Category Archives: Projects

The Honduran staff was a joy to work with…Dr. Maggie Jolly

I slipped on a scrub top and walked down the hill to the hospital. It was one of my call days, and the nurses had given the characteristic message on the Ham radio, “Dra. Maggi, Dra. Maggi, tenemos una emergeeencia.” They always seemed to draw that last word out, making it sound more urgent than it really was. This case was simple however, a kid with a rash, and I didn’t expect it to take long. I had turned to Mackenzie as I left, just after breakfast, “You don’t think I need to change out of my shorts and flip flops do you?” “Nah,” she replied, “you won’t be gone long.”

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How long did your child have this? Does it itch? I had made it about two questions into the interview of the child’s mother when I heard a bustle in the other ER bed. Glancing past the curtain, I saw them hoisting a young man with a rather large blood stain spreading down the front of his shirt. “What happened?” Calmly, “Una balla Doctora.” As I could hear the gurgling from his chest from across the room, I turned to the mother and asked her to excuse me for a minute.  After two painstakingly small and difficult to place IVs, several liters of fluid, a measly shot of IM toradol, and a large bore chest tube placement, the patient was finally stabilized.

Quite a rush of adrenaline, when your trauma bay team initially consists of only two generally trained Honduran nurses, other physicians have to be called in by Ham radio, and the Xray tech has to be called in from afar on his bike (we left a voicemail message on his phone and never actually saw him that day). No tension pneumothorax, no other complications, thankfully, and he did extremely well.  The trauma surgeon who came in to help me place the chest tube, a veteran of several tours in duty in Afghanistan, looked at me after all was said and done, stating, “Well will you look at that. You didn’t even get blood on your shorts!”  I think that will be my first and last chest tube insertion while in flip flops, for the record.

While one of the most intense, the past three weeks have been spent full of similar intriguing learning experiences.  I was lucky enough to be able to spend them working at Hospital Loma de Luz, a small but comprehensive missionary hospital approximately two hours south of La Cieba, a large city on the North Coast of Honduras.  Typical days were spent in clinic, after rounding on any patients, mothers or babies you had admitted in the days prior. Clinic encounters ran the entire gamut of possibilities, from the familiar triad of HTN, Diabetes, and hyperlipidemia to more unfamiliar complaints such as “diarrhea/stroke” (that was a disconcerting chief complaint to read, and quite complicated to deal with in clinic). I noted that most patients were in the practice of not taking their medications the day of their appointment, as they knew we were to be evaluating their blood pressure and they did not want the medications to interfere with the value…  I saw mothers and babies whom I delivered (recen naciedos), well child checks (one “chequeo general” turned out to be a 12 yr old with an obvious genetic syndrome and bilateral cataracts who had never been seen before), as well as numerous bouts of Giardiasis and parasitosis. I also saw a girl with Bells palsy, lots of optho complaints (and the removal of the largest cataract I have ever seen), orthopedic complaints, kidney stones, gallstones, and an abundance of ladies presenting for prenatal care.

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Call days were always interesting, and as is characteristic for the visiting doctors I’m told, were usually busy.  Often paired with Mackenzie, I was able to do a multitude of vaginal deliveries as well as help out with a C-section and do the baby resuscitation. The vaginal deliveries often tended to be at 4AM, after walking back and forth to check on the patient and make sure the nurse’s vaginal check was accurate (they almost always were). Monitoring was brief, but the nurses would turn it on for ten minutes prior to my arrival, as they knew I was used to at least glancing at a part of a baby’s strip. Otherwise, it was all by sound, if the mother was on the monitor at all.  As I had witnessed in Guatemala previously, the mothers delivered their babies without so much as Tylenol, and all were very gracious. It always made me smile: in the warmth and humidity of the tropics, the families often dressed their new infants in tank tops rather than onesies.

I learned to cast broken bones on call days, and also sewed up lacerations from machetes.  I learned that treatment of stroke is difficult without the aid of an immediate CT scan. Treatment of MI is difficult without PCI or heparin or lovenox.  Treatment of cancer is often impossible, and sometimes people can get septic and die from infections that have been present much longer and progressed much more quickly than they might have in the states. Pressors don’t work as well if you can’t stop the bleeding and you don’t have ready access to blood transfusions.  (Thankfully these were not all lessons learned on my own personal patients).

In general, my Spanish had improved greatly after my 9 months in Guatemala during medical school. Rather than being stuck on basic communication, the Honduran nurses spent their time improving my pronunciation and correcting inaccuracies: “Como lo veo?” I asked the ladies working in the lab. “You look very pretty today Doctora. Giggle giggle.” I had accidently asked them how I looked rather than asking how the labs looked.  They appreciated the extra laughs.

The Honduran staff was a joy to work with, as was the medical missionary staff.  I spent time with an ER doctor from the states, who to this day is so dedicated to teaching that whenever he staffed patients with me he inevitably made it home hours later than he normally would, solely from the extra time spent with me on the ultrasound machine or looking up new concepts. I was able to witness Mackenzie Slater use her full spectrum skills from VCMC as she delivered babies vaginally, did C-sections, worked in clinic and took care of ER patients. I was able to see how much she had gained even, adeptly carrying out obstetrical ultrasounds for dating and reducing and casting fractures in the ER. It was encouraging to see how much she uses her skills, how much her skill set has grown, and how happy she is post residency doing work that she loves.

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I go back to back to medicine in a couple of days, then surgery service again in a month. I’m glad to continue learning, but am betting that the next time I do a chest tube, I won’t be in shorts and flip flops…

Dr. Maggie Jolly

Honduras 2014

The baleada is a fresh tortilla, made with a smear of beans, scrambled eggs and topped with a sour-tasting cheese, named after a bullet, given its folded in half and aerodynamic shape. This small, but delicious Honduran cultural delight is certainly something I won’t forget.

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As the patients got wind of food in the halls, ever so kindly they notified me they would be in the cafeteria eating lunch while they waited for their visit with me. I would often accompany them at the table, discussing a sick family member while passing the pico salsa to place on top of our baleadas. Whether they were dropped off by a friend, paid a small red taxi to take them or walked a far distance, these patients were happy to be seen, were patient with their time and loved to give hugs to show their gratitude.

They had the usual medical diagnoses, Diabetes, Hypertension, then the more rare, Batsi-fly infestation, or “Honduran Hysteria” a surprisingly common dramatization of their symptoms, ie faking a seizure or passing out, pretending to be paralyzed from a car accident, though suddenly regaining strength. These people were kind, humble and had so many values deeply entrenched in them, and they exemplified a God-focused life.

I really did feel my work at Loma de Luz Hospital in the Northern coast of Honduras was needed, such as bringing a pre-eclamptic, 19 year-old’s daughter in the world, teaching her to breast-feed and to take care of her newborn, placing a cast on the broken foot of an injured soccer player from the neighboring village, sewing up a complicated facial laceration on a young boy running from trouble, and even helping a worried, single mom learn to de-stress by teaching her yoga stretches. These people gave me so much excitement to be a doctor, to use my skills from VCMC to provide honorable, quality health-care and showed me why international medical travel is so important for both the people receiving care and providing it, igniting in me a new passion to continue to do so in my future practice.

I met wonderful volunteers while in Honduras, other surgeons, medical students, ER, and family medicine doctors who made me feel I was part of something great. We saw patients together in a multi-disciplinary approach though also donated toys to the orphanage together, frolicked on the beach and in the surf with the kids, went snorkeling, and even made homemade baleadas together.

My time abroad was an immeasurable experience. Driving by the small open-aired shacks, with smoke from dinner preparations, roaming chickens and dirty-footed babies running around in diapers, I saw where these patients lived, I also saw how unassuming and appreciative they were.

I would love to continue to return here, to remind myself of how blessed we are to have what we have, and to use our blessings to give to those less fortunate. I will likely get a craving for that bullet-shaped delight that cost me 30 cents per day and helped me taste the beautiful culture of his little Honduran village of Balfate.

Chris Adkins

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Pop Wuj Clinic & Spanish School in Quetzaltenango, Guatemala

With the generous support of the Family Medicine Education Fund (FMED) I had the privilege to work and study at Pop Wuj, a non-profit organization in Quetzaltenango, Guatemala. Pop Wuj is a Spanish school with a medical clinic and several public health outreach programs that students participate in while learning Spanish. My medical work while at Pop Wuj was split between primary care at the clinic and public health community outreach through mobile clinics, a nutrition program and a safe stove building project.

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At Pop Wuj clinic I saw a combination of the chronic diseases such as diabetes and hypertension, as well as acute illnesses such as diarrhea and parasitic infections. Much chronic disease management was similar to Ventura, but other diseases, such as some parasitic infections, I had not treated before. Many patients who visited the clinic lived in outside Mayan villages and often sought the help of a village healer or midwife before seeking a physician’s help. This added additional challenges and learning opportunities as we sought to provide culturally sensitive, but effective care.

The nutrition outreach at Pop Wuj consisted of sites in three villages where children ages 6 months through 2 years old came monthly to be weighted, examined by a physician and given nutritional supplements. Mothers of the children were given prenatal vitamins for themselves, regardless of pregnancy status, children’s vitamins for all other siblings and teaching on family planning. As part of the outreach I helped with the educational program, assisted in examining patients and helped prepare supplies for each trip. I found this an effective public health outreach due to the continuity with monthly visits and the focus on prevention. I would love to use a similar model in a developing country in the future.

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Finally, the Safe Stove Project at Pop Wuj, was a project where families were taught and assisted in building stoves within their homes with a cooking surface and chimney, instead of using an open fire. This helped prevent prevalent pulmonary diseases in children and adults that are caused by fumes. Safe stoves also served to prevent burns experienced by women and children cooking or playing near an open fire. For the safe stove project I helped present the educational program to women about the health benefits of using a safe stove as well as helped build a stove in a home one morning.

Thank you so much for this opportunity to study and serve in Guatemala.  I found my time at Pop Wuj enriching and I would love to return in the future to continue to study and serve. I grew in my language ability and experienced effective medical and public health outreach in a developing country. I know I will use this in future practice abroad. Furthermore, upon return I am happy to see how it has benefited my relationship with my Spanish-speaking patients in Ventura. Not only do I feel more confident and capable to converse in Spanish, but I have a better cultural context to approach our relationship.

Dr. Alicia Parsons, PGY2

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Dr. Connie Leeper Spends Elective In Njinikom, Cameroon

I spent my elective in St. Martin de Porres Catholic Hospital in Njinikom, Cameroon.  St. Martin de Porres Hospital is on a Catholic compound that also contains a convent, orphanage, schools and outreach programs.  At the hospital, there are currently 2 married American missionary family physicians, Dr. Brent Burket and Dr. Jennifer Thoene, a Cameroonian general practitioner, Dr. Eugene, a Guinean Ob-Gyn, Dr. Dabo, a Cameroonian general surgeon, Dr. Foku, and a Cameroonian orthopedic surgeon, Dr. Lazare. Brent and Jennifer, with whom I primarily worked, moved to Cameroon in August of 2013. Prior to living and working in Cameroon, they have worked and lived in Ghana and Guatemala. They have 4 children (2 biological and 2 adopted- one from China and another from Ethiopia). They work through an organization called Mission Doctors Association, a Catholic organization.

Njinikom is a small town in northwest Cameroon. The majority of people in Njinikom speak Pidgen English or the local dialect Kom. Some people speak and understand English, fewer speak and understand French. Njinikom is in the hills. I landed in Douala after 26 hours of flying and the next day spent about 9 hours driving past banana, plantain, pineapple, and papaya plantations to arrive in Njinikom.

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My first 2 weeks were spent with Brent and Jennifer on the inpatient medicine service. We were responsible for the male, female and children’s wards and any newborns that were ill. My days on inpatient medicine consisted of rounding on the inpatients with either Brent or Jennifer in the morning, then going to the outpatient department (OPD) once done with rounds. The most common diagnoses seen for inpatients were malaria, typhoid, pneumonia, stroke, diarrhea, tuberculosis and complications of HIV. Diagnoses were difficult as we were limited in the labs that were available (electrolytes, blood count, malaria antigen, Widal test, stool O&P, HIV), in how reliable those labs were, and in the imaging available (ie. chest x-rays taken with patient’s in prone position, EKG, portable ultrasound that was brought by Brent & Jennifer from the US). I realized quickly that I didn’t know who was badly sick in this setting.

I was called one night as a 26 year old patient was being resuscitated. The patient was admitted for pneumonia and anemia. His hemoglobin was 5 and he had been transfused 1 unit of blood (whole blood donated by a family member) and was on antibiotics. We had seen him that morning and he was talking and in no respiratory distress. We checked an HIV test which was positive. That evening, when I arrived, he was non-responsive, breathing heavily and hypotensive. The night nurse had put him on an oxygen concentrator. I told the nurse to bolus him fluids given his hypotension. The nurse said that his lungs sounded wet. I thought he was septic and needed volume and in the US we can just intubate if someone’s lungs get flooded. I thought about it and realized that we couldn’t intubate him and I didn’t know if I should bolus him or not. I asked about giving him more blood. The nurse said that there was no blood. I knew we had a very small supply of blood saved in the lab and I wondered if the nurse was trying to tell me that there was no hope in saving the patient and that it would be a waste of the precious supply of blood we had. The patient’s breathing became agonal. The nurse put up a curtain so that the other patients in the ward and their families would not have to watch and the patient died. I would not have predicted him dying that morning. He was young and just had pneumonia which was being treated, but having HIV changes everything. I also realized that I rarely actually watched someone die in the US. Usually, we know someone is dying and they were on comfort care and then I am called to pronounce them.

My last week I worked with Dr. Dabo, the Ob-Gyn to get some OB experience. Brent & Jennifer, Dr. Dabo, Dr. Foku, and Dr. Lazare rotate who is responsible for cesarean sections. While I was there, Brent and Jennifer were unfortunately not scheduled to be responsible for OB, so I decided to work with Dr. Dabo. It was a little difficult because his primary language is French and being from Guinea, he doesn’t really understand the US medical training system so it was hard for him to understand what a 2nd year resident would know.

We rounded on post-cesarean section patients in the morning and any antenatal complications. The normal vaginal deliveries are all managed by midwives. The midwives deliver all vaginal deliveries including breech presentations. They only call the doctors for complications such as hemorrhage, need for induction or augmentation, etc. I scrubbed for 4 cesarean sections while in Cameroon. I assisted in all 4 cases. Two of them were primary cesareans (one was done by Pfannenstiel by Dr. Foku and one done by Joel-Koen by Dr. Dabo). The other 2 were repeat cesarean sections and were repeat vertical incisions. Dr. Dabo did a lot of ultrasound in clinic (gyn and OB). We saw a lot of infertility consultations and many of the women had been exposed to Chlamydia. The only test available was an antibody test, therefore, it was difficult to know if Chlamydia was truly the cause or if she had only been exposed prior, therefore, most women got treated.

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Overall, Njinikom was a great experience. It was my first time in the African continent and it was the most resource poor area I’ve ever visited. I encountered diseases that I’ve never seen and had to stretch my thinking and get creative when medications or tests that I was used to weren’t available. Brent and Jennifer were wonderful mentors and hosts. I lived just below them and ate dinner with their family every night. They truly were my family during my stay as I spent Christmas, my birthday, and New Years in Cameroon. I would recommend the experience for people that want to see what it’s like to work in Africa in a resource poor area. There is not a lot to do in and around Njinikom tourism-wise, but medically I learned a lot.

Dr. Connie Leeper

See more images of Cameroon below.

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Honduras With Dr. Christopher Adkins

International training is an essential part of a broad spectrum family medicine residency, and thanks to Dr. Starr and the FMed Fund, I was able to partake in a week long international elective in Honduras.  The initial plan was to assist Dr. Starr and other Honduran Plastic Surgeons in performing cleft palate surgery on children.  This plan then changed when I was made aware of a desire on the part of some very prominent physicians and administrators in the University Hospital in Tegucigalpa to form a Family Medicine training program.

As a soon-to-be Family Medicine graduate, I was asked to present the basics of family medicine, its benefits to health systems, and ways that the training was carried out at the VCMC Family Medicine Residency Program.  Included in this time was discussion with current internal medicine, surgery, and OB/Gyn residents in Honduras, as well as tours of their hospital and medical school.

I was taken aback at the level of representation at the meetings, including the Pan American Health Organization, the Ministry of Health, and leadership in the department of Public Health.  I was able to use the experience I gained as Chief Resident, specifically working with the ACGME guidelines and the leadership of our residency program, to advocate for the essential role of Family Medicine in Primary Care.  I am excited to maintain and grow the relationship the VCMC Family Medicine Residency has with the Hospital Escuela in Tegucigalpa.

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The Lake Clinic, Cambodia

The Lake Clinic was started in 2008 by Jon Morgan, an American nurse with an MPH who had been the director of the Angkor Hospital for Children in Siem Reap, Cambodia for many years. The goal of The Lake Clinic is to provide healthcare to rural communities on the Tonle Sap lake. This is one of the largest lakes in SE Asia and provides one third of the protein for the people of Cambodia in the form of fish. More than 1.5 million people live on or around the lake, some in unique floating villages that drift with the rise and fall of the waters.

For the past six years, TLC has been taking medical teams by boat to eight of these villages to provide healthcare. The full-time Cambodian team consists of a doctor, dentist, midwife, registrar, cook, boat driver and clinic coordinator. Volunteer doctors are extra. They spend three days on the lake running a walk-in clinic and try to visit each village about once a month. I had the privilege of going on two trips to the lake as well as one trip to the Stung Sen river where TLC has a second team that goes every week to a remote village.

Clinic starts Monday morning just before dawn when the whole team meets at the office in Siem Reap and piles into a van with all of our gear. We drive out to the lake and then take a boat to the village. The trip takes about 4 hours, a difficult and cost-prohibitive journey for most locals. Once at the clinic (a 20×20 room built by TLC with a bathroom out back), we have lunch and then unpack. There are boxes of charts, carefully filed with histories going back more than 5 years. The dentist sets up her equipment. We lay out the pharmacy and hang curtains to create “rooms” to see patients. Clinic runs for a half day on Monday, then a full day Tuesday and another half day on Wednesday before we head back to town. We can see as few as 30 patients in a day or as many as 200 depending on the size  and needs of the village.

The staff have been coming here for six years and know the patients well. There are a lot of musculoskeletal complaints as the people spend all day hunched over fishing nets in tiny boats. I saw the usual colds as well as diarrhea, likely related to poor water quality. TLC has worked hard to educate people about water safety and has even set up water filters in some villages, but it’s difficult to get people to use them and change age-old habits. Most of the kids have horrible dental disease, even as young as two years old, and the dentist stays busy doing extractions and fillings. The midwife provides prenatal care and advises women to go to the hospital for delivery, although most will deliver in their home with a local midwife due to the long journey into town. Interestingly, the government has mandated that all women deliver in a hospital with a doctor and midwives can be fined for doing deliveries. Because of the political culture it is basically illegal to provide training to rural midwives leading to persistently high maternal-infant mortality in rural areas.

On some of the slower afternoons I had the opportunity to do home visits. We saw an 80 year old woman with end-stage dementia, a 60 year old man paralyzed by polio, another 80 year old man who’d had a stroke. One afternoon we even got to visit one of the smaller villages to follow up with two patients who had recently had cataract surgery. When they can, TLC transports the locals back to town to see specialists or have surgeries. However, resources are still very limited. I saw an 8 year old girl on the river with congenital heart disease causing her to have very low oxygen levels. She’s seen the specialists at the children’s hospital and is on the list to have the life-saving surgery she needs, but the list has 2000 other children on it and it’s a long wait. In the meantime she’s already developed irreversible complications from her disease.

For information about the Lake Clinic http://www.lakeclinic.org

Elizabeth Uno, PGY3

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VCMC Resident provides care at Pediatric HIV clinic in Malawai with aid of VGHP And FMed travel grant

Pediatric HIV Elective in Malawi

After missed flights, lost bags, and 3 days of travel I arrived in Lilongwe, the capital of Malawi, on a sunny morning during the rainy season.  The Baylor International Pediatric AIDS Initiative has a Clinical Center of Excellence in Lilongwe, an impressive pediatric HIV clinic staffed by Malawian clinical officers, nurses, social workers, pharmacists, research staff and a few American pediatricians. The clinic is adjacent to the massive government hospital, Kamuzu Central Hospital, which includes a pediatric emergency zone, high dependency unit, malnutrition ward, nursery, NICU, oncology ward, peds surgery ward, and several general peds wards.

During my month in Malawi, I worked in HIV clinic, Kaposi’s sarcoma clinic, HIV Teen Club, cervical cancer screening clinic, inpatient peds wards, and in a rural northern region of the country on a community outreach and mentoring trip.

My first day was spent in Kaposi’s sarcoma clinic where we saw children with oral KS, severe lymphedema, GI involvement, and HIV-negative KS. If children are fortunate enough to have access to the central government hospital in the capital, they are able to get chemotherapy for KS, and many do quite well.

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During my second week, I flew up north to Mzuzu with the mentorship team that works in rural health clinics to help strengthen pediatric HIV care. Some of the challenges addressed included HIV positive children lost to follow up, ARV stock outs, insufficient clinical staff, and dosing of pediatric ARV regimens.  At the local district hospital, we rounded in the ICU and used my VCMC ultrasound education (thank you Dr. Rutherford, Dr. David) to demonstrate evaluation of intravascular volume. This was particularly useful for our CHF patient who appeared to be in acute renal failure while the hospital had no serum chemistry available due to reagent stock outs and insufficient funds to purchase more.

Back in Lilongwe during my third week, I worked alongside Malawian clinical officers in HIV clinic, learning the first-line and second-line ARV regimens, (there are no third-line options), malnutrition treatment guidelines, TB prophylaxis, and malaria prophylaxis for HIV positive kids.  During my week on the inpatient peds team, we had many interesting cases including a girl with cryptococcal meningitis, on fluconazole and ampho-B, who underwent frequent therapeutic lumbar punctures to relieve her headache and vomiting – all without local anesthesia since it is a fairly limited resource.  We started a cachectic 20 year old HIV positive woman with a BMI of 12 on TB treatment. She had chosen not to take her ARVs for the preceding 12 months because she had moved to live with her cousins and did not want them to know she was HIV positive.  We saw numerous cases of severe pneumonia, malnutrition, diarrhea and TB.

Within the pediatric HIV clinic, there is a weekly VIA clinic (visual inspection with acetic acid) for cervical cancer screening. Instead of Pap smears, which are unrealistic due to cost and lack of sufficient pathology services, screening is performed by applying vinegar to the cervix and using gross inspection to identify acetowhite lesions. If a precancerous lesion is identified, cryotherapy is offered. Malawi has national guidelines, adopted from the WHO, which recommend all women be screened regularly from age 30-55. The country does not yet have recommendations for when to initiate screening in HIV positive women. I finished the rotation with a journal club presentation on cervical cancer screening in HIV positive adolescents, ending in a lively discussion on the optimal age to start cervical cancer screening in girls who are perinatally infected with HIV.

Despite the admirable slower pace of life in Malawi, the month flew by. It was a tremendous educational opportunity and would not have been possible without the generous support of the Ventura Family Medicine Education Fund.

Thank you!

 

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Sahara Desert, Niger: The Nomad Project

VGHP is partnering with Dr. Robert Skankey, a retired Obstetrician who has delivered over 3500 babies in Ventura and Ojai, and his Nomad Foundation in the Sahara Desert.

The Nomad Foundation has started a clinic in Tamesna, which is located on the annual migration route of the local Nomads. The clinic has a midwife training program.

One in seven women in Niger has a lifetime risk of death during childbirth. Midwives trained by Dr. Skankey have assisted at more than one hundred births since November of 2011 with no maternal mortality and no infant mortality of a child born alive. They are reporting to Tamensa clinic staff that is developing the first health statistics ever for this remote region.

While vigorous and very committed, Dr. Skankey is 82 years old, and VGHP has committed to help him pass the torch to younger Ventura doctors. VGHP will recruit and fund OB/GYN’s to continue the work of training midwives at the Tamesna clinic.

Donations Coming Soon





Maneadero, Mexico: Medical Outreach and possible Startup Clinic

VGHP is partnering with Dr. Carlos O’Bryan, a 2011 graduate of the Ventura Family Medicine Residency, to assess needs in providing care to underserved peoples in Maneadero, Mexico.

Maneadero is an agricultural community five miles South of Ensenada in Baja California. There is a strong migrant farm worker population, many of them Mixteco people from Oaxaca, Mexico.

Dr. O’Bryan intends to provide care to Mixtec peoples as his life’s work. He presently practices at Las Islas Family Medical Clinic, a county-run facility in Oxnard which provides care to a mostly immigrant, and strongly Mixteco, population. Over the next five to ten years he intends to transition more of his practice to Maneadero, where fewer healthcare options exist.

As an interim step to full time practice in Maneadero, Dr. O’Bryan and VGHP are partnering to conduct medical outreach and perhaps provide clinical care on a part time basis. The first step is medical outreach; ad-hoc provision of care to gain exposure and assess the needs in the community. If medical outreach activities indicate a need and a culturally appropriate fit, the mid-term goal is to start a clinic that is open on weekends, with Dr. O’Bryan serving as medical director and with rotating volunteer doctors from the Ventura community.

Note: our first VGHP-sponsored rotation will take place February 16-17. Dr. Carlos O’Bryan (MD), Dr. James Appel (MD), and Dr. John Chung (DDS) will provide care at Casa Hogar, an orphanage for abused children in Maneadero.

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Donations Coming Soon





Santo Tomas La Union, Guatemala: Clinica Medica Cristiana

VGHP is partnering with Dr. Zachary Self, a 2012 graduate of the Ventura Family Medicine Residency, to support his startup Clinica Medica Cristiana in Santo Tomas La Union, Guatemala.

Santo Tomas is a city of 25,000 residents, mainly indigenous Mayan, with four satellite towns of 5,000 residents each. Dr. Self’s goal is to “live out a life of solidarity with the marginalized indigenous population of Guatemala” and to “provide our patients with a quality of care comparable to that found in more developed countries”.

Dr. Self will provide care without regard to political affiliation, religious belief, ethnic identity, or ability to pay. VGHP has committed a grant to Dr. Self to help him procure medical equipment required for his clinic. VGHP intends to support the clinic with short-term rotations of volunteer doctors from Ventura beginning in late 2014.

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Donations Coming Soon