12/18/2016

2016 NEWSLETTER

EARTHWIDE SURGICAL FOUNDATION

2016 Summary

I would like to thank all our generous contributors. It has been approximately 12 years since Earthwide Surgical Foundation was granted 501(C)(3) non-profit status by the Internal Revenue Service. I am very happy with our progress towards achieving the Foundation’s goals, namely, to deliver surgical care to the poor of the world by means of manpower, equipment and education. The following are some of the highlights of the past year:

MISSION TRIPS


1.     On 1/2/16, Dr. Camazine returned to the Nigerian Christian Hospital for a mission trip. During this 4 week trip, 10 Nigerian upper level healthcare workers participated including Drs. Jombo, Acho, Enyinnah, Akunekwe, Akpanudo, Madu, Nkeonye, Ifeanyi, Oje and Nurse Anesthetists, Wilson, Uruakpa and Oje. Many nursing, medical and nurse anesthetist students were also present. Over 750 patients were treated and 150 operations performed. All members of the team were Nigerians except Dr. Camazine. This aspect of the trip is quite unique and we were very proud to get such a strong local participation.

2.     On 3/23/16, Dr. Camazine returned to the Nigerian Christian Hospital for a mission trip. During this 4 week trip, 11 Nigerian upper level healthcare workers participated including Drs. Jombo, Acho, Enyinnah, Akunekwe, Akpanudo, Madu, Nottidge, Oje and Nurse Anesthetists, Wilson, Uruakpa and Oje. Many nursing, medical and nurse anesthetist students were also present. Over 700 patients were treated and 147 operations performed. All members of the team were Nigerians except Dr. Camazine.

3.     On 5/29/16, Dr. Camazine returned to the Nigerian Christian Hospital for a mission trip. During this 4 week trip, 13 Nigerian upper level healthcare workers participated including Drs. Jombo, Dabs, Acho, Enyinnah, Akunekwe, Akpanudo, Madu, Unaka, Chidi, Nottidge, Oje and Nurse Anesthetists, Wilson, Uruakpa and Oje. General surgery residents from Federal Medical Center, Uhmaiha (Drs. Okpokiri, Chukwu, Nnana) started official 3 month rotations at the Nigerian Christian Hospital in order to get exposure to complex cases. Many nursing, medical and nurse anesthetist students were also present. Over 700 patients were treated and 121 operations performed.

4.     On 8/10/16, Dr. Camazine returned to the Nigerian Christian Hospital for a mission trip. During this 5 week trip, 13 Nigerian upper level healthcare workers participated including Drs. Jombo, Dabs, Acho, Akunekwe, Akpanudo, Madu, Nottidge, Oje and Nurse Anesthetists, Wilson, Uruakpa and Oje. General surgery residents from Federal Medical Center, Uhmaiha (Drs. Imahigbe, Udemezue and Orgi) came to get exposure to complex cases. Many nursing and medical students were also present. Over 700 patients were treated and 138 operations performed.

5.     On 11/1/16, Dr. Camazine returned to the Nigerian Christian Hospital for 4 weeks. During this 4 week trip, 13 Nigerian upper level healthcare workers participated including Drs. Jombo, Dabs, Acho, Akunekwe, Akpanudo, Madu, Nottidge, Oje and Nurse Anesthetists, Wilson, Uruakpa and Oje. General surgery residents from Federal Medical Center, Uhmaiha (Drs. Imahigbe, Udemezue and Orgi) came to get exposure to complex cases. Many nursing and medical students were also present. Over 700 patients were treated and 138 operations performed. This trip all the pathology was performed locally by Chidi Onwuka. MD, at Surepath Pathology Consultants.


PROJECTS

1.     Dr. Camazine has expanded the teaching opportunities in Nigeria by introducing “Surgical Workshops”. These are hands on teaching opportunities for Nigerian Surgeons and residents. Surgical colleagues from many different parts of Nigeria have been invited to join the team at the Nigerian Christian Hospital and learn from the unique surgical pathology. Physicians from Delta, Benin, Abia, River, Enugu, and Anumbra States have participated.

2.     Dr. Camazine, Eric Oje, RN, and Wilson Anyanwu, RN, have expanded the teaching opportunities in Nigeria by introducing “Anesthesia Workshops-Anesthetic Techniques for the Complex and Unusual Patient” These courses provide hands on teaching opportunities for Nigerian anesthesiologists, nurse anesthetists and nurse anesthetist students. Eric and Wilson are the best nurse anesthetist in Nigeria!

3.     Dr. Camazine continues his Blog on the work of Earthwide Surgical Foundation. It can be seen at www.earthwidesurgicalfoundation.blogspot.com. Dr. Camazine is also blogging on Facebook and this has been well received.

4.     Earthwide and the IHCF purchased a portable ventilator for NCH (AutoVent 2000). This will be very valuable for our patients who develop respiratory distress or who fail to wake up immediately from anesthesia.

5.  We are expanding our teleconsulting for difficult cases. Charlotte Jacobs, MD, oncologist at Stanford University, Charles Branch, MD, neurosurgeon at Wake Forest Baptist Health Center, John Melvin, MD, radiologist at ETMC Henderson, Ted Hopens, MD, radiologist at Central Texas Veterans Hospital, Louis Carter, MD, hand surgeon, Dr. Fred Mennick, plastic surgeon have been very helpful.

5.     The Nigerian Christian Hospital, with the support of Earthwide, has expanded its treatment possibilities by adding consultants in Urology (Dr. Achor), Orthopedic Surgery (Dr. Nottidge), Plastic Surgery (Dr. Akunikwe), and Pathology (Dr. Onwuka Chidi) Specialties already present are Pediatric Surgery (Dr. Emem), OBGYN (Dr. Oje), General/Thoracic/Head and Neck (Dr. Camazine) and Oncology (Dr. Jombo).

6.     Earthwide has started an Education Fund to help support the training of nurses and physicians. A Nigerian nurse is currently being supported for advanced training.

7.     General surgery residents from Federal Medical Center Uhmaiha are officially taking 3 month rotations at the Nigerian Christian Hospital in order to get exposure to complex cases. This is a new regulation determined by their Residency Review Committee. The residents are doing very well.

8.     The International Health Care Foundation and Earthwide Surgical Foundation purchased a SonoSite M-Turbo Ultrasound machine for the Nigerian Christian Hospital. Drs. Hopen and Melvin, in the USA,  have agreed to read our ultrasounds in order to improve our skills. In addition, our general surgery residents (above) will be taking online courses in reading ultrasound and reading the hospital’s ultrasounds.

9.     The International Health Care Foundation and Earthwide Surgical Foundation purchased a Welch Allyn monitor for the operating room at NCH.

10.  Dr. Camazine completed another book about his work at NCH.


GRANTS

1.     Ethicon Endo-Surgery/Johnson & Johnson, Inc. provided a grant (Grant Request #81618) to Earthwide for  needed GI stapling devices/laparoscopic equiopment for our gastrointestinal work.

2.     Cook Medical Group provided a monetary grant to Earthwide to support the work at the Nigerian Christian Hospital.

3.     Zimmer/Biomet provided a grant to Earthwide for an ATS Touniquet System.

4.     Jansport provided a grant to Earthwide to deliver backpacks to Nigerian students.

AWARDS

1.     In April, 2016, Dr. Camazine received an Award of Honour at the 50th Anniversary of the Nigerian Christian Hospital.

WHAT DO WE PLAN TO ACCOMPLISH?

  1. We are intensifying our efforts to obtain needed supplies and equipment. Many companies have been very generous.

  1. We will continue to branch out to additional areas in Nigeria and the world that are in need of surgical assistance. In July, ESF will collaborate with Professionals for Humanity for a surgical trip to Northern Nigeria.

  1. We will continue our efforts to train future generations of surgeons, anethetists and nurses in Nigeria.



Brian Camazine, MD
President, Earthwide Surgical Foundation
1933 Eastwood Drive
Henderson, TX 75652
254-718-0659
www.earthwidesurgicalfoundation.blogspot.com










     
      









11/28/2016

LAGOS

Lagos is a city in the Nigerian state of Lagos. The city, with its adjoining conurbation, is the largest in Nigeria, as well as on the African continent. It is one of the fastest growing cities in the world [and also one of the most populous urban agglomerations in the world. Eight million people are crammed into the city



11/05/2016

CONDITIONS

Many have asked about living conditions and working conditions. Here are some pics. For people interested, I also blog on Facebook. https://web.facebook.com/Earthwide-Surgical-Foundation-134981946573355/?_rdr



10/28/2016

PATHOLOGY

Without a diagnosis we know nothing!.

DESPERATE NEED FOR PATHOLOGY SERVICES
Earthwide Surgical Foundation is a non-profit 501(c)(3) organization dedicated to providing care to the poor of the world. Every other month for 4 weeks, Dr. Camazine goes to the Nigerian Christian Hospital to do surgery. The cases are often advanced and difficult. Proper pathologic diagnosis is critical so the patients can get appropriate postoperative treatment such as chemo or radiation. For the past 8 years, the Brigham and Women's Hospital has been graciously performing our pathology but this has come to an end. We are in DESPERATE need of pathological assistance. The work would involve 10-30 specimens every other month. There would be no rush as long as we could get results within one month. Getting involved would be lifesaving and a chance to be a teleconsultant on fascinating cases. If you can help, contact me-Brian Camazine, MD 254-718-0659, briancamazine@gmail.com.








10/02/2016

Terrible

This is not hidradenitis suppurativa! This man had this condition for 5 years before seeing us. We performed a radical debridedment and found that there was pyomyositis. In addition, pus tracked under the inguinal ligament into the pelvis-probably necrotic lymph nodes. After the debridement, simple dressing changes with honey cleared all the infection. He will be skin grafted in November. By the way, the same procedure was necessary on his right buttocks.




9/24/2016

PECTORALIS MAJOR FLAP FOLLOWING RADICAL PAROTIDECTOMY

This man required a radical parotidectomy for mucoepidermoid carcinoma. A pectoralis major myocutaneous flap was tthen used to close the defect. He is now receiving radiation.



9/17/2016

RETINOBLASTOMA






 This little child had a fast growing mass in the left orbit. We did an enucleation and the pathology showed retinoblastoma. The child is about to start chemotherapy and later, perhaps, radiation as well. Charlotte Jacobs, MD, at Stanford University, has been helping with post surgical treatment recommendation.


TRAM FLAP FOR FUNGATING BREAST CANCER

This delightful lady had a fungating breast cancer. She received 3 courses of chemotherapy followed by radical mastectomy. Ten days after surgery, Dr. Mishack Akunekwe and I performed a TRAM Flap. She is discharged home and doing well. Of course, she probably is not cured but her quality of life is astonishingly better. She will no longer have the smelly mass attached to her and be a pariah in her village.




8/08/2016

SUPPORT EARTHWIDE SURGICAL FOUNDATION

If you use the link below to shop on Amazon, a portion of your purchase will go to Earthwide without costing you anything!

SHOP TILL YOU DROP

7/21/2016

RETURN

I am returning to Nigeria on August 11. Many patients are waiting. Also, I am almost done with a new "picture book". Here is a small sampling.

7/12/2016

SONOSITE M-TURBO

We desperately need a new US machine at NCH. Our current machine is dead, The Sonosite M-Turbo seems to be the best choice for us. We have raised about $2000. It will cost $10,000 with probes. I am hoping to take this on my Aug trip. Please help! There are about 100 visits to the site daily. If everyone contributes $100 we can get it.

If you decide to help, send checks to Earthwide Surgical Foundation, Attn Brian Camazine, MD, 1933 Easywood Drive, Henderson, TX, 75652 OR donate dierectly to Earthwide via Paypal using briancamazine@gmail.com.


7/09/2016

HELP

YOU HAVE SEEN A SMALL SAMPLING OF THE PATIENTS WE ARE DEALING WITH BUT YOU DON'T KNOW THEIR STORIES. THE NIGERIAN MONEY, THE NAIRA, HAS DEVALUED GREATER THAN 50%. MANY PATIENTS CANNOT AFFORD EVEN THE LOW PRICES WE CHARGE AT THE NIGERIAN CHRISTIAN HOSPITAL. EVEN FEWER CAN AFFORD POSTOPERATIVE CARE SUCH AS CHEMOTHERAPY, RADIATION THERAPY, FOLLOWUP XRAYS OR EVEN CRUTCHES. PATIENTS ROUTINELY HEAL POORLY BECAUSE THEIR DIET IS LOW IN PROTEIN. I CONSTANTLY TELL THEM TO EAT 6 EGGS PER DAY BUT FEW CAN AFFORD THEM. PLEASE HELP. I WOULD LIKE TO RAISE $7500 BEFORE MY NEXT TRIP ON AUGUST 15. 

IF YOU CAN GIVE A LITTLE, PLEASE SEND A CHECK MADE TO EARTHWIDE SURGICAL FOUNDATION, ATTENTION BRIAN CAMAZINE,  1933 EASTWOOD DRIVE, HENDERSON, TX 75652 OR SEND A CONTRIBUTION VIA PAYPAL -BRIANCAMAZINE@GMAIL.COM. 
HELP THIS LADY GET SURGERY!
HELP THIS LITTLE GIRL GET CHEMOTHERAPY. HELP THIS GIRL GET HER FACE CORRECTED. HELP GET REAL CRUTCHES FOR THIS WOMAN!














7/08/2016

TRAM

AMARACHI

Amarachi came to us in September , 2015. She had been treated at another hospital and now had recurrent breast cancer on the right chest that extended almost to the axilla and was fixed to the chest wall. She also had breast cancer in the left breast.  Despite the situation, she had a very good functional status.

We decided to proceed with excision of the recurrence. Unfortunately, resection left a much bigger wound than I had initially expected. This was a significant problem because we wanted her to get healed as fast as possible so we could initiate chemotherapy.

While looking at the gaping hole we had produced, it occurred to me that we could do a TRAM Flap (transverse rectus abdominis flap). The TRAM, consists of the skin, fat, and muscle of the lower abdomen with its blood supply, which  is tunneled beneath the skin to the chest. This would be a perfect way to cover the wound with healthy tissue. The only problem was that I had never done this procedure before. After a few minutes of reading, we proceeded.

The flap was raised using the skin between the umbilicus and the pubic bone, keeping it attached to the rectus muscle. We then tunneled the skin to the chest and the skin paddle perfectly fit our surgical defect. We then closed all the wounds and Amarachi healed great. She had a nice tummy tuck as well.

In January, 2016, I returned to find her doing very well. She had actually added some weight and was healed. We then proceeded with a modified radical mastectomy on the left side.

When I saw her in April she was already back on chemotherapy . Her weight was stable and she had no signs of metastatic disease. Of course, statistics are not in her favor but she is living a healthy life and I expect she will be around for some time to come. She may dies from this cancer but she will avoid a fungating cancer on her chest .  Most importantly, she is happy with the results.








ORBITAL TUMOR

This little girl has a rapidly growing retro-orbital tumor. At a later time i will post her CT scan. She required enucleation. We are waiting on the pathology to determine future treatment. 

These tumors are rare but include  rhabdomyosarcoma, neuroblastoma metastases, optic pathway glioma, plexiform neurofibroma, leukemia, lymphoprolipherative disease, orbital inflammatory syndrome, dermoid and epidermoid inclusion cysts, and Langerhans’ cell histiocytosis. Vascular lesions reviewed are infantile hemangioma and venous lymphatic malformation.


7/01/2016

MALIGNANT PAROTID TUMORS

Parotid tumors frequently come to the Nigerian Christian Hospital. Parotidectomy is a technically difficult operation requiring dissection and preservation of the facial nerve. In the picture below I the facial nerve trunk can be seen at the clamp at 6 O'clock and major branches are visible at 5 and 8 O'clock. This patient had a superficial parotidectomy and the nerve was preserved.



Unfortunately, some of these tumors are malignant and require excision of the nerve with the tumor. This was the case with the following patient. Removal of the tumor not only required removal of the 7th nerve but also left a large defect.



We closed this defect with a pectoralis major myocutaneous flap:





The patient had a good recovery and will be ready for adjuvant radiation therapy much faster as a result of the flap coverage

MORE JAWS

Ameloblastoma is common in Nigeria. (see http://earthwidesurgicalfoundation.blogspot.com/search?q=ameloblastoma). Ameloblastoma (from the early English word amel, meaning enamel + the Greek word blastos, meaning germ) is a rare, benign tumor of odontogenic epithelium (ameloblasts, or outside portion, of the teeth during development) much more commonly appearing in the lower jaw than the upper jaw. Treatment is resection. This is well tolerated in patients who have a tumor on one side of the jaw since people can eat and speak quite well with half the mandible removed. Surgery is more difficult in patients who have a central ameloblastoma or one that is so advanced that surgery requires removal of the entire mandible. Nonetheless, these patients can eat well (especially since the favorite food is gari which is not chewed). Speaking is more difficult but still understandable.

The following old woman had a very advanced tumor that required near total mandibulectomy. She is doing quite well since surgery and is happy with the results.