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Another Shriners Miracle

Little six-year-old Raebine Tibweana has just returned home to Christmas Island in Kiribati after more than two months at Shriners Hospital for Children in Honolulu, where she underwent successful surgeries for two displaced hips and treatment for involuntary muscle contractions.

“It’s another miracle performed by the wonderful physicians and nurses at Shriners Hospital in Honolulu,” said Carlton Smith, president of Pacific Islands Medical Aid, Inc. (PIMA) “She’s on her way to recovery and will return to Honolulu in a year’s time for reevaluation,” he said.

Tebweana and other children from the isolated central Pacific nation of Kiribati needing orthopedic intervention come to Honolulu as a result of a special agreement between Shriners, PIMA and the Kiribati Ministry of Health, Carlton said.

Under this worthwhile program, Shriners sends physicians to Kiribati once a year to examine needy children and place them on a priority list for help. Shriners provides all medical care without cost, under the direction of chief of staff Dr. Craig Ono.

The Kiribati Ministry of Health pays for round-trip airfare for the child and chaperone (most often a parent), and PIMA takes care of visa fees and provides all necessary housing, transportation and translation services on Honolulu.

PIMA Heart Team Sees 177; Nine Require Cardiac Surgery

Our intrepid heart team has returned home after seeing 177 patients in a week’s time on isolated Christmas Island in the central Pacific, where they identified nine needing life-saving surgery.

Nine heart patients heading for surgery. Plans are underway now to bring the nine patients to Baylor Scott White Heart Hospital in Plano, Texas for surgery, says team leader cardiothoracic surgeon Dr. David Moore, M.D.

Team members on the island were divided into small units for their one-week stay and were able to perform 176 heart echoes on adult patients and 975 rheumatic heart disease-screening echoes for children at local schools on the island.

In addition, team members offered educational talks to teachers and students about rheumatic heart disease, its causes and cures… where many islanders suffer as a result of undiagnosed and untreated rheumatic fever in children that results in heart disease later in life.

Counseling Patient: Volunteer cardiothoracic surgeon Dr. David Moore, M.D., counsels patient on Christmas Island after tests show the patient needs heart surgery to correct the effects of his rheumatic heart disease. In just one week, the PIMA Heart Team saw 177 patients with 176 echos and 9 patients identified for surgery back in the U.S.

Counseling Patient: Volunteer cardiothoracic surgeon Dr. David Moore, M.D., counsels patient on Christmas Island after tests show the patient needs heart surgery to correct the effects of his rheumatic heart disease. In just one week, the PIMA Heart Team saw 177 patients with 176 echos and 9 patients identified for surgery back in the U.S.

“We are really proud of our professional team members who volunteered time and expertise in helping the good people of Kiribati, where the need it great,” said Carlton Smith, president of Pacific Islands Medical Aid.

The physician and medical officer in charge for the Kiribati Ministry of Health on Christmas Island, Dr. Teraira Bangao, says ‘the team worked very hard when they were here… they did a great job… starting out each day at 8:30 a.m. and working straight through to 6 p.m.”

“We are so thankful to the team members and everyone at Pacific Islands Medical Aid and look forward to their next visit,” he said.

In this humanitarian outreach, Dr. Moore and his team of heart surgeons at Cardiac Specialists in Plano, Texas and Baylor Scott White Heart Hospital in Plano will provide surgeries and hospitalization for the patients, while Pacific Islands Medical Aid provides all housing, meals and local transportation in the Dallas area for the patients and their chaperones, and the Kiribati Ministry of Health provides round trip airfare.

Please help support this life-saving program with your donation. Here is Dr. Moore’s report.

By Dr. David Moore, M.D.

Rheumatic heart disease remains a major global health concern primarily affecting young adults in the developing world.

This is particularly true in many of the islands of the central and western Pacific.

Our team from Baylor Scott White Heart Hospital in Plano, Texas recently returned to Kiritimati (Christmas Island) in the Republic of Kiribati with the support and coordination of Pacific Islands Medical Aid.

 

Team members included Dr. David Moore, CV surgery; Dr. Steve Mottl, cardiology; Michael Rampoldi, echo cardiographer, Candice Rampoldi, echo assistant and echo data collection; Amy Moore, trip coordinator and data management; Sherry Swanson, Baylor Heart Hospital social services; and Tom Roma, school education program.

Little Ones Included: All islanders, young and old, showing signs of possible heart disease were checked out by our volunteer heart team on their most recent visit to Christmas Island in Kiribati, where nine were identified for life-saving heart surgery back in the U.S.

Little Ones Included: All islanders, young and old, showing signs of possible heart disease were checked out by our volunteer heart team on their most recent visit to Christmas Island in Kiribati, where nine were identified for life-saving heart surgery back in the U.S.

In the course of our week on the island, we functioned as two teams; one evaluating patients in the clinic at Ronton Hospital and the other focusing on education regarding prevention of rheumatic heart disease (RHD) as well as echo screening in the primary schools.

Echo screening of asymptomatic children allows for early detection of RHD with the identification of subtle abnormalities in the heart valves. Children with these findings can then be started on prophylactic penicillin injections preventing subsequent episodes of Strep Throat and thus avoiding further immune response and valve damage.

A total of 950 children were screened by our team over a period of four days. At the same time, children, teachers and some parents received education on the prevention of RHD, emphasizing hand washing, appropriate coverage for cough, and the need to see a physician or nurse for treatment of sore throats.

At the clinic, our team evaluated and obtained an echo on 175 patients. Two children with congenital heart disease were identified, three adults with probable coronary artery disease and eight patients with rheumatic heart disease were diagnosed.  The adult patients will be brought to Baylor Scott White Heart Hospital in Plano, Texas for additional testing and surgery. The children with congenital heart disease will be referred to an appropriate facility for surgical correction.

Our team appreciates the opportunity to continue this good work made possible by Baylor Scott White Health Care System, the Republic of Kiribati Ministry of Health and Pacific Islands Medical Aid.

We are grateful to the people of Kiritimati (Christmas Island) for their warm hospitality and support.

Diabetes Attack Team Plans Twice Yearly Expeditions

Plans are now nearing completion for a comprehensive campaign to fight diabetes in the Line Islands of Kiribati, where adult onset rates are among the highest in the world… more than 30 per cent of adults suffer with Type 2 adult onset diabetes, according to results of our recent Pacific Islands Medical Aid studies.

Our PIMA team plans to spend two weeks on Christmas Island (Kiritimati), Tabuaeran and Teraina this August and return to the islands twice each year for follow-up and training.

“We are very proud to announce the formation of a top-notch team to help address this critical need, invited by and working alongside Kiribati Ministry of Health personnel in the islands,” said Carlton Smith, president of Pacific Islands Medical Aid.

“Leading the team is Dr. Elizabeth Beale, diabetologist and professor at the University of Southern California, who has been to Christmas Island previously to study the effects of this terrible disease on the local population and begin planning a comprehensive program to help alleviate the suffering,” Carlton said.

Joining Dr. Beale is Dr. Julie Chatigny DPM, podiatric specialist with Central Coast Foot and Ankle Specialists in California and Dr. Michael Goran, PHD, Professor of Preventive Medicine, Childhood Obesity Specialist. University of Southern California.

Diabetes Team Planning: In one of several planning meetings to prepare for upcoming Diabetes Team expedition to the Line Islands in Kiribati this August are (from left) Dr.Lydia Lam, trauma and critical care professor at Keck School of Medicine, University of Southern California; Dr. Julie Chatigny, podiatric specialist, Central Coast Foot and Ankle Specialists; and Dr. Elizabeth Beale, endocrinologist and professor at University of Southern California.

Diabetes Team Planning: In one of several planning meetings to prepare for upcoming Diabetes Team expedition to the Line Islands in Kiribati this August are (from left) Dr.Lydia Lam, trauma and critical care professor at Keck School of Medicine, University of Southern California; Dr. Julie Chatigny, podiatric specialist, Central Coast Foot and Ankle Specialists; and Dr. Elizabeth Beale, endocrinologist and professor at University of Southern California.

Helping put together this great team is our Pacific Islands Medical Aid Director of Medical Service, Dr. Lydia Lam, MD, FACS, professor of Clinical Surgery and Emergency Medicine at Los Angeles County-University of Southern California Medical Center. She is also associate program director of the Trauma/Critical Care Fellowship at the Keck School of Medicine, University of Southern California.

Dr. Beale said the mission approach will include a clinical program for adults and research-based prevention program in children and adolescents.

In the clinical program, Drs. Beale and Chatigny will visit Kiritimati and outer islands for two weeks and conduct one-day clinic and educational sessions at the various villages. They will focus on consolidating work initiated in foot care in 2017, identifying patients at risk for diabetes related foot problems and how to reduce the risk of foot injury and amputations.

Dr. Beale will also evaluate management of diabetes in pregnancy and both will conduct an initial assessment of diabetes on the outer islands of Tabuaeran and Teraina.

Dr. Beale said that Dr. Goran visited Christmas Island in March of 2017 and assessed nearly 400 school children where a high prevalence of pre-diabetes was identified.

This year, she said, children will be re-evaluated with A1C testing and those with diabetes will be referred for medical care.

Additionally, she said, annual visits under the direction of Dr. Goran will conducted to maintain a data base to track diabetes development in the school children and effects of interventions.

Children from Tarawa Get Heart Surgery

For the parents of 2 year old Iotua Nenetaake and Bwabwane Meeia, 10, it’s a dream come true that their children have been saved, thanks to the efforts of Pacific Islands Medical Aid, the leader of HeartGift Texas and heart surgeon Dr. Camile Hancock Friesen at Dell Childrens’ Medical Center of Central Texas in Austin.

Ready to Go Home - Children from Tarawa in Kiribati are ready to go home after successful heart surgery in Austin, Texas. Sitting between children is their heart surgeon, Dr. Camile Hancock Friesen of Dell Childrens Medical Center of Central Texas. Second from right is Sonya Keeling, International Director of HeartGift of Texas, who arranged help for the children. Others include parents of the children and Kiribati Ministry of Health nurse/translator.

Ready to Go Home – Children from Tarawa in Kiribati are ready to go home after successful heart surgery in Austin, Texas. Sitting between children is their heart surgeon, Dr. Camile Hancock Friesen of Dell Childrens Medical Center of Central Texas. Second from right is Sonya Keeling, International Director of HeartGift of Texas, who arranged help for the children. Others include parents of the children and Kiribati Ministry of Health nurse/translator.

The children, their mothers and Kiribati Ministry of Health nurse have now all returned to their home island of Tarawa in the Central Pacific following successful heart repair surgery for both children.

Congenital heart problems for each child were first discovered by our volunteer heart team leader, cardiothoracic surgeon Dr. David Moore of Baylor Heart Hospital in Plano, Texas and his team, traveling to far-away Tarawa last year.

Surgery was made possible with the help and leadership of Ms. Sonya Keeling, national patient coordinator for HeartGift Texas, who’s efforts made it possible for the children to come to Dell Childrens’ Medical Center.

Ms. Keeling said both children “were amazing in their recovery from surgery. Having them here has been such a great experience for all of us involved,” she said.