Photo Journal

Click HERE for a photos of the Chengde Mission.

Click HERE for slide show of Chengde Mission photos.

The last day

Zhao Ming Yuan before & after surgery

The final clinic was held today. There were 15 children still on the ward and about 35 children and teens showed up for the clinic. Those that lived more than four hours away were told to only come if there were complications.

It was truly wonderful to see the children that had surgery earlier in the week. Even with some swelling still evident the remarkable change in the appearance of the children with cleft lips was gratifying. The change was not as dramatic for children with cleft palates but the change in their lives, personal comfort, health and psychological well being is significant.

Small gifts were handed out by some children and parents to the volunteers. One parent brought a box of apples from their own small plot and apologised that that was all they had to give. Hand written notes were posted on the wall by a few of the teens.

The last packing of the equipment was completed. The volunteers spread out across Chengde for the final opportunity to buy souvenirs. Tonight is the farewell dinner.

With mixed emotions we will leave Chengde tomorrow. We have made many new friends at Chengde North Hospital. We have also changed the lives of the children and teens. For the Rotarians it has truly been an opportunity for Service Above Self. For the non Rotarians on the team they too have put Service Above Self.

The Final Surgery

Applause and cheers were heard today as the last child operated on during this mission was wheeled out of the recovery room. Hugs and hand shakes were exchanged between team members and Chengde North Hospital staff. The two teams learned to work together and became friends with a shared goal to ensure the best possible treatment for the children.

The Rotaplast team started to pack up, do inventory and complete the final records. The fifteen children operated on today will be checked during the evening by a surgeon and a paediatrician. Tomorrow (Saturday) is the post mission clinic. The majority of the children and their parents will return for a final check-up and advice to ensure a successful recovery. On Sunday the team starts their long journey home or for a few sightseeing in China.

During the week 175 children and teens were examined, 122 were operated on and 214 different procedures were performed. Every operation was free.
A legacy was left to the community of children who are healthier physically and mentally, because their cleft lip and/or palate have been corrected. A gift was left with the medical staff at the Chengde hospital of the opportunity to work with a gifted group of surgeons, anaesthetists and nurses. The American, Canadian and New Zealand Rotaplast medical team in exchange learned from the Chinese medical staff. The exchange of learning and the changed lives of the children is the sustainable endowment of this mission.

Smiles on the children’s faces were the only reward the volunteers wanted. The bonus was the many thank yous from parents and the children.

Meet the Surgeons

Our team of plastic surgeons in Chengde are:

• Dr. Frank R. Walchak, Spokane, WA
• Dr. Paul D. Angelchik, Glendale, AZ
• Dr. James Leake, Marrietta, GA
• Dr. Alex McCulloch Jr, Colorado Springs, CO

The team keeps three operating room busy eight to ten hours a day. The operations variety from some of the less complex cleft lips to the difficult palates and children in need of several procedures. They were also part of the team that screened the children at the start of the mission and daily visit the children in the post op room and on the ward. They meet with the family to stress the requirements of child’s post operative care.

To repair a cleft lip, the surgeon makes an incision on either side of the cleft from the mouth into the nostril. He then turns the dark pink outer portion of the cleft down and pulls the muscle and the skin of the lip together to close the separation. Muscle function and the normal shape of the mouth are restored. The nostril deformity often associated with cleft lip may also be improved at the time of lip repair surgery.

To repair a cleft palate, the surgeon makes an incision on both sides of the separation, moving tissue from each side of the cleft to the center or midline of the roof of the mouth. This rebuilds the palate, joining muscle together and providing enough length in the palate so the child can eat and improve their speech.

A home visit

Today I had the opportunity to visit one of the children in their home. I was driven 60 km out of Chengde into a rural farming area to visit Zhang Ru. Zhang had a cleft lip repaired and rhinoplasty (nose surgery) on October 31. On November 4th his mother presented the Rotaplast team with a banner (see yesterday’s blog post) to thank the team for helping her son.

The area where Zhang and his family live is subsistence farming. Most of the people in the area are living in poverty. Zhang’s home is heated with dried corn husks, stocks, tree branches and bits of wood. His mother sells vegetables and apples grown on the plot of land. His father works at odd jobs when available. The main room of the house is wall papered with pages from old books and newspapers. The kitchen is black from the cooking stove. Zhang travels 40 km to high school. He comes home from school once a month. The family must pay for his education.

The family was extremely grateful for the work done by Rotary and Rotaplast. I was given a bag of apples and pears to share with the Rotaplast team as a thank you gift. Seeing how Zhang and his family live convinced me more than anything that we are offering surgery to the right children and teens. Without Rotaplast they would never be treated.

By the end of today the team completed 81 operations and many more procedures as some children have more than one operation. The team has settled into an 11 hour day. We start at 7:00 am and finish at 6:00 pm. One surgeon and a paediatrician visit the ward later in the evening to check on the children operated on during the day.

Heartfelt Thanks

Everyday we are thanked by the children and their parents. Today was special. One parent took the time to have banner made and presented to the team (see photo). We also received notes and letters from the children and their parents. What more can we say!

To the Uncles and Aunts from Overseas

I would like to express to you my gratitude and thanks. It must be hard work for you all. If not for you, I couldn’t face up to life. If not for you how can I show myself as a lovely, gentle and confident person?

Thanks to you. Not only have you given me beauty, health, confidence, you have also given me every lasting love. Because of this, I have the confidence in life. Also I have confidence in the future. I shall get on with life with the love from so many people. I shall not disappoint you. I shall learn well and pay back to society with everything I have.

I am speechless with words from my heart. Heartfelt thanks to you again. Thanks for your love across the boundaries. This will be the everlasting spiritual fortune in my life.
When you are home, remember there is a Chinese girl, Shang Wei, who is missing you. I love you.

November 1, 2008

A LETTER OF THANK YOU

International Medical Team, China Population Welfare Foundation, North Hospital Medical Staff.

On behalf of my son and my family I thank you very much for this gift. This has allowed my son to return to his classmates as another student. When he returns this time the laughs and teasing will be gone.

From this activity I would like to express my deep feeling. International Medical Specialists - you have given the service with passion, utmost care and a high level of medical care which we should all follow.

The parents of Li Tian You
2008-11-4

Sister

I am leaving today. I am very happy and emotional when we took the photo together and I gave you my address. I shall always remember you.

When my child, Xiao Yue, grows up, I shall tell him to remember the free surgery you have done for him. I shall keep your scarf for him forever. I shall miss you forever. Please take care.

Li Lei
October 31, 2008

Make Dreams Real

“Make Dreams Real” is the theme this year of Rotary International President D.K. Lee. His goal is to reduce infant mortality and improve the lives of children. The partnership of Rotary and Rotaplast clearly does “Make Dreams Real”. Passion, dedication, commitment are more than words in Chengde. You see the words become reality in the enthusiasm and dedication of the volunteers. They desire to change the life of each child. The rewards are great for the volunteers. Each smile from a child is the reward the volunteers receive and the only reward they want.

After a much needed one day respite where the team members took in some of the incredible sites and history of the Chengde region we were back at the hospital by 7:00 AM. The first task is for our two pediatricians, Dr. Collin Yong, from the Rotary Club of Vancouver Chinatown and Dr. Steven Finkleman from Kelowna, B.C. They visit the ward where the children have stayed overnight. One of the challenges has been to enforce the no food and restricted liquid diet. The families staying with the children on several occasions have fed the children during the night. This means a forced delay of the operation, often to the next day. Collin and Steven examining each child scheduled for surgery. They were examined on the screening day and this is the final check on their health before their surgery. By 8:00 AM the first children are escorted down to the pre op room.

Non medical volunteer Peter Wu of the Rotary Club of Vancouver Chinatown sits with the children and families until they are wheeled into the operating room. Peter’s fluency in Mandarin is indispensible in this area. The children are thrust into strange surroundings and are afraid.

Today 15 operations were completed, four were the more complex palates and six had dental work in addition to the main operation.

A seven hour half day

Saturday was scheduled as a half day. That means we started at 7:00 AM and the last child left the recovery room at 1:30 PM to move to the ward. Some of the surgeries were more complex involving dental work by our Orthodontist Ramtin Nassiri and Dentist Keenman Feng. Ramtin and Keenman in most cases are extracting teeth that will obstruct the work of the surgeons. In some cases they are doing basic dental work on children who have never seen a dentist. The day stretched out also due to some of the work taking longer than anticipated.
The change in the children is remarkable. Many have significant deformities when we first meet them. There is a notable difference when they come out of the operating room. The next day on the ward other than swelling and stitches their appearance is incredibly improved. Showing a child their photo on the back of a digital camera brings big smiles. Other than the infants they understand the change to their lives. The parents are incredibly grateful.
The sterilizer for the team is Elaine Luk. Elaine is a member of the Rotary Club of Richmond Sunset and a non medical volunteer however she was previously a registered nurse. Her skills are put to good work. She must quickly clean and sterilizer the surgical instruments after each operation. Rotaplast brings their own instruments and Autoclave on the mission. Different instruments are needed for cleft lip and cleft palate operations. The time between operations is often short meaning Elaine must move on the double to get ready. She also rolls and sterilizes dressings to save money rather than buy pre-packaged dressings.

Trick or Treat

Today there were only treats for the children. They did not all appreciate that today would mark a significant change in their life. Many only saw a lot of strange looking people wearing odd clothing, with masks on and talking in incomprehensible gibberish. This odd group of strangers took them away from their parents and hurt them. Good reason to cry and there was a lot of that today.

These children who we will unlikely ever meet again, as adults may recall today and understand the significance it has made to the lives. The world will be a little bit happier and a little bit richer because of the life altering surgery these children received because Rotary and Rotaplast care.

The more difficult cleft palate surgeries started today. These operations meant longer and more complex operations. Three operating rooms were kept busy for eight hours. The sterilizer, a non medical volunteer, turned the instruments around quickly to ensure the require tools were available when needed. The ward clerk, another volunteer, spent her birthday at the computer stuck in a corner updating records as the children entered and left the operating area. The Rotaplast nurses and the non medical volunteer in the recovery room held the children and reassured them. When their mother arrived the world was a lot better.

The mayor of Chengde visited the hospital and presented a beautiful hand made traditional Chinese wall plaque to the Rotaplast team. He thanked everyone for caring for the children of his community. He then visited the ward and presented gifts to a few of the children.

First Day of Surgery

Today was about four year old Tian Rui and twelve other children who received life changing surgery because of the partnership between Rotary and Rotaplast and the commitment of the medical and non medical volunteers. Most importantly Tian received his surgery today because of the people who care and donated to Rotaplast and attended the fundraising events organized by the Rotary Club of Vancouver Chinatown and Rotary Club of Richmond Sunset (D5040).

Tian had his lip repaired surgically and received dental work. He walked into the operating room without a tear but clearly frightened. He was wheeled out clutching the teddy bear that was given to him after surgery and covered with a colourful blanket that he was also given as a gift. He held back his tears until he saw his mother.

The first day of surgery on a Rotaplast mission is hectic and at times confusing. Fewer surgeries are scheduled the first day to allow the teams to get to know each other and permit the hospital staff to explain local procedures.

Each parent had to sign consent to surgery form as required by the Chengde Hospital. The form is not treated as trivial or unimportant by the hospital staff. The form was careful explained and the type of surgery their child would receive is described. After signing the form the parent placed their mark on the form by placing a fingerprint in red ink over their signature.

An exhausted Rotaplast team returned to the hotel knowing that the lives of children they will never see again have been profoundly changed. The start of a week of sharing and teaching with the medical staff of Chengde Hospital has also started. The learning and teaching is clearly two way, for the Chengde medical staff and for the Rotaplast team.

Screening Day

Today was the screening day. A remarkable 172 infants, children and teens were examined today. Many traveled four or more hours to get to the hospital. Each person was first registered, given a number and a medical chart started. They were then photographed with their chart number and name, the photo was printed and attached to the file. They were then weighed. The next stop was an examination by the surgeon and anaesthetist. The paediatrician next examined them to assure they are healthy enough for surgery and find out if they have any other medical problems.

The next stop was the speech pathologist and finally the dentist and orthodontist. Each member of the medical team assessed the children’s health, what surgery needs to be done and could we do it if their health permits surgery.

Part of the screening process is to prepare a draft schedule for the operating rooms for the next week. This schedule depends on the complexity of the surgery and expected recovery time. The Rotaplast team were assisted by doctors and nurses from the Chengde Hospital. All of the infants, children and teens received a scarf hand knitted and donated by the Rotary Club of Richmond Sunset

Today we start to set up

Today there were the official welcomes and many thank you’s. We were all treated royally on our arrival at the hospital. A large contingent of the nursing staff was waiting in the lobby to meet us and escort us to the welcome ceremony. The local media was out in force.

Hospital representatives, the mayor and state officials all gave speeches thanking the Rotaplast International, Rotary International and the volunteers from Canada and the United States. They also said thank you for caring about the children of China. The medical and non medical teams had the opportunity to tour the hospital and were pleased with what they saw.

We had an official photograph taken in front of the hospital and then we were treated to a luncheon banquet at our hotel.

In the afternoon the process of moving the boxes of medical equipment started and setting up the surgical equipment. The medical and non medical teams started working together. The team members had to put on their scrubs and move the boxes into the operating rooms. The process of sterilizing the equipment has started. All the electrical equipment needs to be checked and the inventory verified. Another long day – all in preparation for the children who arrive tomorrow. More than 130 children have been selected by the local hospital staff and area medical represent atives as being in the need of surgery. This is possibly more than can be accommodated in the ten days we are here. We will see when the paediatricians start to examine the children tomorrow.

Another long day

The Journey Has Started

A group of half awake Rotarians met at YVR – Vancouver airport at 5:00 AM on October 26, 2008 to start our journey to Chengde, China. Each one of us had our one suit case stuffed with two weeks clothing and teddy bears. The second piece of luggage is a box of medical equipment and supplies needed on the mission. It is assigned to us and loaded in San Francisco. Each medical and non medical volunteers checks one box of supplies.

After clearing US customs we are on our way to San Francisco to meet the rest of the team. In SF we meet our team and onto United airlines flight bound for Beijing. A few old acquaintance from past Rotaplast missions renew their friendship. We are then off filled with excitement and for those of us who are new to Rotaplast uncertainty. Most importantly we know there are children waiting for us and we have an opportunity to make a difference.

It is a long process in Beijing to sort out the bags and boxes. The customs officials want to search all the medical boxes. The truck is moved to a parking lot where this can occur. The bus proceeds to Chengde and the truck follows later.

A long slow three hour bus ride gets us to Chengde where we are met by the local media. A few interviews, check into our rooms, a quick welcome dinner and everyone quickly crashes.

Teddy Bears Join Rotaplast Mission

A group of local teddy bears have joined the Rotaplast mission to Chengde. The 100 bears have volunteered to remain in China after the mission and be adopted by the children who will have cleft palate and cleft lip surgery.

The 100 hand made bears were donated by the seniors program from Kiwassa Neighbourhood House in east Vancouver. The seniors live in one of the lowest income neighbourhoods in Canada but wanted to make a contribution to children who have even less.

Each of the Rotary volunteers on the mission will stuff a few bears in the nooks and crannies of their suitcase.

Non Medical Volunteer Team

Left to Right - front row seated: Magdalen Leung,
Ken Funk, Chris Offer
Back row: Jackie Lau, Gail Maida, Elaine Luk, Dave Rogers,
Peter Wu, Byron Cai, Penny Offer

Non Medical Volunteers

1 Mission Director - Ken J. Funk, Abbotsford, BC
2 Quartermaster - David Rogers, White Rock, BC
3 Patient Transfer Coord. - Liang Cai, Richmond, BC
4 Photo Journalist - Chris Offer, Delta, BC

5. Sterilizer - Elaine Luk, Richmond, BC
6 Med. Records Keeper - Gail Maida, Delta, BC
7 Med. Student - Adam C. Walchak, Philadelphia, PA
8 Patient Ward Coord. - Jacqueline Lau, West Vancouver, BC
9 Pre-Op Asst. - Magdalen R. Leung, Richmond, BC
10 Recovery Room Asst.- Penny Offer, Delta, BC
11 Interpreter - Peter K. Wu, Vancouver, BC

The Chengde Medical Volunteer Team

Medical Volunteers

1 Medical Director - Frank R. Walchak MD, Spokane, WA
2 Surgeon - Paul D. Angelchik M.D., Glendale, AZ
3 Surgeon - James Leake MD, Marrietta, GA
4 Surgeon - Alex McCulloch Jr M.D., Colorado Springs, CO
5 Lead Anesthesiologist - Alan S. Andacht MD, Paradise Valley, AZ
6 Anesthesiologist - Amy K. Gull DO, Sacramento, CA
7 Anesthesiologist - Linda M. McBryde MD, Eagle River, AK
8 Anesthesiologist - Leigh A. Pederson MD, Whangeri, New Zealand,
9 Lead Pediatrician - Collin K. Yong MD, Vancouver BC
10 Pediatrician - Steven C. Finkleman MD, Kelowna, BC
11 Head Nurse - Carolyn Walchak RN, Spokane, WA
12 OR Nurse - Margaret Ford, Grand Junction, CO
13 OR Nurse - Monika Nelson RN, Napa, CA
14 OR Nurse - Yipi Yang RN, South San Francisco, CA
15 Lead PACU Nurse - Judi A. Farrington RN, Bozeman, MT
16 PACU Nurse - Carole McCulloch, Colorado Springs, CO
17 Dentist - Keenman Feng DDS, Vancouver, BC
18 Orthodontist - Ramtin Nassiri DDS, Richmond, CA
19 Speech Pathologist - April A. Johnson, San Mateo, CA

Norman Bethune - Hero of China

Canadian doctor Norman Bethune is one of the heroes of China. Bethune (1890-1939) was born in Gravenhurst, Ontario. He went to the University of Toronto, where his education was interrupted when he enlisted as a stretcher bearer in World War I. He received his M.D. in 1916.

Bethune was diagnosed with tuberculosis, he had given up hope of a cure but a letter from the Trudeau sanatorium at Saranac Lake, New York allowing him admittance changed his life. While at Trudeau, Bethune read about a new and controversial treatment for tuberculosis called compression therapy, or artificial pnemothorax (insertion of air into the chest so as to collapse one lung either permanently or temporarily depending on the case). His left lung was compressed, he recovered and was cured. Bethune left Trudeau for Montreal to study thoracic surgery.

From 1928 to 1936, Bethune worked as a thoracic surgeon in Montreal. He became famous there for his treatment of tuberculosis patients. Although he cured hundreds of cases successfully, many of his poorer patients became ill again when they returned to crowded, unsanitary homes. Bethune realized they could not be cured without proper living conditions and medical care. He wanted the medical system to provide the same level of health care for everyone. Bethune, and others with similar ideas, developed a plan for socialized medicine. However, when they presented it to the government they received a strong negative reaction. Bethune became unpopular among other doctors who thought his ideas were too radical.

At the time that the Spanish Civil War was raging (1936-1939), a spokesman from the Committee to Aid Spanish Democracy visited Bethune. The Committee had chosen Bethune, if he would accept, to head the Canadian Medical Unit in Madrid. Bethune was one of the top paid doctors in Canada, 39, and one of the world's top thoracic surgeons. He found it a hard decision to make, but left for Madrid on November 3, 1936.

While in Spain, Bethune did pioneering work with blood transfusions, developing the world's first mobile medical unit. This whole unit contained dressings for 500 wounds, and enough supplies and medicine for 100 operations. It could also be carried by just one mule. The service collected blood from donors and delivered it to hospitals and to soldiers at the battlefront. On many occasions, Bethune risked his life to deliver blood to the front line. Bethune and his colleagues discovered difficulties with some patients, however, in that the blood they transfused didn't work, and the patient died. The discovery of blood types by Dr. Landsteiner solved this mystery. Bethune returned to Canada on June 6, 1937.

In 1938, Bethune went to China to help Mao Tse-tung and the Red Army fight the Japanese. He became the Red Army’s Medical Chief and trained thousands of Chinese as medics and doctors. He also designed the world’s first mobile medical unit despite limited equipment. The unit saved the lives of many soldiers. Unfortunately, Bethune soon lost his life assisting the Chinese.

On November 12, 1939, Norman Bethune died of disease at Huangshikou Village in Tangxian County, Hebei Province. On December 21 the same year, Mao Zedong published his "In Memory of Norman Bethune". Now 69 years have elapsed, but the Chinese still cherish deep memory of Canadian doctor Norman Bethune.

Ordinary people of Hebei Province have never forgotten Dr. Bethune or his 22 months of service for the Chinese army and people in their fight against aggression. His former residence and memorial hall at Huangshikou Village in Tangxian County receive numerous visitors each year. There are many memorials to Bethune in China.

Rotary Clubs Fund Rotaplast Mission

Rotarians from the Rotary clubs of Vancouver Chinatown and Richmond Sunset are making their final preparations for a Rotaplast medical mission to Chengde, China north of Beijing. The team leaves on October 26 and returns November 9, 2008. Rotaplast International selected Ken Funk of the Rotary Club of Abbotsford as the volunteer team leader. Ken is a veteran of many Rotaplast missions.

The two Rotary clubs raised $95,000 to fund the mission and in addition have received a donation of all ground and equipment transportation in China valued at more than $8,000.00. A large thank you to all Rotarians and friends of Rotary who have supported this initiative.

In June the clubs held a dinner and auction with Past RI President Richard King as the keynote speaker. Former B.C. Attorney General Geoff Plant and MLA (member provincial legislature) and Rotarian John Yap as auctioneers. Geoff had cleft lip and palate surgery as a child.

At another event Rotary club member and Soprano, Rei Miyamoto and her singing partner, Tenor, Derek Bacchioni, gave an opera presentation. The two clubs in cooperation held a golf tournament at University Golf Course.

These events raised about half the required funds. Many generous donors from the Rotary clubs and friends of Rotary stepped forward with large and small donations.

More than 100 children will have their lives changed by this two week mission. In addition local doctors will have the opportunity to observe and learn from a group of medical leaders in their fields. The mission will leave a lasting legacy for each child helped, a gift of knowledge for the community and a message of peace and understanding from Rotary.

The ten Rotary club members are joined by a 20 member medical team of surgeons, anaesthesiologists, paediatricians, and nurses. The lead paediatrician is Dr. Colin Yong a member of the RC of Vancouver Chinatown and the dentist for the medical team is Dr. Keenman Feng, partner of a member of the RC of Vancouver Chinatown.