Another Record Setting Year

2013 proved to be an exciting year indeed. The team was very anxious to see the wonderful improvements that our hospital administrator Mr. Jay had worked so hard to get completed. With an additional operating room we were able to bring both an additional surgeon and anestetist. Set with additional capacity we were poised to provide service to many more poor during our two week sprint. What we learned is that with capacity also comes complexity which requires the team to work in an even more coordinated manner to keep the process moving. We also came to realize that no matter how much we try, sometimes the external factors of working in this poor area of India can cause challenges beyond our control. Despite all of this we had another record setting year and the team should be commended for working so hard and so well together.

On the first day our team of 11 had all arrived at the First Transit Hotel in Hyderabad near the airport by 9AM breakfast, some with more sleep than others, with greetings all around, and introductions of the first timers. John Mark and T.L.Reddy joined us. We loaded the bus John Mark had hired to take us all and our 33 pieces of luggage (most of which contained donated medical supplies and equipment) to Khammam, and were ready to leave by 10AM. Unfortunately, one of Glenn’s duffles was delayed from Dubai, arriving at 9AM, so we had to go to the airport to claim it. It contained the “loaned Harmonic Scalpel” worth a lot of money. The Customs guys knew they had struck gold. It took Glenn and John Mark over 2 hours to wade up through the bureaucracy to the top guy who struck a deal with Glenn valuing the instrument at $400, making the 36% import duty $144 which we had to pay even though it was a loaner to be used only for free on the poor and had to be taken back to the USA in 2 weeks. The customs guys said that Glenn could apply to get the money back when he showed them that he was taking it back out in 2 weeks. Yeah, right!!

We finally arrived in Khammam a little after 5 PM, unloaded our personal stuff into our rooms, and the surgical goods were taken to the OR at St. Mary’s Mission Hospital (SMMH), where they were unpacked and put away in the organized shelves David Emerson had made for us last year. We ate dinner about 9PM and crashed in bed, exhausted.

Monday AM dawned early. All our meals are always graciously provided for us by John Mark and Vasantha in their home, stretching it to the limit. We needed to eat early (7AM) to be on time for Bishop Vadapalli coming from Dornakal (the Diocese owns the SMMH complex)  to bless the amazing new construction area  before Opening Ceremonies, which is always filled with lots of pomp, welcoming, garlanding, and many kind words, mostly in Telugu.  Joining us were our Indian colleagues who rounded out the team.

Unfortunately, we were delayed 2 hours, setting everything back, and we finally got to Screening Clinic where we tried to sort out the various patients by disease, and schedule those needing surgery. Between 11AM and 7PM we saw over 200 patients, and scheduled surgeries through Thursday into Friday. We did 3 small cases that afternoon. Everyone pitched in and made the system, which had been set up by Joe jr, work better than ever before.

Tuesday AM we started the regular OR schedule, running 3 tables at once: 2 in the main OR, and 1 in the room next to the main OR, just converted into a superb, clean, new, 2nd OR. Thanks to a couple of very generous grants from friends and families in USA made through FOCI (Friends Of Christ in India – our 501(c)3 tax-exempt funding organization) we were able to create this new OR, pushing the wall out 9 feet, and also redoing the “doctors’ lounge” (which is for everyone) and the nurses sterilization work-station, adding 2 new toilets (1 western style). Grants also enabled the equipping of both ORs with new state-of-the-art ceiling lights which were much needed, a new OR table, and a new Anesthesia machine (much needed because rats had eaten the guts out of our old machine, rendering it unusable and too old to rebuild). All this was very carefully and painstakingly supervised by Mr.Jay, our fabulous Hospital Administrator, over the past 6 months with dozens of emails back and forth. What a great improvement!! A giant step toward the 21st Century for SMMH. Great job, Mr. Jay!! Atta-boy!!

We usually scheduled 23-25 cases a day, some major, some minor. The top number was 28 cases in one day. We usually start about 8AM and finish around 6 or 7PM, sometimes later. Then we make rounds on our in-patients, making sure everyone is healing properly and being cared for, then get to supper at John Mark’s house around 8 or 9PM.

The patients stay longer than in the USA hospitals because they often have considerable distances to travel home, walking, or by bus, frequently to primitive conditions. We want to be sure their wounds and bodily functions are all healing properly before letting them go, because there is usually no opportunity for follow-up. Occasionally a patient or two will return the next year because of a problem, related or unrelated, or just to say thank you. The people we see are all so grateful. They often try to bow down to wash our feet as a sign of gratitude, but I try not to let them, as it is demeaning.

Dirk did most of the head and neck cases, including thyroids, thyroglossal duct cysts, and parotids. Glenn did a lot of everything as did Joe, in true general surgical fashion. I did some of the hydrocoeles that everybody gets rather sick of  because they are so prevalent. I did a few hernias, and some burn scar releases, some requiring skin grafts. Joe harvested the skin grafts using the superb, electric graft taker and mesher, graciously donated by Zimmer, through MAP International (worth $12,000 in the USA). Over the past few years this machine has really helped a lot of people, and we are very lucky to have it.

On our second Tuesday, 15 Jan., Dr. Joe and I were invited to the Centenary Celebration of the Diocese of Dornakal by Bishop Vadapalli. It was a fairly large affair with several thousand people present, full of pageantry and pomp. We were honored for our work these past 15 years with garlands and shawls and asked to speak about it….very special.

While we were in Dornakal, Dirk, Glenn, Hussain, and Lesley went to Mamata Medical School in Khammam, to give Grand Rounds to the residents and students. This had been arranged by our colleague surgeon, Dr.Pavan from Mamata. It was a great success, and opened a few doors between us and the Medical School. We are in Dr. Pavan’s debt.

On Sunday 13 Jan, Dr. David Raphael, a pediatric dentist and husband of Lesley Wojcik, arrived for the 2nd week. We had had the dental chair set-up repaired and the room cleaned up. David ran a very successful dental clinic during that week. He consulted on 24 patients with a wide variety of dental problems, most of whom needed teeth extracted. David did extract teeth in 9 of these patients, some single, some multiple, but he ran into an interesting local belief that forbid dental extractions because it would cause loss of eye-sight. Never heard that one before!

Due to a travel-agent’s error, which put them on a flight at 7AM from HYD on Friday instead of Sunday, Dirk, Cath, Glenn, and Heidi had to leave Thursday afternoon Jan.17th. Joe & I struggled on with Hussain, Lesley, Gopi Chand, and the rest of the team. This freed up one of the 3 tables which was well utilized by Drs. Usha and Pavan (Gyn from Mamata). Dr. Pavan is the wife of surgeon, Dr. Pavan. They saw gyn patients and scheduled several hysterectomies, for which we were most grateful.

After the cases were all done Friday PM, Hussain, Lesley, and Dr.David left for Hyderabad. Dr. Joe, Joe, jr, David & Lee Emerson, Dr. Mary and I made rounds, discharging patients where it was timely and safe to do so, and planning for future care of others we were leaving behind.

As scheduled, Bishop Vadapalli, Martin Luther, the Diocese treasurer, and several others in the Bishop’s team came to meet with Dr. Joe, Joe, jr, John Mark, Jay, Dr. Mary, and me to lay out plans for future development of SMMH as a full time quality medical facility for the poor. The decision was made to recruit a new G.P. for SMMH to replace Dr. Mary, and to elevate Dr. Mary to full-time Specialist Pediatrician, seeing all patients from birth thru 14 years. We also reaffirmed the need to recruit and hire a full-time, Certified Ob-Gyn Specialist. In addition, our consulting engineer who had drawn the plans for the wonderful New OR/Lounge/Sterilization room expansion to look at the old doctors’ residence building. He opined that it was very restorable, and could be rehabilitated into a very nice living quarters for future new Specialists hired by SMMH. This renovation has been generously funded by a grant from the Walker Family in Florida, for which we are very grateful.

Closing Ceremonies were meaningful, full of pomp and thanks-givings, and speeches both by Bishop Vadapalli and the District Superintendent of Health. We made final rounds Saturday AM, loaded 2 cars, and left for Hyderabad after fond farewells with all our wonderful friends in Khammam.

We did 238 procedures on 233 patients (including the dental) in 9 1/2 operating days. We consulted on 954 patients in Screening Clinic during the 10 days we saw patients. There were no significant complications, infections, or deaths. A lot of progress was made toward re-establishing SMMH as a year-round, good medical facility for the poor. We are very grateful to Bishop Vadapalli and his team for their partnership in this endeavor, and to the Khammam community for their interest as well.

We are also extremely grateful to all those who donated their time, talents, and money to Free Surgical Camp and our efforts to bring SMMH into the 21st century. Without all their generous donations, we would not have been able to build and equip the 2nd OR, plan and help pay for Specialists in Pediatrics and Ob-Gyn, repair the infrastructure, and most importantly, continue to run the Free Surgical Camp. We are already working on plans for 2014. Thank you to all of you who helped us. It would never have happened without your support. Most of you will never meet the hundreds of patients you allowed us to help, but they will never forget your generosity, and the fact that you cared enough to make it happen.

God Bless you all,

Respectfully submitted:
George Longstreth,MD, FACS
Joe Bardenheier III, MD, FACS

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The Team:

Dr. George Longstreth, MD, FACS
Surgeon, Fairfield CT, sixteenth Free Surgical Camp

Dr. Joe Bardenheier III, MD, FACS
Surgeon, Essex CT, seventh Free Surgical Camp

Dr. Dirk Noyes, MD, FACS
Surgeon, Salt Lake City, UT, second Free Surgical Camp

Dr. Glenn Winslow, MD, FACS
Surgeon, Great Falls, MT first Free Surgical Camp

Hussain Lakdawalla
Anesthesiologists,  Portland, OR, first Free Surgical Camp

Lesley Wojcik
Anesthesiologists, Portland, OR, first Free Surgical Camp

Dr. David Raphael
Pediatric Dentist, Portland, OR, first Free Surgical Camp

Catherine  Noyes
Medical assistant, Salt Lake City, UT, second Free Surgical Camp

Joe Bardenheier IV “jr”, MBA
Medical assistant, Boston MA, third Free Surgical Camp

Heidi Winslow
Medical assistant, pre-medical student, Gerat Falls, MT, first Free Surgical Camp

Dr.  Gunti Mary Anurupa
Pediatrician working as a GP at St Mary’s Mission Hospital

Dr. Deepika Kennedy, MD
Medical resident, Dornakol Hospital, India, second Free Surgical Camp

Dr. Sulochana Christopher
Surgeon, Member of the Board of Christian Service Unit “CSU”, Chennai India, ninth Free Surgical Camp

Dr. Gopi Chand
Anesthesiologist, Khammam India, sixteenth Free Surgical Camp

Dr. Hephzibah Antony
Medical resident, St. Mary’s Hospital, Khammam India, second Free Surgical Camp

David Emerson
Patient log keeper, medical assistant, carpenter, Georges Nephew, Norwich, VT, second Free Surgical

Lee Emerson
Patient log keeper, medical assistant, Norwich, VT, first Free Surgical (SMMH), Khammam, India, first Free Surgical Camp

Dr. Seethi
Working as a GP at SMMH, first Free Surgical Camp

Drs. Usha and Pavan
Gynecologists from Mamata Medical School, first Free Surgical Camp

Mr. Jayaseeludu (Jay)
Our wonderfully enthusiastic Hospital Administrator

Titus, Joseph, and Rev. Vincent
Our 3 superb translators

Rev. PC John Mark and his wife Vasantha
Our lovely hosts

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Trip Photos:

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Report Of Surgeries:

Patients consulted in Screening Clinic, including dental  954