Canvasback medical teams mend bones, eyes and spirits on Ebeye
Taken from the The Kwajalein Hourglass on Saturday, Feb. 13, 2010
February 2010
Dan Adler, Media Services Manager
Canvasback Mission doctors give the incredible gift of sight by removing cataracts. They give the aged and injured the gift of being able to walk with new knee replacements. They give people, young and old, who have suffered terrible pain, sometimes for years, the gift of being pain-free.
For their efforts, they get a halting “Thank You” from someone who doesn’t speak English. Maybe they see tears of joy from the eyes of those who can once again see the faces of their loved ones. Or perhaps they get wide grins from children whose fractured arms and legs they have repaired. Maybe they see the faces of children turn from grimaces of pain to wide smiles of happiness.
If you ask the doctors and nurses who give those gifts, they will tell you that the smiles and the tears and the simple “Thank You’s” are more than enough payment.
This year, a team of eye surgeons, orthopedic surgeons, a dentist, a cardiologist and a physical therapist along with nurses and anesthesiologist joined Canvasback Mission Director Jacque Spence on another mission of mercy to Ebeye. The teams arrived on Jan. 16 and will depart on Feb. 15.
The trip was at the request of Irene Paul, the Assistant Secretary of Health for the Republic of the Marshall Islands. The RMI Ministry of Health provides airfare, meals and lodging for the Canvasback medical teams.
According to Spence, the ophthalmology team broke a record by completing 192 cataract surgery cases in just nine days at Ebeye’s EroijKitland Memorial Hospital. The ophthalmology volunteers included Dr. Paul Chung, Dr. Iris Chung, Shawn Apperson, RN, Chris Whaley, CRNA, and Alex Archibald, OD from Chehallis, Wash. and Charles Ahn, from Chicago, Il.
“Patients lined the halls at the clinic seeking care,” said Spence. “Many of the patients were blind in both eyes and had white cataracts that were as hard as rocks, which made the surgeries challenging. A good percentage of the patients showed damage to their eyesightdue to diabetes. Diabetes doesn’t cause cataracts, but it wrecks eyesight. Some people here can’t see the coconuts on a tree.”
Spence said that while the eye surgeries were primarily for cataracts, “There was one man who had glaucoma [pressure in the eye from a buildup of fluid] and they put a shunt in it to help drain the pressure. He was in a great deal of pain from it and we were able to relieve that.”
The dentist and hygienist, Dr. Ric Hufnagel from Cloverdale, Calif. And Kathy Garvin from Port Townsend, Wash. helped the Dental Clinic assess how to address the overwhelming dental problems. Ebeye Hospital Dental Chief, Hermes Takito, referred some of his hardest cases to Hufnagel.
Garvin said, “We did complete dentistry on our patients. One patient required ten restorations as well as three root canals. One little boy came in with an abscessed tooth that had infected the bone, saliva glands and lymph nodes. The side of his face looked like a huge tumor and the floor of his mouth was swollen and covered his lower teeth — he was chewing on tissue on the floor of his mouth. We extracted the tooth and put him on antibiotics. The next day, he was a happy little boy.”
Spence said that during the PACOM Pacific Partnership mission last year, the medical teams that worked on Ebeye identified residents who needed cataract treatment and passed that information on to Canvasback.
“That helped us get the patients in,” she said. “That’s always been a concern of mine that the patients don’t come in timely fashion for us to do the work. So we had a list from the Navy and the [Ebeye] hospital. That was very key. We arrived on a Saturday, unpacked on a Sunday and got the operating rooms ready and by Monday we were doing surgeries.”
Spence estimated that nearly $1 million in eye surgery and orthopedic supplies were used during their visit.
In addition she said, “The eye surgeons said they charge $3,000 for a cataract surgery in the states, so if we did nearly 200 that’s close to$600,000 in value. We don’t know how much labor value we’ll do in the orthopedics until we finish up.” There were a total of 14 people on the orthopedic team including two surgeons, a physical therapist, nurses and a physician’s assistant. A cardiologist, Alan Jacobson, helped train the Ebeye Hospital internist on doing proper evaluations of cardiac patients so they can get referral off island if they need to.
Dr. Steve Peterson is a private practice orthopedic surgeon from Sonora, Calif. This was his first trip with Canvasback. “I’m really excited to be here,” he said. “The first few days I operated on things I haven’t seen in years. Medically it’s challenging, but it’s very rewarding.”
He said some of the conditions he saw are related to diabetes, but a lot of them are related to not having access to care. “We’ll see things that are old like fractures or broken bones people got when they were children. Some of them have angled elbows that go in the wrong direction. We’ve operated on the nerve conditions associated with angled elbows and we can help to a certain amount. You can’t repair it completely but you can make it much better.”
There are sometimes truly heart wrenching situations the doctors ran across.
“There’s a little boy we operated on the second day we were here that dislocated his hip,” Peterson said. “He was riding on a bicycle and fell off in a way that he dislocated his right hip and he had been like that for around two months.” Spence said, “This poor little boy had to wait for the Canvasback team because Ebeye Hospital didn’t have a pediatric anesthesiologist. A doctor told me that if that had happened in the United States, they would have cleared the whole surgery schedule and taken him in right away because it’s that serious.”
Peterson agreed, “We would cancel all of our office patients and work on him immediately or if we were in the operating room already, he would be the next case. Fortunately, we were able to put his hip back in place and Gary [Deacon], our physical therapist, made a special brace for him. He has to stay in the brace until it heals so it won’t re-dislocate.”
Peterson came to be on the team and made the trip because, “Gary and I work together and I heard about it [Canvasback] from him. He told me he was coming out here last year and I asked him if he needed another orthopedic surgeon and it worked out that I came on this trip.”
Peterson had to close his practice temporarily to come here. “But you look at life in the bigger picture and it’s things like this that I’ll remember forever, not missing two weeks of work. It’s a bigger reward than any monetary reward.”
He added, “Working with the people here is amazing. They’re so stoic and uncomplaining. I know what people would be like in the states and how much pain medication they would want. When we first talked to patients in the clinic, they always said, ‘Thank you for coming to help us.’”
This is therapist Deacon’s second trip to Ebeye. “I get many things out of coming here,” he said. “Just working together with a team like this, giving of our time and our abilities to come out and help people, it’s really rewarding. I enjoy it a lot. And the people we help are so appreciative for what we do for them. It gives satisfaction and a good feeling that you’re doing something to make a difference.”
While there are the heart wrenching situations, there are the heart warming ones as well.
“Donna Caldwell, our recovery room nurse, was saying that the first total knee replacement patient’s husband was in the corner crying when they took her into the ward,” said Spence. “So Donna went up to him and told him it was alright, that his wife would be fine. He looked up at her and said he was crying out of joy because, ‘You have come to help her.’”
Spence spoke about another patient. “Three years ago we replaced one knee. Last year, he had an appliance in the other knee that was very old and had to come out. The guys on Kwaj helped us put together some instrumentation to take it out. This year, we replaced that knee and also did cataract surgeries in both eyes. He had a big smile on his face afterwards. He’s completely rebuilt.”
Spence credits Dr. Robert Wells with starting the orthopedic program for Canvasback.
His first trip with Canvasback was in 1988. He has been a doctor since 1962 and a surgeon since 1967. He has come on trips every two or three years since then. Wells said he got involved when he heard that some people were in the process of building a boat a little ways from Portland, about an hour and a half drive to the west right off the coast.
“I found it a very fascinating concept and one of my associates, who is a general practitioner, went out on the first trip to the Marshall Islands,” Wells said. “He contacted me afterwards and told me I ought to consider it. He thought I would find it interesting and challenging. So I did and we went to Ebon and spent a lot of time in Micronesia, particularly Chuuk on several visits. While it was considered risky to do knee replacements in third world countries, I was able to get the implants and these people did beautifully.”
He added, “Now that Ebeye has a new hospital and a clean working environment, plus the logistical advantage of Kwajalein, it’s an ideal place to work.”
Wells continued, “I enjoy working with these people. They’re lovely people. They’re very grateful people. They really appreciate what you do and if we weren’t here, they wouldn’t have access to these types of services. I enjoy spending time with them, particularly as I get into retirement. I also have the ability to acquire resources that they wouldn’t have access to otherwise. I’ve been very fortunate and this is payback.”
As with all of the Canvasback trips, it requires a lot of planning and the unselfish efforts of a lot of people. It takes about a year to put a mission together coordinating the doctors and nurses who want to come and gathering donated supplies. “We get done with one and we start working on the next one,” said Spence.
She particularly appreciates the efforts of Jimmy Matsunaga, Kwajalein Range Services Shipping and Receiving Manager.
Spence said, “Jimmy arranged with Mike Garvin of Matson Lines for a 20-foot container and it was packed with the supplies that we needed both for eye surgery and orthopedic.”
According to Spence, two keys to the success of this year’s trip were a donated Alcon Laureate Phaco machine and a loaned Sovereign Phaco machine that enabled the team to run two operating rooms. In addition, Spence said that SEE International donated double the amount of the supplies that they usually allocate for a mission. Pacific Medical donated orthopedic bracing and shoulder arthroscopy equipment. Sonora Regional Medical Center in California donated the C-ARM.
She is very appreciative of the USAKA Host Nation office. “Host Nation allows us to stay here [on Kwajalein] and that’s a huge bonus. I just don’t think we could do everything we do unless we could stay here. They gave us a golf cart to get the teams back and forth to the dock. They allow us to eat at Café Pacific. And the people on Kwajalein have been so nice and helpful to us. They make it a lot easier.”
Spence added, “Jack at the machine shop can make anything. There have been times when our equipment has broken down and Jack comes through and makes us up something. He’s just really special.”
The Canvasback Missions work couldn’t be done without the generosity and donations that people and companies give.
“The biggest donations come from the pharmaceutical companies and hospitals,” Spence said. “A lot of the doctors will contact their suppliers and ask for donations. Dr. Wells has gotten one of the major manufacturers of implants, Smith and Nephew, to donate. Not only did they donate the implants, they donated the instrumentation and all the accessories. That’s where some of the major donations come from. A lot of our volunteers play a major part in getting the supplies. The doctors know what they need to have.”
It truly takes generosity on the part of a supplier to donate such expensive items.
“For a total knee replacement, there are four components and suppliers will charge hospitals in the states $35,000 for a set,” said Peterson.
Spence said that before trips are made, nurses and other support staff are recruited by the doctors because they want to work with the professionals they are used to working with on a daily basis. If the doctors can’t get those people, Canvasback will pull from its own sources of volunteers.
Getting volunteers is not as hard as one might think. “The week before I came on this trip, I had 40 nurses come up to me and say they wanted to go next year,” said Peterson. “They gave me their numbers and said to call them so they could go on the next trip.”
Spence and her husband, Jamie, created Canvasback Missions after becoming Christians during sailing trips in the Pacific.
“We would see the island people who had far less than we did and yet were willing to give the shirts off their back if someone needed it,” said Spence. In 1981 they returned to the United States from a sailing trip and founded Canvasback Missions. More than 200 volunteers built a 71-foot long aluminum medical ship to be used. “My husband felt that Canvasback was a good name because the ship was a sailing vessel and we migrated like canvasback ducks,” Spence said.
They started their mission in the Marshalls because, “The coral atolls were well-suited to a boat ministry and we loved the people.”
Canvasback has also helped the RMI tackle the immense problem of diabetes in the country by opening the Diabetes Wellness Center on Majuro in 2005. Spence feels that if diabetes in the RMI could be brought under control it would solve many of the health problems the country faces.
Donations are always needed and anyone wishing to donate money to Canvasback can contact Jacque at jacquespence@canvasback.org. Doctors and nurses who would like to volunteer for missions can fi nd applications at www.canvasback.org.
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