NEWSPEACE
Send One. Train Many. Heal the World. Third Quarter | 2012
Photo By: Kris Giacobbe
A newsletter from Physicians for Peace
Dr. Jack Bevivino, West Bank 2011
When the Operating Room Becomes the Classroom K ris Giacobbe noticed the toddler first. His name was Amboul. He was hard to miss in the halls of a busy Moroccan hospital, especially for a photographer like Giacobbe. His upturned face and inquisitive expressions were made for the camera. He had that spark of life. He was three years old and on an adventure.
Amboul’s grandmother, sitting beside him, had no such glow. She knew what Amboul could not. He needed surgery, again. In his short life, he’d been through a series of mistakes and botched procedures, and his kidneys were failing. During medical training at the hospital, Giacobbe, her husband, Dean Giacobbe, MD, an anesthesiologist, and other Physicians for Peace medical educators saw many patients move ahead of Amboul. Amboul’s case was serious, but not serious enough, yet. The hospital couldn’t accommodate everyone. When Physicians for Peace left the hospital, after more than a week of training programs outside the scope of Amboul’s specific case, the boy and his grandmother were still seated in the hall, waiting, no closer to the promise of a healthy, normal life than they had been when they arrived after a seven-hour bus ride. The memory is a knife in Giacobbe’s heart.
Amboul isn’t the only child the world is failing. Two billion people in the world lack access to basic surgical care, according to the World Health Organization (WHO). The organization calls surgery the “most neglected” aspect of primary care – a critical piece of the global health puzzle that nonprofits and government agencies ignore or address superficially, with surgeons “dropping in” to perform one-time clinical procedures that local teams could manage year-round, with appropriate levels of education and support. Learning Through Training For more than two decades Physicians for Peace has been working alongside local surgical teams, providing much-needed training programs and educational tracks that ultimately lead to the best result of all: healthier patients. “The surgeons I’ve worked with are like sponges,” said Anthony Caldamone, MD, a pediatric urologist and longtime Physicians for Peace international medical educator. “It’s unbelievable. You do a six- or eight-hour operation and the whole (local) team is there watching you, the whole time. Every case becomes a teaching case.” STORY CONTINUES ON PAGE 2
11 percent of the world’s disease burden could be treated with surgery.
(Source: WHO)
CEO Message In August, Tropical Storm Haikui struck the Philippines. It was a massive, slow-moving
This summer, we also focused on the health of newborns in Nigeria
storm, and it couldn’t have come at a worse time – in the middle of monsoon season, when
– and those critical seconds after birth that too often separate life
the risk of floods and landslides is already high. Despite record-breaking floods and massive
from death. In July, Physicians for Peace deployed a team of inter-
destruction, the storm didn’t break the spirit of Physicians for Peace-Philippines. In fact, dur-
national medical educators to Rivers State to teach Nigerian mid-
ing the disaster, many of our colleagues helped with relief operations, delivering food, water
wives, nurses and health workers about Helping Babies Breathe,
and other basic items to people who lost everything.
an award-winning program released by the American Academy of
In my eight years as president and CEO of Physicians for Peace, I’ve seen this kind of selflessness again and again. We are a compassionate community. Without fail, people who support Physicians for Peace – as international medical educators or funders – are also the first people to volunteer in their own communities, responding to a need and putting the welfare of others before their own. When I talk to our supporters, I’m reminded of our shared capacity for greatness, our collective ability to right injustices that hurt our friends.
Pediatrics in 2011 and tailored for underserved areas, where hightech resources are limited or nonexistent. This training is critically important. Seven hundred babies die each day in Nigeria. That’s 30 deaths an hour. With proper intervention in the first minute after v
birth, many of these babies would have survived.
Health workers in Nigeria learn critical skills to help them save newborns’ lives.
These are just two of the inspirational stories from the past few months. You’ll find much more, including detailed blogs from
Thank you for your support. I’ve also been inspired by your support of our work in Haiti, another country that’s shouldered more than its share of devastating disasters. If you followed news from Haiti after the earthquake in January 2010, you’ll know that some well-intentioned relief efforts twisted and tangled that country, creating an alphabet soup of non-profits competing with each other to effect change in the impoverished nation.
our teams educating young surgeons in Malawi, on our website, www.physiciansforpeace.org. Looking forward, I can tell you that the upcoming months will bring no end to our activities. This fall, we’ll celebrate our Seventh Annual Gala in Norfolk, Va., but you’ll also find Physicians for Peace represented at regional and international conferences in Brazil, Scotland, Colombia and the United States, where staff members will present
That’s why I’m especially pleased to report this quarter that, 2.5 years after the earthquake,
on education models for international burn care at the American
we’ve invested funds from individual supporters, as well as the Major League Baseball Play-
Burn Association’s Southern Region Conference in Norfolk, Va.
ers Trust and ChildFund International, in projects that bring groups together, to minimize redundancy and empower Haitians who want to get their country on track for a healthier future. These investments have helped train Haitian orthotic and prosthetic technicians
Thank you for all that you do to make Physicians for Peace and the world stronger and healthier. Sincerely,
and they’ve fueled building projects, ongoing training for healthcare providers and even
Photo By: Howard Chen
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Brig. Gen. Ron Sconyers (USAF, Ret.) President and CEO
Photo By: Brian Clark
Dear Friends,
supported a memorable experience at a camp retreat for young adults and children with disabilities who live at St. Vincent’s Center for Handicapped Children. At the camp, Physicians for Peace provided hands-on physical therapy training to St. Vincent’s caretakers,
Brig. Gen. Ron Sconyers (USAF, Ret.)
so that they can make life easier and more comfortable for their charges year-round.
President and CEO v
MISSION SCHEDULE
Jake McCrowell, DPT developing physical therapy exercises for caretakers working with young Haitians with disabilities.
August 2 - September 29, 2012 Blantyre, Malawi
September 8-14, 2012 Edinburgh, Scotland - ISBI Conference
October 9-14, 2012 Florianópolis, Brazil
August 29 - September 1, 2012 Bogotá, Colombia
October 7-13, 2012 San Salvador, El Salvador
October 14-20, 2012 Santo Domingo, Dominican Republic 1
When the Operating Room Becomes the Classroom
Team Approach to Patient-Centered Care
Since 1989, the Physicians for Peace Specialized Surgery program has evolved dramatically – and it continues to be adapted to better suit the needs of partner sites in the developing world. Here are some recent highlights. A Broad Scope of Specialties
“Because of the condition, the teenagers were incontinent, wet all of the time,” Caldamone said. “This kept them out of school. It kept them from getting married. It was absolutely unfair. I saw children who had gone through multiple failed surgeries. You hardly ever see that in the U.S. because we have so many trained pediatric urologists.”
In Ecuador, Physicians for Peace also works to refine and enhance surgical teams’ knowledge of specialized skills. Since 2009, Physicians for Peace, led by Jon Partington, MD, has provided local teams with hands-on training in neurosurgical and reconstructive surgeries at Luis Vernaza Hospital in Guayaquil, which provides care for half the adult population of Ecuador. Like Caldamone, Partington said in-country teams have the necessary talent and drive – but they lack proper resources and opportunities for education and training. “The hospital has excellent physicians and good diagnostics, though they lack much in the way of equipment and one-time use items in the OR that we take for granted in U.S. hospitals,” Partington said.
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In the early 2000s, Anthony Caldamone, MD, was shocked to meet Egyptian teens with bladder exstrophy. In the U.S., the condition – where the bladder sticks out of the abdominal wall – is rare and treated within weeks of birth. The early intervention prevents a lifetime of physical and emotional suffering. But the unlucky teens Caldamone met were struggling with the disorder and had been for years, sinking into cycles of poverty, sickness and isolation.
Egypt had a base of adult urologists and surgeons, including healthcare professionals at Physicians for Peace partner hospitals, but at that time the country had no foundation for pediatric urology, a specialty that requires considerable reconstructive skill. Today, the Children’s Hospital at Cairo University, a Physicians for Peace training site during Caldamone’s outreach, maintains an active pediatric urology unit.
Photo By: Kris Giacobbe
continued
Eid Mustafa, MD, has led Physicians for Peace training programs for more than two decades.
Eid Mustafa, MD, has led Physicians for Peace training programs in the West Bank for two decades, and one thing he’s learned in that time is that you can’t improve patient outcomes without addressing all of the patients’ needs… including the host of challenges they’ll face postsurgery. That’s why a “parachute” model for international medical aid – where the expert comes, performs surgeries and leaves – will never be sustainable.
“(Through each effort, we) focus on introducing new skills to get our hosts to self sufficiency,” Mustafa said. “Improving the skills of cardiologists, cardiac surgeons, burn surgeons and their ancillary staff, are just examples of a long list of accomplishments.” For Dr. Abusafa Anas, a surgeon at Rafidia Hospital in the West Bank, the long-view approach to sustainability is what sets Physicians for Peace apart from other nonprofits.
Meaningful Partnerships for Lasting Change Regardless of the country, Physicians for Peace works to build lasting partnerships with in-country professionals, so that the exchange of information and ideas can continue long after any single workshop or conference has ended. To build skills, that continuity is crucial, Anthony Caldamone, MD said.
Follow-up care also has been a priority in Bolivia, where Physicians for Peace often works with surgeons who perform reconstructive surgery on children to improve their bladder control.
“Each (training program) has to build on the one before it,” he explained. “In the long run, that model has a much better effect in terms of long-term gains for both the medical teams and the patients.”
To view the video of Dr. Anas’ testimonial, use a scan reader app on your smartphone or iPad to capture the image code.
“We don’t just teach the surgeons how to do the surgeries, we also train the nurses and support staff. You have to step back and look at the care your patients are getting. What are you going to leave behind, to improve every aspect of the child’s care?”
Photo By: Kris Giacobbe
During previous training workshops at Luis Vernaza Hospital in Guayaquil, Ecuador, materials were in short supply. That wasn’t the case this year, when Medtronic provided the necessary surgical instrumentations for 46 life-changing spinal surgeries.
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“Without people to care for patients afterwards – meaning nurses and therapists – what you do has a lot less positive effect overall,” Caldamone said.
The WHO recently reported that poorest third of the world’s 7 billion population receives only 3.5 percent of the surgical operations undertaken worldwide. Many hospitals in these countries do not have a reliable supply of clean water, oxygen, electricity and medications, making even the most basic surgical operations a challenge.
The strong peer-to-peer connections have been especially important to Caldamone, who stays in frequent contact with his colleagues abroad.
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If that follow-through doesn’t happen, the surgery alone isn’t likely to improve the child’s health or quality of life. That’s why team members have to focus on a holistic view, accounting for both the short and long-term needs of the patients.
Donor Corner FIT FOR PURPOSE SUPPLIES
Focusing on the educational needs, rather than on direct clinical care, strengthens professional ties between in-country teams and Physicians for Peace medical educators. Whereas other models of aid can inadvertently encourage people to wait for foreign medical assistance, the Physicians for Peace approach empowers local hospitals and clinics to serve patients year-round with confidence.
“A part of me is still there,” he said. “Teaching in these countries taught me about that part of the world. Before, it was just another place that was struggling. Now, it’s a place where I have friends, colleagues.”
“Here you come up against societal norms, and you have to help the medical teams learn how to push back with education,” Anthony Caldamone, MD, said. “These children can lead normal lives, but their caretakers and families have to be educated, too.”
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“Other organizations focus on direct clinical care and patients then wait for a foreign team to come in rather than coming to see us,” he said. “This reinforces the myth that we are not qualified to provide these healthcare services and breaks the bond of trust between patient and local doctor.”
Post-surgery, the children need urinary catheterization about three times a day to empty their bladder, a concept that’s still new in many poor areas.
Medical student Emmagene Worley on a Physicians for Peace training program in the West Bank
To view the video of Dr. Partington’s team in Ecuador, use a scan reader app on your smartphone or iPad to capture the image code.
Blogging from the field, Medtronic representative, Trey Schott, shared the enthusiasm of the doctors receiving additional training on epilepsy treatment. The initiative represented “a tremendous step forward for epilepsy patients and the ability of Ecuadorian doctors to offer a new form of treatment.” This mission was made possible because of the generous donation of $340,000 in medical supplies from Medtronic.
The world we live in has tremendous disparity in the availability of and access to healthcare. With more resources, Physicians for Peace can do even more. ” — Eid Mustafa, MD
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2012 Volunteer Award Winners Honored at Gala
Specialized Surgery Program Milestones 1985 - 1988
1987
This fall, we’re recognizing our 2012 Award winners during the Seventh Annual Physicians for Peace Gala on October 27 in Norfolk, Virginia.
1999
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Winfred O. Ward, MD
For 12 years, Ward has been a dedicated Physicians for Peace international medical educator and volunteer leader. In the Dominican Republic and Libya, he laid the groundwork for Physicians for Peace training programs, forging connections and building long-lasting relationships among U.S. healthcare teams and their counterparts in Prior to incorporation, Physicians for Peace had already conducted 29 medical missions to Syria, Turkey, the West Bank, Egypt, Jordan, Cyprus, Panama, Iraq, Israel and Greece.
The Physicians for Peace Foreign Medical Graduate Physicians (Medical Scholars) program is established and chaired by the Honorable Lawrence M. Cox, former Undersecretary of the Department of Housing and Urban Development.
Juan Montero, MD, and Charles Horton, MD, founded Physicians for Peace-Philippines. The Philippines surgery program is now sustainable and run by in-country medical educators.
underserved areas. He is especially passionate about safe, effective surgeries and rehabilitation for amputees and burn victims.
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Gail Grisetti, PT, EdD
Grisetti has led training efforts for Physicians for Peace in the Dominican 2004
2009
Republic, Haiti and the Philippines. Among many other projects, she
2010
helped Catholic University in Santo Domingo, Dominican Republic, develop its first physical therapy degree program in 2006. Grisetti also coordinates exchanges between Physicians for Peace partner sites in Photo by: Kris Giacobbe
Photo By: Stephen Katz
the Dominican Republic and Old Dominion University in Norfolk, Va.
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The Honorable Maurice Jones
Jones, deputy secretary of the U.S. Department of Housing and Urban Physicians for Peace, in collaboration with GWU, launches the Partnership for Eritrea to assist in development and implementation of post-graduate medical programs in surgery, pediatrics and gynecology. International medical educators also engage in trainings focused on high-need foot and ankle surgeries.
Annual training on neurosurgical and plastic surgery begins in Guayaquil, Ecuador. In 2012, Physicians for Peace starts an epilepsy program in collaboration with in-country partners, performing detailed diagnoses using interventional neuroradiology.
Physicians for Peace collaborates with Moroccan surgical team to perform the first off-pump bypass surgery in Fes, the country’s third largest city.
— German Quevedo, MD, pediatric urologist, Japanese Municipal Hospital, Santa Cruz, Bolivia
of Physicians for Peace for two years, but his keen insights, experience and ability to bring people together for a common cause will influence the organization far into the future, empowering the group to expand strategically and tackle some of the world’s biggest health challenges with evidence-based, proven solutions that empower local communities.
2011
“Physicians for Peace gives children without opportunities the chance to resolve their health problems with amazing doctors and good people. For me, as a doctor, the opportunity to learn and get new information is unique. I want to say thank you from the depth of my soul.”
Development in Washington, D.C., played a direct role in the leadership
A former board director, he helped form the organization’s Marketing and Communications Committee.
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J. Morgan Davis
Since 2011, Davis, president and chief banking officer of TowneBank in Virginia Beach, Va., has raised more than $55,000 for Physicians for Peace through his personal “Up on the Roof” summer parties. The parties are decidedly lighthearted – with guest appearances from Morgan’s “soon-to-be-world-famous” back-up singers, the Morganettes International medical educators begin rotation deployment to serve as faculty overseeing the Surgical Intern Training Project at Queen Elizabeth Central Hospital in Blantyre, Malawi.
– but they bring together hundreds of people who want to show their support for Physicians for Peace’s medical education programs in the developing world. Davis is a former board director.
Gala tickets and sponsorship opportunities are still available. For information contact Laurie Harrison, lharrison@physiciansforpeace.org, 757.625.7569. 4
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500 East Main Street, Suite 900, Norfolk VA 23510
Non-Profit Org. US Postage PAID Norfolk, VA Permit No. 2015
Send One. Train Many. Heal the World. Would you like to give online? Visit our website: www.physiciansforpeace.org