Archive for the ‘Volunteers’ Category

Helping the Girls of the Congo: Part Fourteen

November 22, 2010

Phil Fischer, M.D. is one of the Mayo Clinic physicians who recently went to the Democratic Republic of the Congo. In the video interview below, Dr. Fischer offers a personal reflection on the trip.  

He also explains the potential for future research and how those plans are already advancing.

Also, many of you have inquired as to how you can donate so we can continue to help the girls of the Congo. You can mail checks to the Mayo Clinic Department of Development at 200 1st Street SW, Siebens 9, Rochester, MN, 55905. Be sure you write “Girls of the Congo” on the memo line.

Helping the Girls of the Congo: Part Thirteen (Saturday & Thanks)

November 19, 2010

The following is another update from the Mayo Clinic team that was in the Democratic Republic of the Congo last week, written by Dr. Deborah Rhodes. While this is the final update from their trip, please check for additional posts next week including video interviews with some of the team describing their experiences.

“After a long drive through the beautiful countryside of Rwanda, in a fierce rainstorm that only made the hills more luminous, we reached Bujumbura. We said good-bye to our good friends and trusted drivers, Bercky and Benge, and boarded the plane. We were so anxious to see our families, but we were quieter than usual. We stared out at military forces boarding a neighboring plane and thought about how much more needs to be done.

Our flights were seamless, as has been our entire itinerary. For this, and for so many other things, we have Jane Gould to thank. Without her, we would still be trying to book our flights. She was our greatest defender from bureaucracy, our solver of any problem, and our most enthusiastic advocate when our own belief that this trip would happen wavered.

We have so many others to thank:

  • Jim Hodge, who initially said, “We can find a way to make this work.”
  • Roger Dearth, who found a way to make it work. Roger kept us smiling when the chips were down. When we realized we needed to purchase additional pieces of critical cystoscopy equipment 2 days before our departure, Roger made them appear by the next morning.
  • Shirley David, from Carlson Wagonlitt, who answered hundreds of phone calls and coordinated our flights.
  • Terry Gorman, who connected us with Tom Griffin, who worked his magic to get 5 pallets of medical supplies to travel thousands of miles and arrive safely at a destination with no street address.
  • Mayo Medical Laboratories, for all the help they provided in delivering the pallets of medical supplies.
  • Leo Wagner and the staff at the Mayo Warehouse, for helping us to collect and pack the supplies.
  • Beth Creedon, for all of her help collecting and cataloguing the supplies.
  • Federal Express for their generosity and precision in delivering the pallets.
  • Rebecca Buss at Rochester Medical, for her generous donation of supplies.
  • Dr. C. R. Stanhope, who was instrumental in gathering many of the medical supplies and advising us on appropriate goals for an international medical mission.
  • Paula Boos, without whom our six boxes of medical supplies would never have made it on the plane.
  • The Stryker company for their generous donation of cystoscopy equipment.
  • The Stortz company for their donation of supplies.
  • Donna Springer and Etta Meinecke, for protecting us against all things infectious with innumerable vaccinations.
  • Stacey Rizza, for her outstanding lecture on HIV transmission and prophylaxis and for her donation of medications.
  • David Claypool and the team at Preferred Response, for providing us with safety advice and medications for any emergency (thankfully, we did not need the Imodium).
  • Mitch Nelson, for security advice in Burundi and DRC.
  • Jan Swanson and Mark Williams, for helping us to prepare for the trauma we would encounter.
  • Elizabeth Rice, who recognized the importance of documenting this trip, and along with Makala Johnson, assisted with this blog.
  • Dr. Bobbie Gostout, Dr. Don Hensrud, and Dr. Robert Jacobson, for supporting our trip.
  • Lenae Barkey and Jim Yolch , for solving the administrative hurdles on our behalf.
  • Our spouses, for their support, patience and sacrifices: Beth Creedon, Jill Dowdy, Julie Fischer, Ned Groves, Bill McGuire and Mariana Trabuco.
  • Shirley Weiss and John Noseworthy.
  • Carolina Owens, from the U.N. Office of Special Representative of the Secretary-General for Children and Armed Conflict.
  • Eve Ensler and V-day, the model for effective, courageous, transparent and noble activism – words cannot express our admiration for you.
  • Christine DeSchryver, an angel warrior, our hero.
  • Pat Mitchell, for telling me the story that launched this trip and connecting me with Eve.
  • Our anonymous benefactor, without whom I would still be crafting a letter to Ben Affleck!”
  • Helping the Girls of the Congo: Part Twelve (More from Friday)

    November 18, 2010

    The following is another update from the Mayo Clinic team that was in the Democratic Republic of the Congo last week, written by Dr. Deborah Rhodes .

    Dr. Sean Dowdy and Dr. Emanuel Trabuco had another long day in the OR, with two large fistula repairs and a radical hysterectomy for advanced cervical cancer – what would be an easily preventable disease if Pap smear screening was available. We wrapped up our clinical and teaching work, and then Dr. Mukwege called us together for a final meeting. Earlier in the day, we had seen a magazine in his office in which he appeared on the cover. One sentence in the article stuck in our minds. It said, “Many visitors come here to eat sandwiches and cry, and then they return home.” We had brought a container each day with a sandwich for our lunch, and we had certainly shed our fair share of tears. But we were determined not to be the next in a long line of passive sympathizers. Dr. Mukwege presented us with a flag of the DRC and his words reassured us that he understood our intent and commitment to build a long-lasting relationship in support of Panzi.

    Dr. Denis Mukwege, the founder, director and chief surgeon of Panzi Hospital in Bukavu. Photo source:

    As we were walking out of the hospital, Dr. Mukwege’s secretary ran up to deliver a message to him. She had just received an e-mail on which she was apparently copied inadvertently. The e-mail, from an American organization at which Dr. Mukwege is scheduled to speak, conveyed concern that his remarks might stray into the causes of the conflict in the DRC rather than strictly the medical response. He sat down on a bench, shook his head and smiled. A four-year-old boy wandered over and lay his head down on Dr. Mukwege’s lap. I remembered this boy. On my first day at Panzi, I almost tripped getting out of the car as two little arms grabbed me around the knees. I looked down, and a boy was grinning up at me. He took my hand and led me into the morning prayer service, but then we were separated. Now, Dr. Mukwege stroked his head while we talked. He lay perfectly still for 45 minutes, his eyes closed in contentment. In my right peripheral vision, I saw a young woman staring at him, knitting and undoing the same small crocheted hat as if in a trance. At the age of 15, she had been forced to watch rebel forces kill her entire family and village. She was taken by the forces and held as a slave, during which time she was impregnated by her captors. This boy was the result of that pregnancy. She would stand close enough to watch her son, but could not bring herself to get close enough to mother him. They now both lived at Panzi Hospital. A few days earlier, I had seen him jump into Christine’s car at the end of a long day. She told him she needed to leave, but he refused to let go of the steering wheel. “Take me home, Mama Christine,” he pleaded. As she pulled out some candy to coax him out of the car, there were tears in her eyes, even though I’m sure she has witnessed this routine innumerable times. How could you watch these things day after day, year after year, and not have an opinion on the genesis of the problem or the outline of a solution? Dr. Mukwege had always intended to follow in his father’s footsteps and become a pastor. But he realized that he could not care for peoples’ spiritual needs if their physical needs were so great. And so he turned to medicine. Yet it is clear that no amount of medical care – nor the food and safe haven that he provides – can solve this. The solution, ultimately, will require an open discussion of the root causes of this conflict without fear of reprisals.

    On Friday night, we drove to Christine’s mother’s house, overlooking beautiful Lake Kivu. The house where Christine was born had been destroyed in an earthquake several years earlier, but a new house had been built just above it. We were joined by Eve, Christine, and Elaine Doughty (the trauma therapist from San Francisco who is training the staff at City of Joy). Christine’s mother treated us to an incredible Congolese dinner, complete with tilapia, feuilles de manioc (cassava leaves), and red beans. Dr. Mukwege arrived and gave the most eloquent tribute to Eve and Christine. Christine stood up and said that her faith was starting to come back. She was referring to a story she had told us the night we arrived. She had been handed a six month-old baby who had been raped. She cradled the baby and drove quickly to Panzi hospital, but the baby had already died. She cried out to God to ask how this could be happening. Alysa, a young girl who had arrived at the hospital at the age of 8 after she and her mother were attacked in their village, ran to comfort Christine. Alysa said, “Christine, sometimes the clouds cover the sky, but the sun is still there.” I had not known or even heard of Christine at the time I began planning this trip, but I recognized this story. I asked Christine if this had happened in May of 2009. She said yes. This was the same story that was told to me by Pat Mitchell in Rochester, Minnesota in late May of 2009. At the exact moment that Christine’s faith had faltered, this story had traveled thousands of miles and lit a flame that we carried back to her. As Bercky said to us when he first picked us up in Bujumbura, it will take many sticks to light this fire.

    Dancing is a great part of the culture in DRC, and the therapy for the survivors. All week, Eve had warned Dr. Sean Dowdy that she would have him dancing by the end of the week. Those of us who knew Sean were skeptical, but we have witnessed many miracles this week. When we got back to the lodge, we were all very tired. There was no dancing. And we all simultaneously said…..’next trip.'”

    Helping the Girls of the Congo: Part Eleven (Friday)

    November 17, 2010

    The following is another update from the Mayo Clinic team that was in the Democratic Republic of the Congo last week.

    “We started the morning surrounded by the staff and patients of Panzi, gathered in the courtyard for morning prayers. We looked out on the beautiful women wrapped in colorful pagnes. We felt like we understood Bercky’s inspirational devotion. Then Dr. Mukwege invited Dr. Phil Fischer to give our thanks and good-bye in Swahili. Dr. Fischer responded that the Bible says we should love God with mind, body and heart. This week, we have seen God’s love as we see all the staff here teaching, healing and caring for minds, bodies, and hearts. We will leave here with them in our hearts, and we leave half of hearts here with them. It was beautiful benediction and everyone cheered.

    Dr. Fischer evaluating a 4-day old infant with vomiting, Panzi Hospital

    We then joined the women survivors for morning dancing and singing in the courtyard, and we were welcomed as part of the group. Dr. Sean Dowdy and Dr. Emanuel Trabuco went to the OR to facilitate the ongoing adoption of the new cystoscopy instruments. Dr. Fischer made rounds and did more teaching, as did Dr. Doug Creedon. Lois McGuire, R.N., C.N.P., gave a lecture of incontinence. Dr. Deb Rhodes met with Bev, the administrator for Panzi, to discuss long-term strategies. Lois also played tic-tac-toe with some young girls at the hospital.

    Lois McGuire, R.N., C.N.P., giving a lecture on incontinence, Panzi Hospital

    We are leaving the hospital a little earlier than usual today in anticipation of a traditional Congolese farewell feast at the home of Christine’s mother. We are so sad to realize that we will be leaving early tomorrow. We would like to thank beyond words the individuals without whom this trip would not have happened – please check back for our final post from Amsterdam so that we can acknowledge the extraordinary contributions of those in Rochester and beyond who are as devoted to this cause as we are.”

    Helping the Girls of the Congo: Part Ten (Thursday)

    November 16, 2010

    The following is another update from the Mayo Clinic team that was in the Democratic Republic of the Congo last week.

    Housing for the women waiting for surgery at Panzi Hospital, Democratic Republic of the Congo

    “In the car on the way to Panzi, we had time to discuss with Dr. Mukwege a plan for continued collaboration between our group and Panzi. He had told us earlier in the week that one of the most important goals for his hospital and staff is to establish a strong research program at Panzi, which in turn will attract important government recognition and funding. He also wants Panzi to serve as a standard for high level, accountable care throughout the DRC. After morning report for the various pediatric, medical, and surgical services, Dr. Mukwege called a meeting of all the staff and our team. He challenged his staff to work with us over the remaining two days to identify a strategic plan for developing research collaboration, as well as goals for their own academic progress. We then had a chance to express our appreciation and admiration for the staff and the work they are doing.

    Following this, Dr. Sean Dowdy and Dr. Emanuel Trabuco headed to the OR. They were able to demonstrate the assembly and use of the new cystoscopy set that we brought for the hospital. The cystoscopy worked beautifully, and the OR staff cheered when they saw the clear images on the screen. This was a very complex case of an 18 year-old woman who had lifelong urinary incontinence, due to an extra ureter emptying into the vagina. The team was able to divert this ureter to the bladder. When she wakes up from surgery, she will be dry for the first time in her life.

    We got a glimpse of the extraordinary daily demands on Dr. Mukwege. After morning devotions, rounds, and staff meeting, he began his outpatient gynecology clinic. He then joined Drs. Trabuco and Dowdy in the OR, and then returned to the outpatient clinic. He was then called to OB for a delivery, and then back to the outpatient clinic. He was then called to the OR for a difficult case in which Dr. Dowdy and Dr. Trabuco had discovered unexpected anatomy and were requesting his input. He then returned to the clinic, where he and Lois saw a total of 50 patients by 5:30 p.m.

    Bedside rounds in the OB ward with medical students, Panzi Hospital

    Dr. Doug Creedon went to the inpatient OB-GYN ward and did bedside teaching and lectures with the medical students. Dr. Phil Fischer spent the day teaching pediatrics to the medical students – the crowd of students following Phil grows daily. Dr. Deb Rhodes spent the day in the cardiology clinic and worked with the internal medicine staff to establish ideas for future collaboration. The Mayo and Panzi staff were so enthusiastic about the project ideas, and we later discovered that 3 staff members have signed up for English lessons starting Monday so we can better communicate.”

    Helping the Girls of the Congo: Part Nine (More from Tuesday)

    November 15, 2010

    We are happy to report that the Mayo Clinic team in the Democratic Republic of the Congo arrived home safely late yesterday. We will continue to post their updates from the trip throughout this week.

    Morning Prayer at Panzi Hospital

    “Behind the operating rooms is an expanse of grass and circular shelters consisting of a thatched roof without walls and a fireplace in the center. This is the heart of Panzi Hospital. It is where the women and children who have survived rape live together, some for months and some for years, to await the time for their fistula repair. Where despair and defeat should pervade, there is color and singing and dancing and praise. These women and children are a family to each other, and Esther is the one who nurtures them and brings them back to life and safety. Every morning, she leads them in a ritual of chanting and swaying and stomping and clapping that erupts into laughter, catharsis and play. Young mothers dance as tiny feet peek around their waists, their babies swaddled to their backs. Children rush to take your hands and dance. Old women join in the circle.

    We head back late in the evening for dinner with Eve, Christine, and Elaine. Elaine has just arrived from San Francisco. She is a trauma therapist who will do training workshops with the ten Congolese women who will become the staff and counselors at City of Joy. City of Joy is due to open in February, and there is much to be done, both in terms of training and construction that has been delayed by shortages of basic building supplies. Eve and Christine are routinely working 14 hour days. Our evenings together are dizzying exchanges of questions and ideas, and the jumble seems by morning to lead to measurable steps forward. We have had many conversations with residents of DRC about the complex political and economic forces that have led to this 12-year war. The U.N. is spending over 2 million dollars a day for peacekeeping forces, and yet the violence continues. But it would likely be far worse without these forces. It is hard to see any end in sight without a radical shift in the political structure and the distribution of profits from the rich mineral deposits.”

    Helping the Girls of the Congo: Part Seven (Monday)

    November 11, 2010

    The following update was sent from the Mayo Clinic team currently in the Democratic Republic of the Congo:

    “We set off early for Panzi Hospital, the car packed with our supply boxes. The drive itself was an adventure. There are no paved roads, and the rainy season has just begun, creating huge craters filled with mud. The roads are tightly packed with pedestrians heading in all directions – including directly in front of the car. There are no traffic lights, and the rules governing right of way are entirely unclear. We drove past thousands of tiny wooden sheds with vendors selling bread or fruit or fish. We pulled into Panzi, a little late for the morning prayer service. We then attended morning report with about fifteen staff physicians and 30 medical students. They began with the deaths that had occurred over the weekend, including a patient whom Dr. Mukwege had tried all weekend to save after she developed kidney failure from a complex fistula repair that some other surgeons had tried. The team then presented the admissions from the weekend, with a tremendous variety of cases and successes. We split up according to our various specialties. Dr. Emanuel Trabuco and Dr. Sean Dowdy saw patients who needed surgery. Their first patient was a 22 year-old woman who had just arrived at the hospital after having a rifle forced into her vagina and rectum and fired, shattering her pelvis. In consultation with Dr. Mukwege, it was decided that surgery would have to be delayed for several months to allow the inflammation to heal. They saw many cases of teenage girls who had experienced obstructed labor for days because of lack of access to a hospital. When they arrived days later at the hospital, the babies were stillborn and the girls were left with fistulae. Alain, Dr. Mukwege’s son who has just finished medical school, did an exceptional job translating the womens’ stories.

    Lois McGuire and Dr. Doug Creedon saw patients in Dr. Mukwege’s outpatient gynecology clinic. They were struck by how many of the conditions are similar to what they would see in Minnesota, but treatment options are limited. Dr. Phil Fischer rounded on the inpatient pediatrics service. Phil lived in DRC for six years, and has so much experience with diseases experienced by children in this region. He also happens to speak fluent French and Swahili, and he had a trail of medical students following him by the end of the day. He has written a book (in French) on pediatric diseases in DRC, and he brought copies for the students. Dr. Deb Rhodes rounded on the inpatient medical student service. The majority had complications from tuberculosis or HIV. When a patient needed a procedure, it was done immediately at the bedside on rounds, with incredible precision despite a fraction of the equipment that we would use for this procedure in the U.S. One woman came in with abdominal pain. She walked in and allowed numerous examinations before an x-ray was taken revealing free air in the abdominal cavity, likely from typhoid. This is an incredibly painful condition, and the stoicism and lack of complaint that she exhibited is characteristic of all the patients we saw.

    We left with a sense of awe for what this hospital provides to patients every day in conditions that would cripple western medicine. The clinical acumen of the doctors is extraordinary, because they do not have the luxury of coming to the right conclusion by running numerous tests to exclude “everything but.” There is no running water. There are 20 patient beds per small hospital room. There are no isolation rooms. There are no hospital gowns or drapes or disposable paper products. The electricity falters numerous times a day. The heat in the OR is stifling. There were so many patients to see, with suffering so raw that we had to choke back tears many times. The stories of unspeakable violence are so difficult to hear that you think you eventually could not listen to another. But day after day, the staff continues to listen and comfort and heal, giving good care to every patient no matter how long the line.”