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Hearts and Minds: Dr. James Hammel Leads Omaha Children’s Hospital Team Beyond Borders to Repair Heart Defects in Young Patients in La Paz, Mexico


It seeems as though every year or so now I get an assignment to write about a medical mission team from Omaha that travels beyond borders to deliver care. In this Journeys story for Metro Magazine I write about the trips led by Dr. James Hammel and his team to the peninsula Mexican state of Baja Sur California and the city of La Paz, where life saving operations are done on infants and toddlers.

Visit the digital edition of the magazine, including my story, at–

http://www.spiritofomaha.com/Metro-Magazine/The-Magazine/

 

 

 

Hearts and Minds: Dr. James Hammel Leads Omaha Childrens Hospital Team Beyond Borders to Repair Heart Defects in Young Patients in La Paz, Mexico 

©by Leo Adam Biga

Appearing in the May-June-July 2016 issue of Metro Magazine (http://www.spiritofomaha.com/Metro-Magazine/The-Magazine/)

 

The peninsula Mexican state of Baja Sur California is a tourist draw for its ocean-front beaches and vistas. But isolation from the Mexican mainland makes it hard for residents to access specialized medical care. Poor residents lack the means to travel, much less afford treatment. A lack of pediatric heart services results in many congenital defects going unevaluated and undiagnosed. Consequently, many children die before getting an opportunity to be treated.

To bridge that care gap Cardiothoracic Surgeon Dr. James Hammel twice a year leads a medical mission trip to the southern city of La Paz in that Mexican state. He and his all Children’s Hospital & Medical Center team were there in November and they’re back again this April.

Before starting the La Paz trips four years ago, Hammel was a veteran of medical missions to Honduras and Nicaragua. His work in Mexico grew out of a collaborative with a Sioux Falls, S.D. health center that received children cancer patients from Big Sur through the Los Cabos Children’s Foundation based on the peninsula. Foundation founder Tom Walsh is from South Dakota. Children sent to Sioux Falls who presented heart problems then came to Omaha for treatment.

When a boy named Mario died before ever making it to a Chidlren’s operating room, Hammel resolved to provide care in Southern Baja in order to circumvent the delays that result in such needless tragedy.

 

“Before we went down for our first trip there was no pediatric cardiologist in that state of Mexico, there was no cardiac surgeon, adult or pediatric. There had never been an open heart operation performed there historically. There was no intensive care unit team either, And there obviously was no familiarity with doing heart surgery, so we were really pioneering something there.” – Dr. James Hammel

 

“It was obvious to me he’d been turned away again and again and again,” Hammel says. “His mother was very sweet and she had taken him repeatedly across to the mainland and sort of begged for surgery from one of the centers there. But they just couldn’t get it. That case firmly cemented my commitment to this charitable foundation and when the opportunity did arise to work down there that seemed like a lot better option than bringing people up.

“Bringing kids up is very expensive, cumbersome, difficult. It takes a long time and it’s only possible to do in very small numbers. I thought. Well, for the same amount of money we could treat a dozen children there by bringing our team down.”

Hammel leads some 20 medical professionals, most specializing in critical care, on each 10-day trip. They’ve instituted many firsts there.

“Before we went down for our first trip there was no pediatric cardiologist in that state of Mexico, there was no cardiac surgeon, adult or pediatric. There had never been an open heart operation performed there historically. There was no intensive care unit team either, And there obviously was no familiarity with doing heart surgery, so we were really pioneering something there.”

He brings intensive care doctors, children’s pediatric intensive care nurses, a perfusionist to run the heart-lung bypass pump, cardiac anesthesiologists, operating room nurses and a surgical assistant. Everyone volunteers their time. Their care is entirely free to families.

 

“What we do is a calling, a passion, it’s what we love to do, but it is a job and you don’t always appreciate and grasp the enormity of what you’re able to do until you give it to somebody for free. What we give down there is something nobody in the United States will ever appreciate the way the people in La Paz do. I cannot over-stress the amazing feeling you get when you save the life of a child whose family has tried every avenue and lost hope and then you do that for them and they are so grateful. I can’t imagine not doing this work. I’m in it for the long haul.” – Dr. Bridget Norton

 

It’s taken awhile to build trust with local leaders but a permanent program is now in the works.

“Little by little the administration of the hospital we’re working in and the government health ministry and the state government began to take an interest in the possibility of making an ongoing program. That’s when my goals took their last maturational step,” Hammel says. “We’ve been back every six months for a total of six missions and we’ve operated on 68 children – some with simple diseases but some with very complicated heart defects. Mostly they’ve done fine.”

 

 

 

 

 

 

 

 

 

 

Some children require multiple surgeries.

“My goal is to establish a new cardiac treatment program to be a permanent part of that state’s health care system. In all of Mexico there are about 11 pediatric cardiac surgery programs and eight are located in Mexico City itself, thus the distribution of this resource is really poor and access is really limited. There are probably 18,000 children born in Mexico with heart defects every year and probably only about 3,600 corrective operations and catheter procedures performed. So, nearly 80 percent of the children with heart defects likely die, It’s a really big unmet need in the country.”

His goal is to help the Mexicans “build a viable, self-sustaining program that goes on treating these children when we’re not there and even after we stop coming.” He adds, “We have recruited to the state two pediatric cardiologists, a pediatric intensive care doctor and the first cardiac surgeon in the state. We have trained a group of pediatric intensive care nurses in special techniques for cardiac intensive care nursing. We trained the operating room staff.”

Before it can be self-sustaining, he says a “critical mass of manpower” is needed. Progress to get there is being made.

“It’s a gradual thing. This last summer the program performed its first open heart operation without us being there. They have performed a larger number of non-open heart cardiac cases, simpler cases, so they’re beginning to get going.”

He expects the program to reach a major milestone in 2016.

“When we get the program fully accredited by the Mexican federal government the hospital system can begin to receive some reimbursement for each case they do. It amounts to about $6,000 or $7,000 per case, but we can do it for that. It’s going to take a little more investment for needed supplies before we get to that point.

“In the meantime, we go and we do a dozen cases twice a year and that’s wonderful. It’s a great thing for the children we treat and their families, but it’s not enough. I would estimate there are about 60 children born in this state of Southern Baja a year with critical heart defects who need an operation, so we’re not reaching all of them.”

 

“The trip has evolved and the camaraderie has become much more important and never more so than last trip when the kids were much sicker.”  – Shannon Hoy

 

 

 

 

 

 

 

He’s created a nonprofit, Abriendo Corazones – Opening Hearts, to coordinate the medical care and logistics of the trips. It partners with the Los Cabos foundation. Children’s may soon be formally involved.

“Our hospital administration has seen the positive effect this kind of work has on our staff as far as their resourcefulness, their creativity, their career satisfaction. It’s something that really brings us together

and that has real tangible benefits in terms of our ability to do our job with excellence. I think Children’s is coming to see this work as a two-way street with great benefit to the people there and to our patients and staff here.”

Dr. Bridget Norton, a Specialist in Pediatric Critical Care Medicine, has been on all but one La Paz mission. She says it’s a “team-building” experience for both her and her fellow professionals who go.

“We make relationships and connections and friendships with colleagues we wouldn’t necessarily make without that experience.”

Many things Children’s does in Omaha, such as blood conservation and comfort med administration, have come out of what the team’s learned to improvise with in resource-poor La Paz.

Norton says the trips put in perspective the gifts she and her mates have to give.

“What we do is a calling, a passion, it’s what we love to do, but it is a job and you don’t always appreciate and grasp the enormity of what you’re able to do until you give it to somebody for free. What we give down there is something nobody in the United States will ever appreciate the way the people in La Paz do. I cannot over-stress the amazing feeling you get when you save the life of a child whose family has tried every avenue and lost hope and then you do that for them and they are so grateful.

“I can’t imagine not doing this work. I’m in it for the long haul.”

Perfusionist Joe Deptula, who’s made multiple Central American mission trips with Hammel, says the work is about “being able to give back.”

Shannon Hoy, a Certified Registered Nurse Anesthetist (CRNA), has made many mission trips herself. She sums up the La Paz mission as “a great experience,” adding, “The trip has evolved and the camaraderie has become much more important and never more so than last trip when the kids were much sicker.”

The team can’t forget a patient named Oscar.

“Oscar came to us with a very serious congenital heart defect, which was previously operated on during a different trip,” Hammel says. “Due to his age and heart defects, his heart had sustained a lot of wear and tear and we were unsure how well he would do despite the repair.”

When the team left for home his vitals looked good. Then a fire in the unit forced a patient evacuation. His lines were cut and he expired off the meds. News of his death hit the team hard as he’d twice beat the odds only to lose his life anyway.

Most operations are scheduled in advance but families often show up unexpectedly with a sick child. The parents of a 6-month-old named Derek drove hours to reach La Paz, where the team found the baby so fragile they simply admitted him for observation without a single line or anything started lest the trauma prove too much. The boy’s surgery the next morning went well and today he’s totally repaired and healthy.

The life-and-death surgeries and the intense emotions take their toll.

“You are exhausted and not just physically,” Norton says. “It’s hard work and we work long hours. We do overnights in the hospital. But it’s also emotionally draining. You just have a lot of feelings and emotions you work through.”

Once back home, some decompression is necessary. Thoughts of La Paz, however, are never far from Children’s team members’ minds. Not only do patients and families leave an imprint, but so do staff.

“We’re like family,” Norton says of her team and the Mexican team they work alongside. Collaboration is vital to the program’s success. “They’ve been amazing and are on-board with the mission. We really couldn’t do anything we do without them – all the support services they provide, the hoops they jump through, taking care of the equipment we leave down there. Any blip that comes up, they handle it.”

Los Cabos foundation former executive director Greg Edwards now heads Abriendo Corazones – Opening Hearts with Dr. Hammel. He says building the program has inherently high stakes and complexities because it’s critical care. Since that care is largely delivered by Omaha specialists, much coordination and navigation is required. These specialists not only practice their healing arts in La Paz but impart expertise there. Locals also travel to Omaha for training.

“The support of Dr. Hammel’s team and friendships that exist at Children’s has been essential for this to happen,” Edwards says. “You cannot have a cardiac program without intensive care. Building a pediatric cardiac care program is no small task. It has meant creating relationships with Mexican officials. recruiting qualified staff, turning the surgeries into not only life-saving operations but a training theater for the local Mexican medical staff, creating a pipeline for medical supplies needed for the surgeries and intensive care from Omaha to Baja.

“It really is a huge undertaking.”

Abriendo Corazones accepts donations to support its efforts at strengthening hearts. Contact Dr. Hammel at 402-955-4360.

For more on the trips, visit http://www.loscaboschildren.org/donate/.

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To Tanzania with Love: Mary Williams to Make Documentary on Alegent Creighton Health Mission in Africa Led by Bob Kasworm

January 3, 2014 1 comment

Good works come in many forms.  So do life transformations.  Former Omaha, Neb. resident Bob Kasworm has always tried doing the right thing.  This devoted family man has been a model employee and he’s also faithfully served his church and his community.  But he took things to a whole other level when after several mission and fact finding trips toTanzania he decided to live and work in that African nation.  He made a life-changing  commitment to Alegent Creighton Health and its onging initiatives in Tanzania in collaboration with the Evangelical Lutheran Church of America to improve the health and medcal care, living conditions, and opportunties for residents there.  As the point person for the organizaton’s work in Tanzania, Kasworm will be featured in a documentary that former Omaha television reporter-anchor Mary Williams will be making with videographer Pete Soby.  The reporter-videographer team will be traveling to Tanzania in early 2014 to document the project’s efforts.  My Omaha Magazine story about the mission in Tanzania and the planned film follows.

 

To Tanzania with Love: Mary Williams to Make Documentary on Alegent Creighton Health Mission in Africa Led By Bob Kasworm 

©by Leo Adam Biga

Originally appeared in  Omaha Magazine

 

 

Bob Kasworm

 

 

Life-changing work by Alegent Creighton Health in Tanzania, Africa is the focus of a forthcoming documentary from a one-time Omaha television news personality. When former KMTV anchor-reporter Mary Williams and videographer Pete Soby travel to Tanzania in February their main point of contact will be ACH’s man on the job there, Bob Kasworm. whose life has been transformed by the calling he follows in that distant land.

Kasworm, a biomedical engineer and devout Christian, combines career and faith in Tanzania, his home the last 10 years.

“This was never in my plans. I really wasn’t thinking I would ever go to Africa or have a life of service,” he says.

He first visited in 2001 on a Nebraska Synod of the Evangelical Lutheran Church of America sponsored trip. He went to evaluate the potential of Alegent assisting hospitals. dispensaries and public health programs there.

The pull of Africa began then.

“From the very first trip there was never a day and rarely an hour when Africa was not on my mind. Yes, it was the poverty and the need, but it was more than that. Somehow Africa just got into my blood.”

He made a dozen or so additional visits in a three-year span as Alegent committed itself to working with the evangelical church and various health and civic partners in Machame, Tanzania. He cultivated and coordinated the growing relationship between the partners and implemented various initiatives.

The organization’s efforts there include training medical staff at Machame Hospital, developing Machame Nursing School, providing nursing scholarships and delivering medical equipment and supplies. Kasworm leads the Homes for Health program that uses local laborers to build new, cleaner, safer homes for residents.

 

A Homes for Health project

 

At the end of 2004 Kasworm decided to live in Tanzania full-time. He says it was then his wife “realized that what she thought was just a temporary ‘mid-life crisis’ was something I was powerless to resist.”

He’s since learned Swahili well enough to speak it fluently.

Machame Lutheran Hospital, founded some 110 years ago by German missionaries, is at the center of much of Alegent’s work there.

“We have the hospital with about 120 inpatients and many outpatients and clinics. We also have a Clinical Officer Training school and now the nursing school. There are about 20 homes for staff,” says Kasworm.

 

 

 

Neema, the first graduate of Machame Lutheran Hospital  Nursing School

 

 

The campus is on a rare paved road. There’s running water (“usually”), electricity (“much of the time”) and Internet access – though slow.

Progress is plodding but satisfying.

“The most satisfying thing is that in many cases if not for our efforts and involvement many would simply not get help. A child with a club foot would become an adult with a club foot. The nursing student would not have had a chance to study. It is not like you can just go down the street to an alternative. There is no safety net. We do it or it won’t happen. We can now point to a number of successes.

“There is such a shortage of trained healthcare workers that our efforts in education may well be our biggest legacy. If you educate one nurse they will care for thousands over their career.”

 

Machame Hospital

 

Williams, who interviewed Kasworm on one of his periodic visits to Omaha, describes him as a “strong, driven” man who “sees opportunities where others don’t.”

ACH mission integration consultant Lisa Kelly says. “He’s so embedded in that culture now it’s amazing. He’s definitely a problem solver, which is huge in that country. Everything from unloading containers of things we send to fixing machines to keeping a water source going or getting an Internet connection set up, you name it, Bob is the guy who figures out how to do it.

“He has to navigate what’s possible in the developed world with what’s possible there in that culture and that setting. So you have to think of medicine in a whole new way and what he has been able to do is to bridge that gap.”

Williams and Soby are eager to tell this story from a grassroots perspective.

“You can’t really tell the story without talking to the people on the ground who are being helped and that would start with the patients coming through the door,” says Williams. “You cannot tell the story without talking to all the players – the patients, the nurses, the young women who have a fighting chance now.

“We can’t tell the story unless we go past the borders and see how exactly the people live and the challenges they face every day. We’re going to experience that first hand. It doesn’t get any better than that.”

 

Mary Williams

 

Pete Soby

 

 

When Williams left KM3 in 2009 and launched her own marketing and media production company she set her sights on telling stories that engage people’s hearts and minds. From reporting medical news she knew Alegent had compelling stories to be told and she wanted to be the storyteller that shared them.

There wouldn’t be a Tanzania story without Kasworm, whose year-round presence in that county makes the Alegent Creighton mission model unique. Much emphasis is placed on building relationships and making connections through ministry and medical mission trips organized by ACH and the Nebraska Synod of the ELCA.

For Williams, who’s only previous overseas assignment was covering local airmen serving in Desert Storm, this is an opportunity she couldn’t pass up.

“I’m sure it’s going to be a life changing experience.”

She and Soby expect to complete the 30-minute documentary in the spring.

Kasworm sees the project as another vehicle to foster awareness between Tanzanians and Americans.

“Our experience lets us serve as a bridge between the cultures and reduce misunderstandings. It seems much of our important work has not come from analysis or needs assessment – the work has just found us. I am sure more will present itself.

“As long as the doors keep opening and my health stays good, I hope to continue.”

Joseph Dumba and his Healing Kadi Foundation make medical mission trips to South Sudan

January 3, 2014 3 comments

Westerners have a long history of aiding developing nations through mission work.  Sometimes though the assistance that Americans or others from the Western world provide can appear to be coming from a colonial mind space and consequently the recipients can be made to feel less than.  That’s why what Dr. Joseph Dumba does through his Healing Kadi Foundation’e medical mission trips to South Sudan is different.  Dumba lives in the States, with his wife and children in Omaha, Neb., where he practices family medicine, but he is a native of the very South Sudan area that his medical mission trips serve.  He was and will always be a Sudanese and he infuses the work that he and his teams do there with cultural sensitivity.  In the following Metro Magazine piece I profile Dumba and the work of his foundation.

 

Journeys

Healing Kadi Foundation

©Milton Kleinberg: Omaha resident who survived little-known chapter of Holocaust history releases new edition of memoir_BY LEO ADAM BIGA
Originally published in Metro Magazine

Joseph Dumba and his Healing Kadi Foundation Make Medical Mission Trips to South Sudan

A U.S. doctor brings relief to his African homeland

When Dr. Joseph Dumba leads medical mission trips to South Sudan through his Omaha-based Healing Kadi Foundation, it’s personal. The Methodist Physicians Clinic doctor grew up in the same deprived, war-rabaged area, Kajo Keji County, his mission teams serve. His father, siblings and their families still live there.

His parents were subsistence farmers. As the oldest child he worked the fields before school. He grew up in a mud hut with no electricity or running water. Despite the struggles his folks paid for his and his siblings’ education. Life was interrupted when hostilities between government and rebel forces reached deep into southern Sudan.

Dumba fought in the civil war that forced his family into a Uganda refugee camp. He ended up in a Kenya camp. The war still raged.

When peace came in 2005 refugees returning home found conditions little improved from when they left. Dumba’s persistence to make a better life brought him to America in 1990, where he followed his dream to become a physician. He initially resettled in Tacoma, Wash., where he put himself through college and medical school.

He and his wife, Sabina, a fellow South Sudan native and advanced practice registered nurse, began a family on the west coast. The couple have three children.

Dumba came to the Midwest for his residency. After completing graduate training Alegent Health hired him in 2004 and then Methodist in 2010. The Omaha church he joined soon after moving here, Covenant Presbyterian, did mission trips to Nicaragua he went on. In 2007 he led his first South Sudan mercy mission through Covenant.

He’d long wanted to aid his countrymen. “I was looking for that opportunity,” he says. His resolve grew after his mother fell ill and died in the bush. No doctor was around to treat her. He vowed to help prevent such tragedies. He has by providing care to thousands via the Healing Kadi Foundation he formed in 2009. Its South Sudan clinic opened in 2013.

Last spring, KETV reporter Julie Cornell and photojournalist Andrew Ozaki accompanied Dumba for a documentary, Mission to Africa, profiling the foundation’s work serving what Dumba calls “the poorest of the poor.” The film shows the arduous life of residents who line up to receive care at mobile clinics conducted by Dumba’s team in remote villages. Most patients have never been seen by a doctor before. Women, many widowed from the war and raising children alone, present chronic illnesses from their backbreaking work.

“I think the documentary really did bring some light to how things are,” says Dumba. “It’s had tremendous impact, especially in bringing some awareness.”

He says donations to Healing Kadi are up since the doc aired last year.

The film doesn’t skirt showing how tough things are. Cornell was struck by the contrasts of a country rich in beauty yet beset by suffering and hardship. She says Dumba’s “spirit, calm and sense of purpose” impressed her, adding, “It’s clear that faith guides and directs his life.”

Dumba says everything’s in short supply in South Sudan, even things taken for granted in the States, such as medical syringes and gloves. What’s disposable here is reused there. Nothing’s wasted.

“We’re so far from being able to provide the most comprehensive care but at least we’re there to provide some of the most basic things they don’t have.”

The foundation’s set up a permanent clinic containing everything from x-ray machines to a surgical room. Thousands of dollars in medicines are brought over each trip, much donated by Omaha families and organizations.

In addition to doctors, nurses and pharmacists, the team includes prayer ministry members, mental health professionals, educators, water purification specialists and financial literacy experts.

All the foundation’s work depends upon donated time, expertise, money and supplies. Everyone pays their own way.

“All of us doing this do it on a volunteer basis,” says Dumba.

Healing Kadi hopes to build a roof atop its open-air clinic to better shield patients from the elements. Dumba says the foundation also hopes to construct a patient admitting structure and a hydration station. A longer term goal is building an acute care hospital. Dumba says there isn’t a single intensive care unit in all of South Sudan. The sickest patients must go to hospitals in more developed border nations.

In late March Dumba will lead a seventh mission trip. He and his team. including colleagues from Methodist, will put in grueling hours.

“We work for five days, very intensively, Monday through Friday. They’re long days. We work from sunrise to sundown until we can’t see anything. Then we go back to where we base and there we find patients also needing care, so sometimes we work until 10 or 11 pm. Then we just go to sleep and wake up and start all over again.”

Sometimes I think what did I get myself into because you think you’re making progress and you hit a standstill. But then God opens the door and you move forward.

~ Dr. Joseph Dumba

As the film details, Dumba is welcomed as a hero and his team  accorded great respect. Expressions of gratitude abound.

Dumba says his greatest satisfaction is “people coming to the clinic and saying, ‘Thank you for being here.’ The clinic is delivering care to thousands who wouldn’t have had any care at all. They don’t have anywhere else to go.” He knows the missions are making a difference as more and more people come for treatment.

“The last trip we saw about 10,000 patients, averaging about 2,000 a day, and even with that we’re not able to see everybody.”

Patients are required to pay a small fee or to barter, he says, in order to “empower” the people to be self-sufficient in the future.

He arrives in advance of his team to arrange logistics. As a well-placed South Sudan native, he’s able to cut through red tape.

“I know most of the leaders in the country. It makes things a lot easier. When my team arrives at South Sudan airport the appropriate authorities have already been informed and all the proper paperwork has already been sent ahead so that my team can quickly pass through to start work.”

He says his country’s “very slow” rebuilding can be frustrating.

“Sometimes I think what did I get myself into because you think you’re making progress and you hit a standstill. But then God opens the door and you move forward.”

It’s then he’s reminded how far South Sudan and Healing Kadi have come in a short time. He and Sabina have helped put all but one of his siblings through college and all are productive citizens today.

He’a also reminded how simple health care can be.

“It’s like a relief. You don’t have paperwork there, you don’t have computers, all you do is just take care of patients. You talk to the patient, examine the patient, find out what it is, write down the diagnosis and medicine, that’s it.”

As the film depicts, physically touching patients is a big part of the healing delivered. Dr Jim Steier, who’s been on several mission trips, says, “It’s not only the medicine…it’s the people” that stand out.

Dumba says everyone who goes is affected.

“The doctors who go with me come back with a different perspective.”

Trip veterans return humbled by the experience and grateful for what they have. They think twice before throwing something away or complaining.

Julie Cornell was impacted, too. She senses the film she made affects viewers the same way. She says she finds “intensely satisfying” the film’s “ability to move people, open their minds and call them to action.”
Dumba likes that it paints a vivid but hopeful picture of his homeland’s struggles and of his foundation’s efforts to address some of the needs.

To get involved with the foundation’s work or to make a donation, visit http://healingkadi.org or email info@healingkadi.org.

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