A Job Well Done in Honduras, Team Plans for Next Year

Lutheran HealthCare's volunteer team is back from their medical mission in Honduras. It was one of the most successful of all the New York Honduran Committee missions thanks to the dedicated volunteers who, in a matter of days, created a fully functional community health center and surgery clinic in one of the poorest regions in the hemisphere.

The numbers speak for themselves: 276 total patients seen, 62 surgeries, 85 patients evaluated for speech, language, hearing and swallowing issues, and 13 fitted with life-changing hearing devices.
 
Before they left Honduras, the staff at the Tela Hospital thanked the team for their support. They gave each volunteer a certificate of appreciation and with out delay, talked about plans for next year. As it's a small hospital by U.S. standards, 100 beds, there are many needs and the medical staff can use all the help they can get. Specifically, they are hoping we can bring additional gastroenterology, urology and dental support for next year. The New York Honduran Committee and the Lutheran staff will start making the necessary arrangements immediately, and begin planning for the next mission.

At the end of the day, as most of the team are now getting acclimated into their normal daily routines, they can look back and feel good about another successful medical mission in Honduras.

To learn more about the New York Honduran Committee and their work with Lutheran HealthCare in Honduras, please e-mail committee founders Jean and Ruperto Hemmans at rhemmans@comcast.net or info@hondurascommittee.org.

James Hansen's "Tipping Point" piece from "State of the Wild" available

link (PDF)
via Grist
I'll read this later and see if I have any comments, but I wanted you to know it was available.

Justifications for Torture

link
I think this is really breathtaking every time I read something like it.

"The fact that an act is undertaken to prevent a threatened terrorist attack, rather than for the purpose of humiliation or abuse, would be relevant to a reasonable observer in measuring the outrageousness of the act," said Brian A. Benczkowski, a deputy assistant attorney general.

The Bush Administration is just cynically playing on their supporter's distrust of government, a distrust they keep reinforcing by being untrustworthy. How many acts are taken for the purpose of humiliation or abuse? Pick your favorite atrocity producer. Hitler, Pol Pot, anyone you like. I'll give you a minute.

Now, do you seriously think the stated goals of their atrocities were to cause humiliation or abuse? Don't you imagine they had some other stated goal? DAAG Benczkowski's implication is that one function of government is to just arbitrarily hurt people, and they're choosing not to do that. It's one again hard to pick out exactly where in the uninformed-dishonest-evil-crazy phase space this assertion lies.

Liquid Water

There's no link
I was just thinking about the persistent and chronic understatement of global anthropogenic climate change from those in a position to know, the inconvenient delay built into the exponential climate response, and all of our planet's positive feedback loops.

I'd been kind of assuming we could stick it out for millennia in HGWellsian underground caverns, but doesn't that kind of presuppose we'll have a planet with liquid water on the surface? For how long do you imagine we'll have liquid water?

Just a question. Don't get alarmed.

Eating a good breakfast is the best way to... have a boy

link
Just to underscore the arbitrary nature of this blog, I'm now passing on advice on how to choose the sex of your children.

It may be that male embryos are less viable in women who regularly limit food intake, such as skipping breakfast, which is known to depress glucose levels. A low glucose level may be interpreted by the body as indicating poor environmental conditions and low food availability, the researchers said.
...
In the United States, for instance, the proportion of adults eating breakfast fell from 86 percent to 75 percent between 1965 and 1991. And although women may be eating more overall, a nutrient-poor diet could be less favorable to a male embryo. Glucose levels may also fluctuate in women who are dieting and trying to lose weight prior to pregnancy. In animals, more sons are produced when a mother ranks high in the group or has plentiful food resources.

For all of the yammering about how great the modern world is, our boy birth rate is going down because women's nutrition is poor. Put that in your smoke and pipe it.

It’s all About the Children in Honduras

Fourteenth post:
The volunteer medical mission in Honduras is winding down for photographer Michael Paras and writer Neal Gorman, but the brigade continues for the majority of the medical team still on site.

By Wednesday the medical team on the ground in Honduras had already seen and treated 230 patients and performed 40 surgeries. Although the team focuses mostly on children, they don’t turn anyone away that they can treat.

There are so many obstacles that each family has had to endure just to see the medical team in Tela. Some have traveled for hours on stifling hot school buses, the Telan version of a Greyhound coach. Others just walk.

They always arrive in their Sunday best (if they have them), and with no air conditioning and temperatures hovering in the high nineties, each patient waits patiently to receive care from the Lutheran HealthCare team.

In a country where the majority of its citizens have no access to basic health care, many of their stories highlight the lengths families in Honduras have to go to receive any type of medical help. Fortunately, the volunteers have done everything in their power to provide high quality care and, more importantly, compassion. Those that we can’t see this week will wait until next year to see us.

Exploding Permafrost

link
Ah, Dude. Grist's got some news posted from NOAA about rising levels of Carbon Dioxide and Methane. Methane's one of the positive feedback loops of Climate Change -- the warmer the tundra, the more the 'perma' frost melts, and the more Methane is released. But, check this out from Sean Casten in the comments section.

A good friend of mine does GIS work in Alaska, and his colleagues up there have told him that that the melting permafrost is the gigantic problem that no one's talking about, which explodes once it starts to melt.

Exploding permafrost sounds like it would mess with oil transport -- pipelines and roads -- but they'd be hosed simply by going from being on rock to being in a bog anyway. But, it's always interesting to hear about stuff blowing up.

RealClimate lauds Ed Lorenz

link
Like a lot of people, I've done scientific work made possible by Professor Lorenz, say in EOFs or with Chaos. And it's a nice article to read if you want a character to think about in the evolution of modern thought, or get sciency things to say at cocktail parties.

But how can climate be predictable if weather is chaotic? The trick lies in the statistics. In those same models that demonstrate the extreme sensitivity to initial conditions, it turns out that the long term means and other moments are stable. This is equivalent to the 'butterfly' pattern seen in the figure above being statistically independent of how you started the calculation. The lobes and their relative position don't change if you run the model long enough. Climate change then is equivalent seeing how the structure changes, while not being too concerned about the specific trajectory you are on.

You might want to spend some time in the comments section as well.

Rest in peace. The alternative being zombie meteorologists, I guess.

Elizabeth Warren on the FHA Expansion

link
I seem to be receding into puberty as I approach middle age, tomorrow now. I pick out a couple of personalities that I crush on -- Elizabeth Warren, Nouriel Roubini, Al Gore, Bruce Schneier -- and just repeat whatever they say. It's appalling to watch this, but I don't seem to be able to help myself. I'm just going to let it happen. It's probably just a phase.

Anyway, the point of the linked post by Dr. Warren is that what's happening now is that mortgage industry nogoodnicks are leaning on the same lawmakers that brought you the depredations of the 2005 Bankruptcy Bill, in order to Bear Sterns the mortgage meltdown into taxpayer pockets by expanding the Federal Housing Authority. I just now coined that use of 'Bear Sterns' as a verb -- let me know what you think.

Well, that may not be the point. But, it was my takeaway.

One way a lack of self worth plays out in application development

there's no link
This is a little funny. The online support facility of some website requires that I turn off my spam filter, and if I can't, that I talk with someone who can. Now, I think two-thirds of the email I get at the address I gave them gets marked and quarantined as spam, with an amazing hit rate. I'm not going to turn that off.

But, I was tickled by the assumption that they'd probably be marked as spam. This is probably due to the support staff's loathing of the marketing staff -- they figure the latter'll get everything sent from their domain marked as spam. I'm not taking any of their steps, so we'll see how they do.

---

Your request has been received and will be reviewed.

Our response will be sent to the E-mail address entered on your support request.

You can also view our responses by clicking the "Messages" link on the right side of the screen.

Attention: To ensure that you receive important e-mails, please do one of the following: Add (I've elided the email address) to your e-mail address book, contact list or safe list. Disable your e-mail filtering "SPAM" or "Junk" software. Look in your "SPAM", "Revoked", "Junk Mail" or "Bulk Mail" folders for our e-mails. If you are not able to do one of the above items, use your Help section or contact your e-mail/internet provider's Customer Support to find out other options.

The Right People and Tools

Thirteenth post:

Dr. Annabell Zaratzian is an anesthesiologist at Lutheran. She's on her first trip to Honduras with the medical mission. The group tries to be as self sufficient as possible, bringing each key component needed, including an anesthesiologist. From operating room supplies, to all kinds of
medications, to the right people, they are a fully functioning mobile medic unit in Honduras.

Lutheran Volunteer Takes the Medical Mission to Another Level at Para Iso de Lutheran Volunteer Takes the Medical Mission to Another Level

Twelfth post*:
We make another off-site visit to see new patients at Para Iso de Los Ninos, a special rehabilitation center for developmentally disabled children. It's located on a dirt road on the outskirts of town in a mainly agricultural area. Most of the children have severe developmental issues. Some suffer from attention deficit disorder, cerebral palsy and Down's syndrome. The
center cares for more than 80 kids and relies only on private donations.

Our ear nose and throat expert Dr. Melissa Inniss intends to see as many of them as possible, 13 of which the center knows for sure are hard of hearing. She wants to try to see at least 40. Borris Del Arca, 5, is sitting on his Aunt Cindy's lap as Dr. Inniss runs through a variety of procedures. One of them tests for middle ear fluid (pictured). The fluid alone can be the cause
of long-term language delays. She'll establish with the series of exams some recommendations for the boy's family. Each patient's exam, along with other tests, takes 15-30 minutes so Dr. Inniss will be there awhile. Her commitment and dedication to making a difference in Honduras is unparalleled.

* -- The title here is truncated, and should read "Lutheran Volunteer Takes the Medical Mission to Another Level at Para Iso de Los Ninos"

Trauma Surgeon and Lutheran Team Leader Mohan Kilaru

Eleventh post:

Dr. Mohan Kilaru is the team leader for Lutheran HealthCare's medical mission in Honduras. He's also a senior trauma surgeon in the hospital's level 1 trauma center so he's used to a hectic schedule.


This is is sixth trip to Honduras, a place perfectly suited to his skills since each day and year is different. In the OR Dr. Kilaru has performed a number of general surgeries like hernias and assisting the plastic surgeon with keloids and other disfigurements. During the clinic days, when patients are identified for surgery, Dr Kilaru can be found examining and discussing options with patients the team can't operate on. We may not be able to operate, but we can use our resources and contacts here to help them find an alternative means of support. Unfortunately, the main source of health care for most Telans is the medical brigade.

On Tuesday, Dr. Kilaru is checking on patients in the hospital's recovery area. Two young boys Ronnie and Rodin Caballero, both 2, had hernias repaired. They are now sitting comfortably and ready to go home. Dr. Kilaru provides their mom, Gina, with instructions. A relative who accompanied the boys and their mom is so surprised how smooth everything went.

A Surgery Scrub Tech and Two Physician Assistants

Tenth post:

Experience a Whole New World in Honduras Donald Gibbs is a surgery scrub tech at Lutheran who travels on many missions abroad. This is his second with the Lutheran Honduran team. The operating room isn't as fully supplied like back in the states so Donald does a lot of improvising here.

Sue Farrell is a physician assistant in her day job back at Lutheran but here she's performing a number of different duties. This is her third mission with the crew. She can be found each day assisting and circulating in surgery and providing pre- and post-op.

Victoria Stoyanovsky is also a physician assistant at Lutheran. She spends most of her time helping during minor and major operating room procedures. From scrubbing in on a serious hernia surgery to making rounds after, she's a vital part of the medical team.

Lillian Chavez and Plastic Surgeon Ahmad Nawaz

Ninth post:
Like any other year, patients come to the medical brigade's clinic seeking all kinds of medial relief. Some are suffering life-threatening illnesses and diseases, some are dealing with major and minor quality of life issues.

Dr. Ahmad Nawaz, a plastic surgeon at Lutheran Medical Center, has already operated on 20 patients with a variety of issues. He has seven cases already scheduled for today. Many are congenital lesions and disfigurements, cysts, moles, kiloids and burn scars. A serious car accident left one 12-year-old boy unable to move his right hand.

Others, like Lillian Chavez, 12, had a large cyst on her forehead. She and her mom, also named Lillian, traveled from a nearby neighborhood called Barrio Retirro where she is tormented by her schoolmates every day. For this young girl, the cyst was not threatening to her physical health but its removal has made a huge difference in her emotional health. The first thing
she said was how the other kids at school and in her neighborhood won't tease her anymore.

They waste so much time with legislation

link
via TPMMuckRaker
You know that the president occasionally calls for Congress to get off of its duff and pass legislation that he wants, while we the American people say, "Dude, let them do some investigations. They only have so much time to impeach you." But, historically we have perceived Congress as a legislative body, empowered by the Constitution to make and pass laws.

There's apparently another view.

Mr. Diamond, for his part, said Mr. McCain had only done his job. “I think that is what Congress people are supposed to do for constituents,” he said. “When you have a big, significant businessman like myself, why wouldn’t you want to help move things along? What else would they do? They waste so much time with legislation.”

Interfering with the Judicial and Executive branches is why Congress is there. That's why Senators and Representatives and tied to states, so that they can peddle influence locally. I've got to say I don't think I ever thought of them as having this express purpose, but I can see the perspective.

Pollan's Question

link
[T]he most upsetting moment in “An Inconvenient Truth” came long after Al Gore scared the hell out of me, constructing an utterly convincing case that the very survival of life on earth as we know it is threatened by climate change... when we are asked to . . . change our light bulbs. That’s when it got really depressing.
...
Scientists’ projections that seemed dire a decade ago turn out to have been unduly optimistic: the warming and the melting is occurring much faster than the models predicted. Now truly terrifying feedback loops threaten to boost the rate of change exponentially, as the shift from white ice to blue water in the Arctic absorbs more sunlight and warming soils everywhere become more biologically active, causing them to release their vast stores of carbon into the air. Have you looked into the eyes of a climate scientist recently? They look really scared.
...
Whatever we can do as individuals to change the way we live at this suddenly very late date does seem utterly inadequate to the challenge. It’s hard to argue with Michael Specter, in a recent New Yorker piece on carbon footprints, when he says: “Personal choices, no matter how virtuous [N.B.!], cannot do enough. It will also take laws and money.”
...
Going personally green is a bet, nothing more or less, though it’s one we probably all should make, even if the odds of it paying off aren’t great. Sometimes you have to act as if acting will make a difference, even when you can’t prove that it will.

The question -- Today's "Going Green" issues of the New York Times central organizing question -- is "Why bother?" It's an impressive struggle for him to try to answer it. I was talking to a woman recently who really believed that we should reduce emissions of CO2 just out of tidiness, while she refused to accept global anthropogenic climate change as a real thing. This is stupid -- there'd be nothing wrong with greenhouse gases if they weren't going to kill us -- but apparently had been a socially acceptable stance for her.

I don't really believe we have the eight years Jim Hansen gives us, and I don't think that returning to 1988 levels of CO2 -- the '350' of 350.org -- is going to fix the problem, as temperature lags greenhouse gas concentration by decades. While regulation has to change most of the problems, adopting green lifestyles and encouraging others to do the same is an important component of reducing emissions. But, it's unlikely we'll save this civilization. All I believe we can hope for is to keep some of humanity alive; we'll do better the earlier we start, and we'll do better with more commitment.

Some Behind the Scenes Teamwork

Eighth post:
It's really a team effort required to make each medical mission a success. From members of the New York Honduran Committee to the crew from Lutheran HealthCare to those already on the ground in Honduras, each plays an important role in getting things done.

There's Jean and Ruperto Hemmans, who as founding members of the New York Honduran Committee get things ready for the team each year. They are responsible for everything, from fundraising to all the nuts and bolts like coordinating travel and lodging.

Harold Burke, a trial lawyer from Connecticut has provided vital support registering the bulk of the patients, coordinating tracking efforts, and scheduling.

Jeannette Rivers and Edwardo Cameron (also president of the committee) serve as jacks of al trades helping anywhere and everywhere they are needed.

Rosa Garcia, who's in risk management at Lehman Brothers, is helping translate (she's fluent in Spanish), coordinating intake and general customer service.

Sasha Kurumety is only 12 but is playing a large role each day greeting patients, passing out toys and candy to waiting kids and providing support during exams and procedures.

Students Julio Ariel and Vanesa Benites, both 12, attend a bilingual English/Spanish school in Tela and are providing immeasurable support by translating for the team.

The group of volunteers from ATAN (Agrupacion Telena de Ayuda a Los Ninos) take care of much of the local Honduran work like coordinating with the hospital, arranging translators to most importantly, letting the community know we'll be in town.

Ann Robinson has been volunteering for the New York Honduran Committee since 2002. She helps the team with translation, registration and paper work.

Photographer Michael Paras is on his second trip to Honduras for the Lutheran HealthCare team. In tandem with Neal Gorman, VP of Public Relations at Lutheran, (who is on his fourth trip to Honduras) he helps to document and build awareness for the team and its cause.

Ear Nose, and Throat Expert Examines One Day Operates the Next

Seventh post:

A critical member of the Lutheran HealthCare team in Honduras is otolaryngologist Ramez Habib, M.D. The New York Honduran Committee, the group that Lutheran partners with each year, informed the Telan community that an ENT expert would be accompanying the team.

It was quickly evident when we arrived that there we many Telans suffering from a variety of ear nose and throat issues. After examining dozens of young children on Sunday, Dr. Habib was able to schedule six surgeries for Monday.

One of them, 8-year-old Christopher Flowers, who lives in the nearby town called Barrio Way, was having tonsils issues. After a visit with Dr. Habib Sunday morning, he was admitted to the hospital and by 9 a.m. the next day, his tonsils were removed.

A Nurses Provides Comfort, Care and Crowd Control

Sixth post:

Mary Haeney, a registered nurse at Lutheran has accompanied the medical brigade to Honduras for three years now. She's always level headed and calm. And that ability to deliver comfort and support was evident in two very different situations.

As is usually the case, patients -- after waiting a full year -- are very anxious to see the health team.

Besides comforting nervous patients one-on-one during an exam, she has had to switch gears and perform crowd control. Nurses everywhere have to be both tough and kind, and like Mary, be calm and compassionate in a wide variety of situations.

Going the Extra Mile by Making Home Visits in Honduras

Fifth post:

Our ear nose and throat expert Dr. Melissa Inniss works full-time for Lutheran's community health center in Sunset Park, Brooklyn. She works mostly with children at the health network's Center for Child Development, but on this trip she's not only seeing patients of all ages, she's reaching out to them too by making home visits. She was bombarded with patients at the clinic all day Sunday but by 7 p.m. was able to break away and examine two patients at home.

Eugenio Garcia, 63, has significant hearing loss and to date, no one in Honduras has been able to help. At home in his crowded dining room, Dr. Inniss gets his basic history and we learn he used to work in a factory in Charlotte, North Carolina. Years of noise exposure could have something to do with his hearing loss. She fits him with a hearing device called a pocket talker. She asks him to go about his normal routine to see, and get used, to how it works.

Ferdinando Maradiago, 78, has had ear and hearing problems for some years now. After a thorough exam Dr. Inniss, found fluid and general hearing loss and recommended he see Dr. Habib, the Lutheran ENT specialist on the trip.

Lutheran HealthCare Becomes The Town's Family Doctor

Fourth post from Micheal Paras:
With an extremely poor economy and little or no access to health care services, we are in fact the "family doctor" for most Telans.


Like Dania Aguilar, age 11. She was seen by our team last year and says we are the only nurses and doctors she's ever seen. She has been given medication to deal with severe sinus pain last year, which helped, but her meds have run out and she's hoping the team can do more.

Oympia Savion, 65, lives in a town one hour east of Tela called Progresso. She's the legal guardian for Maria Eugenia, 12, who's profoundly deaf. After a number of tests and examinations, Maria's smile is as big as ever, but the doctor thinks the only thing that might help is a cochlear implant, a surgically implanted electronic device that provides a sense of sound to those who are severely hard of hearing.

Virginia Viera is 48 and sees no other health professional in Honduras. She saw on TV and a flyer on the bus that we would be back in town this April. She'll be seen by our ear nose and throat expert for some coughing and airway issues. She says she can't afford to see any other providers, but also admits, she trusts the American practitioners much more.

Each Case is Different

Third post from Michael Paras:

The day before the Lutheran team landed in Honduras, Julian Acosta, age 5, was playing outside and had gotten a stone lodged in his right ear. He was in great pain and his mom, Miriam, age 22, brought him to the hospital's emergency room. The hospital staff suggested she wait and see the volunteers the next day. This was an easy one for the group, and after a thorough flushing, the pebble was removed.

The team can't treat everyone though, as was the case with Mariana Casellanos, 41. Mariana who had sought help before from other doctors with little success was excited to see the team. She has been in severe pain and discomfort for years with some type of sinus issue. She was at her wits end but was sure the American health crew could solve her problems. After an exam by otolaryngologist Ramez Habib, M.D., the team knew they couldn't help. She had a polyp, too large for them to operate. Mariana was crushed, and so was the team.

Patient Snapshots

Second post from Michael Paras:

Lutheran's team of doctors and medical staff performed 162 examinations in Honduras the first day. Here are just a few patient snapshots. Elsa Romero, 77, experiencing periodic but serious painful ear aches. She heard about us on a little transistor radio she always keeps with her to catch up on the news. Odalia Flores, 30, and 4-month old son Avner and 7-year old daughter Claudia live in a nearby town called Colonia January 4th. They were here for Claudia, who had been experiencing serious stomach pains for the past 6 months.

Angeli Idalmir Arzu Palacios, 19, lives in a neighborhood in Tela called Barrio San Jose. She heard about the medical team and hoped someone could remove a mole from her daughter's chest. Although it's probably not too serious, young Shelsea Diana Arzu, 2, is traumatized by the whole experience so far. Il