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Published: March 4th 2009
HOME VISIT
Dr. John pictured during his home visit to this family who live on a boat.Doctor John Sherman was introduced to me by a mutual friend, Richard Tregear. John and Richard have been friends for fifteen years and have worked together at Open Family, an outreach program in Melbourne for many years. John first attended our annual Lifestart Foundation Dinner Dance and Charity Auction a few years ago and subsequently became interested in the work that Lifestart Foundation was doing in Vietnam. It wasn't long before he volunteered to come over and help. After returning from his first volunteering trip with Lifestart, John published a story in Australian Doctor Magazine.
The following is an excerpt from this story.
Dr.John Sherman. “WORKING FOR KAREN”.
I have recently worked in Vietnam for 2 weeks with Karen Leonard’s charity, LIFESTART FOUNDATION.This charity is based in central Vietnam,in Hoi An,on the South China Sea. Lifestart Foundation provides a range of services:schooling for the disadvantaged, indepth support for over 50 disabled adults, care for needy families and a physiotherapy training programme is in development stage.
We kicked off with home visits. The homes we visit are tiny, with cement floors, no glass windows and the most basic furniture. Muoi aged
CLINIC IN THE PAGODA
Dr John examines Thao, one of the nuns in training. Thao is a student at the Lifestart Foundation School. 53 is the mother of Thong, who is one of Karen’s many success stories. Thong has an excellent restaurant job and speaks perfect English. Muoi has chest pain and dyspoena, exacerbated by changes in the weather! She has angina and CCF, plus diabetes, all freshly diagnosed! Karen will pay for medications as the family haven't the funds. Hoang, her husband has lost his right foot from a land mine. He is a fisherman. Nextdoor there’s a boy with face and scalp rash. It’s infected eczema but it might be fungal. Karen will provide a worker to dispense medications, creams, etc. Hygiene is a real problem in this house;the volunteer can make a difference here too.
We then visit Karen’s school.The disabled women’s art co-op.has been at work in one of the rooms.Two volunteer artists, Sherry from USA and Lonnie from Norway are helping the women develop art work to retail in Vietnam and sell online. After the session they negotiate the 3 steps from the school to the 3 wheeled adapted motor scooters.The first 2 women, with flaccid paralysis from polio of the lower
IMPROVISATION
I am guessing at this point that Dr. John would have been very happy with a bed of some description to lie the patient down on... limbs are carried down.Then 2 with the same disability, move by squatting and lifting each foot forward. Bilateral mid thigh amputee , Luong uses 2 plastic stools and “hops” from one to the next! Two cerebral palsy women take up the challenge and make it.
They are all smiling. I’ve got the sunglasses and tissues out!!
Next day I work with Josh Solomon an intensive care and pulmonary specialist from USA. He does volunteer work in Hoi An several months of the year. Karen refers Nugyen, a 19 year old with an untreated VSD.. She has marked pulmonary hypertension and Isomenger’s syndrome. It seems too late for surgery. Josh will email a cardiologist in Denver for advice. Nguyen works 12 hours a day,7 days a week in an internet café for $A10 per week! Her medications cost $6 weekly! Karen invites her to resign and will provide her with lodgings, food, medicines and the offer to do what she wishes. She wants to study. That wish is granted.
A thirty year old man from a far off village is next. He has had a right sided CVA.He has had Rheumatic fever as a child,
BOAT VISIT
Doctor John visits a mum with cancer. I am still trying to work out why Ghi ( Dr. John's translator, now living with me in Melbourne doing a traineeship) needs a helmut on the boat? then mitral stenosis, causing atrial dilatation and atrial fibrillation , thus the CVA. We will provide blood thinners and slow his pulse rate with medication.
In the arvo. I do a “boat visit”. Families live on boats moored along the river bank. They are 3 to 4 meters long and 1 ½ meters wide. They have tin and bamboo roofs. I’m rowed out and see a fellow with osteoarthritis of the hip. Eight live on the boat! They sleep,cook and wash on the boat and “toilet”over the side! The boat is spotless. His wife has a swollen jaw. I’m thinking foul play or dental abscess. Wrong on both counts; she shows me the Xray—malignant bone tumour of the mandible. She is considering the major surgery on offer but fears with half her jaw removed, she will look old and dribble when she eats. Grandma is squatting by the small kerosene stove cooking greens. The smell of coriander even dominates that of the open air fish market just up stream and cooking in 38 degrees!
Karen asks me to see a new patient,a man called Nguyen he has been confined to a wooden bed for 12 years. He’s a
Dr. JOHN, THUY & THANH
Clinic at the local Pagoda. Thuy attends the Lifestart Foundation School. sorry sight, lying in a semi foetal position and grossly undernourished. There’s a story of a head injury when he was 18,but clearly he suffered from encephalitis at the time. He has sight and hearing but no speech. He has upper limb strength but not lower. I was unable to test his core strength that day. He is highly intelligent. His father and sister care for him but there are problems. He is chained to the bed during the day,possibly because he could elbow his way to the fridge for food or turn on the TV and waste electricity!!
Karen sketches out a plan with the family’s and Nguyen’s permission. Firstly,an air mattress,a day carer to feed him high protein supplements, get him sitting, start an exercise programme, and get him out and about in a wheel chair. He did art before his illness,there are 2 fine pencil portraits above his bed of Princess Di and Oscar Wilde..
Karen will cover all the costs long term.
Karen supports the local Buddist Pagoda which houses the head
nun Nhu and 5 trainees,aged 14 to 26. I run checkups on all of them. Thuy suffers from migraines, her sister from dysmennhoea. Medication is ordered. I’m guest at lunch-a vegetarian feast! I run a clinic for the poor cared for by the nuns. One old man has heart failure, one women is jaundiced. She had a gallbladder operation and 2 subsequent operations”for leaking”. I’ll order an ultrasound,surgery . Stricture and cirrhosis are the most likely diagnoses. Further surgery is probably contraindicated. I order an ultrasound.
I do 2 home visits, 2 of the many success stories of Karen. Hiep is another polio victim,with 1 weak leg and the other withered. He gets around on crutches and has a 3 wheeled “Karen”motor scooter. His country plot was a jungle. Karen got it cleared and backed him financially. He now has a thriving organic market garden,giving employment to his mother,brother and himself. He has bought 2 water buffalo,one a worker and one hired out to other farmers.
Thong has total flaccid paralysis of both legs. He wraps his legs into the lotus position and walks on his hands using plastic sandals[He leaves these outside the front door, as we
HEALTH CLINIC
This health clinic in the country side has been set up by Dr. Josh (in the foreground). Dr John and Dr Josh were able to see an enormous amount of patients that day. do our shoes]. Karen has set him up with a bonsai farm and he is now self sufficient. He gives me a plastic bag containing a dozen or so tiny orange balls, less then pinhead size. He passes these painlessly in his urine from time to time!! I’ll get them analysed. Are they oocytes from an hydatid cyst?
He also has cataracts which seem to be a given for anyone over fifty.
Josh and I do a home visit on a 20 year old man,injured in a scooter accident 2 years ago.. It’s a C 4-5 lesion,his only movement below the neck,is shrugging of his shoulders. He is being very well cared for by his family. Air-bed, well groomed, perfect teeth and no bed sores. He has a plastic bag over his penis held with a rusty paper clip. He gets fevers weekly, which distress him no end. His father catheterises him daily using the same catheter for 12 months! It’s a wonder it has’nt colonized kangaroos by now! Josh will revisit with a supply of disposable catheters, gloves, alcohol wash, hygiene advice and a supply of antibiotics. Karen will assess his psycho-social needs.
PRIVACY?
The lack of privacy doesn't seem to bother anyone, these elderly people are just grateful to be seeing a doctor. Back at Josh’s surgery,he asks for a second opinion on a 14 year old girl.She is one of thirty who live in an orphanage/hostel. Thanh has presented weekly with lots of symptoms: headache, dyspepsia, dizziness and numbness. On examination she is fit and well. She has not taken her eyes off handsome Josh! She has a crush. I suggest lengthening the time between appointments, she’ll drop him soon!
I get a taxi to Da Nang airport. The driver has a most unfortunate ring tone on his mobile, a loud fart. When someone rings and it blows off he looks accusingly at me! For once I’m innocent. He then smiles, picks up the true offender and puts him to his ear. Ah,Vietnam!I’m back there in October.
After this story was published, several doctors have since offered to volunteer in 2009.
Doctor John Sherman returned to Vietnam in October 2008 to generously dispense another round of his invaluable expertise, diagnosis and his own very unique sense of humour.
Lifestart Foundation and the many sick people that Doctor John treated during both of his volunteering trips in 2008 will be eternally grateful.
Doctor John was planning another trip
HOME VISIT
Dr John doing a home visit with one of the families who are currently squatting. The family lives under a few sheets of tin supported by bamboo poles. to Vietnam this month however this is now not possible so we are very much looking forward to his return trip later in 2009.
Lots of Love from Karen.
www.lifestartfoundation.org.au
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miriam
non-member comment
Karen, your work is not only amazing, but truly inspiring. Congratulations to you and all your volunteers! I hope you are all blessed with the energy and inspiration to continue your wonderful work.