What a Wonderful World-CCC’s Dr. Fischbein’s Rendition

Original Post, March 17 on  CureCervicalCancer.org

I see trees of green, red roses too

I see them bloom for me and you

And I think to myself what a wonderful world

I see skies of blue and clouds of white

The bright blessed day, the dark sacred night

And I think to myself what a wonderful world

(from “What a Wonderful World” Written by George David Weiss, Robert Thiele)

 

Bus ride through Vietnam to CureCervicalCancer Clinics.

Bus ride through Vietnam to CureCervicalCancer Clinics.

From my familiar seat on our little bus I see clouds and haze and rice paddies, too. I also see propaganda signs, tall skinny dwellings and lots of motor scooters as I gaze out the window into the Vietnamese countryside. Staring out the window keeps my eyes off the road and the swerving and honking and frequent jarring that I’ve come to expect when traveling to remote places with the Cure Cervical Cancer (CCC) team. Sanity on the road here requires inner peace and occasional outright laughter. The dance of the traffic is almost as surreal as imaging pigs can fly until a truck carrying live pigs flies by, passing us on the right….twice….and we all just crack up. What a wonderful world it is! This is my second trip with CCC to help screen for cervical disease using the “see and treat” method of visualizing the cervix with acetic acid and offering immediate cryotherapy to those with positive findings. Donating money to a worthy cause is a charitable act. Donating time is even more selfless. I cannot praise enough the fantastic group of people I was so fortunate to travel with for their energy, dedication and sacrifice. While none of us really consider our volunteer work with CCC to be a sacrifice, in actuality, it is. These lovely people put their Los Angeles lives on hold for a week to give of their time and skill for the benefit of women they have never met. Thank you to Leila, Rebecca, Julia, Phorum, Alborz and, of course, Dr. Gordon.

For me, volunteering to use a simple skill learned a long time ago to make a difference is very easy, yet very rewarding. I mean, I’ve seen a lot of cervixes in my 35 years as a physician. Determining negative from positive is not rocket science and yet, teaching and reaffirming these skills to the local doctors and nurses makes a huge difference in the lives of the women and families who access one of the 7 CCC clinics in the northern part of Vietnam.

Dr. Fischbein announcing a successful “See and Treat” procedure on a young woman to the excitement of Dr. Gordon and the CCC team

Dr. Fischbein announcing a successful “See and Treat” procedure on a young woman to the excitement of Dr. Gordon and the CCC team

We were greeted each day with a cup of green tea as a welcoming tradition as we said our hellos to the directors in front of a bust of Ho Chi Minh and a mural of Lenin and Marx. Pretty much the only obvious reminder we were in a communist country.

Members of the CCC team in Hoanh Bo Clinic in Vietnam

Members of the CCC team in Hoanh Bo Clinic in Vietnam

I was really impressed by the knowledge, skill, and efficiency of the medical personnel. I was also moved by the women who came from long distances to be seen by the American team and who were almost giddy to take selfies with us. How things have changed from my memory of Vietnam growing up in the 60s!

Ha Long Bay, Vietnam

Ha Long Bay, Vietnam

The area around Halong Bay, famous for its exotic rock formations in the sea, is having a construction boom as the country embraces a limited amount of capitalism. Admittedly, the locals benefit mainly from the jobs and the tourism but it’s a start. They could use some wider roads with lane markers and rules but then it wouldn’t be quite the adventure. A real life Mr. Toad’s Wild Ride dodging scooters and buses, the occasional ox or cow and even a truck full of pigs, passing on the right! These are the funny fleeting twitter moments. What I will remember long after those are my amazing teammates, our wonderful ground partner Vu, translator, Han, my colleagues Dr. Dzung and Dr. Ha and the relieved and happy faces of all the local women who will never suffer from a 100% curable disease.

The colors of the rainbow so pretty in the sky

Are also on the faces of people going by

I see friends shaking hands saying how do you do

They’re really saying I love you

I hear babies crying, I watch them grow

They’ll learn much more than I’ll never know

And I think to myself what a wonderful world

Yes I think to myself what a wonderful world

 

Pictured here from left to right: Julia Scott, Dr. Fischbein, Rebecca Lepsik RN, Vu

Pictured here from left to right: Julia Scott, Dr. Fischbein, Rebecca Lepsik RN, Vu

Thank you CCC for the opportunity to serve.

With affection,

Dr. Stuart Fischbein’s (OB/GYN) Perspective

So begins the long journey home. From Nairobi to Istanbul, then back to Los Angeles, the reverse of a journey that began 15 days ago. Same group of people, same food, the same airline movies and even the same clothing. But we are different. We are changed. We just spent 2 weeks in Kenya working with the people there. Talking with strangers who are now friends. Indelible memories and faces that could not have possibly been imagined before. Traveling in the world opens vistas. Traveling and volunteering in Africa alters lives, theirs and ours. We are not the same. 

About two months ago I was a busy home birth obstetrician. Always on call, enjoying my work if not the hours, grumbling about traffic and the cost of living and excited about the upcoming Los Angeles Kings hockey season. Then I received a call from my friend and colleague, Jennifer Lang, MD, asking if I would be interested in going with her team from CureCervicalCancer to Kisii and Nairobi, Kenya to teach trainees about screening for cervical cancer. Founder of CCC and friend, Patricia Gordon, MD, had to cancel and they needed another MD pretty last minute. As a solo practitioner in a personal, midwifery model home birth practice it is not easy for me to get away without placing the burden of stress of some clients for even a weekend, let alone 16 days. Each of us must make our way in life by choosing a path that cannot always be planned. Some days you turn right, some left and sometimes you pause, take a deep breath and realize that life is not an algorithm and decisions made for the right reason cannot be wrong. And so I said yes, expressed my plans to my clients, and was relieved when I found they were almost all supportive.

 

I had been to Kenya as a tourist 29 years ago with my father. The country holds great memories for us and my 95 year old father was excited to hear I was going back. I think back on the bold decision my father made to do something very out of character for him and fly alone to Nairobi at age 66 to meet his son at the end of a 4 month sojourn after residency. Memories are funny things. I remember the Acacia trees, the smell of diesel, the Masai and the wildlife. But coming to Kenya for tourism and coming to work here are not the same. I did not remember the roads, the traffic, the crazy pedestrians, the speedbumps, the potholes and lack of lanes and at times I just broke out laughing as a way of coping with the chaos. 

I had no idea what to expect as the CCC group left Los Angeles and flew for nearly 26 hours to arrive on a bright African Sunday morning only to load up our gear and drive for another 7 ½ hours from Nairobi to Kisii in western Kenya. We then stopped at the Level 6 Hospital in Kisii to drop off our supplies and set up for the next morning. Along with Jennifer, the rest of our team included Caitlin RN, and Yvonne, Jackie & Leila, brilliant and energetic premed students all. We were fortunate to have documentarian, artist and world traveler, Stephen Reynolds along for the journey. His talented eye for photography, his creativity and his sense of humor were much appreciated. And I was glad to have some male energy surrounded as I was by estrogen, as usual.

The ten days we held clinic in 2 counties and 3 locations were a mix of exhaustion and reward. Previous blogs here have noted some of the sadness and success. But we did change the lives of countless people. We screened nearly 2000 women and performed nearly 250 cryotherapies on women with visual signs of cervical dysplasia. The WHO suggests that the single visit method of visual inspection with acetic acid (VIA) and cryotherapy after consent is successful in curing 90% of disease. In my mind this means that so many of these women who may have died a rather horrible death will now live on to care for their children and families. HPV is a viral disease that with proper attention has no business killing anyone. Kenya has the resources to stop this scourge and in the past has lacked only the political will. But we met some remarkable doctors, county directors and ministers who all seem poised to join in with the initiative of the First Lady of Kenya and make women’s health a new priority. Donating to organizations that go to these places is always welcome but we can’t always be sure the money or equipment gets used properly. We were told a story by Ruth, one of the local doctors, of donated cryotherapy tanks and equipment from 3 years ago that remain unopened to this day. It’s just a tragedy. The CCC model of hands on training can be a big part of this initiative as the 30 plus skilled Kenyan practitioners we graduated will now go on to screen and train more practitioners in an exponential fashion. CCC and the good people that make it happen are changing lives. 

 

After 2 weeks away from my life in Los Angeles I am ready to come home. I miss my family. I miss my practice and my staff. I am tired, I need a shave and I miss driving on the right side of the road and the smell of fresh air. Funny to think that it takes coming back to LA to have fresh air. Was it the reverse in 1986? I don’t remember. I may quickly fall back into the habits I had before I left. But, then again, I may not. Africa affects you. I have been asked by many if I would do it again. I think so but I know I cannot say for certain. Life is not an algorithm.

Read the original blog post and learn more about curecervicalcancer.org