CAMTA has many wonderful participants in Ecuador AND CAMTA's Spanish language blog

Hi All,
I would like to announce that the Spanish language blog, http://camtaparaquitenos.blogspot.com/ has been assumed by Pablo Montahuano of Quito. Pablo received a total hip from CAMTA in February of this year and he has enthusiastically endorsed our work and is now a CAMTA volunteer!


Pablo will be updating the blog as we progress towards the Mission 2009 and during the mission.


And I would like to describe for you our Ecuadorean CAMTA volunteers:


Maria Clara Duran is our Quito travel coordinator and we are so happy to have her help again this year. Marieclara believes strongly in our work. We met her through her father, Cesar Duran who is a colleague of Don Stewart, member of the CAMTA board. She and her sister operate a travel business in Quito. Al Tardif is our travel man here in Edmonton and he works closely with Marieclara throughout the year.


Janela Romero is a translator for us. She lives in Guayaquil and knows Pablo through family. I look forward to meeting her.


Mari Teresa Vásconez and Juan José Vásconez have worked as translators too. This mother and son team are sensitive, understanding and compassionate.


I cannot tell you how exciting it is for me personally to see the growth in CAMTA from INSIDE Ecuador. It is delightful to have these five working for CAMTA.

Our longest standing participant in CAMTA is Fern Cannon. Fern lives in Katy, Texas but she lived in Cuenca when she first came to translate for CAMTA's staff in that city in 2000. We weren't CAMTA then -- it wasn't formed until August 2001.


Luis Piedrahita is a pediatric orthopod in Tucson, Arizona. But his roots are in Quito. His father was an eminent orthopedic surgeon in Quito. Luis participates in the mission annually.


We were fortunate that both Fern and Luis were able to enjoy Edmonton in April during a blizzard when they came here for the strategic planning exercise.


The staff at the Tierra Nueva who welcome us so warmly each year include Dra. Patricia Jarrin and Dr. Manuel Ordonez. Patricia is the coordinator of external brigades and a leading physician at the Tierra Nueva. Dr. Ordonez is the orthopedic surgeon who does yeoman's work before our mission by assessing patients and getting the preoperative preparations completed. After the mission he personally does the medical follow-up on each and every one of the patients with repeated post-operative "control" clinics.


Without our Ecuadorean colleagues we would not have the ability to connect with sensitivity and respect to the Ecuadorean community. We feel that we have great friends in Quito within the city and within the Tierra Nueva hospital and a good part of that is because of the people I have described above.


Thanks.
John
Secretary
Canadian Association of Medical Teams Abroad

Strategic Planning -- A GREAT! Weekend

On Saturday the 19th, 35 members of CAMTA gathered under the guidance of Ms. Janet Emmett, facilitator to plan the future of our organization. On the 20th, the process continued but with the executive plus Luis Piedrahita and Fern Cannon.

CAMTA has existed now for seven years. It was timely to review our past and determine our future, collectively as members. The future of CAMTA is in passing on the skills and knowledge accumulated over the prior years and the multiple orthopedic missions to new volunteers. The need to enhance education in Ecuador and develop new skills and experience in fundraising and business management in Canada were a couple of the themes that were presented in the course of the day. This week, Janet Emmett will consolidate the posterboard notes into a document that the executive can present to the membership, later in the spring.





Dr. Luis Piedrahita flew up from Tucson, Arizona to participate.

He is an Ecuadorean. Our charity must continue to be sensitive to the needs of Ecuadoreans.

Here, Dr. Marc Moreau, the President of CAMTA presents the results of his small group's work.

During a break, Fern Cannon, Mathew Moreau and Doris Kent talked in the hallway. In the background are the photoboards of past medical school graduates. Fern is an Ecuadorean and she has participated with CAMTA since it's inception in 2001. Fern flew in from Katy, Texas.

The weather was TERRIBLE! It snowed the WHOLE WEEKEND!


Over lunch Linda Ushkowski, Adam Petriw, Aline Young (back row) and Cecilia Tardif, Fern Cannon, Cori Kalven and Kathleen Shearer talk.

And here's Al Tardif, John McIvor, Erin Ennis and Carol Maynard. The retreat participants are all active CAMTA members. The turnout was large -- over 50 percent of the Edmonton membership.

In the early afternoon, small group sessions reconvened. Here Carol and Eileen consult over their idea of the future vision of our organization.

And over in the other corner of the room, Andriy Rodyniuk, anesthesiologist and Bethany Lewis, Clinical Nurse Educator and adult orthopedic ward nurse, complete their small group work.

The day got very exciting when everybody was issued orange and green dots to place on the priorities of their choice for CAMTA. It was amazing how a few items got most of the dots. I guess we were in agreement!


It's 4:20PM and nobody is sleeping! Ms. Janet Emmett stirs the group to a great high!

And finally at about 1730h the day wound-up. Here I present Janet with three beautiful Ecuadorean scarves. She liked them - because she wore them home when we dropped her at the airport Sunday afternoon.

Thanks to Janet for her expert facilitation! The results: STAY TUNED. It'll get posted here!

John

After the OR: Recovery on the Ward!

Today you'll see the ward in action. CAMTA nurses and the Tierra Nueva nurses working literally arm in arm (a brazo a brazo)

Here's Janet, the physio again with Kathleen Shearer. This little guy had a epiphysiodesis. If you want to know what is look it up. He had an infection in one knee and that changed the rate of growth. Look at that nice red cast -- courtesy of 3M.

Here's Darlene Hammell and Adela Sandigo. Adela is an RN and Spanish is her first language. That's so very handy since everybody can come running to Adela and get a first hand answer. Fern Cannon is from Cuenca but lives with her three children and husband in Katy, Texas. Fern has been a participant in our missions since 2002.

That's Marta in the middle between Adela and Deb Chalupa. Deb is a pro at orthopedic nursing since she is in charge of the orthopedic ward at the Misericordia Hospital. Martha is a long time nurse at the Tierra Nueva. She knows all the ins and outs of requisitions and lab tests.

Now look closely here. This young woman is ambulating on the stairs. Mom's at the bottom and watching Janet and Craig help her learn how to handle stairs with muleta's. That's crutches in Spanish.

But now a little surgery. Here's a club foot that was partially treated. This young girl is walking on the side of her foot. There was no possibility of a functional foot.

Notice on the right x-ray how the foot is turned inwards.

The only possibility to help this young woman was to fuse the ankle. Here's the final result with the pins to stabilize the joint while the bones fuse together.


Isn't this a beautiful shot of a happy family! That's student nurse Adrienne Robson kneeling and Clinical Nurse Educator Christina Hanna on the right. Everybody is just glowing!

Dr. Darlene Hammell examines Rodrigo. He's one of three patients this week who had bilateral hip replacements. The down side to a bilateral is higher blood loss. But they don't have to wait a year to get the second hip replaced.

This handicapped teenager is very happy but quite handicapped from her CP. She's quite smar upstairs and gave a number of us a drawing of mountains or houses done on her notepad. She was practicing her letters in a scribbler. Angela had tendon releases on both legs to improve her spasticity.

I had to include this shot because you can see just how bad this man's painful limp from his hip arthritis is. Note how he's tipped to one side as he is assisted by Eve Moreau and Heather Perl down the hall to the quirofanos. That's operating room in Spanish.

Here's another Pablo all tucked in and with sedation on board during his spinal anesthetic. I included this picture to show his sun-creased face from decade working in his field's to grow a crop on 5 acres to feed his family and sell for some cash.

We have one more day to operate! And then there is the big packing bee late on Friday to prepare some items for storage at the Tierra Nueva and others (such as the instruments) for return to Edmonton in the hockey bags. And we will say some sad goodbyes to our surgical nurses from the Tierra Nueva. The goodbyes for the nurses on the ward will be on the weekend because we'll still have patients in the hospital recovering from their late week surgery.

Thanks!

Analyzing the preoperative clinic flow

Hi Everyone,
I thought you might like some insight into how CAMTA staff see our patients before the surgery begins each year.
Last night several of us met at the Moreau residence and thanks to the skills of one CAMTA volunteer, Mark Fedorak who is an engineer, we outlined the flow of patients in our clinic. Why you might ask would we try to analyze this?
Each year the clinic has been very busy and very long. There is a constant flow of patients and their family members here and there throughout the large physio centre that the Tierra Nueva lends us on the first Sunday of our project. By the end of the 14hour day we have seen about 100 patients and filled the operating room schedule for two weeks with some open spots for patients who show up later.
But it is really organized confusion! We've adjusted the clinic before and each year it is a little bit smoother and better organized. But we are trying to improve it more! That would be more satisfying for the patients.
We have many small children and some frail elderly. Thus if we can improve the process we can get them out of the clinic sooner. They would rather wait for the day of their surgery at home or with a relative!
Mark Fedorak recorded our description of the patient flow. The people present last night are all CAMTA veterans and they each described their role and the changes they thought could help. Mark also recorded the roles of each clinic staff member. The translator brings the patient to the surgeon and acts as the "patient advocate". And the surgeon does the obvious thing -- takes a history and physical from the surgical perspective and examines the xrays. If the patient needs surgery then the next "station" in the clinic has to be one of nursing, family doctor, anesthesiologist and/or physiotherapist. Sometimes additional tests are needed and for those the patient needs to see a Tierra Nueva nurse or social worker. Every surgical patient needs instructions about when to stop drinking and eating before their surgery. They need their questions answered.
The very first and the very last clinic "stations" are the data entry stops. At the first station we'll enter the patient in the database and print identifying labels for the chart. At the last visit to the data entry personnel we take a photograph and ensure the patient has been through all the steps.
The Tierra Nueva social worker interviews each patient who has surgery planned before they leave the hospital. That ensures all is clear in the patient mind.
Eve Moreau lives in Quito and she has been a translator for us each year. She is the provisional "clinic organizer" since there is a lot of preparatory work in advance of the clinic. She prints and assembles the charts and prepares the signage for the clinic. Eve needs her chance for input into the clinic process. And likewise Darlene Hammell and Doris Kent, our two veteran family doctors need their input too.
All for now and thanks for reading! Please post some comments.
John

Today is a big packing day!

Sort! Wrap! Sterilize! Pack!



Down at the warehouse at 1000h today there will be a busy hive of activity!

Operating room nurses from pediatrics and from adults will be organizing and sorting supplies. Some are recently procured from what's been discarded at the hospitals but can't be reused. Other materials have previously been wrapped by the nurses and sterilized for our surgical caseload in Ecuador. There are surgical sponges, drapes to cover the patients during surgery and various single use instruments and staplers.

We have to take down two hockey bags per mission volunteer participant. Each bag is stuffed with all of things we need to deliver hospital care in Quito at the Tierra Nueva hospital. There are also medications for anesthesia and medications for the ward. There are dressings and IV giving sets. There are blood pressure cuffs and even a device called a Hemacue which provides "point of care" laboratory results. We take many crutches which have been discarded by our patients.

I would estimate that there are probably 10 hours of preparation for each hour of surgery. I don't think that's an exaggeration!

We are very very lucky to have a donated warehouse. It is shared with a car racing club. They use the facility for meetings and some storage. We have secured the back half of the facility with shelves for the surgical supplies and we use the front meeting hall for the preparation, sorting and wrapping.

Rotary and Lions service clubs support us in our work. And there are many numerous smaller donations made by individuals and businesses. The budget for a two week surgical mission is over $200,000. Each individual is responsible to raise the $2,000 cost of their travel, accomodation and meals. But the cost of a mission is far more than the cost of looking after our professional volunteers. We must buy surgical prostheses and surgical supplies and these are expensive. A hip prosthesis costs about $2,000 and we insert 40 of them each year!

If you think you can help us out then go to http://www.camta.com/ and click on the "Donate" link. We have only 13 weeks left until departure for Ecuador.

Please add your comments!
Thanks.
John Lilley

Getting ready for Mission 2008 to Quito, Ecuador

Hi Everyone,
It's only 13 weeks until our group departs for Ecuador.
On February 8th the first half of 50 doctors, nurses, physiotherapists, students and lay people will leave Edmonton, Alberta and head for the Tierra Nueva Hospital in Quito Sur, Ecuador.

The mission is an annual event. The Canadian Association of Medical Teams Abroad or CAMTA for short is the charity. Check out www.camta.com!!!!

CAMTA was formed in 2001. Until last year we have done one week of surgery each year. It takes about 10 days to conduct that surgery because first after traveling to Ecuador we have to set up the operating rooms; then screen the patients; and then create the operating room slates.

One week has always meant two theatres of surgery: one for pediatrics and one for adult orthopedics.

There seem to be a lot of club feet and dyspasia of the hip in children in Ecuador. And if the dysplastic hips are corrected in childhood then these kids get early osteoarthritis of the hip.

Osteoarthritis means PAIN and REDUCED FUNCTION!!! In Ecuador that means that the person can't work and therefore can't help his family put food on the table.

This last spring we doubled our mission to two weeks of surgery. Thus we could help about 28 kids and about 40 adults get better. And it was so successful that we are going to do it again.
But planning a mission with 80 staff is a lot of work. Thus with 13 weeks left until departure we have lots of work to do. I'm going to keep you up to date on preparations with this blog.

If you look at the website there are pictures of our mission. www.camta.com

Thanks everybody!!!