Podiatrists serve those in need every day in the office and some
volunteer to treat those in other nations who cannot afford medical
care. This author talks to DPMs who say mission trips have impacted them
professionally and personally.
More and
more DPMs are volunteering their time and considerable expertise to
travel abroad to help those in need of medical attention. While the
concept of missionary work is certainly not new, the number of
opportunities to help others across the globe seemingly grows each year.
It is not only the patients in other countries who benefit from the
gifts these trips provide.
Daniel Lee, DPM, AACFAS, remembers going on mission trips as an
elementary school student while living in South America. He currently
serves on the faculty of the Baja Project for Crippled Children.
Since 1976, the Baja Project has been treating children free of
charge at the Mexicali Red Cross Hospital in Baja California, Mexico.
The nonprofit corporation is funded entirely through corporate and
private donations although Dr. Lee notes a major source of income comes
from the annual Baja Project Seminar on Pediatric Foot and Ankle
Surgery.
Dr. Lee, who also serves on the faculty at the LAC+USC Medical
Center, became involved in the Baja Project as a resident in 1999.
“As a podiatric surgical resident, I was fortunate to acquire
specific pediatric surgical training,” recalls Dr. Lee. “The faculty
that I trained with was very supportive toward medical missions. Now, as
part of the faculty for the Baja Project, I have been able to apply my
education and training, and provide specific medical and surgical
services to the people in need.”
At year-round clinics, Dr. Lee regularly treats children with
conditions ranging from pediatric clubfoot to congenital deformities to
acquired neuromuscular disorders of the lower extremities. He describes
“the smile of a child being able to walk and the tears of joy of parents
watching their child walk for the very first time,” as the most
rewarding aspects of the job.
According to Dr. Lee, part of the Baja Project’s goal and mission
is to promote education and they teach members of the orthopedic
community the surgical procedures involved for the correction and the
postoperative treatment needed for each patient. Dr. Lee says they
“strongly emphasize” the Ponseti method for treating clubfoot deformity
and that quick intervention in these cases is essential.
Challenges On Mission Trips
Go Beyond The Medical
Even apart from the medical side, the work can be difficult. “Visiting
third-world countries is quite a challenge,” admits Dr. Lee. “But
actually going there for missions is much more than challenging.”
Dr. Lee cites customs, religion and socioeconomic and behavioral
changes as some of the factors that require high levels of knowledge and
sensitivity on the part of specialists visiting foreign countries.
“Financial support is always a concern,” notes Dr. Lee.
“Furthermore, having the proper team of physicians and supporting staff
is crucial.”
Dr. Lee says there are many other things to consider, from
receiving authorization from local authorities and transporting hundreds
of boxes of supplies to the site to educating local surgeons and even
gaining the respect and friendship of local residents.
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| Here is a photo of Luke D. Cicchinelli,
DPM, and a five-year-old Nicaraguan girl who was treated for a
large lipoma deep to her plantar fascia. Dr. Cicchinelli says
participating in mission trips “frames my daily work in a
context of value and service beyond the hustle for the next
dollar. It completes my sense of being a human being.”
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“It is very important to realize that we are there as ambassadors
representing not only our country, as Americans in a foreign land, but
we are also representing podiatric foot and ankle surgeons,” adds Dr.
Lee.
The impact of mission work on Dr. Lee’s life cannot be
overstated.
“This is about making a difference,” he says. “If we can make a
difference in this world as individuals and as podiatric surgeons, then
I think we have achieved part of our goals as physicians and human
beings sharing this world.”
Heeding
The Call To Serve
Patrick DeHeer, DPM, credits his first mission trip to Honduras three
years ago with awakening a “call to serve those in need with the gifts
God has given me.”
Dr. DeHeer, who practices in central Indiana and is team
podiatrist for the Indiana Pacers and Indiana Fever, went to Honduras
with a large mission group from a church in Little Rock, Ark. He says
his initial experience was “fantastic” and has led to three subsequent
mission trips.
According to Dr. DeHeer, the Little Rock team has been going to
Honduras for several years now. The group is comprised of about 90
missionaries, some medically trained and some not.
In fact, the experience in Honduras left such a positive impact
on Dr. DeHeer that he wanted to help out in another country as well.
After doing some research on the Internet, he spearheaded a trip to
Haiti in September 2003.
“This took some time and work to arrange, but it came together
well,” he says. “It can be difficult to set something up on your own,
but you have to stay with it and continue to offer yourself and your
skills.”
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| “The mission trips have had a huge impact
on me,” says Patrick DeHeer, DPM, who performed a clubfoot
reconstruction for this 13-year-old patient in Honduras. “ … You
come to the understanding that you are receiving much more than
you are giving and it becomes addictive. You yearn to serve.”
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For Dr. DeHeer, the biggest challenge he has faced in both
Honduras and Haiti has been providing adequate follow-up care for
postoperative patients. There are certainly other issues to deal with as
well. He says he tries to bring equipment and supplies with him so he
tries to “borrow and plead for donations well in advance of a trip.”
The facilities can also present potential problems, especially
when it comes to surgical procedures and, of course, there are
communication issues. Dr. DeHeer notes it was difficult to communicate
with patients and hospital staff as he does not speak Spanish or Creole.
Despite what Dr. DeHeer describes as “the physical demands of
operating in locations such as Honduras and Haiti,” such experiences
have had a profound influence on his life.
“Being able to serve those who are less fortunate is truly a
blessing from God,” offers Dr. DeHeer. “Frankly, if there was a way to
do it and still provide for my family, I would do it full-time.”
Going
Beyond The Call Of Duty
One 12-year-old patient with clubfoot deformities stands out in Dr.
DeHeer’s mind to this day.
“I could tell he was a special young man from the time I first
met him,” says Dr. DeHeer, who operated on the boy’s left foot while in
Haiti.
A month later, after checking up on the patient, Dr. DeHeer
learned that a severe infection and wound complication had resulted in
the decision to amputate the boy’s leg. “I was stunned,” he says. “I
came to the realization that I had to do whatever I could to get him to
Indiana and try to save his foot.”
Hard work and determination, including calls to ambassadors,
senators, congressmen and local Haitian officials, enabled Dr. DeHeer to
secure a visa and passport for the boy in 10 days rather than the six
months it usually takes. Once in Indiana, numerous medical personnel
worked on the boy for months, ultimately saving his foot. The treatment
culminated in a nine-hour operation in which Dr. DeHeer corrected the
right foot and plastic surgeons performed a skin and muscle free flap on
the boy’s left foot.
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| “The thing that struck me the most was
the profound appreciation these people had for what we were
doing for them. To these less fortunate people, fixing their
deformity was a precious gift,” recalls Joe Southerland, DPM,
shown above with members of the missionary group with whom he
traveled to Nicaragua in 2002. |
“It was truly humbling to see so many give of themselves for this
little Haitian boy they did not know in the least,” recalls Dr. DeHeer.
“It still brings tears to my eyes.”
Recent reports suggest the boy is doing well. It is a case Dr.
DeHeer will surely never forget.
“The mission trips have had a huge impact on me,” he says. “They
have changed my life so much for the better. You realize what is
important. Serving those in most need with little or no hope far
outweighs the money, acclaim and status. Very soon, you come to the
understanding that you are receiving much more than you are giving and
it becomes addictive. You yearn to serve.”
Overcoming Obstacles And Making The Most Out Of Mission Trips
Luke Cicchinelli, DPM, has been on 10 missions to date and remembers
every single patient he has treated. He will be traveling to El Salvador
this fall.
Dr. Cicchinelli, who is on the faculty of the Podiatry Institute
in Atlanta and also practices with the Eastern Carolina Foot and Ankle
Specialists in Greenville, N.C., first became interested in mission
trips after practicing for a year and a half in Madrid, Spain. Upon his
return in 1996, Dr. Cicchinelli was contacted by Todd Gunzy, DPM, who
invited him to join a mission team that Dr. Gunzy was organizing. (See
“‘Small Steps’ Makes A Big Impact” below.)
Dr. Cicchinelli began to prepare for his first trip to Guatemala
by learning Spanish, which he says helped with “both cultural
sensitivity as well as surgical teaching.”
He also quickly got involved in fundraising and coordination
efforts for the trip, which was a collaboration between the Guatemalan
Pediatric Foundation and the organization Healing the Children,
Northeast. He kept busy on that first visit, which lasted 10 days. “We
evaluated about 125 kids and provided surgical treatment for 40,”
recalls Dr. Cicchinelli. “We fostered interchange with the local doctors
for the sharing of techniques, as well as conducted follow-up
evaluations of the kids.”
Dr. Cicchinelli says getting used to the rougher conditions,
including no running water or air conditioning in the operating rooms,
wasn’t all that difficult.
“You get used to it,” he says. “The focus is on the kids and
trying to help them get a better step in life.” He says most of the
children being treated were born with congenital foot and ankle
deformities that required surgical correction.
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| During a mission trip to Nicaragua, John
McCord, DPM, performed a bunionectomy for this patient, who
traveled nine hours (including the first three hours on foot) to
get to the clinic. |
What has Dr. Cicchinelli found most rewarding about his mission
work?
“It was the interaction with the host country people and doctors,
appreciating their customs, the families of the children,” he says. “You
gain a sense of appreciation for our comforts here at home.”
For Dr. Cicchinelli, much of it comes down to destiny.
“Many of these folks were simply born into circumstances they had
no control over,” notes Dr. Cicchinelli. “There are so many ways to
help.”
In fact, Dr. Cicchinelli says being a missionary “frames my daily
work in a context of value and service beyond the hustle for the next
dollar. It completes my sense of being a human being.”
“Todos somos hermanos,” he adds. “We are all brothers in the
world, just born and existing in, at times, very different
circumstances.”
The
‘Gift’ Of Treating Deformities
Among The Less Fortunate
Joe Southerland, DPM, who is based in Arlington, Texas, began his
involvement with mission trips as a resident at the Northlake Regional
Medical Center in Tucker, Ga. His first trip was a weekend trip with the
Baja Project and it reaffirmed his interest in mission work.
After the Baja Project experience, Dr. Southerland went on to
join Dr. Cicchinelli and Dr. Gunzy in Guatemala in 1999. He is currently
involved with the Texas Podiatric Medical Foundation, which started a
monthly clinic in Reynosa, Mexico. The project has been ongoing for
three years.
Dr. Southerland, a faculty member of the Podiatry Institute, has
vivid recollections of his first trip to Guatemala, which he describes
as “a phenomenal experience.”
There were certainly issues to deal with, he remembers. “We did
have to do everything with cold sterilization. The autoclave at the
hospital we were at was small and could only run at night due to the
power it pulled.” However, the nurses set up a system through which the
instruments were rotated. “This actually worked quite well,” notes Dr.
Southerland.
As the other doctors have described, it was the families and
patients that had the greatest impact on Dr. Southerland.
“The thing that struck me the most was the profound appreciation
these people had for what we were doing for them,” recalls Dr.
Southerland. “To these less fortunate people, fixing their deformity was
a precious gift. One nurse told me it was the lottery of life and that
we could have just as easily been born here. That phrase has stuck with
me ever since.”
The story of one Nicaraguan girl with an immensely large foot is
also something he will never forget.
“She was 5 at the time,” says Dr. Southerland. “As it turned out,
she had a large lipoma deep to her plantar fascia. I would love to see
her today to see how her foot healed. She was such a cute little girl
and I felt so bad for her.”
Currently, Dr. Southerland travels to Reynosa three to four times
a year. “Those of us from out of town fly in on Friday night and spend
Saturday seeing patients and doing surgery,” he says. “We then fly out
on Sunday morning.”
He says they often lack materials but have learned to adapt.
“Sometimes you just have to make do with what you have,” notes Dr.
Southerland.
He says the positive effect of the mission trips has been
twofold. “You can’t go there and see and do the things you do, and not
come back feeling better about yourself,” he explains. “And hopefully,
you helped make someone’s life a bit better.”
Realizing
There Are ‘No Barriers To Care’
John McCord, DPM, has incorporated the philosophy of mission work right
in his own backyard of Centralia, Wash., so to speak.
“The economy in my community has always been a challenge,” says
Dr. McCord, a Diplomate of the American Board of Podiatric Surgery. “I
don’t have to travel far for the opportunity to provide services to the
poor. I have that opportunity daily in my clinic.”
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| Daniel K. Lee, DPM, says having the
proper team of physicians and supporting staff is crucial for
mission trips. His colleagues on a recent trip to Honduras
include (standing from left to right): Stanley Weinstein, DPM,
Matt Roberts, DPM, Jeff Yung, DPM, Jack Reingold, DPM, David
Levitzky, DPM, Steven Schwartz, DPM, Stanley Zussman, DPM, Fred
Hernandez, DPM, Michael Zapf, DPM, and a resident colleague
(kneeling in photo). |
Dr. McCord, along with Michael Dujela, DPM, have a policy of “no
barriers to care” at their office. Nobody is turned away because they
cannot afford treatment.
Travel has always been a passion for Dr. McCord. When he was
approached in 1978 to volunteer some time in a clinic run by the
Dominican Sisters in Cuernavaca, Mexico, he agreed to go. Although he
didn’t speak a word of Spanish, the work he did with orphans at the
clinic was well organized and one of the sisters translated for him.
Last fall, Dr. McCord traveled to Rivas, Nicaragua with a local
orthopedic group that conducts such trips each year. The trip was
extremely well organized, according to Dr. McCord, who stayed for one
week seeing patients and conducting surgical procedures.
“The clinical problems we faced were not sore toenails and flat
feet,” recalls Dr. McCord. “There were birth defects, trauma and
complications from prior surgical procedures and wounds. People traveled
for days to get to the clinic and they were always grateful even if we
didn’t have a solution to their problems.”
There was one patient in particular Dr. McCord says he will
always remember. “She was a 4-year-old girl with multiple birth
defects,” notes Dr. McCord. “Her mother wanted me to operate on the
child’s clubbed feet so she could walk. The child was paralyzed from the
waist down. There was no muscle control at all in the lower extremities.
Through a translator, I was about to give the young mother the worst
news she could imagine.”
Before Dr. McCord left Centralia, a Catholic chaplain had given
him a bag containing 350 sets of brightly colored rosary beads to give
to the Nicaraguan patients. “I gave a set of pink rosary beads to the
little girl. She and her mother beamed as the mother showed the beads to
the little girl.”
Despite having to tell the mother that her daughter would never
walk again even if the clubbed feet were corrected, Dr. McCord says
“they continued smiling at the pink beads. The mother explained to her
daughter what the rosary was used for. She thanked me in Spanish and
left.”
Dr. McCord says working with doctors in other countries has
helped him to appreciate the medical system we enjoy here.
“I have learned to respect the medical providers from Mexico and
Nicaragua for their ability to care for their patients with little
resources or reward,” emphasizes Dr. McCord. “I learned a lot from them
about the real calling of medicine.”
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‘Small Steps’ Makes A Big Impact
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Todd Gunzy, DPM, who practices in Mesa, Ariz., has been
instrumental in creating one of the longest-running
podiatric mission teams in existence. It took one phone call
to get the ball rolling.
In 1992, Dr. Gunzy worked at St. Raphaels, a Catholic
hospital in New Haven, Ct. A nun at the hospital put in him
in touch with a plastic surgeon who had just returned from a
mission trip to Guatemala. The plastic surgeon gave Dr.
Gunzy the phone number of Angeles Glick, who runs the
organization Healing the Children, Northeast. The program,
which has chapters nationwide, is involved in securing
medical and surgical teams, and placing them in areas of
need.
“The phone call was made Oct. 1 and I was on a plane Oct. 10
to Guatemala,” recollects Dr. Gunzy.
After that first trip, Dr. Gunzy began recruiting medical
personnel from the West Jersey Health Systems Residency
Program, from which he graduated, to form the first
podiatric medical mission team. The team began annual trips
to Guatemala in 1993. When Luke Cicchinelli, DPM, got on
board in 1996, it was his idea to link up the team with the
Atlanta-based Podiatry Institute. In addition to rotating
its podiatrists and residents through the team, the Podiatry
Institute also provides funding.
Currently called Small Steps, Dr. Gunzy’s team travels
abroad on an annual basis, focusing mainly on countries in
Central and South America. To date, the team has operated on
over 450 children. The team is composed of 14 core members
and several rotating members, including two residents from
the West Jersey Health System’s program, one guest
orthopedic surgeon and one faculty member from the Podiatry
Institute. It is currently working with the Greater
Philadelphia Chapter of Healing the Children.
Understanding The Considerable Preparation And Legwork
To say it takes a lot of legwork to conduct each trip is an
understatement.
“I begin preparing for the actual trips about six months
prior to us departing,” says Dr. Gunzy, who once tracked the
number of hours he devoted to preparation at 140. “We gather
our own supplies and ship them one month prior to our
arrival, travel on Saturdays, screen patients on Sundays,
operate Monday through Friday, and are back home on Sunday.”
As team leader, Dr. Gunzy is responsible for everything from
the designation of supplies and the coordination of shipping
with Healing the Children to creating the operating room
schedule after the triaging of patients and maintaining
public relations with each country’s liaison. However, he is
quick to give credit to Dr. Cicchinelli, who “has been my
right-hand man and has helped break down many barriers with
his bilingual abilities and his pleasing personality.”
Achieving A Deeper Perspective
For Dr. Gunzy, the mission work has been extremely
gratifying. “As Americans, we take a lot for granted,” he
says. “You could call it a reality check. It makes me
appreciate what I have each day.”
Dr. Gunzy acknowledges that the key to success is the
follow-up care his team provides. “We try to return to the
same country for a few years in a row so we can evaluate the
children and the procedures that were performed,” notes Dr.
Gunzy. “We make it a point to include the surgeons of the
host country so we can continue to learn from each other."
Although there is usually a long waiting list, people who
are interested in joining Dr. Gunzy’s team may contact him
at Tgunzy@aol.com.
“Applying physicians must have surgical experience with
pediatric clubfoot either in their residency or current
private practice,” notes Dr. Gunzy. “We are always looking
for ancillary medical personnel.”
For information on various chapters of the organization
Healing The Children, go to
www.healingchildren.org/local_chapters.html. For information
on the Baja Project For Crippled Children, please visit:
www.bajaproject.org.
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Ms. Garthwait is a freelance writer who lives in Downingtown, Pa.
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