1. 2 nd Global Conference and Medical Mission: A Strategic Journey for the Future Deskan Institute & Training, Inc.

2. 2 Guyana’s Outreach Medical Care Mission 2013: List of Collaborating Community Partners DESKAN BRIDGES- 2013

3. Why Deskan Mission in Guyana?  Guyana is situated on the northern coast of South America. The majority of Guyana’s population (approximately 750,000) live along the narrow coastal plain, but for the scattered communities inland even basic health facilities are often unavailable.  There are about 30,000 adults and children in Guyana who are blind or have low vision; the priority eye diseases include cataract, glaucoma, refractive error, and diabetic retinopathy.

4. Guyana’s Healthcare Challenges  The relatively limited training of the doctors in Guyana; a health care system still struggling to achieve legitimate professionalism and a sizable population of poorly educated patients whose destiny lie at the hands of the first two circumstances….a circle of life among the poor semi-literate masses  Significant economic and social changes in Guyana have placed the nation’s youth, representing nearly 60 percent of the population, at great risk.

5. Specific Health Problems In 1999, the main reason for infant visits to outpatient clinics at hospitals and health centers in Guyana was acute respiratory infection (56%). Amerindian populations faced malaria (60% of all cases), diarrhea diseases, acute respiratory infections, teen pregnancy, tuberculosis, dental caries, and inadequate access to health care. Malaria is a major public health problem in Guyana. Plasmodium falciparum is the main infectious agent transmitted. New cases represent over 90% of the cases detected each year. Nutritional and metabolic diseases: Protein-energy malnutrition, iron- deficiency anemia, and obesity remain the major nutrition-related problems in the population. Malignant Neoplasms: In men, cancer of the prostate was the leading cause of death, accounting for 11% of cancer mortality.

6. Prevalence of Domestic Violence in Guyana  Statistics released by the government of Guyana indicate that over 3,600 cases of domestic violence were reported in 2007 as compared to 1,708 the previous year (Guyana Chronicle 12 June 2008; Stabroek News 12 June 2008).  The largest increase was recorded in Berbice, where the number of reported cases rose from approximately 300 in 2006 to about 1,890 cases in 2007 (ibid.; Guyana Chronicle 12 June 2008).

7.  Teen hangs self on dad’s suicide anniversary (Kaieteur News, April 16, 2013).  Spurned man commits suicide after two attempts (Kaieteur News, July 02, 2013). Personal Testimonials: Suicide Increase

8. 3-Day Medical Conference at Project Dawn Addressed to over 75 Participants Included:  Health Disparities in Guyana  Use of a Global Trigger Tool in Health Informatics  Diabetes, Glaucoma, Cataract  Cancer and Associated Risks  Endocrine Disorders  Vision Care Education and Optical Screening  Diabetic Screening and Diabetic Retinopathy  Domestic Violence and Child Abuse  Foot Care and Education

9. 9 Continuing Medical Education Offering: Techniques, Methods and Solutions  Presented in three sessions to > 200 physicians, medical students, and nurses for CME credit: Georgetown Public Hospital, New Amsterdam Hospital & Project Dawn

10. Using the Global Trigger Tool in Population Health Informatics Addressing Georgetown Public Hospital Members CME Presentation at New Amsterdam Hospital

11. Continuing Medical Education Training Offering : New Amsterdam Hospital CEO, Dr. Vishua Mahadeo

12. Record of Patients’ Ailments in One Community: Elderly Adults and Young Adults  175 elderly patients ranging from ages 63-75 complained of stroke, heart disease, back pain, dermatitis, dental caries, asthma and diabetes.  65 adults from ages 51-59 complained of diabetes and vision problems, such as loss of vision in one eye, reading problems, inability to afford reading glasses, sugar problems, etc.  78 young adults, aged 18-50 years, complained of hypertension, prostate cancer, cervical cancer, suicide, fibroids, UTI/STI, kidney problem, liver failure, COPD, and hemorrhoids.

13. 13 Summary of Outreach Medical Clinic: Cane Grove: Region 4: Demerara-Mahaica  19 Team members who traveled from USA also included speakers for the conference.  20 Local Team members were from Guyana and Jamaica.  Approximately 108 patients received medical care and a two- month supply of donated medication.  Over 200 patients were seen at Project Dawn Vision Care Clinic & Follow-up Vision Clinic; all received eye glasses and sun glasses.

14. CADVA & IMRAARC Cane Grove Medical Outreach Mission and Vision Care Relatives say Cane Grove woman died from beating – Stabroek News - http://www.stabroeknews.com

15. 15 Medical Outreach: Cane Grove Dr. Lionel Henry: New Amsterdam Hospital 4th Year Medical Student Antonette Hamer: Vision Care

16. Abdominal mass? DS  Headache for 5 years w/o vomiting  Anterior cervical adenopathy  Nevi  Abdominal vs. chest pain  Abdominal mass Lessons Learned… Donors and workers are needed NOW! Nevus Right Mid-back Nevus Left inner Thigh

18. Nutrition Counseling And Diabetes Screening at Cane Grove: CADVA & IMRAARC Vivette & Sam Jones Vivette, a registered nurse, has an undeniable passion to empower individuals who are suffering with diabetes.

19. 19 Planter Dyshidrosis Case History: A form of eczema, known as bullous dermatitis Under treatment by local physician with minimal improvement; there is no effective treatment. Palliative care is recommended. Complications include:  Neuropathy (nerve damage)  Poor circulation  Diabetic ulcers  Fallen arches (Charcot’s foot)  Infected ulcers  Amputation  Foot Care and Education

20. Advice Corner: Personal Foot Care  Aim to keep blood glucose level in normal range  Inspect feet daily: Check for break in skin, change in shape of nails or toes, corns, calluses, blisters, etc.  Wash feet daily  Thoroughly dry between toes  Moisturize feet daily – no cream between toes  NEVER GO BAREFOOT  Seek professional help for ingrown toenails, bunions, corns, and large calluses  Have feet inspected by a healthcare provider at every health visit

21. Health & Wellness Screening  Vision Screening & Pharmacy  Antonette Hamer MS4  Stacy Noble, Nurse  Leona Kyte, Pharmacy Tech.

22. Men’s Health Male MS Prostate Cancer Education GOUT High blood pressure Kidney disease Heart disease Diabetes

23. Health Education: GOUT  An inflammatory arthritis  Mostly affects joints of lower extremity – can also affect upper extremities  Red, swollen, hot joints  Most often affects the “big toe”  Very painful – mostly at night  More common in men Caused by elevated levels of uric acid (crystallizing) in the blood from:  Diet – rich meats, seafood, (purine-rich foods), & fructose  Obesity  Metabolic syndrome – large abdominal girth, hypertension and insulin resistance (pre-diabetes)  Medication – diuretics, ASA

24. Gout Treatment  Attacks can be self-resolving – in about a week  Recurring attacks common  Can become a chronic condition Medications include:  Non-steroidal anti-inflammatory drugs (NSAIDS – i.e. naproxen)  Allopurinol  Colchicine  Steroids

25. Gout Prevention  Lots of fluids, esp. water  Reduce intake of “rich” meats and seafood  Stop or reduce alcohol intake  Weight loss  Vitamin C (1500mg/day)  Decrease high-fructose intake (corn-syrup added to processed foods)  Coffee

26. Co-Morbidities Seen With Gout Include:  High blood pressure  Kidney disease  Heart disease  Diabetes

27. Addressing Healthcare Challenges in Cane Grove

28. Global Conference Project Dawn

29. 29 Cane Grove Medical Outreach: Strengthening the Fragile Healthcare System of Guyana. Thanks to All Collaborating Partners.

30. Many Thanks to CADVA

31. Special Thanks to Direct Relief International The donation of pharmaceuticals to Deskan by Direct Relief International provided the support to hospitals and community centers for follow-up patient visits and funded the hospitals’ efforts to provide essential medical services to the residents of Guyana.

32. Thanks to Direct Relief International cont’d  Direct Relief works to improve the health of people living in high-need areas by strengthening fragile health systems and increasing access to quality health care in 70 countries.  To achieve this goal, Direct Relief partners with local health providers, leading healthcare companies, and business leaders to deliver medicines, medical supplies and equipment through transparent, reliable, and cost-effective channels.  Mission would not have been possible without the much- needed medication.  Direct Relief seeks to support existing health providers over the long term, delivering aid without regard to race, ethnicity, political or religious affiliations, or ability to pay.  A partner of Guyana Medical Relief, International, CA.

33. 33 List of Collaborating Community Partners 2013: Dr. Wayne Sampson Deskan donated pharmaceuticals to H.E.R.O Health & Educational Relief Organization, Inc. Over 200 patients received services at the Linden Regional Hospital Complex.

34. Gratitude  Thanks to our sponsorship and shared collaboration of members in partnerships with Guyana Medical Relief, Inc., Los Angeles, CA, The University of Guyana, School of Medicine, Direct Relief International, supporters from Atlanta, New York, New Jersey, California, Texas, Pennsylvania, Miami, and Guyana  To the many volunteers, such as Arleen Dinally, Leona Kyte, Patricia Dinally, Pastor Andy Cameron of Craig Village, Vivette Jones, Sam Jones, Dr. Yanick Vibert, Tiffany Jackson, Dr. Kelwyn Thomas, Dr. Claudette Heyliger-Thomas, Dr. Aliya Heyliger, Dr. Gwendolyn Dean, Susan Camacho, Precella Speid-Isaccs, Denise Tucker, Stacey Noble, Yonette Garnett, Eze Hamilton, Joy Gravesande, Julene Barrett, Adolphus Dean, Marsha Archer, Barbara-Thomas-Holder, Antonette Hamer, photographer Charles E. Liverpool, nurses who did follow-up clinic in Georgetown, and all others who provided quality medical assistance

35. Thanks to Georgia Lions Lighthouse Foundation Over 200 patients received donated glasses/sunglasses for vision care.

36. Thanks  This mission would not have been possible without the much- needed humanitarian donation of medical supplies.  Total Value: $388,715.91

37. Thanks to Deskan-Bridges 2013: For Conference Presenters & Coordinators Through the 2 nd Global Conference and Outreach Medical Mission activities, Deskan Institute & Training collaborated with BRIDGES 2013 to offer CME and CEU, and to work with educators on non-traditional teaching methods in life-skills training methodologies.

38. Thanks to Empowerment and Equity Through Education, Inc. Empowerment and Equity Through Education, Inc. is a charitable organization founded in 2006 by Elizabeth A. Wilson- Anstey to provide books, supplies, and other resources needed to ensure that children and others who are disadvantaged by lack of these basic supplies can learn effectively; to empower young people who come from these backgrounds and to promote equity. Way to Go!

39. Thanks to the Students of University of Guyana Medical School Julene Barrett et al.

40. Thanks to All: Sorting Medications & Gifts Educator: Precella Speid-Isaacs, Nurse Vivette Jones & Volunteer: Marsha Archer Nurse Stacey Noble, Volunteer Hortense Speid- Jeffers & Dr. Liverpool

41. Thanks to Lloyds Auto Care of Decatur, GA Support for Education and Sports (in Guyana) begin with contributions from Lloyds Auto Care of Decatur, GA, to Deskan Institute & Training, Inc. Contributions included substantial cash donations, school supplies, and boys and girls Sports Wear for the Villages of Buxton & Friendship, ECD. This support is on-going. Thank you for your generous give-back initiative.

42. Thanks to Lloyds Auto Care of Decatur, GA. - Buxton High School Scholars

43. Thanks for the last twelve years of Medical Outreach Clinics and Train-the-Trainer Workshops and Seminars in Georgetown, St. Culhberts Mission Kuru-Kuru, Craig Village, Grove Village, Buxton, Ann’s Grove Village, Melaine Village, Queenstown, Essequibo, Mainstay Amerindian Reservation, Lake Capoey Reservations, Princess Street Hostel, Cane Grove, No 28, Village, Hopetown Village, West Coast Berbice, New Amsterdam, Berbice, No 1 Berbice, Corriverton Berbice, Santa Rosa Mission, Moruca, Pomeroon, Parika, Project Dawn

44. Summary of Deskan’s 2013 Medical Mission to Guyana  The mission assists Guyana’s Ministry of Health to strengthen a decentralized primary health care program that faces serious economic, material, and human resource shortages.  Volunteers work directly with health centers in Regions 4, 5, and 6 and other communities to help them identify local and national resources, facilitate community health assessments, design and implement health education projects, and train health center staff and community leaders.  The Continuing Health Education CHATs addressed high numbers of heart attacks and neonatal incidences of HIV/AIDS in the country and focuses its efforts on breast, cervical and prostate cancer, diabetic shock/insulin overdose, increase of suicide in adolescents under 18 years of age, and hearing loss in children.

45. Summary cont’d  Volunteers worked with youth organizations and the Ministry of Education to provide at-risk youth with educational, personal, and life skills development opportunities, and thus enabled these youth to meet the challenges of adolescence and contribute positively to their communities.  Through Train-the-Trainer activities, Deskan Institute and Training collaborated with DESKAN BRIDGES 2013 to offer CME and CEU and to work with educators on non-traditional teaching methods in life-skills training methodologies.

46. Summary of Patients’ Seen

47. Accomplishments What we attempted to give were the skills and up-to-date knowledge about the diseases, prevalent in Guyana, that are affecting the Guyanese people. We hope that an end would soon come to diabetes, hypertension, blindness, cervical cancer, prostate cancer, insulin overdose, suicide, domestic Violence, and gun violence.

48. Global Conference on Domestic Violence, Gender Violence, Suicide and Child Abuse: Crises in Guyana

49. Global Conference

50. Referral Care & Follow-up: Education Program/Reading

51. AWARD: TEE SHIRT TIE DYE Class

52. DESKAN Family: Relaxation Time

54. 54 BRHA Goal # 3: Align services to meet population needs.