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May 10th
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Thanks for the Sunshine - The medical exchange

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"When I suture, I take extreme care to shield the patient from all unnecessary needle pricks. Better my finger than the patient's intestine that gets a prick unnecessarily," Dr. Chen Fu-min (陳福民) said to his audience. Dr. Chen, a surgeon from Cleveland, Ohio, and his TIMA colleagues conducted a free clinic at Hospital Municipal Frances (HMF) in Santa Cruz. This clinic focused on surgeries, especially on hernia repairs and gallstone removals.

Many HMF surgeons, physicians, and nurses came to observe or help the TIMA surgical team, filling the operating rooms to capacity. They seemed to be reliving their days in medical school when they made the rounds with their professors, soaking up all the techniques and nuances necessary to be good physicians.

Dr. Chen showed the local surgeons his best techniques for hernia repairs, which he had fine-tuned through years of medical practice. His techniques can be performed simply and quickly with near perfect closures and minimal chances of recurring.

In contrast, the surgeons at HMF typically sewed the muscle tissues first, and then sewed on plastic mesh before closing the skin--a time-consuming technique that leaves the wound hard to suture completely, frequently resulting in a recurrence. Cases in point were found right on the spot: Of the nine hernia repair operations done on February 27, six were to repair recurrences, something that Dr. Chen's techniques could have helped prevent from happening.

Dr. Yao Fan-sheng (姚繁盛) of New York noticed that the Bolivian doctors did not know how to administer local anesthesia. Instead, they would put patients under epidural or even general anesthesia, complicating the surgery. Dr. Yao, a professor of anesthesiology, presented several textbooks on the subject to HMF for reference.

Li Zu-lian (李祖漣), a veteran operating room nurse from Maryland, shared with her local counterparts the importance and procedure of tallying operating instruments and supplies. Items such as scalpels, surgical needles, and gauze must be strictly accounted for in each operation to prevent any regrettable and unsafe incidents of leaving such foreign objects buried and sewn inside the patient.

Because HMF is short-staffed, usually only a maximum of eight operations can be performed in a day at the hospital, a record that the free clinic broke. The TIMA members all seemed so experienced, knowledgeable, efficient, and willing to share. The host doctors asked whether TIMA could station physicians in Bolivia on a regular basis to teach them, to be their mentors.

"During these last few months of flooding, I had my dark moments when I really had a sense of helplessness," admitted Dr. Fernando Lacoa Mendoza, the superintendent of the hospital. "I was about to give in to the unrelenting situation at the hospital. I couldn't even manage to squeeze out a smile. Now you are here. You have expelled my sense of being alone and given me a shot in the arm. We have so much to be thankful for. We are moved by your visit and all you have done here. We will make arrangements to attend the TIMA annual conference in Taiwan in September."
In a small ceremony at noon on February 28, Dr. Chen Fu-min presented Mrs. Aguilera with the keys to a bus. When Tzu Chi members were here in August 2007 to run a free clinic, Mrs. Aguilera requested that the foundation donate a 30-passenger bus so that local physicians could organize free clinics of their own. Her request was granted just half a year later--courtesy of Tzu Chi members in Bolivia.

Forty dentists in Santa Cruz de la Sierra promoted giving dentures as gifts so more people could "smile happily." Dr. Zhang Gong-feng (張恭逢) of Los Angeles responded with the gift of a set of mobile dental equipment kits to Dr. Duberty Soleto Ledesma, a local dentist. This equipment makes a mobile dental clinic possible, greatly enhancing the local dentists' capacity to conduct clinics in remote areas.

Hopefully, with the equipment donated by Tzu Chi, local Bolivians--the prefect, first lady, surgeons, dentists, hospital administrators, doctors, and nurses--can extend their reach and bring a better life to more of their fellow countrymen

By Chen Ci-zhen, Yang Ci-fu, Zou Yu-ru, Fan Sheng-zong, and Cen Hui-yi
Translated by Tang Yau-yang
Source: Tzu Chi Quarterly Summer 2008

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