Dr. Paula Dhanda consults with a young patient.

CLEARLAKE >> In conjunction with a Thanksgiving Day outreach event that included a meal for members of the City of Clearlake community, free health screenings were provided at the Clearlake Youth Center by Worldwide Healing Hands.

Dr. Arthur Bikangaga, health screening organizer and team leader, was joined by Dr. Paula Dhanda and several volunteers to check blood pressure and other vital signs and to discuss health concerns with individuals. Additionally, participants received knit caps and socks donated by Worldwide Healing Hands and handmade soap donated by community members.

Assisted by Registered Nurses Kathy Madsen and Zamitley Saroza, the doctors screened 28 people — 18 females and 10 males — ranging in age from 8 to 84 years old. Patients were screened for health problems and were referred for appropriate services depending on their needs, said Dr. Dhanda. The individuals were given written recommendations and contact information for follow-up.

Health issues identified during the consultations included high blood pressure, the need for contraception and family planning counseling, the need for breast and cervical cancer preventative exams, the need for vaccinations including the Gardasil vaccine to prevent cervical cancer, and smoking cessation counseling. The physicians identified patients at risk for domestic violence, counseled an individual with fetal alcohol syndrome, and advised one woman to seek treatment due to high risk for cancer of the uterus.

“Also noted was the lack of knowledge about availability of health care coverage or how to get it,” said Dr. Bikangaga. “This may be a major factor in avoidance of care.”

The physicians plan to conduct similar screening clinics in the future. Informing individuals about health care availability will be emphasized at the next session, Bikangaga said.

Volunteers assisting with sign-in and distribution of written materials and hats, socks and soap included Karna Horn, Wendy McCrae, Michael DelValle, Susan Stout, Irene Lopez, Angelique Fricke, Darian DelValle, Jasmin Clarke and John Paul Clarke.

“Worldwide Healing Hands thanks all the volunteers who gave up time with their families on Thanksgiving Day to participate in caring for members of our community,” said Dr. Dhanda.

For information about upcoming screenings or availability of health care, call Patti Lee in Dr. Bikangaga’s office at (707) 263-1677.

by Susan Stout
Dr. Paula Dhanda is a practicing physician in Kelseyville. She is the founder of Worldwide Healing Hands. She may be reached at 279-8733 or visit http://drspecialtycare.com/ or http://www.worldwidehealinghands.org/.

Published in the Lake County Record Bee: Event provides health screening

Paula R. Dhanda, MD
Obstetrician & Gynecologist
Team Leader
“I am excited to be returning to Nepal to work with Himalayan Healthcare and continue the work that we started in 2012.”    Dr. Dhanda has led several medical missions in the past 10 years and has received numerous awards for alleviating the suffering and promoting wellness.

Nancy Jane Reynolds, MD
Obstetrician & Gynecologist
“I love to travel and work with different cultures; providing surgical and medical care.”  Dr. Reynolds traveled to Nepal in the early 1980s and this inspired her to volunteer to return with this mission.

Rafal Jan Wyskowski, MD
Anesthesiologist
“I love being a doctor.”  This is Dr. Wyskowski’s first medical mission; he loves his profession and offered his skills in that spirit.

Margaret Jennifer Burns, RN
“I have wanted to work on a medical mission and now that I have retired, this is the perfect time.”  Jennifer’s experience for the past 25 years has been as an OB/GYN nurse.

Lonnie Marie Hlusko, Registeded Ultrasoun Technician
“I am dedicated to women’s healthcare in the developing world.”  Lonnie founded the organization Hands for Humanity in 2000 to educate nurses and hospital staff in remote rural settings such as Nepal on healthcare and the use of ultrasound as a tool to diagnose problems in pregnancy.  Since its founding, Lonnie has traveled on numerous medical missions.

Lynn Arnold, Licensed Practicing Midwife
Lynn feels she has “a unique ability to teach at a simplistic level” – grasp the complex and translate so everyone can understand. Lynn has been working in women’s health since 1975.  She founded and operated a free standing birth center from 1985 to 2011 serving more that 13,000 Hispanic women.  She also wrote and taught a state approved midwifery educational program to over 800 students around the world.  This will be her second mission to Nepal with Worldwide Healing Hands.

Flora Shepherd Krasnovsky, Epidemiologist
Flora volunteered to “gather information on this mission for training.”  Her skills are in research, counseling, training, data collection and analysis.

Nathan DeHart, Professional Photographer
“I want to provide inspiring professional photography for WHH to use for promotion and education.”  Nathan has traveled as a photographer to South East Asia and India in the recent past.

Nathan Powers, Student
Nathan volunteered for this mission “to have an opportunity to learn about the medical field while giving to the less fortunate and learn about the world I live in>”  Nathan has traveled to Ghana in the summer of 2011 to work with children.

This program is a huge endeavor that requires the coalition of multiple organizations. It is for

this reason that Worldwide Healing Hands is excited to announce its partnership with the Department of Obstetrics and Gynecology at the State University of New York (SUNY)Upstate Medical University. Together, they have developed a curriculum to improve health for women and infants in Sierra Leone. SUNY Upstate Medical University will assist with equipment procurement, sending volunteer professors from SUNY Upstate Medical University to assist with teaching medical students and resident physicians, as well as developing remote access so that students and clinicians in Sierra Leone will be able to attend teaching conferences sponsored by the University in New York.

This is a one-year training program that will enroll new medical school graduates from the University of Sierra Leone who have a special interest in women’s health care. The program will be time-based and advance the physicians through basic patho-physiology, basic surgical skills, and recognition and treatment of common obstetrics issues. Upon the completion of the one-year internship, the physicians will be able to perform a cesarean section, a dilation and curettage of the uterus, basic obstetrical ultrasound evaluation of the fetus and mother and other life-saving skills.

The graduates of this program will also be qualified to become educators and mentors for other physicians and midwives in Sierra Leone. The program ultimately hopes to increase access to high quality services for women and reduce the heath, social, and economic burden of serious perinatal morbidity and mortality on the families of Sierra Leone.

by Meghan McCurry
WHH Intern

According to the World Health Organization, certain kinds of fruit bats are thought to be the natural host of the virus, with the initial transmission resulting from a wild animal infecting a human. Once the disease infects a person, it is easily transmissible between people in close contact. The virus spreads by direct contact with bodily fluids, and often moves more rapidly in remote areas.

There is no vaccine or cure for the Ebola virus, and it kills up to 90% of its victims. According to the Centers for Disease Control, doctors can only offer “supportive therapy” to patients with Ebola, and isolate the patient so that he or she cannot infect others. Initial symptoms of the Ebola virus include fever, headache, joint and muscle pain, lack of appetite, and sore throat. Advanced symptoms include vomiting, diarrhea, stomach pain, and both internal and external bleeding – often from the eyes, nose, or mouth.

In the 1976 outbreak, the Ebola virus killed more than 400 people. The latest outbreak has infected 1,600 people and killed over 800 people and it has spread across four West African nations including Guinea, Liberia, Nigeria, and Sierra Leone, which has the highest number of Ebola cases.

The intensity of this outbreak is placing a great strain on the already unstable health systems of Africa’s poorest countries and the health professionals who try to combat the outbreak are being confronted with increasing suspicion and doubt from the Ebola patients and their families. In fact, many of the people in Sierra Leone have more faith in traditional medicine and as a result are hindering efforts to contain the outbreak by gathering outside clinics and hospitals and protesting what they believe to be a conspiracy. Some have even gone as far as threatening to burn down buildings and remove the sick patients from hospitals to carry out traditional funerals which often involve manual washing of the body instead of allowing the officials to bury them safely. These types of burial ceremonies in which the mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola virus, which is highly contagious and still spreading.

Not only are health professionals being confronted with suspicion and mistrust, they are also putting themselves at great risk trying to contain the outbreak. The disease has killed one of Liberia’s top Ebola doctors and two of his nurses and it has infected two Americans combating the outbreak. Due to the deadly risks facing health professionals, it has been determined that a trip to Sierra Leone is too dangerous at this time. It is with great regret that Worldwide Healing Hands postpones its trip to Sierra Leone.

by Meghan McCurry
WHH Intern

Patient at West Africa Fistula Foundation

Terefa is fourteen years old. She lives in a small village in Africa, more than 200 km from the country’s capital. She is the sixth child in a family of eight children and has never been to school. Her father, a farmer, did not have enough money to send all of his children to the village school. The older children—two boys—thus benefited from schooling, while Terefa stayed at home to help her parents to survive. Her chores were to gather firewood, draw water and help work the fields.

When she was thirteen, her father married her to one of his friends who was a little better off. Terefa could only accept this marriage and, a few months later, she became pregnant. Throughout her pregnancy she continued working, as if nothing had changed. The closest antenatal clinic was a few dozen kilometres from her house, but she didn’t go to it because she didn’t have money to pay for transport. Also, everyone in the village said that pregnancy was not an illness and that the other women had always given birth without any problems, so why shouldn’t she?

Terefa’s husband and mother-in-law let the village traditional birth attendant know when labour started. The contractions became more and more violent, and more and more painful, but the baby did not seem to want to come out. Terefa saw the sun rise and set three times. She was exhausted by the long ordeal. The village birth attendant tried to speed up events, first with herbal potions, then by inserting various substances into the vagina and, finally, by making incisions with a rusty knife in her vagina, but nothing worked.

The village elders then met to take a decision: Terefa had to be sent to the health centre. It took several hours to collect the necessary money, transport Terefa in a cart to reach the road and find a driver to take her to the town. Terefa was afraid, for she knew no one there and wondered how she, a simple peasant, would be received.

At the health centre she was examined by a midwife. The midwife was not happy that Terefa had come so late and told her that the baby was dead, but that an operation was required. As the doctor who performed caesarean sections was away for several days for a training course, she had to go to another hospital.

After the operation, Terefa realized that she couldn’t retain her urine. Back at the village she was ashamed because she had lost her child, was constantly wet and continually gave off the smell of urine. Seeing that the situation did not improve, her husband rejected her and chose another wife and, little by little, the entire village turned its back on her.

Since then Terefa and her mother have lived in a tent at the edge of the village. The two women subsist on charity, but Terefa’s health is becoming a little more precarious every day. No one knows how much longer she will survive.

Originally published in Obstetric Fistula by World Health Organization, Department of Making Pregnancy Safer

Amber Warner Photo credit Nathan DeHart

Our first annual Hike 4 Healing was a great success thanks to all our wonderful sponsors and supporters.  We raised $9,168 for our mission to Sierra Leone!!  This money will save the lives of many mothers as we will use it to train local doctors and midwives.  This makes our work sustainable.

We had a great hike on Saturday! Tom Nixon and the docents made the hike very special with their interesting historical facts and stories.  They allowed us to climb the tower at the top of Mt. Konocti for a spectacular view of Lake County.

A special thank you to Peter Windrem who was instrumental in making this event possible by working with the county to resolve all the legal roadblocks.

We appreciate Scott and Kami from the Kelseyville Fire Department keeping watch over us and making sure everyone made it off the mountain safely.

Thank you Nathan DeHart for taking all the wonderful photos.  Visit http://nathandehart.zenfolio.com/hike4healing to look at and purchase photos from the event. Can’t wait to do it again next year!

GOLD SPONSORS- $500
Arthur Bikangaga, MD
Linda Cornett
Jan & Bruce McKinney
David Santos – St. Helena Hospital Clearlake
Wayne Scheidemann, MD
Sieg & Deedrian Taylor
John Weeks, MD

SILVER SPONSORS – $250
Parinaz Azari, MD
Dr.’s Keith & Elyse Donald
Barbara Flynn – The Brick Oven
John Hodgkin, MD
Catherine Moizeau, MD
Margaret Walker

Photo credit Nathan DeHart

SUPPORTERS
Mary Heare Amodio
Emalene Anderson
Andrea Bollakis
W. Bradley Electric
Roni Brown
Evelyn Carlon
Hali Croner
Joseph Destein
Martha Echols
Emilene Fearn
Green Key Commercial
Christine Hansom
Tina Hittenberger
Pamela Illian
Lynn Imm
Thomas Isaak
Melissa Kinsel
Bruce Kurnow
Peggy Landini
Bridget Mackay
Mary Ann McQueen
Anthy O’Brien
Diane Pege, MD
Petaluma Coffee & Tea
Stephen Pollaine
Geraldine Reisen
Diane Remoundakis
Jane McKnight Renner
Marc Shapiro, MD
Linda Sheppard
Gretchen Singer
Karen Spurgeon
Guy Strohmeier
Amber Warner
Scott Welker, MD

Lynnette Bertelli, Kathleen Spencer-Ahart, Sally Jean Fistler
Photo credit Nathan DeHart

Dr. Paula Dhanda (right) teaching surgery to Dr. Asha Jha (left) and Dr. Chunmila Maharjan (center)

Dear Supporters,
Worldwide Healing Hands returned to Ilam, Nepal in 2013 to care for the many women left behind in this remote area from our 2012 mission there.

Namita, a 49 year old mother of 6 children, suffered from severe prolapse of her uterus and bladder causing her to be in constant pain.  Despite this, her typical day consisted of working for 18 hours, the majority of it doing heavy lifting.  She heard that our team was coming to care for women on the radio and traveled about 100 miles by bus and on foot hoping that we could lessen her pain.

On examination, it was evident that she had this condition for many years and she never dreamt that anything could be done to help her.  Our gynecologic team performed a hysterectomy with repair of the pelvic floor with an excellent outcome.

On evening rounds we noted that she had not been taking any pain medication after having undergone a major surgery just 10 hours earlier. We questioned this and the nurse translated for Namita saying,” I have been suffering for over 20 years and you have saved me from this [future] pain. I am so grateful to all of you for what you have done and I do not wish to complain.”

Namita’s response bespeaks the common condition for the women of Nepal. For like Namita, their suffering is a way of life. No gynecologist had been in this remote area of Nepal for a year, not since our last mission in 2012. The women expect so little and appreciate everything that they receive.

On behalf of Namita and many other grateful patients, we express our gratitude for your generosity.  WHH would like to extend a special thank you to Chuck and Anne McMinn for hosting our fundraiser at Vineyard 29 as well as to all the generous donors who made this a success.

Our team of ten healthcare volunteers worked side by side with Nepali medical professionals to provide free medical care for close to one thousand women, including performing major gynecologic surgeries, delivering babies and performing numerous ultrasounds.  We also introduced a cervical cancer prevention program to the region.

Worldwide Healing Hands achieved our goal of sustainability as we trained 18 midwives and mentored local physicians.  Dr. Asha Jha, OB/GYN and Dr. Chunmila Maharjan, OB/GYN wrote “we are very grateful to work with you in surgery and learned lots of new techniques.  You gave us a chance to do surgery independently which is a great achievement.” (A copy of our Nepal 2013 Mission Report is available upon request.)

Looking forward, WHH is planning a medical mission to Sierra Leone in 2014 where we will partner with a well-established local organization.  Prior to the 11-year civil war (1991-2002) that left over 50,000 dead, the nation had 500-600 doctors – now there are less than 100; and in a country of approximately six million people there is only one OB/GYN physician severely limiting access to care.

Sierra Leone is one of the most dangerous places on earth to give birth. Estimates for infant mortality in Sierra Leone are among the highest in the world; and the maternal death rates are also among the highest in the world. In this tiny West African nation, a shocking one out of seven women dies during childbirth. If a woman lives in a rural area, she may not have the emergency transportation she needs to seek medical care from a midwife or hospital – and if she is lucky enough to get to medical care, she may not have the $3.50 she needs to pay for her medicine and treatment. “Thousands of women bleed to death after giving birth. Most die in their homes. Some die on the way to hospital; in taxis, on motorbikes or on foot. In Sierra Leone, less than half of deliveries are attended by a skilled birth attendant [midwife] and less than one in five are carried out in health facilities.” – Amnesty International

Charitable donations have enabled WHH to change the lives of countless women. We hope this letter has touched you to reach out to help save the lives of the mothers and their babies in Sierra Leone. Your support of $150 will help pay for a major surgery for a woman, $250 will pay for the equipment a midwife needs and $400 will support the training of one midwife who can save numerous lives.

Each tax-deductible donation is a valued gift and means a great deal to women living with and in these terrible conditions. Thank you for supporting Worldwide Healing Hands in its missions to assist the women in the most under-served areas of the world.

Sincerely,

Paula R. Dhanda, MD

Founder and Medical Director

GIVE NOW

A team of nine volunteers flew to Kathmandu where we met with our local hosts from Himalayan Healthcare (HHC). We then flew east along the Himalayan ridge to Bhadrapur and traveled by jeep for three hours to the town of Ilam where we were welcomed by the entire hospital staff.

Dr. Parajuli Community Hospital was built by HHC in 2004 to provide much needed medical care to people living in this remote and impoverished region of eastern Nepal. With the help of international volunteers HHC’s services have changed countless lives and helped reduce the infant and maternal mortality rate in this area.

Nepal is one of the world’s least developed countries. Half the population lives in poverty, with high rates of malnourishment, maternal mortality and illiteracy. A decade-long civil war further hindered the government’s ability to provide healthcare. The Ilam region, high in the Himalayas, previously had only one doctor to serve its entire population of 250,000, leaving villagers without adequate healthcare and forcing many to travel long distances to clinics in the lowlands or Indian border towns.

The volunteers carried with us approximately 600 pounds of donated medical supplies and equipment including hundreds of clean birth kits.

Among the things we accomplished were:

• successfully performed 25 GYN surgeries
• performed 960 patient visits, outpatient as well as emergency visits
• delivered 4 babies (including one emergency operative vaginal delivery)
• performed 625 ultrasound examinations
• trained 2 Nepali OB/GYN physicians to improve their surgical skills
• mentored one Nepali house officer (intern)
• mentored one Nepali anesthetist
• trained 18 midwives from the eastern region of Nepal, many of whom traveled for 4 days by bus to attend the training
• equipped 10 midwives with basic supplies needed to practice
• introduced a cervical cancer prevention initiative
• trained and improved the skills of the local hospital staff

Our volunteers worked long hours to accomplish this was amazing work. They are our heroes! This work would not be possible without the ongoing generosity of all of our supporters.

We are dedicated to improving the quality of health care for women and children in the most underserved areas of the world.