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Archive for the ‘Emory Surgical’ Category

By Jennifer Browning

At 13, Amos spends his summer vacation working to help support his family. At sunrise, he goes down to the river, collects the sand on the bottom, places it in large buckets and then carries it to a central location.

Amos and his mother Ann. Amos is recovering well from his first surgery. Today, surgeons will perform a skin graft. Photo by Jennifer Browning.

Over a week ago, Amos fell and punctured his hand while at work. Not wanting to worry his family, he told no one about his injury. Within a week, Ann, his mother, began to notice Amos wasn’t sleeping.

That’s when Amos showed her his hand, which was swollen and showed signs of infection. Ann brought her son to the government hospital in Hinche last week where doctors prescribed antibiotics and tried to clean the wound. They recommended that Amos return to see the doctors arriving from Emory.

When the doctors from Emory met Amos, his hand was enormously swollen and he was complaining not only of pain in his right hand, but all the way up to his shoulder. His forearm was already showing signs of swelling. The surgeons determined that Amos was suffering from necrotizing fasciitis.

“He is the bread winner in his family, he fell and probably had wood penetrate the wound, those are dirty wounds in general, and they are set up for rapid bacterial overgrowth,” Dr. Jahnavi Srinivasan, a visiting surgeon from Emory said. “So when he got here he was actually septic, he had a very high fever, he couldn’t move his fingers at all. If this had gone on too long there wouldn’t have been a chance of his hand coming back.”

The infection was so bad that there was a possibility Amos could lose his hand or had the infection worsened, his life.

The surgical team comprised of Dr. Srinivasan and Dr. Viraj Master decided to perform surgery to relieve pressure from the wound.

“He had global body wide infection and non-use of his hand,” Dr. Master said.

Ann said she is thankful for what the doctors could do here.

“The Lord has given me grace to help my son. I prayed for something to come, and the Lord sent me these doctors to help my son,” she said. “I am very happy. After thanking God, I thank the doctors for coming here. The doctors are very nice and professional.”

Three days after the surgery, the surgical team says that Amos’s wound is overall healing well, but there are still concerns for the young boy.

“The concern is that it is going to form a bunch of scar tissue, and as the scar tissue forms, the skin is not going to be as elastic as regular skin,” Ira Leeds, a third-year Emory medical student said.

Leeds explained that this elasticity problem would prevent Amos from being able to open and close his hand properly. In order for him to regain full use of the hand, he will require a skin graft and long-term physical therapy.

Dr. Srinivasan and Dr. Master plan to do a skin graft on his hand today, because they are not sure when he will have the opportunity to see a plastic surgeon. And if the wound care isn’t done properly, the hand could become infected again.

“He would have died if we hadn’t debrided this and if it gets infected again he could die,” Dr. Srinivasan said. “Normally when you have a wound like this you wait seven to 10 days just to make sure the superficial bacterial counts from the fresh tissue has gone down because it gives you a better chance of the skin graft taking and healing.”

The surgeons are hoping the skin graft will take. Project Medishare’s nurse liaison, Maguy Rochelin, is staying in touch with the patient so if Amos needs another skin graft she can possibly schedule Amos to see the next plastic surgery team arriving to work at Bernard Mevs/Project Medishare hospital in Port-au-Prince.

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By Jennifer Browning

While some will be basking in the sun by their barbecue grills or lining up their fireworks on Sunday for Fourth of July celebrations, Emory Medishare, in partnership with Project Medishare will be arriving in Hinche, Haiti in the Central Plateau to begin a week of surgeries. Above is a sideshow, produced by Emory University and narrated by Dr. Viraj Master regarding the realities in operating in rural Haiti.

This will be the third year Emory will be working out of the government hospital. Check back to the Project Medishare Blog for updates regarding their specialty surgical trip.

Click here to read posts from previous Emory surgical trips in Hinche.

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Photo by Nick Vitone.

Photo by Nick Vitone.

By Nick Vitone

I recently traveled to Haiti to photograph a team of medical students and professionals from Emory University who were working on partnership with Project Medishare.  The trip was designed to offer surgeries to patients in the central plateau, who might not otherwise be able to improve their health.

For me, the first trip to Haiti is like the first trip to the moon; I couldn’t begin to form any worthwhile expectations.  What I read in the news or in books helped, but was limited.

Having been there and back, I now feel there are two different Haiti’s.  There is the popularized Haiti that grabs attention in the headlines- for the poverty, the violence, natural disasters, politics, the relief efforts and the list goes on.  Truth be told, the level of poverty is quite shocking, and everywhere you travel is saturated with reminders of it.  Perhaps that is the greatest contrast to most other places I have visited–that there is no escape from the poverty.  The poverty, violence, etc. are the “facts and figures” of Haiti, and as such they are informative, but do little to speak of the actual Haitians.

Another Haiti exists as well, this one is much more personable and warm, even inviting.  So many of the patients we worked with were very open and generous with us, but what really surprised me was the extent to which their families were involved.  Every single patient that we saw had family that traveled to be there.  There were no hotels nearby, no accommodations for them.  Often times they slept on the floor next to their loved one, or at the foot of the bed.
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Roselande Bruni, 4, waits with her parents before her going into pre-op. Bruni was diagnosed with a Wilm's tumor which was removed today. Photo by Jennifer Browning.

By Jennifer Browning

HINCHE, Haiti– As she was bathing her 4-year-old daughter in early June, Iralande Ulyss began noticing a walnut sized lump on her daughter’s back hip. The lump was palpable and firm to the touch. Three weeks later the mass had grown larger than a cantaloupe. Concerned for her daughter, Iralande brought Roselande to the Hospital in Hinche where doctors performed tests including an ultrasound.

Roselande Bruni was diagnosed with Wilm’s tumor, a kidney tumor that only happens in children. It is caused when there is loss of tumor suppression meaning that the properties the body has to normally prevent tumors from forming, has disappeared.

Lead surgeons Drs. Viraj Master and Jana MacLeod agreed that removing a tumor of this kind is risky, but MacLeod felt that Roselande didn’t have any other options.

Without the surgery today, MacLeod said while it is difficult to determine, the little girl possibly had six months to live because should the tumor show cancerous it would surely spread.

“By doing this surgery today, we are giving her a chance to live a normal life,” MacLeod said. “Her only other option was to go to Port-au-Prince for surgery, but her family cannot afford this.”

The doctors have successfully removed and will send the tumor for biopsy to Port-au-Prince.

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By Jennifer Browning

HINCHE, Haiti— “In God’s hands…..”

This is how 22-year-old Jean Massenat views his life.

Twenty-two-year-old Jean Massenate with his mother by his side waits for the doctors to take him to surgery.Photo by Nick Vitone.

Twenty-two-year-old Jean Massenate with his mother by his side waits for the doctors to take him to surgery. Photo by Nick Vitone.

Walking alongside the road in Carrefour Marin outside of Port-Au-Prince, Jean turned to the screams behind him where seven others were running, warning him to get out of the way. Barreling toward him was a tap-tap carrying a load of passengers. The vehicle had lost control of the brakes and now headed directly for him. Just before leaping into a nearby ditch, the tap-tap hit Jean’s hip. Jean survived, but seven others were killed during the incident.

Bruised and in pain, Jean seemed he would begin to heal from the tragic ordeal, then three months later, he began to have trouble urinating. The young man was eventually diagnosed with a displaced urethra.
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General surgeon Dr. Jana MacLeod, follow-up patient Nicholas George and Urology surgeon Dr. Viraj Master. Photo by Nick Vitone.

General surgeon Dr. Jana MacLeod, follow-up patient Nicholas George and Urology surgeon Dr. Viraj Master. Photo by Nick Vitone.

By Jennifer Browning

HINCHE, Haiti—When Nicholas George walked into the government hospital last year, he showed a noticeable mass underneath his long shorts.

George, diagnosed with elephantiasis of the groin, had been carrying the 35 pound mass for 17 years. Zanmi Lasante Hospital in Cange referred him to Project Medishare’s surgical team who were working here in Hinche last July. Drs. Viraj Master and Jana MacLeod performed the difficult six and a half hour surgery, which proved to be a success.

Before returning for another surgical trip Master and MacLeod asked staff at Hinche to make sure George returned for follow-up. George returned with and notified the doctors that while he was much better after the removal of such a mass, that there were two remaining sutures irritating him.

The doctors applied a local anesthetic and removed the sutures. George once again expressed how thankful he was to Project Medishare and the Emory surgeons who helped him get his life back to normal.

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Photo by Nick Vitone.

Photo by Nick Vitone.

By Jennifer Browning

HINCHE, Haiti—The Emory surgical team will be performing surgeries in Hinche this week. Drs. Viraj Master and Jana MacLeod are returning with a team of doctors, nurses and medical students, many which are returning volunteers from last year’s trip.

Master and MacLeod led the surgical team partnered with Project Medishare last year. It was the first time a surgical team was hosted by the government hospital in Hinche. Last year the team performed 15 successful surgeries over four days.

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