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Posts Tagged ‘Pediatric Neurosurgery Program’

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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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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Dr. John Ragheb, from Miami Children's Hospital, performs an ultrasound on a tiny patient who arrived at the Project Medishare field hospital. Dr. Ragheb is in Haiti this week with his pediatric neurosurgical team.Photo by Jennifer Browning.

 

By Jennifer Browning

Project Medishare’s Pediatric Neurosurgery program is in full swing this week in Port-au-Prince at Bernard Mevs Hospital, where up to 20 surgeries are scheduled to happen over a three day period.

In 2003, Dr. Ragheb created the Pediatric Neurosurgery Program through Project Medishare to treat hydrocephalus in children in Haiti. This all-volunteer surgical team travels to Haiti twice per year to perform surgeries on children with hydrocephalus.The program’s goal has evolved to develop a neurosurgery training program with Haiti’s Minister of Health and the Dean of the National School of Medicine in Port-Au-Prince.

This week a neurosurgery team from St. Louis are joining Dr. Ragheb and his team.

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Project Medishare's Pediatric Neurosurgical Specialty Team arrived last week to continue their surgeries for children with neurosurgical problems including hydrocephalus, head injuries, brain tumors, and spine fractures. This is one example of the many programs that must continue along side of Project Medishare ongoing earthquake relief efforts in Haiti. Photo by Ann McNeil Ann McNeil, BSN, RN, Pediatric Neurosurgery, University of Miami/ Miami Children's Hospital.

By Jennifer Browning

While Project Medishare is continuing earthquake relief efforts in Port-au-Prince, we are also keeping attention to our other various programs in Port-au-Prince and the Central Plateau.

The Project Medishare Pediatric Neurosurgery Specialty program traveled last week from Miami to continue their work with children with hydrocephalus and myelomeningoceles.

Within hours of the team’s arrival, three other pediatric neurosurgery cases were admitted and/or transferred to the hospital.

A child waits in pre-op for surgery for hydrocephalus at the Project Medishare and UM Global Institute Hospital in Haiti. Photo by Ann McNeil.

“There is a clear need for continued care and our plan is to provide continuous neurosurgical coverage,” surgical team organizer Ann McNeil said. “Pediatric neurosurgery teams will be able to come and operate on a weekly basis as needed. For now the surgeons will come from the States, but we already have plans to train a local surgical resident and to work alongside the Haitian medical staff to provide training and education.”

Project Medishare has provided the in-country logistics for the pediatric neurosurgery trips twice a year since 2003. Since the earthquake, our organization’s collective efforts focus on the needs of those injured and displaced by the destruction. Many individual nurses and doctors, who had accompanied us on medical or surgical trips in the past, were the first to show up in Haiti to volunteer- in the operating rooms and on the wards of the Project Medishare and UM Global Institute field hospital.

Last week, the Haitian government marked February 12, as a national day of mourning for all those killed in the earthquake. Project Medishare and the UM Global Institute, in a strong partnership, continue necessary earthquake relief efforts in Port-au-Prince, but Project Medishare is also continuing support for other ongoing programs like the Community Health Program based in Thomonde and the Integrated Community Development Program in Marmont which are seeing a population growth from those migrating from Port-au-Prince.

The Pediatric Neurosurgical Specialty Team never changed their original plans, despite the challenges they would face from the destruction the earthquake left behind. The team saw children with neurosurgical problems including hydrocephalus, head injuries, brain tumors, and spine fractures.

“When presented with the option of providing care in Haiti or transporting the child to another country, we have always supported Project Medishare’s philosophy of treating the child in Haiti if feasible and safe,” McNeil said. “Why take a child and parent away from home and family. There is a high cost in dollars; there is a social and emotional cost.”

The team faced several challenges while they worked to continue their surgeries. While they found an Ultrasound available, the team discovered the CT scanners in Port-au-Prince were damaged in the earthquake which meant no useful imaging was available. Access to a CT scanner is necessary.

Two of the three children who were recovering from surgeries on Saturday had severe head injuries. Fortunately, with some skillful coordination, they were able to be transferred to the USS Comfort, a Navy medical ship, to have a CT scan, but such a delay can have devastating consequences.

“We are back in business caring for the children of Haiti, but we will have to continue to gather resources to build an effective and sustainable program,” McNeil said about her Pediatric Neurosurgery team. “I am proud to be a part of the team that makes it all possible. ”

Another specialty surgical trip scheduled in May. If you would like to donate to the Pediatric Neurosurgery Specialty Program in Port-au-Prince click here.

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