Volunteer OB/GYN Helps on Tarawa; Observations Aim to Help Outcomes

One of our most highly regarded ob/gyns has returned home to Mount Sinai Hospital in New York after spending two weeks on far-away Tarawa in the Republic of Kiribati, helping the obstetrics department at the main government hospital there.

“It was a great experience and one that I hope to do again and again,” according to Dr. Maria Teaiwa-Rutherford, MD, assistant professor at the department of obstetrics and gynecology, Icahn School of Medicine Mount Sinai Hospital.

“I was there for two weeks and spent time with the obstetrics team consisting of two physicians, including one physician from Cuba who spoke no English or I-Kiribati, two registrars and four interns,” she said. Her observations, in her own words:

P.S. We at Pacific Islands Medical Aid were blessed to have found Dr. Maria. She has relatives who live on Tarawa in Kiribati. Hope she can return again and again.

By Maria Teaiwa-Rutherford, M.D.

Since they had midwives doing deliveries, they mostly needed my help with gynecology. We did rounds every morning on the in-patients, saw patients in the emergency room and gynecology clinics.

At the end of the day, I would sit with the interns on the labor floor and go over triage patients with them, taught them how to use the ultrasound (they rely on the ultrasound tech but I have always liked to do my own.) I think they enjoyed seeing that.

I taught the interns and residents some simple office procedures like endometrial biopsies. I think the hands-on teaching was much appreciated.

The power went out during a c-section surgery and I asked the people to shine their smartphone flashlights into the field.

The power went out during a c-section surgery and I asked the people to shine their smartphone flashlights into the field.

The attendings take calls every night for a week and all the C-Sections happen overnight so they are often tired and take breaks or nap which is totally reasonable. They gave me one day on the OR and I think it was a nice break for them.

The power went out during a C-Section and I asked people to shine their smartphone flashlights into the field.

I was shocked at the number of anemic patients admitted for blood transfusions. A typical admission was abnormal uterine bleeding with a hemoglobin of 6 requiring a blood transfusion. I saw probably 10 patients like this in two weeks. The blood bank cannot keep up with those demands and after the first unit of blood, the patient is told to go find blood donors.

Needed is education about diet and getting enough iron and vitamin C. The staple of rice and fish is not helping anyone’s iron stores!

I was also surprised at the volume of deliveries. The Tarawa Hospital does 150-200 deliveries a month and has a 15 percent C-Section rate.

Overall it was an incredible trip. I definitely plan to return.

Blind Islanders Can See Again; Team Performs 48 Surgeries

Helping the blind to see again.Few things are as rewarding as watching the joy on a cataract patient’s face when the bandages first come off and he or she can see again after being blind for years.

The expression of wonder and happiness makes all the effort worthwhile.

For the fourth time in six years, our great eye surgery team, led by Oregon ophthalmologists Dr. Paul Jorizzo and Dr. Paul Imperia, have returned home after completing 48 eye surgeries, this time on patients from Christmas Island (Kiritimati), Teraina and Tabuaeran in the Line Islands of Kiribati.

“Most were cataracts and the outcomes were universally excellent,” Dr. Jorizzo said, “with many patients seeing for the first time in several years.”

He said the excitement of people being able to return to their normal lives was contagious, “leaving us moved and feeling fortunate that we were able to participate in the experience.”

This year’s eye surgery expedition required a lot of pre-planning and organization, according to Carlton Smith, president of Pacific Islands Medical Aid, Inc. (PIMA) He said an advance team, led by long-time PIMA volunteer, general surgeon Dr. Larry Falk and ophthalmologist Dr. Jack Mason, traveled to Christmas Island (Kiritimati) and the neighboring islands of Tabuaeran and Teraina to examine and assess eye patients and prepare a list of patients for surgery back on Christmas Island.

Happy patients lined up, recovering. So excited to see again.Then, patients were brought by boat and plane to Christmas Island for surgery at the small hospital there, Carlton said, under the direction of the medical officer in charge for the Kiribati Ministry of Health, Dr. Teraira Bangao.

Surgery supplies and loaned equipment was provided by Seeing Eye Expeditions (SEE International) in Santa Barbara, California, “a wonderful organization that we have worked with over the years,” Carlton said.

In addition to Dr. Paul Jorizzo, Dr. Paul Imperia, Dr. Larry Falk and Dr.Jack Mason, the surgery team consisted of ophthalmologist Dr. John Welling, nurse Laura Imperia and nurse Jessica Jones, from Medical Eye Center in Medford, Oregon.

“We were blessed to have such a great team help the good people of Kiribati,” Smith said, “and we look forward to being able to continue this worthwhile effort.”

If a picture is worth a thousand words, we have attached a volume’s worth in our newsletter this edition. As you look at the faces, just imagine the feelings of the patients at the moment they are able to see again.

Here is Dr. Paul Jorizzo’s story, in his own words:

By Dr. Paul Jorizzo, MD

Our eye team returned to Christmas Island for the fourth time. Patients at Christmas (Kiritimati), Fanning (Tabuaeran) and Washington (Teraina) had been screened by Dr. Larry Falk and Dr. Jack Mason, who, in addition to addressing their medical needs, found 50 patients in need of surgery.

Happy patient can see again after cataract surgery.  Happy patient can see again after cataract surgery.  Happy patient can see again after cataract surgery.  Happy patient can see again after cataract surgery.

A substantial coordinated effort to get patients and supplies to Christmas Island was greatly aided by Dr. Falk, Carlton Smith at PIMA, Surgical Eye Expeditions (SEE) International and the motor sailing vessel Kwai.

High quality surgical microscopes and supplies arrived along with the patients from the outlying islands prior to our arrival.

Under the guiding eye of Dr. Teraira, Dr. Paul Imperia and Dr. Jack Mason efficiently performed pre-operative examinations and measurements. Dr. Larry Falk was miraculous in finding ways to make all of our equipment work.

From blind to sight, in one day!

Meanwhile, the operating room team of Dr. John Welling, Laura Imperia RN and Jessica Jones, RM, joined me in setting up the operating room to accommodate two patients simultaneously.

With surprising efficiency, we were operating the next morning. Thanks to excellent screening, the majority of patients were profoundly blind… many blind bilaterally.

With the help of the Kiribati nursing staff, we completed 48 surgeries in one week. Most were cataracts and the outcomes were universally excellent, many patients seeing for the first time in several years.

The excitement of people being able to return to their normal lives was contagious, leaving us moved and fortunate that we were able to participate in the experience.

Paul and I had visited Christmas Island on several occasions prior to our surgical trips and hoped to find a way to give back to the warm people that we had visited. We are so appreciative of Carlton Smith and Pacific Islands Medical Aid, and the wonderful team at SEE International for helping us fulfill our quest.

We look forward to our next trip.