Archive for the ‘hydrocephalus’ Category

This past weekend, nine-month old Bidina Joseph received endoscopic third ventriculostomy (ETV) to treat her hydrocephalus. Today Magdala will take Bidina back to their home in Ti Goave, a two-hour drive from Port-au-Prince. Magdala said she is so thankful for the pediatric neurosurgery team who helped her daughter. Over a three-day period a pediatric neurosurgery team from Washington University School of Medicine performed 22 surgeries. Photo by Jennifer Browning.

By Jennifer Browning

Magdala Ezeve started noticing Bidina’s head was growing abnormally larger when her baby was three months old.

She brought Bidina to Bernard Mevs in February. At that time, Project Medishare’s nurse liaison Maguy Rochelin was working at the field hospital assisting medical staff with earthquake victims. After a call from a Bernard Mevs nurse stopped by the hospital on her way home, met with Magdala, retrieved all of her information and told her she would contact her when pediatric neurosurgeons arrived to do another assessment for children with hydrocephalus.

Earlier this month, Dr. Keith Rich from Washington University School of Medicine assessed Bidina and determined she was a candidate for surgery. This past weekend in spite of the cholera outbreak, Dr. Rich and his team of pediatric neurosurgeons performed an endoscopic third ventriculostomy (ETV) on Bidina.

Today Magdala will take Bidina back to their home in Ti Goave, a two-hour drive from Port-au-Prince. Magdala said she is so thankful for Dr. Rich being able to help her daughter.

“I am so very happy because before the surgery she had a crooked eye that was going to the left,” Magdala said. “I was so worried about this, but today it is already looking normal. My daughter is happy, she is playing with me and laughing.”

Over a three-day period the pediatric neurosurgery team performed 22 surgeries. Eleven of those children have already been cleared to return home, and five more, including Bidina, will be discharged from the hospital today.

For follow-up appointments parents will be able to take their children to Healing Hands, one of Project Medishare’s partners, or return to Hospital Bernard Mevs Project Medishare. For those who do their follow-up through Healing Hands, Natacha Guillaume, a clinical manager with Healing Hands, will send a report to Maguy so Project Medishare can continue to have an accurate case file of the patient.

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Pediatrician Dr. Heidi Sandige and neurology resident Suzanne Schindler measure 9-month-old Shaina Shirley Vil’s head to asses the child's condition before recommending surgery. Dr. Sandige and Schindler are part of a pediatric neurosurgical team led by Dr. Keith Rich from Washington University School of Medicine. Photo by Jennifer Browning.

By Jennifer Browning

A pediatric neurosurgical team is working this week at Hospital Bernard Mevs Project Medishare. Last weekend Dr. Keith Rich was at the hospital participating in a neurological assessment of prospective surgical patients, as well as providing follow-up care to others.

Pediatric neurosurgery teams have been coming to Haiti since 2003 to provide surgeries to children with hydrocephalus. Those surgeries in the past have been primarily performed by neurologist Dr. John Ragheb and his team from the University of Miami Miller School of Medicine. While Dr. Rich and some of his team have participated in Project Medishare’s specialty surgical trips with Dr. Ragheb, this is the first time Washington University School of Medicine has organized their own pediatric neurosurgical trip to Haiti.

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Three-year-old Michael Odelis arrived at Hospital Bernard Mevs Project Medishare (HBMPM) this morning to follow-up with doctors regarding his endoscopic third ventriculostomy (ETV) procedure which took place in April 2008 at Hopital Universitaire de la Paix. During pediatric neurosurgical trips like the one happening this week, doctors not only perform surgeries, but offer follow-up care to patients Project Medishare has helped in the past. Photo by Jennifer Browning.

By Jennifer Browning

Two years ago, Michael Odelis, 3, couldn’t hold his head up because his hydrocephalus made it too heavy.

In April 2008 Dr. John Ragheb’s pediatric neurosurgical team performed an ETV surgery on Michael at Hopital Universitaire de la Paix. And today, while he can’t walk without assistance, Michael holds his head up high and giggles at his mother as she speaks to him.

Mary-Maude, his mother, is very happy with Michael’s progress so far.

“This is a good program and I am so thankful that doctors could help my son,” she said.

She is here today for Michael’s follow-up and to inquire about physical therapy for him so that he can begin to learn to walk.

Michael walks for now with his mother's assistance, however, doctors hope that with physical therapy, in time he will learn to walk on his own. Photo by Jennifer Browning.

A few months after Micheal was born, Mary-Maude noticed that her son’s head was getting larger. Doctors in Jacmel told her she needed to go Port-au-Prince to get an opinion. She saw a doctor at St. Vincent in downtown Port-au-Prince who referred her to Maguy Rochelin, Project Medishare’s nurse liaison who arranged for Michael’s assessment and surgery.

Doctors have recommended that Michael obtain another CT Scan so they can see how the little boy’s brain is developing two year’s after surgery.

A pediatric neurosurgical team from Washington University School of Medicine led by Dr. Keith Rich is working here at Hospital Bernard Mevs Project Medishare. Over the next three days, the team is planning to provide surgeries to 21 children, but the time also provides an opportunity for follow-up on children who have received surgeries in the past.

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CMO Dr. Eddy Carmant is joined by nurse liaison Maguy Rochelin measures one-year-old Franck Marden's head during a pediatric neurosurgery assessment. Marden was approved for endoscopic third ventriculostomy (ETV) surgery which will take place this week when the pediatric neurosurgery team returns to Port-au-Prince. Photo by Laurene Leger.

By Jennifer Browning

Last weekend Dr. Keith Rich, a neurosurgeon from Washington University School of Medicine in St. Louis, arrived at Hospital Bernard Mevs Project Medishare (HBMPM) to conduct a medical assessment of children who are suffering from hydrocephalus.

Dr. Rich was joined by Project Medishare Nurse Liaison Maguy Rochelin and HBMPM Chief Medical Officer Dr. Eddy Carmant.

Dr. Keith Rich discusses CT scans of a patient during the pediatric neurosurgery assessment last weekend at Hospital Bernard Mevs Project Medishare. Dr. Carmant, a general surgeon in Haiti, is currently training to become specialized in neurosurgery. Photo by Laurene Leger.

Over the weekend the medical team assessed 50 children. Twenty children were approved for surgery, and doctors provided follow-up care to 21 other children who received surgery to correct their hydrocephalus from the previous May 2010 and November 2009 surgical trips.

Pediatric neurosurgery teams have been coming to Haiti since 2003 to provide surgeries to children with hydrocephalus. Currently, there is no formal neurosurgery training in Haiti, therefore Project Medishare’s ultimate goal is to teach Haitian surgeons how to provide neurosurgical care. This would include taking the surgeons and in a span of three years teach them how to perform neurosurgeries for adults and children and support them with equipment, training and supplies so they could become the foundation of a neurosurgical training program in the future.

Dr. Carmant, who is a general surgeon in Haiti, is Project Medishare’s first neurosurgeon trainie. Once Dr. Carmant completes his training he will be Haiti’s only pediatric neurosurgeon.

Project Medishare has formed strong partnerships with the following organizations and institutions in Miami and Haiti to provide operations to childrensuffering from hydrocephalus in Haiti: Miami Children’s Hospital, Jackson Memorial Hospital, Hopital Universitaire de la Paix, STEM Ministries, Healing Hands for Haiti, Haiti’s Ministry of Health and Centre d’imagerie.

Click here to read more about previous pediatric neurosurgery trips supported by Project Medishare’s Specialty Surgical Program.

If you would like to help fund Project Medishare’s Pediatric Neurosurgery Program click here to make an online donation today.

*Laurene Leger contributed to this story.

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By Jennifer Browning

It is fortunate chance that three-month-old Seinthia Michel was able to receive her endoscopic third ventriculostomy (ETV) procedure this week as part of Project Medisahre’s pediatric neurosurgery program.

Three month old Seinthia was abandoned at Hopital St. Michele in Jacmel. Seinthia received life saving surgery for her hydrocephalus this week from Project Medishare's pediatric neurosurgery team. Photo by Jennifer Browning.

At the end of April, Judy Hoffman, President of Art Creation Foundation for Children (ACFFC) visited Hopital St Michele in Jacmel to see the sister of one of the kids at the foundation who was ill.  A doctor approached Judy to ask if ACFFC could help with a baby who had been abandoned there.

“That is all we had to hear! She took us to see the baby and we all fell in love,” Hoffman said. “There was this beautiful tiny little girl lying in a crib, clean and cared for, but alone.  They showed us where her head was bulging [due to hydrocephalus].”

A Haitian doctor told Judy that he hoped ACFFC would take Seinthia because the baby was going to die and there was nothing the doctors at St. Michele could do.

“I called a doctor friend in Port-au-Prince who said as far as he knew, the shunt surgery was not done in Haiti and children like this die, but he would check and get back to me. “

All night into the next day Judy and everyone at ACFFC kept thinking about the baby.  The next morning Judy started calling and searching online for someone who could help.

“Some time that Sunday afternoon, I found reference to Project Medishare and neonatal care.  After a few emails Judy received the contact information for Maguy Rochelin, Project Medishare’s nurse liaison in Haiti.

“Next day, I called [the field hospital], spoke with the CMO and a nurse and they explained a team would be coming in,” she said, “and that we needed a CAT scan and an assessment.”

After several trials and tribulations, Hoffman along with a few staff members where able to bring Sienthia to Project Medishare’s field hospital for an assessment and to read the CAT scan.

Nurse practitioner Alicia Hill and surgical trip coordinator Ann McNeil get ready to take Seinthia to surgery. Seinthia came through surgery with flying colors and has the opportunity now to grow and develop as a normal child. Photo by Jennifer Browning.

“Based on the CAT scan and assessment, the word was that she would ‘probably’ be fine and they did not see congenital brain damage on the CAT scan,” Hoffman said.

Surgical team organizer Ann McNeil said children who are as young as Seinthia have a better chance at growing up and living a normal life.

“We have pediatricians who do outreach and who refer children to the program. We have doctors who now know about increasing head circumference, so children are now referred earlier, before their heads get big. Now at birth they know as soon as the head starts increasing they get referred to the program. Most of the kids now are between birth, some were born two or three days before we arrive,  or they  are under a year old. So those are children that we see have the opportunity to have a normal life, which means that they have a normal brain that can develop.”

Joseline Pantaleon, who works with the children at ACFFC, brought Seinthia to Port-au-Prince from Jacmel. Pantaleon said she is happy that Hoffman was able to find doctors who could help the child.

“I hope that after [Seinthia] has this operation,” Pantaleon said, “that she will grow up and be able to be a normal child.”

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Genia Francoi smiles at her 7-month-old daughter Violonda as they wait to see what doctors find out from lab tests. Photo by Jennifer Browning.

By Jennifer Browning

Not all children scheduled for surgery head to the operating room. Sometimes complications occur such as a fever or signs of possible infection.

Violonda, who was originally scheduled for endoscopic third ventriculostomy (ETV), awoke with a fever, so doctors postponed the surgery. In addition, doctors took a sample of brain fluid to send to the lab to check for an infection. If Violonda doesn’t have an infection, and her fever returns to normal, then doctors will proceed with her surgery.

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By Jennifer Browning

Fifteen-month-old Margaret giggles and coos at Marie Lourdes as she kisses the child’s face. Marie, a cousin, started caring for Margaret after the child’s mother died during childbirth.

Today is especially hard for Marie, because it is Mother’s Day in Haiti. Tears stream down her face as she begins to talk about her cousin, Margaret’s mother.

“I am happy that even though she is sick, that she is able to smile,” Marie said. “But it should be Margaret’s mother here today, on Mother’s Day, making her smile.”

Fifteen-month old Margaret is all smiles before doctors prep her for surgery.Surgeons performed endoscopic third ventriculostomy (ETV) on Margaret this morning to cure her hydrocephalus. Photo by Jennifer Browning.

When Margaret was four months, Marie began to notice that something wasn’t right. As Margaret started trying to sit up, she wasn’t able to hold her head up.

“That’s when I noticed that something is wrong, because I have two kids and they never had this problem. I knew that something wasn’t right when she couldn’t hold her head up and sit up right.”

Marie took Margaret to the pediatrician who told Marie the child may have a brain problem and recommended a CT scan. After viewing the scan, the doctor said that it looked as though Margaret had hydrocephalus.

“The problem was that there was no one in Haiti who could do the surgery Margaret needed,” Marie said.

In most places, hydrocephalus is diagnosed shortly after birth, a somewhat simple operation allows a child a greater chance at a normal life. Unfortunately, this is rare in Haiti; instead when undetected, the cerebrospinal fluid (CSF) that flows normally through a healthy baby is blocked or unabsorbed. When this happens, the fluid creates pressure on the brain causing swelling, severe damage and eventually death.

Months later another doctor told Marie that he knew of a program that treated hydrocephalus at Hopital Universitaire de la Paix, which is where Project Medishare’s pediatric neurosurgery team worked out of before the earthquake. The doctors at La Paix directed Marie to Project Medishare’s nurse liaison Maguy Rochelin who assists with the pediatric neurosurgery program.

When Marie found Maguy, the nurse was working at Project Medishare’s field hospital.

“When we arrived at the hospital, to look for Maguy, doctors examined Margaret, because they could see her head was large,” she said. “They called Maguy to come see Margaret, and that is how we got into the program.”

Surgeons performed endoscopic third ventriculostomy (ETV) on Margaret this morning. This type of surgery allows for the CSF to escape relieving pressure on the child’s brain.

“I am so happy for what Project Medishare is doing, everyone here treats all patients as equals,” Marie said. “This hospital helps a lot of patients. I believe in the doctors who have come here to help Margaret, and I am so thankful.”

Click here to learn more about Project Medishare’s Pediatric Neurosurgery Program.

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