Assist in any way possible

During a mission of this nature, individuals are called upon to do a variety of tasks they may not used to. Each of our team members have done an amazing job of going beyond their typical boundaries and reaching outside of their comfort zone.

Surgery gone wrong

This young male patient presented with severe knee pain, really limiting his ambulation. Upon examination and interview, we discovered that he broke his tibia a while back and had surgery to repair it. You actually can see the head of the screw they used to hold it in place at the surface of his skin. Still not being able to diagnose the severe knee pain, we requested that he get an x-ray if possible close by and return to clinic the next day. Mystery solved. Viewing the x-ray which showed the surgical repair of the tibia, you can clearly see that one of the prongs of the screws is sticking right into the knee joint, thus every time the patient takes a step, he feels this piercing pain in his knee. Bac Si Ha said that even with his limited resources he could remove the screw, however, since we would be departing this location tomorrow, there is no chance for follow-up. Therefore for liability reasons, we could not relieve this patient’s issue.

From crawl to walker to walking

This 6 year old had to be carried into the clinic by a relative because he was unable to walk on his own. After review of his x-ray and examination by Bac Si Ha, we discovered that he had a severe L5-S1 compression for years. (Typical for a hard-laboring adult but rare for a child). His mother told us that he has to crawl out of bed in the morning because he can not control his legs. We treated him once with injections and manipulations to release the compression with the plan to follow-up 2 more times while we are in this province. The following day, his mother brought him back asking for a walker to assist with his ambulation, because he seemed to be able to walk more independently. Of course, we buy walkers each year to provide to patients as gifts and we were delighted to present him with one. Following the second treatment we watched in amazement, this young boy walk across the clinic to the pharmacy area independently with the assistance of only our walker. He then returned on our final day in Binh Phuoc, and with only slight assistance from his mother, we watched him walk with less dependence on the walker (Just enough for safety for now) From the first day, his face was sad and scared, to the final day where he felt comfortable and got to know us and left us with a huge smile. He spent a good portion after treatment taking selfie photos with many who treated him so well. Success!!!

Broken Patella

As I moved to work between 4 beds in the medical room, I glanced up and saw this x-ray. With a curious look, I then looked at the patient being examined on the bed. Now it makes sense. This patient had a traumatic accident a few years ago, which left him with a broken patella. This isn’t even the chief complaint that the patient presented with. He has no access to care, continues to work hard at supporting his family, and has tolerated the pain since the accident. The way he walks changed his gait and he developed severe sciatica pain, thus coming to the clinic for treatment. After treating his sciatica pain, he even joked with the student by moving the pieces of his patella around and laughing sinisterly. The shame is that without surgically repairing the issue, his sciatica will return.

Bone Infection

One of the first patients who arrived in clinic was a 40 year-old male who could barely walk to the intake table. He was assisted by his mother on one side and crutches on the other. At first our intake team didn't think much of it, considering the majority of our patients need assistance because of orthopedic pains. While I was setting up the medical room getting ready for a full day of patients, one of my students came in to inform me that we had a patient with a leg infection and we should see him immediately. We are used to seeing infections on this mission, however, what I saw when he walked through the door made me literally gasp. This patient was in an accident 3 years ago and broke his femur. What would occur in the US is that a metal bar would be placed in the femur to assist with the healing and provide stabilization. Well, what the doctors did here, was place screws through the lateral side of his leg and secure them with an external bar sticking out about 2-3 inches. He told us that this surgery occurred 3 years ago and he has had an active infection on and off ever since. He would take a short course of antibiotics but would never follow-up with any practitioner. To say the least, it took my breath away, just to witness the type of medical care that some of our patients receive. I looked at his face, which was one of dire need for help, and it broke my heart. Short of removing the implants and placing a "actual" replacement bar in his femur, we could only provide so much help. We cleaned, debrided, and and prescribed a long course of antibiotics. We will follow-up with him in a fews days to evaluate and clean the incisions again. Hopefully with our treatment, we can prevent him from one day soon being an amputee that we have to fit in years to come.

Binh Phuoc Clinic

Our second clinic site is in Binh Phuoc, on the border of Cambodia. It was a 7 hours bus ride from Ben Tre, so we arrived at 3:30 PM. We had a very quick lunch, unloaded the trucks nd did a survey of the facilities to organize a clinic space with proper work flow. As opposed to Ben Tre, this clinic site is at a main reception hall attached to our hotel. It takes some vision to evaluate the space. We decided to build a make shift medical room from plywood and curtains for patient privacy, a few tables for intake and interviews, another side area with pharmacy and the entire back of the hall for prosthetics. This makes for a challenging workflow to say the least as well as some difficult noise to perform all our functions. This is, however, the way most clinic sites have to work out. We make the best of it for the betterment of our patients.

Finished Clinic in Ben Tre

We worked for a total of 8 and ½ days in Ben Tre clinic. This is always our first and one of my favorites sites to do clinic. The staff is so helpful organizing and assisting in everything we request and it is an actual clinic so the facilities are conducive to medical treatment, including having an onsite X-ray machine. During the farewell thank you ceremony, The leaders of Ben Tre and the clinic offered these words to our team, “We have hosted many charity work teams in the past, and OUR team works the hardest, and provides the most effective treatment of all. They thank us for our hard work each and everyday, especially during a few very very hot days. They worry about our health because we arrive early, treat poor patients all day and leave late in the day. They want to continue to strengthen and grow our mutual relationship of treating needy and poor patients in Ben Tre. Totals for Ben Tre: 921 orthopedic patients and 291 prostheses and braces.