Project Health for León

PO Box 1209 Greenville, NC 27835

EIN 56-1917546


November 14, 2016

2016 has been a very busy year for Project Health for León, and we would like to share our experiences with you. Many of you have been loyal supporters of PHL for many years, but we certainly welcome the interest and participation of new friends. As you may know, the goals of the organization are threefold:

1: To provide specialty and general health care to the citizens of Nicaragua,

2: To educate Nicaraguan and American medical professionals, and

3: To provide needed medical supplies and medications to health care facilities in the country.

Several groups travelled to Nicaragua this year to provide direct medical care which is often unavailable to Nicaraguans because of the general impoverishment of the country and the scarcity of medical resources.

In February and September, two large brigades arrived in León for two weeks. Through the years as our residents and fellows, and some veterans of the organization have dispersed across the country, the composition of the group has become more national in character, with participants from several states this year, though the core of the group is still mostly at Brody/ECU School of Medicine in Greenville, North Carolina, and in Raleigh.

The major activity was a cardiology clinic which evaluated and treated more than 400 adults and 125 children, most with serious valvular or congenital heart disease. An astonishing total of nearly ½ of these patients will need a surgical or catheter based procedure as optimal treatment for their problems. Our cardiac surgical colleagues were unable to join us in 2016 because our lead surgeon, Dr. Ted Koutlas, was deployed to Afghanistan as a surgeon for our medical forces. He returned safely, and he and his group plan to accompany us in February 2017 with the goal of performing 8-10 open heart operations in León. In the meantime, we are actively seeking additional surgical teams which could travel to Nicaragua to operate, and surgical sites in the U.S., though charity surgery in our country is in limited supply. Nonetheless, a Nicaraguan was treated surgically by Dr. Koutlas in Cour d’Alene, Idaho in 2016. Another option for children with congenital heart disease is Corazon Abierto, a fledgling organization which provides surgery for a number of young patients in the capital, Managua. PHL has supported this program for several years, and a generous PHL member again donated funds for several operations this year. In a new departure in 2015 and 2016, interventional cardiologists from UNC were part of our group, and they think it would be possible to treat some of these patients with catheter-based interventions, as in a cardiac catheterization. We are in the planning stages to make this type of treatment a reality in León in February 2017. Other clinical activities included ward rounds in the Rosales Hospital with the infectious disease and medical teams, several sessions working in a nearby Ministry of Health clinic in Poneloya, participation in the HIV clinic, and running two large medical clinics with a total of more than 200 patients seen. The nursing group also worked in the ICU and provided gynecology care. An electrophysiology group, led by Dr. Jeff Brumfield from Kentucky, has continued an ongoing project with an arrhythmia clinic, pacemaker and defibrillator implants, and plans to begin arrhythmia ablation procedures.

With respect to our educational goals, we brought a total of 11 medical students from Brody/ECU. Nine nurse practitioner students were part of the group in February. They all gained knowledge about medical care in a country with few resources. We also emphasize collaboration with our Nicaraguan counterparts, and promote the concept of interprofessional training among medical and nursing students. We receive excellent feedback from the students and use it to modify our practice and teaching there. Virtually all of the students report a very substantial medical and cultural experience in Leon. We meet with the Dean of the UNAN-León Medical School on a regular basis to discuss our collaboration. The nurses have established an extensive collaboration with their counterparts at Rosales hospital, including courses which they teach in León, video conferences originating in Greenville, and joint research projects. The improvement in nursing care and morale at Rosales hospital is apparent to many of us who have been going to León for many years. Every PHL group that goes to Nicaragua also carries supplies, often of considerable volume and value, necessary for their mission. Most of these materials are donated by hospitals and other organizations, and those purchased by PHL are often covered by a donation by PHL members. Furthermore, because the Rosales Hospital maintenance department has very few funds for purchase of needed parts for repair of necessary laboratory and radiology equipment, we frequently are able to purchase or receive donated materials to meet these needs, without which valuable clinical services would not be delivered.

We write with a dual purpose: To inform you of our activities and to request your personal and financial support. Although we negotiated very favorable pricing, we did expend considerable funds this year on equipment and supplies, virtually depleting our balance. The two echocardiographic machines that we and they use, and which are essential for cardiology there and around the globe, malfunctioned this year and were unable to supply us with satisfactory images. We have spent $5000 for repairs, and hope that one of the machines will function properly. The other is simply too old and must be replaced. We negotiated a very favorable price, $26,000, for a new machine and hope that it will function for very many years. When we are not in Nicaragua, the machines are used full time by our cardiology colleagues there. We may need to contribute expensive supplies for the interventional cardiologists who accompany us this year to perform their catheter-based cardiac procedures. In the current economic climate, it is becoming increasingly difficult to obtain donations from hospitals and medical schools, and in the future it may be necessary for PHL to buy more supplies for clinical work. Your tax deductible financial support will be increasingly important to us. We fully realize that you have many very worthwhile causes competing for your attention.

Here are a few reasons why we think we merit your consideration:

1. Project Health for León has no employees and its overhead is less than 1%. Board members are a major source of our financial contributions and do most of the work, including the physical part of obtaining and packing supplies. Participants in our trips to León fund their own trips; a few are funded partially, usually by extra contributions by one of the PHL board members. Therefore, contributions to PHL go almost entirely for our missions.

2. We do not bombard you with requests and ask for your financial support once a year.

3. We are constantly looking to expand what we are able to do. For example, we are actively soliciting more cardiac surgical teams to join us in meeting the urgent needs of our patients in Nicaragua, and are hoping to expand treatment options to include catheter-based procedures. We believe that what we have instituted in nursing education is making a real difference in raising the level of knowledge and competence of Rosales Hospital staff, and that the education programs have been very meaningful for both Nicaraguan and American students and residents.

4. We are persistent. Over the nearly 30 years since members of what became PHL in 1995 first went to León, we have never ceased in our efforts to meet our goals, and to change and expand. Many other groups have come and gone over that period of time. We have had successes and failures, but we have learned from all our experience and have not given up, in spite of some major obstacles. Many thanks for the opportunity to report to you on our efforts, to thank those of you who have been our faithful supporters, and to invite those of you who are new to us to consider your participation. That could be financial only or could indeed involve your professional input, if appropriate for the program. We welcome your inquiries. Best wishes for the holidays and for the coming new year.

______________________                                ______________________

John D. Rose M.D                                                 John A. Paar M.D.