Dr. Paula Dhanda is being recognized for her dedication to improving the quality of healthcare for women and children in the most under served areas of the world. She began her international medical work in 2009 when she was invited by a fellow surgeon to participate in a medical mission in Chad, Africa. There they performed 50 surgeries in 2 weeks, delivered many high risk babies and trained the local staff. Since then she has led medical teams on 2 missions to Haiti in the aftermath of the 2010 earthquake. In 2012, Worldwide Healing Hands embarked on a mission to Nepal where they trained 10 midwives in life saving procedures, gave care to 1500 women and performed numerous surgeries.

Her efforts to alleviate suffering and promote wellness received recognition in 2010 when Adventist Health presented Her with its “Physician of the Year Mission Award.” In 2011 she received the Soroptimist Ruby Award, which acknowledges women who are working in extraordinary ways to improve the lives of women and girls. More recently, at the 2012 Stars celebration she was named Humanitarian of the Year. In 2013 she was given the American Red Cross Real Heroes award, which “recognizes those in our community who have shown courage, dedication and character through extraordinary acts of heroism and kindness.”

In the words of Dr. Paula Dhanda “Something happens to you, when you leave your family, friends and comforts behind to care for strangers. You discover the opportunity to touch lives in a lasting way.”

Shannon had contacted me on this blog to tell me about MedShare and I was curious as to how she found drpauladhanda.com.  She told me she had a special fondness for maternal health and was just piloted their own Clean Birthing Kit program and found my post “A Lifesaving Little Kit”.

“According to Healthcare Without Harm, U.S. hospitals generate more than two million tons of medical waste each year. Much of that waste is unused medical supplies and equipment. Meanwhile, the World Health Organization estimates that more than 10 million children under the age of five die in the developing world due to inadequate medical care.

MedShare is a nonprofit organization dedicated to improving the environment and healthcare through the efficient recovery and redistribution of surplus medical supplies and equipment to underserved healthcare facilities in developing countries.”

Founded in 1998, MedShare provisions over 400 medical teams with medical supplies each year doing wonderful work in developing countries all over the world. If you are a hospital with surplus medical supplies please consider donating them to this wonderful organization and know that your surplus will be put to good use while saving the environment. It is a winning solution!

In March of 2011 she went back to Haiti for another medical mission, while there she visited the ‘Amputee Soccer Team’ that she had adopted the first time she was in Haiti. The soccer team is made of of young men who lost limbs during the earthquake.

Dr. Dhanda is extremely devoted to her mission and gives her all to help those who are in need. Her next mission will be to Nepal in 2012. She is truly an angel of mercy who spreads love and caring wherever she goes.”

– Stars of Lake County, 2012

This year we pay tribute to mothers everywhere, but one special woman takes that tribute far beyond giving a pretty card and a wrapped present. Her devotion to helping underprivileged women, often mothers, is truly inspiring. Dr. Paula Dhanda is a gynecologist, surgeon and a Park Lane Fashion Director. She uses her Park Lane earnings to support her charity, “Worldwide Healing Hands.”

As a physician and surgeon, Dr. Paula is dedicated to providing medical care to women in some of the most under-served areas of the world.  She has worked in Chad, Haiti and is currently planning her next mission to an isolated hospital in Nepal. Admirably, she donates 100 percent of her Park Lane profits to her charity.

• It is probably one of the most difficult things you will ever do mentally, emotionally and physically. The hours are excruciatingly long and the emotional toll can be unrelenting.

• It is an emotional roller coaster. One moment you will feel joy and satisfaction because over having made a significant difference in someone’s life and the next moment you may witness the sorrow of a tragic loss of life.

• You will be continually confronted with the challenge of giving adequate and meaningful health care under difficult circumstances.

• You will meet like minded volunteers and create life time bonds with wonderful, giving people.

• Working in a resource poor environment you must be creative and invent solutions for problems.

• Be prepared to teach so that you will leave something behind that is long-lasting.

• Be prepared and open to learning. You cannot help but come back changed for the better.

• Communication is challenging due to language and cultural differences.

• Cultural sensitivity is particularly relevant to maternity care. It is important to incorporate those traditions that will strengthen family ties and provide a support system for the woman and her baby.

• It is an adventure but it is not a vacation. The accommodations are usually spartan but luxurious compared to what the local people live in all the time. The food will sustain you and you may learn about hunger. For me weight loss is a good thing.

• It is not uncommon for volunteers to experience profound reactions when arriving home, such as—guilt, sadness, anxiety, and depression.

• Coming home is difficult because your friends and family may not really relate to what you have been through unless they have had a similar experience. Keeping in contact with other volunteers is helpful.

• You may be struck by our shameful waste and abundance. How can we have so much while others have nothing?

• It is life changing as you will never look at things the same way again.

• This experience is rewarding beyond measure.

• You may come away, as I did, with a renewed belief in what humans are able to accomplish when we all work together for a common purpose.

• Mission work is definitely not for everyone.

I invite other volunteers to share their views and comments here.

I am an OB/GYN physician who practices medicine in rural Northern California. I recently returned from my second volunteer medical mission to Haiti where I worked excruciatingly long hours performing surgeries and providing other medical care for women. I want to tell you just one of the powerful stories that has occupied my heart and mind.

Let me provide the setting. The two-bed emergency department was noisy and crowded. It adjoined the ten-bed medical/surgical department and the four-bed ICU, without much separation. There were too many patients and not enough beds. Some patients were sitting in chairs between the gurneys and others were lined up outside the hospital with their chief complaint and vital signs taped to them on a piece of paper, but that is a story for another day.

I asked the translator to bring a screen for some privacy while I found a paper gown to use as a sheet to cover Sarah. In past missions, I have found it easier to perform an ultrasound than to ask a lot of questions to try to determine a woman’s last menstrual period. The translator explained to Sarah what I am doing as I performed an ultrasound with a scanner that was not designed for obstetrics–but it is all we had (and it is more than we had on my last mission here). She was about 14 weeks pregnant, but there were no fetal heart tones I expected to see on ultrasound.

I asked her questions, through the interpreter. “When did the bleeding begin?” “When did the pain start?” The story kept changing and the answers were conflicting. A Haitian surgeon tried to help. He told me she said she had had a D & C elsewhere and subsequently developed pain and bleeding.

I have been taking care of women for many years and I follow my instincts. I told the medical student who had been shadowing me that I was suspicious that something was missing in Sarah’s story. I asked the translator to translate my words exactly, “What did you put up inside your vagina?” Finally, the truth. She had inserted a medication called Cytotec and taken some orally as well.

Port-au-Prince Market

I ordered medication for Sarah to help with the pain of her contractions. She needed a bed. I checked the isolation room. As I looked in, I remembered the 24 year old young man who lay dying of AIDS, yearning to see his mother, who never came. I shook my head to clear it. The bed in the isolation room was empty, so I arranged for Sarah to be placed in there.

I did not want Sarah to be left alone. The nurses were too busy to leave the Emergency Department, so I assigned the bright young Haitian medical student the task of monitoring this scared teenager. Luckily, the student also spoke English, so I gave her very specific instructions to check Sarah’s vital signs, time her contractions, and call for help if there was heavy vaginal bleeding.

Two young men were now at Sarah’s bedside. I could not tell who was the partner and who was the “cousin,” so I let them both stay in the room.

The teenager labored while I cared for other patients, checked on her intermittently, and gave her more pain medication. She delivered the gestational sac intact and the family wanted to see it. After some questioning, they were satisfied that she was no longer pregnant. It was 11:00 p.m. and even though we needed the bed, it was unsafe for the Sarah to go home through the streets of Port-au-Prince.

The following morning, I found a “fatherly” translator and asked him to talk to the two young men about using condoms for birth control. I counseled Sarah about caring for herself during her recovery. She had been through a lot and definitely did not want to repeat the experience. I told her to say “NO!” if her partner does not use a condom. They were all laughing now at my emphatic gesturing. In the previous four days, I had done three emergency D & C’s on young women for incomplete abortions. Unlike Sarah, these women were hemorrhaging. I wondered how many of these had been self-induced.

There is little or no access to birth control in Haiti and a lack of education for young people. There is so much need. I have done a lot, but it is not enough. I return to my home in California with renewed conviction in what people are able to accomplish when we work together for a common purpose. I am determined to raise the funds that will enable me to go on my next medical mission. Don’t underestimate the things that we can do.

In Haiti slews of women who came to see our medical team worked at the nearby T-shirt factory. The translator said while the women earned a meager wage, they were all provided with some form of health insurance. The T-shirt Company had an agreement with the hospital to care for its employees. If any of the employees needed surgery, the financial office readily gave them their stamp of approval without any questions.

Typically the hospital provided care for all emergencies, but did ask for nominal payment for clinic visits (less than $1) and for elective surgeries. If a woman came in for a consultation and was advised to have surgery they were sent to the financial office to pay for the services before they were admitted. A great number of patients could not come up with the money readily and went around collecting money from relatives in what I called their “private fundraiser.”

This is what happens if well-meaning people send all their unwanted T-shirts to Haiti: At a recent fundraiser a donor suggested I go to Goodwill or the Salvation Army to collect clothing to take on my next medical mission. This might seem like a great suggestion on the surface, but I had to wonder what would happen to the economy in Haiti if there was an influx of free clothing. The jobs of the women at the T-shirt Company could be in jeopardy.

According to an article in Foreign Policy Magazine, there is a great acronym for the leftovers people send to the poor under the guise of helping: SWEDOW, which stands for “stuff we don’t want.” Charles Kenny makes a clear and compelling argument against just clearing out our closets and the coffers of U.S. farming surplus to make room for the next unwanted T-shirt or surplus crop. Kenny eloquently explains this issue and why it is a detrimental way to provide aid:

“Here’s the trouble with dumping stuff we don’t want on people in need: What they need is rarely the stuff we don’t want. And even when they do need that kind of stuff, there are much better ways for them to get it than for a Western NGO (Non Governmental Organization) to gather donations at a suburban warehouse, ship everything off to Africa or South America and then try to distribute it to remote areas. World Vision, for example, spends 58 cents per shirt on shipping, warehousing and distributing them, according to data reported by the blog Aid Watch — well within the range of what a secondhand shirt costs in a developing country. Bringing in shirts from outside also hurts the local economy: Garth Frazer of the University of Toronto estimates that increased used clothing imports accounted for about half of the decline in apparel industry employment in Africa between 1981 and 2000. Want to really help a Zambian? Give him a shirt made in Zambia.”

Our first mission to Haiti during the election, kept us confined to the hospital for our own safety with armed guards and fortress style gates. During the second mission we ventured out to the historic Marche de fer (Iron Market), which was restored by Irish mobile phone entrepreneur Denis O’Brian after the catastrophic magnitude 7.0 MW earthquake that destroyed much of Port-au-Prince in 2010. Fresh out of surgery, the car was leaving and I jumped in at the last minute in my scrubs.

We went there with the intent of supporting the local economy without any expectation but were amazed with what we found. After driving down dirty streets and witnessing the rubble we arrived at a building that was beautiful and immaculate. We entered and were greeted by welcoming vendors and a self-appointed guide/translator who excitedly showed us around and negotiated for our purchases. The handcrafted goods were beautiful and obviously made with pride. Buying these items goes a long way in supporting the local economy.

As we were leaving the market, I saw huge bags of rice labeled “PREMIUM QUALITY U.S. RICE” from Riceland Foods, Inc. in Arkansas. Importing food, especially rice from the U.S. has destroyed the local agriculture and left Haiti unable to feed itself. Cheap foreign imports drove impoverished farmers off their land as they were unable to compete with the subsidies paid by the U.S. Haiti uses to grow enough rice to export. I flashed on former President Clinton’s apology for creating policies that destroyed Haiti’s rice production.

The bottom line is to be mindful about how to give. Donating rice may have been good for some farmers in Arkansas, but it does not help the Haitians to be self-sustaining in the long run. Emptying your closet of T-shirts and clothes may feel good but it is not the kind of help that they need. I use Haiti in this article, but this concept really applies to any economy. It is much better to stop giving people the stuff we don’t want and start giving cash donations, which are almost always more necessary.

I would encourage all healthcare professionals to consider donating some of your time to this worthy cause. You will come back challenged and fulfilled and your services will be greatly appreciated. I met many wonderful, giving volunteers from all over the world including the twin Bitar surgeons while working at Hospital Bernard Mevs/Project Medishare in Haiti. Following is a letter of appreciation I recently received.

Dear Volunteers,

As you are settling back into your life back at home, we would like to express how much we appreciate your coming to Hospital Bernard Mevs/Project Medishare. We realize the work here is challenging and sometimes frustrating, and we hope that you realize how much we truly value your help. Since the earthquake on January 12, 2010, Project Medishare has treated over 180,000 Haitians in need. This could not have been possible without volunteers like you who have given your time, skills, and money. You have helped many more than the handful of people that came to the hospital during your volunteer tour. Equally important, the assistance and knowledge that you have imparted to the nurses, translators and other local staff will allow them to continue in your footsteps long after your stay with us.

Hospital Bernard Mevs/Project Medishare has made some remarkable advances since the merging of the two organizations in June. Now, we have the Spinal Cord/Rehab unit fully staffed by only local Haitian nurses who are able to provide all nursing care independently. The nurses who staff the ICU are learning to be able to negotiate ventilators and other aspects of critical care nursing of which they had never had previous exposure. These nurses continue to be eager to learn to be independent in one of the most challenging aspects of nursing care. We have a pediatric unit in which nurses and interpreters are learning to manage complex patients including ventilated and cardiac patients as well as premature babies in the only PICU in the country. For Haiti, these advances are a giant leap in the realm of medical care and are due in a large part to you and the other volunteers who have given your time and patience.

We hope very much that you return to Hospital Bernard Mevs/Project Medishare as we continue to help the people of Haiti. We are working everyday to improve our hospital and build sustainability, and your assistance with this process is invaluable.

Thank you again and please keep in touch.

Sincerely,

Dr. Marlon Bitar and Dr. Jerry Bitar
Directors of Hospital Bernard Mevs/Project Medishare

Many of the problems faced by volunteers in developing countries are complex and vast. There aren’t enough resources available. Poverty is overwhelming. Education is lacking. Clean water can be difficult to find and malnutrition makes medical care even more challenging. It is almost too much to bear to see a mother die in childbirth of something that is preventable. How do you send a child back to the same environment they came from knowing they may become sick again?

Many times, though, we have an opportunity to touch lives in a very lasting way. So many people suffer from lack of access to the most basic medical care, which really does mean the difference between life and death. Partnering with local healthcare providers and sharing your knowledge leaves behind something that is everlasting. And that’s just the beginning of the difference our volunteers can make.

I am always humbled by the kindness shown to the volunteers. People who have nothing go out of their way to make sure that we are as comfortable as possible, and they are genuinely grateful for our presence. The Haitian staff expressed gratitude to our volunteer team for choosing to stay at the hospital during the turmoil and danger caused by the election. How must it be to know that strangers cared enough about you to fly across the world to care for you? On a very basic, human level, volunteers change lives simply by reaching out.

When you care enough about strangers to leave your family, friends and comforts behind to make a difference in their lives, something happens inside of you. You discover that the secret to happiness is not in what you have, it’s in what you give away. Yes you will absolutely make a difference; perhaps more in yourself than the people you came to help.