19 December 2006
by Kelly Bothum
Dr. Robert Arm's preventive dental care helps children from Moldova.Dr. Louis Rafetto, an oral surgeon from Wilmington, experiences a new culture during a trip to serve people in Cambodia.Milford Memorial nurse Gail Geesaman holds a child during a trip with Operation Smile to the Philippines.Illinois, USA:
Working 12 hours a day for a week or two in an impoverished country probably doesn't sound like much of a vacation to most people.
But Gail Geesaman isn't most people. The Milford Memorial Hospital operating room nurse has used her vacation time to take five such medical missions. She's visited Kenya, Honduras, China and the Philippines.
She said helping people overseas augments her world travel and gives her the chance to change someone's life for the better.
Like Geesaman, Dr. David Birch can't imagine a life that didn't involve caring for those less fortunate, no matter where they are.
"I have to," said the Lewes family physician.
This year, the US-based daily The News Journal is shining the spotlight on a handful of Delaware health professionals who donate their time to help strangers half a world away. They are but a few of the many good people across the state who do so.
The work is done quietly, without any desire for recognition.
Because of them, children can smile without shame.
Because of them, little girls can show off a pair of earrings and a renewed sense of pride.
Because of them, a child's heart pumps the right way.
Because of them, an old women gets the medication she needs to treat her high blood pressure.
Because of them, the world is a better place for many.
Here are their stories.
Dr. Rafael Zaragoza, Retired urologist, Kent General Hospital in Dover
Country visited: Philippines
For all but one of the last 17 years, Dr. Rafael Zaragoza has made annual trips to his native Philippines on humanitarian medical missions.
In the beginning he went as part of the Society of Philippine Surgeons in America. But in 1995 Zaragoza, a member of the Dover Rotary Club, decided to open up the mission experience to those in the Dover area. He and other local physicians formed Operation We Care. They joined with another group of medical volunteers from Ohio who also were active in their local Rotary Club. (Operation We Care still receives financial support from both Rotary Club groups.)
Since then, a group of Dover doctors, nurses and other health professionals have traveled at their own expense to the Philippines once a year to provide surgery to Filipinos who can't otherwise afford it.
Last February, in a five-day period, the group handled 122 major and 131 minor surgeries, including thyroidectomies, bladder stone removal, hernia operations and prostate operations. They also handled nearly 1,200 dental extractions.
Because there are so many cases, the surgeons in Operation We Care get a little crafty. That means there usually are two surgeries going on at the same time in the operating room. Minor surgeries using local anesthesia typically are performed outside the operating room, in a corridor.
Zaragoza is a urologist by training, but over the years he's learned how to perform surgery to repair cleft lips, a common congenital deformity. One of his most memorable cases was that of a 7-year-old girl with a cleft lip who refused to go to school because she was teased about the way she looked. After Zaragoza repaired her lip, he handed her a mirror.
For the first time since Zaragoza had seen her, the little girl smiled. She told him she was ready to return to school.
Gail Geesaman, Operating room nurse, Milford Hospital
Countries visited: Honduras, Kenya, China, Philippines
Gail Geesaman was in the operating room during her first overseas medical trip when a volcano erupted seven miles from where volunteers were working in the Philippines.
The team, already performing surgery by flashlight, did the only thing they could -- they kept working. Later that night, volunteers watched from the roof of their hotel as lava streamed down the sides of the volcano.
"You do what you have to do," said Geesaman, 54, of Milford, who has been on five trips with Operation Smile, a medical service organization that provides reconstructive facial surgery to poor children worldwide.
She likes working on children with facial deformities because of the difference the surgery makes. In many developing countries, anyone born with a cleft palate or cleft lip is immediately looked down upon by the rest of the community. They're often ostracized and forced to beg in the streets to survive.
"It's a surgery where you see results. It's just immediate gratification," said Geesaman, who often works 12-hour days during the 10-day trips. "You can change a whole child's life."
Watching an erupting volcano might have scared someone else off another medical mission, but not Geesaman. Not even an earthquake on the last day of her trip could deter her.
"I want this to be a habit for me," she said. "Doing this is quite addictive."
Dr. David Birch, Family physician, affiliated with Beebe Medical Center in Lewes
Countries visited: Haiti, Colombia, Ecuador, Nicaragua, Honduras, China
Dr. David Birch wasn't yet a doctor the first time he traveled overseas to help someone he didn't know. In 1985, he was still an intern, just a year out of medical school, when he went to Haiti after hearing of a need for medical help there.
More than 15 overseas trips later, Birch is still helping people he doesn't know in countries far from home. He most recently returned from a trip to Macau, China, to fill in for other doctors who work in a clinic there but were leaving to treat patients in another part of the country. He found out about that trip while helping out during the aftermath of Hurricane Katrina in New Orleans.
For him, volunteering his time and talent is like breathing. "I have to," said Birch, 47, a family physician who lives in Lewes. "During Katrina, I told my wife I couldn't sit and watch it on TV. I had to be there to help."
Birch isn't affiliated with any particular international program. He responds to requests from churches and others. His usually sets up a clinic for the local church or community where he visits. His clinics have been located in plywood bus stops, homes and mud huts.
He always pays his own way, from airfare to lodging to food. And he brings all medications and equipment he plans on using.
Over the years, volunteering has become a family affair. His wife, Melanie, a registered nurse, often accompanies him on mission trips. His two children, Miles, 17, and Lydia, 20, also have gone along at times to take on the role of check-in nurse, pharmacist or lab assistant.
It's a good thing they're together for those two weeks. "That's the only vacation I get," Birch said.
Kassie Grey, Nurse, St. Francis Special Care Nursery at St. Francis Hospital in Wilmington
Countries visited: Haiti and Jamaica
To this day, Kassie Grey still doesn't know who slipped the volunteer application for Global Health Ministries into the nurses station at the St. Francis Special Care Nursery. But she's eternally grateful for its mysterious delivery.
For years Grey, 49, of Wilmington, pondered the possibility of going overseas on a medical mission. She thought the experience would give her a better understanding of different cultures.
What she didn't know was just how much it would steal her heart.
The neonatal nurse made her first trip with Global Health in 2004. She was part of a team of doctors, nurses and other health professionals who traveled to Haiti to provide medical care for people in the country's rural villages and decaying cities. Since then she's made two more trips, returning to Haiti in 2005 and Jamaica in May.
During the trips, the group worked out of old schools and churches with dirt floors, stringing up curtains to create makeshift exam rooms. They distributed medicines that came out of someone's suitcase. Some days they treated as many as 60 people, some who walked miles for the chance to see a doctor.
Grey's memories are vivid: the little children with their hair tinged red because of malnutrition, the old women with high blood pressure and back pain from doing manual labor, the smiles on the faces of the people grateful for someone to listen to them.
And then there was the baby.
He was only 6 or 7 months old and so tiny, no more than 12 pounds. He was in the late stages of AIDS. There was nothing doctors could do to save him. Someone suggested that the grandmother allow the little boy to be taken to the hospital; she refused.
Grey and the others knew he would die soon, probably before the end of the week. It pained her to know that if only he had been born in the United States, he could have had an excellent chance of having a long childhood, if not life.
But sadness isn't something Grey associates with her volunteer experiences in the Caribbean.
"It was much more than I expected," she said. "I think it rejuvenated me in my nursing practice. It renews your spirit. You see you can make a difference."
Dr. Christian Pizarro, Cardiothoracic surgeon and director of the Nemours Cardiac Center, Alfred I. duPont Hospital for Children
Countries visited: Chile, Peru, Argentina and Mexico
Pediatric heart surgery had never before been done in Arequipa, Peru, before Dr. Christian Pizarro arrived last January as part of a humanitarian mission.
By the time he left 10 days later, 16 children had been operated on to treat problems ranging from septal defects -- sometimes called a hole in the heart -- to more complicated cases like tetralogy of Fallot, a rare but life-threatening congenital problem made up of four separate heart defects.
Pizarro, who was born in Chile and attended medical school there, wanted to help as many children as he could on the mission. But it was just as important to him to teach local surgeons how to perform some of the procedures themselves.
So while Pizarro took the lead in most of the surgeries -- including three he did as soon as he got off the plane -- he made sure the local surgeons were there to assist. Eventually, they were the ones performing heart surgery, with Pizarro walking them through the delicate process.
"We train these native physicians so there is someone local who can help," said Pizarro, who volunteered for the trip as part of Hearts with Hope, a foundation aiming to teach Latin American medical professionals how to treat and care for children with heart problems.
"The goal is to leave something in place," he said.
Dr. Louis Rafetto, Oral and maxillofacial surgeon in Wilmington
Countries visited: Peru, India, Honduras, Cambodia and Colombia
After five trips overseas on medical missions, Dr. Louis Rafetto has learned a thing or two about volunteering. First, the experience gets in your blood and never leaves. Second, it stretches you far beyond your comfort zone.
The Wilmington oral and maxillofacial surgeon also discovered that some new technologies don't translate well in older cultures. Rafetto and other surgeons learned that while visiting a government-run hospital in India. They brought with them bone plates commonly used here in facial reconstruction surgery, especially trauma cases.
The plan was to give them to surgeons at the hospital. But Rafetto and his colleagues discovered doctors there worked differently than in the United States. "They said they don't treat trauma patients. It wasn't something they did," he said.
Rafetto, who has traveled abroad with Health Volunteers Overseas, said it's those cultural differences he finds so interesting. While on his medical missions, he also has eaten dog meat and tree ants. He has discovered that some countries don't think impacted wisdom teeth are a big deal like they are in the United States. And he has seen doctors not even bat an eye at the sight of pus coming out of a patient's wound from a postsurgical typhoid infection. Rafetto, on the other hand, had never even seen typhoid before, let alone after surgery.
"I think one of the added benefits of this whole experience is that you get to see things you wouldn't otherwise see," he said. "You learn you have to be flexible."
Kathy Chupp, Outpatient nurse, Nanticoke Memorial Hospital in Seaford
Countries visited: Ecuador and India
It was called "The Flying Hospital" because that's what it was. And Kathy Chupp was on board to help.
Chupp, a nurse at Nanticoke Memorial Hospital, made two trips on the specially equipped jumbo jet -- one in 1997 to Quayquil, Ecuador, and one in 1998 to Hyderbad, India -- as part of her volunteer service with Operation Blessing.
The nonprofit humanitarian organization no longer uses The Flying Hospital, but at the time it was something to see. Imagine a double-decker plane big enough to hold six operating suites -- three for cataract surgeries, two for dental procedures and one for cosmetic repairs such as cleft palates. There also was a pharmacy and a teaching area.
Chupp's job was in recovery. She stayed with cataract patients and children undergoing cosmetic procedures. It was a busy place, since about 40 cataract surgeries were done each day of the two-week mission.
One of the youngest cataract patients was an 8-year-old girl who lived with her grandmother. She was blinded by the condition at an early age. As the doctor removed the patches from her eyes, he held a toy airplane in his hand as a gift for his young charge. Her enormous smile at the sight of the toy conveyed the success of the surgery.
"It was so exciting to see that as a result of what was done for her she could see again," said Chupp, 57, of Seaford. "He was showing her this airplane, and it was just a thrill for this little girl to be able to see it."