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AusHeal Blog
March 2018 Update
Dr Neil & Gwen Wetzig write from HEAL Africa Hospital (HAH) Goma DRCongo:
AusHEAL …
Practical Training in Surgery – Neil's Story of the week …
…..A milestone medical event for HEAL Africa Hospital during the week. A 14-year old boy was hit in the head by a stone and languished in another hospital for 24 hours before arriving at HAH at midday on Tuesday. He was assessed; had a CT scan of his head in the newly functioning scanner; was taken to the operating theatre for emergency surgery to drain a large extra-dural haematoma (blood clot) from his head to save his life…. with minutes to spare as he had a cardiac arrest as he was being anaesthetised.
…..All completed by 4.30pm. He was stable Tuesday night. Although perhaps commonplace in the developed world, this was a unique experience for DRCongo and excellent teaching experience for our COSECSA trainees and other theatre staff. One young life saved is worth fighting for!!
…..One of the problems with any trauma is how quickly the correct initial treatment can be administered. As can happen in Congo, the 24 hours delay for this teenager resulted in early damage having already occurred prior to his arrival at HEAL Africa. Sadly, this boy died during the following Wednesday night due to the original injury accentuated by treatment delay.
COSECSA surgical training:
….. Senior Trainees sat a trial MCQ (multiple-choice questions) test last week in preparation and training for their written exams during the first week of September this year. The questions were really tough – but toughness toughens them up to work hard and get some insight into what to expect.
….. Meanwhile the Junior Trainees (beginning this year) sat their 'Pre-Test' as an indicator of their current knowledge and understanding coming into the first year of the COSECSA course.
….. Both Seniors and Juniors are already a united group – helping and supporting each other.
….. Gwen attends each of the Training Sessions and notes any difficulties with English – spelling, pronunciation and use of words. Following surgical training, she runs a 15-20 minute session teaching pronunciation, spelling, grammar etc. We all enjoy these sessions with much humour and interaction (and learning too of course!!!)
AMC Congo held a Clinical Day today at HEAL Africa:
….. Dr Neil was invited to speak about COSECSA – not only the basic essential & emergency surgery teaching program at HAH, but also in the context of HAH beginning to help address the global burden of unmet surgical needs – which are highest in Sub-Saharan Africa and India.
ANNUAL MEETING of the HEAL Africa ASSEMBLIE GENERALE (Board):
Annual Reporting….. The 2-day meeting of the Assemblie General (AG) is preceded by a reporting day for the different 'services' (or departments) of HEAL Africa to present their annual reports to the AG. This was a great opportunity to hear about the enormous work being done by both the Hospital and the Outreach Programs. – and also now the newly formed HATS (HEAL Africa Training Scheme).
The HATS Management Team (HEAL Africa Training Scheme) met recently to prepare their report for presentation at the annual reporting day. A great encouragement was that Dr Medard (HAH surgeon) led strongly and facilitated each Training Department to report a brief summary of 2017, outline objectives for 2018 and also mention any anticipated challenges. He and others had learned this reporting & planning strategy from the HA Chief of Operations – Patrice. How satisfying to see the Congolese sharing their strengths with each other, taking initiatives and becoming much more effective.
A desire to conduct research and write papers is also increasing. It was reported that 8 HEAL Africa staff had written and presented papers to various clinical meetings and conferences.
HEAL Africa Board visitors from the USA & UK:
The visiting USA medical team included 2 general surgeons, a family physician with his son (a physician's assistant), and a plastic surgeon with his wife & daughter (both physicians' assistants) providing excellent contributions to teaching and care in their areas of expertise.
Some together with the visiting CEO of HEAL-Africa-USA are members of the HEAL Africa AG timing the US team visit to coincide with the annual board meeting. Also present were AusHEAL's David Kelly (& wife Heather Kelly) together with two representatives from the newly formed HEAL Africa-UK Board (Paluku Lusi and Martin Healy).
An important outcome was improvement in international relationships between DRCongo, USA, UK and Australia.
HATS-AusHEAL Training Centre:
Plans have been drawn and approved for the new storey to be built. Funding has been sent from AusHEAL in Australia to HEAL Africa to enable the project to proceed. Building materials are being purchased. Scaffolding is being collected close to the construction site. Staff are being notified that a temporary roof will be put in place over the existing Outpatients building so that no-one will need to evacuate during construction of the top floor for the Training Centre. Preliminary infrastructure will be put in place by the end of this week. Construction is scheduled to commence on Monday 26 March.
International Women's Day:
Gwen was able to attend the International Women's Day celebrations by HEAL Africa women on Saturday 10 March at Maji Matulivu beside Lake Kivu. Chairs were all in place by 8.45am ready for the 10 am start. At 10 am there were 2 women sheltering in the shade of our balcony. By 10.45 a few more ladies arrived and finally things got underway about 11.30am. There was joyful praise and worship, greetings and prayer.
One of the female doctors spoke about 'Stress' while another recently returned female specialist paediatrician spoke to the gathering on women's health matters (with some added encouragements from the HA physiotherapist about specific women's issues. A lot of laughter coming from the women!!) All this was followed by fun and games, skipping, frisbees and dancing. Then at about 3pm lunch was served (scheduled on the program for 12.30pm). All in all, a great day, and anyway, who cares about 'time' in Africa?
There is a saying that "God gave us Westerners watches….. but He gave the Africans TIME!" How true it is.
Beauty Queen gives back … A few years ago, Gwen happened to be in the HEALing Arts sewing room when she met 'Mrs Africa Queen 2014' – from South Africa. Coincidentally a couple of weeks ago, this beauty pageant winner showed up again with a film crew and was offering to support one area of the work of HEAL Africa – an area that does not attract external funding as it is not considered a disability – large neck goitres from diet-indices thyroid disease. Although this disfigurement is not regarded as a disability, the stigma attached to the problem of large goitres, particularly in women, is debilitating. It destroys a woman's beauty and may often preclude a woman from getting married.
They were particularly impressed at being able to meet the women, and to see and film thyroid surgery being conducted. She intends to spread the word about the plight of some of the poor Congolese who suffer from this condition and to raise support to bring healing and wholeness to these people.
"The Rains came down and the Floods came up"
During a Tuesday morning Chapel service recently, there was a huge storm. Water began pouring in through the roof in a number of places. Thunder roared over the already very loud loudspeakers, then lighting struck with an electrical flash inside the building. Everything went quiet – well it went quiet inside the chapel, while outside the heavy rain continued pelting down on the roof, through the roof, and gradually flooding the front of the church. With the electrical equipment not working, the chapel brass instruments struck up in praise and worship, and singers gradually moved to the front and began singing, soon to be joined by the Uamsho dancers (ex-street boys) singing and dancing in the water! Just another sign of the resilience of the Congolese!
Nearby volcanoes continue the reminder of multiple risks for the people of Goma and visiting international teams.
Posted by ausheal on March 31, 2018
February 2018 update
Neil & Gwen Wetzig have returned to HEAL Africa Hospital in Goma DRC for a further 2 months.
Gwen writes: " we are again becoming accustomed to the unruly motorbike riders… impatient drivers… honking of horns… the smell of smoke… UN cars, trucks and helicopters …
… and … instead of a policeman directing traffic at the main busy intersection going into the town, Goma's first traffic lights have been erected – in the form of a 'robot' policeman in a tower. He moves 90° towards the oncoming traffic showing a green light or a red light. We have never seen anything like it before. Apparently, a female student from the capital, Kinshasa, designed the robot. Does everybody obey?? One still has to be very diligent when passing through this intersection. But it looks great!!! (Post-script…… the robot lost power in a recent storm and is now not working!!)"
3 new Trainees have begun the basic surgical course this year from the College of Surgeons of East Central and Southern Africa – one female and two males. One of the new trainees has been a medical student interpreter for our teams in previous years. Dr Neil began teaching them basic anatomy last week. The interactive style of teaching has been helpful. The nearby UN hospital Commanding Officer (a Colonel) is a Professor of Anatomy who is willing to assist with anatomy training. It has been encouraging to see the improvement in English of the senior Trainees who have been having English lessons since starting the course.
HATS (AusHEAL) Training Centre: (HATS = HEAL Africa Training Scheme)
… Thanks to the generosity of Gateway Baptist Church in Brisbane through their Christmas appeal, HEAL Africa is now able to commence the construction of a Training Centre which will provide space and facilities for training doctors, nurses, paramedical staff, chaplains and admin staff. The Training Centre will form the new top floor of an existing building.
… Currently there is only one space available for training and it is often required simultaneously by many groups. The new facility will include a large conference room, smaller training rooms, a skills laboratory, library & reading room and the AusHEAL office.
… The HATS Committee is excited to be able to increase training opportunities for both HEAL Africa staff and in time for other hospitals in Goma and surrounding areas.
… A special meeting of the 'Building Committee' (pictured right) (technical, admin, finance, procurement, building and architect) was such an encouragement with so many HEAL Africa staff ready and willing to co-ordinate the commencement of this project.
Practical Training in Surgery…
Dr Neil arrived at the Hospital to find neither of the staff general surgeons in town. Dr Luc remains in Canada undertaking his PhD. Dr Medard was away on one of the hospital's 'surgery outreach' teams. Surgical cases continue to provide opportunities for practical 'hands-on' teaching and training for the COSECSA surgical Trainees.
Neil's Story of the week……
… "In October last year, I was asked to see a 3-year old boy in the paediatric ward. I was told that he had a large heart, heart failure and pus in the left side of his chest. He had apparently been diagnosed with TB. I was informed this was a medical and not a surgical case. I was simply requested to insert a tube to drain the pus from his chest. The pus was drained. Unfortunately, the child managed to pull out his chest tube 2 weeks later. I inserted another tube. He was so ill that I thought he was going to die.
… Last week, he appeared in the paediatric ward as an outpatient. I was told that he had been leaking food from where his chest tube had been. I was astounded to discover this – so now this was obviously more of a surgical problem. The clinical situation did not make sense. The surgical trainees were given the task of taking a thorough history of his problems. The child had not been eating food well and in September last year, before being admitted to HEAL Africa Hospital, his mother took him to the 'traditional healer' in his village, who gave him some strong potion to drink. To cut a long story short, it now appears that much of his problem stems from the fact that he was given some form of corrosive drink, which subsequently has eaten a hole in his oesophagus. The original diagnosis in October last year was incorrect.
… when I explained he needed another chest x-ray, I was told, as I was last year, his mother was so poor she could not afford for him to even have a chest x-ray. Soon after this I was called away. About two hours later I was shown a chest x-ray of this young boy that clearly showed he needs more treatment. When I asked how his mother had afforded this x-ray, I was told that the female nurse who had been on the ward round with us that morning was so upset that his mother could not afford this simple test, she had gone around other staff members and patients and collected money to pay for the chest x-ray!!
… Clearly the young boy will need further investigations and further surgical treatment. This story underlines several problems….firstly, no-one had taken an accurate history from his mother in the first stage, even though he was in hospital for 3 months; secondly, it underlines the degree of poverty that prevents a child having even a simple chest x-ray. This is where the AusHEAL Hospital Patient Fund can be truly effective by providing funds for what may be quite complex management of a very poor patient, while at the same time providing an excellent teaching opportunity for HAH staff. This little boy needs further treatment in the weeks, months and possibly even years ahead, and only time will tell whether he will survive – but at least we can give him a chance, now that we know the full story.
… What really makes this the 'story of the week' is the attitude of the nurse, as it shows great care and compassion, intervention and ingenuity!"
The most prominent feature at HEAL Africa at present is the massive building program.
… A new Fistula Building (foreground of photo right) funded by the Fistula Foundation will enhance the treatment and care of a common health problem in eastern DRC – that of women who have suffered a fistula resulting from poor childbirth or sexual violence.
… Also a 3-storey Women's and Children's Inpatient Building (pictured right behind the Fistula building) funded by a donor in USA, will increase the capacity for treating a major sector of the community – women and children.
… So the addition of the new Training Centre will increase the building activity around HAH – but all to enhance opportunities for improved patient care.
- Dr Marlene has returned to HAH from her specialisation training in Paediatrics. She is a welcome addition to the staff, especially with the new building program emphasis on women and children.
D.R.Congo …
… The Churches of DRCongo (Catholic & Protestant) and even Muslims have called for 'silent protests' across the country on Sunday 25 February. There is still no certainty as to the political situation and no absolute guarantee that elections will occur in December this year. It is anticipated that all communication will be cut on Sunday.
Posted by ausheal on March 7, 2018
AusHEAL MOVING INTO 2018
Lots of activities already including:
Preparation for the Year
- November 2017 — APRAM: the AusHEAL Planning and Reporting Annual Meeting. Members of the 2017 teams gathered to reflect on the achievements of the year and began to bring together strategic plans and suggestions for 2018 and even longer term
- December 2017 — the AusHEAL Board met. Dr Neil, Board member, had returned from 4 months overseas, and was able to give a first hand report of AusHEAL in Goma DRCongo
- January 2018 — the AusHEAL Congo STEERING COMMITTEE met to discuss outcomes of the APRAM meeting and lay down operational plans for the year ahead including the draft budget to be reviewed by the Board
- January 2018 — the AusHEAL Board met, reviewing the above, finalising due annual reports and laying out AusHEAL's future timetable
- In the midst of these meetings and the preparation required for them, governance & operational personnel continued to meet with various people, both potential medical volunteers and others. We see this as a way of maximising effective medical work, both at HEAL Africa Hospital and in central Africa generally, by seeking opportunities to network. Our aim is to make the most of opportunities that come across our path.
The Year Begins !!
- January 2018 — Teams 'Interest Meeting' held for people who over the past year or two expressed interest in joining an AusHEAL team – 14 new interested people attended (out of which about 11 have committed to be part of a team in 2018 or early 2019)
- January 2018 — AusHEAL received a donation of A$150,000 from Gateway Baptist Church as a result of their "Hospitals of Hope" Christmas Appeal. The funds were raised to support the building of a permanent training centre at HEAL Africa Hospital (HAH) to house both AusHEAL's educational involvement of national staff and HEAL Africa's own outreach educational program to provincial health personnel – i.e. HATS: the HEAL Africa Training Scheme. Construction is due to begin in the second quarter of this year.
- We are grateful for the generous donations of Brisbane people as an expression of their christian faith during the Christmas season
- February 2018 — AusHEAL 2017 AGM with presentations to supporters. Invitations were extended to previous attendees of our Fund Raising Dinners. An excellent opportunity for one-on-one interaction between supporters and volunteers involved in DRCongo
- February 2018 — Team Training Session #1 was attended by 20 team members, keen to be involved, somewhat nervous about the unknown, but enthusiastic about the opportunities. Team training & preparation is a pivotal & essential aspect of all AusHEAL volunteers' involvement in our overseas aid every year. Training takes the form of 5 half-day and 1 whole-day sessions. Beneficial medical, nursing and para-health expertise sharing is not a matter of fly-in/fly-out but a relationship of repeated visits, mentoring and encouragement of national professionals in a culturally appropriate manner.
- February 2018 — Dr NEIL & GWEN WETZIG leave for 2 months in Goma DRCongo at HEAL Africa Hospital with Neil involved in surgery and the training of the COSECSA surgical trainees. Gwen continues to administer the J730N AusHEAL Congo Project, tutor in English and interact with the financial department of HEAL Africa
- February 2018 — DAVID & HEATHER KELLY leave to return to HEAL Africa for 3 weeks in March. David will continue his hospital administration interaction. As a member of the HEAL Africa Assemblie Generale (HA Board) he will be present for its international annual meeting on 7-9 March. Heather will continue with her English tuition.
Building Programs
- AusHEAL-HATS Training Centre to begin construction as outlined above
- Women's & Children's In-Patient Department, a 3-storey building currently under construction sponsored by a generous grant from a USA donor
- Women's & Children's Out-Patient Department, another 3-storey building. Construction to begin this year, following the 2016 visit by Princess Caroline of Monaco ,and subsequently funded by the charity her mother, Princess Grace, founded : the Amade Mondial foundation
- Fistula Care Building, currently under construction for the specific care of women suffering from vaginal fistulae, funded by The Fistula Foundation
- 2 newly trained and internationally qualified female medical specialists return to HAH this year to begin work.
- Dr CATHY — Obstetrician & Gynaecologist
- Dr MARLENE — Paediatrician
- COSECSA – the specific training & qualification of regional doctors from North Kivu Province in DRCongo in essential and emergency surgery.
- The HEAL Africa Hospital course & curriculum accredited by COSECSA, the College of Surgeons of East, Central and Southern Africa, began as a combined initiative of the HAH executive and Dr Neil Wetzig with an ongoing seeding grant from AusHEAL.
- The three current trainees of the inaugural 3-year course enter their final year this year. they are due to sit their final qualifying COSECSA exam at the end of 2018 before moving out to regional North Kivu. 3 new COSECSA surgical trainees have been accepted onto the program, commencing their training in 2018. Their photo below with Dr Neil.
Posted by ausheal on February 17, 2018
November News — Neil & Gwen Wetzig
Technical questions to/from team member, Paul Bakes, in Brisbane re safety of IT (Information Technology) cabling during demolition
English sessions with Gwen after COSECSA Trainee sessions help build confidence in speaking/presentations (COSECSA: College of Surgeons of EAST, CENTRAL & SOUTHERN AFRICA)
Anaesthetist from Sydney, Dr Peter Tralaggan, at HAH (HEAL Africa Hospital – DRCongo) for 2 weeks teaching/training the Nurse-anaesthetists
MAP documents (Monitoring/Accountability/Planning) being analysed from 2017 Team Members
Surgical teaching/training continues under the mentorship of Dr Neil Wetzig, clinically & with COSECSA
Australian partners, Global Development Group (GDG) conducted 'Monitoring Visit' in early October
Understanding relationship between HAH & AusHEAL to review current MoU Memorandum of Understanding
Short-Term Development Grants (STDG) continue to attract interest from staff wishing to improve their clinical skills
HEAL Africa Hospital Senior Staff request AusHEAL to continue their valued partnership, support & assistance
Engineer from Oxair in Perth, WA, visited to install & connect the Oxygen Plant – cylinders filling now!!
Accounts being reconciled and finalised before Gwen departs on Friday 10 November to return home
Loyal donors enabling the AusHEAL Patient Fund to pay medical expenses for genuinely very poor patients
HATS (HEAL Africa Training Scheme) – Dean of HATS, Dr Luc Malemo, begins PhD in Montreal, Canada
Education of hospital children – Tuungane School relocated from Hospital compound – now next to Chapel
Action happening on the hospital compound – 2 buildings demolished preparatory to new construction
Lava strike!!! Digging old foundations and struck the layer of lava flow from the Volcano in 2002.
Architect designing plans for new AusHEAL/HATS Training Centre due for construction early 2018
Focus on Fistula – training/mentoring visit from Medical Director of Hamlin Fistula Hospital in Addis Ababa, Ethiopia
Relocation of patients to various other locations during demolition/construction phase
Imaging Department – new part required for the CT scanner arrived from USA – looks like this will be the 'missing piece'
COSECSA Trainees & 3 Trainers to attend COSECSA Annual Conference in Mozambique in early December
Australian High Commission representatives from Harare, Zimbabwe, to visit HEAL Africa on 13 November
Posted by ausheal on November 10, 2017
AusHEAL Team News – week 5
Long-term AusHEAL Team Members, Dr Murray Thorn and Sue Reid remained at HEAL Africa Hospital (HAH) for a further week following the departure of the September teams. Radiologist Dr Murray used his last week to instruct not only the surgical COSECSA trainees on the intricacies of CT scans and how to read them, but also similar sessions with all the remaining HAH Medical Staff.
Even though 2 replacement circuit boards had been brought from Australia for the CT Scanner the CT is still not functioning properly. Disheartening after an initially successful 'start-up' last week.
Currently only Dr Neil & Gwen remain from AusHEAL. They will stay for some weeks yet at HAH.
Other AUSHEAL NEWS:
RECOVERING PATIENT…… One of the ICU patients, Prince, who warmed the hearts of many of our team members, is doing really well. He is 22 and has no parents or family. He was stabbed when he went to help separate 2 people in a fight. From an initially hope-less clinical situation, he has progressed to where he now requires probably just one more week with chest tubes.
OXYGEN PLANT….. Preparation for the installation of the new AusHEAL supplied Oxygen Plant has commenced with clearing a new and more appropriate site ready for laying the cement slab on which the plant will be installed. At the end of October an Engineer from the supplying company in Perth, Western Australia, will visit to install the plant and ensure good functioning.
DR KIGAYI….. AusHEAL Scholarship recipient, Dr Kigayi, has been visiting HEAL Africa Hospital at the end of his second year of training as a Specialist Anaesthetist. Neil and Gwen took the opportunity to catch up with him to chat about his studies in Tanzania. As the only non-Tanzanian in his course, he found it extremely difficult at first studying in English but he indicated that the other Tanzanian trainees were very welcoming and supportive of him. It will be an added bonus for HAH when he returns as the only medically trained Anaesthetist in what has been historically a department totally staffed by nurse-anaesthetists who perform an amazing work in difficult and challenging circumstances. We are grateful to AusHEAL donors who help to make these Scholarships possible.
GLOBAL DEVELOPMENT GROUP ….. a representative from our Australian partner, Global Development Group, is conducting a 'monitoring visit' this month to HAH to personally see the work of the 'AusHEAL Congo Project'.
MAMA VIRGINIE is the HAH Public Relations Officer. She has facilitated and organised much of the logistics of AusHEAL visits over the past 11 years. She turned 60 this week and has become a dear friend and such an encouragement to team members.
…… 'Abdominal Catastrophe' is a term that HAH staff have given to the disastrous surgery we see referred in from peripheral centres and sometimes from other health sites in Goma. One example was a young 19 yr old mother who'd had supposedly had just a caesarean section in a 'small clinic' in Goma – and subsequently presented to HAH with peritonitis. At the time of the surgery at HAH she was found to have had a hysterectomy – as well as the caesarean. Thankfully the baby survived. A day later, another woman arrived after a caesarean-section in a rural area. Unfortuntely her bladder had been sewn to her womb and her abdomen left open! The baby's arm had been broken during delivery. Such horrific cases continue to cause us great stress – but also continue to reinforce why AusHEAL is here to improve training.
…… Paediatric Cases – the Hospital was visited last week by the UNICEF Director for West and Central Africa, and the UNICEF director for Eastern Congo. The group was given a tour of sections of the hospital relating to children. They were introduced to a tiny baby born with several congenital abnormalities & recently transferred from the neonatal ward. Due to the extent of malformations, the child's gender was unidentifiable, with part of the bowel sitting outside the child's body. Two surgeries were performed by Dr Neil and Dr Luc together in an attempt to give hope for the future. From the waist up bub is normal and feeding well from the breast. Such tragic cases are not uncommon in this part of the world.
FANNY, Neil & Gwen's adopted Congolese daughter continues to follow up patients who have had the same significant major surgery she underwent in 2009. The photo portrays 10-year old Kitso on her return visit, 18 months after surgery. Kitso is doing well physically and topping her class at school. Her family is poor and struggling to meet school fees. A common predicament for families in Congo. Often only one child in a family has the opportunity to attend school.
….. AusHEAL-HATS Training Floor – (HATS = Heal Africa Training Scheme) It is anticipated that with projected funding from Australia, the current Outpatients Building will have a top floor added as part of the HAH building program. It will provide space for an AusHEAL base and training facility to include a large teaching room, smaller training rooms for small groups, a skills workshop and library, training rooms for small groups etc. Construction is envisaged in 2018.
….. Women's & Children's Pavilion – Demolition of the building mentioned in the previous Newsletter is now complete and the site ready to commence construction. This building is to accommodate hospital 'inpatients'.
….. Community Women's & Children's Health Centre – Following a casual conversation last year between Dr Neil and the Brazilian Ambassador to DRC during a visit by the Princess Caroline of Monaco (a Patron of UNICEF) the Ambassador made contact in June this year with Dr Neil, advising that the Princess was keen to arrange building project funding from a Foundation established by her mother (Princess Grace of Monaco). A project to improve the health of women and children from the community of Goma.
Discussions followed and on our arrival (Neil & Gwen) in Goma at the end of August a number of planning meetings were held to prepare an official submission to AMADE MONDIALE, (the Foundation) to fund the construction of a new Community Health Centre (as an 'outpatient' facility). The new Health Centre, when completed, will provide a larger and more welcoming 'space' for existing services for women and children, as well as the opportunity to enhance other services.
The Health Service is accountable to the Provincial Health Department, though located on the property of HEAL Africa Hospital. HEAL Africa is responsible for the expansion of existing programs and staffing. Currently these programs and services are conducted in very cramped conditions at one end of an existing building.
This week, the Princess Caroline, the Brazilian Ambassador and the Secretary-General of Amade Mondiale visited HEAL Africa Hospital to lay a Foundation Stone, sign a Memorandum of Understanding and view a PowerPoint presentation by Dr Jo Lusi regarding the plans for the new Health Centre. The official duties were followed by a number of ceremonies by local ladies.
'CAPOIERA for PEACE' is a project based in the Democratic Republic of Congo. The Brazilian Ambassador and Dr Jo Lusi invited Neil & Gwen to attend a graduation ceremony of the Goma Capoiera, as part of the visit by UNICEF and Princess Caroline of Monaco.
CAPOIERA is an Afro-Brazilian martial art that combines elements of dance, acrobatics and music. It was developed in Brazil mainly by Angolans at the beginning of the 16th century. It is known for its quick and complex maneuvers, power, speed, and leverage across a wide variety of kicks, spins and techniques. Capoeira is currently being used as a tool in sports development to promote psychosocial wellbeing in various youth projects around the world.
Neil & Gwen were visited by a friend from Brisbane, Dave Malengret. He was born in Gisenyi, Rwanda and grew up in Goma DRC. His father ran a business in the main street of Goma when he was a boy. Dave, who had not returned to Goma since he left the area as a child about 47 years ago, welcomed the opportunity to meet up with friends and acquaintances from long ago.
Dave also fulfilled one of his goals in coming to Goma – that of 'climbing the mountain'. What he had not realised was that it takes about 5 hours to ascend Mt Nyiragongo (the volcano) and that the tour includes an overnight stay at the top to maximise the experience of gazing down into the crater to see the burning lava at night. The descent takes about 3 hours. He is a fit man so managed the trip very well – however, some have said that it is very difficult. Neil would love to do the climb, but Gwen is not sure she would make it.
Posted by ausheal on October 14, 2017
Medical and Nursing Team update
On Saturday 2 September, seven MEDICAL Team members arrived at Goma Airport to join the NURSING team already working hard the previous week. The second team settled in to prepare for two very full-on weeks.
In total, AusHEAL has had 15 volunteers at HEAL Africa Hospital (HAH) this month. It has been an extremely effective AusHEAL team!! Hospital staff here have commented positively and often about the clinical skills of the team, the style of teaching/training, as well as the relationships formed.
On the second last day of the Nurses teaching/training program, the Secretary-General of the DRCongo North Kivu Province Health Committee attended a 'thank-you' ceremony to the AusHEAL Nursing Team with the presentation of 'Participation in Nursing Training' Certificates to all the HEAL Africa nurses who had attended the various training sessions AusHEAL had conducted.
MATERNITY, Ante-Natal Nursing Training……
Visiting AusHEAL midwife, Alison Gregory, was invited to contribute to the ante-natal classes which are conducted by the HEAL Africa Hospital community health centre. She was very well received. It is an area that has been on our minds for the past couple of years. It was a great opportunity to have Alison visit.
HEAL Africa Hospital has the ONLY qualified Emergency Department Specialist in all of DRCongo, Dr Muller, his specialist training and qualification in Tanzania sponsored by AusHEAL. It was good for him to meet up once again with visiting AusHEAL Emergency Medicine volunteers: Dr Graham Zerk and Nurse Mercy Hanna.
The visit also allowed Dr Muller and Dr Graham to discuss higher management issues of the HAH Emergency Department. It's current physical location and department setup means maximum efficiency cannot be further achieved as facilities are not adequate to deal with current emergencies being received. The 2 doctors were able to assess and discuss the issue.
Approximately 100 HAH staff from across the Hospital, doctors and nurses together with parahealth and Projects personnel gathered from 9am – 3pm for an AusHEAL Weekend WORKSHOP to address the topic of 'A B C'……
- A = Attitude
- B = Back to Basics
- C = Communication
AusHEAL had previously identified areas requiring attention throughout the Hospital in previous visits. Senior Leaders of HEAL Africa Hospital affirmed such emphasis and education was needed across the whole organisation. The AusHEAL Team conducted a role-play throughout the day that began with a patient arriving in the Emergency Department with a leg abcess and following that patient through Imaging (Radiology), Surgery, Recovery, Ward, Intensive Care and finally being discharged.
All attendees were divided into groups across all departments with a series of questions being posed at the end of each role-play scenario that related to the topics of Attitude / Back to Basics / Communication. There was lively discussion regarding the answers and much hilarity at some of the acting abilities of the team!!
The major benefit of the day was when HEAL Africa attendees divided into their respective hospital departments to consider the impact of these three focus areas in their own service area. The results of these discussions are still to be relayed back to the HAH Senior Leadership and the AusHEAL Team Leaders.
(College of Surgeons of Eastern Central & Southern Africa): AusHEAL anaesthetists (Dr Kerstin Wyssusek and Dr Luke Heywood) participated in training sessions to teach/train basic anaesthesia to the COSECSA surgical trainees, doctors who will ultimately work in rural areas. Sessions were also spent with and directed towards the HEAL Africa Hospital Nurse-Anaesthetists.
Dr Kerstin Wyssusek, the Director of Anaesthetics at the Royal Brisbane and Womens Hospital in Australia also addressed higher skills such as management of an anaesthetic department. Dr Luke Heywood taught ultrasound guided nerve blocks using an ultrasound machine donated by AusHEAL for this specific purpose to HEAL Africa Hospital. Nerve blocks rather than general anaesthesia form an important component of anaesthetics in hospitals in Sub-Saharan Africa.
Dr Kigayi, Congolese recipient of an AusHEAL Scholarship for Specialist Training is training as a Doctor- Anaesthetist in Tanzania. He returned to HAH for a 3-weeks during the AusHEAL team visit, only having exposure to our 2 Team Anaesthetists for 2 days. It was timely & beneficial that they could all meet up.
Finally!! …… the CT Scanner, originally sent from Australia a few years ago, is now operating. This is great news. Fine tuning is still to occur. Three CTs were performed during the last couple of days before the majority of the team departed last Saturday. It has been a long journey for AusHEAL Radiologist, Dr Murray Thorn. Wonderful for him to see and be instrumental in the eventual operation of the scanner.
What a bonus! Again, a first for AusHEAL teams. We had a Medical Equipment Specialist Technician (Tim Maleevsky) on team who spent most of his time helping the HEAL Africa Hospital Technical team get the CT scanner working.
AusHEAL HOSPITAL PATIENT FUND:
The AusHEAL Hospital Patient Fund was established to fund the care of both surgical and medical patients (treated by AusHEAL team members) who have genuinely been unable to afford their clinical care during the team visit. Every Hospital Service (department) where an AusHEAL team member was involved, reported the value of the teaching and training provided through same.
- There have been several difficult paediatric surgical cases to deal with. Appropriate advice was sought by our surgeons and given from a senior Australian Paediatric Surgeon in Brisbane, Dr Peter Borzi. This has been greatly appreciated!!
- Several team members suffered illness including diarrhoea & vomiting, colds & flu necessitating disappointing 'days off'.
- The patient death-toll seen on this trip was high, emotionally draining on team members who gave their all to keep patients alive. Some of the patients who died were critically ill.
- Once again there were patients referred from peripheral areas who arriving in an extremely poor state. Hence the AusHEAL emphasis on educating those in Goma and those who will go on to practice in peripheral centres.
- On a more positive note, team members worked hard with input into the care of a 22- year-old orphan in Intensive Care, stabbed in the chest when trying to break up a fight. He was an innocent victim with no family and no resources. The AusHEAL Hospital Patient Fund contributed to his care. In past years, there has often been 1 patient with whom many team members have been closely involved, both clinically and consequently emotionally. AusHEAL Team Leaders were later approached separately by a representative of the orphanage to thank the team for all their support and care.
The whole team was invited to the wedding of one of the HAH staff members. Ten AusHEAL members attended, mostly dressed in Congolese attire. Embarrassingly, they were seated down the front at the wedding reception. The team was presented with a cooked goat (highly valued in DRCongo) and one of the tiers of the wedding cake.
Plans for new buildings: Today, the roof is being removed from an old building in the hospital. The remainder of the building will soon be totally demolished to make way for a new 3-storey Women's & Children's Pavilion, funded by a donor from the USA.
The DRCongo national Doctors' strike mentioned in our last blog has ended with work returning to normal. Over the weekend, a Congolese doctor travelling to Goma from a northern centre to attend a Provincial Health meeting, was kidnapped. A ransom was requested. The Doctor and a few other staff were to be travelling in a convoy guarded by the Congolese Army. The incident caused reconsideration by other doctors in North Kivu Province to go on strike again, demonstrating to the Government that the kidnapping practice was not acceptable.
TEAM LEADERS & organizers Neil & Gwen Wetzig, tired from 3 busy weeks with AusHEAL Teams visiting HAH, were greatly energised and encouraged by the quality of the team members, their skills, personalities, team participation and willingness to 'go the extra mile' in so many ways. A really great team!!!!
Posted by ausheal on September 26, 2017
September 2017 Nursing Team – D.R.Congo
Touchdown at Goma International Airport on Saturday 19 August began our introduction back into the hassles of entering DRCongo with Immigration border difficulties / dusty roads / people-people-people everywhere, women selling anything and everything on the sides of the roads…… from flour in open piles to fresh meat laid out on tables in the open / bicycles being pushed along carrying heavy loads / chuck-a-doos (the local wooden push-bike) pushed along the roads with even heavier loads / women carrying/balancing bowls of goods on their heads / horns beeping / cars dodging motos and other cars / and general mayhem everywhere.
Then to the quiet and peaceful Maji Matulivu by the lake, where we were warmly welcomed 'home' again…. to unpack and settle in for the next few months.
Nursing Team Arrives –
6 AusHEAL Nurses from Brisbane arrived at Goma Airport to be met by similar hassles. Sunday was their day to recover from the long trip before starting work early on Monday morning 28 August with attendance at the Nurses 7.30am meeting.
An orientation tour of HEAL Africa followed. Interpreters were allocated to each of the nurses, then all went to meet local staff in their various departments. First impressions from the AusHEAL Nurses included:
- The Hospital is big & progressive but lots still to do. Wards lacking resources (including privacy)
- A lot happening in the Hospital
- Small ICU for the number of hospital patients and staff – no space / no room to ventilate patients
- Super impressed – cleaner than previous visits
- A lot more equipment now in some areas
- Big hospital but space can be a premium for patients
Thursday, the AusHEAL Nursing Team was invited to meet with the Provincial Minister of Health (North Kivu Province). He warmly welcomed our team to Goma and expressed his appreciation for the efforts made to come to teach and train HEAL Africa staff.
COSECSA surgeon training continues –
4 HEAL Africa COSECSA Trainers (together with the HAH CEO) travelled to Kigali for a 'Train the Trainers Course' conducted by the College of Surgeons of East, Central and Southern Africa (COSECSA). All believed the course was worthwhile. Each of the Trainers gained official registration from the College.
New Buildings –
At the end of Chapel on Friday morning, the HEAL Africa CEO, Dr Justin, announced to the staff the plans to build a new Women's and Children's Pavilion on the Hospital site as well as a new building dedicated for the care of fistula patients. This will build the capacity of the hospital to treat the ever-increasing numbers of women and children who need to be hospitalised.
Equipment –
The CT Scanner is still not in working order, however our visiting AusHEAL Radiologist will next week be bring further replacement parts. Radiology staff are trusting it will very soon be functioning well.
The Oxygen Plant donated and transported through AusHEAL has arrived at HEAL Africa Hospital. It awaits a visit from an Engineer from Australia to install and connect it.
Amidst the difficulties, challenges and sad medical conditions we encounter here, we continue to thank God for the opportunity and privilege to be involved in this
Posted by ausheal on September 11, 2017
April 2017 Update
NEW BRISBANE TEAM ARRIVES in GOMA
On 2 April it was good to welcome Paul & Lyndee Bakes, Brian & Vanessa and Ben to HEAL Africa Hospital after considerable issues with obtaining their visas. (not due to the helpful Congolese authorities but due to difficulties with a major courier company) The visas arrived about 45 minutes before team members left their homes for the Brisbane airport departure.
The team has been involved in planning the site for the AusHEAL Oxygen Plant, soon to be shipped from Perth Australia to D.R.Congo. They are assessing other building projects and becoming involved in a number of community projects. Paul and Lyndee will stay on in Congo for at least a further 10 weeks as Paul assists with the IT network at the hospital and Lyndee teaches English.
ECG Dots
The team was able to bring over a supply of 'ECG dots' to use with ECG recordings and anaesthetic procedures. These were supplied though the Mater Health Service technical team and will allow for ECG tracings to be performed on equipment sent over last year by AusHEAL. Dr Muller, HEAL Africa Hospital Emergency Department Director, was delighted to receive them. Such simple things make a big difference for patient care and staff morale.
Dr Neil Wetzig and Surgery
Dr Neil has continued with clinical work, in particular as one of the HAH staff general surgeons (Dr Luc) has gone on a 'cleft lip and palate surgical outreach' to a western province in DRCongo. Activity is ongoing at the hospital. In the last 3 weeks there have been sad cases with times of overcoming adversity.
- A major triumph saving a young woman referred from another health centre in Goma DRCongo, who was comatosed with life-endangering low haemoglobin (blood count) following a Caesarean section earlier that morning elsewhere. The woman's womb had not been closed well after the caesarian section with resultant ongoing haemorrhage. Additionally, her baby had died!
- A 7-month old baby died from a treatable surgical condition. Specialist staff were not notified of the baby's admission overnight. The relevant staff only became aware of this very sick baby when told by a medical student at the morning handover meeting. Urgent surgery was arranged but the baby died before an operation could be performed. None of the COSECSA surgical trainees were involved with this case. The unfortunate incident has been a significant teaching opportunity on communication essentials and protocols.
- In early March, a combined USA and Australian surgical team operated on a 3-year old boy removing a large facial tumour. He had previously had an eye removed for tumour. His facial reconstruction has gone well and he may go to Uganda for further treatment. The boy has however become attached to the 'Talking Paul' app on Dr Neil's mobile phone. It was initially used to pacify his fears when he was about to have anaesthesia. Now on each ward round he asks Neil if he can play with it. He is such a happy character and so respectful as he hands the phone back when it is time to move on. His overall outlook is not good, but at least this brightens his day.
Neil has been involved with a number of other cases:
- The care of a number of family members of HEAL Africa Hospital staff
- A 25-year old woman with an unusual congenital abnormality on her left kidney. There was considerable pressure from some staff to 'simply remove the kidney'. However, Neil was able to use this case as a teaching opportunity to sort through what the longer term consequences could be for such a young woman in a Congolese environment with only one kidney. Should the abnormal one be removed without at least an attempt to preserve it? She is still recovering from her kidney-preserving surgery and so far doing well.
- A 19-year old woman was referred by MSF (Médecins Sans Frontières, Doctors Without Borders) from an outlying village with an 'open abdomen' after a Caesarean Section conducted in the local village by local staff and a second operation for severe infection. Exploratory surgery at HEAL Africa Hospital found that the infection had been due to the patients womb being sutured to her bladder. Neil reports seeing similar cases such as this from outlying areas. The patient underwent a further operation. She is now doing well, as is her baby who she is feeding.
Neil continues to be involved in meetings with HEAL Africa staff e.g. focussing on exploring further ways of Australian support for development of additional community development programs. elections are scheduled later in 2017. Hope remains for opportunity in DRCongo for growth and development.
AusHEAL: Australians advancing healthcare in the developing world
Posted by ausheal on April 25, 2017
Aussies to Goma in 2017
AusHEAL representatives David and Heather Kelly arrived in Goma D.R.Congo from Brisbane on the 15th February such that David could resume oversight of some of the HEAL Africa Hospital administration, mentoring the Chief of Operations, as well as his continuing involvement on the HEAL Africa Assemblie Generale, the Board for HEAL Africa Hospital (HAH) and external Community Projects. Heather is resuming her English lessons with various members of the staff.
On 25th February Dr Neil Wetzig, Director of the AusHEAL Congo Project, also returned to Goma from Brisbane to resume the 'on the ground' partnership between AusHEAL and HEAL Africa Hospital.
Having come through a period of uncertain security in 2016, Goma is currently peaceful albeit still coping with political uncertainty.
International Co-operation:
An American surgical team from Wisconsin (pictured below) arrived for a two-week visit on 27th February. Neil has therefore continued with clinical activity (though less operating time) to allow the visiting team to teach and train the local surgeons and COSECSA Trainees. (College of Surgeons of East, Central & Southern Africa)
It has been encouraging to see the USA team embracing the basic surgical training program at HAH. Their interaction with the COSECSA Trainees has been of great benefit. This was demonstrated on Thursday 9th March, in an additional training session, when all the visiting surgeons formed a panel to answer Trainees' questions. Subjects included not only clinical problems, but also the craft of surgery, the responsibility of surgical care in DRCongo, and the significance of the current group of Trainees being the vanguard of improving surgical care in their resource-poor country.
Staff Presentations to Heal Africa Board:
The annual HEAL Africa Assemblie Generale Meeting was held from 1st to 3rd March, a good productive time. Australia has two representatives on the board: David Kelly from AusHEAL and Lindsay Thitchener from Sonic Healthcare.A new board member, Dr Bill Clemmer (a long term USAid Program Manager with extensive experience in DRCongo and South Sudan) was welcomed.
On the first day, HAH staff presented the previous year's activities in both the hospital and the community development programs to the Board in a public open session. While this was a long day, Neil and Heather were able to attend . It was a wonderful opportunity to observe the breadth of HEAL Africa's activities in both the medical field and in community development.
Medical Care at HAH:
A few facts gleaned from the presentations the medical care are as follows:
- The hospital is expanding its capacity from 197 beds to 203.
- The current hospital staff includes 14 specialists, 13 'other' doctors, many on training programs, 82 nurses, 14 paramedical staff, together with 15 in administration. 42% of the hospital staff are female.
- Consultations at the hospital rose from 22,576 in 2015 to 27,443 in 2016. There were an additional 17,244 consultations for preventative measures such as HIV follow-up & nutritional care.
- 5,102 operations were performed by HEAL Africa staff in Goma in 2016.
- 1,828 pregnancies were delivered. Questions had been raised about the 39% Caesarean section rate. It was explained that HAH deals with many of the difficult cases on referral from other hospitals.
- There were no cases of maternal mortality for patients treated within HAH.
- Sadly, presentations of victims of sexual violence rose from 347 in 2015 to 393 in 2016 -having fallen dramatically from 768 in 2010 to 271 in 2013.
- Outreach surgeries by Heal Africa staff visiting rural centres increased from 719 in 2015 to 825 in 2016 – 28% were orthopaedic procedures, 53% gynaecology (mostly fistula and prolapse repairs) and 18% for general surgery. The latter mostly being for cleft lip and/or palate repair.
- Activities of the Laboratory and Radiology departments, income generating for the hospital, continue to increase.
Daily Life at Heal Africa Hospital:
David has spent the past week 'tying up loose ends' from the Assemblie Generale, while Heather has continued English lessons. Neil has been working alongside the USA surgeons, helping to deal with decisions regarding difficult cases.
Examples have been:
- The sad case of a 3 year-old child with necrosis (death) of much of the tissue on the right side of her face, the result of a severe infection. She was eventually offered palliative care after extensive consultation with colleagues both in the USA and Australia.
- Another notable case was the resection of an enormous left facial tumour. Surgery involved 4 surgeons and was a great USA/Congolese/Australian team effort.
Posted by ausheal on March 18, 2017
December 2016 Update and Farewell
SECURITY in D R Congo:
Saturday 19 November passed peacefully – perhaps because the President appointed a 'Prime Minister' 3 days earlier. It seems though, the date everyone is anticipating is 19 December. Most ex-pat NGOs and non-essential UN staff are being told to leave DRC by 15 December. There is not only the youth movement who post anti-government twitter-feeds regularly – but now also a movement called "Bye-bye Kabila", who are calling for a peaceful protest march on Friday 25 November. We have not been aware of any related anti-government incidents in Goma though there have been a couple of incidents of lawlessness.
Mt Nyiragongo volcano, overlooking Goma, continues to please photographers with its array of cloud formations – and keeps on smoking from its crater!!
Some of you will have read this on Neil's Facebook post, but for those of you who do not follow Facebook……the following is Neil's account of one 'Diverse Day'…….
"…. I sat in the morning chapel service and watched a little guy at the front who lives in poverty, dancing for joy with the choir. Then I received a text message "Abdominal ballistic trauma in Operating Room now". Four hours later after successfully repairing the liver, spleen, stomach, small bowel, colon and left kidney in a young male, I determined that Anton Kalashnikov who invented the AK47 rifle, has a lot to answer for! I returned to our office to find a flat-bed funeral truck bearing a coffin and 30 or so relatives of another patient leaving the hospital. The next task was to help the newly returned Emergency Department physician, Dr Muller, put into action plans to improve his poorly resourced department. Then further planning and communications re AusHEAL work in 2017 and, finally, home for a well-earned shower and clean-up. Such a diverse day!"
The patient with the gun-shot wound did well following surgery. We were hopeful of a full recovery….. unfortunately, when we arrived in Mombasa later in the month we received news that he had died after we left.
HATS – HEAL Africa Training Scheme:
The inaugural meeting of the HATS Management Team was held on Monday 21 November, presided over by the Dean of HATS, Dr Luc Malemo. Ten departmental heads of various training programs at HAH were informed of the renewed emphasis being given to 'training' within the organization. Teaching and Training in all HAH services and departments will lift the standards of the organization and contribute towards improved healthcare at the hospital and the community services it provides.
- HAH Dentist, Siva, who has been mentored and trained by AusHEAL team dentist, Dr John Yared, spent 18 days at the large dental unit at Kijabe Hospital in Kenya. He was sponsored by an AusHEAL Short-Term Development Grant. Siva was able to observe how work was organized and performed in Kijabi, as well as learning about root canal treatment and the use of dental braces.
- Following discussions with the Chiefs of Nursing about selection of suitable nurses to receive an AusHEAL Short Term Development Grant (STDG), Orthopaedic Officer, Katembo, who works in the operating theatre, was awarded a grant to visit a Nairobi hospital to observe and learn the necessary skills for new procedures now being undertaken at HAH (knee and hip replacements).
SURGICAL TRAINING – COSECSA (College of Surgeons of East, Central and Southern Africa)
Tests & interviews were conducted for the 5 College Trainees at HAH to assess their progress with the COSECSA Membership Training Course. Lack of proficiency in English is a major hurdle contributing to difficulties in comprehending the clinical texts they are studying. They are showing good improvement in this area. All agreed the training program was quite heavy, but realised the opportunity they have been given. The trainees reported learning many new things with resultant improvement in the care and management of their patients. All 5 are keen to continue.
This week, the 5 COSECSA Trainees and 4 of the HAH Trainers are in Mombasa, Kenya (together with Dr Jo Lusi, founder of HEAL Africa) attending the COSECSA Annual Scientific Conference. Not only is it beneficial for the HAH doctors to be exposed to a wider experience of surgery in Africa and attend the scientific presentations, but equally important for the COSECSA College to witness the enthusiasm and commitment of the first Membership Training Program established in D R Congo.
Dr Muller
Congratulations to Dr Muller on his Graduation in Emergency Medicine in Dar es Salaam in early December.
Neil attended the G4 meeting in Washington DC on 10-11 November. The G4 Alliance for Global Surgery, Obstetrics, Trauma and Anaesthesia care is seeking a way ahead to provide access to safe, affordable surgical and anaesthesia care for 5 billion people worldwide who do not have such access. He was representing HEAL Africa Hospital. Of the 83 organisations represented at the conference, only 12 were from Low and Middle Income Countries – therefore the importance of being there as a voice for the truly neglected surgical patient, as well as for HAH and its work.
Neil had opportunity not only to highlight HEAL Africa Hospital but also stress to those present the need to include more representation from LMICs. It was an interesting time to be in Washington so soon after the Presidential election and to be briefed about the potential impact that will have on US relationships with the rest of the world.
On a previous trip, we (Neil & Gwen Wetzig) kept acknowledging a female security guard at the hospital gate – but, there was not much response. We kept smiling every day and said "Bonjour". Slowly there was a little response. On this trip there has been a great response – hellos and smiles and even calling each other by name. To top it all off – her son was a patient at the hospital. – Now there is a very happy security guard who smiles and greets us enthusiastically!
For a few weeks we greeted a young disabled girl with hydrocephalus (maybe aged 10-11 years) who just sat on some steps as we walked past every day. We would greet her but there was no response. We kept saying "Jambo" and waving and smiling. Gradually, after many days she began responding. Then she began waiting for us. Then she initiated the waves and smiles and called "Jambo" out to us. Then one day, she was gone! We just hope that for those few weeks we were able to bring some small amount of joy to her days.
One day we found a young boy in a wheelchair sitting in the doorway of a room at the bottom of the steps we use to go up to the AusHEAL office. His leg was pinned and in plaster. He was perhaps about 8 or 9 years old. The first day we said hello and smiled, but there was no response – then again the next day but still no response – then a few days later a little acknowledgment – then half a smile – then a "jambo" response!
By the time we left there were big smiles and 'jambos' and 'bonjours' every day and a very warm and hearty response from him every time we passed. One day he was crying and Gwen stopped beside his wheelchair. What could she do????? Nothing much – so she prayed… and touched him on the shoulder and continued on. When she returned about 15 mins later, he was happy again and smiled brightly! Gwen also had the opportunity when seeing him wheeling himself out of the outpatients building, to offer to push his wheelchair back to his room. He agreed – what a precious moment in time.
One day there was a young girl walking through the hospital wearing a T-shirt that said "Use your Smile to Change the World." No one of us can change the whole world – but we CAN change someone's world…. sometimes!!!
Posted by ausheal on February 1, 2017


text:
South Motors is again proud to sponsor another year of the wonderful Miami Book Fair International! The fair will be running November 13 to 20, and features more than 300 international authors and is the foremost of its kind in the nation. Tens of thousands of authors and readers converge for eight days for dozens of literary events, parties, signings and readings with the world's most prolific writers and poets.
South Motors has been a longtime supporter of this incredible event and 2016 is no different. This year, South Motors will be presenting a newly-wrapped Miami Book Fair Art Car in addition to its traditional booth presence at the fair.
Please stop in for a visit, as we will be raffling off prizes and giving away some cute little Miami Book Fair tchotchkes to the lucky few. We hope to see you there!

subset: commoncrawl


text:
Consultant & Director of Health Affair Department
MBBCH-1994, Arab board family Medicine 2001 (first batch graduate in UAE), Membership Royal college of general practitioner (INT) 2007, Master in health care management RCSI 2009, Fellowship Royal college of general practitioner (INT) 2014.
Consultant Family Medicine.
Head of Al-Barsha HC.
ABFM, MRCGP(int.). MSc. Quality in healthcare
Post. Grad Cert.in Medical Education.
Consultant Family Medicine
International Membership of the Royal College of
General Practitioners, Dubai UAE Centre
Specialist Senior Family Physician
Head of Clinical Development Unit
Primary Health Care Services Sector
Ass. Professor Dubai Medical College
Specialist Senior Family Medicine
Head Of 24 Hours Services in
Al Barsha Health Centre
Primary Health Care Section
Family Medicine Consultant & Head of Department,
Al Zahra Hospital Dubai
Specialist Registrar Family Medicine
Acting Head of Nad ALHammer Health Centre
Consultant Family Physician
Director of International
Health Regulation Office
Consultant Family Medicine & Occupational Health
Vice President - Emirates Family Medicine Society