Tag Archives: OB-GYN

From a Clinic in Kenya, OB-GYN Deb Matityahu, MD, Shares One Young Woman’s Journey

Dr. Deb Matityahu, OB-GYN and Chief of Service for Kaiser Permanente in Redwood City, has returned to Eldoret, Kenya. She volunteers at the Gynocare Fistula Centre, a clinic dedicated to repairing gynecologic fistulae, which arise when a pregnant woman’s delivery stalls. Tissues are damaged when the baby dies and must be removed from the womb. Dr. Matityahu and her teenage daughter started a non-profit, “A Little 4 A Lot,” which works to rehabilitate the often poor and shunned women after their repair. ALittle4ALot.com has raised money to provide sewing machines and lessons for the women. Here is one of their stories:

Ann  is one of our patients.  She lived in a poor village, and had to drop out of school. She was sent to Nairobi to be a maid. While in Nairobi, she was dating a boy for just over one year and became pregnant.

At first, Ann didn’t know she was pregnant; she just thought she was sick.  When she found out, Ann returned home to her village and  went to the hospital.  When she delivered in the local hospital, she had a large tear through the rectum that was not repaired well.  This resulted in a recto-vaginal fistula (RVF). For those of you not familiar with RVF, it is a tear from the rectum to the vagina, resulting in stool leakage through the vagina.  Not pleasant, as you can imagine (understatement).

Because of the stool leakage, she was reluctant to eat or drink anything if she was out of the house.  She was embarrassed, ostracized, and depressed.  She lived with the fistula for three years before learning she could come to Gynocare (Fistula Centre in Eldoret)  for repair.  She was repaired in 2011.

Ann was tearful and crying through most of her story.  She recently finished her dressmaking class, and says that learning to sew has changed her life.  If it weren’t for us and for her sewing machine, she would be working in someone’s home again for 800 kes a month (the equivalent of $10 US).  Now, she knows she has a skill and has value.

Ann believes she will be able to return home to give her 5-year-old daughter a better life and an education.  On the sewing room wall behind her were about six tote bags that she has already sewn.   I plan to purchase them all and sell them in the states.

She continues to cry, insisting that we have changed her life and cannot thank us enough.  At this point, I am crying too and got up to hug her.  I don’t think I fully realized what we have started with this program, and what we have already accomplished in such a short time.

Dr. Deb.
Eldoret, Kenya

RWCDrMatityahu-L-Pt-ClinicDirector-R 2012

In this 2012 photo, Dr. Debra Matityahu poses for the camera with a fellow doctor and patient in a clinic in Kenya.

Susan Dean, RN, and a Dozen Kaiser Permanente Colleagues Return to Guatemala

Susan Dean, RN, is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s sixth consecutive year serving on a Faith In Practice surgical mission; last fall she wrote several dispatches for this blog.  We’ll publish subsequent dispatches from her mission this spring as she has time to send them.

March 14, 2012

The majority of the group flew into Guatemala City on Friday, March 9,  and then traveled by bus to Antigua, where the work would take place.  The trip took all day.  Saturday was spent touring the hospital and Casa De Fe (a place to stay for post surgical care before returning home to the villages).  Sunday was a day for triaging patients and setting up the operating rooms with the medical supplies brought from home.  Eighty patients were scheduled for surgery, approximately 10 patients could not be scheduled for lack of operating room space/time and another 50 were helped on the spot!
…And the team was ready to go.  The team was made up of translators, cooks, the pastor, doctors/surgeons/anesthesiologists, pharmacy person, patient advocate, group journalist/photographer, scrub techs and nurses.  There will be pictures posted on the Faith In Practice website. Please look under volunteer missions – group 315.  Thirteen of our team’s 38 members are from Kaiser Permanente.

Kaiser Permanente San Rafael Medical Center
Brian Bane, MD, Director of Anesthesia

Kaiser Permanente San Francisco Medical Center
Bonnie Souva, RN (OR)
Rae Ann Gustafson, RN (OR)
Paul Preston MD, Department of Anesthesia
Robert Karoukian MD Department of Anesthesia
Susan Dean RN, Manager, Medicine Department

Kaiser Permanente San Mateo Medical Center
Karen Preston, Physical Therapist

Kaiser Permanente Santa Clara Medical Center
Brenda Gips, Admin, Department of Anesthesia
Gordon Haddow, MD, Chief of Anesthesia
Rachel Scheuring, MD, Dept of Anesthesia
Sharon Rose RN, CVICU
Johny Zapanta RN, CVICU

Kaiser Permanente Vallejo Medical Center
Anatole (Tolak) Besman, MD, General Surgeon

We were able to help 79 patients with surgery.  We ran four rooms: two general surgery, one Gyn surgery, and one plastic surgery room.  There were 21 children,  most of whom had cleft lips and cleft palates repaired.  Two kids had hernias repaired.  The adults had gall bladders removed, hysterectomies, and hernias repaired…One patient had an infected mass across the top of his shoulders removed.  He had this mass for 10 years and tried to cover it up by growing his hair long.  He felt ostracized.  When his surgery was scheduled he felt relieved.  The first words out of his mouth following his surgery were, “Thank you.”

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Our week had words and feelings repeating themselves.  Some of these were “blessed,” “connected,” and “team.”  The team felt blessed to be here.  That the Guatemalan people would allow us to enter their lives.  They trusted us and did not even know us.  The feeling of being connected…  We felt so fortunate to meet these patients.  We felt connected and yet could not even speak the same language.  I had a patient who spoke Mayan.  Her husband was able to speak Mayan and Spanish.  He spoke with one of our wonderful translators in Spanish.  The translator conveyed all of the information to me in English.  We had a long, productive, and informative communication. We had a group of 38 volunteers who became a team.  We had a team of cooks who made amazing meals for all, at the beginning and end of long work days.  We had many teams in the operating room, all working closely to help patients, some who were in very difficult situations.  Since care is at a minimum, the surgeries seem to be more difficult.  Patients have had to wait longer for care and had to  endure more suffering. One of the surgeons shared his thoughts…”At home if you do not provide the care someone else will do the work.  Here, no one else will do it and it won’t get done.  The patient will not be taken care of.”

The team felt that being here was such a privilege and an opportunity.  We are so lucky.  The gift of knowing that you are helping someone who might not otherwise get help is fulfilling as well as overwhelming.

In conclusion for now, I would like to share a story.  The cooks went to the marketplace.  They wore their badges, which included our group name.  The woman in the textile stall got excited when she saw our Faith in Practice name. She ran down the hallway to another stall and introduced the cooks to her daughter who had a cleft lip repaired by Faith in Practice many years ago. She went on and on about how thankful she was. All she could say was “Gracias” over and over.

…And this is why we come to Guatemala.

Susan Dean, RN
Kaiser Permanente San Francisco Medical Center

Susan Dean Shares Impressions From Guatemala

Susan Dean is a nurse manager at Kaiser Permanente San Francisco Medical Center.  She’s currently in Antigua, Guatemala, as part of a medical team with Faith In Practice, a nonprofit organization that provides continuity of medical care to the poorest of Guatemala. This is Susan’s fifth consecutive year serving on a Faith In Practice surgical mission.  She sent along this dispatch. We’ll publish subsequent dispatches as she has time to send them.

May 1, 2011
The team arrived safely in Antigua, Guatemala … some from the Bay Area, others from Chicago, Oregon, and Ohio.  Seven are from Kaiser Permanente! All of us are looking forward to doing a lot of cases.  The expectation is to do 80 cases this week…plastic, gynecology, and general.

Lots of children were in the triage area, some for hernias and others for clefts.  We heard a very interesting presentation by a man named Jose from Faith In Practice. Jose was a patient found by a village team and brought in for surgery.  He’s so grateful for the care he received that he spoke with some of the FIP team and ended up working for FIP as an assistant to the Obras director.

We spoke about why some of us are here.  We are grateful how the patients trust us; we feel privileged to be able to come and care for them. We are all traveling out of our comfort zone and feel an obligation.  It is a privilege to come to Guatemala and participate in this mission.

Our intent is to bring the same high quality of care that we give at home, here — just in a different setting. We will be doing time outs and debriefing just like we do at home. Patients are checked and double checked.  Lab work is checked.

But it’s definitely different than home. More than 75 percent lives in poverty here, making $2 a day.  The infant mortality rate is 25 per 1,000 in Guatemala; in the United States it is 6 per 1,000.

Faith In Practice expects to serve 25,000 patients in 2011. That care will be delivered for 16 weeks by FIP personnel; for the rest of the year, it’ll be delivered by volunteers like us from around the world.

Here’s a photo gallery for our team.

Take care,

Susan Dean
Nurse Manager,  APC1, APC3 and HIV/AIDS Module
Kaiser Permanente San Francisco Medical Center