2017 Clinic: Day 2

Another very successful day at CRILE in Gracias. We saw 16 new patients!

Yesterday the local news interviewed Ben and our host, Rafael, about our work at CRILE.

Yesterday the local news interviewed Ben and our host, Rafael, about our work at CRILE.

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.

 

Ovidio, the carpenter, works with Ashley and one of our translators to measure and make a plan to make more chairs. 

Ovidio, the carpenter, works with Ashley and one of our translators to measure and make a plan to make more chairs. 

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. 

Ben checks this little one's reflexes while discussing his care with Ashley. 

Ben checks this little one's reflexes while discussing his care with Ashley. 

Here, Ben is examining a very young baby. We see children of all ages at CRILE. 

This little baby had a complicated genetic condition that affected how his bones formed. We referred him to a specialist for follow up. 

This little baby had a complicated genetic condition that affected how his bones formed. We referred him to a specialist for follow up. 

We are looking forward to several more days at CRILE.

2017 Clinic: Day 1

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.

Our team is hard at work constructing one of our magic chairs for a little patient. The chairs were a big hit with so many families who don't have kid-size chairs to give their children the support they need to sit and participate in daily activities. 

Our team is hard at work constructing one of our magic chairs for a little patient. The chairs were a big hit with so many families who don't have kid-size chairs to give their children the support they need to sit and participate in daily activities. 

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.  

 

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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.  

Melanie and Ashley fit this little girl with braces to support her feet and ankles and help her walk. 

Melanie and Ashley fit this little girl with braces to support her feet and ankles and help her walk. 

Today we are going to see even more beautiful children at the Centrp de Rehabilitatcion Integral de Lempira! 

The Little Magic Chair

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. 

 

Here is how they make the chairs at Pro-Fab Plastics.  The patterns we will provide to local carpenters do not require this machinery, but its much faster if you have it!

Here is how they make the chairs at Pro-Fab Plastics.  The patterns we will provide to local carpenters do not require this machinery, but its much faster if you have it!

2016 Brigade Report

2015-03-19 09.08.34 Hello friends and supporters! It's been a while since we've posted an update, but we've been busy behind the scenes.

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 any of the medical supplies on our list, please get in touch with us by leaving a comment.

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.

Day 6 - Gualcinse, and Summary of the 2015 Mission

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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.

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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!).

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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.

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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.

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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!

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Day 5, La Union

image1-1  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!

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Here, Clive and Fabian are providing preclinic exams, directing the children to the areas for appropriate treatment.

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This little guy required extensive treatment for multiple dental abscesses, but now is feeling much better!

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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!

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Day 4

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. 2015-03-18%2021.38.00~2

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.

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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.

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Day 3

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Today was another busy day! We travelled three hours through mountains lined in coffee plants to arrive at our destination.
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We met many amazing children and families today, and provided medicine, care and counselling. Many of the children came with acute infections requiring antibiotics or antiparasitics; others had asthma and could go home with ventolin and aerochambers. As the nearest hospital is 3 hours away, asthma treatment is extremely important for children who have this condition. We also saw a few children between the ages of 9-11years old with symptomatic undiagnosed heart disease that we were able to organize cardiology assessment for the first time. We are thankful everyday for all the donations and support we have received that allow us to provide this medicine to these children!
Today we also got the good news from Dr. Mabel Henriquez, our local Honduran doctor who will continue to provide care to the communities after we leave, that the child we sent by ambulance to Gracias from yesterday's clinic is recovering well after his appendectomy! Further, the appointment has been confirmed for the 6 year old girl we saw yesterday with previously undiagnosed cleft palate to see a specialist for repair. It has been truly amazing to be able to contribute to the care of these incredible kids!We are thankful everyday for all the donations and support we have received that allow us to provide this medicine to these children!
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Day 2, San Sebastian

2015-03-17 16.28.50 Waking up at the crack of dawn, we split forces and the pediatrics tram left on our 3 hour journey to the town of San Sebastian, Municipalidad de Piraera, Lempira. Meanwhile the oral health team stayed in  Gracias with public health officials and local dentists to develop a risk management program for oral health (see blog post below!!).

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On arrival in San Sebastian, we set up shop while the line of children to see grew. Over the course of a busy day, they were assessed and treated for a wide variety of ailments. Some of the interesting children we saw today included a child with acute appendicits who required ambulance to Gracias; an infant with an ear infection actively having a febrile seizure; a child with a loud heart murmur who had not had cardiac assessment before; and a child with previously undiagnosed cleft palate and a congnetial lower limb abnormality.

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One of the more striking observations we made today was that the vast majority of the children we saw were severely malnourished, and had significant dental decay.

In all,  131 children were seen by our team today. Off to a good start! Tomorrow we had out again for another full day of clinic.

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Successful first day from the Oral Health Team in Gracias!

Today we met with representatives of the public oral health team in Gracias to develop a risk management program intended to improve oral health in school-aged children. The day began by engaging the local team in a dialogue in order to assess local needs of the community, the current state of oral health, and perceived barriers to care. The Honduran dentists identified the relationship between oral health and general health with an emphasis on oral infection and general infection being a common theme. The main barriers to care identified were access and resources. Once these were identified, they prioritized the issues and set specific goals that are measurable, attainable, realistic and timely for this community (“SMART”). With this in mind, the local oral health team created a pilot program whereby supervised tooth brushing will be implemented in primary schools. The “PUFA” oral health evaluative system, which identifies infection, was introduced to the public health team and was accepted with enthusiasm to help determine baseline and outcome impacts of any intervention. This system is best used in countries where decay rates are extremely high (90-99%). P-pulp involvement

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The pilot program will involve 6 members of the oral health team working in different communities. In the next days, hands-on training will occur in the PUFA system and development of educational tools for teachers. Baseline measurements will be compared to future results after the tooth-brushing program is implemented.

We have committed to supply the materials needed to drive this program for 2 years. The mayor of Gracias, who is also a dentist, was an enthusiastic supporter of developing this pilot project and promoting Gracias as a model for affecting cost effective sustainable interventions to improve overall health.

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