Saying Goodbye

Things are coming to an end for the mission trip. Most everyone has returned to Spokane. The OR team completed 16 open heart operations plus 3 pacemaker cases. The CICU nurses provided outstanding care for some very sick patients and over time, were able to move them to step down. The step down nurses continued to give outstanding love and care until it was time to send the recovered patient home. All of us have grown very attached to each patient and as much as it was our over all goal to see each patient be able to go home, it was difficult to see them go. It is with tears of happiness and sadness that we say good bye.
As one nurse pointed out, "They have done more to change us then we have done to change them".

Thank you to all the people who supported us on this mission trip!

Last night at 7:15 pm the OR group completed their 16th and final surgery of this mission trip. They spent a total of 96.25 hours in the OR over the eight days of surgery,or slightly more than 12 hours each day. The shortest day was 9.5 hours, the longest was 16 hours.
Everyone (that wasn't working) met for a dinner put on by the Minister of Health last night. Staff from KFH attended also. There were many great speeches by KFH leaders, Dr. Goldberg, and the Minister of Health.It was a wonderful time to reflect on why we came to Rwanda.

Today is Tuseday, February 16th. Dr. Siwek (right), Dr. Worrall (left) and Jason PA (center) and the OR team have completed the first case of the day and are currently working on the second case of the day. This will be the teams 16th and final surgery of the mission trip. It seems like we have just arrived but, 5 of the patients have already recovered and gone home. It won't be long till this trip is a fond memory for both us and the people of Rwanda that we have operated on and the many people we have met.

Project Rwanda—Hearts and Bikes

One of many challenges encountered by the HHNW team in addition to the medical staff at King Faisal Hospital is tracking the proper prescriptions for Rwandan patients, pre- and post-op. Several of the 16 HHNW patients live in rural areas, anywhere from three to four hours from the capitol city of Kigali and King Faisal Hospital in addition to their local clinics and drug dispensaries. And since 90 percent of Rwandans work on farms and live in the countryside, modes of transportation consist of foot or bike.


In response to the 1994 genocide and growing need for utility farming bikes, renowned mountain bike rider and manufacturer Tom Ritchie founded Project Rwanda in 2005 to help Rwandans rebuild their country and economy via a bicycle.

CICU pulmonalogist Dr. Sam Joseph read about Ritchie's efforts and project in Bicycling magazine prior to leaving Spokane on the HHNW trip. An avid road biker himself, Dr. Joesph reached out to Project Rwanda and even linked up with a few of the team riders last week for a ride about two hours north of Kigali.

So when Dr. Joseph and Physician Assistant Larry Keyser listened to two male patients speak of needing a bike or some mode of transport to get their vital prescriptions post-op, they immediately contacted Project Rwanda and purchased two utilitarian, seven-speed coffee bikes.


The bikes showed up at the hospital yesterday to the delight of the two patients and Dr. Joseph and Keyser. Actually, we all celebrated in the generous gifts. Although happiness by all was a given, it became difficult to decipher who was happier--the patients or Sam and Larry. Regardless, it was another display of compassion by the hard-working and selfless HHNW crew. Thanks for letting us all enjoy the moment of seeing those two patients smile wide while staring at their shiny, new bikes.—Johnny Stifter

Dr. Worrall and Jane RN, CICU doing morning rounds.
As you can see, things are very busy in the morning.

Saturday was the first day off for the OR group after five days of doing two surgeries per day. People went shopping, on treks and safaris, and to a football (soccer) match.

Rwanda played Angola. The match ended in a 2-2 tie.
Photo by Dr. Worrall

Dr. Worrall and the OR group continue their work as the echo is reviewed.

Dr. Worrall and PA Jason work together in the OR. Two cases a day have been completed over our first five days. Saturday is a day off.

Dr. Worrall and patient Rebecca (TET on 2/8) and Rebecca’s aunt all smile about her results. Rebecca now has returned home. It is very rewarding to see the patients as they recover and to see their smiles and the smiles of their family members. They have thanked us in words and by holding our hands and smiling. (This picture is worth clicking on in order to see it larger)

From OR to Conference Room, Training is in Full Swing

Watching the HHNW Operation Room team perform their work LIVE acts as nothing short than scientifically astounding. And, yes, as fascinating as it is inside the OR, it's almost just as amazing outside of it. How so? The team wired a live feed to a TV monitor down the hallway from the OR with headcam footage from Drs. Lee Siwek and Neil Worrall that provides a clear, introspective look at the heart and the surgery.


In turn, the live action on screen serves a higher purpose than merely raw surgical action: Rwandan doctors and nurses sit and watch the action while HHNW physicians and nurses explain what's happening on screen. The whole setup—headcam to monitor to dialog—proves to be one of the many key training opportunities for the Rwandan staff at King Faisal Hospital.


Following surgery on Friday, the two surgeons—Siwek and Worrall—in addition to the two cardiologists on the trip, Drs. Goldberg and Williams, led a PowerPoint seminar on their respective skill sets for the inquiring minds of Rwandan physicians and medical students.


From Operating Room to the classroom, it's obvious that the external training aspect is central to the principle of this mission.—Johnny Stifter

At Last! All The Boxes Have Arrived

Dr. and Mrs. Goldberg slept soundly last night. As did Dr. Williams and the rest of the Healing Hearts Northwest crew. Reason being for their sound sleep? The 56 lost boxes that traveled a circuitous route through Africa--from Kenya, to Burundi, and finally Rwanda--arrived yesterday to the relief of the entire crew, especially the aforementioned who either spent countless hours at Kenya Airlines' office or managed the original pack effort. As has been noted earlier on the blog, Rwandan Customs--specifically, for medical equipment--is quite meticulous and that's a massive understatement. Suffice to say, the shipment of so much equipment from Spokane, WA, to Kigali, Rwanda, acts as another key cog in this overwhelming effort. So the arrival allowed for a deserved celebration and sent a surge of positive energy throughout the entire 50-plus person crew.

Now that the remaining boxes have arrived, the team is now equipped with all the necessary items to continue administering care. After today, all 10 surgeries have been a success, with patient's post-op recovery exceeding expectations.—Johnny Stifter

(Click on photo for enlarge image)

Dr. Siwek having his hands washed at an Ethiopian restaurant. It was nice have some thing other than hotel buffet.

Abbie and Rwandan John Paul prepare for the next surgery.

We have had many different Rwandan medical staff in the OR with us.

The OR team hard at work as Rwandan physicians watch the procedure via TV in the hall. Rwandan physicians and nurses also work beside our team in the OR.












Dr. Siwek and Sandi with some of our new Rwandan friends.

Abbie with a patient only three days after surgery. This patient has been referred to as our team’s poster child because she has recovered so quickly and is such a ball of fire.

These pictures were taken at 6:30 in the morning as we walked to the hospital.

People in Spokane have been making positive comments about our blog. Thank you for all your interest and support. One thing that has been asked for is pictures of the scenery.
Most of us have not had the chance to go siteseeing. We have only walked between the hotel and the hospital. We are finding interesting things along the way, so here are some pictures.

You can click on the pictures to make them larger.

FINALLY!

Well, it is finally happening! All those months of planning are paying off. Several HHNW nurses, HHNW respiratory therapists and our King Faisal Hospital (KFH) nursing colleagues assist with settling our second Post Open Heart (POH) patient on our first day of surgery. We have at least one and sometimes two KFH Intensive Care nursing staff per shift to mentor. These nurses are very knowledgeable and eager to learn the specifics of recovering POH patients.

Yvette (Peds ICU Nurse) and Merry (Respiratory Therapist) explain POH surgery paraphenalia to a family member. Many of the HHNW staff are quickly learning the Kinyarwanda word for thank you very much (mwakoze cyane) simply because the families are telling it to us constantly. Many family members are very stoic before surgery. It is gratifying to see them smile, revealing their relief, once surgery is finished; not to mention the smile on our patients' faces once we get the endotracheal tube out of their mouth!

MORNING PATIENT ROUNDS

Drs. Goldberg and Elmer check the results of a chest xray during morning rounds. Rounds consist of all doctors, nurses and respiratory therapists gathering together and discussing the care and plan for each patient for that day. We were successful in safely transferring both of our surgical patients on post-op day one.

Pre-Operative Assessment Presentation

Tuesday marked the second day of surgery administered by the HHNW crew. It also acted as the first of several PowerPoint presentations given by one of the HHNW members. Sara Morasch R.N. led this morning's discussion titled, "Pre-Operative Assessment and Evaluation."

The room was full of Rwandan nurses and medical personnel—28 to be exact. They listened intently to Sara's clear, informative speech regarding rheumatic heart disease and all of its subsequent effects—most notably, the physiology of pulmonary edema. Although nearly every Rwandan medical staff member can speak English, they were a bit reticent in responding to her questions. Nevertheless, it's obvious the class and its loads of information are helpful.

"I've learned a lot," remarked George, a nurse in Kenya for eight years prior to coming back to Rwanda two years ago to continue nursing. "They [HHNW] have a lot of knowledge."

The seminars will continue throughout HHNW's project here in Kigali.

Also of note today, the first patient—a 26-year-old female named Clair—moved from the ICU to the telemetry room for her post-op recovery. And like everything here or anywhere foreign, really, we quickly learned that we couldn't roll her bed from the ICU to the telemetry room because the bed was too wide to pass through medal gates. But it allowed for another remarkable moment, as a confident Claire walked comfortably to her new bed in the telemetry room. Yeah, Claire...Cool times, indeed, here in Rwanda.

High performance

Yesterday (Monday) was our first day of operating. We did two cases, one a 26 yo women, the other a young child. Both cases presented some challenges but the results were great. We walked to the hospital at 6:30 am and walked home in the rain at 8:00 pm. It was a long day but a great day. Both patients are in CICU doing very well. The CICU nurses are taking great care of them. Today we have two more case. The first is another young child that is really ill.
I am not a medical worker, my wife is. I have always respected the field, but after having the privilege to help them and see what they do, well, all I can say is they all are amazing. The level of expertise, the amount of hard work, and above all the love and care of their patients was beyond imagination. I stood and watched them perform with better team work than any professional sport team. They are all heroes in my eyes.
Today more nurses begin there work as patients can leave CICU. These patients will never know better care.
We will do five days in a row of surgery (a change from the planned four days). Then surgery will have one day off to let the CICU clear some patients.

Here on Super Bowl Sunday, Spent all day at KFH unpacking and setting up OR. Met a lot of great people. Excited to start surgery at 8:00 am tomorrow. The first patient is 26 years old and the second is nine. We have to stay flexible.

MISINTERPRETATION (aka WEIGHT=WAIT)

As it turns out this number of boxes at King Faisal Hospital does not translate into the number of boxes that left Spokane, oops. So while we were ecstatic that our shipment cleared Kigali Customs, we did not realize only two thirds of the shipment had arrived. (The weight of the Supplies that left Spokane did not equal the weight of supplies that arrived in Kigali.) We believe one third of our shipment is still in London somewheres. We are like hound dogs on a fox hunt trying to locate them.

Katie Bland, Jane VanTassel, Jim Dixon and Jennifer Day helping to unpack the Supplies that actually arrived.

Our second, mostly surgical, team arrived tonight. Finally able to relax and have a bite to eat at the Top Tower Hotel before going to King Faisal tommorrow to assess the situation.

Wish us luck as we try and locate the rest of our supplies and deal with our ever-changing surgical schedule. We are hopeful we will still be able to commence surgery on Monday, since we are all eager to start changing young adults' lives.

WE HAVE ARRIVED!

Dr. Hal Goldbert, Sandy Goldberg and Jim Dixon relieved to finally be on the plane.

Andrea Daugherty, Katie Bland and Morgan Lonsford entertain themselves while waiting in the San Francisco Airport.

Jane Vantassel at the "Yotel, Motel, Holiday Inn..." at Heathrow's Airport in London.

The first team arrived at noon yesterday. We cleared Customs at Kigali International Airport with no problems and we were greeted by our wonderful colleagues from King Faisal Hospital, there to make sure our Customs experience went smoothly.

It was great to see all of our pallets of supplies unloaded in the CICU and ready for us to unpack tomorrow. We are all looking forward to a quick dinner and a long rest as we plan to start this organizational process.

Great article

Tomorrow morning the rest of the team heads to Rwanda (ten left on Wednesday).
There is a great article in today’s Spokesman Review. Check it out.
http://www.spokesman.com/stories/2010/feb/04/medical-team-taking-expertise-to-rwanda/

Here we go!!

Our first group gets on the plane early this morning to head to Kigali, Rwanda! Additional groups will leave at several different times on Friday. This trip has been over a year in the making and thousands of hours have been put in by many, many volunteers.

Four of our amazing nurses and surgical staff becoming familiar with a hippo.

Five of the nearly 30 pieces of luggage containing supplies for the mission.


Eleven pallets of supplies and equipment have already arrived in Kigali.

A dedicated nurse’s home refrigerator storing supplies for the trip.
She has an understanding husband.

Team members discussing the needs of the mission trip.