with braces to help them walk, and special chairs so they can sit and interact with their families. Ashley showed the parents how to improve their children's eating and playing so they can live fuller lives.
Muchas gracias a nuestros amigos en CRILE que nos ayudaron.
It was a very long day--8 am to 7:30 pm--but we made a difference in the lives of many children. Ashley and Ben explained the practice kids need to walk and develop their muscles, and what kinds of equipment can help them.
A little patient waiting for her turn to see Melanie, Kristie, and Ashley! She loved trying out one of our little chairs. It was just her size.
Today we are going to see even more beautiful children at the Centrp de Rehabilitatcion Integral de Lempira!
Lately, we have been so fortunate to receive donations of equipment and other supplies from members of the community. The following generous donors are helping make this year's trip a success:
- Benik Corporation donated all of the wrist and hand braces in the photo above
- Holland Bloorview Kids Rehabilitation Hospital (Orthotics Department) - donated 30 ankle and foot braces that will help children walk
- Terrace Hill Pharmacy in Brantford, ON - donated much-needed medication that will help children with complicated medical needs feel better every day
- Fastenal in Simcoe, ON - donated hardware for us to attach trays to chairs so kids have a place to eat and play
- Biodesign Prosthetics and Orthotics in Brantford, ON - donated much-needed padding and strapping material, which we will use to fit kids in their equipment
- Cascade DFO - donated dynamic ankle foot braces that will help children walk
We are so grateful for all of these donors' generosity. They are part of a very important team of supporters that make our funds go farther, and our work in Honduras possible.
Thank you all so very much!
A chair gives a child so many advantages: to sit up and see the world around them, to reach towards a toy or food, to socialize and play with family who have otherwise been holding them, to eat and drink with better control and to show off skills that people didn’t know they possessed! These are all things that many of us take for granted, but for some children a chair that works is what they need to take a more active role in their lives.
This year we will be taking along little wooden chairs that can provide these opportunities.
Using the skills and smarts of Keith Oakes, a local Brantford business owner, we have developed an innovative design that will allow us to serve kids in Honduras. Keith and Ashley worked together to develop an adjustable seat that can be customized with cushions and seat belts to fit even the smallest child. Kristie, our seating technician, will bring foam and postural pieces to help stabilize the children for upright sitting. We have trays for ten of the chairs, generously donated by the Swiss Chalet in Paris, Ontario. The chairs we are bringing with us were fabricated at Pro-Fab Plastics with the generous help of Don and Neil.
Of course there will be some additional expense for transporting these wooden chairs, but they are made out of light-weight plywood and pine to minimize shipping costs.
The best part is that this design can be replicated in-country. While in Gracias, we will make connections with local carpenters who can build more chairs, using the designs and hardware we will provide.
We need your help to make this a reality. Please donate to make this new piece of equipment a success.
All that in this little wooden chair.
The Canada Honduras Child Health Initiative (CHCHI) team is gearing up for a another mission to Honduras March 26 to April 1, 2017. We will again be treating children with disabilities including cerebral palsy and spina bifida in the town of Gracias, Honduras at the local rehabilitation centre CRILE (Centro Rehabilitacion Integral Lempira). This year we are planning some exciting initiatives, including new specialized seating and orthotics therapists and expanded capacity to treat more children. We will now feature medical assessment and treatment, therapeutic seating, feeding assessment and orthotics for children with disabilities, enabling children to better sit, walk and enjoy greater participation in life. We work closely with local staff, sharing our expertise and building capacity.
All of our volunteers fund their own travel expenses, so all donations made to CHCHI goes directly to therapeutic equipment and medication to help Honduran children with disabilities.
The team has now arrived back in Canada after another successful medical and dental brigade in Honduras. It's hard to believe how fast the week flew by, and the amount that we were able to do in five days of clinic. This year, we had the privilege of not only having our own extraordinary Dental Team, but also having two local dentists, Carolina and Byron, join us for the entire week of clinics. In addition, having a Pediatric Developmental/Rehabilitation Team based out of CRILE, a rehab centre in Gracias, added a whole new dimension to the work we were able to accomplish for children with special needs in the region.
MORE ABOUT THE CANADA-HONDURAS CHILDREN'S HEALTH INITIATIVE
The Canada-Honduras Children's Health Initiative (CHCHI) is a non-profit group of individuals working towards improving the health of, and health care delivery for children in Honduras. The CHCHI group (which previously did not have a formal name), started doing medical missions in Honduras after the devastation following Hurricane Mitch. Inspired by the people of Honduras and the continued need for medical support, the group continued to come on a yearly basis, and the rest is history! Over the years, the brigade has gone to different parts of the country, and worked with different Honduran populations (street youth, incarcerated youth, in hospitals, and in rural and remote regions of the country). For the last four years, the team has been concentrating its work in Gracias, Lempira. The group has evolved overtime as well, and now includes Pediatric Dentistry, Developmental Pediatrics, and Pediatric Rehabilitation in addition to Pediatric medical care.
Every year as part of the mission, the group has also tried to contribute to Honduran health care or public health with a sustainable project. Some examples have been building a well for clean water in one community; providing an autoclave in Gracias to enable surgeries to be done locally, including emergency cesarean sections; providing a transport incubator for premature and critically ill newborns; and donating containers with medical equipment to be used in different locations, including Puerto Lempira, Santa Barbara, and Gracias.
As always, there are so many incredible people who make our work possible, both at home and in Honduras. We sincerely thank every single person who made a contribution by work, donation, or support! Particularly, we would like to thank the following supporters (in alphabetical order, by region):
- Dr. Aurora Mabel Henriquez, physician and administrator, has been a key player in the ongoing collaboration and organization of our missions. She also coordinates local health care providers (local doctors and dentists) who are able to help in our free clinics, as well as arrange for translators for our group. Dr. Mabel furthermore continues to follow-up on patients we see in clinic, and ensure they get the ongoing care they require going forward. Thank you!
- AHPROCAFE Executives Mr. Armando Aguire, Mr. Miguelito Pascual, and Mr. Hermes Fernando Reyes spent the entire week with the group, driving us each day to clinics, and more than that, supporting all aspects of our time in Honduras! Thank you so much!
- Mr. Asterio Reyes, President of the Asociación de Hondureña de Productores de Café (AHPROCAFE), arranged ground transportation to clinics in Honduras, and honoured us with a special dinner at the end of our week in Honduras.
- Mr. Samuel Reyes, Minister of Defence for Honduras, generously provided a military transport by plane from La Ceiba to Gracias at the beginning and end of our week. This allowed us to save valuable time in travel, and devote it to clinical work during the week. Your support is much appreciated!
- Mr. Rafael Funes Quijada, director of CRILE, was instrumental in organizing patients for the Pediatric Development/Rehabilitation Team to see both at CRILE and at home visits in the community. Thank you, Rafael, for inspiring us with all of the work you and your team do for patients with special needs in Gracias!
- Also, we have to thank Ana, Kimberly, Sara, Laura, Sheryl, Ana, and Cristian! These young women and young man acted as translators for our group this year and did an absolutely brilliant job. They were there in morning early, ready to go, and stayed to the end of every work day. We could not have accomplished our work as effectively or efficiently without you!
In London, Ontario
- Dr. David Cavanagh, General Practitioner, donated medication and supplies.
- Dr. Peter Fendrich, Dentist, donated dental supplies.
- Dr. Clive Friedman, Pediatric Dentist, who has joined the group on many missions previously, assisted with gathering donations, organizing equipment, and provided other help and advice with pre-departure preparation for the Dental Team.
- Ms. Janine Ogglesby from the London Health Sciences Foundation helped us arrange finances and donations for our mission this year as well as in previous years!
- Mr. Paul Rutherford at Pharmasave (Huron and Highbury) generously helped us acquire many of our medications required for the mission at cost. This made a huge difference to how far our donations could go!
- Ms. Cheryl Watson from Nexion Canada helped with our travel and flight arrangements.
- Members of the Valleyview Mennonite Church and Nairn Mennonite Church donated many items for our mission, including tooth brushes, tooth paste, vitamins, and toys for the children.
In Brantford & Region
- Landsdowne Children's Centre and Brantwood Community Services supported our brigade in many ways!
- Ms. Nervana Meleka, Owner and Pharmacist at Terrace Hill Pharmacy, donated medications.
- Mr. Daniel Pecorella, Certified Orthotist from Toronto Orthopedic Services, donated many AFO's for the Rehab Team.
And of course, a big thank you to all the donors! Whether you donated a couple dollars or many, we cannot stress how important your contribution was to making our brigade a success. We are already looking forward to the work we can do next year, and hope you will continue to support us going forward!
OUR TEAM, 2016
In addition, the mission could not have been the success it was without the hard work of our team members this year. Thank you so much Dr. Fabian Gorodzinksy, Esther Kern, Dr. Tinka Kornerup, Dr. Benjamin Klein, Ashley Jakovljevic, Sharon Rich, Dr. Heather Flieger, Dr. Chloe Davidson, and Danielle Stampley! Please see each team member's biography below to find out the special skills and interests of our team members!
Dr. Fabian Gododzinsky
Dr. Gorodzinsky is a Community Pediatrician in London, Ontario who also works at the Children's Hospital, London Health Sciences Centre. He is an associate professor in the Department of Pediatrics at Western University in London.
Dr. Gorodzinsky has been a part of 16 missions to Honduras with this group, and is one of the founding members. The first mission took place in 1998 following Hurricane Mitch, and since then, he has worked hard to make and maintain local contacts in Honduras and also has played an important role organizing each mission prior to departure. As Dr. Gorodzinsky is originally from Mexico and is a first-language Spanish-speaker, he has been invaluable to our brigade, not only as an experienced and resourceful Pediatrician and group leader, but also as a liaison between our team and local Honduran officials, health care providers, and community members. Through his contacts, we have been able to have much of the logistics of a mission such as ours sorted out prior to our arrival (which allows us to spend more time working clinically!). For the last nine years, Dr. Gorodzinsky has also recruited Pediatric Resident Doctors to join the team, and acts as a supervisor and teacher during clinics.
Dr. Gorodzinsky is the proud husband of Janice Gorodzinsky, who makes a very special contribution at the beginning of each mission by providing the most delicious cookies for all team members! His interests are clay sculpture and history.
Esther Kern is a veteran of the CHCHI group! She has been on 16 missions, and was also part of the first mission in 1998 following Hurricane Mitch. Esther is an experienced nurse: She completed her nursing training in Indiana and then spent 32 years of her career in London, Ontario at the London Health Sciences Centre working in many clinical areas, including Orthopedic Trauma, General Surgery, Urology, Clinical Neurosciences, and Rehabilitation. She also worked as a employee relations officer, nurse recruiter, clinical instructor in the Department of Nursing at Western University, and nurse manager. Her role in the last number of years on our missions has been in running the pharmacy, both dispensing the medications, and also providing medication information to families.
Esther is someone with a passion for volunteering and giving back to the community, and this passion has truly lead her to some interesting places! In addition to the volunteering she has done each year with our group in Honduras, she has also been on humanitarian missions in Cuba and Russia, been a Health Liason in Timmons, Ontario for First Nations communities, been an International Observer for parliamentary elections in Iraq and Turkistan in 2013, and volunteers a lot in London, Ontario.
Dr. Tinka Kornerup
Ida Margarita "Tinka" Kornerup is a vivacious member of our Dental Team, on her second brigade in Honduras with the Canada-Honduras Children's Health Initiative! Tinka was born in Bogota, Colombia, and studied pediatric dentistry there at the University Javeriana. She worked as a Pediatric Dentist in Colombia, but moved to Canada 13 years ago with her two daughters, Silvia and Carolina. In Edmonton, she works as a full time faculty at the Unviersity of Alberta in the division of Pediatric Dentisty. She is also Director of the Pediatric Dental Clinic at the University of Alberta.
Tinka became involved in the group last year through her friend, colleague, and mentor Clive Schneider-Friedman, who has been an integral team member for many years. Tinka had a wonderful experience last year in Honduras, both clinically and socially with our team! She remembers that although the days are so busy, and you never feel like you could possibly see all the patients and teach the local Dentists at the same time (so they can continue providing pediatric dental care after the group is gone), somehow in the end, you see everyone and feel energized by the patients! A huge accomplishment that Tinka was a part of last year was teaching local dentists for the first time how to provide atraumatic restorative treatment (ART) for patients, so they could save teeth from being extracted. Overall, Tinka has found her involvement in this group to be very rewarding, and so has come this year again! (And we couldn't be luckier to have her!!)
Dr. Benjamin Klein
Dr. Klein is a Developmental Pediatrician and the Medical Director of Lansdowne Children's Centre (a children's treatment centre in Brantford, Ontario). He also works as a General Pediatrician at Brantford General Hospital, and is an assistant clinical professor at McMaster University in the Department of Pediatrics. His academic interests involve developmental problems in children and clinical outreach for special populations, including those involved with child protection, aboriginal and First Nations children, and child mental health agencies. Outside academics, he loves learning Spanish and about ancient history, and playing hockey!
Dr. Klein has been a previous as well as current team member with the Canada-Honduras Children's Health Initiative, having come on a brigade in 2007 during his Pediatric Residency. He joined the team again this year to bring a new dimension to the group in the form of Developmental Pediatrics at CRILE (Centro Rehabilation Integral Lempira ). He also recruited Ashley and Sharon from the Lansdowne Children's Centre , and together the three of them have made a huge contribution to children with special needs in the region of Gracias, Lempira. We are looking forward to having Dr. Klein join us again next year to continue this much needed service!
Ashley is an Occupational Therapist, wife, proud mother of 2 terrific teenagers. She has been working with children in some capacity for the past 25 years. After completing her BHScOT at McMaster University, she worked in eastern Ontario for 10 years before settling back to her home-town of Brantford. Ashley is blessed with an energetic family who loves adventure, learning about different cultures, languages, lifestyles, and food through travel too.
This week in Honduras was the first time Ashley had the opportunity to participate in a brigade such as this, and bring her clinical skills abroad. Her enthusiasm here was infectious, and she was able to share her skills, and provide support to our colleagues in Honduras and the children they provide services to.
Before we came, she was looking forward to learning from the people we meet and working alongside them to offer another perspective or ideas to advance the well-being and quality of life to the youngsters in this part of the world. After having been here this week, this has definitely been accomplished!
Sharon Rich is a Pediatric physiotherapist who works with Ashley and Dr. Klein at Lansdowne Children's Centre. Sharon has been working at Lansdowne for the last 10 years since finishing her Master's in Physiotherapy from MacMaster University. She completed her undergraduate training in Kinesiology at the University of Waterloo, and has recently finished her Masters in Health Management from MacMaster University as well. She is the physiotherapy team coordinator at Lansdowne Children's Centre and provides outpatient physiotherapy as well as home care and school care physiotherapy. This is her first year as part of our team in Honduras, but she has previously been part of a church mission for food and clothing distribution in the Dominican Republic in 2012. Sharon lives in Ancaster, ON and outside of work she enjoys biking, hiking, and playing baseball.
Dr. Heather Flieger
This is Dr. Heather Flieger's first year as a member of the CHCHI brigade. She is a second year Paediatrics resident at Western University but is originally from Miramichi, New Brunswick on the East Coast. Heather completed her undergraduate training in Biochemistry at Memorial University in Newfoundland and her undergraduate medical training at Dalhousie University and attended their satellite campus in Saint John, New Brunswick. Prior to joining our team in Honduras, Heather had become interested in global health through a summertime elective in she did in Vellore, Tamil Nadu, India as a medical student.
Dr. Chloe Davidson
Dr. Chloe Davidson is a 3rd year Pediatric Resident at Western University/London Health Sciences Centre. This is her second time in Honduras with the CHCHI as well! Chloe grew up on the Bruce Peninsula, did an undergraduate degree at the University of Ottawa, and completed medical school at McMaster University. In medical school, she did similar work providing medical care to children and families in rural Guatemala. She got involved in the CHCHI in Residency through her staff and mentor Dr. Gorodzinsky, who has been a member of the group since the first mission, 18 years ago. Chloe was excited to come back to Honduras this year to continue working to provide medical care for children in rural Honduras, and also learn from this extremely generous and inspiring group of volunteers and patients.
Today was our last day of clinics for this year in Honduras, and the Pediatric Medial and Dental Teams spent it in Camalote-Tampuca. It is hard to believe that the week is already done, and we will be flying back to Canada to return to our day jobs on Monday!
The Dental Team, as always, was very busy with extractions, atraumatic restorative treatment (ART), preventative treatment, and tooth brushing education.
One patient, a young girl, particularly needed a lot of dental treatment. The dental clinic was having a rare quiet moment so we were able to offer her more comprehensive treatment.
We started by providing ART fillings with glass ionomer to both of her lower primary second molars. She had carious lesions on these teeth that needed to be filled. Her upper anterior teeth were also carious but not yet cavitated. We wanted to prevent further decay so we treated these teeth with silver nitrate to arrest the caries, and then gave fluoride to assist the remineralization of the enamel. She also had retained roots of her upper first primary molars. These roots were decayed and infected. We were able to remove these root tips from her maxilla to prevent further infection and disease.
Meanwhile in the Pediatric Medical Clinic, 118 patients were seen. There were many cases of skin infection, such as scabies and impetigo that kept the team busy. We also had our second instance in the week of a child presenting with undiagnosed Down Syndrome. These conversations are always difficult, because often the parents hope their child will get better, or that there is a cure. However, as this is a genetic syndrome, it is very important for these families to understand that their child will always have some differences, but that there are ways to support them and their development going forward.
The Rehab Team changed their pace today and did three home visits instead of clinic at CRILE. This was a much needed service to these families who were unable to bring their complex-needs children to CRILE.
The first child we saw was Moses, an 11 year old young man with cerebral palsy, who suffered a secondary brain injury after a severe respiratory infection. He lived in a house with his very caring mother and three siblings. As swallowing is difficult for Moses, he cannot eat solid foods, so Mom has been using formula only for his nutrition. During our assessment, Ashley (OT) was able to educate Mom on how to thicken his formula to reduce his risk of aspiration; Moses responded very well to this change and we were able to see him swallow well!!
We also souped up his wheelchair, so it was more comfortable and safe for him. Dr. Klein provided some insight onto medication on that could make him for comfortable as well. We are optimistic that the changes we were able to provide will help Moses have an improved quality of life, and hopefully keep him safely out of hospital.
Our second patient, Cesar, was a lovely and very smily 3 year old boy also with cerebral palsy. He did not have a wheelchair yet, but we were able to build him a seat with more appropriate positioning for him! This way he will be able to keep his head up and interact with his environment and his family more when he's in an upright position. He also has some rigidity, so we provided him with some AFOs to help maintain his range of motion.
Our last patient, Daniel, was an extremely active 8 year old boy with choreiform movements (non-purposeful rhythmic movements). We think he had these movements secondary to a brain insult in the peripartum period. His twin brother is healthy, and unaffected. Daniel also had a wheelchair, but because of his constant movements while he's awake, it is difficult for him to stay in his chair. Ashley and Sharon's skill with improving and making seating for patients has gotten so good over the course of the week, that we think Daniel's chair may be the best one yet! We were also able to provide the family with an exercise ball so he can continue working on his exercises at home (and we knew he already loved the ball because of his previous sessions with the physiotherapist at CRILE!).
Today was the longest journey outside of our base in Gracias, Lempira. Our Medical and Dental Teams traveled to Las Peñas, which is 2 hours away by car.
Members of the Medical and Dental Teams were both joined by local doctors and dentists today, which made our clinic fly by. A local Obstetrician/Gynecologist, Dr. Karla Guevara, also joined us and was able to perform prenatal ultrasounds. Karla also joined our group on many of our clinic days last year, so it was wonderful to work with her again!
Today the medical team saw an underweight 2 month old baby weighing only 2.3 kg (less than her birth weight). After obtaining the history and examining the baby, we determined her mother's milk supply was inadequate for her growth, and although she had been providing formula, it was expensive and she had not been feeding her enough. We luckily had formula with us, and were able to provide this along with instructions regarding safe preparation of formula, as well as give her anticipatory guidance for her infant's growth going forward.
Today we also saw a young child who's mother was told he needed to go to San Pedro Sula for an ultrasound of his head to rule out hydrocephalus (too much fluid in the ventricles of the brain). Fortunately, Karla was with us today! She is very experienced in ultrasound technique, and used her portable ultrasound machine, which was donated by our team in a previous mission, and performed his ultrasound for him. This saved the family an expensive trip to San Pedro Sula, and we were able to give the family the good news that he did not have hydrocephalus.
Our dental team continues to be busy doing much needed work on children with a spectrum of dental decay and disease. They have been providing fluroride treatment, iodine treatment to reduce the bacterial load in the mouth, atraumatic restorative therapy (ART), and extractions.
Again, we have been fortunate to have donations from community members back London, Ontario to assist us in helping these patients: each year members of our nurse, Esther Kern's church, the Valleyview Mennonite Church, donate vitamins and toothbrushes at the weekly service. We are thankful for these donations as many of the children we see do not even own a toothbrush.
Today was the Rehab Team's last full day at CRILE, as tomorrow we plan on doing mostly home visits to assess and treat patients who are unable to come to the clinic.
Today, the medical and dental teams travelled to Belen, a town not far from Gracias, and felt pampered by travelling on paved roads for a change. We set up our pharmacy, medical clinic, and dental clinic in three separate school classrooms while the student graciously moved outside into the sunshine to learn.
In the medical clinic, we saw a 4 month old infant with congenital heart disease who presented in heart failure with concomitant failure to thrive. He had been previously diagnosed with pulmonary stenosis and had a pre-arranged follow-up appointment for 3 weeks from now, but luckily we were able to see him today and recognize his symptoms as urgent. Fortunately, through the partnerships we've created over the years of this mission, we were able to use our contacts to have this baby seen in follow up tomorrow.
The dental clinic had another high-volume day with 142 patients being assessed and treated, including many of the teenage students from the school.
Sometimes the smallest contributions to our mission can make a big difference. We wanted to send our sincere thanks to two very special girls from London, Ontario, Julianna and Nellie, who took the time to make bracelets for many of the hundreds of kids we see each day. They are a hit!
Today the rehab team saw a 16 year old young man who was clinically diagnosed as having Limb Girdle Muscular Dystrophy. He had been previously spending much of his day in a small children's lawn chair which caused him to have a very stooped, forward-flexed posture. Our therapists were able to use a plastic chair and foam padding to create a seat for him so he is able to sit upright at the same height as other teens and adults in a seated position. We hope this change will enable him to have greater dignity and a better quality of life.
The entire team reunited at the end of the day at CRILE as some of the team members had yet to see the clinic. When we arrived, the waiting area was full as there were many patients who unexpectedly travelled from the nearby town of Los Flores - some of whom had heard about the clinic through a radio interview Dr. Klein had done on the local radio station earlier this week. A dental team member joined the group at CRILE today and provided fluoride treatment, toothbrushes, and toothpaste to the children there. In the end, all members present ended up pitching in to see the last few patients of the day and worked well into evening.
Today, the group again split into two parties. Some of us ventured to San Manuel to hold our Pediatric Medical and Dental clinics.
One highlight of the day was assessing an 9 year old boy who had suffered an injury to the eye the day before. On examination, it was clear that his eye was very compromised, and worsening. With the assistance of our local Honduran medical contact, Dr. Mabel, we were able to arrange for him to be transferred to a centre with an Opthalmologist, who will be waiting to see him when he arrives. We believe it is early enough in the course of his symptoms that his vision should be able to be saved! We felt fortunate that we happened to be in his town at the time of his symptoms, otherwise he may not have had access to urgent medical attention.
Another memorable patient encounter was with an 8 year old boy, this one coming in to clinic for not being able to talk. Unfortunately, it became clear that this young man had some developmental delays in multiple areas of development, with the most predominant being his speech and language abilities. We were able to discuss this diagnosis with his mother, and reassure her that the actions she was taking at home to provide developmental care for her son were admirable. The amazing part, however, was connecting with his Gr. 1 classroom teacher, who came into clinic to hear about how to best support him in the classroom.
Meanwhile, Dr. Heather Flieger (2nd year Pediatric Resident) joined Dr. Klein, Ashley, and Sharon at the rehab centre (CRILE).
The day at CRILE started with a group prayer by the staff that work there, and then we started to work. Typically Dr. Klein will first see patients and make a diagnosis or do an assessment of a child who has already been diagnosed to see what their function and overall health is like. Then, if they require a physiotherapy / occupational therapy assessment for strengthening or balance exercises or for orthoses, the child will be seen and assessed by Sharon (PT) and Ashley (OT) who are working with the clinic physiotherapist there as well. Today we saw several children of various ages with cerebral palsy as well as as child with Prader-Willi Syndrome, children with seizures, and two children who are deaf. Sharon and Ashley have gotten very creative in engineering assistive equipment for these children. In addition to remodelling ankle-foot othoses (AFOs) which were kindly donated secondhand by many of the children at the Lansdowne Children's Centre, they also created assisted seating devices out of car seats, pool noodles, and duct tape so that children with low tone can improve truncal tone, have greater use their hands, and be able to be more interactive with their environment.
This is a picture of Sharon and a two year old little boy who was given one of these "seaters" today:
By far, the most vivid part of our day today was in the form of a home visit to a 12 year old girl with seizures and regression of her developmental milestones. The family is very poor and lives nearby, but high up on a hill and they have limited means to be able to bring her to the clinic. Home visits by health care professionals are eye-opening even in Canada, as you are able to appreciate your patient's actual environment and how they live, but in Honduras the experience was truly humbling. The director of CRILE, Rafael, and his wife, Cynthia, drove us a few minutes outside of Gracias and then we had a short, but steep trek up the hill to visit Johanna and her family. Johanna lives with her mother and grandmother, with many members of her extended family, including lots of tiny cousins, nearby. She is a 12 year old girl who's had seizures from a very early age, and is now having more and more trouble with ambulation and self-care. The family graciously invited us into the outdoor kitchen of their simple home and provided us with chairs - also present in the outdoor kitchen were two new litters of puppies, and many chickens and baby chicks! Johanna was in a hammock, where she spends a lot of her day and her family told us her seizures are getting worse and she is also not able to walk as well as she used to. Johanna impressed, however, us by being able to weight bear and had eye contact and seemingly the ability to follow what was going on around her, although she is non-verbal and has never talked. We witnessed two atonic seizures while we were there (aka: drop attacks) and luckily were able to catch her before she fell, although she did have several scars on her forehead from previous falls where she was not so lucky. The family gave a history of different seizure types so we are suspicious that her regression with walking and self-care is due to uncontrolled seizure activity. Although we were not able to make a definitive diagnosis at this assessment, we were able to offer her seizure medication as well as a helmet which we can have made and sent to Rafael once we return to Canada. Dr. Klein will also be creating a written document of his assessment in case she is able to be seen by a specialist here in Honduras in the future. This is so extremely different from how a child with a similar presentation would be assessed and treated in Canada but, sadly, we do not have easy and free access to lab tests, imaging, and specialist care here.
We had a very successful first day of clinics in Honduras!
Most members of the group ventured into the mountains to the town of San Sebastian, where we were greeted by a group of close to 250 children and their families. The local elementary school allowed all children to attend clinic for the day! Local volunteers helped guide the flow of traffic and register patients for both the medical and dental teams, and members from the Centro de Salud graciously leant us their clinical space.
The medical team saw over 100 patients. Many children today were suffering with viral infections, fevers, and asthma. We also saw children with severe dental abscess, skin infections, and learning problems.
Our dental team worked next door in very nice clinic space with a proper dental chair and even air-conditioning! Their service was quite popular, and they got plenty of referrals from the medical team as many of the children's teeth are in very poor condition. They did, unfortunately, have to do extractions for some children; but they also were able to provide tooth brushes and paste, demonstrate how to brush, provide fluoride treatments, and use atraumatic restorative treatment (ART) as well! Three local dentists also joined our team in clinic and two have volunteered to join us again in clinic tomorrow!
Meanwhile, at the CRILE (Centro de Rehabilitacion Integral de Lempira) in Gracias, our Pediatric Developmental/Rehabiliation team had a busy day assessing and treating 14 children with special needs. Many of these children had extremes of developmental disorders and physical limitations from conditions such as cerebral palsy, Angelmann Syndrome, incontinentia pigmenti, Duchenne Muscular Dystrophy, and spina bifeda. Ashley, our physiotherapist, and Sharon, our Occupational Therapist, got creative engineering pediatric assistive equipment like seats, ankle-foot orthoses (AFOs), shoe-lifts, and hand splints.
Looking forward to another busy day tomorrow!
We have arrived! We had a long day of travelling, but could not have asked for better luck in the amount of support we received from local Honduran people who picked us up from the airport and helped us manage our many suitcases full of medication and medical and dental supplies; as well as our very gracious military transport, who flew us from La Ceiba to Gracias. We were thrilled to see the same pilot that supported our journey last year help us again! We are now settled in Gracias, Honduras, ready to depart for our first day of clinic tomorrow!
In the morning we will split into two groups: Three team members (a Pediatrician, Occupational Therapist and Physiotherapist) will go to the CRILE (Centro de Rehabilitacion Integral de Lempira) and assess children with developmental and physical rehabilitation concerns; while the other members will head into the mountains to set up a mobile Pediatric Medicine and Dental clinic.
Over the course of the week, we will introduce you to members of our team, and highlight some of the stories we encounter across our clinics. Thank you everyone for your support!
Last year's mission was a great success. We treated hundreds of children in the clinics, and delivered much-needed supplies.
For the first time, dental residents joined us on the trip, and they had a very rewarding experience. Not only did they receive valuable training and experience, but also they helped to teach the local dentists some of their strategies. You can read more about it here.
We're in the process of preparing for next year's trip, which is just around the corner. We are very excited to welcome Dr. Ben Klein, a developmental pediatrician from Hamilton, Ontario, and Ashley Jakovljevic, a children's occupational therapist from Hamilton, Ontario, to our team.
Ben and Ashley are going to work with the medical team at the clinics as well as in a local rehabilitation centre in Gracias. They will bring a new dimension to the services we provide at the clinics.
We are also hoping to bring dental residents again this year. They were a huge help to our dental team last year, and it was a great learning experience for them.
As for fundraising, we are not planning any large shipments this time. We are, however, gathering supplies for the clinics. Some of the items on our "wish list" are:
- used but no longer needed orthotics, such as Ankle Foot Orthosis;
- unopened, not expired as of May 2015, scabies treatment cream (permethrin 5%);
- sample or over-the-counter children's pain medications (e.g. ibuprofen, acetaminophen) that are unopened and not expired as of May 2015;
- children's vitamins; and
- last, but not least, funds to purchase the prescription medications we need to supply our clinics.
If you are able to donate funds for supplies, please click here! Select “other” when choosing where to direct your donation, and specify Honduras Medical and Dental Team, Account 70-410-01.
If you want to make a donation by Credit Card, you can call Janine Ogglesby at the London Health Sciences Foundation - (519) 685-8300 ext 52364.
You can also send in donations by mail to the following address: London Health Sciences Foundation Attention: Janine Ogglesby 747 Baseline Road East London, Ontario, N6C 2R6
**Please include Account # 70-410-01 on all donations and specify Honduras Medical and Dental Pediatric Team
Thank you all for you support and encouragement.
We'll be back soon with more updates about our plans for the trip and fundraising.
On Saturday, we had our last clinic day in Gualcinse, and ended our medical brigade for 2015. Some of the highlights from our last clinic were seeing four children arrive together from San Sebastian, the community we travelled to on Day 1, to receive the dental care that they needed. One of these children was the child with cleft palate, whose surgery has now been arranged! These four children had such a degree of dental decay and abscess that they required sedation for multiple extractions. In hopes of preserving some teeth atraumatic restorative treatment (ART) was also used.
By the end of the day, all children had been assessed and treated by the medical and dental teams, and went home with a toy (we had just enough for every last one!).
Overall, we ended the week on a high note, with lots to look back on and be thankful for. In five clinic days, we were able to see about 600 children, and arrange four necessary surgeries, including a VP shunt placement, an emergency appendectomy, a bilateral inguinal hernia repair, and a cleft palate repair. Throughout our mission, we saw the clear benefits of the donations that were made this year, as well as in years past. Most notably, we saw the new autoclave machine at the Gracias hospital which is being used to sterilize surgical equipment, and the physiotherapy equipment, wheelchairs, and other items at the CRILE (Rehabilitation Centre), that are helping transform the CRILE into a Centre of Excellence in rehabilitation for the region.
We were also overwhelmed by how everyone we met in Honduras was so helpful; from the hotel staff who helped us load our vehicles every morning and unpack every night, to the local people who cooked lunch for us while we were running clinics, to the local teenagers who helped us with translation. We also much appreciated the support of the local health unit workers who helped to triage our patients and make the clinics run smoothly, as well as local dentists who participated in clinics. We also were so proud to be joined each day by Dr. Karla Guevera, an Obstetrician/Gynecologist who donated a week of vacation time to help with our mission, and specifically provide prenatal care in the communities we visited. Furthermore, Dr. Guevera used a portable ultrasound machine that had been donated in a previous mission to perform an abdominal ultrasound to assess an abdominal mass, and a head ultrasound to assess hydrocephalus.
We also could not have been as successful this week without the help and support of Dr. Aurora Mabel Henriquez, who identified areas of need, helped troubleshoot our day-to-day happenings, and will be following-up on our specialist referrals and patients with arranged surgeries. Her daughters also joined us and acted as invaluable translators!
When we reflect back on our week in Honduras this year, we find that it was a great experience of providing care, being involved in such amazing communities, and working with Honduran health care providers and advocates. Many of the children we saw had minor ailments, such as colds, but many had treatable conditions we were able to help with, such as asthma, bacterial diarrhea, parasites, and skin conditions. A few children, as we have mentioned in other posts, received a life-changing diagnosis that now will be treated with surgical correction. Others were diagnosed with syndromes or developmental delay for the first time, and families received counseling on their child’s condition. Many children who came to us with debilitating dental conditions, which lead to them not being able to eat due to their dental pain, received dental care that will help them towards optimizing their nutrition and overall health, and others received dental treatments that will prevent cavities from forming. Our oral health team engaged local dentists in creating their own public health program for oral health. They also taught local dentists how to provide atraumatic restorative treatment (ART), which will be used to arrest dental decay with the intention to save teeth. This therapy will improve the experience of Honduran children visiting the dentist, whose experience of odontology clinic and brigades more often is of tooth extraction alone, and therefore frightening for them. We hope that with these measures, as well as the other non-extraction dental treatments we provided, we can improve these children’s experience and help alleviate fear of seeing the dentist. Overall, we feel we are continuing to make a positive difference in Honduras through this medical and dental mission.
That being said, we still see a great need here. There are children who require reading glasses that they do not have access to, and there continues to be challenges with access to clean drinking water and adequate nutrition. In seeing these areas of need, we are already thinking of ways to grow, including involving local health services in public health strategies and programs, continuing to provide medications that are inaccessible to many Honduran children in remote areas, and engaging more local health partners towards providing care for the pediatric patients we encounter. We look forward to seeing the progress made by the local dental group with their supervised tooth brushing programs next year (see the post below, entitled “Successful first day from the oral health team in Gracias!”), but realize that these programs will require ongoing support with donated supplies of toothbrushes and toothpaste to be sustained.
We have a long list of thank-yous, because we could not have accomplished what we did alone!
In Canada, Mr. Harvey Katz generously donated the funds to get the shipping container with all of its donated supplies to Gracias. Mr. Lindsay Brucks, Director of International Medical Equipment Distribution, was the representative we worked with from Food for the Hungry Canada. This organization so kindly donated the majority of the contents of the container, including the autoclave for the hospital in Gracias. ERD Transport ensured the donated medical supplies for our container made it to Edmonton (where they were shipped from) for free. Claudia Sighomnou from Health Partners International (HPI) Canada helped us attain HPI Physican Travel Packs that were donated by Merck Pharmaseuticals. These HPI boxes contained the majority of the medications we provided in Honduras. Mr. Paul Rutherford at Pharmasave (Huron and Highbury) generously helped us with additional medications required for the mission. Elvira Villazon from PediaPharm arranged for medical donations as well. The tour group from Museum London helped with consolidating vitamins and with donations as well. Ms. Janine Ogglesby from the London Health Sciences Foundation helped us arrange finances and donations for our mission. Ms. Cheryl Watson from Nexion Canada helped with our travel and flight arrangements. And of course, two Pediatric Residents, Dr. Alisha Gabriel and Dr. Mallory Chavannes who participated in this mission last year were invaluable in helping us prepare for this year’s mission as well!!
Our dental clinics could not have been completed with the support of Henry Schein's donations, as well as 3M Canada, GC America, and Sunstar for tooth brushes and tooth paste.
In Honduras, in addition to those mentioned above, Dr. Yolanis Batres, the Honduras Minister of Health, provided us with meaningful support. Transportation in Honduras was successful with the help of Mr. Asterio Reyes (Presdente Aprocafe - IH-cafe) and Mr. Samuel Reyes (Ministro de Defense). We would also like to thank Dr. Jose Perez, the Director of the Hospital in Gracias, and Dr. Henry Garcia for their support.
Thank you again to everyone who donated to our medical and dental mission, and supported us along the way, in Honduras and at home in Canada! We hope to continue this work, and provide more care to communities in Honduras alongside local health partners next year!
We had another successful day today, this time in the mountains at La Union! Today we encouraged patients to see the dental team first, so they could receive much needed dental care, including fluoride application, disinfection, sealants, and extractions for treatment of dental abscesses. All the children recieved toothbrushes and toothpaste, as well as instructions on proper tooth brushing technique!
Here, Clive and Fabian are providing preclinic exams, directing the children to the areas for appropriate treatment.
This little guy required extensive treatment for multiple dental abscesses, but now is feeling much better!
Tinka and Maureen provide fluoride treatment and toothbrushing for these children. This treatment will help regulate their oral bacteria, protecting them from further tooth decay.
Today the medical team had the opportunity to counsel a family about their child who presented with global developmental delay at the age of nine; children with nightly bed wetting; as well as asthma prevention and care. We also treated the usual suspects, including respiratory infections, parasitic infections, rashes and skin conditions, and bacterial diarrheas.
It's hard to believe that our medical mission is almost at an end as we have our last clinic tomorrow. Tune in next time!
Last night, we had the honour of sharing a meal with the Minister of Health in Honduras as well as local health officials. The Minister recognized Dr. Fabian Gorodzinsky, the Pediatrician on our team, with his work and commitment to the promotion of health in Honduras.
With the Minister of Health and her colleagues, we also had the amazing opportunity to see the transformation of a rehabilitation facility, the CRILE (Centro de Rehabilication Integral de Lempira), that in part was due to equipment sent in our container earlier this year. Last year, this centre was a location for our dental team to perform dental care. At that time, the team was in awe of the ingenuity and perseverance of the rehab centre staff who were operating their facility with very little equipment and minimal resources. When asked how we could help, the centre provided us with a list of useful items that would allow the centre to transform into a Centre of Excellence. Generous donations obtained over the year towards this end allowed for this equipment to be shipped from Canada and delivered to CRILE. We saw how the equipment is now being utilized by the Centre, and were able to share in the pride the staff had for their facility.
Today we awoke before dawn and started on our journey to Tambla, Lempira. There, the line was longer than we'd seen yet! Today was the first day in our brigade that had the opportunity of working alongside our dental colleagues. It was a busy and rewarding day, with 178 children seen!
Today we were overwhelmed with a sense of accomplishment and teamwork in facilitating a ventriculoperitoneal shunt placement for a young child we saw yesterday in clinic with obvious hydrocephalus. This child had never been evaluated before. Our team and the health community here came together not only to organize for the shunt to be delivered to the hospital in Santa Rosa, but also enlisted a neurosurgeon here in Honduras to operate, free of charge. This treatment will prevent permanent brain damage by relieving pressure in the brain that would otherwise occur with this condition. We anticipate the procedure will be performed in the very near future as supplies are on their way!
Looking forward to another busy day tomorrow! We continue to be motivated by the amazing people we meet and the opportunity to participate in delivering health care in this region.