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June 2019, Volume XXXIII, No 2
Each year, Minnesota Physician Publishing recognizes physicians and health care providers who have volunteered their medical services. Whether volunteering at home or overseas, these caregivers help people in need and come away with a revitalized sense of their work. Their compassion, commitment, and generous spirit reflect the deeply held values in Minnesota’s medical community.
Recognizing Minnesota’s Volunteer Physicians
By Richard Ericson
Derek Beyer, MD
Grand Itasca Clinic & Hospital
erek Beyer, MD, an obstetrician-gynecologist at Grand Itasca, traveled with a group called Community Health Initiative (CHI) to Haiti last March. The group consisted of a general surgeon, reproductive endocrinologists, and other OB/Gyns. Dr. Beyer also brought along his high school-aged daughter, who has an interest in the field of medicine.
Beyer learned about CHI through a colleague who had accompanied his son on a CHI medical visit to Haiti. Based on that account, Beyer and his daughter made plans to volunteer themselves. CHI representatives provided extensive background and advice prior to the trip. As their journey approached, Beyer still had some concerns.
“I worried about being prepared to actually treat potentially very ill patients with little or no support,” he wrote in an account of his trip. “I worried about contracting one of a multitude of infectious diseases that could be life threatening to me or my daughter.” Once he arrived in Haiti, however, he quickly engaged with patients and CHI team members, and his worries faded.
The group spent most of their time in the village of Do Digue, hiking up to a nearby mountain community for one of the days. On the first day they triaged about 200 men and women for services to be provided throughout the week. About 100 women were screened for cervical cancer, with 12 of them requiring treatment.
The team also provided prenatal care. For many women, this was the only time during their pregnancy that they ever saw a doctor. They identified placental location problems and preeclampsia, and administered malaria prophylaxis. They also performed hysterectomies, primarily removing fibroid tumors. They saw patients from sun up to sun down and traveled with their own drugs and record-keeping system.
“Many of my misconceptions about Haiti have been dispelled,” Dr. Beyer wrote. “I now know what proud, dignified, and wonderful people inhabit that nation. They have challenges, to be sure, but they need our help, not our pity. A little goes a long way there.”
Dr. Beyer intends to go back to Haiti in the coming year, and may bring his son, who is also interested in pursuing a career in medicine.
Fred Bogott, MD
Mayo Clinic Austin
fter retiring as a family practice physician at Mayo Clinic–Austin, Fred Bogott, MD (pictured third from left above), drew upon his PhD in physics and writing background to provide volunteer consulting services to scientists through The Hormel Institute (HI), an Austin-based cancer research facility affiliated with the University of Minnesota’s Masonic Cancer Center. Zigang Dong, MD, executive director at HI, praised Dr. Bogott’s work in the lab, where he supported researchers in preparing papers to be published in top tier/high impact journals and wrote grants to be submitted to institutions such as the National Cancer Institute and the Department of Defense.
In addition to his volunteer consulting here in Minnesota, Dr. Bogott traveled to HI partner labs in China to provide research, support, and consulting. He assisted with papers and conducted a weekly informal class that covered English as a spoken language—an approach that differed from what Chinese researchers had been taught in school. He also provided a link to the local community for Chinese researchers who work long hours and are often unable to get out of the lab.
His travels extended beyond the research facilities as well. “We go to areas where Americans very rarely go, and I have been invited as a speaker in their institutes and hospitals,” Dr. Boggot wrote. “In some of the many cities I have visited, I have encountered professionals for whom I am the first Westerner they have ever met, and I represent the U.S. and American medicine as best I can. The scientists and doctors are often very interested in how we live and do things, and I represent a non-threatening, non-governmental source of information and contacts.”
Recently, Dr. Boggot was referred as an editor to a nurse—the wife of a scientist in Zhengzhou—who was working on a proposal for post-stroke home care. Dr. Boggot arranged a contact between her and an Austin nurse working the same field. “A web of contacts like this among scientists, doctors, and others, spreading and linking, can only be for the good,” he wrote. “I also spend time with Americans, explaining what things are like in China. Most Americans know little of China and what they do know is 20–30 (or more) years out of date and is totally wrong. So I represent a two-way source of information and cultural exchange.”
Y. Ralph Chu, MD
Chu Vision Institute
hu Vision Foundation was created to target, treat, and prevent blindness through educational and surgical mission trips. In many countries, cataract sufferers require a sighted person to guide them through daily life. Cataract surgery gives patients back their independence, and also increases the productivity of formerly sighted guides.
Chu Vision Foundation has traveled to countries such as Myanmar and Fiji and plans to continue mission work in under-served communities, teaching local ophthalmologists and performing surgery. Recent missions:
Myanmar. After joining the Hawaiian Eye Foundation (HEF) volunteer faculty, Dr. Chu and Chu Vision Foundation traveled to the capital city of Yangon in Myanmar. While there, Dr. Chu performed surgery while instructing dozens of Burmese ophthalmologists and ophthalmology residents on the latest technologies and procedures. The location’s isolation contributes to a large number of residents living with treatable blindness and a lack of trained physicians to treat the problem.
After joining the HEF volunteer faculty once again, Dr. Chu and Chu Vision Foundation returned to Yangon in Myanmar for an education-based mission trip. The goal was to continue to educate and train Burmese ophthalmologists and ophthalmology residents to help create sustainable eye care.
Fiji. Chu Vision Foundation also traveled to Fiji to help at Ba Vision Eye Center. While at Ba Vision Eye Center, Dr. Chu and the Chu Vision Foundation performed sight-saving surgeries with hands-on patient care. Dr. Chu also shared his techniques with the local ophthalmology community.
Dr. Chu is a recognized opinion leader, innovator, and global voice for research aimed to improve and impact eye health for patients of all ages, cultures, and economic conditions. With a personal commitment to forge new frontiers in the field of ophthalmology, Dr. Chu regularly participates in clinical evaluations and FDA studies regarding cataract and intraocular lens implantations, phakic lens implantations, laser vision correction, and ocular therapeutic treatments.
Chu Vision Foundation also works with local charities in Minnesota and provides care to uninsured or under insured members of the community.
Melissa Gleaves, FNP-BC
Fairview Lakes Medical Center
hen a friend initially invited her to join a medical team in Haiti, Melissa Gleaves had never traveled outside North America and certainly hadn’t considered using her medical expertise globally—but faith and an inner voice told her that “sometimes you have to say ‘yes’ to opportunities that seem bigger and more challenging than you can imagine and figure out the details later.”
Working with Healing Haiti, a nonprofit Christian organization, she and her colleagues traveled to Port au Prince, Haiti, to treat patients via mobile clinics in several tent cities. She soon realized that the trip was only the beginning of a journey, and determined to continue delivering care beyond the walls of her local clinic and the borders of her home country.
She later joined a colleague in developing a Maternal Child Program at Grace Clinic in Titanyen, Haiti, which strives to reduce maternal, fetal, and neonatal morbidity and mortality. Using WHO guidelines, the program enrolls pregnant women to the local clinic for scheduled prenatal care with a Haitian provider. Expectant mothers are provided education, prenatal vitamins, fetal ultrasounds, lab testing, and screening for high-risk conditions, and are offered post-partum care and education.
The program also connects with community midwives to assist with most of the home births, teaches hygiene, safety, and maternal care, and provides education about nutrition, breastfeeding, sleep safety, and other parenting issues. Teams include obstetricians, labor and delivery nurses, neonatal nurse practitioners, lactation consultants, home care nurses, medical assistants, and other medical staff. Gleaves and her team have been asked to bring this program to the Cité Soleil in Hope Clinic, Healing Haiti’s newest clinic.
She will continue her regular visits to Haiti to champion the work she and her colleagues started from a small Haitian “tap tap or taxi.” Delivering care in Haiti demands bold leadership and risk taking in a country with limited resources. One of the most basic challenges has been letting local women know about their services and providing transportation to the clinic. Despite these challenges, she derives great rewards from the clinic visits, and in building deeper, personal relationships within the community.
Carson Harris, MD
Retired ER physician and current pain management specialist
r. Harris is the medical director and inspiration behind Medical Educators for Latin America (MELA), which partners with Mano a Mano Bolivia to provide acute care conferences for local physicians and nurses in Bolivia.
He recently helped organize the 12th conference with volunteer physicians, nurses, social workers, psychologists, and interpreters to train medical personnel serving the rural population of Bolivia and educate them on management of acute trauma, emergency care, acute and chronic medical care, and mental health care.
As they teach and share knowledge, MELA’s teams of medical professionals develop meaningful and strong relationships with Latin American colleagues. MELA partners with organizations committed to improving the health care of their communities and country. In addition to its ongoing continuing medical education conference, MELA has completed smaller courses in advanced trauma management, fundamentals of critical care, and pre-hospital trauma management.
Volunteers include doctor and nurse educators as well as physician extenders, paramedics, dentists, psychologists, and social workers. The only prerequisite to volunteer with MELA is to have a passion or a desire to teach and learn. Although some degree of Spanish fluency is helpful, MELA does not require it, since it provides professional Spanish interpreters.
Dr. Harris believes that the experience of teaching with MELA is ideal for residents-in-training, and encourages their participation. For residents and others who are interested, MELA helps coordinate a Mobile Clinic (Jornada de Salud) to rural areas of Bolivia where the volunteer can consult alongside local Bolivian physicians, nurses, and dentists to provide care to patients with limited access to care. Participating residents get a first-hand look at medical systems located in a resource-poor country and learn to appreciate the abundance of our own health care system.
“Leading groups of health care professionals to Bolivia to share potentially life-saving knowledge has been one of the most rewarding aspects of my involvement with MELA,” Dr. Harris said. “The hospitality and friendship of our Bolivian colleagues has been paramount to our continued involvement in coordinating and developing educational programs.”
Thomas J. Haus, MD
Glacial Ridge Health System
r. Haus signed up years ago with International Health Services (IHS) to go to Honduras—and has been there four times. Each February, 150 people from around the world disperse throughout Honduras with teams of doctors, nurses, pharmacists, an interpreter, and a communications person with a short-wave radio. Medical staff frequently diagnose and treat malnourishment, hypertension, diabetes, chronic wounds, and ocular conditions related to sun exposure. Honduran dentists also join each team for dental care and tooth extractions. Local college students serve as interpreters, visiting each village and then going to the next. They set up in a municipal building with sheets hung up for patient privacy. Patients line up for hours, return home when it gets dark, and return to line up again the next day. “You look at all of the people that are lined up, and they keep coming,” Haus said. “It doesn’t take long to realize, yes, it matters to each and every individual you are helping.”
The local Honduran Army provides security and Dr. Haus has always felt safe. On his last three trips, he has taken one of his four children along as a member of the team. Two of his three high school daughters, who are fluent in Spanish, assisted at clinics and helped communicate as needed. Dr. Haus often has Rural Physician Associate Program students. Last year when he went to Honduras, his student, Daniel Harren, who also lived with Dr. Haus’ family, accompanied him on the medical trip.
In addition to volunteers, medical centers in Honduras need equipment and supplies. Dr. Roderick Brown, a colleague of Dr. Haus’ at Glacial Ridge Health System, has helped work with local hospitals to get the equipment they are replacing or upgrading donated to hospitals in other countries. Rotary Clubs in Honduras cook for them and do what they can to help. A Rotarian himself, Dr. Haus and others met with local Rotarians and hospital staff last year to find out what equipment they need most, and is currently seeking a Rotary grant to get a badly needed ventilator for one of the hospitals, along with a service contract for sustainability. “Imagine their priority needs compared to ours in the United States and at our own hospitals,” he said. “We’re definitely making a difference on mission trips—one person at a time.”
John Kvasnicka, MD
St. Joseph’s Hospital
houlder to Shoulder, in conjunction with Global Health Ministries, has partnered with Ilula Lutheran Hospital in Ilula, Tanzania, for more than 15 years to develop and improve the services provided to the local area by the hospital.
Starting in 2014, Shoulder to Shoulder presented the inaugural Ilula-Minnesota International Healthcare Conference. The first course was presented in January 2014 with 30 attendees. Based on extremely positive feedback from the initial conference, the partners in Tanzania encouraged them to significantly expand the conference to offer this educational experience to a much larger audience of caregivers. As a result, they expanded the 2015 conference to include all 28 Southern Zone Lutheran Hospitals with a total attendance of approximately 80 professionals. For the 2016 conference, they added an administrative track to the conference and included over 100 attendees. The 2017 conference expanded attendance to include nursing school staff. For the 2019 conference they hosted over 100 Tanzanian health care professionals.
Five principles of the work: lifelong learning, inter-professional teamwork, mutual respect, continuous improvement, and sustainable impact. In addition to the benefits to patients and staff in Tanzania, participation in this program provides a unique opportunity for volunteer U.S. physicians, nurses, pharmacists, administrators, and students by promoting engagement in the profession, providing an opportunity to serve and learn about medicine in the developing world, engaging interest in contributing to global health development, and fostering a culture of education.
Course evaluations rank the conferences as 9/10 and participants rave about the experience. Dr Kvasnicka has served as a volunteer course director for this work since its inception and is passionate about the importance of health care education and quality improvement. He actively plans the curriculum, recruits speakers, and collects feedback for ongoing refinement of the conference and topics. All the faculty involved in the program provided all services on a volunteer basis without any compensation and are fully responsible for all costs of their own transportation, travel expenses, and living expenses while volunteering to serve in this program. See also a published paper highlighting this work: http://www.journal.cjgh.org/index.php/cjgh/article/view/129.
Richard Peller, MD; Susan Peller, APRN, CPN; and Cathy Davis, MD
Mankato Clinic
ankato Clinic providers Richard Peller, MD; Susan Peller, CNP; and Cathy Davis, MD, provide free medical care to people living in remote areas of Guatemala and Mexico through Minnesota Doctors for People (MDP). Cofounded by Susan Peller in 2006, MDP has completed 27 medical mission trips with the help of more than 200 volunteers, establishing pop-up primary care clinics in remote villages that have served more than 12,000 people. For many, this may be the only opportunity to see a doctor all year.
MDP took three week-long medical mission trips in 2018. In April, Davis and Susan Peller led a trip to San Lucas Tolimán, Guatemala, and in November the Pellers returned to serve. In February, Richard Peller was a provider on a medical mission to Chiapas, Mexico.
Davis and Susan Peller’s group of eight included three health care providers who treated mostly coughs, colds, rashes, OB issues, and malnutrition and strengthened partnerships with community health promoters.
Chronic pain related to physical work is prevalent among the Highland Maya people. Serving on the team to Chiapas, Richard Peller and his colleagues taught patients the importance of water intake with foods rich in potassium and sodium to prevent dehydration during outdoor work on hot days. To prevent giardia, they reminded people to boil water at night for use the next day. With Mankato Clinic physical therapist Megan Linder, PT, DPT, they demonstrated ways to relieve and prevent chronic neck and back pain.
In November, Richard and Susan Peller traveled to San Lucas Tolimán, Guatemala, to set up primary care clinics and to give a talk on diabetes and women’s health to the local health providers in the villages. “They’re doing a phenomenal job improving the health of their communities,” wrote Richard Peller. “We can definitely see a big difference when we visit these communities.”
“Coming home from Guatemala is always a transition. I don’t wake to the roosters and the smell of smoke in the morning and I find I miss that,” Susan Peller wrote. “Most of the people I encounter during the day don’t worry about not having enough food for their family. The stark differences between there and here are painfully apparent.”
Tom Schrup, MD
CentraCare Clinic Pediatrics
om Schrup, MD, provides critical wellness visits and consults to homeless youth at Pathways 4 Youth, a newly opened homeless youth resource center in St. Cloud (Pathways4YouthMN.org). Once a week, Dr. Schrup sees youth for a variety of reasons, from strep throat to addiction issues. He also sees single homeless moms and their children with a variety of medical needs. Dr. Schrup says many of the youth he visits with each week have not been seen by a doctor in many years.
Pathways for Youth is a St. Cloud Rotary project, serving youth ages 16 to 23 experiencing homelessness in the St. Cloud area. Each night, approximately 150 homeless youth in the St. Cloud area sleep outside, in cars, porta potties, or couch-hop with friends. In addition to medical and addiction services, Pathways 4 Youth provides youth experiencing homelessness with the opportunity to learn about and gain access to resources that can put them back on a path that will help them to grow as individuals and be contributing members of their community. Pathways 4 Youth is a partnership project with HOPE 4 Youth, a nonprofit that provides pathways to end youth homelessness in the north metro suburbs of the Twin Cities. Some of its nonmedical services include providing connections to local resources for prevention, outreach, employment/education, and housing.
Tim Wensman, who has been a local leader in starting the center, said Dr. Schrup’s work is valuable in not only helping youth with health challenges but also with connecting them with medical resources. According to Wensman, “The youth, volunteers and staff at Pathways love Dr. Tom! ‘He is so approachable and easy to talk to’ is the quote I hear quite often. Without his help, the youth would not have any idea how to navigate the health system in our community.”
Dr. Schrup is a true ambassador for CentraCare Health, and he is making an impact on the homeless population in the central Minnesota community through this work. He provides referrals and makes sure that the youth have a “place to call home” when it comes to their medical needs.
He began his CentraCare career in 1994 as a pediatrician and continues his pediatric practice part-time in addition to his administrative duties as CentraCare’s executive vice president, chief physician officer.
Stephen Setterberg, MD
PrairieCare
uilding a thriving, vibrant society requires every citizen to be fully engaged in the economy, political process, and community. But this can be impossible for citizens in the Republic of Kosovo, who have experienced trauma, depression, debilitating anxiety, or existential despair after years of war.
Dr. Setterberg, pictured third from left with research colleagues at the Kosovo Ministry of Health, addresses these psychological obstacles by providing a model for psychiatry and psychology to support healthy societies and economies, and also to fight radicalization, violent extremism, political corruption, and authoritarianism worldwide. His work began with an extensive field-research survey in collaboration with Dr. Evangelos Tsempelis of Zürich, Switzerland. The aim of the 500 assessment interviews across ethnicities and regions in Kosovo, and the subsequent statistical analysis thereof, was to diagnose the psychological state, not of an individual, but of an entire society. The results, based on the Kissane Demoralization scale, were shocking: in Kosovo, nearly 20 years after the war, rates of demoralization are comparable to those of terminal cancer patients in palliative care in Western Europe and the United States.
In response, Dr. Setterberg—leading his co-founders and team at the humanitarian nonprofit Stillpoint Engage—continues to share research results across Kosovo in hopes of improving the functioning of the nation’s mental-health system. They also launched a collaborative program-design phase in collaboration with the local field researchers. Providing both professional training, transportation, and room and board for these all-women research teams, Dr. Setterberg worked toward gender parity and youth empowerment in Kosovo, while also supporting and leveraging local knowledge.
The result is a community-based, psychosocial healing methodology, Reparative Narrative, the basis of the intervention Dr. Setterberg continues to lead and provide the resources for. Now in its pilot phase, Reparative Narrative draws widely from the psychologies to build local expertise through training; help individuals heal by integrating past traumas into the life-story narrative; strengthen communities through innovative dissemination of materials; and intervene in authoritarian, biased, and extremist ideologies by leveraging—through the use of digital medias—shared experiences.
Samreen Vora, MD
Children’s Simulation Center at Children’s Minnesota
r. Samreen Vora, medical director of the Simulation Center at Children’s Minnesota, has always known that she wanted to give back in a big way, and the perfect opportunity to give back internationally presented itself in 2018.
Dr. Vora’s mentor from a fellowship in simulation and medical education connected her to the Certification Program in Emergency Medicine at Indus Hospital, a charity hospital in Karachi, Pakistan. “It was the perfect time to apply to this program,” said Dr. Vora. “With becoming an instructor for Pediatric Advanced Life Support (PALS) from Children’s and expanding my knowledge of the nuances in pediatric care, I knew I had unique contributions to make to Indus Hospital’s emergency department.”
Emergency medicine is still a developing discipline in Pakistan. In order to develop this specialty, Indus Hospital hosted one international expert in emergency medicine each month to train medical officers and residents to better manage initial triage and stabilization with varying medical, surgical, and traumatic conditions. The certification program acts as an intermediate solution to the lack of emergency medicine specialists in the country.
Dr. Vora spent one month teaching and working in emergency medicine, and worked to develop the hospital’s simulation program. In her current role at Children’s Simulation Center, she works on developing simulations for all specialties, not just emergency medicine, making it a very integrated program. Dr. Vora worked to bring more integration to Indus Hospital’s program to help physicians prepare for any emergency situation. “Anytime you go to a new setting it can be challenging, even in the U.S.,” said Dr. Vora. “Hospitals don’t always have the same tools to do simulation but regardless of available technology, it was my responsibility to make the exercises feel ‘real’ to the cohort.” Emergency medicine and simulation are in early development phases in Pakistan, so the simulation program at Indus Hospital relied fully on donated adult simulation tools. Dr. Vora made the most of the limited technology and resources to create simulation lessons that lent themselves to culturally appropriate, real-world application. By stepping out of her comfort zone of providing care to kids at Children’s Minnesota, Dr. Vora was able to not only enrich her own learning but provide a few pediatric care pearls to practicing physicians from emergency departments across Karachi.
Derek Beyer, MD
Carson Harris, MD
Tom Schrup, MD
Fred Bogott, MD
Thomas J. Haus, MD
Stephen Setterberg, MD
Y. Ralph Chu, MD
John Kvasnicka, MD
Samreen Vora, MD
Melissa Gleaves, FNP-BC
Richard and Susan Peller; Cathy Davis
2019 Recognized Volunteer Physicians
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Each year, Minnesota Physician Publishing recognizes physicians and health care providers who have volunteered their medical services. Whether volunteering at home or overseas, these caregivers help people in need and come away with a revitalized sense of their work. Their compassion, commitment, and generous spirit reflect the deeply held values in Minnesota’s medical community.