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Month-long expedition aids islanders in need

One of our most prolific and well-regarded volunteer general surgeons, Dr. Larry Falk from the Ukiah (California) Valley Medical Center, has returned from a month-long assignment on Christmas Island in Kiribati, located in an isolated region along the equator in the Central Pacific.

“Dr. Larry’s dedication to the people of Kiribati led him to volunteer for an entire month, available for elective and emergency surgery while there,” said Carlton Smith, president of Pacific Islands Medical Aid, Inc. (PIMA).

Below are Dr. Larry’s observations:

Dr. Larry Falk: Volunteer general surgeon from Ukiah, California, shown here with a young Kiribati pneumonia patient, has just returned from a month-long expedition to Christmas Island in the Central Pacific.

Dr. Larry Falk: Volunteer general surgeon from Ukiah, California, shown here with a young Kiribati pneumonia patient, has just returned from a month-long expedition to Christmas Island in the Central Pacific.

An invitation from Dr. Teraira and Carlton Smith motivated me to accept an assignment as a volunteer general surgeon at Ronton Hospital on Christmas Island from November 17 Through December 16. Their surgeon from Cuba, Dr. Miguel, had taken an absence from the island, leaving the general surgical services uncovered. I leapt at the opportunity to help since I know from past experience how vital these services can be and how rewarding it is from a professional and personal point of view.

I have been on some one and two week excursions in the past, but this was my first try at four weeks. I wasn’t disappointed and had a productive trip.

The general surgical work comes in spurts and the complexity and nature of the cases is difficult to predict. There are cases of chronic and acute appendicitis, gallbladder disease, hernias and others. There is a disturbingly high incidence of diabetic foot infections, which frequently lead to amputations. At one point I accompanied Dr. Teraira in his capacity as Chief Medical Officer of the Line Islands to a fishing boat to examine the remains of a fisherman who had become despondent and, sadly had committed suicide. It was a somber excursion, to say the least.

I had occasion to rub shoulders with other aid workers on the Island. There was a group from the World Health Organization working to survey the effects and minimize blindness related to trachoma, an infection of the eyes. I went with them on a boat across the lagoon to Poland and participated in their clinics. I learned a lot about trachoma and felt a true sense of collaboration with the WHO team.

Saving Lives: Volunteer PIMA surgeon Dr. Larry Falk begins surgery while volunteer anesthesiologist Dr. John Rosoff looks on at left. Thanks to your donations, the Christmas Island hospital operating room was upgraded and equipped by Pacific Islands Medical Aid, allowing for more complex surgeries to be performed on the isolated island.

Saving Lives: Volunteer PIMA surgeon Dr. Larry Falk begins surgery while volunteer anesthesiologist Dr. John Rosoff looks on at left. Thanks to your donations, the Christmas Island hospital operating room was upgraded and equipped by Pacific Islands Medical Aid, allowing for more complex surgeries to be performed on the isolated island.

There was also a contractor from Australia, Simon Troman, whose company was working under a grant from New Zealand to improve the electrical services on the Island. Right now there are four separate generators, with different electrical standards and without interconnections among them. The goal is to standardize the grid, interconnect the generators and build new transmission lines. This will have important implications for Ronton Hospital, which currently suffers from periodic power interruptions.

There are obvious consequences of the current El Niño phenomenon affecting the people and their hospital. Complicated by sea level rise, the changes in the prevailing wind patterns are causing excessive rain, flooding and interruption of transportation and other services on the island. This is yet another of the challenging problems the people of the island face on a daily basis.

The new desalinization plant installed with support and funding from Pacific Islands Medical Aid is working to provide fresh water to the hospital. Taaren, the Clinical Engineer and Director of Facilities at the hospital, has been working through some technical details to ensure a steady supply of clean, healthy water.

We are working with the help of PIMA and Ukiah Valley Medical Center to bring Taaren to Ukiah, California, for a one-month work/study program with our Chief of Bioengineering, Jack Smiley. Jack and Computer Engineer John Reilly were on a recent PIMA team and have established a close personal and professional relationship with Taaren, which should yield important benefits to the program at Ronton Hospital into the future.

Helpful Hints: Volunteer anesthesiologist Dr. John Rosoff, on left, joined surgeon Dr. Larry Falk for one week of the month-long visit to Kiritimati, Christmas Island, and spent some of his time helping local medical officer in charge on the island, Dr. Teraira Bangao, shown on right.

Helpful Hints: Volunteer anesthesiologist Dr. John Rosoff, on left, joined surgeon Dr. Larry Falk for one week of the month-long visit to Kiritimati, Christmas Island, and spent some of his time helping local medical officer in charge on the island, Dr. Teraira Bangao, shown on right.

With the new Head Nurse at Ronton Hospital, Tomató, we were able to help with organizing and in making an inventory of medical supplies and equipment at the hospital. PIMA has plans to help install some new shelving and to streamline the supply and equipment procurement process to make it more efficient and useful to the doctors working at the hospital.

Overall, one gets the sense of growth and progress in the air at Ronton Hospital and on Christmas Island in general. Nevertheless, there remain major difficult issues that will need ongoing attention from the local people and professionals on the island their partners, of which Pacific Island Medical Aid stands out as a long-term and trusted example.

Renowned Heart Surgeon Volunteers on Isolated Isle

In the Republic of Kiribati, islanders suffer at an early age with heart disease, the result of early-undiagnosed rheumatic fever.

Without help to mend or replace diseased heart valves, many suffer and die in their 20s and 30s.

To save lives and help reduce suffering, highly-regarded cardiothoracic surgeon Dr. David Moore and his team from Baylor Heart Hospital in Plano, Texas will travel to isolated Christmas Island (Kiritimati) later this month to see and treat as many heart patients as possible, in a trip sponsored by Pacific Islands Medical Aid, Inc.

Thanks to Dr. Moore and his colleagues at Baylor Heart Hospital, islanders found to be needing urgent life-saving surgery will be treated at the hospital in Plano, Texas.

“We are absolutely thrilled at Dr. Moore and his team will be there to provide care where there is a critical need,” says Carlton Smith, president of Pacific Islands Medical Aid, Inc.

This will be the third time that Baylor Heart Hospital has stepped forward to help those suffering with heart disease in Kiribati, one of the most isolated and medically needy regions of the world, Carlton said.

On this one-week visit November 25 to December 2, he will take with him an ultrasound technician, James Rampoldi, from the Baylor Hospital, and portable equipment to properly diagnose heart patients.

While this will be Dr. Moore‘s first visit to Kiritimati in the Line Islands of Kiribati, he has contributed his skills in the past to perform successful open-heart surgery at Baylor on several patients from the islands needing life-saving help.

“The good-hearted people at Baylor will provide all medical care, but we need to raise funds to bring patients from the Central Pacific islands to Plano and back and provide housing and meals for them while they are in the U.S., Carlton said. On average, it will cost about $2,000 each for round trip airfare, plus another $500 for lodging and meals.

“Please help save precious lives by making a contribution to Pacific Islands Medical Aid and designate the donation for ‘heart patients.’

Thank you!

PIMA Volunteer Surgeon Works to Help Infrastructure

Good hearted general surgeon Dr. Larry Falk, from Ukiah Valley Medical Center in Ukiah, California, has added new dimensions to our medical team visits to the isolated nation of Kiribati in the central Pacific by concentrating on improving infrastructure at the small hospital on Christmas Island, as well as being available for emergency surgeries.

“Dr. Falk has volunteered his services to Pacific Islands Medical Aid, Inc. (PIMA) in Kiribati more times than any other physician,” said Carlton Smith, PIMA president, “and continues to be willing to help these good people in any way he can.”

In his most recent visit in July, Dr. Falk took with him two associates to help identify, repair and maintain vital equipment at the small hospital on Christmas Island (Kiritimati) by working with the bio-medical technician there. “This is a daunting task in a remote and harsh physical environment, but vital to the successful diagnosis and treatment of islanders there,” Dr. Falk said.

“It takes more than just medical personnel to make it happen,” he said. Here is Dr. Falk’s description of his most recent trip. He will be returning to Kiritimati in late November and December.

By Dr. Larry Falk, MD

With the support of the Kiribati Ministry of Health, Pacific Islands Medical Aid, Inc. and our hospital, Ukiah Valley Medical Center in Ukiah, California, a PIMA team of general surgeon Dr. Larry Falk, chief of biotechnology Jack Smiley and chief computer systems engineer John Reilly, spent a productive week working with the staff at the small, isolated Ronton Hospital on Christmas Island in Kiribati.

While we were there to offer general surgery support, a main focus was to partner with the new local biotechnician to review every piece of vital equipment and every computer to develop repair and maintenance procedures.

This is a daunting task in a remote and harsh physical environment such as exists on this beautiful coral atoll.

Jack and the local biomed tech, Taaren, worked on the dental x-ray machine, the operating room respirator, the new ultrasound machine, the wiring in the operating room, the operating room light, the OR sterilizers, lab machines and many other instruments.

Most importantly, the two developed a close personal and professional relationship, which is certain to pay off in the future in the form of advice, communication and mutual assistance.

John went through each computer in the hospital and cleaned them of malware and virus, significantly improving the performance of each of them. Through Ukiah Valley Medical Center, he provided the medical officer in charge, Dr. Teraira Bangao, with an up-dated laptop and desktop computer which he uses constantly as he administers the affairs of the Ronton Hospital in the Line Islands.

John has plans to send more updated laptops in the future for the use of key personnel and for use of PIMA teams in the future.

John also analyzed the connectivity capabilities on the island. The data transmission parameters were defined and optimized.

John will be working with other PIMA teams to facilitate transmission of x-rays, patient photographs and test results, such as echocardiogram reports. He will be making suggestions on how to optimize this all-important aspect of hospital operations.

With improved communication capability, it may be possible in the future to take advantage of telemedicine options through PIMA medical consultants, extending the range of services available to the people of Christmas Island.

Overall, it evolved into an extremely productive week of hard work and relationship building, with prospects for future collaboration that will benefit the good people of Kiribati.