Luis's story

Luis is a 4 year old who was born with several problems. He had a hole in his heart as well as a cleft of his lip and palate. When he was less than a year old he had his heart defect repaired in Lima. Last year he came to us to have his lip repaired. Normally, we do not do children with multiple problems as the risk of complications after surgery is higher. Last year our pediatrician was also a heart specialist and he felt there was no reason not to do the lip repair. The day of surgery, Luis had a cold so we had to cancel him. This year he came again, but I did not remember him right away and the rest of the team was concerned. After hard work by our anesthesia resident who found the local cardiologist and had the studies interpreted, we all agreed that he was not at any higher risk than any other child and today he had his surgery.





Luis before his surgery





Luis after his surgery.

Next year he will have his palate repaired.


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Ears are us

Jose is a 12 year old who was born with both ears only partially formed. One of the procedures that plastic surgeons do is to take cartiledge from the rib and form it into the framework of the ear. We were able to do this for Jose today.




His left ear before the operation.




The rib after forming it into the framework.




At the finish of this stage. It will take two more operations to complete the reconstruction.


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Finally working

The boxes with our disposable supplies finally came today and we were able to do 7 cases.




Arrival at the hospital









A cleft patient before and after.



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What to do?

Well after doing cases on Weds., we have been back on hold. Not being given an arrival time for the disposable supplies, we had to keep putting families off.
When nothing arrived by Thurs. AM, we took a trip to a sacrificial site a bit south of the city.


Part of the complex




Collection of skulls.

Friday was no better. Back to the hospital to tell the families that they would have to wait another day. Figuring that if some thing happened today, we would be working hard for the rest of the trip to catch up, we went to the beach, stopping along the way for a nice lunch.




Part of group at a small resort.




Birds




Sunset.

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Finally we get to do some surgey

Today we were able to do 4 cases, but only because I have a really great team that was will to be inventive. All of the patients required skin grafts that we do not like to do late in a trip because of the need for dressing changes before we leave.
One patient is Yajaira who was burned while helping her mother cook over an open fire. She has had many operations, but could still not close mouth completely. This makes eating difficult. We were able to improve that situation today.
The Mother showed us a picture of her at age 4 when she won a beauty contest.










This is her current condition.




After releasing the tissue and putting in skin from her abdomen.


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Shopping

Due to issues that we can not get good answers to our disposable supplies which were sent a month ago have not been able to be released from customs.
As we did not want to lose another day of doing surgery,the team agreed that we would try to obtain what we needed from the hospital. There were also some items left from last year. We had great cooperation from the head nurse in the OR and have enough to do 4 burn cases tomorrow.
Who knows what the next day will bring.




I'm searching the cabinet to see what we can use to do the cases planned for tomorrow.

To console ourselves we had dinner at a local culinary school. I think we gave the students a real test as they had to deal with 16 people at one time. The food was some of the best I have had.




The students working on our dinners




One of our meals. Ceviche, which is various seafoods marinated in lemon juice.


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Location:Piura

First Day

We all met in Lima, coming from all parts of the US and Norway.


Some of the group in airport waiting to board the plane for Piura.

We had a slight delay, but arrived in Piura Sunday morning. Many of us just rested, though some went exploring. We were all readying to start seeing patients Monday morning.









Patients waiting to be seen.




Marc and me consulting on a patient.





Duke examining a patient.

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Location:Piura

A Visit to the Ancient Port

About 15 miles by easy train is the port city for ancient Rome. It's name is Oestia as it sits at the mouth of the Tiber River. The site is expansive.




Part of the site.




One of the well preserved mosaics.




Tending bar at the local pub!

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A Rainy Day

I knew the good weather would not hold. I tried to find some indoor activity, but only partially succeeded. The first stop was a Miro exhibit in a monastery.



Anyone know what this is?


Then on to the Pantheon. Once the main temple in Rome, it is now a church where several Italian kings and Raphaelle are buried.





A final stop was a cat sanctuary which is in one of the excavated ruins. It is a no-kill shelter for stray and abandoned cats. They had about 130 currently in residence.




Cats in the wall.

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On to Ancient Rome

From the opulence of the Vatican to imagined opulence of Ancient Rome. It's hard to imagine constructing the Colosseum, especially without cranes. The interior must have been impressive especially when filled with spectators watching what ever games were occurring.




Approaching the Colosseum.




The interior.

From there I explored the posh residential district of the Palatine. This was where the emperors and high officials lived.




A little garden.

Then on to the Forum.


Looking down the Sacred Way.

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The Vatican with 27000 of my closest friends

Spent my first full day at thenVatican. The place is amazing. I think they most of the art of the world. The lines are long, but move fairly quickly. One can join a tour to decrease the wait, but I really wanted to see it at my own pace.


St. Peter's Square




In the museum




A fresco by Raphael





The main alter in the Basilica


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Halong Bay

Well I'm back at the Hanoi Hilton having spent the last three days in Halong Bay. Pictures don't really capture the place, but I'll add some here.










I'm going to save the rest for when I see you.

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Final Day in Phan Rang

The team finished the last day of surgery on Thursday and celebrated with the local nurses and OR help. It was a nice evening at one of the beach hotels with Keroke by the pool.


Some of our local hosts




The chief of ENT entertaining us.

We got on the bus for Saigon, where some returned to the US, some to Cambodia, and I went to Hanoi to spend 2 days on a junk boat in Halong Bay.
More when I get back to Hanoi.

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Dalat

For the weekend I decided that rather than going to a beach resort I would got to the town of Dalat, which is in the mountainous part off Vietnam. One does not think of Vietnam as mountainous, but much of the country is. We had a 4 hour ride up some rather steep roads with many switchbacks.




The road to Dalat

Once there we were treated to many interesting sights, including several Buddhist temples.





We also visited a large flower park and saw a beautiful exhibit of orchids.




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Food

They say an army travels on it's stomach, well so does a Resurge team. Each day we are given lunch made by a local woman. Today we had a lamb sausage, sweet potato, fried sticky rice and mango.

Our lunch
Just in case we hadn't enough, we decided to have "street food" for dinner. That meant we went to one of the local eating places that on the sidewalk. This one served a type of soup which had quails eggs, bean sprouts, peanuts and a type of ham as well as noodles in a broth.

My dinner.
Another place specialized in a sort of crepe. Hope to go there next week.

The crepes.
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Ytron

Ytron is an 18 month old child from one of the mountain villages. He was born with a cleft lip. When his mother heard a team was coming she walked for several hours and the took a bus, spending about 8 hours total time to get to the hospital. She arrived the day after we had clinic and the schedule was fairly full. The team decided that we would add him to the next days schedule even if it meant the day would run a little longer.




Before his surgery.




After his surgery.






With his Mom, nursing.

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