Project Health for León

PO Box 1209 Greenville, NC 27835

EIN 56-1917546


October 17, 2017

2017 has been a very active year for Project Health for Leon, 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.

In terms of the third goal, to provide supplies, 2017 was a very rewarding year. As usual, we provided needed supplies to the laboratory and other medical facilities in the medical school affiliated hospital, brought medications, and obtained supplies for our clinics and hospital procedures, including pacemakers, defibrillators, heart valves and other surgical supplies. Some of these were donated by hospitals and manufacturers, others purchased by PHL. We were able to purchase two new echocardiogram machines, essential for our cardiology and cardiac surgery program, to replace two older machines which had worn out and no longer supplied the image quality required. We were able to pay the Central American price, less than half of what we would have paid in the U.S., but still expensive and supported by your generous contributions. These machines are carefully supervised by a Nicaraguan cardiologist, and provide useful information even when we are not there. We have even more ambitious goals for the rest of this year and next. We need another echo machine, as two adult teams and a pediatric team need to work together when we are on a medical mission to the country. Even more importantly, the C-arm X-ray machine which provides portable X-rays when we are not there, and is necessary for our catheter based interventions and electrophysiology services, has been reclaimed by the donor organization, and moved permanently to another hospital. These devices are expensive, in the range of $35,000, but are essential for us, and we are seeking funds to purchase one and send it by container to Nicaragua in the next several weeks.

Several PHL 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 Leon: for three weeks in February, and two weeks in September. As before, the majority of our group members are from North Carolina, but we do have participants from several states, virtually coast to coast. The major activity was the cardiology clinic, which evaluated and treated more than 500 adults and 125 children, most with serious valvular or congenital heart disease. Impressively, more than 100 of these patients will need a surgical or catheter based procedure as optimal treatment for their problems. In February, our surgical team, led by Dr. Ted Koutlas, performed 11 procedures, mostly valve replacements. The ability of this team to perform these complex procedures efficiently and well within 5 days is little short of amazing. Also significantly, an interventional cardiology team from UNC, led by Dr. Mike Yeung, Dr. Alan Hinderliter, Dr. John Vavalle, and Dr. Lucius Howell, were able to perform 4 catheter based interventions to open diseased mitral valves, a first for Leon, and with great results. In September, two other UNC participants, Dr. Elman Frantz, and Dr. David Tate, accompanied us. Dr. Frantz plans to return in February to perform additional catheter based procedures, including opening obstructed pulmonary valves and closing defects between the two upper chambers of the heart.

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, and running several large medical clinics, with a total of more than 200 patients seen. The nursing group also provided gynecology care. An electrophysiology team, led by Dr. Jeff Brumfield, now practicing in Florida, has continued an ongoing project with an arrhythmia clinic and pacemaker and defibrillator implants. His group was larger this year, and he was accompanied by a colleague, and they were able to perform the first ablations (catheter based electricular termination of arrhythmias) in Leon. Dr. Brumfield also made shorter trips to Leon to provide particular procedures.

With respect to our educational goals, we brought a total of 9 medical students and 6 nurse practitioner students from Brody/ECU. 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, to my knowledge the largest such participation in our school. 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 also meet with the Dean of the UNAN-Leon medical school on a regular basis to discuss our collaboration, and hope to bring two Nicaraguan students to Brody/ECU for a rotation this spring. The nurses, led by Dr. Debra Kosko, have maintained their extensive collaboration with their counterparts in the Rosales hospital, including courses which they teach in Leon. A joint paper was published by this international group this year. The improvement in nursing care and morale at Rosales hospital is apparent to many of us who have been going to Leon for years.

We write with a dual purpose: To inform you of our activities, and to request your personal and financial support. As I mentioned earlier, we expended considerable funds for supplies last year, and have even more ambitious goals for the coming year. In addition, we may need to contribute additional funds to the interventional cardiologists, electrophysiologists, and surgical colleagues. In the current economic climate, it is becoming increasingly difficult to obtain donations from hospitals, medical schools, and manufacturers. 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 Leon has no employees (aside from my former secretary, now retired, who provides some secretarial support for a small fee). 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 Leon fund their own trips; a few are funded partially, usually by extra contributions by one of our 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 only once a year.
  3. We are constantly looking to expand what we are able to do. For example, we continue to actively solicit more cardiac surgical teams to join us in meeting the urgent needs of our patients in Nicaragua, and hope to expand what our interventional colleagues are able to accomplish. We believe what we have instituted in nursing education is making a real difference in raising the level of knowledge and competence of the 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 Leon, 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. However, we have learned from all our experiences 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. The participation could be financial only, or could involve your professional input, if appropriate for the program. We welcome your inquires.

Best wishes for the holidays and for the coming new year.


Best Regards,

______________________                                ______________________

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