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.

Carol LVN teaching Meghan

being princesses and I dreamed of being a doctor. So, I was very excited to be granted this amazing opportunity to work as an intern under Dr. Dhanda and her staff.

I expected to gain insight into the medical field and healthcare system, and as an intern I have gained all that and so much more. As an intern, I have not only been an observer, but have had hands-on experience taking blood pressure, blood sugar, and testing specimen samples. My most memorable experience so far has been observing the surgeries. The staff was concerned that I would be queasy during the surgeries and possibly even faint, instead, I stood mesmerized by all that I witnessed during the operations. I have found the operating room to be an exciting and fascinating place.

To be able to watch Dr. Dhanda interact with patients and perform surgeries has been an inspiring experience. I am so impressed with Dr. Dhanda’s ability to be so caring and informative with the patients she treats. In fact, when I came home after my first day of interning with Dr. Dhanda, I told my parents that I want to be a doctor like Dr. Dhanda. During my time so far as an intern, I have already gained so much knowledge about the medical field especially regarding women’s health.

I have also gained insight about women’s health in developing nations by learning more about the work she does through her non-profit organization Worldwide Healing Hands. Working under Dr. Dhanda has provided me with insight into our own healthcare system, as well as the need of healthcare in other countries. My experience as her intern has cemented my decision to pursue a career as a medical doctor and possible surgeon, and I am excited about how much more I know I will learn from Dr. Dhanda and her staff.

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

TnT offered us a perfect space in a secure storage location. It’s ample, spotlessly clean and will keep our supplies clean, dry, safe and very importantly, all in one place. We depend on the kindness of individuals and organizations to be able to be of services in places where much of the medical interventions that are common to us, are a veritable miracles to others.

Once more a generous business in Lake County offered us the perfect solution to our quandary and contributed to our goals and purpose for service. In these somewhat uncertain times, it’s remarkable to see how kindness multiplies.

Thank you TnT Mini Storage

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Summary
WHH serves women in underserved areas worldwide. WHH is traveling this Spring to Sierra Leone, partnering with Dr. Maggi – founder of the West Africa Fistula Foundation. Sierra Leone, is one of the most dangerous places on earth to give birth, infant mortality and maternal deaths among the highest in the world. Sierra Leone, a country of about 6 million has only 1 OB/GYN. Women spend from 2 -15 days in labor – no midwife – no Cesarean childbirth; causing obstetric fistula to become inevitable.

What is the issue, problem, or challenge?
In Sierra Leone, a shocking 1 out of 7 die during childbirth. Women who survive suffer unimaginably; effects that can include nerve damage preventing women walking and kidney diseases that lead to death if untreated; or, they endure obstetric fistulas that leave them incontinent, trickling urine and sometimes feces through the vagina. They are shunned by the community, ostracized by their husbands, discarded by their families as human debris and abandoned to fend for themselves, often to die.

How will this project solve this problem?
This cause is very compelling – WHH teaming with Dr. Maggi on a medical mission Spring 2014, will treat women suffering with obstetric fistula – a devastating complication of delivery affecting the poorest women around the world. To provide obstetric fistula surgery, a woman needs to be housed about 6 months, provided meals and vitamins to ensure a strong body before surgery and monitored to be sure she heals after surgery. Training midwives to assist in delivery is an essential for prevention!

Potential Long Term Impact
WHH partnering with the West Africa Fistula Foundation to perform fistula surgery will literally save the lives of hundreds of the most vulnerable Sierra Leone women and their unborn babies; restore them to physical, mental and emotional health, deliver them from rejection and isolation, return them to their families, empower the women to lift themselves – transforming their lives. Training midwives to prevent delivery complications is the critical step to stem the tide of obstetric fistulas.

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

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Profiles of the volunteers traveling on this mission:

Paula R. Dhanda, M.D. Lakeport, CA – Team Leader
As a Gynecologist OB GYN, Paula Dhanda is known for her service to the women of Lake County for over 20 years and, for half as many years, her activities in the international community promoting women’s health. Dr. Dhanda has led several medical missions in the past 10 years. She has received numerous awards for alleviating suffering and promoting wellness, including the 2013 Medical Red Cross Hero Award, the 2012 Marla Ruzicka Humanitarian of the Year Award, as well as the 2010 Adventist Health Physician of the Year Mission Award. It was stated at the 2012 Stars of Lake County Ceremony that she is truly an angel of mercy who spreads love and caring wherever she goes.. Her passion to save the lives of the mothers and babies in Nepal is evident in leading this – a second – mission to Nepal. ” It is my privilege to be able to care for women both locally and internationally.”

Lynn Arnold, Practicing Midwife, Pitkin, Colorado
Lynn is a licensed midwife, practicing in women’s health since 1975. She founded and operated a free standing birth center from 1985 – 2011 serving more than 13,000 Hispanic women. She also wrote and taught a state approved midwifery educational program to 800 plus students from around the world. Lynn feels she has a “unique ability to teach at a simplistic level” – grasp the complex and translate so everyone can understand – she has volunteered to go, help, learn and “pass on my knowledge [gained from this experience] to others.”

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

Nathan DeHart, Student of Photography, Lakeport, CA
Nathan has traveled as a student photographer to South East Asia and India in the recent past. Nathan volunteered for this mission because “I want to provide inspiring professional photography for WHH to use [in the future] for promotion and education.”

Lonn Marie Hlusko, Registered Ultrasound Technician, Littleton, Colorado
Lonnie founded the organization Hands for Humanity in 2000 to educate nurses and hospital staff in the outlying remote rural settings of such as Nepal on healthcare and the use of ultrasound as a tool to early-on discovery of problem pregnancies. Since its founding, Lonnie has traveled on several medical missions assisting WHH, this being her second mission trip to Nepal.”I am dedicated to women’s healthcare in the developing world.”

Flora Shepherd Krasnovsky, Epidemiologist, Kelseyville, CA
Flora’s skills are in research, counseling, training, data gathering and analysis; and volunteered “to gather information [on this mission for] training.”

Nathan Powers, Student, Lakeport, CA
While just due to turn 18 years old this month, this is not Nathan’s first trip out if the US; he traveled to Ghana in the summer of 2011 working with children there. He has volunteered for this mission, not only to help but . . . “ to have an opportunity to learn about the medical field while giving to the less fortunate and learn about the world I live in.”

Nancy Jane Reynolds, M.D., Fort Bragg, CA
Nancy traveled to Nepal in the early 1980s and has volunteered to return with this mission as … “I love to travel and work with different cultures; providing surgical and medical care.”

Rafal Jan Wyszkowski, M.D., Colmar, Pennsylvania
Rafal is an anesthesiologist making his first medical mission; he loves his profession – “I love being a doctor,” and offers his skills at administering pain medication in that spirit.

“BRAVO” to all of these volunteers . . . and WHH wants to takes this opportunity to thank all who have generously contributed to make this mission possible.

The foot pedal we have been searching for!

Another wonderful trip today to MedShare, the exceptional organization which daily gathers, organizes and makes available tons of medical supplies and equipment to help improve the health of many underserved communities.  The staff has a tremendous training program to make sure that the health care providers recycle all the usable medical supplies that they no longer use but can really add to the health of so many.  They serve all who are in need for very valuable and essential equipment and supplies.

We were met by the amazing Shannon Kuehnel who knows where everything is or knows the person who can help us.  She had set aside more supplies for the LigaSure unit donated by Sutter Novato and also some of the items that will be used to train midwives and provide care for the grateful patients in that remote region.  Shannon is always graceful and patient even when we arrived on short notice.  Thank you Shannon.

Dr. Dhanda had asked Rene Steinkellner, the biomed tech for MedShare who is responsible for repairing and refurbishing all the donated biomed equipment, to keep an eye out for a very expensive and necessary component for the LigaSure unit, which was a foot pedal, and there is it was.  Rene cheerfully tested the pedal to make sure it was operational and happily it was found to be sound.  This adds another dimension to the capability of the unit, which is very useful in controlling excessive bleeding in a very effective and expedient manner.

John Clarke joined us today on our expedition and he willingly braved the traffic and got us safely to all our destinations.  He was very impressed by the MedShare staff, the willing volunteers and the sheer volume that they are able to gather, sort and prepare for organizations that can make great use of these items.

by Perla Lovejoy, RN