Africa is Not a Country, continued and 100 cases

The Cardiac Centre is hoping to complete 100 cardiac operations this year.  Approximately half of these will have been completed by the teams from Europe and Mozambique that provide congenital cardiac surgery, with a large proportion of funding from Cuore Fratello and other groups.  The remainder are “adult cases”, meaning not congenital although many of the patients are young people, with rheumatic disease, performed by the local team and visiting anesthesiologists.  This year Dr. Maurizio Meme was here for 6 months and together with Dr. Charles Mvondo and the local team completed approximately 36 cases.  I was here in February and will be here until December.  Dr. Italo Milocco was here in January and September, working with the Mozambique team while Dr. Mvondo sought additional education and training in Leuven, Belgium.  We have completed 5 cases and the first patient was discharged on Friday on post-op day 10. (See photo below with the patient next to Dr. Charles in the center).  The Italian mission team from San Donato will arrive next week and we expect them to complete 13-15 cases.  We have patients in the ward awaiting treatment of conditions not related to their cardiac conditions before proceeding with their cardiac operations.  Unlike in the US, it is difficult to fully evaluate patients before they arrive for their operations.  They often come from long distances and are unable to incur the expense of pre-operative evaluation until the procedure is actually scheduled.  This means that unexpected findings lead to delays in proceeding with surgery.  “Unexpected findings” can include something as simple as a rare blood type, meaning that we are unlikely to have the patient’s blood type readily available and need to seek it locally or import it from the cities.
 

Working with Dr. Charles for the 6 month period beginning in October is Dr. Marta Pugliese, a cardiothoracic surgery resident from Rome.  Below you see Dr. Mvondo discussing a complex aortic case with the team and Dr. Pugliese displaying her notes resulting from that discussion.
 

 

I came across this reflection from a Ugandan journalist titled “Why I Cannot Tell the African Story.”  She describes the many situations of Africa and how they cannot be distilled into a brief summary.  Even within the US we have various cultures, economic scenarios, and even languages.  How much more so in Africa!

http://www.bbc.com/news/world-africa-34508552
 
Sunday November 1 was All Saints Day.  The Gospel reading included what we call the Beatitudes:

THE BEATITUDES
Blessed are the poor in spirit, for theirs is the kingdom of heaven.
Blessed are they who mourn, for they will be comforted.
Blessed are the meek, for they will inherit the land.
Blessed are they who hunger and thirst for righteousness, for they will be satisfied.
Blessed are the merciful, for they will be shown mercy.
Blessed are the clean of heart, for they will see God.
Blessed are the peacemakers, for they will be called children of God.
Blessed are they who are persecuted for the sake of righteousness, for theirs is the kingdom of heaven.
Blessed are you when they insult you and persecute you and utter every kind of evil against you [falsely] because of me.  Rejoice and be glad, for your reward will be great in heaven.  Thus they persecuted the prophets who were before you.
 

Next time I would like to share some updates on the Lifebox program (www.Lifebox.org).

Home Sweet Home

Greetings from Shisong and my apologies for being so delinquent about posting to this blog!

I arrived in Shisong on October 8 after leaving Rochester on the 5th.   There have been some delays in performing surgery, so I have been catching up on other work and projects.  Sr. Jethro was in the US over the summer making connections with Cameroonians here and with Americans interested in the work of the Cardiac Centre.  We were talking by phone and she laughed when she accidentally referred to me coming “home” to Shisong.  In many ways, though, it is another home for me.

I arrived near the end of the rainy season.  It is lovely to see everything so green.  There are some students from the north of Italy and I went with them to the waterfall which I show below with much water!  In the picture are Gonas Mayr and Alicia Adajar-Duante.  Alicia is a Lay Mission Helper; she is a critical care nurse from California who will be here at the Cardiac Centre for three years.  Her blog is here: http://aliciaincameroon.blogspot.com/
 

 

 

While I was preparing to return to Cameroon, I was working on preparing several responsibilities that I have in Rochester for me to be able to manage long-distance or for others to be able to manage.  In the midst of this, I came across this story describing a tremendous act of generosity.  So many of the stories about troubled areas describe acts of unspeakable cruelty or at best stories of indifference to suffering.  Yet among the poor and struggling, generous acts like this occur daily.  It is good for us to be inspired (and humbled) by stories like this.  (http://www.cbsnews.com/news/young-nurse-adopts-newborn-he-had-no-one-else/)  This man encountered a dying woman and her newborn son.  He only owed them medical care, and for that they were rapidly transferred elsewhere, yet responded by offering the baby a family.  Nurses who are employed in Sierra Leone might be financially better off than some others, but they are hardly wealthy.  Anyone in a community such as his that has any money is instantly tapped to support many others.  It is acts such as this that remind me that I have much more to give.

February 2015

I arrived here in Shisong on February 1, and had a couple of days to relax and see people since the surgeon, Dr. Charles Mvondo, had to be at an appointment in Italy.  We began operations on Wednesday, February 4 and the work has been steady.  In the past, some people have suggested that I say more about the patients that we care for.  I have been reluctant to say much about my patients due to their right to confidentiality and privacy.  Some of the patients have agreed to have their pictures posted on the Cardiac Centre website and I have referred people there for more specifics.  However, as readers of this blog have seen, this year there was a very successful fundraiser for sponsorship of several patients.  Mi-Do (www.Mi-Do.org), run by the amazing team of Dr. Claudia von Lutterotti and Andrea Maria Zeller, has been incredibly successful at raising sponsorship funds since their inception a little over a year ago.  Fr. Herald Joseph Brock, CFR, with Franciscan Mission Outreach (https://www.facebook.com/franciscanmissionoutreach), joined forces with them prior to Christmas to advance fundraising in the US for this very special project.

Donations to this project can still be made at either of the above sites or here:  http://www.youcaring.com/nonprofits/a-heart-for-cameroon/262505


These are the patients that were listed for the FMO/Mi-Do fundraiser.

I met all of these patients here during this trip, and we were able to operate on several of them, and the others will be cared for by the congenital team next week.  I am frequently inspired by my patients, particularly here in Shisong.  These patients are very happy to be having their operations.  One patient the other day was escorted to the OR by two previous patients who were recovering on the ward!  I also witnessed one patient who was in the hospital awaiting the results of her testing prior to surgery sitting with the family of a patient who had died.

Thank you from the bottom of my heart and on behalf of our patients for all of the support and financial gifts.

These post-op patients and guardians (theirs and others) were sitting outside yesterday:

Congress

Saturday was the 2nd Annual Congress of the Cameroon Northwest Anaesthetist Association.  It was well-attended by over 90 anesthetists, theater staff, and nursing students of the hospitals and health centers of the Northwest Region as well as the Western Region.  There was a Lifebox distribution and training program, as well as instruction and training on the WHO Surgery Safety Checklist.  There were also specialty lectures and discussions.  Overall I think this is a successful organization that represents the commitment to excellence and ongoing improvement of Cameroonian nurse anaesthetists.

Globalization of Indifference

Sunday was the First Sunday of Lent and the letter from Pope Francis for Lent, 2015 (“Make your hearts firm,“ Jas 5:8) was presented.  Pope Francis is concerned about what he is calling the “Globalization of Indifference.”  His idea is that when we are healthy and comfortable, we fail to think about those who are suffering.  In America, with the 24/7 News Cycle, we can sometimes feel overwhelmed by the problems of the world and within our nation, and it is easy to try to push this away and exist in our healthy and comfortable environment.  One way to overcome this sense of feeling overwhelmed is to focus on one or 2 things.  This is not to be indifferent to the rest of the suffering, but to realize that most of us are not in a position to correct all of the world’s injustices – but not to unduly contribute to them either!  Let’s not let the sense that we cannot fix everything lead us to indifference and selfishness so that we do not try to be part of the solution of anything.

The letter can be found here: http://w2.vatican.va/content/francesco/en/messages/lent/documents/papa-francesco_20141004_messaggio-quaresima2015.html

Happy Lent!

Much Progress with Sponsoring Patients! Please Consider Helping.

Merry Christmas!  I love this season and this year once again am so grateful for many things.  I wanted to show the great work that Fr. Herald and MiDo have done in getting patients their much needed heart surgery in Cameroon.  Below is Fr. Herald's Christmas Newsletter with a link to a donation website.  I will be headed back there in a few weeks and we hope to operate on these patients.

Peace and Happy New Year!

Franciscan Mission Outreach December 2014 Activity Report

 

A HEART FOR CAMEROON
From October 15 to 24 Fr. Herald accompanied US cardiac anesthesiologist Dr. Ellen Dailor (top right) to the Cardiac Centre at St. Elizabeth Hospital, Shisong Cameroon, run by Franciscan Sisters. Dr. Dailor has served several times at this state-of-the-art medical facility - the only one of its kind in Central Africa - and shared her experiences with Fr. Herald. He went to see how Franciscan Mission Outreach might help provide life-saving heart surgery to Cameroonians in need. By God’s providence, Dr. Claudia von Lutterotti and Andrea Maria Zeller (below left, with Fr. Herald) of the European nonprofit Mido - which raises funds for the same purpose - were also visiting at the same time.

Cameroon is a developing country of 22 million, a vast number of whom live in rural areas, survive on what they grow and lack adequate medical care. The average yearly income is under $2000 and life expectancy reaches only into the mid-50s. Cameroon has an extremely high incidence of rheumatic heart disease: 100-200 times higher than in wealthier countries. Rheumatic heart disease (caused by the strep virus) damages heart valves, affects mostly children and young adults and is the most common cause of cardiovascular death in the region. It’s estimated that 40,000 people in Cameroon suffer from this disease.

The Cardiac Centre at St. Elizabeth Hospital has the  advanced capacity to do open-heart valve replacement surgery to treat this disease and save lives. The Centre has a full time, European trained Cameroonian cardiac surgeon, Dr. Charles Mve Mvondo (right), and the staff and technology to provide intensive pre- and post-operative care. When Dr. Dailor is there the surgical team is complete. Though the cost of this surgery in Cameroon ($7000) is only a small fraction of that in the US, it far exceeds the means of almost everyone there who needs it. Nearly 100 patients unable to pay are on a waiting list for surgery.

That’s where Franciscan Mission Outreach comes in. We are working with the Live Greater Foundation to match donations from Mido and cosponsor patients for heart surgery at which Dr. Dailor will attend as anesthesiologist. We are endeavoring to make sure this amazing Cardiac Centre functions at full capacity for the benefit of the poor. Our goal is to raise $25,000 to give seven Cameroonians in need the Christmas gift of free heart surgery.

Please help us in this effort to save a life!
Visit: www.youcaring.com/fmo-h4c

No Ebola Here!

You have to live under a rock not to know that there is an ebola outbreak in West Africa, an outbreak that is leading to tremendous fear and suffering.  By West Africa, I mean in Liberia, Sierra Leone, and Guinea.  When Dr. Falan Mouton gives presentations on Lifebox in Africa, she likes to display an image like this:

In this image, Liberia, Sierra Leone, and Guinea are generally in the area of Southern California, and Cameroon is essentially in the area that would be south of eastern Texas.  One concerned colleague pointed out that it is “only a plane ride away.”  This is true, but it is also true that if people from West Africa get in a plane, it is more likely to be going to Europe or the US than to Cameroon.  More importantly, the people who are suffering from Ebola Virus Disease are not very likely to get into a commercial airplane, since most of them are too poor to afford an extravagance such as this.

Nevertheless, ebola fear is in full swing and while the Europeans and Americans that I met during my trip to Cameroon were happy to be there advancing our projects, several groups have also cancelled out of fear of ebola.  I am sorry that children in Cameroon will be dying of cardiac disease because children in Liberia are dying of ebola.

Although Ebola Virus Disease is serious and scary, and should be respected, I submit a few observations for perspective.  While I was in Cameroon, no Americans died from Ebola Virus Disease.  (The only Americans who have acquired EVD are those who have directly cared for victims of EVD.  This is generally true of West Africans as well.)  While I was in Cameroon, several Americans died in school shootings and in apparently random highway shooting violence.  It appears that I am still much more likely to get the flu, and die from it, than to get EVD.  I might point out that I have been vaccinated against the flu, and many people I know refuse this vaccine.  For my part, I would like to strongly recommend that we support those trying to treat this terrible problem in the way that we support people in other natural disasters, and avoid treating victims like criminals.

Doings in the absence of Ebola

I returned from Shisong Saturday evening, and I cannot call this trip anything but resoundingly successful.  I was there for 12 working days, and we completed 10 open heart surgeries and 5 pediatric interventional catheterization cases.  These patients ranged from age 10-49 and all of the cases were double valve repair/replacement except for one that was for replacement of aortic valve and ascending aorta and proximal aortic arch.  As of the time I left, all but one patient had been discharged from the ICU and 2 were preparing for discharge from the hospital.  Almost all of the patients were sponsored, at least to a significant degree, by one of the various organizations that I have discussed here in the past.  In particular, Mi-Do has done a phenomenal job of raising funds for both pediatric and adult patients who need cardiac surgery.

There were a variety of visitors and rotating physicians around the cardiac center.  There is a General Practice physician interested in cardiac surgery, and there were 3 cardiology residents rotating at the center for 2 months.  We were able to discuss cardiac surgical issues as well as increase their experience in transesophageal echocardiography.

 

In addition to the successful surgical mission, Fr. Herald Brock, CFR, of Franciscan Mission Outreach (https://www.facebook.com/franciscanmissionoutreach - there are pictures) visited the Cardiac Centre to evaluate options for further fundraising to sponsor patients for surgery and connect the Centre with organizations that can help to acquire funds for equipment and supplies such as heart valves.  I do believe that it was providential that the Mi-Do staff were there at the same time.  It was a great thing for Fr. Herald to meet with Andrea Marie and Claudia to discuss opportunities for partnership and allowing the poorest of the poor to have necessary surgical care.  I expect to have further detail on this soon.

Finally, I was blessed to have excellent timing for this trip in another way.  Both Eric and Logan Horne and Tanjong Benson and Emma had their babies (Gabriel and Cindy Trina) just before I left.  Everyone is healthy.

News!

So I arrived in Rochester at the end of March and never quite got around to posting at that time.  Now that I am preparing to return, I thought it was time for an update.  Besides there is so much to share!

I knew that leaving Shisong would be difficult, but it is not easy to describe that in a blog post.   The last week there was busy.  We operated on six patients, all of whom were doing well at last report.  One woman came from Nigeria after having been refused surgery in Dubai.  Moving back home and into my job here went fairly smoothly, but processing my time in Shisong was a little more challenging.  My thanks to all who are so supportive both while I am there and while I am here.

Sister Jethro and Doctor Sister Helen were in the US for 3 weeks in July and August to attend the Cameroonian Professional Society annual meeting in Houston on August 1-2.  They spent time in Lacrosse, WI on July 20, spend 2 days in Rochester on July 28 and 29 where they visited the University of Rochester Medical Center and spoke at my home parish of St. Marianne Cope in Rush, NY, then on to Houston and Dallas, and finally to Washington, DC.  Please pray that the many contacts that they made lead to collaborators in advancing cardiac care in Africa and serving the poor.  Unfortunately, I forgot to take any pictures of them speaking in Rochester but here they are at Niagara Falls where we made a brief stop:

In October, I will spend about 2.5 weeks in Shisong giving anesthesia for cardiac surgery.  Fr. Herald Brock, CFR, from the Franciscan Friars of the Renewal, will also visit the Cardiac Centre during this time.  We are hoping that Franciscan Mission Outreach will be able to assist us in fundraising to improve the access of cardiac surgery to the poor in Cameroon and the surrounding area.  Fr. Herald has done much work with the poor in Honduras and in what is now South Sudan, and we are very grateful for his support of this work in Shisong.  You can visit him on Facebook here: https://www.facebook.com/franciscanmissionoutreach.

Lent

Last Wednesday was Ash Wednesday, the beginning of Lent.  Even non-Catholics, nominal Catholics, and no-longer-Catholics often have some sense or memory of observing this desert period prior to Easter.  Many of us recall as children practicing or still practice “giving something up for Lent.”  Sometimes it is something easy and specific, like chocolate milk.  Sometimes it is more challenging like sweets or television.  More recently, we have been encouraged to adopt a penitential positive practice during Lent.  Often, though, the purpose of such a practice, in combination with other Lenten observances such as abstinence from meat on Fridays, fasting on Ash Wednesday and Good Friday, and receiving ashes on Ash Wednesday, is unclear.  Two goals of the sacrifice are to recall the sacrifice of Christ and to promote holiness in one’s own life.  How, then, does this work?  The practice of asceticism as part of a pathway to holiness is very ancient and found in many cultures.  Detachment from materialism and slavery to our bodies is widely recognized as promoting the spiritual life.  An act of discipline also promotes the spiritual life.  Of course these things can be and have been overdone, but in our culture my impression is that overdoing it is rare and the risk of underdoing is much greater.  This is not to say that a legalistic approach or trivial approach is useful, although I think that any attention to the spiritual life is better than neglect, given the secularism of our age.  The fear of hypocrisy is often used as a rationalization for neglect of one’s interior life or for failure to observe the work of God in our lives.  Another rationalization for refusing to observe Lent is a failure.  It can be easy to forget a Lenten promise, then on remembering, to give up rather than recommitting and moving on.  Obviously this undermines the discipline that was intended by taking on the practice in the first place.

I have found the observance of Lent to be a great spiritual opportunity.  It is long enough to develop a new habit but short enough to maintain discipline if the promise is difficult and not meant to be adopted for life.  The external observances and reminders are supportive of the Lenten practice, and one’s friends can also be supportive during this time.  Some things that I have done over the years as Lenten practices have included: A daily rosary, fasting on Friday mornings, giving up meat and fish for the entire period of Lent, giving up mindless television while not giving up all television, and adding night prayer to my daily routine.  I have not always been successful at my Lenten plan, and sometimes have even abandoned the original idea after realizing that it really was not useful.  Even though I do not eat much meat, giving up meat and fish completely turns out to be difficult to remember, especially when attending meetings where the food is served and on Saturdays following a Friday when abstaining from meat is already required.  Once I tried to give up computer solitaire, and discovered that playing solitaire helped me to think about other things and I was having trouble concentrating.  Night prayer also turned out to be difficult to remember to do since it was not a habit and required on-going reorientation.  On the other hand, some practices have been overwhelmingly successful at revitalizing my interior life.  The year that I pledged to pray the rosary every day kick-started a daily prayer time that I had previously been unable to maintain.  Although I have varied this practice since then, I credit that Lent to the prayer life that I have now and to many decisions that have been made since.  A short period of fasting turns out to be useful at focusing on the poor and at connecting with the ancient spirituality of Christianity.

It took me a while to get this posted, but it is not to late to consider a more serious observance of Lent if you have not already done so.

From Todays Liturgy:
O Lord, you have been our refuge, from generation to generation; from age to age, you are. (Cf. Ps 90:1-2)